Melius Inquirendum.  
OR, AN ANSWER TO Dr. Olyphant's DISCOURSE Of the USEFULNESS of VOMITING in Fevers.  Foelix quem faciunt aliena pericula cautum. 
EDINBURGH, Printed for John Vallange, and Sold at his Shop on the North side of the Street, a little above the across. M. DC.XC.IX.   

Melius inquirendum, &c.  
I Had not concerned myself with such an idle and unseasonable Discourse as this is, were it not to vindicat the Truth from the Malicious Calumnies, and some who are nearly concerned in the Affair, from the false and unjust Imputations of an Airy Ouibler: And at the same time check the Insolence of one, whom without Breach of Charity I may say is large as Forward as Wise, in Publishing to the World that which in Prudence ought to have been Concealed, and in Justifying a Procedure, which cannot so much as admit of a Tolerable Excuse.  
To Trace the Dr. through all the Windings and Turnings of his Discourse, were to set too high a Value on trifles, and every whit as ridiculous as to chase a Shadow, or pursue the very Wind. Wherefore I shall not with him inquire into the Causes of the Decay of Medicine,( which has no more to do with the present Controversy, than the Causes of the Decay of Christian Piety) nor take upon me to determine, whether the necessary Implements of Death-bed Sickness and Funeral Charges, the Dwarfish Performance of a gigantic Wit, and such like Stuff, be Sparks of Wit and true Eloquence, or Flashes of Folly and Natural Banter: Nor shall I Dispute at present, whether an affencted starched Gravity, or a Real Natural Levity, a saucy Assurance, or a Blind Confidence, a Parasitical Cunning, or an Habitual Slandering, the telling of a Stale Jest or Antiquated Story, or the breaking a Dull Jest on the Scripture, and calling it a Syrophenician Story, a Talking Machine, or a prattling A— doing little, or overdoing, be that which throws most Dirt on the whole Faculty, and almost all that does entitle some to their employment? But this I may be allowed to say, that while the Dr. Extols his own Merit, he Degrades his Profession, and while he Displays his Eloquence, he Bewrays his Ingratitude to those Physicians, who were the happy Instruments of saving both the Patients Life and Dr's Reputation.  
Before I enter upon the Matter, I shall first state the Question, that there may be no Room left for Wrangling. The Question then is,  
Whether the giving an Ounce of Emetick Wine, mixed with three Drams of Syrup of Buckthorn, in the ninth Day of a Fever, to one who had been Blooded twice, Purged twice, Vomited thrice, Clystered several times, all in seven Days time: Which Vomit wrought so violently for eight or ten Hours together, that the Patient was reduced to the last Extremity, his Hands and Feet could, his Pulse quiter gone, Spasmodick Contractions through the Body, be a practise agreeable to right Reason, the Rules of Art, and the practise of the best Physicians, both Ancient and Modern?  
Now this being the true State of the Question, this the Dr. must prove, or he proves nothing at all to the purpose. For while he endeavours to prove, That Vomiting in Fevers is no Novelty, he but Skirmishes with his own Shadow, and like another Don Quixot Fights with Wind-Mills; since it has nothing to do with the present Case more or less. It is indeed a Novelty in this Place, and a Crime that ought to be punished by the Judge, to Murder Men, Women, and Children( which I shall make appear at a more seasonable Occasion) with Vomits, and drive them to another World in this Triumphant Chariot of Antimony.  
But let us hear what the Dr. has to say for himself, and how he justifies this Rash, Dangerous, and Unwarrantable practise.  
I was lately called( says he) to a Gentleman of Consequence and Merit, who had been in a Fever several days before: From the beginning it had been attended with such Symptems, as were evident Signs of Repletion, his Stomach being evercharged with Choler and other Humors, which of its own accord it threw up frequently, with a great Bitterness in his Mouth, and other undoubted Evidences of Redounding gull. Blooding and Clystering with Milk and Sugar had been the Achillean Cures his ordinary Physician had plied him with before I came. When first I saw him, I found him labouring under the greatest Oppression imaginable, his Pulse low and oppressed, his Breathing uneasy, and his Spirits overwhelmed with the continuing Disorder of his Stomach, which he had had from the beginning: In a word, he was in such a Case, that I could not venture to give him that, which I was sure ought to have been done at first, and which as yet was the only thing could be done to purpose, until I had procured a Remission by Injecting a sharp Clyster, which had the desired Effect; so that next day I ordered a Vomit of an Ounce of Emetick Wine, and three Drams of the Syrup of Buckthorn. This by the by was not only aggravated with the Frightful Name of an Antimonial Vomit, but also called a Triple Dose. The Evacuation of gull that followed the taking of the Vomit, both upwards and downward, was so surprising, that in all Probability imaginable, it must have been of Fatal Consequence, if it had been left to the Course of the Fever, to have been carried off by a Crise. After that, the Fever went on, but without any thing near that Oppression I at first found him under.  
Now this is not only a Lame and Imperfect, but a most Disingenuous Account, to say no worse, of a Matter of Fact, the Truth of which can be attested by so many credible Witnesses, particularly by the Apothecary who attended during the whole Course of the Fever, and by the Receipts on his Files; by which it is manifest, that the Patient had not only been treated as the Dr. says, but with Clysters of another Nature, and Vomited several times, and Purged to boot with sensible Advantage, and had been so more, had not the Dr. prevented it by his Rashness, and brought the Patient to so low a Pass, that no Place was left for any thing but Cordials and Gentle opiates. That the Patient was under a great Oppression when the Dr. saw him( tho he was under little the Morning of the same Day when the ordinary left him) was no great wonder, nor could be very surprising to any who was acquainted with Fevers, whose alarums ordinarily return towards Evening. This dreadful surprise frighted the Dr, but nothing could be done to purpose, till he had proc●red a Remission by a Clyster: He should have procured another to himself from the Patient and his Relations, before he had attempted so dangerous and desperat a Cure, especially since there was no necessity for it. That this was aggravated with the Frightful Name of an Antimonial Vomit, is false, and so it is, that it was called a Triple Dose; for it was called a Quadruple: For any Physician who is acquainted with emetics, know that two Drams, which is the fourth part of an Ounce, with a little Oxymel, will evacuat considerably, especially in a Fever where there is any Tendency of the Matter upwards, and when the Season was so extraordinary Warm, that the like had not been for many Years, but this had been too Superstitious to observe Times and Seasons. That the Disease, if it had not been treated thus, would have been, in all Probability imaginable, of Fatal Consequence, has no ground imaginable, but the Dr's Imagination, that is to say, it is a mere groundless Conjecture: Since we see Multitudes recover of Fevers attended with an Inclination to Vomit, by the help of other Medicines, without any Emetick, which is also attested by the Experience of all Ages. Not but that I think Vomits may be given in some Fevers to very good purpose, providing they be administered by a Skilful and Wary Physician, who considers narrowly all Circumstances, but strong ones are Edge Tools, which Fools ought not to meddle with, especially if they be such who are never made Wiser by Experience, and who will needs impose upon the World Dreams for Demonstrations, and groundless Imaginations for probable Truths. But if the Dr. would give half as much Assurance, that the Patient would have died, had he not got this Vomit, as I shall give him that he was almost dead by taking it, I should retract my Opinion, and beg Pardon for my Mistake.  
But since this Account of the Dr's is very lame, as I  told before, I shal supply wherein he is wanting, and so make the Story complete.  
After the Patient had taken his potio Vomitiva, That is, a Purge and a Vomit together, and that it had wrought pretty well upwards, and some downward; Off goes the Dr. with Songs of Triumph, not considering what he had seen was only a Prologue to the Tragedy: For a little after, the Patient begun to Purge so violently, that he was reduced to that Extremity I mentioned before in stating of the Question. At last comes the Dr. and finding he had taken wrong Measures, thought fit to call to his Assistance another Physician. They Consult together, and find he is troubled with Vapours, and so the prescribe him an Hysterick Julep or two, and two Pound of an Emulsion with some Diacodium in it, to be taken for his ordinary Drink, and so leave him for that Night to shift for himself. The Purging continued till Eleven a Clock at Night, and all the rest of the Night he slep't none: The next Morning the Ordinary came, who had been out of Town, and was not a little surprised to find so great Change in so short a time( for he had been Absent only 48. Hours) the Pulse Low, the Strength Exausted, the Fever nothing abated, the difficulty of Breathing the same, with a New Addition of continual Raving: The Case being thus, and he being informed of what had past, desired his Physicians might be sent for, with some other, to consider what was fit to be done in the present Juncture. They met together: And the Ordinary, after he had given them the History of his Disease, and the Method he had taken( which they approved) he  told them he would not look back on what had been done in his Absence; But only consider what was fit to be done in the present straight: That it was evident, the Evacuation had been too Violent, and had brought him to so low a pass, that there was place left for no Remedies, but Cordials and opiates, since he had Slep't none since the Vomit, which was more than 24 Hours: Another proposed Blistering plasters; All which was agreed to with common Consent. Accordingly he got a quieting draft about 12 a Clock and slept about 6. or 7. Hours, a Blistering plaster was applied the next Night, and the quieting draft renewed: And afterwards two Blistering plasters more to his A●ms: But notwithstanding of all that was done, the Fever went on, the Raving and drought continued; with the accession of a New symptom ( Starting of the Nerves) till the Saturday, which was the 6 Day since he had got the Vomi●, and then begun gradually to decline, and the Patient to be a little Sensible of his own Condition.  
Now this being the true Matter of Fact, & for the Truth of which I Appeal to the Physicians, and Apothecary, and other Eye Witnesses, and to the very Receipts; And leave the World to judge of the Drs. candour and Ingenuity, and of his Skill, Care, and Conduct in this Affair. Can any thing be more Disingenuous than the Concealing that part of the story which was most Material? Can any thing be more False and Silly, than to mention only Blooding, and Clystering, with Milk and Sugar, as the Chief Remedies the Patient had been plied with? Since the Contrary is Evident by the Receipts on the Apothecary's File, and the Account the Ordinary gave at the Consultation of his Procedure? Can any thing argue greater Ignorance and Rashness than the giving such a Vomit to one, whose Temper & Constitution he was not in the least acquaited with, and who had undergone so many Evacuations before? Since there could have been no hazard of giving a less Dose, especially considering the extraordinary heat of the Season, and that it was the 9. Day of the Fever; But the Dr. was for no such Puny Feats and Dwarfish Performances: Mr. Doelittle was a Name he abhorred; And therefore in Imitation of the Ancient Heroes, and Modern Mountebanks he would put all to the Touch. Aut cita mors, aut victoria laeta: For, 
He either fears his Fate to much,  
Or his Desert's but small,  
That will not put it to the touch,  
To win or loose it all.   
Can there be a greater mark of Unskilfulness and Negligence, or both, than the leaving of the Patient before the Vomit had any considerable Effects downward? If he did not suspect that it would make any considerable Evacuation that way; then he is most justly Accused of the first, since all Vomits of any Strength work downward, and this could not miss to do so at a more than ordinary Rate, being mixed with a Purgative. If he expected that it would work considerably downward, than he was Guilty of the last, because he did not wait the Event. And if he knew neither more nor less of the Matter, then he was Guilty of both. But to give nothing that was Proper and Pertinent to appease the Tumult, but an Hysterick Julep or two and a Chopine of a Cloying Emulsion with Syroup of white poppy, and this not to be taken at a Dose or two, but a little at a time, for ordinary Drink, is a practise that cannot be justified, since opiates given that way does nothing but Dose the Patient, and instead of procuring Rest or Sleep, make him more Disquiet and uneasy; whereas an Opiat mixed with a Cordial in a small Quantity, & given at one Dose, could not have failed to procure Sleep in one who had been so drained and exhausted; which was evident by what was given the next Day. But ill Conjurers raise always more Divils than they can lav.  
Having thus discussed the Matter of Fact, and made some short Reflections on the Dr's procedure, I shall in the next place consider how he defends himself by Reasons and Authority.  
After some Preliminaries, the Dr. proposes a Question of that which no Physician that I know of, ever called in Question. Viz. Whether we shall assist or stimulate nature to dislodge the boil that is in the Stomach, or shall we suffer it to be carried again into the Blood? For all Physicians allow Evacuations in the beginning of Fevers more or less, and so are for dislodging the Enemy as soon as possible, except there be some contrary Indication, such as Weakness, &c. but they are very wary in making strong Evacuations; especially by Vomit. For they think it a dangerous practise to blow up the House to dislodge the Enemy.  
But whether these Evacuations should proceed or follow Blooding, there the Drs. differ, and are not like to determine the Matter by Euclidse's Elements. But this and the rest of the Dr's. Reasons being about Evacuations in general, and having nothing to do with the present Case, as it is stated in the beginning, I shall insist no longer in it, but proceed to Examine the Drs. Authorities; where I shall make it appear, that never Poor Mortal bewrayed more Profound Ignorance and Inadvertency than the Dr. has done in this; and that the Testimonies which he has adduced for the Vindication of his unwarrantable practise are so far from Commending it, That they either do not justify it, or Condemn it altogether.  
The I. Authority he alleges is Hipoc. Aphor. 21 Sect. 1. But that Aphor. mentions only Evacuations in general, without any Respect to the time or Nature of the Disease; and therefore Hip. to prevent Mistakes, tells us Aphor: 24, That In acute Diseases we must Purge seldom, and in the very beginning, and that with a great deal of care and Circumspection. And Aphor. 10. Sect. 4.( which the Dr. has Cited as the Devil does Scripture, by Concealing a part of the Text) In very Acute Diseases, Purging is to be used if the humour be turgid the very same day, for it is Dangerous to delay. But that this Evacuation is not to be by Vomit, he expressly tells us, Aph. 17. Sect. 4. Loathing of Meat, Gnawing in the mouth of the Stomach( exactly the present Case) signify that there is need of Vomiting, if the Patient be not in a Fever. It is Stuff to tell me that the Vomits of the Ancients were either too weak, or of a poisonous and Deleterious Quality, and that it is only the use of the last that Hip. decrys. For no Vomit of the Ancients, even Helebor do, produce more dreadful effects than the Dr'●, did, except when they kill out of hand, which his would not have failed to do, if either the Dose had been a little stronger, or the Patient a little Weaker, which was to Sail too near the Wind: And therefore the Dr's Vomit is Condemned by Hip. both in respect of the Fever, and time of giving it.  
Next in order comes Celsus who is commonly called Hip. Latinus, who is of the same mind with his God-Father, and whom the Dr. has treated the same way; by concealing the one half of the Truth; & therefore I shall give you his own words, and add what the Dr. has omitted Cap. 13. Lib. 2. At Vomitus ut in Secunda quoque valetudine saepe necessarius biliosis est, sicetiam in his morbis quos bilis concitavit. Ergo omnibus qui ante Febres horrore e tremore vexantur, &c. necessarius est. By which it is manifest to any who understand latin, and have consulted the Comentators on that Chapter, particularly Roneus, he speaks here only of intermittent Fevers, and that no body controverts; & so it does not touch the present Case, and the Vomits he allows is warm Water sometimes, with the addition of a little Salt or Honey or a Radish: no great Achillean Remedies, whose gigantic force, produce such Stupenduous effects as the Dr's Vomit. said potentes potenter agunt.  
Having done with the Ancients, he next applies himself to the Moderns, and begins with the great Fernel, who I fear will afford him but very little help in this affair. For the Citations the Dr has given out of the 11 Chap. only relate to intermittent Fevers, which is evident to any who reads it, who will see that there he Treats of an Exquisite tertian, as is evident by these words, where speaking of the Evacuation of boil, he says, Ac si ejus duntaxat quaedam quoddle stimulatio appareat, vomitio quidem praecipue accssionis initio vel Hydryleo vel exymelite procurabitur. And a little below, Haec in vehementi & exquisita tertiana molienda sunt ad quartam fear accessionem.  
The Citation he has out of the fifth Chapter is nothing at all to the purpose, for the Author speaks of Purging, and nothing of Vomiting at all.  
For Platerus he allowed indeed of Gentle Vomits in the beginning of Fevers, such as Warm Water with a little Vinegar, Fat broth, Oxymel, and such like, and such was given to the Patient by the Ordinary.  
Etmul. I confess allows them in all Fevers, but advices to give them in the beginning, especially if the Fever be Malignant. Its true, that in some Fevers, after the Example of Sydenam whom he cites, and to whom he refers, he allows Vomits in the Increase of the Disease, but no strong ones such as the Dr's, which was evident by the Effects; but since he had this from Sydenam, and allows the use of it for the same end, viz: to prevent a Flux, it will follow the same Fate, and stand or fall with it. What that is I shall show, when I come to Examine Sydenam's Opinion.  
Willis gave Vomits in Fevers frequently, but always in the beginning, and never after the fourth Day, as is evident by his Observations: where he is so ingenuous as to tell us, That a Young Gentleman who had a Fever accompanied with a Vomiting, who by no means would hear of a Vomit, being frighted by a former Example, ( N. B.) nevertheless recovered in nine Days.  
silvius speaks only of them in general, which touches not the present case.  
At last Sydenam brings up the Rear, and if he do not make good the Charge, the poor Dr. I am afraid will be forced to quiter the Field.  
Dr. Sydenam who was a very Learned Man, and who has writ the History of some Diseases very accurately, with the Method of Cure, observed, That the continual Fevers that raged four Years together, viz. 61.62.63.64. which were accompanied with an Inclination to Vomit, were successfully Cured by Vomits: But in the Fevers that followed in the 65. tho accompanied with the same Symptoms, he found, That Vomits which had been of so great Use in the former Constitution, was Hurtful and Dangerous in this, and brought on that very Disease, to wit, a Flux of the Belly, which it prevented in the former. This first made him Wary in giving Vomits in Fevers, and longer Experience and exact Observation made him abandon that practise altogether, and take himself to the Purging Method, as the safest and surest of all others, and as most agreeable to Fevers of all Kinds, as is evident by his Schedula Monitoria, in which Opinion he continued to his Dying Day.  
By what I have said here, it is evident beyond Contradiction, That never any Body bewray'd more Ignorance, Inadvertency and Disingenuity, than the Dr. 1. In mistaking the Case altogether. 2. In concealing the one half of the Story, and misrepresenting the other; And lastly, In adducing Authorities to justify his Procedure, which they either do not approve, or condemn altogether, as a Rash and Unwarrantable practise.  
For Hip. is against Vomiting in Fevers. Celsus and Fernel. allow them only in Intermittent ones. platter. allowed only Warm Water, Oxymel, and such like. Willis gives them in the beginning. Etmulerus is of the same mind, especially in Malignant Fevers. silvius says only in general, they may be given in Fevers. And Sydenam has abandoned them altogether; so that the Dr. is condemned by them all one way or another, either in respect of the Disease, the time of the Administration, or the Vio●ence of the Vomit. And the Truth is, That not only Physicians, but all Men in their rights Wits, must condemn a practise that reduce Men to the last Extremity, and brings them to the Brink of the Grave, especially when there is no necessity for it. It is nothing to the purpose to tell me the Patient escaped, so have may that have been Ship-wrack'd, and others that have been Poisoned by the Malice of Villains, and the Ignorance and Rashness of Mountebanks.  
Now, lest the Dr. when he is beat both by Reason and Authority, should have Recourse to the mathematics as his last Refuge, I shall beat him thence too by the help of Dr. P. who has writ a very Learned and Elaborat Discourse of the Cure of Fevers by Evacuation,( which the Dr. highly approves, and to which I refer the Reader) where he pretends to demonstrat Mathematically, That if Fevers are to be Cured by Evacuations, the surest, safest, and readiest way is by sweeting: And so Discards both Purgatives and emetics; and the Dr's being both, especially the first in an eminent Degree, must needs fall under the Censure. And so I leave the two to Scuffle together, and to reconcile Contradictions by the mathematics; and the World to judge of both, by their Contradictory Discourses of Fevers, both living Testimonies of the useful, ingenious and demonstrative Discoveries of those Learned Men; and then let the Dr. tell me whether an effatum upon which such shame contradictory Demonstrations are grounded justly deserves to be called effartum? and to whom Ignorant Impudence justly belongs.  
After all, I am of opinion, that Fevers may be cured by Vomiring, Purging & sweeting, sometimes separately, sometimes altogether, & sometimes as well without any of them. But of all thesenone require more Warieness & Circumspection than Vomits, as daily experience Teaches, and of which I could give many fatal Examples, which have fallen out in this place, but I shall wave it till another Occasion, and shall conclude with what River. says of Antimonial Vomits, Cap. 3. lib. 17. de feb. tertia: They require a prudent and skilful Physician to administer them: Otherwise they are like a sharp Knife in the hand of a Child, or a Sword in the hand of a Madman; And what that is good for, every body knows.  
FINIS.