THE 
DOCTRINE 
OF 
INFLAMMATIONS 
Founded upon Reason and Experience 
AND 
Intirely cleared from the contradictory 
Systems of 
Boerhaave, Van Swieten, and Others. 
THE SECOND EDITION. 
By Daniel Magenise, M. D. 
LONDON: 
Printed for the Author, and sold by W. Owen, in 
Fleet-Street; and all the Booksellers in Town and Coun- 
try, 1776. 


Entered at Stationers-hall, agreeable 
to Act of Parliament. 


TO 
Sir Clifton Wintringham, 
Fellow of the College of Physicians in 
London, and of the Royal Society, and 
Physician in Ordinary to his Majesty, 
the King of Great Britain, &c. &.
SIR, 
THE skill and judgment, by 
which you adorn both your 
profession, and the honourable office 
you hold from his Majesty, with 
the humanity, disinterested behaviour, 
and those other qualifications, which 
made you so valuable to the Nation, 
both at home and abroad, have in- 
duced me to bespeak your patronage 
for this work, after its being laid 
aside for many years, in which state 
it might, perhaps, have still conti- 
nued, had not your eye at length 
A2 given

DEDICATION. 
given it new light, and myself a jus- 
tifiable courage to offer it to the 
public perusal. I have, therefore, 
taken the liberty to prefix your name 
to it, that being, through your ap- 
probation, presented to the learned 
world, it may engage the candid part 
of it after your example, to receive 
favourably what it finds useful in it, 
and pass over humanely the slips and 
errors which have escaped him, who, 
with great pleasure, embraces this 
opportunity to acknowledge himself 
to be, 
SIR, 
Your most obliged humble Servant, 
DANIEL MAGENISE. 


PREFACE. 
NO disorder is more common, or at- 
tended with greater danger than an 
inflammation; yet in the best physical Au- 
thors, we find its causes and effects, not 
only confused, but even involved in mani- 
fest contradictions. 
As an inflammation is the principal 
source of most disorders, it is easy to per- 
ceive, how difficult it is, to give a com- 
pleat treatise of it; and that it is impossible 
in the narrow limits appointed for this 
essay to describe the various forms it as- 
sumes in the different parts of the human 
body; I shall, therefore, only enquire in- 
to its general causes; and for the better 
accomplishment of my design, and to ena- 
ble the Reader to judge, whether the doc- 
trine of inflammations receives any amend- 
ment from what is advanced in this treatise. 
I shall compare it with the opinions of 
some eminent Physicians, whose theory and 
practice are at present universally defended 
in the schools, both of Physic and Surgery. 
It is much more difficult to discover the 
causes of disorders, than to prescribe for 
their cure; and it is by his skill and saga- 
city in making such discoveries, that a 
Physi-


PREFACE 
Physician shews how much he is above the 
level of Mountebanks and Pretenders. 
As it is impossible to have experienced 
Physicians always at hand, where inflam- 
mations may happen, my design in this 
work, is, to the best; of my abilities, to 
clear up what regards the efficient causes of 
this disorder, for the benefit of the younger 
and less experienced Practitioners. 
From the Authors published hitherto, 
I can quote no authority to support what I 
advance concerning inflammations: there- 
fore, to prove it, I am obliged to draw 
arguments from the very essence or na- 
ture of the disorder; and although these 
may labour under the danger of novel- 
ty, yet I have ventured to publish them 
such as they are, with a view to fix the 
theory aud practice of inflammatory dis- 
orders upon experience and rational prin- 
ciples. It may appear a presumption to 
deviate from the beaten path; yet, as a 
member of society, my duty in some mea- 
sure engaged me to make this trial; and if 
I cannot succeed in my endeavours, it may, 
perhaps, excite the emulation of the learned 
to accomplish it hereafter. 
I

PREFACE. 
I am to give the Reader, without the 
help of any system or hypothesis, a clear 
idea of the various effects of an inflamma- 
tion; point out how they are produced by 
the simple laws of nature, and prove my 
assertions by such familiar examples, as 
daily occur in the practice of physic, and 
in the common actions of life. 
Least the Reader should lose any time 
in forming difficulties against my doctrine, 
I have laid before him the principal objec- 
tions that may be made against it with their 
answers. 
This work being chiefly designed for 
the Gentlemen of the Faculty, who 
are all supposed to understand Latin, I 
thought it needless to insert the English of 
my quotations, as it would only swell the 
volume unnecessarily. And any curious 
Person, who may chuse to amuse himself 
with physical enquiries, can be at no great 
loss, though he were no proficient in Latin; 
because the remarks on every quotation, in- 
clude whatever regards the doctrine of in- 
flammations. 

CONTENTS. 
CHAP. I. 
Of Inflammations in general. 
Sect. I. Of a Phlegmon,—Page 1 
II. Of an Erysipelas,—63 
III. Of an Oedema,—106 
IV. Of the Diognostic Signs 
of an Inflammation,—125 
Prognostic Signs,—Ibid, 
V. Of the Cure of Inflam- 
mations in general—128 
CHAP. II. 
Which proves the curative Indications 
of an Inflammation to be repugnant 
to Boerhaave's Doctrine, aph. 371, 
146 
CHAP. III. 
Of the Resolution or Dispersion of an 
Inflammation.—162 

(1)
THE 
DOCTRINE 
OF 
INFLAMMATIONS, 
CHAP. I. 
Of INFLAMMATIONS. 
Sect. I. 
Of a Phlegmon. 
Boerhaave takes the defini- 
tion of an inflammation or 
phelgmon from its causes. Fer- 
nelius in imitation of all the Anti- 
ents defines it by its effects, and al- 
lows the blood to be its proximate 
cause. This Author was the first of 
the Moderns, who collected from the 
Latin, Greek and Arabian Authors 
what he observed to be true and so- 
lid, and such as by convincing ar-  
B guments

2 Of a PHLEGMON. 
guments proved to be useful in the 
practice of physic. He was so im- 
partial in adopting their doctrine, that 
without favouring one more than the 
other, he omitted nothing of what 
he found requisite for the perfection 
of that science. 
MOST authors adorn their works 
with the authority of the Antients, 
Boerhaave and Van Swieten general- 
ly quote for that purpose, Galen, 
Celsus, or Ægineta. Fernellius in 
every principal point agrees with the 
three last-mentioned Authors; he is 
also clearer, more methodical, and 
throws more light on every sub- 
ject than any of them; for which 
reason, I design to illustrate the be- 
ginning of every principle article of 
this treatise, with an extract of what 
he has collected from the antients 
concerning an inflammation and its 
various effects. It will, without 
doubt,

3 Of a PHLEGMON. 
doubt, be agreeable to the reader, 
as it is the most exact specimen of 
the kind, transmitted to us on that 
subject. I shall afterwards propose 
the principles of my own doc- 
trine, and compare them with 
the systems of Boerhaave and Van 
Swieten. 
PHLEGMONE tumor est calidus 
præternaturam collectus, prominens 
atque circum scriptus, ovi saltem gal- 
linacei magnitudine. Huic quasi 
ex igne aut ex balneo rubor inest: ca- 
lor quoque ex inflammatione vehe- 
mens quasi pars uratur: distensio ex 
copia renitens: pulsatio prosunda & 
molesta, quod arteriarum diastole 
partem inflammatam seriat: dolor ex 
calore, ex pulsu atque tensione acer- 
bus, præsertim quum pars eximio 
sensu predita est. Causa continens san- 
guis est, non in solam cutem, sed in 
B2 sub- 

4 Of a PHLEGMON. 
subjectam quoque carnem impactu, 
qui e venis eo tandem confluxit. 
Quum enim venae arteriaeque majores 
immoderata sanguinis copia disten- 
duntur, lianc gravatæ in minores 
quasi onus deponunt, ex his demum 
in minimas. Ac turn per earum oscu- 
la perque tunicarum meatus sanguis 
cohiberi non potis, effluit illabitur- 
que in spatia vacua quæ inter sibras 
sunt primorum corporum, præcipe-
que musculornm, venarum, arteria- 
rum, nervorum atque membrana- 
rum. Hæ partes fluxione dum per- 
funduntur implenturque, distentæ co- 
pia quasi divelluntur, ferventisque 
sanguinis ardore incalescunt, dolo- 
remque faciunt. Sanguis quippe ex- 
tra vasa colledus, nec libere perfla- 
bilis, necessario putrescit atque in- 
flammatur. Ita quidem si purus is 
erat, ex quisita phlegmone fit, cujus 
species sunt: opthalmia, parotis, an- 
gina, parulis in gingivis, aliaeque ex 
par-

5 Of a PHLEGMON. 
partibus nomina adeptae. Est & alia 
minus exquisita, cujus non sincerus 
est sanguinis, sed aliorum quoque 
humorum particeps. Hinc siunt 
phlegmone erysipelatodes et schir- 
rodes. Fernel. de Extern. Corp. 
Affect, pag. 608. 
Φ. 1. A hot swelling preternatu- 
rally collected, whereof the blood 
is the proximate cause, supposes a 
derivation of this fluid to the affected 
part. This was the opinion of all 
the Antients; it is the source from 
which Dr. Sauvage, Professor of 
Physic in the University of Mont- 
pelier, has taken his system; for he 
maintains that the encreased velo- 
city of the fluids is the only proxi- 
mate cause of an inflammation. 
Some of the antients compared 
an inflammation to a concentrated 
fire, and it is from thence, perhaps, 
B3 Boer-

6 Of a PHLEGMON: 
Boerhaave took his attrition of the 
solids and fluids, which always sup- 
poses heat. 
Φ. 2. Fernellius distinguishes 
inflammatory swellings into tumours, 
tubercles and pustules. A tubercle 
is less than a tumour, but larger than 
a pustule. To these also he gives 
different names according to their 
appearances, and the parts they at- 
tack, whether glandular or fleshy *. 
The largest tumour that appears in 
the skin or fleshy part, he calls a 
phlegmon, which he says should be 
as big as a hen's egg. Though the 
name of phlegmon is confined here, 
by our Author, to a particular tu- 
mour yet under that title, he gives 
us a general notion of inflammati- 
ons according to the mode of the 
antients, and in another part of his 
pathology, we read, Ipsa denique in- 
* Vide, pag. 608. Pathologiæ.
inflam-

7 Of a PHLEGMON. 
flammatio quam proprie phlegmonem 
appellamus *. 
Φ. 3. Pain is the first effect of 
an inflammation, although our au- 
thor says that it arises from the heat, 
pulsation and distension, which at- 
tend that disorder. It is true, that 
as these are violent situations of the 
solids and fluids, they bring on an 
additional, irritation, whereby the 
primitive pain is augmented; so that 
this saying of Virgil may be very 
well adapted to pain. 
—Malum quo non aliud velocius ullum, 
Mobilitate viget viresque acquirit eundo. 
Φ. 4. A Phlegmon takes diffe- 
rent names from the parts it affects; 
if it attacks the eye, it is called an 
opthalmy; if the brain, a phrenzy; 
if the throat, a quinsey; if the 
* Vide, pag. 379. Pathologiæ.  
B4 pleura,


8 Of a PHLEGMON. 
pleura, a pleurisy; if the lungs, a 
peripneumony, &c. 
Φ. 5. Our Author mentions three 
sorts of vessels through which the 
blood is to pass before it works its 
way into the cellular membrane to 
form a tumour; and that when it 
gets into this membrane, it produces 
the symptoms which attend suppu- 
ration. 
Φ. 6. A Phlegmon by the antients 
and moderns is called erysipelatous, 
if the swelling is supposed to con- 
tain a bilious fluid; œdematous, if 
a watery humour; and schirrous, if 
an indurated atribiliary matter *. 
†. The inaccuracy of this distincti- 
on will be discussed in Sect. 2. and 
Sect. 3. 
* Traité des tumeurs par M. Astrue, Medecin de 
S. M. T. C. 
† Chirurgie complete des modernes, par M. Le 
Clerc, Medecin de S. M. T. C. 
Φ. 7.

9 Of a PHLEGMON. 
Φ. 7. INFLAMMATIONS or any 
other disorders become known by 
their names, effects, or causes; by 
the very name of a phlegmon every 
one understands an inflammatory 
tumour. The effects which charac- 
terize it, are a swelling with redness, 
heat and pain; they are all enume- 
rated by Fernellius; but as they 
suppose some cause, they can supply 
the mind with no curative indicati- 
on. The effects of a disorder may 
lead an experienced Physician to the 
knowledge of its cause; but as there 
is a real distinction between the cause 
and effects, the indication taken 
from the former, cannot be supposed 
to proceed from the latter. From 
whence we may judge, that the 
knowledge which results from the 
names and effects of diseases, is very 
defective; and consequently the in- 
dications which can be drawn from 
thence must be equally so; and that 
those

10 Of a PHLEGMON. 
those who fix their practice upon so 
uncertain a foundation, must be lia- 
ble to many dangerous errors; for 
giving no attention to the funda- 
mental principles of physic, nor to 
the sympathy which subsists between 
the different parts of the human bo- 
dy, they never hesitate to prescribe 
cephalics, for example, for every dis- 
order of the head, although they 
generally proceed from an indispo- 
sition of the stomach charged, as it 
often happens, with a faburra. But 
if those people knew how to trace 
out the original causes, they would 
prescribe evacuants instead of cepha- 
lics, and would be thus enabled to 
give the patient (at the same time) a 
true prognostic concerning his cure. 
As the practice of the Antients 
with regard to a phlegmon, could 
have been founded upon nothing 
else but the effects enumerated by 
Fernellius,

11 Of a PHLEGMON. 
Fernellius, we can easily judge how 
obscure and intricate it must have 
been. What I have extracted from 
this Author, is a compendium of 
what he found most select in the 
Writings of the antients concerning 
the present subject. 
Now by the method I have pur- 
posed to follow, I am engaged to 
enquire into the opinions of our 
own cotemporary Physicians; but 
in order to accomplish my design, it 
would be an endless work to cite 
what was said on that subject by 
each of them in particular; for 
which reason, I have selected Boer- 
haave, whose doctrine concerning 
inflammations is universally adopted 
by the Physicians and Surgeons of 
the present age. That the doctrine 
of so great a man should be called 
in question, by a person whose 
name is quite unknown to the learn- 
ed, 

13 Of a PHLEGMON. 
ed, will appear to most people to be 
too bold an undertaking; and the 
more so, as it has been so much il- 
lustrated by the celebrated Van 
Swieten, that it cannot be contra- 
dicted by any Physician, let him be 
ever so learned, without endanger- 
ing his reputation. Notwithstand- 
ing these discouragements, the desire 
of being serviceable to mankind, 
and particularly to young Physicians 
and Surgeons, engaged me to exa- 
mine it still farther, and to try to 
fix it upon evident principles; for 
nothing can dishearten students more 
in the pursuit of learning, than to 
find the basis of their art founded 
upon obscurity and contradictions. 
They must certainly be well pleased 
to be cautioned against the three 
fountains of error, which I have 
discovered in the doctrine of Boer- 
haave, for if they were not fore- 
warned, they might unwarily fall
into 

13 Of a PHLEGMON. 
into them, and that by so much the 
oftner, as every disorder, though not 
inflammatory, should nevertheless be 
compared with inflammations by 
young practitioners, both in physic 
and surgery. For we are to observe, 
that in health the circulation is se- 
date and uniform, and that when it 
is augmented above this standard, 
there is an inflammation or a dispo- 
sition towards it; and that when it 
is below it, there is a debility or 
want of motion, from whence pro- 
ceed various diseases, which may be 
more easily known and cured, by 
comparing their causes and effects 
with those of health, and those 
of inflammatory disorders; for by 
acquiring a true knowledge of the 
effects of the latter in the doctrine 
of inflammations, and also of the 
medicines whereby they are removed 
or prevented, no one in the least 
conversant in the materia medica,  
can


14 Of a PHLEGMON. 
can be at a loss to relieve the com- 
plaints arising from the former, by 
their opposite remedies. This me- 
thod may be of some consequence 
in practice; for I have heard many 
Professors of physic, remark, that 
students most commonly acquired a 
knowledge of the symptoms, and 
cure of inflammatory disorders soon- 
er, and with less study than of any 
other; they may, therefore, by ob- 
serving this method, come to a more 
clear and certain knowledge of such 
disorders as proceed from debility or 
want of motion, than by any other 
method whatever; for it is by what 
we know best, and most clearly, that 
we can form clear ideas of what we 
know but obscurely. 
Boerhaave, for the simplicity of 
his method in tracing out and dis- 
tinguishing disorders by their causes, 
is deservedly accounted by all peo- 
ple


15 Of a PHLEGMON. 
ple to be the light and ornament of 
modern Physicians. Mankind is un- 
der no less obligation to Van Swieten, 
his learned commentator; but it 
will appear from what follows, that 
they are both wrong in what re- 
gards the doctrine of inflammations. 
THE first fountain of error I have 
discovered in their doctrine, springs 
from the different series of vessels, 
wherein they have both placed the 
different kinds of inflammation. The 
diversity of humours which occasion 
these different kinds, fill up the se- 
cond fountain; and the third arises 
from the different causes to which 
this disease is attributed. 
Boerhaave divides the arteries in- 
to sanguiserous, serous, and lympha- 
tics, and says, that an inflammation 
always takes place in these arteries, 
because the blood passes in them, as  
it

16 Of a PHLEGMON. 
it were, from the base of a cone to 
its apex; and that it never attacks 
the veins, because the course of their 
fluids is from the apex to the base, 
unless the circulation is stopped in 
them by compression. He says also, 
that the serous arteries arise from the 
most minute ramifications of the 
sanguiserous, and the lymphatic ar- 
teries from the most minute serous 
arteries, and that the serous arteries 
are smaller than the sanguiserous, 
but larger than the lymphatic arte- 
ries, and that the blood is thicker 
than the serum, and the serum thick- 
er than the lymph. 
From these three sorts of humours, 
and three different series of vessels, 
Boerhaave and Van Swieten, have 
deduced three different kinds of in- 
flammation, as a phlegmon, an ery- 
sipelas and an œdema. They call the 
first an inflammation of the first or- 
der,


17 Of a PHLEGMON. 
der, and place it in the sanguiserous 
or serous arteries; in the first case, 
they suppose it to be always red, 
but that in the latter, a sufficient 
quantity of red blood does not at all 
times enter the serous vessels to give 
it that colour. 
BEFORE I enquire into these prin- 
ciples, order requires, that I should 
mention the true causes of a phleg- 
mon. To know disorders by their 
effects, is to know them by what 
they are not, it is the same as to form 
an idea of a tree we never saw, by 
its fruit; but to know disorders by 
their causes, is to know them by the 
prime attributes which constitute 
their nature or essence. 
Most diseases draw their origin 
from three efficient causes. The first, 
which may be called external or evi- 
dent, produces internally the ante- 
C cedent

18 Of a PHLEGMON. 
cedent causes that give birth to the 
proximate cause, so called, because 
it exists in the body, and is imme- 
diately connected with the disorder. 
Sometimes two efficient causes con- 
cur to produce an ailment, and some- 
times one only is sufficient; as in a 
wound made with the point of a 
sword. It is of the utmost conse- 
quence in the practice of physick, 
to have the distinction of these causes 
present to the mind. 
The external causes of an inflam- 
mation are fractures, luxations, com- 
pressions, aromatic aliments, abound- 
ing with oil and sulphur, passing 
suddenly from a warm into a cold 
place, and many other external ap- 
plications which produce their ef- 
fects, either suddenly or slowly. The 
irritation, irritability and sensibility 
of the fibres resulting from thence, 
are the antecedent causes of this dis- 
order:


19 Of a PHLEGMON. 
order: but it may be properly de- 
fined, according to its proximate and 
immediate causes, an erethism of the 
vessels, with the velocity of the fluids 
preternaturally encreased. 
The nature and effects of an in- 
flammation, with certain indications, 
may be clearly understood at first 
sight of this definition, which will 
evidently appear, by comparing it 
with the following one of Boerhaave. 
"371. Estque sanguinis rubri arte- 
riosi in minimis canalibus stagnantis 
pressio & attritus a motu reliqui san- 
guinis moti, & perfebrem fortius 
acti." 
β. 1. Several incoherencies occur 
in this definition of our celebrated 
Author; for he supposes a stagnation, 
an obstruction, a pressure, and an attri- 
tion of the same red arterial blood 
violently moved and agitated in an 
C2 in-


20 Of a PHLEGMON. 
inflamed part; these are indeed op- 
posites which can never subsist to- 
gether in the same place; for the in- 
flamed vessels are obstructed, or they 
are not; if they are obstructed, the 
blood must stagnate in them, and 
remain without motion; on the 
contrary, if they are not obstructed, 
an obstruction should not be ac-
counted one or the causes of an in- 
flammation, as it is asserted in the 
foregoing aphorism. Moreover, an 
obstruction excludes all motion; for 
it is a stoppage of one or many ves- 
sels, which hinders the distribution 
of the fluids in the part so affected; 
so that it is a gangrene in miniature, 
with this difference, that the ob- 
structed matter does not destroy the 
vellels, so soon as the former; but 
every one believes, that a gangrene 
excludes the distribution of the fluids 
in the affected part; therefore it fol- 
lows very plain, from the true noti- 
on

21 Of a PHLEGMON. 
on we have here given of an ob- 
struction, that the same must hap- 
pen wherever it takes place. 
β. 2. It cannot be understood how 
the fluids can stagnate in the capil- 
lary vessels of the human body. 
Water is said to stagnate in a pool, 
because it is confined there in a cer- 
tain space, from whence it cannot 
move backward, forward, or late- 
rally; it has no other motion, but 
that of fluidity, that is, a facility 
which its particles have of slipping 
easily one over another; but if there 
were only a few drops of water in 
the pool, certainly they could have no 
motion of fluidity; they would re- 
main immoveable in its bottom; 
therefore, in order they should have 
their natural motion of fluidity, it is 
necessary there should be a certain 
quantity of water placed under them, 
C3 over


22 Of a PHLEGMON. 
over them, before them, behind them, 
and laterally. Besides the particles of 
water having little or no cohesion to- 
gether, must certainly be more fluid 
than those of the blood, especially 
in a state of stagnation. 
FROM the nature of fluidity now 
explained, we can easily judge, that 
it is impossible a few particles of 
blood impacted and stopped in ves- 
sels, whole diameters, according to 
Van Swieten, are not equal to the 
tenth part of that of a hair, could 
preserve their fluidity. It will ap- 
pear still more impossible, if we con- 
sider the cohesion and glutinous te- 
nacity of the blood globules, which, 
joined with the heat excited in the 
capillaries by an inflammation, 
would soon render their stagnating 
fluids as hard as an extract. Hence 
we see, that a stagnation of the hu- 
mours

23 Of a PHLEGMON. 
mours in the capillary vessels, no less 
excludes motion than an obstruction. 
β. 3. Our Author supposes the ob- 
structed or stagnated blood to be 
violently moved by attrition. In- 
deed, he might as well say, that the 
blood was at rest, and violently moved 
at the same time, which are two 
contradictories. 
Hence it is evident, that the doc- 
trine of inflammations, which may 
be reckoned the basis of physic and 
surgery, has been founded hitherto 
upon a contradiction, and received 
as a truth by most of the Physici- 
ans and Surgeons in Europe. This, 
among others, may be the reason, 
why some were not ashamed to own 
that their art was founded upon un- 
certainties sufficient of themselves to 
discourage any one from inquiring 
into its principles.  
C4 For

24 Of a PHLEGMON.
For the future, it is to be hoped, 
that both physic and surgery will be 
freed from this aspersion, by the ra- 
tional and experimental principles, 
whereby, I am to account for the va- 
rious effects of an inflammation. 
BOERHAAVE and Van Swieten, 
often mention the red blood going 
into the vessels of the eye, in order 
to prove, that an inflammation is oc- 
casioned by a stagnation and an ob- 
struction; but this example proves 
nothing in favour of their assertion; 
for any one, who attends to the 
works of nature, may easily see that 
there was something prior to the red- 
ness of the eye, which occasioned 
a greater column of fluid than usual 
to come into its vessels. Sometimes 
a sympathy with some ailing part of 
the body, an air, a stinking effluvium, 
and very often a fluxion of some a- 
crid humour may occasion a redness 
in

25 Of a PHLEGMON. 
in the eye; but these are only exter- 
nal or antecedent causes, which, by 
irritating and exciting an unusal mo- 
tion in the vessels of the eye, occa- 
sion so great a quantity of fluids to 
run into them, as to produce a red- 
ness; it cannot therefore be supposed, 
that an obstruction or a stagnation in 
such cases, may be the proximate 
cause of the redness of the eye. 
Moreover, it cannot be conceived that 
the blood could stagnate in the ves- 
sels of this organ for weeks, months, 
and sometimes years, as we see in 
blear-eyed people; it is therefore 
probable, that the blood circulates 
all the time; otherwise it cannot be 
comprehended how the eye could 
recover its native colour, when the 
irritating cause is removed by the 
power of medicines. But of this, 
I shall speak more at large, in Sect. 3.
Now 


26 Of a PHLEGMON. 
Now as it is proved, that an ob- 
struction or a stagnation of the hu- 
mours, cannot be reckoned a proxi- 
mate cause of inflammations, I am 
to prove next, that it cannot be pro- 
duced by the encreased velocity of 
fluids alone, which the celebrated 
Van Swieten, holds to be one of its 
proximate causes in his commenta- 
ry on Aph. 371; and which, Dr. 
Sauvage maintains to be the only 
one; for it cannot be conceived how 
the velocity of the fluids can oe en- 
creased without the concurrence of 
other causes; even if it could, it 
cannot be understood how it could 
bring: on an inflammation. Canals, 
and banks of rivers contribute no- 
thing towards the rapidity of the 
currents; but we cannot infer from 
thence, that the like happens in the 
canals of the human body; for when 
they become any way inactive, as 
for example, in a dropsy, the Pati- 
ent

27 Of a PHLEGMON. 
ent is soon destroyed, unless he gets 
speedy relief from his Physicians, 
Where then can we trace out the 
cause of this velocity given by our 
Author to the fluids? We must not 
feign things we cannot see; for all 
the rivulets of systems, and hypothe- 
ses are stopped at their source, since 
physic is defined an art and a science, 
founded upon reason and experience, 
&c. therefore, we must seek for it 
in the penetralia, or inward recesses 
of nature; but in order to succeed 
in our search, we must give strict at- 
tention to the different changes, 
which, upon every accident of life, 
happen in the human body; thus for 
instance, by the pricking of a thorn, 
or needle, by the stinging of Bees, 
Wasps, by fire, the venereal disease in 
gonorrhœas, &c. by each of these 
and such like causes, are produced 
all the genuine effects of an inflam- 
mation,

28 Of a PHLEGMON. 
mation, as pain, swelling, heat, red- 
ness, &c. 
Now, no obstruction or stagnati- 
on of humours, can be supposed in 
the affected parts; therefore, the 
effects of an inflammation, may pro- 
ceed at least, occasionally from a 
stimulus; I say, occasionally, because 
a stimulus could produce none of 
the foregoing effects in the vessels of 
the human body, if they were not 
sensible and irritable. 
AN irritation and its effects are 
greater or smaller, according to the 
force of the stimulus, and sensibili- 
ty of the affected part. That mode 
of action, which results from the 
sensibility and irritation of the ves- 
sels, I call an erethism, this action 
is neither peristaltic, nor oscillatory; 
it is different in the small-pox, the 
measles, the itch, &c. it varies ac-
cording


29 Of a PHLEGMON. 
cording to the stimulus; so that 
there are as many kinds of it, as 
there are stimuli in rerum natura; 
because different stimuli make dif- 
ferent impressions, that excite the 
vessels to so many different kinds of 
erethism, which are attended with 
as many different disagreeable sen- 
sations. 
FROM the foregoing examples of 
the pricking of a thorn, of a needle, 
stinging of Bees, &c. it is evident, 
that whenever an erethism is excited 
in the vessels of any part, an en- 
creased velocity of the fluids must 
necessarily follow in that part, and 
that by taking away these two causes, 
we take away the inflammation. 
This will appear more clearly, by 
what I am to say, in the sequel of 
this section, concerning heat, a tu- 
mour, and the other effect of an 
inflammation.  
THE

30 Of a PHLEGMON. 
THE chief effects of an inflam- 
mation are heat, pain, a swelling, 
redness, and the acceleration of the 
pulse, which I am now to explain 
one after another. 
β. 4. ACCORDING to Boerhaave's 
doctrine, the production of heat in 
the inflamed capillary vessels, cannot 
be accounted for; for it consists in 
the reciprocal action, and reaction 
of the solids and fluids, which is ma- 
nifested in running Footmen, work- 
ing People, &c. but the fluids are at 
rest and obstructed in these vessel, 
according to the hypothesis of our 
Author, and heat is always diminish- 
ed in such as have obstructions, as 
we know by a very observable case 
in a young Woman labouring under 
a chlorosis; and, therefore the pro- 
duction of heat in an inflamed part, 
cannot be accounted for, if we ad- 
mit the definition which Boerhaave 
gives

31 Of a PHLEGMON. 
gives of an inflammation, in Aph. 
371. 
δ. 1. SOME may object, from 
what is said in this paragraph, that 
Boerhaave attributes a greater velo- 
city to the fluids contained in the 
vessels of the inflamed part which 
are not obstructed. 
These unobstructed vessels are 
inflamed, or they are not; if they 
are inflamed, our Author has no rea- 
son to assert, that an inflammation 
has for its cause, an obstruction of 
these vessels; if they are not in- 
flamed, the objection is not against 
us. 
That the various effects of an in- 
flammation, and what I am to prove 
in the sequel of this work, may be 
easily understood, I find it necessary 
to premise a physiological explication 
of the mechanism of animal heat; 
and

32 Of a PHLEGMON. 
and for that end, I shall first ex- 
plain the two-fold motion of the 
blood in the vessels of a living body; 
for every minute drop or particle of 
it moves round its axis, and advances 
with a progressive motion, from the 
heart to the extremities of the body, 
and back again. 
LET us first, in imitation of all 
Authors, call the minute drops of our 
humours, globules, and let us ima- 
gine, a tube pressed on all sides, con- 
taining an infinite number of these 
globules, all unequal, infinitely small, 
and moved according to all directi- 
ons. 2. Let us suppose, the hu- 
mours of a human body, during their 
actual state of fluidity, to be capa- 
ble of such motions as Sir. Isaac 
Newton has proved all fluids are 
susceptible of. 3. All Authors al- 
low the whole mass of our hu- 
mours, to consist of globules of dif- 
ferent

33 Of a PHLEGMON. 
ferent sizes and densities, as the 
blood, for example, the serum, the 
lymph, &c. 4. Let us suppose the 
fluids in any vessel of the human 
body pressed by the skin, the mus 
cles, the external air, and by the 
other contiguous vessels. 
From these premises may be ea- 
sily understood, that every globule 
of that fluid must receive impulses 
from the skin, the muscles and the 
lateral tubes, its very weight and 
elasticity, from anterior, posterior, 
and lateral globules, and lastly, from 
the different situations and motions 
of the body; therefore, it receives 
shocks or impulses, according to 
innumerable directions; but, by the 
laws of mechanics, when a body re- 
ceives impulses in that manner, it 
should yield to them all, as much, 
as possible, and be moved according 
to their different directions; there-
D fore,

34 Of a PHLEGMON. 
fore, as every globule of blood re- 
ceives impulses in every point, it 
should yield to them all, and of 
consequence move round its axis, as 
long as it receives them after the 
manner here described; but it re- 
ceives them thus whilst the heart 
moves; therefore, every globule of 
our humours moves round its axis, 
at least, in the large vessels, until 
the motion of the heart ceases. This 
motion of the fluids round their axis, 
by the superior force of the heart 
impelling the posterior globules, be- 
comes progressive; for it is a law in 
mechanics, that when a body re- 
ceives impulses from different pow- 
ers, according to different directions, 
it should move with a progressive 
motion, according to the direction 
of the strohgest; but of all the 
the powers acting in the blood ves- 
sels, the impulse of the heart, com- 
municated to the posterior globules, 
is

35 Of a PHLEGMON. 
Is the strongest; therefore, all the 
globules contained in the vessels of 
the human body, should be moved 
according to the direction of the 
heart, with a progressive motion; 
the same may be said of the other 
humours, as they are equally sub- 
ject to the same laws of motion. 
WE are indeed to remark here, 
that it cannot be conceived how the 
globules of our humours can move 
round their axis in the capillaries, 
where only one globule can enter 
at a time, by every fuction and 
attraction, which is the only way 
the circulation can be carried on in 
these vessels; because they have no 
perceptible systole nor diastole. We 
allow the propelling force of the 
heart behind to concur, in as much as 
it conveys the fluids to their orifices. 
It may be easily concluded from 
what is said, concerning the two 
D2 diffe-

36 Of a PHLEGMON. 
different motions of the blood, that 
the heat of the human body con-
sists in the repeated action, and re- 
action of the solids and fluids, and 
as these are augmented in an inflam- 
mation, the excess of heat in this 
disorder may be easily accounted for, 
according to our doctrine; for the 
velocity of the fluids being preter- 
naturally encreased, (which we hold 
to be one of the proximate causes 
of that disease) the contraction of 
the heart must at the same time be 
more frequent and strong, and con- 
sequently the action and re-action 
of the fluids and solids, augmented 
accordingly, and produce heat. On 
the other hand, it cannot be denied, 
but all living creatures have an in- 
stinct which excites them to use the 
utmost of their power to remove the 
cause of pain; for the first law of 
nature is to seek food to preserve 
life, and the second to avoid, as 
much

37 Of a PHLEGMON. 
much as possible, any thing which 
might destroy it; and indeed we 
find, that the heart observes this 
second law inviolably upon all acci- 
dents. 
IT is by this instinct or sympathy, 
that when any part is irritated, the 
heart directs to it immediately a 
quantity of fluid proportionable to 
its irritation, by which its vessels 
are dilated and contracted with 
greater force; and consequently their 
tabulæ or sides must approach one 
another, and repel the fluids which 
rally in their turn, and thus succes- 
sively their motion round their axis, 
with their progressive motion, is ac- 
celerated, and becomes more rapid 
in proportion, as the blood abounds 
with oil and a sulphureous princi- 
ple, or other elastic particles which 
are easily put in motion and warm- 
ed, The heat arising from such 
D3 blood


38 Of a PHLEGMON. 
blood is soon dissused from the heart, 
as the center of motion, through the 
vessels to the circumference of the 
body, in the manner of rays, quasi 
per irradiationem. 
THE force, by which the erethism 
impels the fluids against the sides of 
the vessels, is, as it were, a propor- 
tional medium between their irrita- 
tion and contraction. As that force 
is various, according to the variety 
of the stimulus, and to the additi- 
on it receives successively from the 
preternatural velocity, elasticity and 
quality of the blood, it produces 
also various degrees of contraction 
in the vessels, and consequently va- 
rious degrees of heat. From hence, 
and from the notion I have given of 
an erethism, (page 28) it may be 
easily understood, why one degree 
of contraction brings on a small in- 
flammation, another a great one, a 
third

39 Of a PHLEGMON. 
third suppresses the excretions, as it 
happens in an ardent fever; how, 
by another degree some excretions 
are encreased, as when sweat or 
spitting is brought on by a slow ere- 
thism, in some hypocondriac habits; 
and lastly, how the contraction may 
sometimes be so violent as to cause 
convulsions. 
No Artist was ever found inge- 
nious enough to contrive a machine, 
which could perfectly represent the 
circulation of the blood in a living 
animal; yet, Physiologists are al- 
lowed to use such evident examples 
as they are supplied with from ex- 
perimental philosophy, in order to 
clear up some cases, which are not 
immediately obvious to the senses; I 
shall for that reason, make use of the 
following experiment, that it may 
help to render my physiological ac- 
count of heat more intelligible; and 
D4 that

40 Of a PHLEGMON.
that the conseqences and corrlla-
ries deduced from thence, may be 
more easily comprehended.
LET glass reduced to powder,
water and oil be agitated with a ve-
hement motion in a glass vessel, the
particles of glass being the heaviest
and most dense, advance with a
progressive motion to the circumfer-
ence of the vessel, leaving the oil 
and water behind at the axis and
center; but the contrary happens,
when the motion is less vehement.
Let the center of the glass vessel
represent the heart; its circumfe-
rence that of the human body,
and the different substances it con-
tains the different humours of a liv-
ing animal; and allowing the circu-
lation to be carried on by the like
mechanism, the blood being heavier
and more condensed than the serum
and
 

41 Of a PHLEGMON. 
and lymph, will leave them both be- 
hind, when by a vehement motion, 
excited by an erethism, they are 
propelled all together to the inflamed 
part, where the blood produces irri- 
tations in proportion to the different 
contractions of the vascular system. 
It may be inferred from thence, 
that in every degree of inflammati- 
on, a greater quantity of red blood 
than any other humour must come 
to the affected part; and that it can- 
not be conceived, how an erysipelas 
and a hot œdema, can be formed 
by any humour different from the 
red blood, as Boerhaave and Van 
Swieten assert, in Aph. 380. 
LET it not be imagined, that this 
conclusion is merely hypothetical, 
and entirely founded upon the fore- 
mentioned experiment; for we may 
see the truth of it proved by almost 
every accident which happens to the 
human

42 Of a PHLEGMON. 
human body, as I have constantly 
observed for many years past, by at- 
tending diligently to the changes 
which follow, when it is either hurt 
or irritated by external causes; upon 
all such occasions, a redness ensues 
similar to that which arises by run- 
ning, dancing, singing, or on using 
any other violent exercise, or on the 
prick of a thorn, the sting of a Bee, 
a stroke, &c; so that every such 
accident of life proves, that a great- 
er quantity of blood is determined 
to an inflamed part, than any other 
humour. We may also learn from 
the same principles, why, in an ar- 
dent fever, and in all inflammatory 
disorders, the blood propelled more 
frequently to the circumference of 
the body, should there press the ori- 
gin of the serous and lymphatic ves- 
sels, and occasion an exsiccation of 
the skin. On the contrary, when 
the motion of the fluids is in a na- 
tural


43 Of a PHLEGMON. 
tural state, the serum, lymph, and 
the humour or insensible perspirati- 
on, leave the blood behind, and come 
in a greater quantity towards the 
skin; from whence its whiteness, 
softness, and humidity must neces- 
sarily proceed. 
SOME Authors maintain, that the 
subtil matter of our atmosphere, is 
the chief agent which carries on the 
circulation of the animal fluids, 
produces heat, muscular motion, 
&c. Although, what can be said on 
this subject, borders too much on 
hypothesis, to deserve a place in a 
work, whose object is the preserva- 
tion of life, by rules founded on 
facts; it may not, however, be im- 
proper to entertain the Reader a few 
moments with my opinion, and 
compare it with that of some emi- 
nent Authors, who have most seri- 
ously considered it.
MANY

44 Of a PHLEGMON. 
MANY Physiologists suppose the 
different kinds of matter which float 
in our atmosphere, and which escape 
our sight, to enter into the blood, 
and render it more stimulating, and 
of consequence, more apt to sollicit 
the contractions of the vessels, and 
produce heat. Among the rest, 
Bergerus in his Physiology, supposes 
the blood to become more elastic, 
and to be more easily moved by be- 
ing mixed with the air, and with the 
subtil matter which are expanded in 
the atmosphere. Dr. Whytt, Pro- 
fessor of Physic in the University of 
Edinburgh, seems to suppose the 
same; for he enumerates the acid of 
our atmosphere, among the causes 
of circulation, and the action of the 
muscles, in his elegant treatise on 
animal motion. Some arguments 
now occur to me, for and against 
these systems. 
THE

45 Of a PHLEGMON. 
THE existence of subtil matter 
in our atmosphere, is proved by the 
experiments of electricity; by the 
encreased weight of antimony in the 
focus of a burning glass, and by the 
circulation of the magnetic effluvia, 
from the arctic, to the antarctic pole, 
of which Mariners no more doubt, 
than of the air's existence in violent 
storms. The existence of an acid 
in our atmosphere, has been proved 
by the honourable Robert Boyle, 
who, by exposing to the air the dif- 
ferent bodies, which have an affinity 
with particular acids, found that the 
atmosphere of London abounded 
with the acid of sulphur; and it is 
more than probable, that the atmos- 
phere of every country is impreg- 
nated with some kind of acid. 
FROM these premises, we can rea- 
son thus; it is known by experience, 
that the human body placed in a 
watery


46 Of a PHLEGMON. 
watery atmosphere, swells by ab- 
sorbing water; in like manner, mer- 
curial ointment applied to the soles 
of the feet, ascends to the salival 
glands. It cannot be denied, but 
the air, the acid of sulphur, the 
magnetic and electric effluvia, are 
much more subtil than water or 
mercurial ointment; therefore, it 
may be analogically inferred, that 
these fluids circulate with the blood. 
If they do, the electric matter, by 
its nature, (for it is supposed by 
many to be the same as the matter 
of fire or light) the magnetic efflu- 
via by attraction in the capillary 
vessels, the air by its elasticity, and 
the acid of sulphur by its stimulus, 
must all concur to augment the ac- 
tion and re-action of the solids and 
fluids, and produce heat. 
The froth of the blood coming 
out of the vessels proves that it con-
tains

47 Of a PHLEGMON; 
tains air, and the volume of air ex- 
tracted from it in the receiver of 
the machina pneumatica is three 
times greater than its own. This 
seems to prove, that the air circu- 
lates with the blood; but it can- 
not be easily conceived how the sides 
of the vessels could resist the force 
of the air, if it were condensed to 
that degree, and could at the dame 
time exert its elastic and expanding 
force; besides the fluids are incom- 
pressible, or if they be not, as dome 
ingenious Gentlemen have often at- 
tempted to prove, they must be com- 
pressible in so small a degree, as not 
to admit air as elastic; for if it were 
elastic, its globules by attraction 
would unite, and in a short time 
stop the circulation; moreover, 
it is proved, that an elastic air can- 
not penetrate capillary vessels of 
glass; but the blood vessels are much
more

48 Of a PHLEGMON. 
more minute, than capillary vessels of 
glass; the air, therefore, cannot pe- 
netrate them without laying aside its 
elastic property. 
How can it therefore happen, 
that rheumatic pains and swellings 
are produced in all parts of the 
body, even in the strongest and most 
robust habits, by wind or an expan- 
sion of air, as some grave Gentle- 
men considently assert? 
NOTHING that we know can stop 
the magnetic effluvia in its course 
from North to South; it cannot 
therefore be understood, how it can 
circulate with the blood; we have 
no better proof to convince us, that 
the electric effluvia or the matter of 
light, mix with the animal fluids. 
FROM the chymical analysis of 
bile, and that of urine, we know, 
that

49 Of a PHLEGMON. 
that a sulphureous principle is con- 
tained in the humours of the hu- 
man body; for the smell of the 
salt extracted from the two former, 
proceeds from thence. But we have 
no proof, that this principle is ab- 
sorbed from the ambient air, neither 
have we any occasion for such a 
subterfuge; for our aliments sup- 
ply it very copiously. 
MR. BOYLE asserts, that among 
the different particles of matter, 
which float in the atmosphere, there 
may be some so minute, so solid and 
shaped after such a manner, that they 
may enter the orifices of the cuticu- 
lar glands and the other pores. 
Hence may be understood, why the 
plague (of which Cardanus speaks) 
that reigned at Basil, spared the Ita- 
lians, French and Germans. Boer- 
haave, in his chymistry, concludes 
from thence with our noble Author,
E that

50 Of a PHLEGMON. 
that the pores of these People were 
so formed, that the pestilential ef- 
fluvium could not penetrate them, 
whereas it found an easy entrance 
into the Citizens and Natives, whose 
pores, by length of time were made 
to correspond to the figure of the 
subtil particles of matter which 
floated in the atmosphere, in the 
same manner as iron placed for a long 
time in the pinacles of churches, 
acquires magnetic properties. 
FROM these premises, we may con- 
clude, that neither the air, nor any 
other particles of matter expanded 
in the atmosphere, can enter the 
blood without being so intimately 
combined therewith, as to assume 
its nature, and lay aside in some 
manner some of their own proper- 
ties. It is thus, sal ammoniacum, 
when united with the mucous and 
gela-

51 Of a PHLEGMON. 
gelatinous part of the blood, in a 
state of health, is imperceptible. 
EVERY Physician will grant, that 
the particles of matter which float 
in the atmosphere, exist in all vege- 
tables and animals, as elements; and 
it is in that sense, I allow, that they 
contribute to produce heat in the 
human body. We are to remark, 
that the elementary particles which 
cause heat, are unequally distributed 
in vegetables even of the same species, 
according to the climate and soil 
which produce them; as we see 
manifested in wines of different 
countries and different soils: The 
like inequality may be constantly 
observed in the different classes of 
mankind, which, according to the 
goodness of their climates and ali- 
ments, are more or less subject to 
inflammatory disorders, and the 
preter-natural effects which general- 
E2 ly 

52 Of a PHLEGMON. 
ly arise from too much strength or 
heat in their constitutions. 
β. 5. Now as we have proved, 
that an inflammatory heat cannot 
be accounted for according to Boer- 
haave's doctrine, it is not to be ad- 
mired, that by the same principles, 
we cannot be enabled to explain, 
how a tumour can take place in the 
capillary vessels of an inflamed part. 
For in that case, their diameters 
ought to be enlarged, a thing im- 
possible, on account of an attrition 
of their fluids, which must cause 
their sides to approach one another; 
and of consequence lessen their dia- 
meters, and rather diminish than 
augment their quantity of fluid, on 
account of the repeated contractions 
whereby an attrition is carried on. 
Besides, our Author supposes an ob- 
struction in the inflamed capillaries, 
which, as we have said above, ex-
cludes

53 Of a PHLEGMON. 
cludes all motion; but a hot tu- 
mour cannot be formed in any part, 
without an excessive great motion of 
the fluids; therefore, an obstruction, 
and the sort of motion on which an 
attrition depends, rather hinder than 
bring on a tumour in an inflamed 
part. 
δ. 2, OUR adversaries may object, 
that we can give no reason why the 
sides of the vessels should come to- 
gether in an attrition. 
AN attrition, in what ever sense it 
is taken, arises from the frequent 
contractions of the vessels; but in 
contracting themselves, their sides 
must certainly approach one another; 
and their diameters of consequence 
must be lessened, and this must hap- 
pen constantly so, from a state of 
inanition to the most supreme de- 
gree of a plethora. 
E3 ALL

54 Of a PHLEGMON. 
ALL Physicians know that a ple- 
thora ad vasa often proceeds from an 
attrition of the fluids; for when this 
is carried on to a certain degree of 
intensity, the humours are so tritu- 
rated thereby, as to occasion some- 
times a rarefaction, and an intire de- 
composition or their component par- 
ticles, as Practitioners may frequently 
observe in blood drawn from in- 
flamed Patients. 
When the attrition of the animal 
fluids languishes or is intirely want- 
ing, the circulation of the blood, and 
the rest of the functions languish 
also; as we see in a young girl la- 
bouring under a chlorosis, or in such 
as are cachectic, or weakened by 
chronic disorders. 
INDEED a swelling is not essential 
to an inflammation, as some Authors 
affirm; for the intestines are some- 
times


55 Of a PHLEGMON. 
times converted by this disorder into 
dry, thin, yellow or black mem- 
branes, which I saw often verified 
by opening bodies whose deaths were 
occasioned by inflammations of the 
abdomen. And in scrophulous and 
venereal disorders, there is sometimes 
a slow erethism, with a preternatu- 
ral velocity of the fluids without any 
apparent swelling. 
δ. 3. IT may be objected against 
what I have said in this paragraph, 
that in an inflammation, the vessels 
are distended with a greater quantity 
of blood than in a natural state; 
and that of consequence a tumour 
must, in some sense, be essential to 
that disorder. 
IN many bodies who died of in- 
flammations, I saw the intestines and 
lungs reduced to very small bulks. 
I saw also the bodies of consumptive 
and

56 Of a PHLEGMON. 
and phthisical People covered over 
with ulcers, without any appearance of 
a tumour; but ulcers do not come 
without a previous inflammation; 
therefore we can assert, that an ere- 
thism of the vessels with an encreased 
velocity of the fluids, can exist in a 
part without a tumour; and that of 
consequence, a swelling is not essen- 
tial to an inflammation. If it were, 
a sensation of pain could never hap- 
pen without drawing an afflux of 
humours to the affected part to raise 
a swelling; but every one knows the 
contrary by experience; for in a 
tooth-ach there is very often an ex- 
quisite pain without a swelling. 
A swelling which proceeds from 
an echymosis is caused by a rupture 
of the vessels; but it cannot be sup- 
posed that they burst in a simple in- 
flammation; otherwise how could 
the fluids stagnate in them, as 
Boer-

57 Of a PHLEGMON. 
Boerhaave asserts? in a perfect con- 
tusion, as the circulation ceases in 
the contused part, it must grow 
stronger and more frequent in the 
collateral and subjacent vessels; 
from whence arises very often an in- 
flammatory swelling, which some 
Authors, without any foundation, 
attribute to a stagnation of the flu- 
ids in these vessels. 
THE swelling of an inflamed part 
is easily accounted for, according to 
our doctrine; for whenever the ere- 
thism of the vessels with the velocity 
of the fluids is preternaturally en- 
creased, the action and re-action of 
the fluids and solids being more fre- 
quent and strong, the vessels by their 
continual agitation and distension 
are weakened, lose their tonic and 
contractile force, and by that means 
their pores become fo enlarged, that 
the humours can easily pass through 
them

58 Of a PHLEGMON. 
them into the cellular membrane, and 
produce a swelling which will be pro- 
portionable to the strength and du- 
ration of the erethism, and the pre- 
ternatural velocity of the fluids. 
WE are to remark that the ves- 
sels, muscles, and membranes, with 
every sensible part of the body, have 
a natural tendency to shorten them- 
selves, which by Physiologists is cal- 
led a tone or tonic action; it is so 
much augmented in an inflamma- 
tion, that the pores and orifices of 
the capillaries become so narrow, 
that little or nothing can pass 
through them; but when this action 
is overpowered by too much disten- 
sion, or by the vehement impulse of 
the fluids from behind, the fibres 
are somewhat lengthened and re- 
laxed, and the pores become so 
wide, that the humours can easily 
pass through them into the aforesaid 
membrane.

59 Of a PHLEGMON. 
membrane. The force of the sti- 
mulus and erethism may be so great, 
as to overcome this action in an in- 
stant, and cause a swelling, &c. as in 
β. N°. 3, 4, 5, 6, 7, 8. This action 
supports us when we are awake, and 
it is so much lessened by sleep, that 
it is partly on that account we are 
something taller in the morning than 
going to bed. In a palsy the mouth 
is drawn towards the healthy side, 
by a tonic contraction, and not by 
a muscular motion, as many Authors 
pretend. 
As Dr. Haller, Professor of Physic 
in the University of Gottingen, has 
proved by the authority of Sir Clifton 
Wintringham, that the capillary ves- 
sels are much stronger than their 
trunks, it cannot be conceived how a 
swelling can take place in them, espe- 
cially in an inflammation, wherein 
their bulk and diameters are lessened 
by their tonic action and erethism.  
See

60 Of a PHLEGMON. 
See what is quoted from Dr. Haller,
Sect. II. Φ. 6. 
β. 6. As the redness of an inflamed 
part proceeds from the encreased 
velocity of the blood, it cannot be 
accounted for according to Boer- 
haave; because in Aph. 371, he sup- 
poses the fluids to stagnate, and re- 
main without motion in the inflamed 
arteries. The same thing may be 
said of pain and the acceleration of 
the pulse; because they are no less 
the immediate effects of an inflam- 
mation than redness, as appears from 
the application of the definition I 
have given in the beginning of this 
section. 
WHEN any part of the human 
body is irritated, the heart sends it 
so great a quantity of blood, that 
it will soon cause redness, &c. as in β. 
N°. 1, 2, 4, 5, 6, 7, 8, of this sec- 
tion,

61 Of a PHLEGMQN. 
tion, if the cause is not removed or 
overcome by nature or art. 
β. 7. PAIN is a disagreeable sen- 
sation, which excites all living crea- 
tures to employ the utmost of their 
power to remove its causes. The 
artifice which nature uses to free 
herself from it, is very admirable; 
for she seldom fails to send a flood 
of humours to any part affected 
with pain, even independent of the 
will. Pain supposes a stimulus and 
the sensibility with the irritability of 
the fibres as antecedent causes; but it 
arises immediately from an erethism 
of the vessels, and the impetuous 
velocity of the fluids, which both 
combine to irritate and distend these 
vessels so much beyond their tone, 
as to cause pain. See page 15. 
We may see what is here asserted 
confirmed in Quadrupedes, when
by

62 Of a PHLEGMON, 
by a natural instinct, they contract 
their tunica camosa, to drive away 
the flies. 
β. 8. THE stricture and erethism 
of the vessels is greater in proporti- 
on to the intensity of the inflamma- 
tion, and of consequence, the quan- 
tity of humours is lessened in them, 
it must, therefore, be encreased in 
their collaterals. In the mean time, 
the heart, according to the laws 
instituted by provident nature, dou- 
bles its contractions, in order to free 
it's subservient vessels from their 
stricture and erethism; hereby the 
action and re-action of the solids 
and fluids become stronger and more 
frequent, and consequently the pulse 
must be accellerated.
SECT.

63 Of an ERYSIPELAS. 
Sect. II. 
Of an ERYSIPELAS. 
AN Erysipelas, according to Boer- 
have, is an inflammation of 
the second order. Before I explain 
this celebrated Author's opinion, I 
will present my Reader with what 
Fernellius has collected from the An- 
tients on that subject. 
"ERYSIPELAS, ardor est vehe- 
mens per corporis summa diffusus. 
Nec tumore manifesto extuberat, 
nec partem attollit aut distendit, nec 
penetrat in subjectam carnem, sed 
late diffunditur nulla collectione cir- 
cumscriptum. Quamcunque par- 
tem prehendit, vehementer mordicat
&

64 Of an ERYSIPELAS. 
& urit: color inest ex rubro flaves- 
cens, qui pressu subterfugit, moxque 
redit. Dolor nec pulsans nec admo- 
dum vehemens est. Quum fluxio 
excutitur, horror quidem ac dein fe- 
bris hominem adoritur: ac sæpe 
quum in crura irruit, ab inguinis tu- 
more initium ducit. Serpit id qui- 
dem herpetum more, atque priori 
derelicta sede, in vicinas partes sen- 
sim obrepit. Est autem duplex, 
unum quod simplex erysipelas Celso 
appellatur, solo rubore 8c ardore, 
nulla exulceradone molestum. Al- 
ter um quod eidem sacer ignis nun- 
cupatur estque explceratum erysipe- 
las. Hujus duæ species sunt, una. 
qua summa cutis sine altitudine ex- 
ulceratur, in qua & crustulæ instar 
surfuris excitantur: altera cujus ex- 
ulceratio altius in cutem penetrat, 
e qua ruptis pustulis purulenta sanies 
exit. Simplicis erysipelatis origo 
est

65 Of an ERYSIPELAS. 
est a servente tenuique sanguine, 
qui biliosus appellatur: exulcerati 
vero ex co cui bills supervacuæ ejus- 
que incalescentis nonniliil sit admis- 
tum. Is e venis tenuioribus propul- 
fus nequaquam in carne subsistit & 
hæret, sed tenuitate in cutem sertur 
& evolat, quæ densior & compactior 
hunc retinet cohibetque. Quumque 
tenuis sit humor facile dispergitur, 
neque in conspicuum tumorem se 
attollit. Genus hoc universum ex- 
quisitum est eiyslpelas: quod vero 
phlegmonodes appellatur, tumentius 
quidem, sed minus servidum existit 
multoque minus oedematodes." Vi- 
de Fernel. De extern, corp. affect. 
cap. 4. lib. 7. Pathologiæ. 
Φ. 1. When an inflammation 
does not penetrate deeper than the 
integuments, and causes no apparent 
swelling, it is called ah erysipelas,
F not


66 Of an ERYSIPELAS. 
not only by Fernellius, but by all 
the Antients and Moderns. 
Φ. 2. A SIMPLE erysipelas mani- 
fested by a redness and parching 
heat, can hardly be distinguished 
from an exquisite phlegmon; for it 
has all its characters except a tu- 
mour, but I have shewed in the 
foregoing section, that a tumour is 
not essential to an inflammation; 
nor has our Author any reason to 
assert, that it proceeds from a bili- 
ous blood, for the bile is not red; 
yet this disorder may happen, when 
the bile is of a bad quality, or when 
it is diffused over the surface of the 
body. 
Φ. 3. Our Author, as all the 
Antients and most of the Moderns 
have done, concludes, that the yel- 
lowish colour of the part affected 
by an erysipelas proceeds from the 
bile;

67 Of an ERYSIPELAS. 
bile; but I have observed very of- 
ten, that this colour does not appear 
until the disorder is upon the decline, 
either towards a resolution, or a sup- 
puration. Van Swieten attributes 
this yellowness to the serum, in his 
Commentary on Aph. 390. But 
to prove this assertion, it would be 
necessary, that nature should send 
the serum only to the affected part; 
but it cannot be conceived how that 
could be effected according to the 
known laws of the animal œcono- 
my; for we know by experience, 
that such as labour under this dis- 
order, are no way disposed to sweat, 
nor have any moisture perceivable 
on their skin; on the contrary, they 
appear to the touch to be dry and 
parched, and burn all over with 
heat; and it follows from what is 
said in page 41, that the heart in 
that situation, cannot be disposed to 
separate serum from the blood to
F2 be

68 Of an ERYSIPELAS 
be sent preferably to any other hu- 
mour to the irritated part; for 
which reason, it is not more likely, 
that a yellow colour in an erysipelas 
should rather arise from the serum 
than from the blood. 
NEITHER the blood nor any other 
humour is black; but when col- 
lected in contusions, they take on 
that colour, may not therefore the 
blood decomposed by the heat and 
pulsation of an inflamed part, change 
its colour from red to yellow? Be- 
sides, as the red blood is thicker than 
the serum, it cannot so easily pass 
off by resolution; therefore, it should 
be more retained in the affected part 
than the serum. Moreover, we are 
to remark, that Leuwenhoek ob- 
served the colour of the blood to 
proceed from the union of the white 
globules; therefore, that union be- 
ing dissolved by the rarefaction arising 
from

69 Of an ERYSIPELAS. 
from an inflammatory heat, may oc- 
casion the red colour to vanish partly 
or entirely, which, perhaps, hap- 
pens in the present case; and this is 
further proved by Dr. Sauvage, in 
his Physiology *, where he says, that 
the redness of the blood proceeds 
from its thickness, and proves it by 
the authority of Sir Isaac Newton, 
who has demonstrated, that bodies 
were red, because the thickness of the-
ir particles was equal to 1/15,000,000
of an inch; that they appeared 
yellow, because they were equal to 
20,000,000 part of an inch, and 
to appear black, if one, &c. 
ALL Physicians allow, that an 
erysipelas is never produced without 
a preternatural encrease in the mo- 
tion of the fluids, and for that rea- 
son, it is not certain, that a greater 
* Vide, pag. 179 and 199.
F3 quantity

70 Of an ERYSIPELAS. 
quantity of serum is sent or derived 
to an inflamed part, than what com- 
monly circulates with the blood. 
See β. 2. of this Section. 
Φ. 4. ALTHOUGH an erysipelas 
causes no manifest swelling or disten- 
sion, yet we know by reason and 
experience, that it seldom can hap- 
pen in any external part of the body, 
without attracting to it a greater 
afflux of humours than what is pro- 
pelled to it by the common laws 
of circulation in a healthy state; 
and that of consequence the part 
must swell in some measure, except 
in some consumptive habits, where- 
in the radical moisture is exhausted, 
and the vis vitæ is unable to propel 
the fluids to the circumference of 
the body, or in those in whom the 
sebacean humour is entirely want- 
ing.
Φ. 5.

71 Of an ERYSIPELAS. 
Φ. 5. As it cannot be compre- 
hended, that an ulcerated erysipelas 
can exist without pain, we can con- 
clude from these remarks, that Fer- 
nellius suppposes an erysipelas to be 
attended with heat, redness, swel- 
ling and pain, which, according 
to Celsus, are the four chasteristics 
of an inflammation. 
Φ. 6. We have remarked under 
Φ. N°. 5. Sect. I. three series of 
vessels through which the blood or 
any other humour is to pass, ac- 
cording to our Author, before it can 
work its way into the cellular mem- 
brane to form an inflammatory tu- 
mour. Fernellius seems also to have 
hinted here, that these three series 
of vessels are continued one into 
another, and that the humours can- 
not pass from the first and second 
into the cellular membrane, or empty 
spaces, as he calls it; but if every 
F4 part

72 Of an ERYSIPELAS. 
part of these two series as well as 
the third, had not inspiring and ex- 
piring vessels and pores that open 
into the cellular membrane, there 
could be no supply of oil or moisture 
to preserve the sensibility of the 
nerves, veins, and arteries, and the 
flexibility and elasticity of the mus- 
cles, tendons, ligaments, and carti- 
lages; they would soon grow stiff 
and break by the least motion, just 
like a twig, which withers by being 
long exposed to the sun, and breaks 
before it can be in the least bent; 
I have observed, that many Peo- 
ple who were long subject to scor- 
butic or venereal complaints, break 
their limbs by very small force, 
which must certainly be owing to 
the want of that oily balsamic hu- 
mour, that passes in a state of health 
from the vessels not only into the 
cellular membrane, but even into
the

73 Of an ERYSIPELAS. 
the substance of the bones. But 
when the vessels are attacked by a 
slow continued erethism, as in the 
aforesaid diseases, this balsamic hu- 
mour cannot always pass, and when 
it does, it grows acrid, or evaporates 
before it can get a supply; because 
the erethism or action of the vessels 
is very irregular in such People, on 
account of the great changes which 
the non-naturals produce in their in- 
firm bodies. 
From these examples, we may 
venture to say, in conjunction with 
Helmontius and Hippocrates, that 
every part of the body, both in- 
ward and outward, and consequent- 
ly of the vascular system, is inspir- 
able and expirable; it is therefore 
reasonable to think, that there are 
pores through the whole length of 
the vessels, by which a humour 
passes into the cellular membrane, 
when

74 Of an ERYSIPELAS. 
when the circulation is in a natural 
state; it is therefore probable, that 
when the tonic action of an in- 
flamed vessel is weakened or abo- 
lished in any part by too great a 
distension from plenitude, the pores 
may become so wide in that part, as 
to admit the red globules or other 
humours to pass through them into 
the cellular membrane. 
For which reason, it does not 
seem necessary to suppose, that the 
morbific humour in an inflamed ar- 
tery should pass through its extremi- 
ty before it can get into that mem- 
brane. Besides, by what Dr. Hal- 
ler extracted from the experimental 
enquiries of Sir Clifton Wintring- 
ham, it appears, "that in general the 
trunks of the arteries are in all parts 
of the body weaker and the branches 
stronger in their coats; whence the 
impulse of the blood may exert a 
con-

75 Of an ERYSIPELAS. 
considerable effect upon the former, 
but least of all on those of the 
limbs. 
FROM hence it is, that aneurisms 
are most frequently formed near the 
heart; for in the lower extremities, 
the strength of the arteries and of 
the veins too is much encreased. 
AND the proportion of the arte- 
rial membranes or coats in thick- 
ness, with respect: to their bores or 
capacities, is greater as the arteries 
grow less, and is thickest in the least 
of them, which can transmit only 
one globule at a time. The truth 
of this is proved from anatomy, and 
the forcing of air into the arteries, by 
which they burst always with more 
difficulty as they are less; and from 
the calculation itself, by which the 
magnitude of the least arteries is 
determined from the globules, dis-
tending

76 Of an ERYSIPELAS. 
tending their two semi cylindric 
membranes. 
ANATOMISTS have erroneously 
supposed the strength of the arteries 
and veins to decrease, in proportion 
as they grow less in thickness, for 
by experiments, it appears, that the 
thinest vessels have often a much 
greater degree of compactness and 
strength proportionable than the 
larger; and some whose coats are 
extremely thin, exceed in strength 
the aorta, whose coats are ten times 
as thick, The emulgent artery was 
found a fifth or sixth part stronger 
than the aorta at the heart, and the 
emulgent vein was found two thirds 
stronger than the cava, &c.*" 
* See remark on § 153, of Dr. Haller's Physiology, 
containing an extract of Sir Clifton Wintringham's ex- 
perimental enquiry, concerning the arteries and veins, 
translated into English by Dr. Mihles. 
HENCE


77 Of an ERYSIPELAS. 
HENCE it is more than probable, 
that the tonic action of an inflamed 
artery can sooner be overcome by 
distension in any point where it is 
preternaturally distended, than in 
its apex or extremity, notwithstand- 
ing what Fernellius, Boerhaave and 
all other Authors affirm to the con- 
trary; therefore I see no necessity 
of supposing the morbisic humour 
to pass from the sanguineous arteries 
into another smaller series of vessels, 
to form an inflammation by error of 
place. Why should it not pass rather 
into their corresponding veins, if the 
serous or lymphatic arteries be not 
intermediate between them? if they 
be, the blood with every kind of 
humour should always pass through 
them before it could arrive in the 
veins. Such an assertion would be 
very absurd, though it may be in- 
ferred from Boerhaave's way of rea- 
soning in the following aphorisms. 
"372.

78 Of an ERYSIPELAS. 
"372. QUODQUE ergo sieri po- 
test vel in sinibus arteriosis, vel in 
vasis serosis lymphaticis aliisque mi- 
noribus, arteriosis dilatatis osculis ad- 
missos globulos rubros aut alia fluidi 
elementa crassa, per fines transmit- 
tere non potentibus. Si sanguis 
transfunditur in eas venas, quæ spi- 
ritibus accommodate, inflammatio- 
nem excitat. Cels. 5. 
378. EFFICIUNT eam in vasis 
lymphaticis arteriosis. 1. Omnes 
causæ, quæ initia horum latiora am- 
pliant, ita, ut in ea intrent partes san- 
guinis erassiores, quæ propulsæ ulte- 
rius occurrunt angustiis conni venti- 
bus, ubi tum patiuntur eadem, quæ
exposita (377); talis est laxitas vas- 
culi in suo principio, motus violen- 
tus liquidi arteriosi: 2. Omnes cau- 
sæ alteri inflammationi communes. 
375, 376.
379.

79 Of an ERYSIPELAS. 
379. Unde et similis morbus in 
omni vase conico, ubi fluit ex lato in 
angusta liquor, obtinere potest; ut 
enim in sanguine rubro sic in lym- 
pha alia est forte pars erassior reli- 
quis. 
380. Ex quibus vera diversitas 
phlegmones erysipelatis, oedema- 
tis, schirri cum inflammatione li- 
quet." 
β. 1. An artery, according to Bo- 
erhaave, is like a cone whose base is 
in the heart, and apex in the extre- 
mities of the body. An erysipelas 
takes place nearer the apex of the 
cone than a phlegmon, and it ad- 
vances sometimes as far as the lym- 
phatics, where it is produced by er- 
ror of place. The serum, according 
to this Author, is yellow, and in his 
Commentary on aph. 127, says, that 
in the serous arteries there may be a
red

80 Of an ERYSIPELAS. 
red or yellow inflammation, the first 
happens by error of place, the second 
is peculiar to these vessels. 
If a little cruor with much serum 
stagnates in the pellucid vessels, 
which are obstructed and inflamed, 
the affected part will then appear of 
a reddish yellow, and this sort of 
inflammation he calls an erysipelas. 
HENCE also appears die affinity 
betwixt an erysipelas and a phleg- 
mon, since they only differ in the 
magnitude of their obstructing par- 
ticles; for in a phlegmon the red 
part of the blood is accumulated in 
the obstructed and distended vessels; 
but in an erysipelas, the serum of 
the blood, mixed with a little cruor, 
becomes impervious in the same 
manner; also the seat of a phlegmon 
is the membrana adiposa, whereas 
an erysipelas invades the external
inte-

81 Of an ERYSIPELAS. 
integuments of the body, or the in- 
ternal membranes. 
IN this extract we may see what 
our Author means by an inflamma- 
tion of the second order proceeding 
from an error of place; but I will 
clearly shew by fair arguments drawn 
from the nature of the solids and 
fluids, that this doctrine is contrary 
to reason and experience. 
β.2. It is a well-known truth, 
that the skin is more or less dried or 
parched in a fever, according to the 
vehemence of the symptoms, of 
which we may daily see evident 
proofs in an ardent fever. I suppose 
no Physician will deny, but the 
dryness of the skin in this case pro- 
ceeds from the constriction of its 
vessels, whether they be sanguiserous, 
serous or lymphatics; * but in an in- 
flamed part the stricture of these 
G ves-

82 Of an ERYSIPELAS. 
vessels must be far greater than in 
an ardent fever; they should there- 
fore exclude not only the red glo- 
bules, but also the peculiar humours 
to which they are destined, and from 
thence become parched and dried. 
HENCE we see the reason why a 
resolution docs not happen before 
an inflammation ceases, and why 
a moisture is not perceivable on the 
skin in an ardent fever, before it is 
upon the decline; it appears, there- 
fore, from this experimental proof, 
which is obvious to every Practitio- 
ner, that in an erysipelas, and in 
every kind of inflammation, the se- 
rous and lymphatic vessels are under 
so great a stricture by an erethism, 
that they exclude all kinds of hu- 
mours, and of consequence all degrees 
of swellings; from thence we may 
see, that it is improbable an inflam- 
mation can take place in these ves- 
sels


83 Of an ERYSIPELAS. 
sels by error of place. For that rea- 
son, we can conclude, that the 
plenitude and derivation of humours, 
which happen upon such occasions, 
take place rather in the sanguiserous 
vessels, or in the cellular membrane, 
or in both together than in the for- 
mer; therefore, it plainly follows, 
from the nature of the serous and 
lymphatic vessels, that our Author's 
doctrine, concerning an inflamma- 
tion of the second order, is contrary 
to experience. 
β. 3. In page 41, we have 
proved, that the blood as being 
grosser than the serum or lymph, 
should come in a greater quantity 
than either of these to an inflamed 
part, and that the thickness of the 
humours in this case, is in propor- 
tion to the force of the inflammati- 
on; these are immediate conse- 
quences of the laws of secretions;
G2 for

84 Of an ERYSIPELAS 
for it is allowed by all Physicians, 
that the motion or force of any or- 
gan in the human body is greater in 
proportion, as it is nearer to the 
heart; therefore, the humours se- 
creted in them will be thicker, ac- 
cording to their distance from that 
center of motion. 
HENCE. may be understood, why 
the urine secreted in the kidnies, 
and the bile secreted in the liver, 
should be much thicker than the 
animal spirits, and the humours 
which in a state of health, pass off 
by sweat and by insensible perspira- 
tion; because these three last are 
secreted by organs much more dis- 
tant from the heart than the liver, 
or kidnies; but the action of the 
solids is preternaturally encreased in 
every inflamed part, therefore, the 
humour derived to it will be thicker 
in proportion to the violence of that 
action;

85 Of an ERYSIPELAS. 
action; but the thicker it is, the 
more it irritates and constringes the 
capillary vessels, until it shuts them 
up so close, that it cannot enter 
their orifices; it follows, therefore, 
from this argument drawn from the 
nature of the fluids, that our Au- 
thor's doctrine, concerning an ery- 
sipelas, or an inflammation of the 
second order, is contrary to experi- 
ence and the laws of secretions. 
β. 4. WHAT I have here asserted 
seems to be confirmed by Fernellius, 
whose book is nothing more (if you 
except his stile and language) than 
a copy of all the antient physical 
Authors, who jointly attribute the 
malignity of inflammatory tumours 
to the greater grossness of the hu- 
mours they contain; it is for that 
reason, they all agree, that a car- 
buncle and a suruncle produce me- 
lancholy effects; because they arise 
G3 from

86 Of an ERYSIPELAS. 
from a gross fervent blood, &c. as 
appears from what follows. 
"CARBUNCULUS ex sanguine ori- 
gin em habet, non eo quidem tenui 
& laudabili, sed crasso ac nigro, ca- 
lido tamen fervente atque corrupto. 
Hic in quamcunque partem invase- 
rit, earn mox exurit, pustulas cir- 
cum se ardentissimas acerrimasque 
ciet, tandemque ardoris vi crusta vel 
nigra vel cinerea obducitur. Huic 
partes vicinæ longo sæpe tractu con- 
sentiunt, caloris dolorisque partice- 
pes: valida quoque febris accersi- 
tur. Inflammata pars nunquam 
suppurat, sed fervore exusta corrup- 
ts carnis lobum tandem excutit, quo 
excidente, ulcus cavum sordidum- 
que manet, hocque uno maxime a 
cæteris sejungitur tuberculis. Car- 
bunculorum alius simplex, qui e solo 
ardore simplicique putredine nasci- 
tur, alius malignus, qui his etiam 
jungit

87 Of an ERYSIPELAS. 
jungit venenatam qualitatem: tails 
in pestilentia grassatur, de quo plu- 
ra proprio loco diximus." 
"FURUNCULUM dothien Græcis 
appellatus tuberculum acutum cum 
inflammatione ac dolore, ovum co- 
lymbinum magnitudine non exce- 
dens. Phymate ergo minus est, sed 
acutius, rubentius, ac dolore gravi- 
us. Phlegmones veram speciem ex- 
hibet, sed ejus exiguæ & quæ vix 
infra cutem descendat, atque sub- 
jectæ carnis minimum comprehen- 
dat. Suppurat furunculus perinde 
atque phlegmone, hincque a sim- 
plici carbunculo discernitur. Fit 
autem non quemadmodum phleg- 
mone e probo sanguine, qui in par- 
ticulam vi quadam irruat: sed e 
crasso & vitioso, non perinde tamen 
atque in carbunculo exusto, quem 
a reliquo puiiore natura secernens 
tanquam insensum atque inutilem
G4 in

88 Of an ERYSIPELAS. 
in corporis summa propellit. Quo- 
circa ut phlegmone multitudinis, sic 
surunculus cacochymiæ saboles est: 
raroque fit ut hie solitarius erumpat, 
sed sere multis corpus scatet atque 
inquinatur." Vide Fernel. De ex- 
tern. Corp. affect. cap. 2. lib. 7. Pa- 
thologiæ. 
The comparison here made by 
our Author, between a carbuncle, 
a furuncle, and a phlegmon, plainly 
shews, that their different degrees 
of malignity and intensity is owing 
to the grossness of the humours, 
from which they proceed; and this 
was not the opinion of Fernellius 
alone, but of all the Antients, from 
whom he copied; therefore, the con- 
clusion we have drawn in β. 2. and 
β. 3. of this section from experience, 
the nature of the fluids, and laws of 
secretions agree with the opinion of 
all the Antients, For which rea- 
son,

89 Of an ERYSIPELAS. 
son, it cannot be supposed, that 
what we say is founded upon mere 
system or hypothesis; for all the 
principles of our doctrine are de- 
duced from reason and experience; 
and indeed, no principle should be 
adopted in physic, which has not 
such a real basis. 
HENCE we may judge, that the 
herpes, the itch, and all the other 
diseases of the skin are produced by 
an effort of nature, to debarrass 
herself of the irritating causes from 
whence they proceed. 
β.5. I have proved above in 
sect. 1. that no obstructions or stag- 
nations can be supposed to take 
place in parts inflamed by the prick- 
ing of a thorn, stinging of Bees, 
Wasps, &c. It should not therefore 
be supposed, that the grossness of 
the humour which is derived to an  
in-

90 Of an ERYSIPELAS. 
inflamed part, is owing to its stag- 
nation, or to the obstruction it meets 
with through the smallest capillary 
vessels, let them be of what kind 
they will. Besides the entrance of 
the humours into these vessels is very 
much hindered by their sensibility, 
which by Boerhaave himself and his 
followers, is judged to be very ex- 
quisite. 
The most minute vessels in the 
human body are employed in the 
secretions and excretions, and par- 
ticularly in those of sweat and insen- 
sible perspiration; and as the func- 
tions of these vessels are most com- 
monly suppressed or interrupted in 
an ardent and in all vehement in- 
flammatory disorders, and the cir- 
culation at the same time is carried 
on in the largest vessels, we may 
lawfully infer that the smallest ves- 
sels in the body are more sensible 
than

91 Of an ERYSIPELAS. 
than the largest; and that it is pro- 
bable the force of a stimulus, be it 
internal or external, sooner invades 
the smallest than the largest vessels. 
As a saburra is sooner felt in the 
head than in the stomach, which it 
immediately vellicates, so, in the 
same manner, an impression made 
in the largest vessels may affect them 
less than their contiguous capilla- 
ries. 
It is thus, the small vessels when 
irritated, sollicit nature to send a 
greater quantity of fluid than usual 
to their neighbouring large vessels, 
which by pressing the Oscula or ori- 
gin of the former causes a stricture 
in them, and an irritation propor- 
tionable to the quantity of fluid, 
which, upon these occasions, is sent 
by the heart to the affected part.  
IT

92 Of an ERYSIPELAS.  
It is thus, the capillaries concur 
by their stricture to form swellings 
in their contiguous large vessels, and 
in the cellular membrane, and ex- 
clude it from their own cavities, 
which is quite contrary to what has 
been hitherto imagined. If the func- 
tions of the capillaries were not thus 
regulated, and if distensions or tu- 
mours could so easily take place in 
them, as most Authors have sup- 
posed, their texture would be soon 
destroyed, all the fluids would ex 
travasate, and put an entire stop to 
the circulation in every inflammato- 
ry disorder. 
β. 7. BOERHAAVE'S doctrine con—
cerning an inflammation of the se- 
cond order is quite inconsistent with 
the mechanism by which the circu- 
lation is carried on in the capilla- 
ries; because the suction and attrac- 
tion,

93 Of an ERYSIPELAS. 
tion, on which it entirely depends 
in these vessels, are much dimmish- 
ed, disturbed, and almost quite 
abolished in some inflammatory dis- 
orders, on account of their stricture 
and erethism, as it is proved in 
β. N°. 1. and 5. of this Section. 
β. 8. BOERHAAVE'S doctrine is 
contrary to the very arguments the 
celebrated Van Swieten produces for 
its proof in § 372. 
The surface of the skin grows 
red in persons who run or walk fast 
(says our Author) and in such as 
cry out loud, or use violent exercise; 
he attributes the redness in these 
cases, to the blood's getting into the 
serous, or lymphatic arteries, and 
from this argument he and all Bo- 
erhaave's Followers conclude that an 
inflammation takes place in these 
vessels by error of place. 
THE


94 Of an ERYSIPELAS. 
THE redness observed in these 
cases is no proof that an inflamma- 
tion can happen by error of place; 
it can only be called at most, a dis- 
position towards that disorder; for 
it is seldom or never attended with 
any pain, and it vanishes according 
as the impression of the stimulus 
ceases, which indeed could not hap- 
pen so soon, if the red globules were 
wedged into the serous or lym- 
phatic arteries, especially if their 
structure is such, as it is represented 
by some of those who defend Boer- 
haave's doctrine, For from every 
secretory organ according to them, 
there spring out canals of such dif- 
ferent structures that through some 
the red globules can pass, whilst the 
white globules only can get into the 
other canals. They say likewise that 
one red globule is equal in bulk to 
six or seven white ones, and that 
sweat and insensible perspiration pass 
out

95 Of an ERYSIPELAS 
out through pores and vesssels of dif- 
ferent kinds or diameters. 
If all that be true, how can it 
be conceived that the red globules 
once impacted in the serous or lym- 
phatic arteries can return back by 
their proper canals into the mass of 
blood? Besides, how is it possible 
that the serous or lymphatic arteries 
can be so much dilated, as to admit 
the red globules of the blood? cer- 
tainly if they did, the redness upon 
these occaions would not so soon 
vanish. 
In all such cases a greater column
of blood than usual is sent to these 
parts to rid them of the irritation 
from which the redness proceeds. 
(See Sect. 2.) And perhaps the dif- 
ference of these vessels is not greater 
than that which is between the pores 
and vessels through which sweat, 
and

96 Of an ERYSIPELAS. 
and the matter of insensible perspi- 
ration do commonly pass; and which 
now by Physicians of the first dis- 
tinction are judged to be the same. 
LEUWENHOECK had discovered by 
the help of his microscope that the 
humour which seemed to be white 
in the capillaries, became red in 
the trunks; therefore we have rea- 
son to think that the redness which 
appears in the skin of those who 
run and use violent exercise, is owing 
rather to a greater column of blood 
than usual, sent thither by the sym- 
pathy of the heart, than to an er- 
ror of place. 
The whiteness of the eyes pro-
ceeds from a flowness of circulati- 
on; but in order to account for it, 
it is not necessary to suppose their 
vessels so small as not to admit the 
red globules of the blood; for if 
it

97 Of an ERYSIPELAS. 
it was so, nature could not conve- 
niently send her universal remedy to 
relieve these organs, upon an emer- 
gency, from any accidents. The 
same thing may be said with regard 
to the whiteness of the skin, which 
is different in sickness, and in a state 
of health, according to the diffe- 
rence of circulation, as it may be 
seen in the same Girl when she is 
well, and when she labours under 
a chlorosis. The greater capacity of 
the vessels hinders not the humours 
they contain from being thin, espe- 
cially, as the vessels of the eye, 
the brain, &c. are at a certain dis- 
tance from the heart. This is easily 
perceived by those who know the 
laws of the secretions. 
HENCE it is probable, that the 
circulation is stronger in a red rose, 
and that it contains a greater quan- 
tity of spiritus rector than a pale
H one,

98 Of an ERYSIPELAS. 
one, and that the difference of their 
colour may be thus accounted for. 
I allow that the vessels which 
we call lymphatics, should be nar- 
rower than those wherein the red 
blood commonly circulates; because 
as the circulation is slow in the 
former, they are seldom alike dis- 
tended with fluids; for which rea- 
son, their sides must certainly ap- 
proach one another, and according 
to the mechanic laws of the secreti- 
ons, they should attract the finest and 
thinest part of the humours; but 
it does not follow from thence, that 
the serous and lymphatic vessels 
cannot at one time admit a greater, 
and at another time a smaller quan- 
tity of fluids; nor does it seem con- 
sistent with the laws of the animal 
oeconomy, that they should be 
otherwise contrived. 
MORE-

99 Of an ERYSIPELAS. 
Moreover we know that the va- 
riety of colours depends upon the 
different reflections or the rays of 
light, and that the difference in 
these reflections proceeds from the 
different configurations of the bo- 
dies which reflect them. From 
hence and from the experiments of 
Leuwenhoeck, it is probable that a 
certain quantity of lymph gathered 
together may assume a red colour. 
Hence it may be concluded, that the 
systems of those who contend, that 
inflammations may proceed from 
the red blood passed into the serous 
or lymphatic arteries by error of 
place, is without foundation. 
β. 9. VAN SWIETEN, for the 
greater proof of his assertion, uses 
also the following argument in §. 
372. If any part of the body, says 
he, is exposed to the vapours of 
warm water, it will swell and look  
H2 red-

100 Of an ERYSIPELAS 
redder than usual, from the ingress 
of the red blood into the smaller, 
relaxed serous or lymphatic arteries; 
from hence he concludes, that in 
inflammations, in the same man- 
ner, these vessels are so relaxed near 
their origin, that the red blood and 
other thicker humours than what 
usually circulate in them, can freely 
enter their orifices, and cause an 
inflammation of the second order. 
CERTAINLY redness in this ex- 
periment does not proceed from a 
laxity of the capillary vessels in their 
origin, but rather from an irritation 
excited by the heat of the water. 
But if the body or any part of it, 
is for a certain time exposed to the 
like vapours, it becomes soft, re- 
laxed and pale. Hence we see that 
some caution and prudence is re- 
quired in the application of such va- 
pours. Besides, as it is proved (page 
76)

101 Of an ERYSIPELAS. 
76) that the capillaries in proporti- 
on to their cavities or diameters are 
stronger than the largest vessels; it 
cannot be supposed that the vapour 
of warm water could so suddenly 
relax them. 
MOVEOVER, as it is allowed, that 
there are blood vessels all over the 
surface of the body, and that they 
are larger than the serous or lympha- 
tic vessels, their tunics also must 
be weaker than those of the latter; 
(page 76) and consequently should 
be sooner and more easily relaxed; 
therefore, as laxity must begin in 
the blood vessels in the above ex- 
periment, their strength must be di- 
minished, and for that reason they 
cannot be supposed to propel the 
blood more than usual into the 
aforesaid vessels; on the contrary, 
they should propel it less than in a 
natural state. It is thus, the large
H3 vessels

102 Of an ERYSIPELAS. 
vessels when relaxed in a dropsy, 
cannot propel the humours to the 
circumference of the body, as ap- 
pears from the dryness of the skin 
in this disorder; therefore, as red- 
ness in the above experiment can- 
not proceed from the greater laxity 
of the serous or lymphatic vessels, 
or even of the blood vessels, it must 
arise from an irritation occasioned 
by the heat of the water. 
β. 10. It is surprising that the red- 
ness of the skin after running, hard 
labour, or violent exercise, should 
be judged by the celebrated Boer- 
haave and Van Swieten, to be a pre 
ternatural state; for it would fol- 
low from thence, that young men 
and all those who are in perfect 
health, and in whom the skin is al- 
ways red, should be in such a state, 
which would indeed be contradicto- 
ry and very absurd. 
I PRO-

103 Of an ERYSIPELAS. 
I propose now briefly to explain 
the nature of an erysipelas. 
An erysipelas is that state of an 
inflammation wherein the affected 
part becomes white, when it is pres- 
sed with the finger; but soon as- 
sumes its former colour when the 
singer is removed. 
A glutinous humour is supplied 
by the sebacious glands to preserve 
the sensibility of the skin, and keep 
it moist, by checking in some mea- 
sure, the egress of the fluid which goes 
off through its pores. This glutinous 
humour being wanting in an erysipe- 
las, the skin is dry and parched, 
and little or no swelling can be 
perceived; because the erethism of 
the vessels is but small, and the mor- 
bisic humours having nothing in 
their way to retard their egress ex- 
hale through the expiring vessels of 
H4 the

104 Of an ERYSIPELAS. 
the skin. It is by the want of this 
glutinous humour that an erysipelas 
differs from a hot oedema. 
In an erysipelas the irritability of 
the skin is much augmented through 
want of the sebacious humour, which 
in a state of health covers the extre- 
mities of its nerves, and defends them 
from external objects. The skins of 
Swans, of the Rhinoceros, and those 
of all amphibious animals, are co- 
vered with so large a quantity of this 
humour, that water cannot easily pe- 
netrate them. The bladder, the in- 
testines, the mediastinum, pericardi- 
um, with all the membranes which 
line the different cavities of the hu- 
man body, are covered with a humour 
not very unlike the sebacious. The 
nature of this humour may be better 
understood from what I shall in the 
sequel quote from Dr. Sauvage, when 
I come to treat of a scirrhus. 
IT

105 Of an ERYSIPELAS. 
IT may hence, in the mean time, 
be understood why the intestines 
sometimes by the force of an inflam- 
mation rather grow dry than swell; 
the same thing happens not only in 
these organs, but in every other part 
of the body, when the extremities 
of the expiring vessels are not co- 
vered with this fort of humour. 
But we are to remark, that the ex- 
travasated fluids cannot pass through 
these vessels, when they are inspis- 
sated by the force or duration of 
the disorder, as I am to shew when 
I come to treat of suppuration. 
SECT.

106 Of an OEDEMA. 
Sect. III. 
Of an OEDEMA. 
“UT pituita alia tenuis, aquosa, 
aut mucosa existit, alia cras- 
sa & glutinosa, cujusmodi est quæ 
vitrea aut gypsea appellatur: ita ne- 
cesse est varies ex hac collecta nasci 
tumores. Ac primum quidem oede- 
ma tumor est frigidus, laxus ac mol- 
lis, doloris expers. Nec calor, nec 
rubor, sed vel genuinus vel albidus 
duntaxat color inest: tumor sæpe 
magnus & qui presso digito, vel nullo 
vel exiguo dolore cedit. Est autem 
duplex: unus collectus & circum- 
scriptione definitus, qui proprie ac 
simpliciter oedema nuncupatur: al- 
ter diffusus & expansus, qui rectius 
tu-

107 Of an OEDEMA. 
tumor est oedematosus. Hic ex cru- 
diore pituitosoque sanguine, aut je-
coris aut assumptorum vitio progig- 
nitur, qui in nutriendas partes il- 
lapsus, nec in earum substantiam 
conversus, sensim cumulatus redun- 
dat partemque tumore distendit, ac 
fere retinet prementis digiti vestigi- 
um. Ita sane in tabe, in cachexia 
& in leucophlegmatia, modo pedes, 
modo reliquum corpus omne tumi- 
dum evadit. Verum autern & ex- 
quisitum oedema non ex sanguine 
pituitoso, sed ex pituita fit super- 
vacanea, quæ solum vel aquosa, vel 
mucosa sit, undecunque illa in af- 
fectam partem deferatur. Fere ta- 
men e capitis distillationibus huic 
origo est, quæ sæpe in genua, inter- 
dum in humeros aliasque partes de- 
cumbit.”* 
* Vide Kernel De extern. corp. affect. cap. 3. lib.
7. Pathologiæ. 
Φ. 1.

108 Of an OEDEMA. 
Φ 1. As an oedema may proceed 
from two sorts of humours, so it is 
distinguished by Fernellius into two 
kinds; the one which proceeds from 
a watery humour, and called by our 
Author a true oedema, to which 
may be referred cold swellings, a 
dropsy, for example, an anasarca, 
&c. and the other kind which arises 
from a fort of thick glutinous phlegm, 
called glassy or plastic. The Anti- 
ents believed this sort of matter to 
be a black kind of bile, or a burnt 
sort of blood; but our Author sup- 
poses it to be a superfluous blood, 
which nature not being able to assi- 
milate sufficiently to nourish the 
body, throws out on the surface of 
the skin, where it produces a hot 
oedema; and the glutinous matter 
which covers the skin in this disease, 
may be reckoned the principal cause 
why the humours are collected in 
the cellular membrane in inflamma-
tory

109 Of an OEDEMA. 
tory disorders; for when that matter 
is wanting, they pass out through 
the pores, as in an erysipelas. 
Φ. 2. Our Author does not clearly 
shew the difference between a cold 
and a hot oedema; the latter is di- 
stinguished from the former by its 
heat, and the pain which is felt 
when the affected part is pressed; 
besides it yields not so easily to the 
touch, as in a cold watery oedema, 
in a leucophlegmacy for example, 
or in an anasarca; neither does the 
skin retain the impression of the fin- 
ger so long as in these cold disor- 
ders; but still longer than in an 
erysipelas, nor is the colour of the 
part changed unless there is a diape- 
desis. 
Φ. 3. I SHALL shew when I come 
to treat of suppuration, that an in- 
flammation is most commonly oede-  
matous,

110 Of an OEDEMA. 
matous, and that one method of 
cure may be sufficient in a phleg- 
mon, an erysipelas and a hot oede- 
ma. It can hardly be understood 
from our Author how a hot oedema 
can be inflammatory; for he seems 
to attribute it to bad digestion or 
the disorders of the liver; however, 
it is reckoned a true inflammation 
by Van Swieten, in § 380 of Boer- 
haave's aphorisms. 
From the observations I made in 
the Hospitals of Paris, I found that 
a great number of Patients when 
weakened by the duration of their 
ailments, were wont to complain of 
an intolerable pain all round the ab- 
domen, and in three or four days af- 
terwards to have its whole cavity 
distended with fluctuating water. 
I also observed, that others com- 
plained of the like pain in the in- 
ferior extremities, before the water 
descened

111 Of an OEDEMA. 
descended to the legs and feet. I 
have seen others recover from drop- 
sies by taking antiphlogistic purges 
after bleeding. 
WE are to remark also, that the 
celebrated Dr. Mead, cured an hy- 
dropick Patient by narcotics. Willis 
employed them also with success in 
a similar case, and the learned Spon 
cured an hydropick by twenty bleed- 
ings.* 
THESE facts being premised, and 
the simplicity of nature in her ope- 
rations being attended to, quere, 
whether there be any analogy be- 
tween a cold and a hot oedema, and 
whether they both proceed from 
similar mechanisms? Certainly the 
symptoms which precede the ingress 
of the serum into the cellular mem- 
brane are not very unlike those which 
* See Medical Precepts, by Richard Mead, M. D, 
chap. 8. 
are

112 Of an OEDEMA. 
are observed before suppuration takes 
place. In both cases, to be sure, 
nature struggles as much as possible, 
before she admits the humours into 
the cellular membrane, and com- 
monly the resistance upon these oc- 
casions is very great, especially in dry 
melancholick habits, as I have ob- 
served very often. I attributed the 
dropsy of this class of Patients to 
spissitude and want of serum in the 
mass of blood occasioned by an ex- 
cess of perspiration, which some- 
times happens to be so immoderate- 
ly great in this sort of People, that 
the blood is so much deprived of its 
vehicle, that it cannot furnish the 
minute ramifications of the nerves 
or lymphatics, with a sufficient quan- 
tity of the fluids to which they are 
distined. Hence the force of the 
solids is diminished which occasions 
a lentor, weakens digestion, and 
brings on a dropsy. 
A

113 Of an OEDEMA. 
A HOT oedema arises from a co- 
lumn of humours preternaturally 
encreased and distending so much 
the sides of the vessels, that it causes 
pain. If the distension and pain 
continue for any time, the vessels 
lose their tone and contractile force, 
the pores are enlarged and a free 
passage opened for the humours into 
the cellular membrane. 
ALMOST the same thing is ob- 
served to happen in a cold oedema; 
for the vessels being too much com- 
pressed by a superabundant quantity 
of serum, the Patient feels great 
pain, or a very considerable anxiety, 
until at last, the vessels deprived of 
their tone and contractile force per- 
mit a free passage to the serum into 
the cellular membrane, or into the 
other cavities of the body.  
I FROM

114 Of an OEDEMA. 
From hence we may see, that the 
vessels and pores can be dilated by 
too much motion or by too much 
laxity. The last case is quite fo- 
reign to my subject; I only mention 
it, in order to take away the equivo- 
cation which might arise from a cold 
and a hot oedema. I proceed now 
to shew the defect of Boerhaave's 
doctrine concerning the latter. 
A HOT oedema, according to 
Boerhaave, takes place in the lym- 
phatic arteries nearer the apex of the 
cone than an erysipelas, and in that 
they differ from one another; be- 
hides the blood has no share in pro- 
ducing this sort of oedema. 
AN oedema is the second species 
of inflammation of the second order 
according to our Author, I have 
proved in sect. 2. β. N°. 1, 2, 3, 4,
5, 

115 Of an OEDEMA. 
5, 6, 7, 8, and 9, that it cannot 
possibly exist. 
ALTHOUGH it is evident from 
what has been said in sect. 2, that 
nature cannot send a particular hu- 
mour different from the blood to 
form an oedematous swelling; yet I 
will for a moment admit the sup- 
position and reason in consequence 
of the following quotation, wherein 
Boerhaave maintains the lymph to 
be the quintessence of the blood. 
“Aquosior, fluidior, salina, spirituo- 
sa portio cruoris sic separatur ab ar- 
terioso sanguine ope glandularum, 
quæ vadit in vasa minima ad motum 
& nutrimentum; reliqua pars cras- 
sior, rubra venis redditur sensim lati- 
oribus fine obstructionis metu; ergo 
cruor arteriosus primo venoso dilutior 
magisque lymphaticus, cujus effectu 
vasa majora aperta tenentur, robur 
corpori datur, materies constantiori  
I2 resectui

116 Of an OEDEMA. 
refectui servatur, sed inde venoso 
cruori dilutionis necessitas, ut fluat, 
iterum per arterias minimas pulmo- 
nales aliasqou: hocce effectu lympha 
glandulis secreta functa suo munere 
et circuitu redditur immediate vel 
per ductum Pequeti ante novum in 
cor ingressum.” * 
As it appears from hence, that 
the lymph is accounted by Boer- 
haave to be the most spirituous part 
of our fluids, and to be the chief 
agent of nutrition and animal mo- 
tion, its quantity with regard to the 
other humours, should be very small, 
and the vessels which contain it 
should be also small in proportion, 
if compared with those which con- 
tain the rest of the humours. For 
the same Author asserts in his chy- 
mistry, by the authority of Mr. 
* Vide Institut. Med. § 209. Boerhaavii. 
Boyle,

117 Of an OEDEMA. 
Boyle, that the spiritus rector of the 
plants is not equal to the 1/100,000 part 
of the water or vehicle which con-
tains it. May not therefore the same 
thing be said of the lymph, which 
the former accounts to be as it were 
the spiritus rector of the human bo- 
dy. It is well known, that there 
are many pellucid tumours, called 
lymphatic, which contain upwards 
of 9 or 10lb. of fluid, and the 
muscular motion at the same time 
not in the least impaired. Now 
I ask of those who defend our Au- 
thor's doctrine, from whence such 
a prodigious quantity of lymph can 
come? From whence so much quin- 
tessence in the blood? To pretend 
that such an accumulation of fluid 
could be furnished by the lymph, 
or from a rupture of its vessels would 
seem altogether absurd; besides, 
how is it possible that the blood ves- 
sels could remain quiet and easy, 
I3 and 

118 Of an OEDEMA. 
and make a truce, as it were, with 
the morbisic matter during the time, 
which a swelling of so prodigious a 
size requires to its formation? There- 
fore, it does not seem reasonable, 
that nature can send any kind of hu- 
mour preferable to the red blood to 
form a hot oedematous swelling. 
Indeed it is more likely that the 
blood, the pus and ichor with all 
the diversity of humours which are 
found in such swellings, are engen- 
dered by the heat, pulsation and pain 
of the affected part. Moreover, 
this sort of swelling comes on sud- 
denly, an instance of which sell 
lately under my own observation, 
when a white pellucid tumour of a 
surprising bigness, I perceived to 
arise round the knee in the space of 
one night. Such a swelling could 
not certainly proceed from the 
lymph. 
THE

119 Of an OEDEMA. 
THE Antients attributed oedema- 
tous swellings to an atrabiliary hu- 
mour. Modern Authors thought it 
was easier to keep this opinion in 
view with a little conjectural altera- 
tion, than to make observations of 
their own. It is for that reason, 
Boerhaave attributed this disorder to 
the serum or lymph, and banished 
the term atrabilis. But as most of 
the Antients understood by this 
term, fæx sanguinis, that is the dregs 
of the blood, it was more likely to 
produce a hot oedema, than the se- 
rum or lymph. 
THE term atrabilis, or fæx sangul- 
nis, should not be intirely expunged 
put of physic; because, in the sense 
of the antient Physicians, it compre- 
hended many ideas; for they were 
so exact in distinguishing the diffe- 
rent constitutions of their Patients, 
that they called one constitution,
I4 phleg-

120 Of an OEDEMA. 
phlegmatic, the other sanguine, &c. 
Such as they found of a dry hot 
constitution, thoughtful, lively, and 
given to speculation, they called bili- 
ous. Indeed they were not much mis- 
taken in their account, for these Peo- 
ple commonly perspire so much, that 
their blood, not having a sufficient 
quantity of vehicle or serum, pro- 
duces heat, costiveness, and an al- 
kalescence of the bile, from whence 
inflammatory disorders very often 
proceed. Tumours arising in such 
habits, were supposed by the Anti- 
ents to proceed from an atrabilis or 
fæx sanguinis, that is a thick hot 
kind of humour wherein the bile 
had a share. Hence we see, that 
the Antients, though unacquainted 
with the true mechanism of secre- 
tions, were persuaded that the gross- 
est part of the humours was derived 
to inflammatory tumours, (β. 2, 3, 
sect. 2.) 
THE

121 Of an OEDEMA. 
THE extremities of the nerves all 
over the body, are covered with a 
mucous or glutinous humour, like 
that which the sebacious glands sur- 
nish for the cuticular nerves. The 
more this humour abounds in the 
cellular membrane, the more the 
fluids derived by the force of an in- 
flammation to that membrane, shall 
be detained, and of consequence the 
swelling shall be greater; but as this 
glutinous humour is seldom wanting 
in the cellular membrane, or in the 
surface of the skin, so also an in- 
flammation seldom happens which 
is not oedematous. 
As the thinnest fluids, upon these 
occasions, are very requisite to extin- 
guish heat, and prevent concretions, 
quere, whether this glutinous hu- 
mour, and the stricture of the ca- 
pillaries were not providentially con- 
trived to detain them in the body? 
IN

122 Of an OEDEMA. 
In some consumptive habits whose 
humours are very acrid, dry, and in- 
spissated, whose vessels are almost 
empty, and in whom the force of the 
heart is very small, little or no oedema 
or tumour can be perceived, altho' 
the ulcers, which spread over their 
legs, thighs and other parts of their 
body, are evident signs that they la- 
bour under a very severe inflamma- 
tion. No swelling appears in these 
cases, perhaps, because the sebacious 
humour is defective, being consumed 
by the long duration of the disease.
The diversity of heat observed in 
inflammatory tumours, consists in 
the different degrees of coction of 
the morbific matter, whereof I am
to speak more at large, when I come 
to treat of suppuration. 
I MAKE no doubt, but that several 
Persons, as well as myself, have ob- 
served


123 Of an OEDEMA. 
served a phlegmon on its decline, to 
assume successively the forms of an 
erysipelas and oedema, and by nature 
or art soon to vanish; which would 
not certainly happen so soon, if they 
proceeded from an inspissated blood, 
serum, or lymph wedged, if I may 
use such an expression, into the 
smallest vessels. 
For which reason, as these diffe- 
rent appearances of an inflammati- 
on are known to arise successively 
in the same place, it seems very cer- 
tain, that they proceed from the 
same cause, namely, from the same 
kind of humours, in the same series 
of vessels, and that they are nothing 
else, but the different degrees of in- 
tensity of the same disease. Besides, 
it is known by experience, that they 
are cured by the same remedies, 
which sufficiently confirms the truth 
of what we have advanced upon 
this

124 Of an OEDEMA. 
this article; therefore it is quite 
needless to place those three appear- 
ances of an inflammation in three 
different sections of a cone, and to 
attribute each of them to a particu- 
lar humour, and indeed it is quite 
contrary to what any Physician or 
Surgeon will find verified by obser- 
vation in his own practice.
SECT.

125 DIAGNOSTIC SIGNS. 
Sect. IV. 
Of the DIAGNOSTIC SIGNS 
OF AN 
INFLAMMATION. 
1. THE Diagnostic signs of an 
inflammation may be taken 
from its definition, page 19, and 
from its effects, (chap. I. sect. I. β. 
N°. 4, 5, 6, 7, 8,) and its different 
names are known from the different 
parts wherein it takes place. Φ. 4. 
sect. I. chap. I. 
PROGNOSTIC SIGNS. 
The dignity of the affected part, 
the greatness of the swelling, the 
con-

126 PROGNOSTIC SIGNS. 
constitution of the Patient, and 
the intensity of the symptoms 
will declare the future event of an 
inflammation. Therefore, if the 
Patient is conscious that his humours 
are not vitiated by the pox or scur- 
vy, scrophulous diseases, &c. that 
the phlegmon has not penetrated 
deep into the parts under the skin, 
we may safely say, that it is void of 
danger, and that it is like to termi- 
nate by resolution, or at least by a 
laudable suppuration. 
WHEN the parts attacked by a 
phlegmon, are of a firm texture, 
and have but a small quantity of 
vessels, such as the ligaments and 
glands, the cure is tedious, and sup- 
puration cannot be brought on with- 
out much difficulty. 
The danger is greater or smaller 
according to the pain, heat, pulsati- 
on,

127 PROGNOSTIC SIGNS. 
on, &c. and according as the vas- 
cular system of the Patient is more 
or less irritable. If these symptoms 
are lessened by degrees without leav- 
ing a hardness in any glandular part, 
it is certain, that the disorder will 
not degenerate into a scirrhus. But 
if these symptoms cease suddenly, the 
epidermis is raised into blisters full 
of ichor, or sinks, and the colour 
of the part becomes black, or livid, 
whilst the pulse at the same time is 
but small, the urine and excrements 
become fetid, and the sensibility of 
the affected part is intirely abolish- 
ed, it is most certain, that a gan- 
grene is approaching or already 
begun. When a glandular part, 
after the symptoms are lessened by 
degrees, becomes hard and resisting 
to the fingers, a future scirrhus is to 
be foretold. The phlegmons which 
take place in the eyes, throat, 
ten-

128 The CURE 
tendinous, or nervous parts, are to 
be accounted dangerous. The deep- 
er the phlegmon penetrates into the 
affected part, the harder it is to be 
cured. 
Sect. V. 
Of the CURE of 
INFLAMMATIONS in GENERAL. 
THE indication of cure for this 
disorder, directs the use of all 
such means as may tend to lessen the 
erethism of the vessels, and to abate 
the encreased velocity of the fluids. 
These are both lessened, or some- 
times totally cured by venesection, 
mild purges, diluents, acids, oily, 
mucilaginous, and narcotic medi- 
cines prudently administered.
1. THE

129 Of INFLAMMATIONS. 
1. The diet should be diluent, le- 
nitive, and cooling; Blood should be 
drawn in proportion to the fluxion, 
the intensity of the pain and other 
symptoms, and according to the 
strength of the Patient; large 
draughts of barley water, rice water, 
with nitre from ℈j to ʒj to every 
pint, also maiden-hair tea, whey and 
other liquors of the same class, are 
very efficacious. 
The emulsio communis of the 
London pharmacopœia is excellent 
upon these occasions; but it will 
become more agreeable, if instead 
of gum arabic, you substitute the 
four great cold seeds of each ʒj. 
If the emulsion should weaken 
the stomach, you may in its stead 
use barley water, aromatized with 
some agreeable herb, and sweetened 
with the syrup of maiden-hair. 
K IF

130 The CURE 
IF the emulsion does not pass off 
freely by urine, a proper dose of 
nitre may be added to it occasional- 
]y; for as no salt diffuses itself in 
any fluid so much as nitre, it must 
be very efficacious, by exciting gent- 
ly the contractions of the vessels, to 
prevent the concretions of the ani- 
mal fluids, in an inflammatory state; 
but it must be taken with a sufficient 
quantity of drink; otherwise it may 
irritate the viscera, and particularly 
the kidnies and urinary ducts. Most 
commonly it carries its action upon 
the latter, and when it does, we may 
generally expect good effects from its 
operation; but in the disorders of 
these parts, we are to be cautious, 
least it should irritate too much; it 
should therefore be given in small 
doses, in these cases, especially by 
young Practitioners, who have not 
skill or experience enough to form 
a

131 Of INFLAMMATIONS. 
a judgment concerning the sensibili- 
ty of the Patient. 
WE may be assured, that nitre ir- 
ritates, if, when it is administered 
in proper doses, the quantity of 
urine compared with that of the 
drink, is too small. 
2. AFTER bleeding in the foot, 
or in the jugular vein, and admi- 
nistering a gentle purge to clear the 
primæ viæ, a semicupium of warm 
water will sometimes ease inflamma- 
tions of the head; for by the heat 
of such a bath, a great quantity of 
humour is derived from it to the in- 
ferior extremities, by which means 
their column and quantity is lessen- 
ed in the vessels of the brain, and 
of consequence their irritation and 
erethism. A small inflammation of 
the brain is thus very often cured. 
A warm bath is no less efficacious 
K2 in

132 The CURE 
in curing inflammations in other 
parts of the body. For the fibres 
grow hard in this disorder, it is no 
wonder, therefore, they should soften 
with warm water, when the very 
horns of Deers may be rendered as 
soft as jelly, by being exposed to its 
vapours. A vapour bath, and fo- 
mentations produce the like effect, 
especially when they are more or 
less impregnated with emollients and 
aromatics, or with acids. Fomen- 
tations of warm milk may be or- 
dered for the same end, with great 
success, or a decoction of the root 
of althea, applied warm. A poul- 
tice made of ground linseed, or a 
fomentation made of its decoction 
will answer the same end. 
AFTER employing baths, vapours, 
or fomentation, the following to- 
pics may be used.
3. OINT-

133 Of INFLAMMATIONS. 
3. OINTMENTS, sweet oils, lini- 
ments, anodyne pultesses, made up 
with bread and milk, the oil of 
olives, linseed oil, and saffron, or 
diascordium, applied outwardly will 
contribute to lessen the erethism, not 
only of the external parts, but also 
of the internal viscera of the abdo- 
men, and of the thorax. The oint- 
ments of althea and elder, the oil 
of olives, either jointly or separate- 
ly, in equal quantities, may be ap- 
plied to the side; for example, in a 
pleurisy. The following fomenta- 
tion may be applied in the same 
case. Take four ounces of the tops 
of white poppies, boil them in two 
quarts of common water, until they 
are reduced to one, drain, and add 
two ounces of vinegar; make a fo- 
mentation to be applied to the af- 
fected part. 
K3 4. IN

134 The CURE 
4. In an erethism of the throat, 
oily potions, with some gentle nar- 
cotics, may be given with success. 
INFLAMMATIONS of all parts of 
the body are cured after the same 
manner, but we should have regard 
to the structure, situation, and con- 
nection of these parts, to the ante- 
cedent causes of that disorder, and 
to the constitution of the Patient. 
IT is certain, that the fibres grow 
hard by the force of the erethism, 
and by that means lose their flexibi- 
lity; therefore, to bring them to 
their former state, it is necessary to 
use a great quantity of oil, especi- 
ally in the inflammations of the 
primæ viæ; but regard must be had 
to the strength of the stomach and 
constitution of the Patient; for they 
are not to be given to such as are of
delicate habits, without some pre- 
caution,

135 Of INFLAMMATIONS. 
caution, and if they do take any 
oily medicine, it should be mixed 
with some agreeable aromatic or sto- 
machic distilled water. Dispensato- 
ries abound so much with receipts 
of this kind, that it is needless to 
insert any here. 
As it is necessary to keep the bo- 
dy open, the decoction of tamarinds 
or prunes, lenitive electuary, salts 
and manna, &c. &c. should be given 
or administered either in a draught, 
or in the form of a glyster. 
The primæ viæ being thus cleared 
of all sordes, by the foregoing me- 
dicines, absorbent draughts, such as 
the decoctum album, or julap cre- 
ta of the London Dispensatory, are to 
be prescribed in the inflammations 
of the intestines, as often as they 
proceed from any vellicating acrimo- 
nious leven; and if the Patient finds 
K4 ease

136 The CURE 
ease by them, he is to use them 
plentifully, and afterwards to take a 
gentle purge. In the same case 
glysters are very efficacious. 
GLTSTERS are of great service in 
inflammations of all parts of the 
body, because they derive a great 
quantity of humours to the intestines, 
and because they pass immediately 
into the vessels without weakening 
or fatiguing the stomach. 
NOURISHING glysters are to be in- 
jected, when the functions of the 
organs of deglutition are disordered, 
or weakened, or when, on account 
of a violent vomiting, the aliments 
are rejected by the stomach. Often 
have I seen life supported a long time 
by this means. 
5. IF by too rapid a motion ex- 
cited by an inflammation, the hu- 
mours

137 Of INFLAMMATIONS. 
mours are so much rarefied, that 
they occasion a false plethora, we 
must have recourse to acids. No 
Physician doubts, but volatile alka- 
lies, by the force of inflammations 
are produced in the human body, 
and as a sulphureous principle makes 
no small part of the composition, 
they powerfully dissolve the blood. 
WE are taught by chymistry, that 
acids have a great affinity with vo- 
latile alkalies, whose smell is owing 
to their combination with sulphur; 
hence it is probable, that acids taken 
inwardly, by uniting with the vola- 
tile alkalies, (which by the force of
the disorder, may be extricated from 
the mass of blood) blunt their sti- 
mulus, lessen the erethism, and pre- 
vent the dissolution of the humours. 
FROM hence, and from the answer 
given to the fifth objection, β. 4. 
chap.

138 The CURE 
chap. 2. it is probable, that the par— 
ticles of the fluids are attracted to 
one another, by the help of acids, 
and that their action against the 
sides of the vessels must necessarily 
be lessened by these means. Be- 
sides acids powerfully dissolve the 
particles of tartar, which sometimes 
get into the mass of blood. From 
all which it is easy to judge why 
acids are so efficacious in the cure 
of inflammations. 
6. IF the greatness of the pain 
hinders the Patient to sleep, he is 
to be ordered some preparation of 
opium, and after bleeding, diluting 
and evacuating the faburra of the 
primæ viæ, with a gentle purge pre- 
pared with manna, tamarinds, and 
some neutral salt. It is certain, that 
the impression made by narcotics, in 
the parts which they immediately 
touch, soon abates the sensation of 
pain wherever it takes place, and this 
must

139 Of INFLAMMATIONS 
must be owing to the sympathy 
which subsists between the different 
parts of the human body, and not 
to the immediate application of these 
medicines, a truth I have seen ve- 
rified in many instances. 
NARCOTICS taken in the mouth, 
or in glysters, soon stop or abate 
pain in any part of the body, as 
every one of the Faculty must have 
experienced. It is impossible that 
could be effected in so short a time, 
by an immediate contact; there- 
fore the impression made by them in 
the stomach or intestines, is such, 
that it is soon communicated to the 
whole nervous system; whether that 
impression is pleasing or irritating, 
we are quite at a loss. If a young 
tame, well fed Quadrupede is gently 
stroked in any nervous part by a 
Person with whom he is familiar, he 
stops,

140 The CURE 
stops, and is put into such an extar- 
sy, that he throws himself some- 
times on the ground, and, if the 
stroking is continued, falls a sleep, 
of which I have myself seen many 
proofs made in animals of different 
kinds. It is surprising how variously 
the nerves are affected, not only by 
inward and outward applications, but 
by different sounds. Music touches 
the ears of most People very agreeably, 
and the young more than the old; as 
we may observe in Children, in whose 
tender nerves such a pleasing motion 
is excited by the songs or humming 
of their Nurses, that they generally 
fall asleep; the bag-pipes have the 
effect of a diuretic on some People, 
according to the testimony of Dr. 
Whytt, in his treatise on animal mo- 
tion. Good news moves the nerves 
of some individuals so pleasantly, that 
they die in an extasy of bliss, and the 
death occasioned by too great a dose 
of narcotics is equally pleasant.
BUT 

141 Of INFLAMMATIONS. 
But we cannot infer from these 
similar effects, that the pleasant sleep 
procured by narcotics is owing to a 
pleasing impression. 
I HAVE proved by a great num- 
ber of experiments, that pain in 
People of all ages, can be stopped 
by an immediate application of nar- 
cotics to the affected part. Is it 
not, therefore, beyond all doubt, 
that an impression made by these 
medicines in any part of the body, 
is communicated to the whole ner- 
vous system? 
ALTHOUGH narcotics seldom fail 
to abate pain in robust habits, they 
should not be administered to weak 
and delicate People, without a great 
deal of prudence and precaution; 
especially if they are not accustomed 
to take such medicines; for accord- 
ing to the proverb, natura consuetis 
gaudet, custom becomes a second na- 
ture 

142 The CURE 
ture. It is thus the. Turks accus- 
tomed to take opium from their in- 
fancy, use it instead of spiritu- 
ous liquors, to get drunk before they 
go to battle. 
ABOUT the last stage of an in- 
flammatory disorder, the theriaca of 
Andromachi, may be given from 
℈j to ʒj. when the Patient is rest- 
less, especially if the skin begins to 
grow moist. But if it it be neces- 
sary to sollicit the oscillations of the 
vessels, Dr. Huxham's essence of 
antimony, may be given from 6 to 
30 or 60 drops, in a glass of wine, 
or in a dish of tea. If a gentle to- 
pic medicine is wanting, the saline 
mixture of Riverius, with an addi- 
tion of a little cinnamon, or nut- 
meg water may answer that end. 
By the help of these medicines, 
and others, taken occasionally from
the 

143 Of INFLAMMATIONS. 
the class of stomachics and cordials, 
we can rouse up the decaying strength 
of the Patient, disperse beginning 
obstructions, and prevent their fu- 
ture growth. 
By the application of baths, va- 
pours, liniments, and such like to- 
pics, as we recommended above, it 
may happen, that an erethism may 
be intirely cured, and the preterna- 
tural velocity of the fluids lessened, 
and brought to its due degree of 
uniformity in the affected part. 
The humours which were propelled 
by the force of the erethism into 
the cellular membrane, find by these 
means, a free passage to run back 
by the inspiring vessels into the mass 
of blood, or to exhale through the 
expiring vessels by the pores of the 
skin; and though the erethism 
of these parts may not be overcome 
by topics, as it happens very often, 
espe-

144 The CURE 
especially when proper internal
medicines are not ordered at the 
same time, and when the strength 
of the Patient is too great, we have 
still this advantage, that the texture 
of the skin is so much softened by 
the use of topics, that the extrava- 
sated fluids can easily pass out thro'
its pores. 
By a skillful and timely applica- 
tion of medicines, not only an infi- 
nite number of abscesses, but loss of 
limbs, and fatal ulcers may be pre- 
vented, and it is only by a perfect 
knowledge of physic, we can be 
directed how to act in such cases. 
ANY impartial judge must own, 
that the remedies prescribed in this 
section, directly answer the indica- 
tions which I have drawn from the 
essence or prime attributes ol an in- 
flammation. 
BUT

145 Of INFLAMMATIONS. 
But should any one take the in- 
dications of an inflammation, for ex- 
ample, from the proximate causes 
to which it is attributed by Boer  
haave and Van Swieten, in aph. 371. 
he might try many useless experi- 
ments, and do the Patient more harm 
than good. This will appear more 
clearly in the following chapter. 
L CHAP.

146 The Indications 
CHAP. II. 
Which proves the curative indications of an 
inflammation to be repugnant to Boerhaave's
doctrine, aph. 371. 
According to our Author, an in- 
flammation proceeds from a 
stagnation or siziness of the blood, 
serum or lymph in the capillary ves- 
sels. If it did, the medicines which 
are properly called aperients, and atte- 
nuants; sassafras, for example, lig- 
num guaiaci, and such drugs as en- 
crease the blood's motion, would be 
very efficacious in the cure of this 
disease, even in its increase and vi- 
gour. On the contrary, acids by 
coagulating the blood, and lessening 
its motion, would be hurtful, and 
emollients would be no less prejudi- 
cial, because the capillary vessels in 
that

147 Of an INFLAMMATION.  
that hypothesis, would be so much 
distended by the accumulated fluids, 
as to be in a proximate state to a 
rupture, which would soon be com- 
pleated by the softening quality of 
such medicines; but the contrary 
evidently happens in practice; for 
emollients and acids are prescribed 
with success, to diminish the stric- 
ture and erethism of the vessels 
in an inflammation; for which rea- 
son, it may be justly concluded, that 
Boerhaave's doctrine is contrary to 
the curative indications of that dis- 
order. 
β. 4. SOME unexperienced Gen- 
tlemen, who consider the materia 
medica by the lump, and have no 
certain rule to guide them therein, 
may object, that attenuants and ape- 
rients, are really efficacious in in- 
flammations. 
L2 I

148 The INDICATIONS
I own, that aperients and atte- 
nuants are sometimes useful towards 
the last stage of the disorder, and 
that by a proper application of them 
at that time, obstructions and scir- 
rhi are very often prevented; but, 
I deny that they can be useful in 
the vigour and encrease of this di- 
sease, for by irritating the solids with 
the hard particles upon which their 
virtue depends, and by which they 
procure heat, they would entertain 
and encrease the erethism of the 
vessels. 
β. 5. Many will object, that ve- 
getable acids, far from coagulating 
the blood, dissolve it. 
ALL Physicians agree, that acids 
are cooling, but they cannot cool a 
living body, without diminishing 
the action and re-action of the solids 
and fluids; therefore a lentor must
necessarily 

149 Of an INFLAMMATION. 
necessarily follow an immoderate use 
of acids, whether taken as aliments 
or as medicines. For the blood 
must contain the principles of our 
food, according to the axiom, 
principiata redolent naturam princi- 
piorum, and the chyle, by heat as 
well as by want of motion, grows 
acid; besides it affords a great quan- 
tity of it by a chymical analysis. 
But acids in general have a proper- 
ty of coagulating; therefore it can 
be asserted, that the chyle and blood 
resulting from a lentor occasioned 
by an immoderate quantity of acid 
aliments, are apt to coagulate and 
form concretions. Every one may 
with me have observed, that those 
who make an immoderate use of fari- 
nacious food or acescent vegetables, as 
rice, oat meal, peas, beans, &c. in pap, 
or lemons, oranges, limes, with all 
other kinds of fruit, look pale, have 
bad digestion, are subject to obstruc- 
L3 tions,

150 The INDICATIONS. 
tions, bilious fevers, and other dis- 
orders of the liver, which are re- 
moved chiefly by the use of alkalies, 
purges and absorbents. The truth 
of what is here advanced, will be 
allowed and confirmed by any one 
of the Faculty who has been in Ja- 
maica, or in the other Southern 
islands of America, where the inha- 
bitants, by using too much fruit or 
an acescent diet, are universally sub- 
ject to the disorders which proceed 
from a superabundance of bile. 
WHAT I have said concerning ve- 
getable acids, is contrary to Van 
Swieten's commentary on aph. 117. 
of Boerhaave. Indeed, what is there
affirmed by this celebrated Author, 
is not conformable to experience, for 
he puts wine, vinegar, milk, and 
fruits of all kinds in the same class, 
and says, that they all dissolve the 
blood very powerfully, I am per-
suaded,

151 Of an INFLAMMATION. 
suaded, that this mistake is to be at- 
tributed rather to a slip of the pen, 
or a fault of the Printer, than to our 
Author. For it is well known, that 
very few Physicians in Europe excel 
him in his knowledge of the materia 
medica. 
I ALLOW that fruit and vegetable 
acids are very efficacious to lessen 
the stimulus of the blood, and that 
by an immoderate use of them, it 
may be taken away intirely; but in 
a short time they generally engen- 
der in its place a more hurtful stimu- 
lus; for when they are used as ali- 
ments for too long a time, they sup- 
ply a bad acescent chyle, which may 
pass in the meseraic veins to the li- 
ver, in so great a quantity, as to 
thicken the bile, take away its ac- 
tivity, and render it partly or alto- 
gether unfit to dissolve and combine 
the different elements of the chy- 
L4 mus;

152 The INDICATIONS 
mus; from whence proceeds bad di- 
gestion, bad chyle, bad blood, and 
a lentor, which bring on obstructi- 
ons, concretions, irritations and co- 
lics, with the other evils which arise 
from such complications. 
It may not be foreign to our sub- 
ject, to observe in this place, that 
acids are recommended by Galen to 
cure the scirrhi of the viscera, but 
he ordered them to be mixed with 
aromatics or with bitters; but what 
results from such a mixture, is in- 
tirely different from vinegar, for ex- 
ample, or any other acid, and for 
that reason, possesses different pro- 
perties, and produce different ef- 
fects. Many Physicians give vine- 
gar plentifully as an attenuant in all 
obstructions, and in a moist or dry 
asthma. I allow that vinegar acts, 
sometimes as an attenuant, but it 
does not follow from thence, that it 
should

153 Of an INFLAMMATION. 
should be ranked in the class of at- 
tenuants, for such an arrangement 
would produce a confusion in the 
materia medica, which would be 
very prejudicial in the practice of 
physic. Calcined hartshorn and rice 
are very efficacious in a diarrhœa; 
but surely no Physician will say, that 
they are astringent, yet we know, 
that some empirics give them that 
name, and they retain it eternally 
in families, where such People have 
credit, and these families would ac- 
count the most learned Physicians 
very ignorant, if they should pre- 
scribe them in any other illness, but 
a diarrhœa; for relying intirely up- 
on the affected gravity and authority 
of these favourite pretenders, it is 
impossible to persuade them, but 
that the astringent effects of these 
ingredients, are owing to their es- 
sence or nature, and not to any ac- 
cidents.  
THE

154 The INDICATIONS 
The same thing may be said, of 
acids in general, and of vinegar in 
particular, which only becomes an 
attenuant by its effects, in asthmas 
and obstructions, though it has not 
that property effentially. We are 
to remark, that real attendants would 
be very noxious in circumstances, 
where vinegar is useful, and that it 
is by the rules of physic, only we 
can know this difference. 
NOTHING helps us more to make 
a happy progress in the practice of 
physic, than a due distribution of 
medicines into proper classes, and all 
the abuses which are committed in 
the materia medica, proceed chiefly 
from want of that arrangement. 
Have we not therefore, reason to 
fear, that vegetable acids, lemon 
juice, vinegar, fruit, &c. ranged by 
Van Swieten, in the class of attenu- 
ates, may lead young beginners in- 
to

155 Of an INFLAMMATION. 
to innumerable errors? Are not the 
evils which arise from thence the 
more to be feared, as the authority 
of that celebrated Author prevails 
so much all over the universe, that 
whatever Physician will dare to 
contradict it, must endanger his re- 
putation? 
MANY Empirics, and even some 
Physicians to this day, boast of the 
great success they have had in admi- 
nistering internally preparations of 
gold, silver, copper, and lead. Such 
errors probably derive their origin 
from some celebrated Physicians, 
who prescribed them, perhaps, for 
the sake of trial, before physic was 
so well cultivated, as in our days. 
SOME use preparations of lead ve- 
ry frequently in gonorrhœas, and 
believe them to be specific, though 
nothing more certainly destroys the
stomach  

156 The INDICATIONS 
stomach or intestines, than that me- 
tal, of which forty Persons, who 
died by drinking small wine, where- 
in litharge was infused, afforded me 
a fatal proof. 
The design of these remarks, is 
to shew that the careless slips or in- 
sinuations of great Physicians, are 
very dangerous, especially with re- 
gard to acids and acescent aliments, 
as may be observed by the great 
number of Negroes, which our Mer- 
chants and Planters lose by a mealy 
acescent diet; for they are seldom 
allowed any thing but rice in the 
passage from Africa to America, 
which by turning four on their 
stomachs, produces all the bad ef- 
fects of acidity, and very probably 
renders their perspiration too slow, 
and it is from thence, perhaps, 
and from their other concurring 
circumstances, that they have such 
a disagreeable smell; for the
humour 

157 Of an INFLAMMATION. 
humour which passes off by sweat, 
and insensible perspiration, are of 
the same nature with the urine, so 
that when they are retained, they 
may acquire a bad smell in the same 
manner as the urine, as I shall ex- 
plain, when I come to treat of ob- 
structions. 
RAMAZINI remarks, that clean- 
sers of jakes are subject to inflam- 
mations of the eyes *, and in some 
countries abroad, (I will not name) 
where instead of jakes, pots are kept 
in the bed rooms, the People are very 
much subject to opthalmies, and 
such of them as I advised to keep 
out of the way from bad smell, soon 
got rid of their disorder. 
From hence it is certain, that 
the acrid effluvia, which offend the 
nose, are also offensive to the eyes, 
* See his Treatise on the Disorders of Artificers, 
chap. 14, translated into English by Dr. James.
and  

158 The INDICATIONS 
and that the fetid particles which 
exhale from the bodies of the Ne- 
groes, render them so much subject 
to opthalmies in their passage from 
Africa to America. The poor 
wretches are bled so copiously on 
these occasions, that the circulation 
is weakened, and the disorder en- 
creased, until it carries them off. 
WE are to remark, that the blood 
resulting from acescent aliments, espe- 
cially in these People, who grieve 
without doubt, on account of their 
confinement, must be poor and con- 
tain but little spirit, and that of con- 
sequence, they cannot bear to lose 
much of it; for which reason, they 
should not be bled without due pre- 
cautions, but should be treated accord- 
ing to the method prescribed by Ra- 
mazini, and the disorder should be 
prevented by allowing them better 
food,

159 Of an INFLAMMATION. 
food, and keeping the place where 
they lie very clean and as free as pos- 
sible from bad smell. 
I was informed by several Portu- 
guese Captains who use the African 
trade, that they seed the Negroes 
the same way as the Sailors, and 
give them sometimes a little wine, 
and that they seldom lose many of 
them in passing from Africa to 
their colonies. 
I may venture to say, that who- 
ever has recommended rice as a con- 
tinual diet among our Negroes, has 
been accessary to the death of so 
great a number of them, as to be a 
great hindrance to the cultivation of 
our colonies, and cause our Mer- 
chants and Planters to lose many 
thousand pounds sterling, per an- 
num.  
I

160 The INDICATIONS 
I Do not mean to forbid intirely 
the use of rice, and other mealy sub- 
stances, on the contrary, I allow, 
that in hot climates, it may be ne- 
cessary for all degrees of People to 
take such food now and then, in or- 
der to check perspiration, and re- 
tard the excretion of the liquid part 
of the aliments. But when a custom 
prevails with regard to food as well 
as dress, it is very hard to remove it; 
and, perhaps, our Merchants and 
Planters, will never change their me- 
thod of seeding the Negroes, even 
when they are informed by what is 
here advanced, that it is much 
against their interest to continue it. 
MOST of our cotempories content 
themselves with the thoughts, man- 
ners, and examples of their prede- 
cessors, without examining whether 
they be good or bad; because such 
an enquiry would cost some pains
and 

161 Of an INFLAMMATION. 
and labour, and very few are fond 
of interrupting their pleasures upon 
such an occasion. 
As my assertion, concerning the 
increase of the bile, From an immo- 
derate use of acescent vegetables, is 
a new opinion, it may be objected 
to, by those, who with Dr. Haller, 
maintain, that as the bile has the 
property of soap, it must be always 
composed of proportionable quanti- 
ties of oil and alkali, which can only 
give it that property according to 
their supposition. 
The invalidity of this objection, 
may be easily inferred from what 
I have already advanced on this sub- 
ject, and as soap can be made with 
oil and acid, as well as with alkali, 
the soapy property of the bile can 
afford no ground for an objection a-
gainst me. 
M CHAP.

162 The RESOLUTION 
CHAP. III. 
Of the Resolution or Dispersion of an In- 
flammation. 
THE resolution of an inflamma- 
tory swelling, does not hap-
pen until the disorder is upon the 
decline. Fernelius says nothing in 
particular about it, Boerhaave ex- 
plains it in the following aphorism. 
“ 386. Si humor fluens blandus, 
motus ejus sedatus, causa obstruens 
non nimis solidata, obstructio, parva 
eaque imprimis in arteriis vel in ini- 
tiis lymphaticorum, canales mobiles, 
diluens vehiculum, reducto fluore 
concreti, motu stagnantis, solvitur 
inflammatio resolvendo.” 
BOER-

163 Of an INFLAMMATION. 
BOERHAAVE supposes in this apho- 
rism, that all inflammations proceed 
from an obstructing matter, concreted 
by stagnation; but would it not seem 
very absurd to assert, that the inflam- 
mation which happens the instant 
that the tendon of the muscle biceps 
is pricked by a lancet, should pro- 
ceed from such a cause? Can stag- 
nation happen so suddenly? And if 
it could, how is it possible that the 
stagnating fluid could be concreted 
in an instant? It is certain, that the 
humour collected in the cellular 
membrane during the inflammation, 
may be concreted by the heat which 
attends this disorder; for we may 
see hard crusts remain under the epi- 
dermis, after some superficial inflam- 
mations, and the same may happen 
internally; for as nature contrived 
the epidermis to surround the whole 
superficies of the body, so she has 
been no less kind in supplying every 
M2 vessel

164 The RESOLUTION 
vessel and every muscular fibre, with 
a particular membrane, under which 
may lodge the matter concreted by 
an inflammation, the same way as 
under the epidermis. But no Phy- 
sician or Surgeon will say, that the 
crusts which remain under the epi- 
dermis after an inflammation, were 
the cause of that disorder; therefore, 
there can be no reason why the like 
concretions should be the cause of 
inflammations in the internal parts 
of the body; for the example I 
have mentioned, evidently proves, 
that they are its effects, and not its 
cause. 
HENCE it is demonstrated without 
the help of any system or hypothesis, 
that the humours attracted to an in- 
flamed part by the force of an ere- 
thism, can pass into the cellular mem- 
brane, as well as to the epidermis, 
without the rupture of any vessels. 
See

165 Of an Inflammation. 
See page 58. In treating of ob- 
structions, I will enlarge more on 
this subject. 
In the last stage of an inflamma- 
tion, the erethism of the vessels, 
with the velocity of the fluids, di- 
minish gradually, until the motion 
of the humours becomes so sedate 
and uniform, that the matter of in- 
sensible perspiration can run out 
through the pores of the skin as 
free as in a state of health; but it 
cannot pass out that way, without 
meeting the matter, which during 
the inflammation, was inspissated 
and collected in the cellular mem- 
brane, without mixing therewith, 
and rendering it more fluid. As the 
humour of insensible perspiration 
goes off in a warm vapour, it should 
dissolve concretions very efficacious- 
ly. When the morbific humour is 
attenuated by this vapour, it should
M3 go

166 The RESOLUTION 
go where it finds less resistance, and 
either return into the mass of blood 
by the inspiring vessels, called ab- 
sorbents, or pass out by the expiring 
vessels through the pores of the skin. 
WE are to observe, that seldom 
any part of this fluid returns into 
the mass of blood, for the pulsation 
of the vessels, and the direction of 
the humour which goes off by in- 
sensible perspiration, determine it 
to pass out through the skin. But 
as this cannot happen, until the ere- 
thism, and the preternatural veloci- 
ty of the fluids cease, it may be easily 
understood, that an inflammation 
can never be terminated in the cel- 
lular membrane. For an inflamma- 
tion never ceases on account of a 
preceding resolution; but a resolu- 
tion of the morbific matter comes 
on, because the inflammation ceases; 
therefore, our Author has no reason
to 

167 Of an INFLAMMATION 
to assert, that an inflammation ter- 
minates by a preceding resolution. 
IT follows from what is said in this 
section, that the resolution of an in- 
flammation does not happen after a 
suppuration, but when without any 
suppuration, the disorder ceases. 
We have nothing to do with the 
first part of this objection, because 
it attacks the principles of Boer- 
haave, who contrary to our opinion, 
asserts, that an inflammation termi- 
nates by suppuration, but if after 
suppuration the inflammation does 
not cease, there can be no resoluti- 
on. We know that suppurated tu- 
mours are often removed by a salu- 
tary metastasis. As to the second 
part of the objection, we acknow- 
ledge, that an inflammation goes off 
without any suppuration, when na- 
ture overcomes the disorder. 
SIGNS

168 The RESOLUTION, &c. 
SIGNS of RESOLUTION. 
WHEN an inflammatory swelling 
is but small, without any fluctuation 
of matter, and the rest of the effects 
are not very intense, but vanish by 
degrees, it is certain, that it will pass 
off by resolution or dispersion. 
THE resolution of an inflammation 
may be procured by the remedies I 
have recommended, in sect. 5. chap. I. 
FINIS. 
ERRATA. 
Page 1. Line 11. for Fernellius, read Fernelius, 
5. 5. after erysipelatodes, read schirrodes &c. 
oedematodes 
79. 2. after and, read Van Swieten. 
90. 18. after ardent, read fever. 
96. 15. for sympathy, read force. 
135. 17. after julap, read e. 
138. 16. after opium, dele and. 

APPENDIX. 
AS the Reviewers of 1768, offered nothing 
concerning my doctrine, that was worthy 
of their institution, my friends advised me to pass 
them by with contempt. But as an exhibition of 
their nonsense may be of some service to their 
successors, and to the students of medicine and 
surgery, I submit the following remarks to their 
perusal. 
To the Printer of the PUBLIC LEDGER. 
From the Mount Coffee-house, August 12th, 1768. 
AS I have found every thing advanced in 
Dr. Magenises treatise of inflammations 
supported by a series of facts, my zeal for the 
welfare of my fellow subjects, engaged me to 
offer the public a candid consutation of the ob- 
jections made against it in the Critical Review of 
this month; and it is to be hoped, Mr. Printer, 
as you are influenced by no party, that you will 
give it a place in your Ledger. 
First. Our critic endeavours to persuade the 
public, that Dr. Magenise was wrong in not ad- 
mitting an obstruction to be the proximate cause 
of inflammations; but he should know, that a
A disorder

2 APPENDIX 
disorder, and its proximate cause, are the same 
thing; and consequently, that to affirm an ob- 
struction to be the proximate cause of an inflam- 
mation is the same thing, as to say, that an in- 
flammation is an obstruction, and vice versa, 
that an obstruction is an inflammation, which is 
absurd; for the proximate causes of a disorder, 
being its prime attributes, constitute its nature 
or essence, the same as a soul and body united 
constitute the nature or essence of man. Our critic 
might have found a more satisfactory answer than 
what we have here given, in what he has quoted 
from the author, and in sect. 1. page 31. 
A plausibility is the only argument used by our 
critic, to support his objections, but as he men- 
tions no circumstances to authorise it, we can ac- 
count it nothing more than an ipse dixit, it should 
therefore prejudice no body against a treatise 
founded upon facts. 
Secondly, As Dr. Magenise has clearly ex- 
plained what he means by an erethism in page 28 
and 29, our critic could have no reason to tell 
the public, that he calls it a general stricture of 
the vascular system, and that he accounts it to be 
the universal, and only possible cause of inflam- 
mations; this is a paultry opinion, borrowed 
from some German writers, which Dr. Magenise 
has nothing to do with. The critic should re- 
member, that in the author's definition, the ve- 
locity of the fluids is affirmed to be one of the 
proximate causes of inflammation; he has no rea- 
son therefore to tell the public, that an erethism, 
that is, the action of the vessels, is accounted by 
our author to be the only cause of that disorder. 
Thirdly,

3 APPENDIX. 
Thirdly. The critic says, than an erethism is 
a supposition; it is the same thing, as if he 
said, that the vessels have no action in an inflam- 
mation; or in other words, that an inflammation 
is not an inflammation, which is absurd. No 
man can deny, but an inflammation is an ere- 
thism, that is, the action of the vessels joined 
with the velocity of the fluids preternaturally en- 
creased; for without these two causes, no inflam- 
mation can be conceived; although our critic 
concludes, from his conception of the laws of the 
animal oeconomy, that an erethism can be the 
cause of external, and not internal inflammations. 
But to affirm, that an inflammation can take 
place internally without an erethism, is the same 
thing as to say, that it can exist without the ac- 
tion of the vessels, which is one of its prime at- 
tributes; indeed he might as well say, that man 
can exist without a soul and body united, which 
would be an absurd assertion. If there was no 
erethism or action in the vessels in internal inflam- 
mations, no pain would attend them; if our cri- 
tic therefore could find out a law in the animal 
oeconomy, to hinder pain in an erethism, in such 
cases, he should be accounted the great Apollo 
by all the nations of the universe. 
Dr. Magenise's arguments on this subject are 
so clear and so convincing, that there is no room 
for an objection against; them; and it will appear 
evident to any gentleman of judgment and can- 
dour, that the proximate causes of inflam- 
mations are as far traced in his treatise, as 
they can be, by human understanding; and 
as he published his book for the instruction of 
A2 students

4 APPENDIX 
and preservation of mankind, it is very il- 
liberal to write a heap of absurdity against 
him. 
Fourthly. Our critic endeavours to persuade 
the public, that Dr. Magenise, was wrong in say- 
ing, that hot stimulating medicines, were im- 
proper in the acme or height of an inflammation, 
but in this point our critic will get none of the 
faculty to join him against the Doctor. Let us 
allow for a moment the practice of our critic; in 
this case, bleeding, diluents, oily and mucilagi- 
ginous medicines should not be employed to cure 
an inflammation, because their effect would be 
contrary to that of the stimulating hot medicines, 
authorised by the established practice of our critic; 
but this practice is established upon such an ab- 
surd basis, that we need no other argument, but 
the example we have cited to confute it. 
Fifthly. Our critic should remember that his 
phlogistic and phlegmatic vicidity includes a 
false supposition with an equivocation, and that 
both it and the concomitant indication of impor- 
tance mentioned by him, as objections, are par- 
ticularities which are not to be inquired into in a 
general treatise of inflammations; and that from 
a particular to a general nothing can be conclu- 
ded. 
Dr. Magenise has mentioned the circumstances 
wherein aperients and attenuants can be admi- 
nistered, page 142 and 148. 
Pleuresies, peripneumonies, and inflammations 
of other particular parts, have some particulari- 
ties, besides the general causes which afford con-
comitant

5 APPENDIX. 
comitant indications; but these have nothing to 
do with a general treatise of inflammations. 
As our critic made use of no malicious or 
illiberal expressions, and concluded with the 
encomium of the author, and allows him to be 
capable of making abstruse investigations, he 
proves himself to be some gentleman, who wants 
to be instructed. But as all his objections, ex- 
cept the two last, are resolved in the book, he 
deserves to be blamed for starting them, as they 
may prejudice the public against the Author and 
his work. He might have given a better proof 
of his good breeding, by paying the Doctor a 
polite visit and consulting him about his doubts. 
This answer has been inserted in the ledger by 
an anonymous friend. The editors of all the 
news-papers spoke of my doctrine with so much 
candor, that they shewed themselves to be en- 
dued with liberal sentiments. As for the proprie- 
tors of the Critical and Monthly Reviews, it is pro- 
bable, that unlawful means were used by literary 
swindlers, in order to prevail on them to insert 
their critico-medical contradictories. 
Three or four attempted to make 
themselves authors, by counterfeiting the doctrine 
laid down in this treatise; but to their great con- 
fusion they proved themselves to be strangers, 
not only to that subject, but to every degree of 
knowledge and science, that is necessary to qualify 
a physician. Their efforts were not unlike those 
of the viper in the sable, who lost its teeth in 
driving to gnaw a smith's anvil. 
The Monthly Reviewer for November 1768, 
was probably one of those literary swindlers. He 
made

6 APPENDIX. 
made use of the most illiberal and malicious expres- 
sions that could be imagined, against this work; 
and by that means produced the effect of a false 
witness, before the unlearned part of the public, 
and gives no other authority for what he said, but his 
ipse dixit; therefore he merits very justly, the title 
of a perjuror. What he quotes from page 19 to 
page 29, contains invincible proofs, that a stag- 
nation of the fluids from errors loci cannot be the 
proximate cause of an inflammation. Had he 
proved by fair argument that any part of the 
doctrine was false, ill supported, or pointed out a 
better treatise for the reader, his criticism would 
extort applause from every intelligent man; but 
as he has done nothing more than to desame the 
Author, and a work composed for the preserva- 
tion of every man's life and health, and a work 
essentially necessary for that purpose, he must be 
an enemy to all mankind. 
Objection 1st, “In the definition of an inflam- 
mation an erthism, and the velocity of the fluids 
preternaturally encreased, are considered as the 
proximate and immediate causes, and yet in the 
following passage, the latter of these seems to be 
considered as the effect of the former, page 164. 
Hence it is demonstrated, says our Author, without 
the help of any system or hypothesis, that the hu- 
mours attracted to an inflamed part by the force 
of anerethism can pass into the cellular membrane, 
as well as to the epidermis, without the rupture 
of any vessels.” See page 58. 
By this objection our critic supposes, that the 
motion of the fluids is independent of that of the 
solids: If it were, when the motion of the heart 
ceases

7 APPENDIX. 
ceases, for instance, the fluids would continue to 
circulate, and consequently there would be no 
death. It is no less absurd to think, that the heart, 
or any vessel in the human body, can move with- 
out moving the fluids that are contiguous to them. 
It follows plainly from this objection, that our 
critic is quite ignorant of the circulation of the 
blood. However, to shew the mutual depandence 
of the motion of the solids and that of the fluids, 
it may be allowed to make use of an obvious simi- 
larity. 
The solids determine the motion of the passive 
fluids, almost in the same manner as a man deter- 
mines the motion of a wheelbarrow he drives before 
him with both hands. In this case, the motion of 
the hands and barrow are synchrone; so that when 
the hands stop, the wheelbarrow stops. In like 
manner, when the motion of the heart and vessels 
is accelerated, that of the fluids must be accele- 
rated also; and when the former ceases to act, the 
latter must cease to circulate. 
In pages 33, 34, &c. I have explained at large 
how every motion of a living animal must be pro- 
duced by the action and re-action of the solids and 
fluids; and when I gave these minute explanations, 
for the benefit of young students, I did not in the 
least imagine, that any practitioner of physic or 
surgery or even any grown person among the vul- 
gar, could be ignorant of the circulation of the 
blood. In this objection, our critic affords us a 
specimen of the knowlege of all those who attempt 
to study or practise medicine before they are ac- 
quainted with the liberal arts. They bodder their 
brains in reading things that are above the sphere
of 

8 APPENDIX. 
of their understanding, and they generally abuse 
gentlemen of university education, if they write 
any thing they cannot comprehend. It seems that 
our Reviewers are generally of this class. 
Objection 2d. Our critic quotes the late Dr. 
Whytt for having attributed in his physiological 
essays, a greater determination of the fluids to a 
particular part, to an increased oscillatory motion 
in the capillaries. Dr. Gorter, Dr. Haller and 
many others asserted the same, when they attended 
Boerhaave's lectures, but none of them proved it 
to be so ex professo. As for Dr. Whytt, he was a 
zealous defender of Boerhaave's doctrine before he 
held a conference with me on that subject, and un- 
fortunately he understood my erethism to be an 
oscillatory motion. I say unfortunately, because 
if so honest a gentleman and his pupils understood 
it thoroughly, I should have no occasion to publish 
my sentiments on that subject, or undergo the ca- 
lumny and insults of literary swindlers and pretend- 
ing schemers: Therefore, to prevent the World 
from being led into error, I had put my thoughts 
in order, in 1767, and formed a general doctrine 
of inflammations, which I have published in 1768, 
and sent every professor of physic at Edinburgh a 
copy of it, that they might see it in its maturity. 
I honour Dr. Whytt's memory so far, that he told 
me it was a valuable doctrine, and never published 
by any author; and desired me most earnestly to 
allow time enough to digest it at my leisure. 
Our critic says also, that Dr. Dobson, in his 
Dissert. inaugur. de Menstruis, attributed a greater 
determination of the fluids to any particular part, 
to an increased irriability. 
What

9 APPENDIX. 
What Dr. Dobson said concerning the menses, 
does not belong to our subject: But admitting that 
he applied it to inflammations; the increased irri- 
tability of the vessels, is not the action of the vessels, 
it only supposes the power of acting or receiving the 
sensation of pain, and consequently cannot be the 
proximate cause of inflammations. All men have 
their vessels irritable; but it is mere nonsense 
to assert, that they have all an inflammation; but 
this follows from what our critic ascribes to Dr. 
Dobson. But I cannot believe that gentleman, or 
his president, to be so ignorant as not to be able to 
distinguish an action from the power of acting: I 
will therefore suspend my judgment concerning his 
dissertation, until it comes to my hands. 
Obj. 3. “ And what it is that Dr. Magenise 
means by an erethism, or a species of action in the 
vessels, which is neither peristaltic nor oscillatory, 
we are at a loss to guess.” 
The nature of an erethism has been traced, pages 
28, 29, to its essence or prime attributes; and the 
human understanding can penetrate no farther. 
And what is there asserted, with regard to it, is 
founded on what every man must feel in the com- 
mon actions of life. 
The impossibility of a peristaltic or an oscilla- 
tory motion in the capillary vessels, is sufficiently 
proved from page 35 to page 44. 
All medical authors agree, that an Inflamma- 
tion begins in the capillary vessels. To say, that 
the action of these vessels, in that disorder, is pe- 
ristaltic, or like that of a worm, is false; for a 
worm must have a free space to work with its head 
and tail, but the frequent anastormoses of the ca- 
pillary vessels, and their connection with the  
B muscles,

10 APPENDIX 
muscles, cellular membrane, membrana adiposa
&c. allow them no such space, and consequently 
their motion cannot be peristaltic. It cannot be 
oscillatory; for such a motion supposes them to 
have a systole and diastole, which are not only 
imperceptible, but even impostible, on account of 
their minuteness. Boerhaave and all Physicians 
agree, that only one globule of fluid can enter them 
at a time; their bore, therefore, must exclude a 
systole and diastole, and consequently an oscillatory 
motion. This assertion may be corroborated by 
the reason that has been given why their motion 
cannot be peristaltic. 
It is certain, that the oscillatory motion of the 
large vessels, near the affected part, and sometimes 
throughout the whole body, is augmented accord- 
ing to the force of the stimulus. 
Every physician must allow, that the different 
classes of the materia medica, and the medicines 
belonging to each of them, taken either collec- 
tively or distributively, are so many different sti- 
muli, which produce so many different modes of 
action in the vessels; some, for instance, act as 
purges, emetics, diaphoretics, sudorifics, diuretics, 
or cordials, &c. But no man can affirm for certain, 
that these different modes of action, or any one of 
them, is peristaltic or oscillatory; nor is it neces- 
sary; for it is sufficient that we should know them 
to produce the effects for which they are com- 
monly prescribed. 
As it appears from hence, that an erethism must 
vary according to all the different stimuli in rerum 
natura, it cannot be expected, that the human 
understanding can prefix names to its different 
modes

11 APPENDIX. 
modes of action, nor is it necessary with regard to 
the indications of an inflammation; for it is suffi- 
cient, in this case, to know that an erethism, or 
the action of the vessels, is preternaturally aug- 
mented, and may be lessened by certain remedies; 
and that in so doing, the confusion, anger and 
struggle of nature, signified by the greek root of 
the word erethism, may be removed. 
An erethism is derived forom ερεθω, vel ερεθiζω,
irrito, lacesso; sρεθiσμα, irritamentum; vel ab epiζω, 
ερiσω, ερiμω, certo, contendoy hirrio; thema, ερiς, 
ερiδoς, lis, contentio, hirritus. 
When a man is irritated, provoked, or involved 
in any disagreeable contention, his anger and con- 
fusion shall be proportionable to the irritation or 
provocation, and his blood shall be hurried into 
the capillaries, with an irregularity proportionable 
to his confusion. In like manner, when any part 
of the human body is irritated or disturbed in its 
office, the heart, or vital hero, is alarmed and 
enraged, more or less, according to the violence 
of the stimulus. It excites, without delay, an 
erethism in the vessels, and redoubles its efforts in 
sending as much humour as it can, to the affected 
part, until it either relieves it, or sinks in the 
attempt. 
Hence it appears, that nothing can better express 
the confusion struggle and anger of nature in 
inflammatipn, than the word erethism, for both in 
Greek and Latin it seems to be formed from the 
letter R, which is called canine, because its repe- 
tition resembles an angry dog's arring. Pope, in 
his translation of Homer's Iliads, has this letter 
B2 repeat-

12 APPENDIX 
repeatedly in every line, when he describes the fury 
or contention of his heroes. 
My investigation of the word erethism may open, 
for the learned, a fertile source of important dis- 
coveries in every branch of medicine. By the 
help of my doctrine, students may be enabled to 
distinguish the indications of inflammatory disor- 
ders from those of obstructions, which is of the 
greatest importance, although it be little attended 
to by many practitioners. For being informed by 
the celebrated Boerhaave, that an obstruction is 
the cause of an inflammation, they give stimulat- 
ing medicines, until the disorder degenerates into 
a putrid fever, which seldom fails to carry off the 
patient; especially, if he be of a strong or robust 
constitution. But it should be considered, that an 
author, who treats of all the parts of medicine, 
cannot be infallible in every point. This was 
Boerhaave's case; for his penetration in all other 
cases shews, that his doctrine of inflammation only 
slipped him. But as the great faith of our prac- 
titioners in this noble author, occasioned this flip 
to do more hurt amongst; us than any where else, 
I have published this Essay, in order to prevent its 
farther progress, and to throw light upon the most 
important part of this great man's works, and by 
that means render the whole beneficial to society. 
For as all disorders have home relation with inflam- 
mations and obstructions, his doctrine of the for- 
mer shall be apt to breed confusion, and render 
his whole work obscure to young students, and to 
those who practise without the assistance of theory. 
Obj. 4. “ Neither is the nature of an erethism 
better ascertained in the following paragraph, in 
which

13 APPENDIX. 
which the argument runs in a circle. Pain is a 
disagreeable sensation, which excites all living crea- 
tures to employ the utmost in their power to re- 
move its causes, &c. page 61. 
The idea which our critic attaches to a circle, 
in this case, proves him to be quite ignorant of 
logical terms; and consequently, that he was never 
qualified, either to practise physic, or to begin 
the study of that noble science: For it cannot be 
inferred from the paragraph he quotes, or from 
any other paragraph in the book he calumniates, 
that pain is called an erethism, or an erethism pain. 
It is only asserted in the aforesaid paragraph, that 
pain is the effect of an inflammation: Besides he 
forgot that an erethism is not mentioned in the de- 
finiton of an inflammation (page 19), as its only 
proximate cause. 
As our critic takes pain to be an erethism, he 
must (in other words) take it intirely to be the 
action of the inflamed vessels; but as the foul has 
a share in the sensation of pain, it follows, that 
our critic does not know the difference between an 
inflammation and its effects, or allow himself to 
have a foul, or know the difference between its 
operations and those of the body. 
Obj. 5. Without giving our readers any fur- 
ther quotations from this work, we shall only ob- 
serve, that when Doctor Magenise comes to treat 
of the cure of inflammations, he takes no notice 
of blisters, though these are doubtless to be ranked 
among the most powerful remedies in the cure of 
these diseases. 
This objection proves our critic to be some Pseu- 
domdicus, who was never qualified to begin the 
study

14 APPENDIX 
study of what he professes; For a physician, who 
is regularly bred, must know, that in an inflam- 
mation, the motion of the solids and fluids preter- 
naturally increased, threatens the destruction of 
the whole body; and as the application of blis- 
ters would increase that motion, they would com- 
pleat the catastrophe. I have observed that this 
always happened, whenever these Pseudomedici 
prescribed for strong people labouring under an in- 
flammatory fever. It is by the preposterous use of 
blisters, volatile alkalies, spirituous tinctures, and 
the different preparations of opium, in such cases, 
the greatest part of the West Indians lose their 
lives, and are often carried away abruptly from 
their families before they can settle their affairs. 
Hence it appears how these Pseudomedici may be 
often the original cause of bankruptcies among 
the merchants of these kingdoms. 
The indications of the disorders into which an 
inflammation may degenerate, must be quite dif- 
ferent from those of the original; and consequent- 
ly, to enumerate their remedies, or decide whether 
or no they require blisters, is quite foreign to a 
general doctrine of inflammations. 
I have traced out this fellow's physical chime- 
ras, in order to shew that our country can produce 
the most ignorant and audacious wretches that ever 
disgraced the human species. The College of 
Physicians should prosecute, and punish most se- 
verely, all those who attempt to prevent the pub- 
lic against any work that may contribute to pre- 
serve life and health. Nothing is so common 
amongst us, as practitioners and authors in law, 
physic and divinity, who were never prepared 
even

15 APPENDIX. 
even to begin the study of either. The igno- 
rance, serocity, and immorality, which reign
amongst us at present, proceed entirely from these 
villanous pretenders. 
The impudence of this sort of cattle soars so 
high as to commence critics; or they prevail on 
the Reviewers to admit their malicious libels into 
their monthly publications, and burn any magazine 
that contains a work of character, that they may 
have an opportunity to present it surreptitiously to 
his Majesty as their own, and pass at court for men 
of eminence in learning. This crime is by so 
much the greater, as it makes the King a receiver 
of stolen goods. It is more than probable, that 
the fitst edition of this work was burned by some 
of them for that purpose, in the house of Mr. 
Walker, Tyler-court, near Carnaby-market: For 
Mr. Walker and his wife are so sedate and careful, 
that the neighbours and firemen affirm, to this day, 
that the house was set on fire by some villain. 
About this time a certain man, furnished with no 
other degree of learning but that of the mechani- 
cal part of surgery, pilfered as much from the 
living and dead as filled up two large volumes. 
The elements of my doctrine were put into this 
heap, and all jumbled together without method or 
principles: yet this man had the assurance to pre- 
sent that heap of medical robberies to his Majesty, 
in order to give him a sanction to sell them to the
public as his own property; but he proved to be 
like the viper who lost his teeth in the anvil. 
The impudence, calumny, and insults of this 
class of men, hinder many gentlemen from fa- 
vouring the public with their discoveries. There
cannot

16 APPENDIX. 
cannot be a more evident characteristic of an auda- 
cious russian, than to arraign before the public a 
work he never read, or never was qualified to read 
with any advantage. 
The recovery of this edition from the flames, 
is owing to the subscriptions and patronage of 
Lord Viscount Barrington, Sir Charles Price, 
Baronet, Robert Cooper Lee, Thomas Murphy 
and William Gray Esqrs. I will pay them and 
my other subscribers a proper compliment, as soon 
as I am able to publish my Doctrines of Suppura- 
tion, Gangrene, Sohirrus, Obstructions, and expe- 
rimental Medicine.
FINIS

























THE 
DOCTRINE 
OF 
INFLAMMATIONS 
Founded upon Reason and Experience 
AND 
Intirely cleared from the contradictory 
Systems of 
Boerhaave, Van Swieten, and Others. 
THE SECOND EDITION. 
By Daniel Magenise, M. D. 
LONDON: 
Printed for the Author, and sold by W. Owen, in 
Fleet-Street; and all the Booksellers in Town and Coun- 
try, 1776. 


Entered at Stationers-hall, agreeable 
to Act of Parliament. 


TO 
Sir Clifton Wintringham, 
Fellow of the College of Physicians in 
London, and of the Royal Society, and 
Physician in Ordinary to his Majesty, 
the King of Great Britain, &c. &.
SIR, 
THE skill and judgment, by 
which you adorn both your 
profession, and the honourable office 
you hold from his Majesty, with 
the humanity, disinterested behaviour, 
and those other qualifications, which 
made you so valuable to the Nation, 
both at home and abroad, have in- 
duced me to bespeak your patronage 
for this work, after its being laid 
aside for many years, in which state 
it might, perhaps, have still conti- 
nued, had not your eye at length 
A2 given

DEDICATION. 
given it new light, and myself a jus- 
tifiable courage to offer it to the 
public perusal. I have, therefore, 
taken the liberty to prefix your name 
to it, that being, through your ap- 
probation, presented to the learned 
world, it may engage the candid part 
of it after your example, to receive 
favourably what it finds useful in it, 
and pass over humanely the slips and 
errors which have escaped him, who, 
with great pleasure, embraces this 
opportunity to acknowledge himself 
to be, 
SIR, 
Your most obliged humble Servant, 
DANIEL MAGENISE. 


PREFACE. 
NO disorder is more common, or at- 
tended with greater danger than an 
inflammation; yet in the best physical Au- 
thors, we find its causes and effects, not 
only confused, but even involved in mani- 
fest contradictions. 
As an inflammation is the principal 
source of most disorders, it is easy to per- 
ceive, how difficult it is, to give a com- 
pleat treatise of it; and that it is impossible 
in the narrow limits appointed for this 
essay to describe the various forms it as- 
sumes in the different parts of the human 
body; I shall, therefore, only enquire in- 
to its general causes; and for the better 
accomplishment of my design, and to ena- 
ble the Reader to judge, whether the doc- 
trine of inflammations receives any amend- 
ment from what is advanced in this treatise. 
I shall compare it with the opinions of 
some eminent Physicians, whose theory and 
practice are at present universally defended 
in the schools, both of Physic and Surgery. 
It is much more difficult to discover the 
causes of disorders, than to prescribe for 
their cure; and it is by his skill and saga- 
city in making such discoveries, that a 
Physi-


PREFACE 
Physician shews how much he is above the 
level of Mountebanks and Pretenders. 
As it is impossible to have experienced 
Physicians always at hand, where inflam- 
mations may happen, my design in this 
work, is, to the best; of my abilities, to 
clear up what regards the efficient causes of 
this disorder, for the benefit of the younger 
and less experienced Practitioners. 
From the Authors published hitherto, 
I can quote no authority to support what I 
advance concerning inflammations: there- 
fore, to prove it, I am obliged to draw 
arguments from the very essence or na- 
ture of the disorder; and although these 
may labour under the danger of novel- 
ty, yet I have ventured to publish them 
such as they are, with a view to fix the 
theory aud practice of inflammatory dis- 
orders upon experience and rational prin- 
ciples. It may appear a presumption to 
deviate from the beaten path; yet, as a 
member of society, my duty in some mea- 
sure engaged me to make this trial; and if 
I cannot succeed in my endeavours, it may, 
perhaps, excite the emulation of the learned 
to accomplish it hereafter. 
I

PREFACE. 
I am to give the Reader, without the 
help of any system or hypothesis, a clear 
idea of the various effects of an inflamma- 
tion; point out how they are produced by 
the simple laws of nature, and prove my 
assertions by such familiar examples, as 
daily occur in the practice of physic, and 
in the common actions of life. 
Least the Reader should lose any time 
in forming difficulties against my doctrine, 
I have laid before him the principal objec- 
tions that may be made against it with their 
answers. 
This work being chiefly designed for 
the Gentlemen of the Faculty, who 
are all supposed to understand Latin, I 
thought it needless to insert the English of 
my quotations, as it would only swell the 
volume unnecessarily. And any curious 
Person, who may chuse to amuse himself 
with physical enquiries, can be at no great 
loss, though he were no proficient in Latin; 
because the remarks on every quotation, in- 
clude whatever regards the doctrine of in- 
flammations. 

CONTENTS. 
CHAP. I. 
Of Inflammations in general. 
Sect. I. Of a Phlegmon,—Page 1 
II. Of an Erysipelas,—63 
III. Of an Oedema,—106 
IV. Of the Diognostic Signs 
of an Inflammation,—125 
Prognostic Signs,—Ibid, 
V. Of the Cure of Inflam- 
mations in general—128 
CHAP. II. 
Which proves the curative Indications 
of an Inflammation to be repugnant 
to Boerhaave's Doctrine, aph. 371, 
146 
CHAP. III. 
Of the Resolution or Dispersion of an 
Inflammation.—162 

(1)
THE 
DOCTRINE 
OF 
INFLAMMATIONS, 
CHAP. I. 
Of INFLAMMATIONS. 
Sect. I. 
Of a Phlegmon. 
Boerhaave takes the defini- 
tion of an inflammation or 
phelgmon from its causes. Fer- 
nelius in imitation of all the Anti- 
ents defines it by its effects, and al- 
lows the blood to be its proximate 
cause. This Author was the first of 
the Moderns, who collected from the 
Latin, Greek and Arabian Authors 
what he observed to be true and so- 
lid, and such as by convincing ar-  
B guments

2 Of a PHLEGMON. 
guments proved to be useful in the 
practice of physic. He was so im- 
partial in adopting their doctrine, that 
without favouring one more than the 
other, he omitted nothing of what 
he found requisite for the perfection 
of that science. 
MOST authors adorn their works 
with the authority of the Antients, 
Boerhaave and Van Swieten general- 
ly quote for that purpose, Galen, 
Celsus, or Ægineta. Fernellius in 
every principal point agrees with the 
three last-mentioned Authors; he is 
also clearer, more methodical, and 
throws more light on every sub- 
ject than any of them; for which 
reason, I design to illustrate the be- 
ginning of every principle article of 
this treatise, with an extract of what 
he has collected from the antients 
concerning an inflammation and its 
various effects. It will, without 
doubt,

3 Of a PHLEGMON. 
doubt, be agreeable to the reader, 
as it is the most exact specimen of 
the kind, transmitted to us on that 
subject. I shall afterwards propose 
the principles of my own doc- 
trine, and compare them with 
the systems of Boerhaave and Van 
Swieten. 
PHLEGMONE tumor est calidus 
præternaturam collectus, prominens 
atque circum scriptus, ovi saltem gal- 
linacei magnitudine. Huic quasi 
ex igne aut ex balneo rubor inest: ca- 
lor quoque ex inflammatione vehe- 
mens quasi pars uratur: distensio ex 
copia renitens: pulsatio prosunda & 
molesta, quod arteriarum diastole 
partem inflammatam seriat: dolor ex 
calore, ex pulsu atque tensione acer- 
bus, præsertim quum pars eximio 
sensu predita est. Causa continens san- 
guis est, non in solam cutem, sed in 
B2 sub- 

4 Of a PHLEGMON. 
subjectam quoque carnem impactu, 
qui e venis eo tandem confluxit. 
Quum enim venae arteriaeque majores 
immoderata sanguinis copia disten- 
duntur, lianc gravatæ in minores 
quasi onus deponunt, ex his demum 
in minimas. Ac turn per earum oscu- 
la perque tunicarum meatus sanguis 
cohiberi non potis, effluit illabitur- 
que in spatia vacua quæ inter sibras 
sunt primorum corporum, præcipe-
que musculornm, venarum, arteria- 
rum, nervorum atque membrana- 
rum. Hæ partes fluxione dum per- 
funduntur implenturque, distentæ co- 
pia quasi divelluntur, ferventisque 
sanguinis ardore incalescunt, dolo- 
remque faciunt. Sanguis quippe ex- 
tra vasa colledus, nec libere perfla- 
bilis, necessario putrescit atque in- 
flammatur. Ita quidem si purus is 
erat, ex quisita phlegmone fit, cujus 
species sunt: opthalmia, parotis, an- 
gina, parulis in gingivis, aliaeque ex 
par-

5 Of a PHLEGMON. 
partibus nomina adeptae. Est & alia 
minus exquisita, cujus non sincerus 
est sanguinis, sed aliorum quoque 
humorum particeps. Hinc siunt 
phlegmone erysipelatodes et schir- 
rodes. Fernel. de Extern. Corp. 
Affect, pag. 608. 
Φ. 1. A hot swelling preternatu- 
rally collected, whereof the blood 
is the proximate cause, supposes a 
derivation of this fluid to the affected 
part. This was the opinion of all 
the Antients; it is the source from 
which Dr. Sauvage, Professor of 
Physic in the University of Mont- 
pelier, has taken his system; for he 
maintains that the encreased velo- 
city of the fluids is the only proxi- 
mate cause of an inflammation. 
Some of the antients compared 
an inflammation to a concentrated 
fire, and it is from thence, perhaps, 
B3 Boer-

6 Of a PHLEGMON: 
Boerhaave took his attrition of the 
solids and fluids, which always sup- 
poses heat. 
Φ. 2. Fernellius distinguishes 
inflammatory swellings into tumours, 
tubercles and pustules. A tubercle 
is less than a tumour, but larger than 
a pustule. To these also he gives 
different names according to their 
appearances, and the parts they at- 
tack, whether glandular or fleshy *. 
The largest tumour that appears in 
the skin or fleshy part, he calls a 
phlegmon, which he says should be 
as big as a hen's egg. Though the 
name of phlegmon is confined here, 
by our Author, to a particular tu- 
mour yet under that title, he gives 
us a general notion of inflammati- 
ons according to the mode of the 
antients, and in another part of his 
pathology, we read, Ipsa denique in- 
* Vide, pag. 608. Pathologiæ.
inflam-

7 Of a PHLEGMON. 
flammatio quam proprie phlegmonem 
appellamus *. 
Φ. 3. Pain is the first effect of 
an inflammation, although our au- 
thor says that it arises from the heat, 
pulsation and distension, which at- 
tend that disorder. It is true, that 
as these are violent situations of the 
solids and fluids, they bring on an 
additional, irritation, whereby the 
primitive pain is augmented; so that 
this saying of Virgil may be very 
well adapted to pain. 
—Malum quo non aliud velocius ullum, 
Mobilitate viget viresque acquirit eundo. 
Φ. 4. A Phlegmon takes diffe- 
rent names from the parts it affects; 
if it attacks the eye, it is called an 
opthalmy; if the brain, a phrenzy; 
if the throat, a quinsey; if the 
* Vide, pag. 379. Pathologiæ.  
B4 pleura,


8 Of a PHLEGMON. 
pleura, a pleurisy; if the lungs, a 
peripneumony, &c. 
Φ. 5. Our Author mentions three 
sorts of vessels through which the 
blood is to pass before it works its 
way into the cellular membrane to 
form a tumour; and that when it 
gets into this membrane, it produces 
the symptoms which attend suppu- 
ration. 
Φ. 6. A Phlegmon by the antients 
and moderns is called erysipelatous, 
if the swelling is supposed to con- 
tain a bilious fluid; œdematous, if 
a watery humour; and schirrous, if 
an indurated atribiliary matter *. 
†. The inaccuracy of this distincti- 
on will be discussed in Sect. 2. and 
Sect. 3. 
* Traité des tumeurs par M. Astrue, Medecin de 
S. M. T. C. 
† Chirurgie complete des modernes, par M. Le 
Clerc, Medecin de S. M. T. C. 
Φ. 7.

9 Of a PHLEGMON. 
Φ. 7. INFLAMMATIONS or any 
other disorders become known by 
their names, effects, or causes; by 
the very name of a phlegmon every 
one understands an inflammatory 
tumour. The effects which charac- 
terize it, are a swelling with redness, 
heat and pain; they are all enume- 
rated by Fernellius; but as they 
suppose some cause, they can supply 
the mind with no curative indicati- 
on. The effects of a disorder may 
lead an experienced Physician to the 
knowledge of its cause; but as there 
is a real distinction between the cause 
and effects, the indication taken 
from the former, cannot be supposed 
to proceed from the latter. From 
whence we may judge, that the 
knowledge which results from the 
names and effects of diseases, is very 
defective; and consequently the in- 
dications which can be drawn from 
thence must be equally so; and that 
those

10 Of a PHLEGMON. 
those who fix their practice upon so 
uncertain a foundation, must be lia- 
ble to many dangerous errors; for 
giving no attention to the funda- 
mental principles of physic, nor to 
the sympathy which subsists between 
the different parts of the human bo- 
dy, they never hesitate to prescribe 
cephalics, for example, for every dis- 
order of the head, although they 
generally proceed from an indispo- 
sition of the stomach charged, as it 
often happens, with a faburra. But 
if those people knew how to trace 
out the original causes, they would 
prescribe evacuants instead of cepha- 
lics, and would be thus enabled to 
give the patient (at the same time) a 
true prognostic concerning his cure. 
As the practice of the Antients 
with regard to a phlegmon, could 
have been founded upon nothing 
else but the effects enumerated by 
Fernellius,

11 Of a PHLEGMON. 
Fernellius, we can easily judge how 
obscure and intricate it must have 
been. What I have extracted from 
this Author, is a compendium of 
what he found most select in the 
Writings of the antients concerning 
the present subject. 
Now by the method I have pur- 
posed to follow, I am engaged to 
enquire into the opinions of our 
own cotemporary Physicians; but 
in order to accomplish my design, it 
would be an endless work to cite 
what was said on that subject by 
each of them in particular; for 
which reason, I have selected Boer- 
haave, whose doctrine concerning 
inflammations is universally adopted 
by the Physicians and Surgeons of 
the present age. That the doctrine 
of so great a man should be called 
in question, by a person whose 
name is quite unknown to the learn- 
ed, 

13 Of a PHLEGMON. 
ed, will appear to most people to be 
too bold an undertaking; and the 
more so, as it has been so much il- 
lustrated by the celebrated Van 
Swieten, that it cannot be contra- 
dicted by any Physician, let him be 
ever so learned, without endanger- 
ing his reputation. Notwithstand- 
ing these discouragements, the desire 
of being serviceable to mankind, 
and particularly to young Physicians 
and Surgeons, engaged me to exa- 
mine it still farther, and to try to 
fix it upon evident principles; for 
nothing can dishearten students more 
in the pursuit of learning, than to 
find the basis of their art founded 
upon obscurity and contradictions. 
They must certainly be well pleased 
to be cautioned against the three 
fountains of error, which I have 
discovered in the doctrine of Boer- 
haave, for if they were not fore- 
warned, they might unwarily fall
into 

13 Of a PHLEGMON. 
into them, and that by so much the 
oftner, as every disorder, though not 
inflammatory, should nevertheless be 
compared with inflammations by 
young practitioners, both in physic 
and surgery. For we are to observe, 
that in health the circulation is se- 
date and uniform, and that when it 
is augmented above this standard, 
there is an inflammation or a dispo- 
sition towards it; and that when it 
is below it, there is a debility or 
want of motion, from whence pro- 
ceed various diseases, which may be 
more easily known and cured, by 
comparing their causes and effects 
with those of health, and those 
of inflammatory disorders; for by 
acquiring a true knowledge of the 
effects of the latter in the doctrine 
of inflammations, and also of the 
medicines whereby they are removed 
or prevented, no one in the least 
conversant in the materia medica,  
can


14 Of a PHLEGMON. 
can be at a loss to relieve the com- 
plaints arising from the former, by 
their opposite remedies. This me- 
thod may be of some consequence 
in practice; for I have heard many 
Professors of physic, remark, that 
students most commonly acquired a 
knowledge of the symptoms, and 
cure of inflammatory disorders soon- 
er, and with less study than of any 
other; they may, therefore, by ob- 
serving this method, come to a more 
clear and certain knowledge of such 
disorders as proceed from debility or 
want of motion, than by any other 
method whatever; for it is by what 
we know best, and most clearly, that 
we can form clear ideas of what we 
know but obscurely. 
Boerhaave, for the simplicity of 
his method in tracing out and dis- 
tinguishing disorders by their causes, 
is deservedly accounted by all peo- 
ple


15 Of a PHLEGMON. 
ple to be the light and ornament of 
modern Physicians. Mankind is un- 
der no less obligation to Van Swieten, 
his learned commentator; but it 
will appear from what follows, that 
they are both wrong in what re- 
gards the doctrine of inflammations. 
THE first fountain of error I have 
discovered in their doctrine, springs 
from the different series of vessels, 
wherein they have both placed the 
different kinds of inflammation. The 
diversity of humours which occasion 
these different kinds, fill up the se- 
cond fountain; and the third arises 
from the different causes to which 
this disease is attributed. 
Boerhaave divides the arteries in- 
to sanguiserous, serous, and lympha- 
tics, and says, that an inflammation 
always takes place in these arteries, 
because the blood passes in them, as  
it

16 Of a PHLEGMON. 
it were, from the base of a cone to 
its apex; and that it never attacks 
the veins, because the course of their 
fluids is from the apex to the base, 
unless the circulation is stopped in 
them by compression. He says also, 
that the serous arteries arise from the 
most minute ramifications of the 
sanguiserous, and the lymphatic ar- 
teries from the most minute serous 
arteries, and that the serous arteries 
are smaller than the sanguiserous, 
but larger than the lymphatic arte- 
ries, and that the blood is thicker 
than the serum, and the serum thick- 
er than the lymph. 
From these three sorts of humours, 
and three different series of vessels, 
Boerhaave and Van Swieten, have 
deduced three different kinds of in- 
flammation, as a phlegmon, an ery- 
sipelas and an œdema. They call the 
first an inflammation of the first or- 
der,


17 Of a PHLEGMON. 
der, and place it in the sanguiserous 
or serous arteries; in the first case, 
they suppose it to be always red, 
but that in the latter, a sufficient 
quantity of red blood does not at all 
times enter the serous vessels to give 
it that colour. 
BEFORE I enquire into these prin- 
ciples, order requires, that I should 
mention the true causes of a phleg- 
mon. To know disorders by their 
effects, is to know them by what 
they are not, it is the same as to form 
an idea of a tree we never saw, by 
its fruit; but to know disorders by 
their causes, is to know them by the 
prime attributes which constitute 
their nature or essence. 
Most diseases draw their origin 
from three efficient causes. The first, 
which may be called external or evi- 
dent, produces internally the ante- 
C cedent

18 Of a PHLEGMON. 
cedent causes that give birth to the 
proximate cause, so called, because 
it exists in the body, and is imme- 
diately connected with the disorder. 
Sometimes two efficient causes con- 
cur to produce an ailment, and some- 
times one only is sufficient; as in a 
wound made with the point of a 
sword. It is of the utmost conse- 
quence in the practice of physick, 
to have the distinction of these causes 
present to the mind. 
The external causes of an inflam- 
mation are fractures, luxations, com- 
pressions, aromatic aliments, abound- 
ing with oil and sulphur, passing 
suddenly from a warm into a cold 
place, and many other external ap- 
plications which produce their ef- 
fects, either suddenly or slowly. The 
irritation, irritability and sensibility 
of the fibres resulting from thence, 
are the antecedent causes of this dis- 
order:


19 Of a PHLEGMON. 
order: but it may be properly de- 
fined, according to its proximate and 
immediate causes, an erethism of the 
vessels, with the velocity of the fluids 
preternaturally encreased. 
The nature and effects of an in- 
flammation, with certain indications, 
may be clearly understood at first 
sight of this definition, which will 
evidently appear, by comparing it 
with the following one of Boerhaave. 
"371. Estque sanguinis rubri arte- 
riosi in minimis canalibus stagnantis 
pressio & attritus a motu reliqui san- 
guinis moti, & perfebrem fortius 
acti." 
β. 1. Several incoherencies occur 
in this definition of our celebrated 
Author; for he supposes a stagnation, 
an obstruction, a pressure, and an attri- 
tion of the same red arterial blood 
violently moved and agitated in an 
C2 in-


20 Of a PHLEGMON. 
inflamed part; these are indeed op- 
posites which can never subsist to- 
gether in the same place; for the in- 
flamed vessels are obstructed, or they 
are not; if they are obstructed, the 
blood must stagnate in them, and 
remain without motion; on the 
contrary, if they are not obstructed, 
an obstruction should not be ac-
counted one or the causes of an in- 
flammation, as it is asserted in the 
foregoing aphorism. Moreover, an 
obstruction excludes all motion; for 
it is a stoppage of one or many ves- 
sels, which hinders the distribution 
of the fluids in the part so affected; 
so that it is a gangrene in miniature, 
with this difference, that the ob- 
structed matter does not destroy the 
vellels, so soon as the former; but 
every one believes, that a gangrene 
excludes the distribution of the fluids 
in the affected part; therefore it fol- 
lows very plain, from the true noti- 
on

21 Of a PHLEGMON. 
on we have here given of an ob- 
struction, that the same must hap- 
pen wherever it takes place. 
β. 2. It cannot be understood how 
the fluids can stagnate in the capil- 
lary vessels of the human body. 
Water is said to stagnate in a pool, 
because it is confined there in a cer- 
tain space, from whence it cannot 
move backward, forward, or late- 
rally; it has no other motion, but 
that of fluidity, that is, a facility 
which its particles have of slipping 
easily one over another; but if there 
were only a few drops of water in 
the pool, certainly they could have no 
motion of fluidity; they would re- 
main immoveable in its bottom; 
therefore, in order they should have 
their natural motion of fluidity, it is 
necessary there should be a certain 
quantity of water placed under them, 
C3 over


22 Of a PHLEGMON. 
over them, before them, behind them, 
and laterally. Besides the particles of 
water having little or no cohesion to- 
gether, must certainly be more fluid 
than those of the blood, especially 
in a state of stagnation. 
FROM the nature of fluidity now 
explained, we can easily judge, that 
it is impossible a few particles of 
blood impacted and stopped in ves- 
sels, whole diameters, according to 
Van Swieten, are not equal to the 
tenth part of that of a hair, could 
preserve their fluidity. It will ap- 
pear still more impossible, if we con- 
sider the cohesion and glutinous te- 
nacity of the blood globules, which, 
joined with the heat excited in the 
capillaries by an inflammation, 
would soon render their stagnating 
fluids as hard as an extract. Hence 
we see, that a stagnation of the hu- 
mours

23 Of a PHLEGMON. 
mours in the capillary vessels, no less 
excludes motion than an obstruction. 
β. 3. Our Author supposes the ob- 
structed or stagnated blood to be 
violently moved by attrition. In- 
deed, he might as well say, that the 
blood was at rest, and violently moved 
at the same time, which are two 
contradictories. 
Hence it is evident, that the doc- 
trine of inflammations, which may 
be reckoned the basis of physic and 
surgery, has been founded hitherto 
upon a contradiction, and received 
as a truth by most of the Physici- 
ans and Surgeons in Europe. This, 
among others, may be the reason, 
why some were not ashamed to own 
that their art was founded upon un- 
certainties sufficient of themselves to 
discourage any one from inquiring 
into its principles.  
C4 For

24 Of a PHLEGMON.
For the future, it is to be hoped, 
that both physic and surgery will be 
freed from this aspersion, by the ra- 
tional and experimental principles, 
whereby, I am to account for the va- 
rious effects of an inflammation. 
BOERHAAVE and Van Swieten, 
often mention the red blood going 
into the vessels of the eye, in order 
to prove, that an inflammation is oc- 
casioned by a stagnation and an ob- 
struction; but this example proves 
nothing in favour of their assertion; 
for any one, who attends to the 
works of nature, may easily see that 
there was something prior to the red- 
ness of the eye, which occasioned 
a greater column of fluid than usual 
to come into its vessels. Sometimes 
a sympathy with some ailing part of 
the body, an air, a stinking effluvium, 
and very often a fluxion of some a- 
crid humour may occasion a redness 
in

25 Of a PHLEGMON. 
in the eye; but these are only exter- 
nal or antecedent causes, which, by 
irritating and exciting an unusal mo- 
tion in the vessels of the eye, occa- 
sion so great a quantity of fluids to 
run into them, as to produce a red- 
ness; it cannot therefore be supposed, 
that an obstruction or a stagnation in 
such cases, may be the proximate 
cause of the redness of the eye. 
Moreover, it cannot be conceived that 
the blood could stagnate in the ves- 
sels of this organ for weeks, months, 
and sometimes years, as we see in 
blear-eyed people; it is therefore 
probable, that the blood circulates 
all the time; otherwise it cannot be 
comprehended how the eye could 
recover its native colour, when the 
irritating cause is removed by the 
power of medicines. But of this, 
I shall speak more at large, in Sect. 3.
Now 


26 Of a PHLEGMON. 
Now as it is proved, that an ob- 
struction or a stagnation of the hu- 
mours, cannot be reckoned a proxi- 
mate cause of inflammations, I am 
to prove next, that it cannot be pro- 
duced by the encreased velocity of 
fluids alone, which the celebrated 
Van Swieten, holds to be one of its 
proximate causes in his commenta- 
ry on Aph. 371; and which, Dr. 
Sauvage maintains to be the only 
one; for it cannot be conceived how 
the velocity of the fluids can oe en- 
creased without the concurrence of 
other causes; even if it could, it 
cannot be understood how it could 
bring: on an inflammation. Canals, 
and banks of rivers contribute no- 
thing towards the rapidity of the 
currents; but we cannot infer from 
thence, that the like happens in the 
canals of the human body; for when 
they become any way inactive, as 
for example, in a dropsy, the Pati- 
ent

27 Of a PHLEGMON. 
ent is soon destroyed, unless he gets 
speedy relief from his Physicians, 
Where then can we trace out the 
cause of this velocity given by our 
Author to the fluids? We must not 
feign things we cannot see; for all 
the rivulets of systems, and hypothe- 
ses are stopped at their source, since 
physic is defined an art and a science, 
founded upon reason and experience, 
&c. therefore, we must seek for it 
in the penetralia, or inward recesses 
of nature; but in order to succeed 
in our search, we must give strict at- 
tention to the different changes, 
which, upon every accident of life, 
happen in the human body; thus for 
instance, by the pricking of a thorn, 
or needle, by the stinging of Bees, 
Wasps, by fire, the venereal disease in 
gonorrhœas, &c. by each of these 
and such like causes, are produced 
all the genuine effects of an inflam- 
mation,

28 Of a PHLEGMON. 
mation, as pain, swelling, heat, red- 
ness, &c. 
Now, no obstruction or stagnati- 
on of humours, can be supposed in 
the affected parts; therefore, the 
effects of an inflammation, may pro- 
ceed at least, occasionally from a 
stimulus; I say, occasionally, because 
a stimulus could produce none of 
the foregoing effects in the vessels of 
the human body, if they were not 
sensible and irritable. 
AN irritation and its effects are 
greater or smaller, according to the 
force of the stimulus, and sensibili- 
ty of the affected part. That mode 
of action, which results from the 
sensibility and irritation of the ves- 
sels, I call an erethism, this action 
is neither peristaltic, nor oscillatory; 
it is different in the small-pox, the 
measles, the itch, &c. it varies ac-
cording


29 Of a PHLEGMON. 
cording to the stimulus; so that 
there are as many kinds of it, as 
there are stimuli in rerum natura; 
because different stimuli make dif- 
ferent impressions, that excite the 
vessels to so many different kinds of 
erethism, which are attended with 
as many different disagreeable sen- 
sations. 
FROM the foregoing examples of 
the pricking of a thorn, of a needle, 
stinging of Bees, &c. it is evident, 
that whenever an erethism is excited 
in the vessels of any part, an en- 
creased velocity of the fluids must 
necessarily follow in that part, and 
that by taking away these two causes, 
we take away the inflammation. 
This will appear more clearly, by 
what I am to say, in the sequel of 
this section, concerning heat, a tu- 
mour, and the other effect of an 
inflammation.  
THE

30 Of a PHLEGMON. 
THE chief effects of an inflam- 
mation are heat, pain, a swelling, 
redness, and the acceleration of the 
pulse, which I am now to explain 
one after another. 
β. 4. ACCORDING to Boerhaave's 
doctrine, the production of heat in 
the inflamed capillary vessels, cannot 
be accounted for; for it consists in 
the reciprocal action, and reaction 
of the solids and fluids, which is ma- 
nifested in running Footmen, work- 
ing People, &c. but the fluids are at 
rest and obstructed in these vessel, 
according to the hypothesis of our 
Author, and heat is always diminish- 
ed in such as have obstructions, as 
we know by a very observable case 
in a young Woman labouring under 
a chlorosis; and, therefore the pro- 
duction of heat in an inflamed part, 
cannot be accounted for, if we ad- 
mit the definition which Boerhaave 
gives

31 Of a PHLEGMON. 
gives of an inflammation, in Aph. 
371. 
δ. 1. SOME may object, from 
what is said in this paragraph, that 
Boerhaave attributes a greater velo- 
city to the fluids contained in the 
vessels of the inflamed part which 
are not obstructed. 
These unobstructed vessels are 
inflamed, or they are not; if they 
are inflamed, our Author has no rea- 
son to assert, that an inflammation 
has for its cause, an obstruction of 
these vessels; if they are not in- 
flamed, the objection is not against 
us. 
That the various effects of an in- 
flammation, and what I am to prove 
in the sequel of this work, may be 
easily understood, I find it necessary 
to premise a physiological explication 
of the mechanism of animal heat; 
and

32 Of a PHLEGMON. 
and for that end, I shall first ex- 
plain the two-fold motion of the 
blood in the vessels of a living body; 
for every minute drop or particle of 
it moves round its axis, and advances 
with a progressive motion, from the 
heart to the extremities of the body, 
and back again. 
LET us first, in imitation of all 
Authors, call the minute drops of our 
humours, globules, and let us ima- 
gine, a tube pressed on all sides, con- 
taining an infinite number of these 
globules, all unequal, infinitely small, 
and moved according to all directi- 
ons. 2. Let us suppose, the hu- 
mours of a human body, during their 
actual state of fluidity, to be capa- 
ble of such motions as Sir. Isaac 
Newton has proved all fluids are 
susceptible of. 3. All Authors al- 
low the whole mass of our hu- 
mours, to consist of globules of dif- 
ferent

33 Of a PHLEGMON. 
ferent sizes and densities, as the 
blood, for example, the serum, the 
lymph, &c. 4. Let us suppose the 
fluids in any vessel of the human 
body pressed by the skin, the mus 
cles, the external air, and by the 
other contiguous vessels. 
From these premises may be ea- 
sily understood, that every globule 
of that fluid must receive impulses 
from the skin, the muscles and the 
lateral tubes, its very weight and 
elasticity, from anterior, posterior, 
and lateral globules, and lastly, from 
the different situations and motions 
of the body; therefore, it receives 
shocks or impulses, according to 
innumerable directions; but, by the 
laws of mechanics, when a body re- 
ceives impulses in that manner, it 
should yield to them all, as much, 
as possible, and be moved according 
to their different directions; there-
D fore,

34 Of a PHLEGMON. 
fore, as every globule of blood re- 
ceives impulses in every point, it 
should yield to them all, and of 
consequence move round its axis, as 
long as it receives them after the 
manner here described; but it re- 
ceives them thus whilst the heart 
moves; therefore, every globule of 
our humours moves round its axis, 
at least, in the large vessels, until 
the motion of the heart ceases. This 
motion of the fluids round their axis, 
by the superior force of the heart 
impelling the posterior globules, be- 
comes progressive; for it is a law in 
mechanics, that when a body re- 
ceives impulses from different pow- 
ers, according to different directions, 
it should move with a progressive 
motion, according to the direction 
of the strohgest; but of all the 
the powers acting in the blood ves- 
sels, the impulse of the heart, com- 
municated to the posterior globules, 
is

35 Of a PHLEGMON. 
Is the strongest; therefore, all the 
globules contained in the vessels of 
the human body, should be moved 
according to the direction of the 
heart, with a progressive motion; 
the same may be said of the other 
humours, as they are equally sub- 
ject to the same laws of motion. 
WE are indeed to remark here, 
that it cannot be conceived how the 
globules of our humours can move 
round their axis in the capillaries, 
where only one globule can enter 
at a time, by every fuction and 
attraction, which is the only way 
the circulation can be carried on in 
these vessels; because they have no 
perceptible systole nor diastole. We 
allow the propelling force of the 
heart behind to concur, in as much as 
it conveys the fluids to their orifices. 
It may be easily concluded from 
what is said, concerning the two 
D2 diffe-

36 Of a PHLEGMON. 
different motions of the blood, that 
the heat of the human body con-
sists in the repeated action, and re- 
action of the solids and fluids, and 
as these are augmented in an inflam- 
mation, the excess of heat in this 
disorder may be easily accounted for, 
according to our doctrine; for the 
velocity of the fluids being preter- 
naturally encreased, (which we hold 
to be one of the proximate causes 
of that disease) the contraction of 
the heart must at the same time be 
more frequent and strong, and con- 
sequently the action and re-action 
of the fluids and solids, augmented 
accordingly, and produce heat. On 
the other hand, it cannot be denied, 
but all living creatures have an in- 
stinct which excites them to use the 
utmost of their power to remove the 
cause of pain; for the first law of 
nature is to seek food to preserve 
life, and the second to avoid, as 
much

37 Of a PHLEGMON. 
much as possible, any thing which 
might destroy it; and indeed we 
find, that the heart observes this 
second law inviolably upon all acci- 
dents. 
IT is by this instinct or sympathy, 
that when any part is irritated, the 
heart directs to it immediately a 
quantity of fluid proportionable to 
its irritation, by which its vessels 
are dilated and contracted with 
greater force; and consequently their 
tabulæ or sides must approach one 
another, and repel the fluids which 
rally in their turn, and thus succes- 
sively their motion round their axis, 
with their progressive motion, is ac- 
celerated, and becomes more rapid 
in proportion, as the blood abounds 
with oil and a sulphureous princi- 
ple, or other elastic particles which 
are easily put in motion and warm- 
ed, The heat arising from such 
D3 blood


38 Of a PHLEGMON. 
blood is soon dissused from the heart, 
as the center of motion, through the 
vessels to the circumference of the 
body, in the manner of rays, quasi 
per irradiationem. 
THE force, by which the erethism 
impels the fluids against the sides of 
the vessels, is, as it were, a propor- 
tional medium between their irrita- 
tion and contraction. As that force 
is various, according to the variety 
of the stimulus, and to the additi- 
on it receives successively from the 
preternatural velocity, elasticity and 
quality of the blood, it produces 
also various degrees of contraction 
in the vessels, and consequently va- 
rious degrees of heat. From hence, 
and from the notion I have given of 
an erethism, (page 28) it may be 
easily understood, why one degree 
of contraction brings on a small in- 
flammation, another a great one, a 
third

39 Of a PHLEGMON. 
third suppresses the excretions, as it 
happens in an ardent fever; how, 
by another degree some excretions 
are encreased, as when sweat or 
spitting is brought on by a slow ere- 
thism, in some hypocondriac habits; 
and lastly, how the contraction may 
sometimes be so violent as to cause 
convulsions. 
No Artist was ever found inge- 
nious enough to contrive a machine, 
which could perfectly represent the 
circulation of the blood in a living 
animal; yet, Physiologists are al- 
lowed to use such evident examples 
as they are supplied with from ex- 
perimental philosophy, in order to 
clear up some cases, which are not 
immediately obvious to the senses; I 
shall for that reason, make use of the 
following experiment, that it may 
help to render my physiological ac- 
count of heat more intelligible; and 
D4 that

40 Of a PHLEGMON.
that the conseqences and corrlla-
ries deduced from thence, may be 
more easily comprehended.
LET glass reduced to powder,
water and oil be agitated with a ve-
hement motion in a glass vessel, the
particles of glass being the heaviest
and most dense, advance with a
progressive motion to the circumfer-
ence of the vessel, leaving the oil 
and water behind at the axis and
center; but the contrary happens,
when the motion is less vehement.
Let the center of the glass vessel
represent the heart; its circumfe-
rence that of the human body,
and the different substances it con-
tains the different humours of a liv-
ing animal; and allowing the circu-
lation to be carried on by the like
mechanism, the blood being heavier
and more condensed than the serum
and
 

41 Of a PHLEGMON. 
and lymph, will leave them both be- 
hind, when by a vehement motion, 
excited by an erethism, they are 
propelled all together to the inflamed 
part, where the blood produces irri- 
tations in proportion to the different 
contractions of the vascular system. 
It may be inferred from thence, 
that in every degree of inflammati- 
on, a greater quantity of red blood 
than any other humour must come 
to the affected part; and that it can- 
not be conceived, how an erysipelas 
and a hot œdema, can be formed 
by any humour different from the 
red blood, as Boerhaave and Van 
Swieten assert, in Aph. 380. 
LET it not be imagined, that this 
conclusion is merely hypothetical, 
and entirely founded upon the fore- 
mentioned experiment; for we may 
see the truth of it proved by almost 
every accident which happens to the 
human

42 Of a PHLEGMON. 
human body, as I have constantly 
observed for many years past, by at- 
tending diligently to the changes 
which follow, when it is either hurt 
or irritated by external causes; upon 
all such occasions, a redness ensues 
similar to that which arises by run- 
ning, dancing, singing, or on using 
any other violent exercise, or on the 
prick of a thorn, the sting of a Bee, 
a stroke, &c; so that every such 
accident of life proves, that a great- 
er quantity of blood is determined 
to an inflamed part, than any other 
humour. We may also learn from 
the same principles, why, in an ar- 
dent fever, and in all inflammatory 
disorders, the blood propelled more 
frequently to the circumference of 
the body, should there press the ori- 
gin of the serous and lymphatic ves- 
sels, and occasion an exsiccation of 
the skin. On the contrary, when 
the motion of the fluids is in a na- 
tural


43 Of a PHLEGMON. 
tural state, the serum, lymph, and 
the humour or insensible perspirati- 
on, leave the blood behind, and come 
in a greater quantity towards the 
skin; from whence its whiteness, 
softness, and humidity must neces- 
sarily proceed. 
SOME Authors maintain, that the 
subtil matter of our atmosphere, is 
the chief agent which carries on the 
circulation of the animal fluids, 
produces heat, muscular motion, 
&c. Although, what can be said on 
this subject, borders too much on 
hypothesis, to deserve a place in a 
work, whose object is the preserva- 
tion of life, by rules founded on 
facts; it may not, however, be im- 
proper to entertain the Reader a few 
moments with my opinion, and 
compare it with that of some emi- 
nent Authors, who have most seri- 
ously considered it.
MANY

44 Of a PHLEGMON. 
MANY Physiologists suppose the 
different kinds of matter which float 
in our atmosphere, and which escape 
our sight, to enter into the blood, 
and render it more stimulating, and 
of consequence, more apt to sollicit 
the contractions of the vessels, and 
produce heat. Among the rest, 
Bergerus in his Physiology, supposes 
the blood to become more elastic, 
and to be more easily moved by be- 
ing mixed with the air, and with the 
subtil matter which are expanded in 
the atmosphere. Dr. Whytt, Pro- 
fessor of Physic in the University of 
Edinburgh, seems to suppose the 
same; for he enumerates the acid of 
our atmosphere, among the causes 
of circulation, and the action of the 
muscles, in his elegant treatise on 
animal motion. Some arguments 
now occur to me, for and against 
these systems. 
THE

45 Of a PHLEGMON. 
THE existence of subtil matter 
in our atmosphere, is proved by the 
experiments of electricity; by the 
encreased weight of antimony in the 
focus of a burning glass, and by the 
circulation of the magnetic effluvia, 
from the arctic, to the antarctic pole, 
of which Mariners no more doubt, 
than of the air's existence in violent 
storms. The existence of an acid 
in our atmosphere, has been proved 
by the honourable Robert Boyle, 
who, by exposing to the air the dif- 
ferent bodies, which have an affinity 
with particular acids, found that the 
atmosphere of London abounded 
with the acid of sulphur; and it is 
more than probable, that the atmos- 
phere of every country is impreg- 
nated with some kind of acid. 
FROM these premises, we can rea- 
son thus; it is known by experience, 
that the human body placed in a 
watery


46 Of a PHLEGMON. 
watery atmosphere, swells by ab- 
sorbing water; in like manner, mer- 
curial ointment applied to the soles 
of the feet, ascends to the salival 
glands. It cannot be denied, but 
the air, the acid of sulphur, the 
magnetic and electric effluvia, are 
much more subtil than water or 
mercurial ointment; therefore, it 
may be analogically inferred, that 
these fluids circulate with the blood. 
If they do, the electric matter, by 
its nature, (for it is supposed by 
many to be the same as the matter 
of fire or light) the magnetic efflu- 
via by attraction in the capillary 
vessels, the air by its elasticity, and 
the acid of sulphur by its stimulus, 
must all concur to augment the ac- 
tion and re-action of the solids and 
fluids, and produce heat. 
The froth of the blood coming 
out of the vessels proves that it con-
tains

47 Of a PHLEGMON; 
tains air, and the volume of air ex- 
tracted from it in the receiver of 
the machina pneumatica is three 
times greater than its own. This 
seems to prove, that the air circu- 
lates with the blood; but it can- 
not be easily conceived how the sides 
of the vessels could resist the force 
of the air, if it were condensed to 
that degree, and could at the dame 
time exert its elastic and expanding 
force; besides the fluids are incom- 
pressible, or if they be not, as dome 
ingenious Gentlemen have often at- 
tempted to prove, they must be com- 
pressible in so small a degree, as not 
to admit air as elastic; for if it were 
elastic, its globules by attraction 
would unite, and in a short time 
stop the circulation; moreover, 
it is proved, that an elastic air can- 
not penetrate capillary vessels of 
glass; but the blood vessels are much
more

48 Of a PHLEGMON. 
more minute, than capillary vessels of 
glass; the air, therefore, cannot pe- 
netrate them without laying aside its 
elastic property. 
How can it therefore happen, 
that rheumatic pains and swellings 
are produced in all parts of the 
body, even in the strongest and most 
robust habits, by wind or an expan- 
sion of air, as some grave Gentle- 
men considently assert? 
NOTHING that we know can stop 
the magnetic effluvia in its course 
from North to South; it cannot 
therefore be understood, how it can 
circulate with the blood; we have 
no better proof to convince us, that 
the electric effluvia or the matter of 
light, mix with the animal fluids. 
FROM the chymical analysis of 
bile, and that of urine, we know, 
that

49 Of a PHLEGMON. 
that a sulphureous principle is con- 
tained in the humours of the hu- 
man body; for the smell of the 
salt extracted from the two former, 
proceeds from thence. But we have 
no proof, that this principle is ab- 
sorbed from the ambient air, neither 
have we any occasion for such a 
subterfuge; for our aliments sup- 
ply it very copiously. 
MR. BOYLE asserts, that among 
the different particles of matter, 
which float in the atmosphere, there 
may be some so minute, so solid and 
shaped after such a manner, that they 
may enter the orifices of the cuticu- 
lar glands and the other pores. 
Hence may be understood, why the 
plague (of which Cardanus speaks) 
that reigned at Basil, spared the Ita- 
lians, French and Germans. Boer- 
haave, in his chymistry, concludes 
from thence with our noble Author,
E that

50 Of a PHLEGMON. 
that the pores of these People were 
so formed, that the pestilential ef- 
fluvium could not penetrate them, 
whereas it found an easy entrance 
into the Citizens and Natives, whose 
pores, by length of time were made 
to correspond to the figure of the 
subtil particles of matter which 
floated in the atmosphere, in the 
same manner as iron placed for a long 
time in the pinacles of churches, 
acquires magnetic properties. 
FROM these premises, we may con- 
clude, that neither the air, nor any 
other particles of matter expanded 
in the atmosphere, can enter the 
blood without being so intimately 
combined therewith, as to assume 
its nature, and lay aside in some 
manner some of their own proper- 
ties. It is thus, sal ammoniacum, 
when united with the mucous and 
gela-

51 Of a PHLEGMON. 
gelatinous part of the blood, in a 
state of health, is imperceptible. 
EVERY Physician will grant, that 
the particles of matter which float 
in the atmosphere, exist in all vege- 
tables and animals, as elements; and 
it is in that sense, I allow, that they 
contribute to produce heat in the 
human body. We are to remark, 
that the elementary particles which 
cause heat, are unequally distributed 
in vegetables even of the same species, 
according to the climate and soil 
which produce them; as we see 
manifested in wines of different 
countries and different soils: The 
like inequality may be constantly 
observed in the different classes of 
mankind, which, according to the 
goodness of their climates and ali- 
ments, are more or less subject to 
inflammatory disorders, and the 
preter-natural effects which general- 
E2 ly 

52 Of a PHLEGMON. 
ly arise from too much strength or 
heat in their constitutions. 
β. 5. Now as we have proved, 
that an inflammatory heat cannot 
be accounted for according to Boer- 
haave's doctrine, it is not to be ad- 
mired, that by the same principles, 
we cannot be enabled to explain, 
how a tumour can take place in the 
capillary vessels of an inflamed part. 
For in that case, their diameters 
ought to be enlarged, a thing im- 
possible, on account of an attrition 
of their fluids, which must cause 
their sides to approach one another; 
and of consequence lessen their dia- 
meters, and rather diminish than 
augment their quantity of fluid, on 
account of the repeated contractions 
whereby an attrition is carried on. 
Besides, our Author supposes an ob- 
struction in the inflamed capillaries, 
which, as we have said above, ex-
cludes

53 Of a PHLEGMON. 
cludes all motion; but a hot tu- 
mour cannot be formed in any part, 
without an excessive great motion of 
the fluids; therefore, an obstruction, 
and the sort of motion on which an 
attrition depends, rather hinder than 
bring on a tumour in an inflamed 
part. 
δ. 2, OUR adversaries may object, 
that we can give no reason why the 
sides of the vessels should come to- 
gether in an attrition. 
AN attrition, in what ever sense it 
is taken, arises from the frequent 
contractions of the vessels; but in 
contracting themselves, their sides 
must certainly approach one another; 
and their diameters of consequence 
must be lessened, and this must hap- 
pen constantly so, from a state of 
inanition to the most supreme de- 
gree of a plethora. 
E3 ALL

54 Of a PHLEGMON. 
ALL Physicians know that a ple- 
thora ad vasa often proceeds from an 
attrition of the fluids; for when this 
is carried on to a certain degree of 
intensity, the humours are so tritu- 
rated thereby, as to occasion some- 
times a rarefaction, and an intire de- 
composition or their component par- 
ticles, as Practitioners may frequently 
observe in blood drawn from in- 
flamed Patients. 
When the attrition of the animal 
fluids languishes or is intirely want- 
ing, the circulation of the blood, and 
the rest of the functions languish 
also; as we see in a young girl la- 
bouring under a chlorosis, or in such 
as are cachectic, or weakened by 
chronic disorders. 
INDEED a swelling is not essential 
to an inflammation, as some Authors 
affirm; for the intestines are some- 
times


55 Of a PHLEGMON. 
times converted by this disorder into 
dry, thin, yellow or black mem- 
branes, which I saw often verified 
by opening bodies whose deaths were 
occasioned by inflammations of the 
abdomen. And in scrophulous and 
venereal disorders, there is sometimes 
a slow erethism, with a preternatu- 
ral velocity of the fluids without any 
apparent swelling. 
δ. 3. IT may be objected against 
what I have said in this paragraph, 
that in an inflammation, the vessels 
are distended with a greater quantity 
of blood than in a natural state; 
and that of consequence a tumour 
must, in some sense, be essential to 
that disorder. 
IN many bodies who died of in- 
flammations, I saw the intestines and 
lungs reduced to very small bulks. 
I saw also the bodies of consumptive 
and

56 Of a PHLEGMON. 
and phthisical People covered over 
with ulcers, without any appearance of 
a tumour; but ulcers do not come 
without a previous inflammation; 
therefore we can assert, that an ere- 
thism of the vessels with an encreased 
velocity of the fluids, can exist in a 
part without a tumour; and that of 
consequence, a swelling is not essen- 
tial to an inflammation. If it were, 
a sensation of pain could never hap- 
pen without drawing an afflux of 
humours to the affected part to raise 
a swelling; but every one knows the 
contrary by experience; for in a 
tooth-ach there is very often an ex- 
quisite pain without a swelling. 
A swelling which proceeds from 
an echymosis is caused by a rupture 
of the vessels; but it cannot be sup- 
posed that they burst in a simple in- 
flammation; otherwise how could 
the fluids stagnate in them, as 
Boer-

57 Of a PHLEGMON. 
Boerhaave asserts? in a perfect con- 
tusion, as the circulation ceases in 
the contused part, it must grow 
stronger and more frequent in the 
collateral and subjacent vessels; 
from whence arises very often an in- 
flammatory swelling, which some 
Authors, without any foundation, 
attribute to a stagnation of the flu- 
ids in these vessels. 
THE swelling of an inflamed part 
is easily accounted for, according to 
our doctrine; for whenever the ere- 
thism of the vessels with the velocity 
of the fluids is preternaturally en- 
creased, the action and re-action of 
the fluids and solids being more fre- 
quent and strong, the vessels by their 
continual agitation and distension 
are weakened, lose their tonic and 
contractile force, and by that means 
their pores become fo enlarged, that 
the humours can easily pass through 
them

58 Of a PHLEGMON. 
them into the cellular membrane, and 
produce a swelling which will be pro- 
portionable to the strength and du- 
ration of the erethism, and the pre- 
ternatural velocity of the fluids. 
WE are to remark that the ves- 
sels, muscles, and membranes, with 
every sensible part of the body, have 
a natural tendency to shorten them- 
selves, which by Physiologists is cal- 
led a tone or tonic action; it is so 
much augmented in an inflamma- 
tion, that the pores and orifices of 
the capillaries become so narrow, 
that little or nothing can pass 
through them; but when this action 
is overpowered by too much disten- 
sion, or by the vehement impulse of 
the fluids from behind, the fibres 
are somewhat lengthened and re- 
laxed, and the pores become so 
wide, that the humours can easily 
pass through them into the aforesaid 
membrane.

59 Of a PHLEGMON. 
membrane. The force of the sti- 
mulus and erethism may be so great, 
as to overcome this action in an in- 
stant, and cause a swelling, &c. as in 
β. N°. 3, 4, 5, 6, 7, 8. This action 
supports us when we are awake, and 
it is so much lessened by sleep, that 
it is partly on that account we are 
something taller in the morning than 
going to bed. In a palsy the mouth 
is drawn towards the healthy side, 
by a tonic contraction, and not by 
a muscular motion, as many Authors 
pretend. 
As Dr. Haller, Professor of Physic 
in the University of Gottingen, has 
proved by the authority of Sir Clifton 
Wintringham, that the capillary ves- 
sels are much stronger than their 
trunks, it cannot be conceived how a 
swelling can take place in them, espe- 
cially in an inflammation, wherein 
their bulk and diameters are lessened 
by their tonic action and erethism.  
See

60 Of a PHLEGMON. 
See what is quoted from Dr. Haller,
Sect. II. Φ. 6. 
β. 6. As the redness of an inflamed 
part proceeds from the encreased 
velocity of the blood, it cannot be 
accounted for according to Boer- 
haave; because in Aph. 371, he sup- 
poses the fluids to stagnate, and re- 
main without motion in the inflamed 
arteries. The same thing may be 
said of pain and the acceleration of 
the pulse; because they are no less 
the immediate effects of an inflam- 
mation than redness, as appears from 
the application of the definition I 
have given in the beginning of this 
section. 
WHEN any part of the human 
body is irritated, the heart sends it 
so great a quantity of blood, that 
it will soon cause redness, &c. as in β. 
N°. 1, 2, 4, 5, 6, 7, 8, of this sec- 
tion,

61 Of a PHLEGMQN. 
tion, if the cause is not removed or 
overcome by nature or art. 
β. 7. PAIN is a disagreeable sen- 
sation, which excites all living crea- 
tures to employ the utmost of their 
power to remove its causes. The 
artifice which nature uses to free 
herself from it, is very admirable; 
for she seldom fails to send a flood 
of humours to any part affected 
with pain, even independent of the 
will. Pain supposes a stimulus and 
the sensibility with the irritability of 
the fibres as antecedent causes; but it 
arises immediately from an erethism 
of the vessels, and the impetuous 
velocity of the fluids, which both 
combine to irritate and distend these 
vessels so much beyond their tone, 
as to cause pain. See page 15. 
We may see what is here asserted 
confirmed in Quadrupedes, when
by

62 Of a PHLEGMON, 
by a natural instinct, they contract 
their tunica camosa, to drive away 
the flies. 
β. 8. THE stricture and erethism 
of the vessels is greater in proporti- 
on to the intensity of the inflamma- 
tion, and of consequence, the quan- 
tity of humours is lessened in them, 
it must, therefore, be encreased in 
their collaterals. In the mean time, 
the heart, according to the laws 
instituted by provident nature, dou- 
bles its contractions, in order to free 
it's subservient vessels from their 
stricture and erethism; hereby the 
action and re-action of the solids 
and fluids become stronger and more 
frequent, and consequently the pulse 
must be accellerated.
SECT.

63 Of an ERYSIPELAS. 
Sect. II. 
Of an ERYSIPELAS. 
AN Erysipelas, according to Boer- 
have, is an inflammation of 
the second order. Before I explain 
this celebrated Author's opinion, I 
will present my Reader with what 
Fernellius has collected from the An- 
tients on that subject. 
"ERYSIPELAS, ardor est vehe- 
mens per corporis summa diffusus. 
Nec tumore manifesto extuberat, 
nec partem attollit aut distendit, nec 
penetrat in subjectam carnem, sed 
late diffunditur nulla collectione cir- 
cumscriptum. Quamcunque par- 
tem prehendit, vehementer mordicat
&

64 Of an ERYSIPELAS. 
& urit: color inest ex rubro flaves- 
cens, qui pressu subterfugit, moxque 
redit. Dolor nec pulsans nec admo- 
dum vehemens est. Quum fluxio 
excutitur, horror quidem ac dein fe- 
bris hominem adoritur: ac sæpe 
quum in crura irruit, ab inguinis tu- 
more initium ducit. Serpit id qui- 
dem herpetum more, atque priori 
derelicta sede, in vicinas partes sen- 
sim obrepit. Est autem duplex, 
unum quod simplex erysipelas Celso 
appellatur, solo rubore 8c ardore, 
nulla exulceradone molestum. Al- 
ter um quod eidem sacer ignis nun- 
cupatur estque explceratum erysipe- 
las. Hujus duæ species sunt, una. 
qua summa cutis sine altitudine ex- 
ulceratur, in qua & crustulæ instar 
surfuris excitantur: altera cujus ex- 
ulceratio altius in cutem penetrat, 
e qua ruptis pustulis purulenta sanies 
exit. Simplicis erysipelatis origo 
est

65 Of an ERYSIPELAS. 
est a servente tenuique sanguine, 
qui biliosus appellatur: exulcerati 
vero ex co cui bills supervacuæ ejus- 
que incalescentis nonniliil sit admis- 
tum. Is e venis tenuioribus propul- 
fus nequaquam in carne subsistit & 
hæret, sed tenuitate in cutem sertur 
& evolat, quæ densior & compactior 
hunc retinet cohibetque. Quumque 
tenuis sit humor facile dispergitur, 
neque in conspicuum tumorem se 
attollit. Genus hoc universum ex- 
quisitum est eiyslpelas: quod vero 
phlegmonodes appellatur, tumentius 
quidem, sed minus servidum existit 
multoque minus oedematodes." Vi- 
de Fernel. De extern, corp. affect. 
cap. 4. lib. 7. Pathologiæ. 
Φ. 1. When an inflammation 
does not penetrate deeper than the 
integuments, and causes no apparent 
swelling, it is called ah erysipelas,
F not


66 Of an ERYSIPELAS. 
not only by Fernellius, but by all 
the Antients and Moderns. 
Φ. 2. A SIMPLE erysipelas mani- 
fested by a redness and parching 
heat, can hardly be distinguished 
from an exquisite phlegmon; for it 
has all its characters except a tu- 
mour, but I have shewed in the 
foregoing section, that a tumour is 
not essential to an inflammation; 
nor has our Author any reason to 
assert, that it proceeds from a bili- 
ous blood, for the bile is not red; 
yet this disorder may happen, when 
the bile is of a bad quality, or when 
it is diffused over the surface of the 
body. 
Φ. 3. Our Author, as all the 
Antients and most of the Moderns 
have done, concludes, that the yel- 
lowish colour of the part affected 
by an erysipelas proceeds from the 
bile;

67 Of an ERYSIPELAS. 
bile; but I have observed very of- 
ten, that this colour does not appear 
until the disorder is upon the decline, 
either towards a resolution, or a sup- 
puration. Van Swieten attributes 
this yellowness to the serum, in his 
Commentary on Aph. 390. But 
to prove this assertion, it would be 
necessary, that nature should send 
the serum only to the affected part; 
but it cannot be conceived how that 
could be effected according to the 
known laws of the animal œcono- 
my; for we know by experience, 
that such as labour under this dis- 
order, are no way disposed to sweat, 
nor have any moisture perceivable 
on their skin; on the contrary, they 
appear to the touch to be dry and 
parched, and burn all over with 
heat; and it follows from what is 
said in page 41, that the heart in 
that situation, cannot be disposed to 
separate serum from the blood to
F2 be

68 Of an ERYSIPELAS 
be sent preferably to any other hu- 
mour to the irritated part; for 
which reason, it is not more likely, 
that a yellow colour in an erysipelas 
should rather arise from the serum 
than from the blood. 
NEITHER the blood nor any other 
humour is black; but when col- 
lected in contusions, they take on 
that colour, may not therefore the 
blood decomposed by the heat and 
pulsation of an inflamed part, change 
its colour from red to yellow? Be- 
sides, as the red blood is thicker than 
the serum, it cannot so easily pass 
off by resolution; therefore, it should 
be more retained in the affected part 
than the serum. Moreover, we are 
to remark, that Leuwenhoek ob- 
served the colour of the blood to 
proceed from the union of the white 
globules; therefore, that union be- 
ing dissolved by the rarefaction arising 
from

69 Of an ERYSIPELAS. 
from an inflammatory heat, may oc- 
casion the red colour to vanish partly 
or entirely, which, perhaps, hap- 
pens in the present case; and this is 
further proved by Dr. Sauvage, in 
his Physiology *, where he says, that 
the redness of the blood proceeds 
from its thickness, and proves it by 
the authority of Sir Isaac Newton, 
who has demonstrated, that bodies 
were red, because the thickness of the-
ir particles was equal to 1/15,000,000
of an inch; that they appeared 
yellow, because they were equal to 
20,000,000 part of an inch, and 
to appear black, if one, &c. 
ALL Physicians allow, that an 
erysipelas is never produced without 
a preternatural encrease in the mo- 
tion of the fluids, and for that rea- 
son, it is not certain, that a greater 
* Vide, pag. 179 and 199.
F3 quantity

70 Of an ERYSIPELAS. 
quantity of serum is sent or derived 
to an inflamed part, than what com- 
monly circulates with the blood. 
See β. 2. of this Section. 
Φ. 4. ALTHOUGH an erysipelas 
causes no manifest swelling or disten- 
sion, yet we know by reason and 
experience, that it seldom can hap- 
pen in any external part of the body, 
without attracting to it a greater 
afflux of humours than what is pro- 
pelled to it by the common laws 
of circulation in a healthy state; 
and that of consequence the part 
must swell in some measure, except 
in some consumptive habits, where- 
in the radical moisture is exhausted, 
and the vis vitæ is unable to propel 
the fluids to the circumference of 
the body, or in those in whom the 
sebacean humour is entirely want- 
ing.
Φ. 5.

71 Of an ERYSIPELAS. 
Φ. 5. As it cannot be compre- 
hended, that an ulcerated erysipelas 
can exist without pain, we can con- 
clude from these remarks, that Fer- 
nellius suppposes an erysipelas to be 
attended with heat, redness, swel- 
ling and pain, which, according 
to Celsus, are the four chasteristics 
of an inflammation. 
Φ. 6. We have remarked under 
Φ. N°. 5. Sect. I. three series of 
vessels through which the blood or 
any other humour is to pass, ac- 
cording to our Author, before it can 
work its way into the cellular mem- 
brane to form an inflammatory tu- 
mour. Fernellius seems also to have 
hinted here, that these three series 
of vessels are continued one into 
another, and that the humours can- 
not pass from the first and second 
into the cellular membrane, or empty 
spaces, as he calls it; but if every 
F4 part

72 Of an ERYSIPELAS. 
part of these two series as well as 
the third, had not inspiring and ex- 
piring vessels and pores that open 
into the cellular membrane, there 
could be no supply of oil or moisture 
to preserve the sensibility of the 
nerves, veins, and arteries, and the 
flexibility and elasticity of the mus- 
cles, tendons, ligaments, and carti- 
lages; they would soon grow stiff 
and break by the least motion, just 
like a twig, which withers by being 
long exposed to the sun, and breaks 
before it can be in the least bent; 
I have observed, that many Peo- 
ple who were long subject to scor- 
butic or venereal complaints, break 
their limbs by very small force, 
which must certainly be owing to 
the want of that oily balsamic hu- 
mour, that passes in a state of health 
from the vessels not only into the 
cellular membrane, but even into
the

73 Of an ERYSIPELAS. 
the substance of the bones. But 
when the vessels are attacked by a 
slow continued erethism, as in the 
aforesaid diseases, this balsamic hu- 
mour cannot always pass, and when 
it does, it grows acrid, or evaporates 
before it can get a supply; because 
the erethism or action of the vessels 
is very irregular in such People, on 
account of the great changes which 
the non-naturals produce in their in- 
firm bodies. 
From these examples, we may 
venture to say, in conjunction with 
Helmontius and Hippocrates, that 
every part of the body, both in- 
ward and outward, and consequent- 
ly of the vascular system, is inspir- 
able and expirable; it is therefore 
reasonable to think, that there are 
pores through the whole length of 
the vessels, by which a humour 
passes into the cellular membrane, 
when

74 Of an ERYSIPELAS. 
when the circulation is in a natural 
state; it is therefore probable, that 
when the tonic action of an in- 
flamed vessel is weakened or abo- 
lished in any part by too great a 
distension from plenitude, the pores 
may become so wide in that part, as 
to admit the red globules or other 
humours to pass through them into 
the cellular membrane. 
For which reason, it does not 
seem necessary to suppose, that the 
morbific humour in an inflamed ar- 
tery should pass through its extremi- 
ty before it can get into that mem- 
brane. Besides, by what Dr. Hal- 
ler extracted from the experimental 
enquiries of Sir Clifton Wintring- 
ham, it appears, "that in general the 
trunks of the arteries are in all parts 
of the body weaker and the branches 
stronger in their coats; whence the 
impulse of the blood may exert a 
con-

75 Of an ERYSIPELAS. 
considerable effect upon the former, 
but least of all on those of the 
limbs. 
FROM hence it is, that aneurisms 
are most frequently formed near the 
heart; for in the lower extremities, 
the strength of the arteries and of 
the veins too is much encreased. 
AND the proportion of the arte- 
rial membranes or coats in thick- 
ness, with respect: to their bores or 
capacities, is greater as the arteries 
grow less, and is thickest in the least 
of them, which can transmit only 
one globule at a time. The truth 
of this is proved from anatomy, and 
the forcing of air into the arteries, by 
which they burst always with more 
difficulty as they are less; and from 
the calculation itself, by which the 
magnitude of the least arteries is 
determined from the globules, dis-
tending

76 Of an ERYSIPELAS. 
tending their two semi cylindric 
membranes. 
ANATOMISTS have erroneously 
supposed the strength of the arteries 
and veins to decrease, in proportion 
as they grow less in thickness, for 
by experiments, it appears, that the 
thinest vessels have often a much 
greater degree of compactness and 
strength proportionable than the 
larger; and some whose coats are 
extremely thin, exceed in strength 
the aorta, whose coats are ten times 
as thick, The emulgent artery was 
found a fifth or sixth part stronger 
than the aorta at the heart, and the 
emulgent vein was found two thirds 
stronger than the cava, &c.*" 
* See remark on § 153, of Dr. Haller's Physiology, 
containing an extract of Sir Clifton Wintringham's ex- 
perimental enquiry, concerning the arteries and veins, 
translated into English by Dr. Mihles. 
HENCE


77 Of an ERYSIPELAS. 
HENCE it is more than probable, 
that the tonic action of an inflamed 
artery can sooner be overcome by 
distension in any point where it is 
preternaturally distended, than in 
its apex or extremity, notwithstand- 
ing what Fernellius, Boerhaave and 
all other Authors affirm to the con- 
trary; therefore I see no necessity 
of supposing the morbisic humour 
to pass from the sanguineous arteries 
into another smaller series of vessels, 
to form an inflammation by error of 
place. Why should it not pass rather 
into their corresponding veins, if the 
serous or lymphatic arteries be not 
intermediate between them? if they 
be, the blood with every kind of 
humour should always pass through 
them before it could arrive in the 
veins. Such an assertion would be 
very absurd, though it may be in- 
ferred from Boerhaave's way of rea- 
soning in the following aphorisms. 
"372.

78 Of an ERYSIPELAS. 
"372. QUODQUE ergo sieri po- 
test vel in sinibus arteriosis, vel in 
vasis serosis lymphaticis aliisque mi- 
noribus, arteriosis dilatatis osculis ad- 
missos globulos rubros aut alia fluidi 
elementa crassa, per fines transmit- 
tere non potentibus. Si sanguis 
transfunditur in eas venas, quæ spi- 
ritibus accommodate, inflammatio- 
nem excitat. Cels. 5. 
378. EFFICIUNT eam in vasis 
lymphaticis arteriosis. 1. Omnes 
causæ, quæ initia horum latiora am- 
pliant, ita, ut in ea intrent partes san- 
guinis erassiores, quæ propulsæ ulte- 
rius occurrunt angustiis conni venti- 
bus, ubi tum patiuntur eadem, quæ
exposita (377); talis est laxitas vas- 
culi in suo principio, motus violen- 
tus liquidi arteriosi: 2. Omnes cau- 
sæ alteri inflammationi communes. 
375, 376.
379.

79 Of an ERYSIPELAS. 
379. Unde et similis morbus in 
omni vase conico, ubi fluit ex lato in 
angusta liquor, obtinere potest; ut 
enim in sanguine rubro sic in lym- 
pha alia est forte pars erassior reli- 
quis. 
380. Ex quibus vera diversitas 
phlegmones erysipelatis, oedema- 
tis, schirri cum inflammatione li- 
quet." 
β. 1. An artery, according to Bo- 
erhaave, is like a cone whose base is 
in the heart, and apex in the extre- 
mities of the body. An erysipelas 
takes place nearer the apex of the 
cone than a phlegmon, and it ad- 
vances sometimes as far as the lym- 
phatics, where it is produced by er- 
ror of place. The serum, according 
to this Author, is yellow, and in his 
Commentary on aph. 127, says, that 
in the serous arteries there may be a
red

80 Of an ERYSIPELAS. 
red or yellow inflammation, the first 
happens by error of place, the second 
is peculiar to these vessels. 
If a little cruor with much serum 
stagnates in the pellucid vessels, 
which are obstructed and inflamed, 
the affected part will then appear of 
a reddish yellow, and this sort of 
inflammation he calls an erysipelas. 
HENCE also appears die affinity 
betwixt an erysipelas and a phleg- 
mon, since they only differ in the 
magnitude of their obstructing par- 
ticles; for in a phlegmon the red 
part of the blood is accumulated in 
the obstructed and distended vessels; 
but in an erysipelas, the serum of 
the blood, mixed with a little cruor, 
becomes impervious in the same 
manner; also the seat of a phlegmon 
is the membrana adiposa, whereas 
an erysipelas invades the external
inte-

81 Of an ERYSIPELAS. 
integuments of the body, or the in- 
ternal membranes. 
IN this extract we may see what 
our Author means by an inflamma- 
tion of the second order proceeding 
from an error of place; but I will 
clearly shew by fair arguments drawn 
from the nature of the solids and 
fluids, that this doctrine is contrary 
to reason and experience. 
β.2. It is a well-known truth, 
that the skin is more or less dried or 
parched in a fever, according to the 
vehemence of the symptoms, of 
which we may daily see evident 
proofs in an ardent fever. I suppose 
no Physician will deny, but the 
dryness of the skin in this case pro- 
ceeds from the constriction of its 
vessels, whether they be sanguiserous, 
serous or lymphatics; * but in an in- 
flamed part the stricture of these 
G ves-

82 Of an ERYSIPELAS. 
vessels must be far greater than in 
an ardent fever; they should there- 
fore exclude not only the red glo- 
bules, but also the peculiar humours 
to which they are destined, and from 
thence become parched and dried. 
HENCE we see the reason why a 
resolution docs not happen before 
an inflammation ceases, and why 
a moisture is not perceivable on the 
skin in an ardent fever, before it is 
upon the decline; it appears, there- 
fore, from this experimental proof, 
which is obvious to every Practitio- 
ner, that in an erysipelas, and in 
every kind of inflammation, the se- 
rous and lymphatic vessels are under 
so great a stricture by an erethism, 
that they exclude all kinds of hu- 
mours, and of consequence all degrees 
of swellings; from thence we may 
see, that it is improbable an inflam- 
mation can take place in these ves- 
sels


83 Of an ERYSIPELAS. 
sels by error of place. For that rea- 
son, we can conclude, that the 
plenitude and derivation of humours, 
which happen upon such occasions, 
take place rather in the sanguiserous 
vessels, or in the cellular membrane, 
or in both together than in the for- 
mer; therefore, it plainly follows, 
from the nature of the serous and 
lymphatic vessels, that our Author's 
doctrine, concerning an inflamma- 
tion of the second order, is contrary 
to experience. 
β. 3. In page 41, we have 
proved, that the blood as being 
grosser than the serum or lymph, 
should come in a greater quantity 
than either of these to an inflamed 
part, and that the thickness of the 
humours in this case, is in propor- 
tion to the force of the inflammati- 
on; these are immediate conse- 
quences of the laws of secretions;
G2 for

84 Of an ERYSIPELAS 
for it is allowed by all Physicians, 
that the motion or force of any or- 
gan in the human body is greater in 
proportion, as it is nearer to the 
heart; therefore, the humours se- 
creted in them will be thicker, ac- 
cording to their distance from that 
center of motion. 
HENCE. may be understood, why 
the urine secreted in the kidnies, 
and the bile secreted in the liver, 
should be much thicker than the 
animal spirits, and the humours 
which in a state of health, pass off 
by sweat and by insensible perspira- 
tion; because these three last are 
secreted by organs much more dis- 
tant from the heart than the liver, 
or kidnies; but the action of the 
solids is preternaturally encreased in 
every inflamed part, therefore, the 
humour derived to it will be thicker 
in proportion to the violence of that 
action;

85 Of an ERYSIPELAS. 
action; but the thicker it is, the 
more it irritates and constringes the 
capillary vessels, until it shuts them 
up so close, that it cannot enter 
their orifices; it follows, therefore, 
from this argument drawn from the 
nature of the fluids, that our Au- 
thor's doctrine, concerning an ery- 
sipelas, or an inflammation of the 
second order, is contrary to experi- 
ence and the laws of secretions. 
β. 4. WHAT I have here asserted 
seems to be confirmed by Fernellius, 
whose book is nothing more (if you 
except his stile and language) than 
a copy of all the antient physical 
Authors, who jointly attribute the 
malignity of inflammatory tumours 
to the greater grossness of the hu- 
mours they contain; it is for that 
reason, they all agree, that a car- 
buncle and a suruncle produce me- 
lancholy effects; because they arise 
G3 from

86 Of an ERYSIPELAS. 
from a gross fervent blood, &c. as 
appears from what follows. 
"CARBUNCULUS ex sanguine ori- 
gin em habet, non eo quidem tenui 
& laudabili, sed crasso ac nigro, ca- 
lido tamen fervente atque corrupto. 
Hic in quamcunque partem invase- 
rit, earn mox exurit, pustulas cir- 
cum se ardentissimas acerrimasque 
ciet, tandemque ardoris vi crusta vel 
nigra vel cinerea obducitur. Huic 
partes vicinæ longo sæpe tractu con- 
sentiunt, caloris dolorisque partice- 
pes: valida quoque febris accersi- 
tur. Inflammata pars nunquam 
suppurat, sed fervore exusta corrup- 
ts carnis lobum tandem excutit, quo 
excidente, ulcus cavum sordidum- 
que manet, hocque uno maxime a 
cæteris sejungitur tuberculis. Car- 
bunculorum alius simplex, qui e solo 
ardore simplicique putredine nasci- 
tur, alius malignus, qui his etiam 
jungit

87 Of an ERYSIPELAS. 
jungit venenatam qualitatem: tails 
in pestilentia grassatur, de quo plu- 
ra proprio loco diximus." 
"FURUNCULUM dothien Græcis 
appellatus tuberculum acutum cum 
inflammatione ac dolore, ovum co- 
lymbinum magnitudine non exce- 
dens. Phymate ergo minus est, sed 
acutius, rubentius, ac dolore gravi- 
us. Phlegmones veram speciem ex- 
hibet, sed ejus exiguæ & quæ vix 
infra cutem descendat, atque sub- 
jectæ carnis minimum comprehen- 
dat. Suppurat furunculus perinde 
atque phlegmone, hincque a sim- 
plici carbunculo discernitur. Fit 
autem non quemadmodum phleg- 
mone e probo sanguine, qui in par- 
ticulam vi quadam irruat: sed e 
crasso & vitioso, non perinde tamen 
atque in carbunculo exusto, quem 
a reliquo puiiore natura secernens 
tanquam insensum atque inutilem
G4 in

88 Of an ERYSIPELAS. 
in corporis summa propellit. Quo- 
circa ut phlegmone multitudinis, sic 
surunculus cacochymiæ saboles est: 
raroque fit ut hie solitarius erumpat, 
sed sere multis corpus scatet atque 
inquinatur." Vide Fernel. De ex- 
tern. Corp. affect. cap. 2. lib. 7. Pa- 
thologiæ. 
The comparison here made by 
our Author, between a carbuncle, 
a furuncle, and a phlegmon, plainly 
shews, that their different degrees 
of malignity and intensity is owing 
to the grossness of the humours, 
from which they proceed; and this 
was not the opinion of Fernellius 
alone, but of all the Antients, from 
whom he copied; therefore, the con- 
clusion we have drawn in β. 2. and 
β. 3. of this section from experience, 
the nature of the fluids, and laws of 
secretions agree with the opinion of 
all the Antients, For which rea- 
son,

89 Of an ERYSIPELAS. 
son, it cannot be supposed, that 
what we say is founded upon mere 
system or hypothesis; for all the 
principles of our doctrine are de- 
duced from reason and experience; 
and indeed, no principle should be 
adopted in physic, which has not 
such a real basis. 
HENCE we may judge, that the 
herpes, the itch, and all the other 
diseases of the skin are produced by 
an effort of nature, to debarrass 
herself of the irritating causes from 
whence they proceed. 
β.5. I have proved above in 
sect. 1. that no obstructions or stag- 
nations can be supposed to take 
place in parts inflamed by the prick- 
ing of a thorn, stinging of Bees, 
Wasps, &c. It should not therefore 
be supposed, that the grossness of 
the humour which is derived to an  
in-

90 Of an ERYSIPELAS. 
inflamed part, is owing to its stag- 
nation, or to the obstruction it meets 
with through the smallest capillary 
vessels, let them be of what kind 
they will. Besides the entrance of 
the humours into these vessels is very 
much hindered by their sensibility, 
which by Boerhaave himself and his 
followers, is judged to be very ex- 
quisite. 
The most minute vessels in the 
human body are employed in the 
secretions and excretions, and par- 
ticularly in those of sweat and insen- 
sible perspiration; and as the func- 
tions of these vessels are most com- 
monly suppressed or interrupted in 
an ardent and in all vehement in- 
flammatory disorders, and the cir- 
culation at the same time is carried 
on in the largest vessels, we may 
lawfully infer that the smallest ves- 
sels in the body are more sensible 
than

91 Of an ERYSIPELAS. 
than the largest; and that it is pro- 
bable the force of a stimulus, be it 
internal or external, sooner invades 
the smallest than the largest vessels. 
As a saburra is sooner felt in the 
head than in the stomach, which it 
immediately vellicates, so, in the 
same manner, an impression made 
in the largest vessels may affect them 
less than their contiguous capilla- 
ries. 
It is thus, the small vessels when 
irritated, sollicit nature to send a 
greater quantity of fluid than usual 
to their neighbouring large vessels, 
which by pressing the Oscula or ori- 
gin of the former causes a stricture 
in them, and an irritation propor- 
tionable to the quantity of fluid, 
which, upon these occasions, is sent 
by the heart to the affected part.  
IT

92 Of an ERYSIPELAS.  
It is thus, the capillaries concur 
by their stricture to form swellings 
in their contiguous large vessels, and 
in the cellular membrane, and ex- 
clude it from their own cavities, 
which is quite contrary to what has 
been hitherto imagined. If the func- 
tions of the capillaries were not thus 
regulated, and if distensions or tu- 
mours could so easily take place in 
them, as most Authors have sup- 
posed, their texture would be soon 
destroyed, all the fluids would ex 
travasate, and put an entire stop to 
the circulation in every inflammato- 
ry disorder. 
β. 7. BOERHAAVE'S doctrine con—
cerning an inflammation of the se- 
cond order is quite inconsistent with 
the mechanism by which the circu- 
lation is carried on in the capilla- 
ries; because the suction and attrac- 
tion,

93 Of an ERYSIPELAS. 
tion, on which it entirely depends 
in these vessels, are much dimmish- 
ed, disturbed, and almost quite 
abolished in some inflammatory dis- 
orders, on account of their stricture 
and erethism, as it is proved in 
β. N°. 1. and 5. of this Section. 
β. 8. BOERHAAVE'S doctrine is 
contrary to the very arguments the 
celebrated Van Swieten produces for 
its proof in § 372. 
The surface of the skin grows 
red in persons who run or walk fast 
(says our Author) and in such as 
cry out loud, or use violent exercise; 
he attributes the redness in these 
cases, to the blood's getting into the 
serous, or lymphatic arteries, and 
from this argument he and all Bo- 
erhaave's Followers conclude that an 
inflammation takes place in these 
vessels by error of place. 
THE


94 Of an ERYSIPELAS. 
THE redness observed in these 
cases is no proof that an inflamma- 
tion can happen by error of place; 
it can only be called at most, a dis- 
position towards that disorder; for 
it is seldom or never attended with 
any pain, and it vanishes according 
as the impression of the stimulus 
ceases, which indeed could not hap- 
pen so soon, if the red globules were 
wedged into the serous or lym- 
phatic arteries, especially if their 
structure is such, as it is represented 
by some of those who defend Boer- 
haave's doctrine, For from every 
secretory organ according to them, 
there spring out canals of such dif- 
ferent structures that through some 
the red globules can pass, whilst the 
white globules only can get into the 
other canals. They say likewise that 
one red globule is equal in bulk to 
six or seven white ones, and that 
sweat and insensible perspiration pass 
out

95 Of an ERYSIPELAS 
out through pores and vesssels of dif- 
ferent kinds or diameters. 
If all that be true, how can it 
be conceived that the red globules 
once impacted in the serous or lym- 
phatic arteries can return back by 
their proper canals into the mass of 
blood? Besides, how is it possible 
that the serous or lymphatic arteries 
can be so much dilated, as to admit 
the red globules of the blood? cer- 
tainly if they did, the redness upon 
these occaions would not so soon 
vanish. 
In all such cases a greater column
of blood than usual is sent to these 
parts to rid them of the irritation 
from which the redness proceeds. 
(See Sect. 2.) And perhaps the dif- 
ference of these vessels is not greater 
than that which is between the pores 
and vessels through which sweat, 
and

96 Of an ERYSIPELAS. 
and the matter of insensible perspi- 
ration do commonly pass; and which 
now by Physicians of the first dis- 
tinction are judged to be the same. 
LEUWENHOECK had discovered by 
the help of his microscope that the 
humour which seemed to be white 
in the capillaries, became red in 
the trunks; therefore we have rea- 
son to think that the redness which 
appears in the skin of those who 
run and use violent exercise, is owing 
rather to a greater column of blood 
than usual, sent thither by the sym- 
pathy of the heart, than to an er- 
ror of place. 
The whiteness of the eyes pro-
ceeds from a flowness of circulati- 
on; but in order to account for it, 
it is not necessary to suppose their 
vessels so small as not to admit the 
red globules of the blood; for if 
it

97 Of an ERYSIPELAS. 
it was so, nature could not conve- 
niently send her universal remedy to 
relieve these organs, upon an emer- 
gency, from any accidents. The 
same thing may be said with regard 
to the whiteness of the skin, which 
is different in sickness, and in a state 
of health, according to the diffe- 
rence of circulation, as it may be 
seen in the same Girl when she is 
well, and when she labours under 
a chlorosis. The greater capacity of 
the vessels hinders not the humours 
they contain from being thin, espe- 
cially, as the vessels of the eye, 
the brain, &c. are at a certain dis- 
tance from the heart. This is easily 
perceived by those who know the 
laws of the secretions. 
HENCE it is probable, that the 
circulation is stronger in a red rose, 
and that it contains a greater quan- 
tity of spiritus rector than a pale
H one,

98 Of an ERYSIPELAS. 
one, and that the difference of their 
colour may be thus accounted for. 
I allow that the vessels which 
we call lymphatics, should be nar- 
rower than those wherein the red 
blood commonly circulates; because 
as the circulation is slow in the 
former, they are seldom alike dis- 
tended with fluids; for which rea- 
son, their sides must certainly ap- 
proach one another, and according 
to the mechanic laws of the secreti- 
ons, they should attract the finest and 
thinest part of the humours; but 
it does not follow from thence, that 
the serous and lymphatic vessels 
cannot at one time admit a greater, 
and at another time a smaller quan- 
tity of fluids; nor does it seem con- 
sistent with the laws of the animal 
oeconomy, that they should be 
otherwise contrived. 
MORE-

99 Of an ERYSIPELAS. 
Moreover we know that the va- 
riety of colours depends upon the 
different reflections or the rays of 
light, and that the difference in 
these reflections proceeds from the 
different configurations of the bo- 
dies which reflect them. From 
hence and from the experiments of 
Leuwenhoeck, it is probable that a 
certain quantity of lymph gathered 
together may assume a red colour. 
Hence it may be concluded, that the 
systems of those who contend, that 
inflammations may proceed from 
the red blood passed into the serous 
or lymphatic arteries by error of 
place, is without foundation. 
β. 9. VAN SWIETEN, for the 
greater proof of his assertion, uses 
also the following argument in §. 
372. If any part of the body, says 
he, is exposed to the vapours of 
warm water, it will swell and look  
H2 red-

100 Of an ERYSIPELAS 
redder than usual, from the ingress 
of the red blood into the smaller, 
relaxed serous or lymphatic arteries; 
from hence he concludes, that in 
inflammations, in the same man- 
ner, these vessels are so relaxed near 
their origin, that the red blood and 
other thicker humours than what 
usually circulate in them, can freely 
enter their orifices, and cause an 
inflammation of the second order. 
CERTAINLY redness in this ex- 
periment does not proceed from a 
laxity of the capillary vessels in their 
origin, but rather from an irritation 
excited by the heat of the water. 
But if the body or any part of it, 
is for a certain time exposed to the 
like vapours, it becomes soft, re- 
laxed and pale. Hence we see that 
some caution and prudence is re- 
quired in the application of such va- 
pours. Besides, as it is proved (page 
76)

101 Of an ERYSIPELAS. 
76) that the capillaries in proporti- 
on to their cavities or diameters are 
stronger than the largest vessels; it 
cannot be supposed that the vapour 
of warm water could so suddenly 
relax them. 
MOVEOVER, as it is allowed, that 
there are blood vessels all over the 
surface of the body, and that they 
are larger than the serous or lympha- 
tic vessels, their tunics also must 
be weaker than those of the latter; 
(page 76) and consequently should 
be sooner and more easily relaxed; 
therefore, as laxity must begin in 
the blood vessels in the above ex- 
periment, their strength must be di- 
minished, and for that reason they 
cannot be supposed to propel the 
blood more than usual into the 
aforesaid vessels; on the contrary, 
they should propel it less than in a 
natural state. It is thus, the large
H3 vessels

102 Of an ERYSIPELAS. 
vessels when relaxed in a dropsy, 
cannot propel the humours to the 
circumference of the body, as ap- 
pears from the dryness of the skin 
in this disorder; therefore, as red- 
ness in the above experiment can- 
not proceed from the greater laxity 
of the serous or lymphatic vessels, 
or even of the blood vessels, it must 
arise from an irritation occasioned 
by the heat of the water. 
β. 10. It is surprising that the red- 
ness of the skin after running, hard 
labour, or violent exercise, should 
be judged by the celebrated Boer- 
haave and Van Swieten, to be a pre 
ternatural state; for it would fol- 
low from thence, that young men 
and all those who are in perfect 
health, and in whom the skin is al- 
ways red, should be in such a state, 
which would indeed be contradicto- 
ry and very absurd. 
I PRO-

103 Of an ERYSIPELAS. 
I propose now briefly to explain 
the nature of an erysipelas. 
An erysipelas is that state of an 
inflammation wherein the affected 
part becomes white, when it is pres- 
sed with the finger; but soon as- 
sumes its former colour when the 
singer is removed. 
A glutinous humour is supplied 
by the sebacious glands to preserve 
the sensibility of the skin, and keep 
it moist, by checking in some mea- 
sure, the egress of the fluid which goes 
off through its pores. This glutinous 
humour being wanting in an erysipe- 
las, the skin is dry and parched, 
and little or no swelling can be 
perceived; because the erethism of 
the vessels is but small, and the mor- 
bisic humours having nothing in 
their way to retard their egress ex- 
hale through the expiring vessels of 
H4 the

104 Of an ERYSIPELAS. 
the skin. It is by the want of this 
glutinous humour that an erysipelas 
differs from a hot oedema. 
In an erysipelas the irritability of 
the skin is much augmented through 
want of the sebacious humour, which 
in a state of health covers the extre- 
mities of its nerves, and defends them 
from external objects. The skins of 
Swans, of the Rhinoceros, and those 
of all amphibious animals, are co- 
vered with so large a quantity of this 
humour, that water cannot easily pe- 
netrate them. The bladder, the in- 
testines, the mediastinum, pericardi- 
um, with all the membranes which 
line the different cavities of the hu- 
man body, are covered with a humour 
not very unlike the sebacious. The 
nature of this humour may be better 
understood from what I shall in the 
sequel quote from Dr. Sauvage, when 
I come to treat of a scirrhus. 
IT

105 Of an ERYSIPELAS. 
IT may hence, in the mean time, 
be understood why the intestines 
sometimes by the force of an inflam- 
mation rather grow dry than swell; 
the same thing happens not only in 
these organs, but in every other part 
of the body, when the extremities 
of the expiring vessels are not co- 
vered with this fort of humour. 
But we are to remark, that the ex- 
travasated fluids cannot pass through 
these vessels, when they are inspis- 
sated by the force or duration of 
the disorder, as I am to shew when 
I come to treat of suppuration. 
SECT.

106 Of an OEDEMA. 
Sect. III. 
Of an OEDEMA. 
“UT pituita alia tenuis, aquosa, 
aut mucosa existit, alia cras- 
sa & glutinosa, cujusmodi est quæ 
vitrea aut gypsea appellatur: ita ne- 
cesse est varies ex hac collecta nasci 
tumores. Ac primum quidem oede- 
ma tumor est frigidus, laxus ac mol- 
lis, doloris expers. Nec calor, nec 
rubor, sed vel genuinus vel albidus 
duntaxat color inest: tumor sæpe 
magnus & qui presso digito, vel nullo 
vel exiguo dolore cedit. Est autem 
duplex: unus collectus & circum- 
scriptione definitus, qui proprie ac 
simpliciter oedema nuncupatur: al- 
ter diffusus & expansus, qui rectius 
tu-

107 Of an OEDEMA. 
tumor est oedematosus. Hic ex cru- 
diore pituitosoque sanguine, aut je-
coris aut assumptorum vitio progig- 
nitur, qui in nutriendas partes il- 
lapsus, nec in earum substantiam 
conversus, sensim cumulatus redun- 
dat partemque tumore distendit, ac 
fere retinet prementis digiti vestigi- 
um. Ita sane in tabe, in cachexia 
& in leucophlegmatia, modo pedes, 
modo reliquum corpus omne tumi- 
dum evadit. Verum autern & ex- 
quisitum oedema non ex sanguine 
pituitoso, sed ex pituita fit super- 
vacanea, quæ solum vel aquosa, vel 
mucosa sit, undecunque illa in af- 
fectam partem deferatur. Fere ta- 
men e capitis distillationibus huic 
origo est, quæ sæpe in genua, inter- 
dum in humeros aliasque partes de- 
cumbit.”* 
* Vide Kernel De extern. corp. affect. cap. 3. lib.
7. Pathologiæ. 
Φ. 1.

108 Of an OEDEMA. 
Φ 1. As an oedema may proceed 
from two sorts of humours, so it is 
distinguished by Fernellius into two 
kinds; the one which proceeds from 
a watery humour, and called by our 
Author a true oedema, to which 
may be referred cold swellings, a 
dropsy, for example, an anasarca, 
&c. and the other kind which arises 
from a fort of thick glutinous phlegm, 
called glassy or plastic. The Anti- 
ents believed this sort of matter to 
be a black kind of bile, or a burnt 
sort of blood; but our Author sup- 
poses it to be a superfluous blood, 
which nature not being able to assi- 
milate sufficiently to nourish the 
body, throws out on the surface of 
the skin, where it produces a hot 
oedema; and the glutinous matter 
which covers the skin in this disease, 
may be reckoned the principal cause 
why the humours are collected in 
the cellular membrane in inflamma-
tory

109 Of an OEDEMA. 
tory disorders; for when that matter 
is wanting, they pass out through 
the pores, as in an erysipelas. 
Φ. 2. Our Author does not clearly 
shew the difference between a cold 
and a hot oedema; the latter is di- 
stinguished from the former by its 
heat, and the pain which is felt 
when the affected part is pressed; 
besides it yields not so easily to the 
touch, as in a cold watery oedema, 
in a leucophlegmacy for example, 
or in an anasarca; neither does the 
skin retain the impression of the fin- 
ger so long as in these cold disor- 
ders; but still longer than in an 
erysipelas, nor is the colour of the 
part changed unless there is a diape- 
desis. 
Φ. 3. I SHALL shew when I come 
to treat of suppuration, that an in- 
flammation is most commonly oede-  
matous,

110 Of an OEDEMA. 
matous, and that one method of 
cure may be sufficient in a phleg- 
mon, an erysipelas and a hot oede- 
ma. It can hardly be understood 
from our Author how a hot oedema 
can be inflammatory; for he seems 
to attribute it to bad digestion or 
the disorders of the liver; however, 
it is reckoned a true inflammation 
by Van Swieten, in § 380 of Boer- 
haave's aphorisms. 
From the observations I made in 
the Hospitals of Paris, I found that 
a great number of Patients when 
weakened by the duration of their 
ailments, were wont to complain of 
an intolerable pain all round the ab- 
domen, and in three or four days af- 
terwards to have its whole cavity 
distended with fluctuating water. 
I also observed, that others com- 
plained of the like pain in the in- 
ferior extremities, before the water 
descened

111 Of an OEDEMA. 
descended to the legs and feet. I 
have seen others recover from drop- 
sies by taking antiphlogistic purges 
after bleeding. 
WE are to remark also, that the 
celebrated Dr. Mead, cured an hy- 
dropick Patient by narcotics. Willis 
employed them also with success in 
a similar case, and the learned Spon 
cured an hydropick by twenty bleed- 
ings.* 
THESE facts being premised, and 
the simplicity of nature in her ope- 
rations being attended to, quere, 
whether there be any analogy be- 
tween a cold and a hot oedema, and 
whether they both proceed from 
similar mechanisms? Certainly the 
symptoms which precede the ingress 
of the serum into the cellular mem- 
brane are not very unlike those which 
* See Medical Precepts, by Richard Mead, M. D, 
chap. 8. 
are

112 Of an OEDEMA. 
are observed before suppuration takes 
place. In both cases, to be sure, 
nature struggles as much as possible, 
before she admits the humours into 
the cellular membrane, and com- 
monly the resistance upon these oc- 
casions is very great, especially in dry 
melancholick habits, as I have ob- 
served very often. I attributed the 
dropsy of this class of Patients to 
spissitude and want of serum in the 
mass of blood occasioned by an ex- 
cess of perspiration, which some- 
times happens to be so immoderate- 
ly great in this sort of People, that 
the blood is so much deprived of its 
vehicle, that it cannot furnish the 
minute ramifications of the nerves 
or lymphatics, with a sufficient quan- 
tity of the fluids to which they are 
distined. Hence the force of the 
solids is diminished which occasions 
a lentor, weakens digestion, and 
brings on a dropsy. 
A

113 Of an OEDEMA. 
A HOT oedema arises from a co- 
lumn of humours preternaturally 
encreased and distending so much 
the sides of the vessels, that it causes 
pain. If the distension and pain 
continue for any time, the vessels 
lose their tone and contractile force, 
the pores are enlarged and a free 
passage opened for the humours into 
the cellular membrane. 
ALMOST the same thing is ob- 
served to happen in a cold oedema; 
for the vessels being too much com- 
pressed by a superabundant quantity 
of serum, the Patient feels great 
pain, or a very considerable anxiety, 
until at last, the vessels deprived of 
their tone and contractile force per- 
mit a free passage to the serum into 
the cellular membrane, or into the 
other cavities of the body.  
I FROM

114 Of an OEDEMA. 
From hence we may see, that the 
vessels and pores can be dilated by 
too much motion or by too much 
laxity. The last case is quite fo- 
reign to my subject; I only mention 
it, in order to take away the equivo- 
cation which might arise from a cold 
and a hot oedema. I proceed now 
to shew the defect of Boerhaave's 
doctrine concerning the latter. 
A HOT oedema, according to 
Boerhaave, takes place in the lym- 
phatic arteries nearer the apex of the 
cone than an erysipelas, and in that 
they differ from one another; be- 
hides the blood has no share in pro- 
ducing this sort of oedema. 
AN oedema is the second species 
of inflammation of the second order 
according to our Author, I have 
proved in sect. 2. β. N°. 1, 2, 3, 4,
5, 

115 Of an OEDEMA. 
5, 6, 7, 8, and 9, that it cannot 
possibly exist. 
ALTHOUGH it is evident from 
what has been said in sect. 2, that 
nature cannot send a particular hu- 
mour different from the blood to 
form an oedematous swelling; yet I 
will for a moment admit the sup- 
position and reason in consequence 
of the following quotation, wherein 
Boerhaave maintains the lymph to 
be the quintessence of the blood. 
“Aquosior, fluidior, salina, spirituo- 
sa portio cruoris sic separatur ab ar- 
terioso sanguine ope glandularum, 
quæ vadit in vasa minima ad motum 
& nutrimentum; reliqua pars cras- 
sior, rubra venis redditur sensim lati- 
oribus fine obstructionis metu; ergo 
cruor arteriosus primo venoso dilutior 
magisque lymphaticus, cujus effectu 
vasa majora aperta tenentur, robur 
corpori datur, materies constantiori  
I2 resectui

116 Of an OEDEMA. 
refectui servatur, sed inde venoso 
cruori dilutionis necessitas, ut fluat, 
iterum per arterias minimas pulmo- 
nales aliasqou: hocce effectu lympha 
glandulis secreta functa suo munere 
et circuitu redditur immediate vel 
per ductum Pequeti ante novum in 
cor ingressum.” * 
As it appears from hence, that 
the lymph is accounted by Boer- 
haave to be the most spirituous part 
of our fluids, and to be the chief 
agent of nutrition and animal mo- 
tion, its quantity with regard to the 
other humours, should be very small, 
and the vessels which contain it 
should be also small in proportion, 
if compared with those which con- 
tain the rest of the humours. For 
the same Author asserts in his chy- 
mistry, by the authority of Mr. 
* Vide Institut. Med. § 209. Boerhaavii. 
Boyle,

117 Of an OEDEMA. 
Boyle, that the spiritus rector of the 
plants is not equal to the 1/100,000 part 
of the water or vehicle which con-
tains it. May not therefore the same 
thing be said of the lymph, which 
the former accounts to be as it were 
the spiritus rector of the human bo- 
dy. It is well known, that there 
are many pellucid tumours, called 
lymphatic, which contain upwards 
of 9 or 10lb. of fluid, and the 
muscular motion at the same time 
not in the least impaired. Now 
I ask of those who defend our Au- 
thor's doctrine, from whence such 
a prodigious quantity of lymph can 
come? From whence so much quin- 
tessence in the blood? To pretend 
that such an accumulation of fluid 
could be furnished by the lymph, 
or from a rupture of its vessels would 
seem altogether absurd; besides, 
how is it possible that the blood ves- 
sels could remain quiet and easy, 
I3 and 

118 Of an OEDEMA. 
and make a truce, as it were, with 
the morbisic matter during the time, 
which a swelling of so prodigious a 
size requires to its formation? There- 
fore, it does not seem reasonable, 
that nature can send any kind of hu- 
mour preferable to the red blood to 
form a hot oedematous swelling. 
Indeed it is more likely that the 
blood, the pus and ichor with all 
the diversity of humours which are 
found in such swellings, are engen- 
dered by the heat, pulsation and pain 
of the affected part. Moreover, 
this sort of swelling comes on sud- 
denly, an instance of which sell 
lately under my own observation, 
when a white pellucid tumour of a 
surprising bigness, I perceived to 
arise round the knee in the space of 
one night. Such a swelling could 
not certainly proceed from the 
lymph. 
THE

119 Of an OEDEMA. 
THE Antients attributed oedema- 
tous swellings to an atrabiliary hu- 
mour. Modern Authors thought it 
was easier to keep this opinion in 
view with a little conjectural altera- 
tion, than to make observations of 
their own. It is for that reason, 
Boerhaave attributed this disorder to 
the serum or lymph, and banished 
the term atrabilis. But as most of 
the Antients understood by this 
term, fæx sanguinis, that is the dregs 
of the blood, it was more likely to 
produce a hot oedema, than the se- 
rum or lymph. 
THE term atrabilis, or fæx sangul- 
nis, should not be intirely expunged 
put of physic; because, in the sense 
of the antient Physicians, it compre- 
hended many ideas; for they were 
so exact in distinguishing the diffe- 
rent constitutions of their Patients, 
that they called one constitution,
I4 phleg-

120 Of an OEDEMA. 
phlegmatic, the other sanguine, &c. 
Such as they found of a dry hot 
constitution, thoughtful, lively, and 
given to speculation, they called bili- 
ous. Indeed they were not much mis- 
taken in their account, for these Peo- 
ple commonly perspire so much, that 
their blood, not having a sufficient 
quantity of vehicle or serum, pro- 
duces heat, costiveness, and an al- 
kalescence of the bile, from whence 
inflammatory disorders very often 
proceed. Tumours arising in such 
habits, were supposed by the Anti- 
ents to proceed from an atrabilis or 
fæx sanguinis, that is a thick hot 
kind of humour wherein the bile 
had a share. Hence we see, that 
the Antients, though unacquainted 
with the true mechanism of secre- 
tions, were persuaded that the gross- 
est part of the humours was derived 
to inflammatory tumours, (β. 2, 3, 
sect. 2.) 
THE

121 Of an OEDEMA. 
THE extremities of the nerves all 
over the body, are covered with a 
mucous or glutinous humour, like 
that which the sebacious glands sur- 
nish for the cuticular nerves. The 
more this humour abounds in the 
cellular membrane, the more the 
fluids derived by the force of an in- 
flammation to that membrane, shall 
be detained, and of consequence the 
swelling shall be greater; but as this 
glutinous humour is seldom wanting 
in the cellular membrane, or in the 
surface of the skin, so also an in- 
flammation seldom happens which 
is not oedematous. 
As the thinnest fluids, upon these 
occasions, are very requisite to extin- 
guish heat, and prevent concretions, 
quere, whether this glutinous hu- 
mour, and the stricture of the ca- 
pillaries were not providentially con- 
trived to detain them in the body? 
IN

122 Of an OEDEMA. 
In some consumptive habits whose 
humours are very acrid, dry, and in- 
spissated, whose vessels are almost 
empty, and in whom the force of the 
heart is very small, little or no oedema 
or tumour can be perceived, altho' 
the ulcers, which spread over their 
legs, thighs and other parts of their 
body, are evident signs that they la- 
bour under a very severe inflamma- 
tion. No swelling appears in these 
cases, perhaps, because the sebacious 
humour is defective, being consumed 
by the long duration of the disease.
The diversity of heat observed in 
inflammatory tumours, consists in 
the different degrees of coction of 
the morbific matter, whereof I am
to speak more at large, when I come 
to treat of suppuration. 
I MAKE no doubt, but that several 
Persons, as well as myself, have ob- 
served


123 Of an OEDEMA. 
served a phlegmon on its decline, to 
assume successively the forms of an 
erysipelas and oedema, and by nature 
or art soon to vanish; which would 
not certainly happen so soon, if they 
proceeded from an inspissated blood, 
serum, or lymph wedged, if I may 
use such an expression, into the 
smallest vessels. 
For which reason, as these diffe- 
rent appearances of an inflammati- 
on are known to arise successively 
in the same place, it seems very cer- 
tain, that they proceed from the 
same cause, namely, from the same 
kind of humours, in the same series 
of vessels, and that they are nothing 
else, but the different degrees of in- 
tensity of the same disease. Besides, 
it is known by experience, that they 
are cured by the same remedies, 
which sufficiently confirms the truth 
of what we have advanced upon 
this

124 Of an OEDEMA. 
this article; therefore it is quite 
needless to place those three appear- 
ances of an inflammation in three 
different sections of a cone, and to 
attribute each of them to a particu- 
lar humour, and indeed it is quite 
contrary to what any Physician or 
Surgeon will find verified by obser- 
vation in his own practice.
SECT.

125 DIAGNOSTIC SIGNS. 
Sect. IV. 
Of the DIAGNOSTIC SIGNS 
OF AN 
INFLAMMATION. 
1. THE Diagnostic signs of an 
inflammation may be taken 
from its definition, page 19, and 
from its effects, (chap. I. sect. I. β. 
N°. 4, 5, 6, 7, 8,) and its different 
names are known from the different 
parts wherein it takes place. Φ. 4. 
sect. I. chap. I. 
PROGNOSTIC SIGNS. 
The dignity of the affected part, 
the greatness of the swelling, the 
con-

126 PROGNOSTIC SIGNS. 
constitution of the Patient, and 
the intensity of the symptoms 
will declare the future event of an 
inflammation. Therefore, if the 
Patient is conscious that his humours 
are not vitiated by the pox or scur- 
vy, scrophulous diseases, &c. that 
the phlegmon has not penetrated 
deep into the parts under the skin, 
we may safely say, that it is void of 
danger, and that it is like to termi- 
nate by resolution, or at least by a 
laudable suppuration. 
WHEN the parts attacked by a 
phlegmon, are of a firm texture, 
and have but a small quantity of 
vessels, such as the ligaments and 
glands, the cure is tedious, and sup- 
puration cannot be brought on with- 
out much difficulty. 
The danger is greater or smaller 
according to the pain, heat, pulsati- 
on,

127 PROGNOSTIC SIGNS. 
on, &c. and according as the vas- 
cular system of the Patient is more 
or less irritable. If these symptoms 
are lessened by degrees without leav- 
ing a hardness in any glandular part, 
it is certain, that the disorder will 
not degenerate into a scirrhus. But 
if these symptoms cease suddenly, the 
epidermis is raised into blisters full 
of ichor, or sinks, and the colour 
of the part becomes black, or livid, 
whilst the pulse at the same time is 
but small, the urine and excrements 
become fetid, and the sensibility of 
the affected part is intirely abolish- 
ed, it is most certain, that a gan- 
grene is approaching or already 
begun. When a glandular part, 
after the symptoms are lessened by 
degrees, becomes hard and resisting 
to the fingers, a future scirrhus is to 
be foretold. The phlegmons which 
take place in the eyes, throat, 
ten-

128 The CURE 
tendinous, or nervous parts, are to 
be accounted dangerous. The deep- 
er the phlegmon penetrates into the 
affected part, the harder it is to be 
cured. 
Sect. V. 
Of the CURE of 
INFLAMMATIONS in GENERAL. 
THE indication of cure for this 
disorder, directs the use of all 
such means as may tend to lessen the 
erethism of the vessels, and to abate 
the encreased velocity of the fluids. 
These are both lessened, or some- 
times totally cured by venesection, 
mild purges, diluents, acids, oily, 
mucilaginous, and narcotic medi- 
cines prudently administered.
1. THE

129 Of INFLAMMATIONS. 
1. The diet should be diluent, le- 
nitive, and cooling; Blood should be 
drawn in proportion to the fluxion, 
the intensity of the pain and other 
symptoms, and according to the 
strength of the Patient; large 
draughts of barley water, rice water, 
with nitre from ℈j to ʒj to every 
pint, also maiden-hair tea, whey and 
other liquors of the same class, are 
very efficacious. 
The emulsio communis of the 
London pharmacopœia is excellent 
upon these occasions; but it will 
become more agreeable, if instead 
of gum arabic, you substitute the 
four great cold seeds of each ʒj. 
If the emulsion should weaken 
the stomach, you may in its stead 
use barley water, aromatized with 
some agreeable herb, and sweetened 
with the syrup of maiden-hair. 
K IF

130 The CURE 
IF the emulsion does not pass off 
freely by urine, a proper dose of 
nitre may be added to it occasional- 
]y; for as no salt diffuses itself in 
any fluid so much as nitre, it must 
be very efficacious, by exciting gent- 
ly the contractions of the vessels, to 
prevent the concretions of the ani- 
mal fluids, in an inflammatory state; 
but it must be taken with a sufficient 
quantity of drink; otherwise it may 
irritate the viscera, and particularly 
the kidnies and urinary ducts. Most 
commonly it carries its action upon 
the latter, and when it does, we may 
generally expect good effects from its 
operation; but in the disorders of 
these parts, we are to be cautious, 
least it should irritate too much; it 
should therefore be given in small 
doses, in these cases, especially by 
young Practitioners, who have not 
skill or experience enough to form 
a

131 Of INFLAMMATIONS. 
a judgment concerning the sensibili- 
ty of the Patient. 
WE may be assured, that nitre ir- 
ritates, if, when it is administered 
in proper doses, the quantity of 
urine compared with that of the 
drink, is too small. 
2. AFTER bleeding in the foot, 
or in the jugular vein, and admi- 
nistering a gentle purge to clear the 
primæ viæ, a semicupium of warm 
water will sometimes ease inflamma- 
tions of the head; for by the heat 
of such a bath, a great quantity of 
humour is derived from it to the in- 
ferior extremities, by which means 
their column and quantity is lessen- 
ed in the vessels of the brain, and 
of consequence their irritation and 
erethism. A small inflammation of 
the brain is thus very often cured. 
A warm bath is no less efficacious 
K2 in

132 The CURE 
in curing inflammations in other 
parts of the body. For the fibres 
grow hard in this disorder, it is no 
wonder, therefore, they should soften 
with warm water, when the very 
horns of Deers may be rendered as 
soft as jelly, by being exposed to its 
vapours. A vapour bath, and fo- 
mentations produce the like effect, 
especially when they are more or 
less impregnated with emollients and 
aromatics, or with acids. Fomen- 
tations of warm milk may be or- 
dered for the same end, with great 
success, or a decoction of the root 
of althea, applied warm. A poul- 
tice made of ground linseed, or a 
fomentation made of its decoction 
will answer the same end. 
AFTER employing baths, vapours, 
or fomentation, the following to- 
pics may be used.
3. OINT-

133 Of INFLAMMATIONS. 
3. OINTMENTS, sweet oils, lini- 
ments, anodyne pultesses, made up 
with bread and milk, the oil of 
olives, linseed oil, and saffron, or 
diascordium, applied outwardly will 
contribute to lessen the erethism, not 
only of the external parts, but also 
of the internal viscera of the abdo- 
men, and of the thorax. The oint- 
ments of althea and elder, the oil 
of olives, either jointly or separate- 
ly, in equal quantities, may be ap- 
plied to the side; for example, in a 
pleurisy. The following fomenta- 
tion may be applied in the same 
case. Take four ounces of the tops 
of white poppies, boil them in two 
quarts of common water, until they 
are reduced to one, drain, and add 
two ounces of vinegar; make a fo- 
mentation to be applied to the af- 
fected part. 
K3 4. IN

134 The CURE 
4. In an erethism of the throat, 
oily potions, with some gentle nar- 
cotics, may be given with success. 
INFLAMMATIONS of all parts of 
the body are cured after the same 
manner, but we should have regard 
to the structure, situation, and con- 
nection of these parts, to the ante- 
cedent causes of that disorder, and 
to the constitution of the Patient. 
IT is certain, that the fibres grow 
hard by the force of the erethism, 
and by that means lose their flexibi- 
lity; therefore, to bring them to 
their former state, it is necessary to 
use a great quantity of oil, especi- 
ally in the inflammations of the 
primæ viæ; but regard must be had 
to the strength of the stomach and 
constitution of the Patient; for they 
are not to be given to such as are of
delicate habits, without some pre- 
caution,

135 Of INFLAMMATIONS. 
caution, and if they do take any 
oily medicine, it should be mixed 
with some agreeable aromatic or sto- 
machic distilled water. Dispensato- 
ries abound so much with receipts 
of this kind, that it is needless to 
insert any here. 
As it is necessary to keep the bo- 
dy open, the decoction of tamarinds 
or prunes, lenitive electuary, salts 
and manna, &c. &c. should be given 
or administered either in a draught, 
or in the form of a glyster. 
The primæ viæ being thus cleared 
of all sordes, by the foregoing me- 
dicines, absorbent draughts, such as 
the decoctum album, or julap cre- 
ta of the London Dispensatory, are to 
be prescribed in the inflammations 
of the intestines, as often as they 
proceed from any vellicating acrimo- 
nious leven; and if the Patient finds 
K4 ease

136 The CURE 
ease by them, he is to use them 
plentifully, and afterwards to take a 
gentle purge. In the same case 
glysters are very efficacious. 
GLTSTERS are of great service in 
inflammations of all parts of the 
body, because they derive a great 
quantity of humours to the intestines, 
and because they pass immediately 
into the vessels without weakening 
or fatiguing the stomach. 
NOURISHING glysters are to be in- 
jected, when the functions of the 
organs of deglutition are disordered, 
or weakened, or when, on account 
of a violent vomiting, the aliments 
are rejected by the stomach. Often 
have I seen life supported a long time 
by this means. 
5. IF by too rapid a motion ex- 
cited by an inflammation, the hu- 
mours

137 Of INFLAMMATIONS. 
mours are so much rarefied, that 
they occasion a false plethora, we 
must have recourse to acids. No 
Physician doubts, but volatile alka- 
lies, by the force of inflammations 
are produced in the human body, 
and as a sulphureous principle makes 
no small part of the composition, 
they powerfully dissolve the blood. 
WE are taught by chymistry, that 
acids have a great affinity with vo- 
latile alkalies, whose smell is owing 
to their combination with sulphur; 
hence it is probable, that acids taken 
inwardly, by uniting with the vola- 
tile alkalies, (which by the force of
the disorder, may be extricated from 
the mass of blood) blunt their sti- 
mulus, lessen the erethism, and pre- 
vent the dissolution of the humours. 
FROM hence, and from the answer 
given to the fifth objection, β. 4. 
chap.

138 The CURE 
chap. 2. it is probable, that the par— 
ticles of the fluids are attracted to 
one another, by the help of acids, 
and that their action against the 
sides of the vessels must necessarily 
be lessened by these means. Be- 
sides acids powerfully dissolve the 
particles of tartar, which sometimes 
get into the mass of blood. From 
all which it is easy to judge why 
acids are so efficacious in the cure 
of inflammations. 
6. IF the greatness of the pain 
hinders the Patient to sleep, he is 
to be ordered some preparation of 
opium, and after bleeding, diluting 
and evacuating the faburra of the 
primæ viæ, with a gentle purge pre- 
pared with manna, tamarinds, and 
some neutral salt. It is certain, that 
the impression made by narcotics, in 
the parts which they immediately 
touch, soon abates the sensation of 
pain wherever it takes place, and this 
must

139 Of INFLAMMATIONS 
must be owing to the sympathy 
which subsists between the different 
parts of the human body, and not 
to the immediate application of these 
medicines, a truth I have seen ve- 
rified in many instances. 
NARCOTICS taken in the mouth, 
or in glysters, soon stop or abate 
pain in any part of the body, as 
every one of the Faculty must have 
experienced. It is impossible that 
could be effected in so short a time, 
by an immediate contact; there- 
fore the impression made by them in 
the stomach or intestines, is such, 
that it is soon communicated to the 
whole nervous system; whether that 
impression is pleasing or irritating, 
we are quite at a loss. If a young 
tame, well fed Quadrupede is gently 
stroked in any nervous part by a 
Person with whom he is familiar, he 
stops,

140 The CURE 
stops, and is put into such an extar- 
sy, that he throws himself some- 
times on the ground, and, if the 
stroking is continued, falls a sleep, 
of which I have myself seen many 
proofs made in animals of different 
kinds. It is surprising how variously 
the nerves are affected, not only by 
inward and outward applications, but 
by different sounds. Music touches 
the ears of most People very agreeably, 
and the young more than the old; as 
we may observe in Children, in whose 
tender nerves such a pleasing motion 
is excited by the songs or humming 
of their Nurses, that they generally 
fall asleep; the bag-pipes have the 
effect of a diuretic on some People, 
according to the testimony of Dr. 
Whytt, in his treatise on animal mo- 
tion. Good news moves the nerves 
of some individuals so pleasantly, that 
they die in an extasy of bliss, and the 
death occasioned by too great a dose 
of narcotics is equally pleasant.
BUT 

141 Of INFLAMMATIONS. 
But we cannot infer from these 
similar effects, that the pleasant sleep 
procured by narcotics is owing to a 
pleasing impression. 
I HAVE proved by a great num- 
ber of experiments, that pain in 
People of all ages, can be stopped 
by an immediate application of nar- 
cotics to the affected part. Is it 
not, therefore, beyond all doubt, 
that an impression made by these 
medicines in any part of the body, 
is communicated to the whole ner- 
vous system? 
ALTHOUGH narcotics seldom fail 
to abate pain in robust habits, they 
should not be administered to weak 
and delicate People, without a great 
deal of prudence and precaution; 
especially if they are not accustomed 
to take such medicines; for accord- 
ing to the proverb, natura consuetis 
gaudet, custom becomes a second na- 
ture 

142 The CURE 
ture. It is thus the. Turks accus- 
tomed to take opium from their in- 
fancy, use it instead of spiritu- 
ous liquors, to get drunk before they 
go to battle. 
ABOUT the last stage of an in- 
flammatory disorder, the theriaca of 
Andromachi, may be given from 
℈j to ʒj. when the Patient is rest- 
less, especially if the skin begins to 
grow moist. But if it it be neces- 
sary to sollicit the oscillations of the 
vessels, Dr. Huxham's essence of 
antimony, may be given from 6 to 
30 or 60 drops, in a glass of wine, 
or in a dish of tea. If a gentle to- 
pic medicine is wanting, the saline 
mixture of Riverius, with an addi- 
tion of a little cinnamon, or nut- 
meg water may answer that end. 
By the help of these medicines, 
and others, taken occasionally from
the 

143 Of INFLAMMATIONS. 
the class of stomachics and cordials, 
we can rouse up the decaying strength 
of the Patient, disperse beginning 
obstructions, and prevent their fu- 
ture growth. 
By the application of baths, va- 
pours, liniments, and such like to- 
pics, as we recommended above, it 
may happen, that an erethism may 
be intirely cured, and the preterna- 
tural velocity of the fluids lessened, 
and brought to its due degree of 
uniformity in the affected part. 
The humours which were propelled 
by the force of the erethism into 
the cellular membrane, find by these 
means, a free passage to run back 
by the inspiring vessels into the mass 
of blood, or to exhale through the 
expiring vessels by the pores of the 
skin; and though the erethism 
of these parts may not be overcome 
by topics, as it happens very often, 
espe-

144 The CURE 
especially when proper internal
medicines are not ordered at the 
same time, and when the strength 
of the Patient is too great, we have 
still this advantage, that the texture 
of the skin is so much softened by 
the use of topics, that the extrava- 
sated fluids can easily pass out thro'
its pores. 
By a skillful and timely applica- 
tion of medicines, not only an infi- 
nite number of abscesses, but loss of 
limbs, and fatal ulcers may be pre- 
vented, and it is only by a perfect 
knowledge of physic, we can be 
directed how to act in such cases. 
ANY impartial judge must own, 
that the remedies prescribed in this 
section, directly answer the indica- 
tions which I have drawn from the 
essence or prime attributes ol an in- 
flammation. 
BUT

145 Of INFLAMMATIONS. 
But should any one take the in- 
dications of an inflammation, for ex- 
ample, from the proximate causes 
to which it is attributed by Boer  
haave and Van Swieten, in aph. 371. 
he might try many useless experi- 
ments, and do the Patient more harm 
than good. This will appear more 
clearly in the following chapter. 
L CHAP.

146 The Indications 
CHAP. II. 
Which proves the curative indications of an 
inflammation to be repugnant to Boerhaave's
doctrine, aph. 371. 
According to our Author, an in- 
flammation proceeds from a 
stagnation or siziness of the blood, 
serum or lymph in the capillary ves- 
sels. If it did, the medicines which 
are properly called aperients, and atte- 
nuants; sassafras, for example, lig- 
num guaiaci, and such drugs as en- 
crease the blood's motion, would be 
very efficacious in the cure of this 
disease, even in its increase and vi- 
gour. On the contrary, acids by 
coagulating the blood, and lessening 
its motion, would be hurtful, and 
emollients would be no less prejudi- 
cial, because the capillary vessels in 
that

147 Of an INFLAMMATION.  
that hypothesis, would be so much 
distended by the accumulated fluids, 
as to be in a proximate state to a 
rupture, which would soon be com- 
pleated by the softening quality of 
such medicines; but the contrary 
evidently happens in practice; for 
emollients and acids are prescribed 
with success, to diminish the stric- 
ture and erethism of the vessels 
in an inflammation; for which rea- 
son, it may be justly concluded, that 
Boerhaave's doctrine is contrary to 
the curative indications of that dis- 
order. 
β. 4. SOME unexperienced Gen- 
tlemen, who consider the materia 
medica by the lump, and have no 
certain rule to guide them therein, 
may object, that attenuants and ape- 
rients, are really efficacious in in- 
flammations. 
L2 I

148 The INDICATIONS
I own, that aperients and atte- 
nuants are sometimes useful towards 
the last stage of the disorder, and 
that by a proper application of them 
at that time, obstructions and scir- 
rhi are very often prevented; but, 
I deny that they can be useful in 
the vigour and encrease of this di- 
sease, for by irritating the solids with 
the hard particles upon which their 
virtue depends, and by which they 
procure heat, they would entertain 
and encrease the erethism of the 
vessels. 
β. 5. Many will object, that ve- 
getable acids, far from coagulating 
the blood, dissolve it. 
ALL Physicians agree, that acids 
are cooling, but they cannot cool a 
living body, without diminishing 
the action and re-action of the solids 
and fluids; therefore a lentor must
necessarily 

149 Of an INFLAMMATION. 
necessarily follow an immoderate use 
of acids, whether taken as aliments 
or as medicines. For the blood 
must contain the principles of our 
food, according to the axiom, 
principiata redolent naturam princi- 
piorum, and the chyle, by heat as 
well as by want of motion, grows 
acid; besides it affords a great quan- 
tity of it by a chymical analysis. 
But acids in general have a proper- 
ty of coagulating; therefore it can 
be asserted, that the chyle and blood 
resulting from a lentor occasioned 
by an immoderate quantity of acid 
aliments, are apt to coagulate and 
form concretions. Every one may 
with me have observed, that those 
who make an immoderate use of fari- 
nacious food or acescent vegetables, as 
rice, oat meal, peas, beans, &c. in pap, 
or lemons, oranges, limes, with all 
other kinds of fruit, look pale, have 
bad digestion, are subject to obstruc- 
L3 tions,

150 The INDICATIONS. 
tions, bilious fevers, and other dis- 
orders of the liver, which are re- 
moved chiefly by the use of alkalies, 
purges and absorbents. The truth 
of what is here advanced, will be 
allowed and confirmed by any one 
of the Faculty who has been in Ja- 
maica, or in the other Southern 
islands of America, where the inha- 
bitants, by using too much fruit or 
an acescent diet, are universally sub- 
ject to the disorders which proceed 
from a superabundance of bile. 
WHAT I have said concerning ve- 
getable acids, is contrary to Van 
Swieten's commentary on aph. 117. 
of Boerhaave. Indeed, what is there
affirmed by this celebrated Author, 
is not conformable to experience, for 
he puts wine, vinegar, milk, and 
fruits of all kinds in the same class, 
and says, that they all dissolve the 
blood very powerfully, I am per-
suaded,

151 Of an INFLAMMATION. 
suaded, that this mistake is to be at- 
tributed rather to a slip of the pen, 
or a fault of the Printer, than to our 
Author. For it is well known, that 
very few Physicians in Europe excel 
him in his knowledge of the materia 
medica. 
I ALLOW that fruit and vegetable 
acids are very efficacious to lessen 
the stimulus of the blood, and that 
by an immoderate use of them, it 
may be taken away intirely; but in 
a short time they generally engen- 
der in its place a more hurtful stimu- 
lus; for when they are used as ali- 
ments for too long a time, they sup- 
ply a bad acescent chyle, which may 
pass in the meseraic veins to the li- 
ver, in so great a quantity, as to 
thicken the bile, take away its ac- 
tivity, and render it partly or alto- 
gether unfit to dissolve and combine 
the different elements of the chy- 
L4 mus;

152 The INDICATIONS 
mus; from whence proceeds bad di- 
gestion, bad chyle, bad blood, and 
a lentor, which bring on obstructi- 
ons, concretions, irritations and co- 
lics, with the other evils which arise 
from such complications. 
It may not be foreign to our sub- 
ject, to observe in this place, that 
acids are recommended by Galen to 
cure the scirrhi of the viscera, but 
he ordered them to be mixed with 
aromatics or with bitters; but what 
results from such a mixture, is in- 
tirely different from vinegar, for ex- 
ample, or any other acid, and for 
that reason, possesses different pro- 
perties, and produce different ef- 
fects. Many Physicians give vine- 
gar plentifully as an attenuant in all 
obstructions, and in a moist or dry 
asthma. I allow that vinegar acts, 
sometimes as an attenuant, but it 
does not follow from thence, that it 
should

153 Of an INFLAMMATION. 
should be ranked in the class of at- 
tenuants, for such an arrangement 
would produce a confusion in the 
materia medica, which would be 
very prejudicial in the practice of 
physic. Calcined hartshorn and rice 
are very efficacious in a diarrhœa; 
but surely no Physician will say, that 
they are astringent, yet we know, 
that some empirics give them that 
name, and they retain it eternally 
in families, where such People have 
credit, and these families would ac- 
count the most learned Physicians 
very ignorant, if they should pre- 
scribe them in any other illness, but 
a diarrhœa; for relying intirely up- 
on the affected gravity and authority 
of these favourite pretenders, it is 
impossible to persuade them, but 
that the astringent effects of these 
ingredients, are owing to their es- 
sence or nature, and not to any ac- 
cidents.  
THE

154 The INDICATIONS 
The same thing may be said, of 
acids in general, and of vinegar in 
particular, which only becomes an 
attenuant by its effects, in asthmas 
and obstructions, though it has not 
that property effentially. We are 
to remark, that real attendants would 
be very noxious in circumstances, 
where vinegar is useful, and that it 
is by the rules of physic, only we 
can know this difference. 
NOTHING helps us more to make 
a happy progress in the practice of 
physic, than a due distribution of 
medicines into proper classes, and all 
the abuses which are committed in 
the materia medica, proceed chiefly 
from want of that arrangement. 
Have we not therefore, reason to 
fear, that vegetable acids, lemon 
juice, vinegar, fruit, &c. ranged by 
Van Swieten, in the class of attenu- 
ates, may lead young beginners in- 
to

155 Of an INFLAMMATION. 
to innumerable errors? Are not the 
evils which arise from thence the 
more to be feared, as the authority 
of that celebrated Author prevails 
so much all over the universe, that 
whatever Physician will dare to 
contradict it, must endanger his re- 
putation? 
MANY Empirics, and even some 
Physicians to this day, boast of the 
great success they have had in admi- 
nistering internally preparations of 
gold, silver, copper, and lead. Such 
errors probably derive their origin 
from some celebrated Physicians, 
who prescribed them, perhaps, for 
the sake of trial, before physic was 
so well cultivated, as in our days. 
SOME use preparations of lead ve- 
ry frequently in gonorrhœas, and 
believe them to be specific, though 
nothing more certainly destroys the
stomach  

156 The INDICATIONS 
stomach or intestines, than that me- 
tal, of which forty Persons, who 
died by drinking small wine, where- 
in litharge was infused, afforded me 
a fatal proof. 
The design of these remarks, is 
to shew that the careless slips or in- 
sinuations of great Physicians, are 
very dangerous, especially with re- 
gard to acids and acescent aliments, 
as may be observed by the great 
number of Negroes, which our Mer- 
chants and Planters lose by a mealy 
acescent diet; for they are seldom 
allowed any thing but rice in the 
passage from Africa to America, 
which by turning four on their 
stomachs, produces all the bad ef- 
fects of acidity, and very probably 
renders their perspiration too slow, 
and it is from thence, perhaps, 
and from their other concurring 
circumstances, that they have such 
a disagreeable smell; for the
humour 

157 Of an INFLAMMATION. 
humour which passes off by sweat, 
and insensible perspiration, are of 
the same nature with the urine, so 
that when they are retained, they 
may acquire a bad smell in the same 
manner as the urine, as I shall ex- 
plain, when I come to treat of ob- 
structions. 
RAMAZINI remarks, that clean- 
sers of jakes are subject to inflam- 
mations of the eyes *, and in some 
countries abroad, (I will not name) 
where instead of jakes, pots are kept 
in the bed rooms, the People are very 
much subject to opthalmies, and 
such of them as I advised to keep 
out of the way from bad smell, soon 
got rid of their disorder. 
From hence it is certain, that 
the acrid effluvia, which offend the 
nose, are also offensive to the eyes, 
* See his Treatise on the Disorders of Artificers, 
chap. 14, translated into English by Dr. James.
and  

158 The INDICATIONS 
and that the fetid particles which 
exhale from the bodies of the Ne- 
groes, render them so much subject 
to opthalmies in their passage from 
Africa to America. The poor 
wretches are bled so copiously on 
these occasions, that the circulation 
is weakened, and the disorder en- 
creased, until it carries them off. 
WE are to remark, that the blood 
resulting from acescent aliments, espe- 
cially in these People, who grieve 
without doubt, on account of their 
confinement, must be poor and con- 
tain but little spirit, and that of con- 
sequence, they cannot bear to lose 
much of it; for which reason, they 
should not be bled without due pre- 
cautions, but should be treated accord- 
ing to the method prescribed by Ra- 
mazini, and the disorder should be 
prevented by allowing them better 
food,

159 Of an INFLAMMATION. 
food, and keeping the place where 
they lie very clean and as free as pos- 
sible from bad smell. 
I was informed by several Portu- 
guese Captains who use the African 
trade, that they seed the Negroes 
the same way as the Sailors, and 
give them sometimes a little wine, 
and that they seldom lose many of 
them in passing from Africa to 
their colonies. 
I may venture to say, that who- 
ever has recommended rice as a con- 
tinual diet among our Negroes, has 
been accessary to the death of so 
great a number of them, as to be a 
great hindrance to the cultivation of 
our colonies, and cause our Mer- 
chants and Planters to lose many 
thousand pounds sterling, per an- 
num.  
I

160 The INDICATIONS 
I Do not mean to forbid intirely 
the use of rice, and other mealy sub- 
stances, on the contrary, I allow, 
that in hot climates, it may be ne- 
cessary for all degrees of People to 
take such food now and then, in or- 
der to check perspiration, and re- 
tard the excretion of the liquid part 
of the aliments. But when a custom 
prevails with regard to food as well 
as dress, it is very hard to remove it; 
and, perhaps, our Merchants and 
Planters, will never change their me- 
thod of seeding the Negroes, even 
when they are informed by what is 
here advanced, that it is much 
against their interest to continue it. 
MOST of our cotempories content 
themselves with the thoughts, man- 
ners, and examples of their prede- 
cessors, without examining whether 
they be good or bad; because such 
an enquiry would cost some pains
and 

161 Of an INFLAMMATION. 
and labour, and very few are fond 
of interrupting their pleasures upon 
such an occasion. 
As my assertion, concerning the 
increase of the bile, From an immo- 
derate use of acescent vegetables, is 
a new opinion, it may be objected 
to, by those, who with Dr. Haller, 
maintain, that as the bile has the 
property of soap, it must be always 
composed of proportionable quanti- 
ties of oil and alkali, which can only 
give it that property according to 
their supposition. 
The invalidity of this objection, 
may be easily inferred from what 
I have already advanced on this sub- 
ject, and as soap can be made with 
oil and acid, as well as with alkali, 
the soapy property of the bile can 
afford no ground for an objection a-
gainst me. 
M CHAP.

162 The RESOLUTION 
CHAP. III. 
Of the Resolution or Dispersion of an In- 
flammation. 
THE resolution of an inflamma- 
tory swelling, does not hap-
pen until the disorder is upon the 
decline. Fernelius says nothing in 
particular about it, Boerhaave ex- 
plains it in the following aphorism. 
“ 386. Si humor fluens blandus, 
motus ejus sedatus, causa obstruens 
non nimis solidata, obstructio, parva 
eaque imprimis in arteriis vel in ini- 
tiis lymphaticorum, canales mobiles, 
diluens vehiculum, reducto fluore 
concreti, motu stagnantis, solvitur 
inflammatio resolvendo.” 
BOER-

163 Of an INFLAMMATION. 
BOERHAAVE supposes in this apho- 
rism, that all inflammations proceed 
from an obstructing matter, concreted 
by stagnation; but would it not seem 
very absurd to assert, that the inflam- 
mation which happens the instant 
that the tendon of the muscle biceps 
is pricked by a lancet, should pro- 
ceed from such a cause? Can stag- 
nation happen so suddenly? And if 
it could, how is it possible that the 
stagnating fluid could be concreted 
in an instant? It is certain, that the 
humour collected in the cellular 
membrane during the inflammation, 
may be concreted by the heat which 
attends this disorder; for we may 
see hard crusts remain under the epi- 
dermis, after some superficial inflam- 
mations, and the same may happen 
internally; for as nature contrived 
the epidermis to surround the whole 
superficies of the body, so she has 
been no less kind in supplying every 
M2 vessel

164 The RESOLUTION 
vessel and every muscular fibre, with 
a particular membrane, under which 
may lodge the matter concreted by 
an inflammation, the same way as 
under the epidermis. But no Phy- 
sician or Surgeon will say, that the 
crusts which remain under the epi- 
dermis after an inflammation, were 
the cause of that disorder; therefore, 
there can be no reason why the like 
concretions should be the cause of 
inflammations in the internal parts 
of the body; for the example I 
have mentioned, evidently proves, 
that they are its effects, and not its 
cause. 
HENCE it is demonstrated without 
the help of any system or hypothesis, 
that the humours attracted to an in- 
flamed part by the force of an ere- 
thism, can pass into the cellular mem- 
brane, as well as to the epidermis, 
without the rupture of any vessels. 
See

165 Of an Inflammation. 
See page 58. In treating of ob- 
structions, I will enlarge more on 
this subject. 
In the last stage of an inflamma- 
tion, the erethism of the vessels, 
with the velocity of the fluids, di- 
minish gradually, until the motion 
of the humours becomes so sedate 
and uniform, that the matter of in- 
sensible perspiration can run out 
through the pores of the skin as 
free as in a state of health; but it 
cannot pass out that way, without 
meeting the matter, which during 
the inflammation, was inspissated 
and collected in the cellular mem- 
brane, without mixing therewith, 
and rendering it more fluid. As the 
humour of insensible perspiration 
goes off in a warm vapour, it should 
dissolve concretions very efficacious- 
ly. When the morbific humour is 
attenuated by this vapour, it should
M3 go

166 The RESOLUTION 
go where it finds less resistance, and 
either return into the mass of blood 
by the inspiring vessels, called ab- 
sorbents, or pass out by the expiring 
vessels through the pores of the skin. 
WE are to observe, that seldom 
any part of this fluid returns into 
the mass of blood, for the pulsation 
of the vessels, and the direction of 
the humour which goes off by in- 
sensible perspiration, determine it 
to pass out through the skin. But 
as this cannot happen, until the ere- 
thism, and the preternatural veloci- 
ty of the fluids cease, it may be easily 
understood, that an inflammation 
can never be terminated in the cel- 
lular membrane. For an inflamma- 
tion never ceases on account of a 
preceding resolution; but a resolu- 
tion of the morbific matter comes 
on, because the inflammation ceases; 
therefore, our Author has no reason
to 

167 Of an INFLAMMATION 
to assert, that an inflammation ter- 
minates by a preceding resolution. 
IT follows from what is said in this 
section, that the resolution of an in- 
flammation does not happen after a 
suppuration, but when without any 
suppuration, the disorder ceases. 
We have nothing to do with the 
first part of this objection, because 
it attacks the principles of Boer- 
haave, who contrary to our opinion, 
asserts, that an inflammation termi- 
nates by suppuration, but if after 
suppuration the inflammation does 
not cease, there can be no resoluti- 
on. We know that suppurated tu- 
mours are often removed by a salu- 
tary metastasis. As to the second 
part of the objection, we acknow- 
ledge, that an inflammation goes off 
without any suppuration, when na- 
ture overcomes the disorder. 
SIGNS

168 The RESOLUTION, &c. 
SIGNS of RESOLUTION. 
WHEN an inflammatory swelling 
is but small, without any fluctuation 
of matter, and the rest of the effects 
are not very intense, but vanish by 
degrees, it is certain, that it will pass 
off by resolution or dispersion. 
THE resolution of an inflammation 
may be procured by the remedies I 
have recommended, in sect. 5. chap. I. 
FINIS. 
ERRATA. 
Page 1. Line 11. for Fernellius, read Fernelius, 
5. 5. after erysipelatodes, read schirrodes &c. 
oedematodes 
79. 2. after and, read Van Swieten. 
90. 18. after ardent, read fever. 
96. 15. for sympathy, read force. 
135. 17. after julap, read e. 
138. 16. after opium, dele and. 

APPENDIX. 
AS the Reviewers of 1768, offered nothing 
concerning my doctrine, that was worthy 
of their institution, my friends advised me to pass 
them by with contempt. But as an exhibition of 
their nonsense may be of some service to their 
successors, and to the students of medicine and 
surgery, I submit the following remarks to their 
perusal. 
To the Printer of the PUBLIC LEDGER. 
From the Mount Coffee-house, August 12th, 1768. 
AS I have found every thing advanced in 
Dr. Magenises treatise of inflammations 
supported by a series of facts, my zeal for the 
welfare of my fellow subjects, engaged me to 
offer the public a candid consutation of the ob- 
jections made against it in the Critical Review of 
this month; and it is to be hoped, Mr. Printer, 
as you are influenced by no party, that you will 
give it a place in your Ledger. 
First. Our critic endeavours to persuade the 
public, that Dr. Magenise was wrong in not ad- 
mitting an obstruction to be the proximate cause 
of inflammations; but he should know, that a
A disorder

2 APPENDIX 
disorder, and its proximate cause, are the same 
thing; and consequently, that to affirm an ob- 
struction to be the proximate cause of an inflam- 
mation is the same thing, as to say, that an in- 
flammation is an obstruction, and vice versa, 
that an obstruction is an inflammation, which is 
absurd; for the proximate causes of a disorder, 
being its prime attributes, constitute its nature 
or essence, the same as a soul and body united 
constitute the nature or essence of man. Our critic 
might have found a more satisfactory answer than 
what we have here given, in what he has quoted 
from the author, and in sect. 1. page 31. 
A plausibility is the only argument used by our 
critic, to support his objections, but as he men- 
tions no circumstances to authorise it, we can ac- 
count it nothing more than an ipse dixit, it should 
therefore prejudice no body against a treatise 
founded upon facts. 
Secondly, As Dr. Magenise has clearly ex- 
plained what he means by an erethism in page 28 
and 29, our critic could have no reason to tell 
the public, that he calls it a general stricture of 
the vascular system, and that he accounts it to be 
the universal, and only possible cause of inflam- 
mations; this is a paultry opinion, borrowed 
from some German writers, which Dr. Magenise 
has nothing to do with. The critic should re- 
member, that in the author's definition, the ve- 
locity of the fluids is affirmed to be one of the 
proximate causes of inflammation; he has no rea- 
son therefore to tell the public, that an erethism, 
that is, the action of the vessels, is accounted by 
our author to be the only cause of that disorder. 
Thirdly,

3 APPENDIX. 
Thirdly. The critic says, than an erethism is 
a supposition; it is the same thing, as if he 
said, that the vessels have no action in an inflam- 
mation; or in other words, that an inflammation 
is not an inflammation, which is absurd. No 
man can deny, but an inflammation is an ere- 
thism, that is, the action of the vessels joined 
with the velocity of the fluids preternaturally en- 
creased; for without these two causes, no inflam- 
mation can be conceived; although our critic 
concludes, from his conception of the laws of the 
animal oeconomy, that an erethism can be the 
cause of external, and not internal inflammations. 
But to affirm, that an inflammation can take 
place internally without an erethism, is the same 
thing as to say, that it can exist without the ac- 
tion of the vessels, which is one of its prime at- 
tributes; indeed he might as well say, that man 
can exist without a soul and body united, which 
would be an absurd assertion. If there was no 
erethism or action in the vessels in internal inflam- 
mations, no pain would attend them; if our cri- 
tic therefore could find out a law in the animal 
oeconomy, to hinder pain in an erethism, in such 
cases, he should be accounted the great Apollo 
by all the nations of the universe. 
Dr. Magenise's arguments on this subject are 
so clear and so convincing, that there is no room 
for an objection against; them; and it will appear 
evident to any gentleman of judgment and can- 
dour, that the proximate causes of inflam- 
mations are as far traced in his treatise, as 
they can be, by human understanding; and 
as he published his book for the instruction of 
A2 students

4 APPENDIX 
and preservation of mankind, it is very il- 
liberal to write a heap of absurdity against 
him. 
Fourthly. Our critic endeavours to persuade 
the public, that Dr. Magenise, was wrong in say- 
ing, that hot stimulating medicines, were im- 
proper in the acme or height of an inflammation, 
but in this point our critic will get none of the 
faculty to join him against the Doctor. Let us 
allow for a moment the practice of our critic; in 
this case, bleeding, diluents, oily and mucilagi- 
ginous medicines should not be employed to cure 
an inflammation, because their effect would be 
contrary to that of the stimulating hot medicines, 
authorised by the established practice of our critic; 
but this practice is established upon such an ab- 
surd basis, that we need no other argument, but 
the example we have cited to confute it. 
Fifthly. Our critic should remember that his 
phlogistic and phlegmatic vicidity includes a 
false supposition with an equivocation, and that 
both it and the concomitant indication of impor- 
tance mentioned by him, as objections, are par- 
ticularities which are not to be inquired into in a 
general treatise of inflammations; and that from 
a particular to a general nothing can be conclu- 
ded. 
Dr. Magenise has mentioned the circumstances 
wherein aperients and attenuants can be admi- 
nistered, page 142 and 148. 
Pleuresies, peripneumonies, and inflammations 
of other particular parts, have some particulari- 
ties, besides the general causes which afford con-
comitant

5 APPENDIX. 
comitant indications; but these have nothing to 
do with a general treatise of inflammations. 
As our critic made use of no malicious or 
illiberal expressions, and concluded with the 
encomium of the author, and allows him to be 
capable of making abstruse investigations, he 
proves himself to be some gentleman, who wants 
to be instructed. But as all his objections, ex- 
cept the two last, are resolved in the book, he 
deserves to be blamed for starting them, as they 
may prejudice the public against the Author and 
his work. He might have given a better proof 
of his good breeding, by paying the Doctor a 
polite visit and consulting him about his doubts. 
This answer has been inserted in the ledger by 
an anonymous friend. The editors of all the 
news-papers spoke of my doctrine with so much 
candor, that they shewed themselves to be en- 
dued with liberal sentiments. As for the proprie- 
tors of the Critical and Monthly Reviews, it is pro- 
bable, that unlawful means were used by literary 
swindlers, in order to prevail on them to insert 
their critico-medical contradictories. 
Three or four attempted to make 
themselves authors, by counterfeiting the doctrine 
laid down in this treatise; but to their great con- 
fusion they proved themselves to be strangers, 
not only to that subject, but to every degree of 
knowledge and science, that is necessary to qualify 
a physician. Their efforts were not unlike those 
of the viper in the sable, who lost its teeth in 
driving to gnaw a smith's anvil. 
The Monthly Reviewer for November 1768, 
was probably one of those literary swindlers. He 
made

6 APPENDIX. 
made use of the most illiberal and malicious expres- 
sions that could be imagined, against this work; 
and by that means produced the effect of a false 
witness, before the unlearned part of the public, 
and gives no other authority for what he said, but his 
ipse dixit; therefore he merits very justly, the title 
of a perjuror. What he quotes from page 19 to 
page 29, contains invincible proofs, that a stag- 
nation of the fluids from errors loci cannot be the 
proximate cause of an inflammation. Had he 
proved by fair argument that any part of the 
doctrine was false, ill supported, or pointed out a 
better treatise for the reader, his criticism would 
extort applause from every intelligent man; but 
as he has done nothing more than to desame the 
Author, and a work composed for the preserva- 
tion of every man's life and health, and a work 
essentially necessary for that purpose, he must be 
an enemy to all mankind. 
Objection 1st, “In the definition of an inflam- 
mation an erthism, and the velocity of the fluids 
preternaturally encreased, are considered as the 
proximate and immediate causes, and yet in the 
following passage, the latter of these seems to be 
considered as the effect of the former, page 164. 
Hence it is demonstrated, says our Author, without 
the help of any system or hypothesis, that the hu- 
mours attracted to an inflamed part by the force 
of anerethism can pass into the cellular membrane, 
as well as to the epidermis, without the rupture 
of any vessels.” See page 58. 
By this objection our critic supposes, that the 
motion of the fluids is independent of that of the 
solids: If it were, when the motion of the heart 
ceases

7 APPENDIX. 
ceases, for instance, the fluids would continue to 
circulate, and consequently there would be no 
death. It is no less absurd to think, that the heart, 
or any vessel in the human body, can move with- 
out moving the fluids that are contiguous to them. 
It follows plainly from this objection, that our 
critic is quite ignorant of the circulation of the 
blood. However, to shew the mutual depandence 
of the motion of the solids and that of the fluids, 
it may be allowed to make use of an obvious simi- 
larity. 
The solids determine the motion of the passive 
fluids, almost in the same manner as a man deter- 
mines the motion of a wheelbarrow he drives before 
him with both hands. In this case, the motion of 
the hands and barrow are synchrone; so that when 
the hands stop, the wheelbarrow stops. In like 
manner, when the motion of the heart and vessels 
is accelerated, that of the fluids must be accele- 
rated also; and when the former ceases to act, the 
latter must cease to circulate. 
In pages 33, 34, &c. I have explained at large 
how every motion of a living animal must be pro- 
duced by the action and re-action of the solids and 
fluids; and when I gave these minute explanations, 
for the benefit of young students, I did not in the 
least imagine, that any practitioner of physic or 
surgery or even any grown person among the vul- 
gar, could be ignorant of the circulation of the 
blood. In this objection, our critic affords us a 
specimen of the knowlege of all those who attempt 
to study or practise medicine before they are ac- 
quainted with the liberal arts. They bodder their 
brains in reading things that are above the sphere
of 

8 APPENDIX. 
of their understanding, and they generally abuse 
gentlemen of university education, if they write 
any thing they cannot comprehend. It seems that 
our Reviewers are generally of this class. 
Objection 2d. Our critic quotes the late Dr. 
Whytt for having attributed in his physiological 
essays, a greater determination of the fluids to a 
particular part, to an increased oscillatory motion 
in the capillaries. Dr. Gorter, Dr. Haller and 
many others asserted the same, when they attended 
Boerhaave's lectures, but none of them proved it 
to be so ex professo. As for Dr. Whytt, he was a 
zealous defender of Boerhaave's doctrine before he 
held a conference with me on that subject, and un- 
fortunately he understood my erethism to be an 
oscillatory motion. I say unfortunately, because 
if so honest a gentleman and his pupils understood 
it thoroughly, I should have no occasion to publish 
my sentiments on that subject, or undergo the ca- 
lumny and insults of literary swindlers and pretend- 
ing schemers: Therefore, to prevent the World 
from being led into error, I had put my thoughts 
in order, in 1767, and formed a general doctrine 
of inflammations, which I have published in 1768, 
and sent every professor of physic at Edinburgh a 
copy of it, that they might see it in its maturity. 
I honour Dr. Whytt's memory so far, that he told 
me it was a valuable doctrine, and never published 
by any author; and desired me most earnestly to 
allow time enough to digest it at my leisure. 
Our critic says also, that Dr. Dobson, in his 
Dissert. inaugur. de Menstruis, attributed a greater 
determination of the fluids to any particular part, 
to an increased irriability. 
What

9 APPENDIX. 
What Dr. Dobson said concerning the menses, 
does not belong to our subject: But admitting that 
he applied it to inflammations; the increased irri- 
tability of the vessels, is not the action of the vessels, 
it only supposes the power of acting or receiving the 
sensation of pain, and consequently cannot be the 
proximate cause of inflammations. All men have 
their vessels irritable; but it is mere nonsense 
to assert, that they have all an inflammation; but 
this follows from what our critic ascribes to Dr. 
Dobson. But I cannot believe that gentleman, or 
his president, to be so ignorant as not to be able to 
distinguish an action from the power of acting: I 
will therefore suspend my judgment concerning his 
dissertation, until it comes to my hands. 
Obj. 3. “ And what it is that Dr. Magenise 
means by an erethism, or a species of action in the 
vessels, which is neither peristaltic nor oscillatory, 
we are at a loss to guess.” 
The nature of an erethism has been traced, pages 
28, 29, to its essence or prime attributes; and the 
human understanding can penetrate no farther. 
And what is there asserted, with regard to it, is 
founded on what every man must feel in the com- 
mon actions of life. 
The impossibility of a peristaltic or an oscilla- 
tory motion in the capillary vessels, is sufficiently 
proved from page 35 to page 44. 
All medical authors agree, that an Inflamma- 
tion begins in the capillary vessels. To say, that 
the action of these vessels, in that disorder, is pe- 
ristaltic, or like that of a worm, is false; for a 
worm must have a free space to work with its head 
and tail, but the frequent anastormoses of the ca- 
pillary vessels, and their connection with the  
B muscles,

10 APPENDIX 
muscles, cellular membrane, membrana adiposa
&c. allow them no such space, and consequently 
their motion cannot be peristaltic. It cannot be 
oscillatory; for such a motion supposes them to 
have a systole and diastole, which are not only 
imperceptible, but even impostible, on account of 
their minuteness. Boerhaave and all Physicians 
agree, that only one globule of fluid can enter them 
at a time; their bore, therefore, must exclude a 
systole and diastole, and consequently an oscillatory 
motion. This assertion may be corroborated by 
the reason that has been given why their motion 
cannot be peristaltic. 
It is certain, that the oscillatory motion of the 
large vessels, near the affected part, and sometimes 
throughout the whole body, is augmented accord- 
ing to the force of the stimulus. 
Every physician must allow, that the different 
classes of the materia medica, and the medicines 
belonging to each of them, taken either collec- 
tively or distributively, are so many different sti- 
muli, which produce so many different modes of 
action in the vessels; some, for instance, act as 
purges, emetics, diaphoretics, sudorifics, diuretics, 
or cordials, &c. But no man can affirm for certain, 
that these different modes of action, or any one of 
them, is peristaltic or oscillatory; nor is it neces- 
sary; for it is sufficient that we should know them 
to produce the effects for which they are com- 
monly prescribed. 
As it appears from hence, that an erethism must 
vary according to all the different stimuli in rerum 
natura, it cannot be expected, that the human 
understanding can prefix names to its different 
modes

11 APPENDIX. 
modes of action, nor is it necessary with regard to 
the indications of an inflammation; for it is suffi- 
cient, in this case, to know that an erethism, or 
the action of the vessels, is preternaturally aug- 
mented, and may be lessened by certain remedies; 
and that in so doing, the confusion, anger and 
struggle of nature, signified by the greek root of 
the word erethism, may be removed. 
An erethism is derived forom ερεθω, vel ερεθiζω,
irrito, lacesso; sρεθiσμα, irritamentum; vel ab epiζω, 
ερiσω, ερiμω, certo, contendoy hirrio; thema, ερiς, 
ερiδoς, lis, contentio, hirritus. 
When a man is irritated, provoked, or involved 
in any disagreeable contention, his anger and con- 
fusion shall be proportionable to the irritation or 
provocation, and his blood shall be hurried into 
the capillaries, with an irregularity proportionable 
to his confusion. In like manner, when any part 
of the human body is irritated or disturbed in its 
office, the heart, or vital hero, is alarmed and 
enraged, more or less, according to the violence 
of the stimulus. It excites, without delay, an 
erethism in the vessels, and redoubles its efforts in 
sending as much humour as it can, to the affected 
part, until it either relieves it, or sinks in the 
attempt. 
Hence it appears, that nothing can better express 
the confusion struggle and anger of nature in 
inflammatipn, than the word erethism, for both in 
Greek and Latin it seems to be formed from the 
letter R, which is called canine, because its repe- 
tition resembles an angry dog's arring. Pope, in 
his translation of Homer's Iliads, has this letter 
B2 repeat-

12 APPENDIX 
repeatedly in every line, when he describes the fury 
or contention of his heroes. 
My investigation of the word erethism may open, 
for the learned, a fertile source of important dis- 
coveries in every branch of medicine. By the 
help of my doctrine, students may be enabled to 
distinguish the indications of inflammatory disor- 
ders from those of obstructions, which is of the 
greatest importance, although it be little attended 
to by many practitioners. For being informed by 
the celebrated Boerhaave, that an obstruction is 
the cause of an inflammation, they give stimulat- 
ing medicines, until the disorder degenerates into 
a putrid fever, which seldom fails to carry off the 
patient; especially, if he be of a strong or robust 
constitution. But it should be considered, that an 
author, who treats of all the parts of medicine, 
cannot be infallible in every point. This was 
Boerhaave's case; for his penetration in all other 
cases shews, that his doctrine of inflammation only 
slipped him. But as the great faith of our prac- 
titioners in this noble author, occasioned this flip 
to do more hurt amongst; us than any where else, 
I have published this Essay, in order to prevent its 
farther progress, and to throw light upon the most 
important part of this great man's works, and by 
that means render the whole beneficial to society. 
For as all disorders have home relation with inflam- 
mations and obstructions, his doctrine of the for- 
mer shall be apt to breed confusion, and render 
his whole work obscure to young students, and to 
those who practise without the assistance of theory. 
Obj. 4. “ Neither is the nature of an erethism 
better ascertained in the following paragraph, in 
which

13 APPENDIX. 
which the argument runs in a circle. Pain is a 
disagreeable sensation, which excites all living crea- 
tures to employ the utmost in their power to re- 
move its causes, &c. page 61. 
The idea which our critic attaches to a circle, 
in this case, proves him to be quite ignorant of 
logical terms; and consequently, that he was never 
qualified, either to practise physic, or to begin 
the study of that noble science: For it cannot be 
inferred from the paragraph he quotes, or from 
any other paragraph in the book he calumniates, 
that pain is called an erethism, or an erethism pain. 
It is only asserted in the aforesaid paragraph, that 
pain is the effect of an inflammation: Besides he 
forgot that an erethism is not mentioned in the de- 
finiton of an inflammation (page 19), as its only 
proximate cause. 
As our critic takes pain to be an erethism, he 
must (in other words) take it intirely to be the 
action of the inflamed vessels; but as the foul has 
a share in the sensation of pain, it follows, that 
our critic does not know the difference between an 
inflammation and its effects, or allow himself to 
have a foul, or know the difference between its 
operations and those of the body. 
Obj. 5. Without giving our readers any fur- 
ther quotations from this work, we shall only ob- 
serve, that when Doctor Magenise comes to treat 
of the cure of inflammations, he takes no notice 
of blisters, though these are doubtless to be ranked 
among the most powerful remedies in the cure of 
these diseases. 
This objection proves our critic to be some Pseu- 
domdicus, who was never qualified to begin the 
study

14 APPENDIX 
study of what he professes; For a physician, who 
is regularly bred, must know, that in an inflam- 
mation, the motion of the solids and fluids preter- 
naturally increased, threatens the destruction of 
the whole body; and as the application of blis- 
ters would increase that motion, they would com- 
pleat the catastrophe. I have observed that this 
always happened, whenever these Pseudomedici 
prescribed for strong people labouring under an in- 
flammatory fever. It is by the preposterous use of 
blisters, volatile alkalies, spirituous tinctures, and 
the different preparations of opium, in such cases, 
the greatest part of the West Indians lose their 
lives, and are often carried away abruptly from 
their families before they can settle their affairs. 
Hence it appears how these Pseudomedici may be 
often the original cause of bankruptcies among 
the merchants of these kingdoms. 
The indications of the disorders into which an 
inflammation may degenerate, must be quite dif- 
ferent from those of the original; and consequent- 
ly, to enumerate their remedies, or decide whether 
or no they require blisters, is quite foreign to a 
general doctrine of inflammations. 
I have traced out this fellow's physical chime- 
ras, in order to shew that our country can produce 
the most ignorant and audacious wretches that ever 
disgraced the human species. The College of 
Physicians should prosecute, and punish most se- 
verely, all those who attempt to prevent the pub- 
lic against any work that may contribute to pre- 
serve life and health. Nothing is so common 
amongst us, as practitioners and authors in law, 
physic and divinity, who were never prepared 
even

15 APPENDIX. 
even to begin the study of either. The igno- 
rance, serocity, and immorality, which reign
amongst us at present, proceed entirely from these 
villanous pretenders. 
The impudence of this sort of cattle soars so 
high as to commence critics; or they prevail on 
the Reviewers to admit their malicious libels into 
their monthly publications, and burn any magazine 
that contains a work of character, that they may 
have an opportunity to present it surreptitiously to 
his Majesty as their own, and pass at court for men 
of eminence in learning. This crime is by so 
much the greater, as it makes the King a receiver 
of stolen goods. It is more than probable, that 
the fitst edition of this work was burned by some 
of them for that purpose, in the house of Mr. 
Walker, Tyler-court, near Carnaby-market: For 
Mr. Walker and his wife are so sedate and careful, 
that the neighbours and firemen affirm, to this day, 
that the house was set on fire by some villain. 
About this time a certain man, furnished with no 
other degree of learning but that of the mechani- 
cal part of surgery, pilfered as much from the 
living and dead as filled up two large volumes. 
The elements of my doctrine were put into this 
heap, and all jumbled together without method or 
principles: yet this man had the assurance to pre- 
sent that heap of medical robberies to his Majesty, 
in order to give him a sanction to sell them to the
public as his own property; but he proved to be 
like the viper who lost his teeth in the anvil. 
The impudence, calumny, and insults of this 
class of men, hinder many gentlemen from fa- 
vouring the public with their discoveries. There
cannot

16 APPENDIX. 
cannot be a more evident characteristic of an auda- 
cious russian, than to arraign before the public a 
work he never read, or never was qualified to read 
with any advantage. 
The recovery of this edition from the flames, 
is owing to the subscriptions and patronage of 
Lord Viscount Barrington, Sir Charles Price, 
Baronet, Robert Cooper Lee, Thomas Murphy 
and William Gray Esqrs. I will pay them and 
my other subscribers a proper compliment, as soon 
as I am able to publish my Doctrines of Suppura- 
tion, Gangrene, Sohirrus, Obstructions, and expe- 
rimental Medicine.
FINIS