THE chirurgical Lectures OF Tumours and Ulcers. DELIVERED on Tusedayes appointed for these Exercises, and keeping of their Courts in the Chirurgeans' Hall these three years last passed, viz. 1632, 1633, and 1634.  
By ALEXANDER READ Doctor of Physic, and one of the Fellows of the Physician's College of LONDON.  
LONDON Printed by I H. for Francis Constable and E. B. and are to be sold at the sign of the Crane in Paul's Churchyard. 1635.   

TO THE RIGHT HONOURABLE AND his much esteemed Lord, THOMAS Lord WINDSOR, Baron of Bradenham, and one of the Knights of the Noble order of the Bath, ALEXANDER READ Doctor of Physic wisheth health, and all happiness.  
FOr many ages past, it hath been a custom amongst those who have endeavoured to leave to posterity, any monument of their learning and skill, to dedicated it to some eminent personage: partly to express their gratitude for benefits received (whereof I may allege many examples: partly to procure with the readers, a more easy acceptation of the work, and a more firm protection for it from the reproachful tongues of malicious censures, which no age hitherto ever wanted. I purposing to publish my chirurgical Lectures which I delivered to the worshipful Company of the Surgeons of the famous City of London, on Tusedays appointed for the keeping of their courts, & the performing of these exercises, these three years last passed, and willing to keep on foot this laudable custom, have made choice of your Honour as most fit unto whom they should be consecrated. For who can be a more fit patron, yea, I add, a more competent Judge to these my labours than he, who hath pierced even into the mysteries of the art. Let no man think it any disparagement to any noble personage to have taken pains to attain to some reasonable measure of knowledge in this art; But rather let him persuade himself that it belongeth properly, and of right to such as are renowned for their greatness & valour to be well versed in this art. Achilles is no less famous for his curing of Telephus by art, than wounding of him by his strength and magnanimity. Besides this, seeing your Honour hath graced this Company by desiring to be admitted into it, rather than into any other, hath been beneficial unto it, and hath embraced me with extraordinary favour and respect, I thought it meet that some testimony of deserved respect towards your Honour should be left to posterity of all the Company in general, and of me in particular. Receive then with a cheerful countenance this first volume of chirurgical discourses into your favour and protection. will serve you at the lest for an index of such things as you have read set down in other Author's dispersedly concerning these subjects, and will further your directions, when occasion shall be ministered by any imploring your advice. This benefit will redound unto me, that the work will found the better entertainment at the Readers hands; because it showeth in the beginning your Honour's name.  
In London the fifth of August 1634.   

To my courteous Reader.  
HEre I present to thy view my chirurgical Lectures of the two first points of the first part of chirurgery, which I call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, to wit, of Tumours and Ulcers, delivered these three years last passed in the Surgeons Hall upon the days appointed for this exercise. I have laboured to instruct thy mind, and to direct thy hand in the knowledge and curation of the diseases mentioned in these two Treatises. If thou shalt think that I have attained to my purpose, and have not frustrated thy expectation, I have my desire. If thou think that they are only clouds without rain, and that I have deluded my Readers, let me entreat thee to lay them down out of thy hands, and to have recourse unto such Authors as thou shalt best like of, they serving thy taste. I dare be bold to affirm that I have more methodically set down the nature of every disease, and prescribed more effectual means for the c●ring of them than thou shalt found in most, who have written of these subjects. I have not concealed from thee my own observations, which I would not have thee to sleight: I have (I thank God) so much literature, as is sufficient to guide me in these studies: And I have practised physic and chirurgery now 42 years. But with what success I will refer it to the testimonies and relations of such as have been my patients in sundry parts of this Realm. If thou doubt of the verity of any thing delivered by me in these lectures, I will labour to clear it, if thou acquaintest me with it. If thou prove evidently that I have declined from the truth, I will acknowledge my error, and tender unto thee thanks for thy friendly admonition. Until thou effect this, let me entreat thee to accept of my labours which I have undergone to further the public good. One thing I would not have thee to be ignorant of, and that is this, that hereafter I mean not to add, detract or change any thing in these Treatises, but to go through the rest of the points of chirurgery, of God grant me life, which are to be added to these now published to perfect the art of chirurgery. Wishing unto thee increase of knowledge, and experience in this study, I will commit thee to the protection of the Almighty God, and rest,  
Thy well wishing friend Alexander Read.   

The contents of the Treatise of Tumours.  

OF the definition and parts of Chirurgery pag. 1  
The general doctrine of Tumours pag. 15  
Of the general indications of curing of Tumours pag. 25  
Of the four times of a Tumour, and the indications taken from them pag. 33  
Of curing of a Tumour come to suppuration pag. 35  
Of a Phlegmon pag. 45  
Of an Erysipelas pag. 56  
Of an Oedema pag. 66  
Of a Scirrhus pag. 75  
Of an aqueous Tumour pag. 83  
Of a flatuous Tumour pag. 90   

The contents of the Treatise of Ulcers.  
OF the Authors who have written of Ulcers, and of the definition of an Ulcer pag. 95  
Of the causes of Ulcers pag. 100  
Of the general differences, and signs of Ulcers pag. 107  
Of the general prognostics of Ulcers pag. 110  
Of the general curation of Ulcers, and of their times pag. 114  
Of the medicaments befitting Ulcers in general pag. 118  
Of the curing of a plain and hollow Ulcer being simple pag. 130  
Of the compound, but milder Ulcers in general pag. 136  
Of a hollow Ulcer without callosity pag. 144  
Of a sinewous Ulcer with callosity in general pag. 150  
Of the curation of Fistulas in general pag. 159  
Of Fistula lachrymalis pag. 166  
Of Fistulas of the breast pag. 174  
Of Fistulas of the belly and joints pag. 184  
Of Herpes exedens pag. 193  
Of Phagedaena and Nome pag. 201  
Of a Cancer and a cancerous Ulcer pag. 211  
Of the Leprosy and a leprous Ulcer pag. 222  
Of the abating of superfluous flesh pag. 231  
Of the scaling of corrupt bones pag. 238  
Of a discoloured and varicous Ulcer pag. 246  
Of a verminous and lousy Ulcer pag. 255  
Of the Ulcers of the hairy scalp pag. 266  
Of Ulcers of the ears, and Opthalmia pag. 277  
Of Ulcers of the eyes pag. 287  
Of Ozaena pag. 299  
Of Ulcers of the mouth pag. 308  
Of Ulcers of the lungs pag. 317  
Of Ulcers of the back, abdomen, and joints pag. 325    


Of the description and parts of Chirurgery, Tab. 1. Of Chirurgery, which is an Art which teacheth the curation of diseases of the body of man by manual operation, there are four parts.  
1. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or Compositrix, the part which teacheth to unite parts disjoined.  
2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or Separatrix, the part which teacheth to sever or separate parts which are unnaturally joined together.  
3. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or Ablatrix, the part which teacheth the removing of those things which are superfluous.  
4. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or Additrix, or Appositrix, the part which teacheth the supplements of such things as are deficient in the body.   

Of the branches of the first part 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or Compositrix, Tab. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the which teacheth the unition of the solution of unity of the parts, showeth the unition of parts disjoined:  
Which either may be gathered and inferred by rational discourse, rather than be deprehended by the sense; and hence ariseth the first branch de tumoribus; of Tumours.  
Or may be deprehended by the sense, and this is 

Either in the soft parts, and from hence arise two branches; 

1. De Vlceribus, of Ulcers.  
2. De Vulneribus, of Wounds.    
Or in the hard parts, and from hence spring 2 other branches; 

1. Of fractures of the bones.  
2. Of the luxations or dislocation of the same.        

A TREATISE OF TUMOURS. The first Treatise.  

LECT. I. Of the definition and parts of chirurgery.  
MAny learned discourses have been delivered out of this sear, of sundry points of the renowned art of chirurgery by Master Doctor Gwyn of famous memory, who by reason of his not vulgar learning, hath left an eternal memory in the minds of those who knew him inwardly, to himself. God having called him out of this transitory life, and vale of misery, to rest from his labours, it seemed good to the Governors of this worshipful Company to have this exercise performed by the most able of the brethren as it should come to every one according to his place and dignity. And undoubtedly this office hath been performed by most, laudably, and fruitfully to the praise of the Hall, and mutual communication of skill, for the better performing of duties which so high a calling doth require. And surely if this course had been continued, it had mightily increased in readers the theorical or contemplative part, which doth consist in the knowledge of the precepts, had made them able to give greater contentment to their patients by their rational discourses, and more emboldened them in particular operations, having sufficient warrant of Art for their practice, and ability to convince empyrickes and malicious calumniators. But seeing (as I understand) the highest power of this Realm, from whom there is no appeal, hath decreed that this exercise shall be performed by a Doctor of Physic, and that the worshipful Company hath for the present made choice of me, who profess myself to be a member of the Company; I shall labour by diligence to supply all defects in me, which sundry may found in me, if they compare my weakness, with the ableness of my predecessor. Howsoever the matter falleth out. I will endeavour to deliver what is for the purpose of that subject whereof I read, although not all peradventure which might be alleged to the purpose. Nevertheless I mean not to be so sparing in my discourses, as that you shall have occasion to think that any thing absolutely requisite hath been kept back. And if it fall out that at any time I check or control those authors, who by some are highly esteemed; I desire that none ascribe this to any ambition or vain glory in me before thy weigh my reasons in the impartial balance of judgement. And as it is impossible for any man, who curiously and scrupulously treadeth in another man's footsteps, to compass a long journey in a day: So let none think that ever he shall be famous in his art, if he give himself only to imitation of others. The ancients have left not a little to be found out by the diligence of posterity. Whosoever is industrious and judicious shall found my words to be an oracle. Many of them have set down sundry things not tried by experience, but imagined by their fancy, which the sickle of trial will prune. Nevertheless, in reprehension I will use them respectively, by reason of reverence, which is due to antiquity. Besides this nothing can be both invented and perfected. Now seeing in all the discourses and lectures which have been delivered out of this place, only particular points of the Art have been handled, and none hath taken the pains to touch any Praecognita, or general notions, which may be instead of an Introduction to the particulars, seeing no subject hath been delivered, or commended to me, I will briefly though some introductory points, which will give no small light to the lectures, which hereafter shall be read. 
The Praecognita.  The first shall be of antiquity and dignity of chirurgery. The second shall be of most famous authors, who have taken the pains to illustrate it, by their writings: The third shall be of its place in the course of Philosophy. The fourth of the definition of it: The fift of the division or parts of it. Which things when I have set down, I shall shut up this lecture; permitting election to the Governors, whether they will have me proceed methodically, through the whole course of chirurgery, or scatteredly to handle dispersed parts of the same as hitherto hath been done. My opinion is, 
The intention of the author.  that it will be both more fruitful and pleasing to intelligent hearers (if God will grant me life and health) to pass through all the points of chirurgery methodically: for first the coherence of the parts will help the memory: And who shall be assiduous hearers shall not by snatches take a hungry morsel; but have a full banquet, fully to answer the appetite. When I come to particulars, I will not only deliver the principles of Hypocrates, and Galen, and their sectators the Arabians: but I will acquaint you with the theorems of the Chemists, and compare the opinions of both, that it may be known who have been most familiarly nursed in the bosom of nature. Of the Chemists Paracelsus is the General. 
The chief Chemists.  He hath sundry Colonels under him, as Petrus Severinus the Dane, Quercetan, Petreius, and sundry others, who are oftentimes clouds without rain; more fraughted with bountiful promises, than real performances. Now to come to touch the first general point of chirurgery, 
The antiquity of chirurgery.  which is the antiquity of it, I dare be bold to affirm, that of all arts liberal, it was the first which was invented after the fall: for as for Agricultura and are pastoralis, husbandry and grazing, they would have been required of man, if he had continued in the state of innocence, to have furnished unto him nourishment, and other things requisite for the enjoying of this life contentedly, until he should have been translated from earth to heaven to enjoy the beatifical vision of his Creator. Now it is most probable, I may say demonstrative, that what strange event did first minister occasion to invent an art, that that art was first enquired for and found out. Such was the wounding and killing of Abel, by his brother Cain, by reason of emulation. This could not but move Adam, and Cain himself to study how they might not only repel violence, but have in readiness means to cure hurts also, if they should have been wounded, and their lives spared. All things which were done before the flood are uncertain and unknown, if you except those things which that eminent Prophet Moses, by the inspiration of the Holy Ghost, hath recorded. You may read of bragging Lamech, Genes 4 23 who boasted of murdering. Besides this the wickedness of man increased, Gen. 6.5. sufficient to set him on, and that there were before the flood, giants and mighty men, vers. 4. and so able to perform by violence of villainy. Shall any man think that men unable to resist, did not think upon remedies to cure their hurts, being endued with reason; but as dogs licked their own wounds, and provided no means for curing contusions, fractures, dislocations, and such accidents as follow after violence offered. As for internal Physic, being so near to the creation, 
Physic not so ancient as chirurgery.  living long even to 969 years, Gen. 6.27. as Methuselah did, it is like they used none, seeing they had no other sickness but that of old age: which falleth out, the natural and accidental heat exhausting the radical moisture, and was unavoidable after that the sentence of mortality was pronounced against Adam and his posterity, Gen. 3.10. Thus we see that as the practice of chirurgery was necessary before the flood, so we cannot gather by any obscure conjectures, that that part of Physic, which cureth by exhibiting internal medicaments, was in use. Yea until the time of Hiprocrates. Physic itself seemeth to have been only a knowledge of simples, fit for curing of internal diseases, and outward griefs found out by experience: and that there were but few precepts concerning the art, showing either the knowledge of particular griefs, or the method of curing of them; They, who are accounted the autors and inventors of Physic, prove this to be true: 
The inventors of Physic.  Amongst the Grecians, Apollo the son of jupiter and Latona, is accounted the first, which gave his mind to the study of Physic and Chirurgery. Or him thus writeth Ovid. 1. Metamorph.  
Inventum medicina meum est, opifexque per orbem  
Dicor, & horharum subjecta potentia nobis.  
Physic is my invention & throughout the world (to me.  
Helpful I am said to be, & the faculty of herbs is subject Aesculapius his son followed his father, who added much to that which his father invented: wherefore he was accounted amongst the gods. His two sons Podalyrius, and Machaon accompanied the Grecians to Troy, unto whom they did good service in curing the wounded persons. Chiron Achill●s his master is said by Pliny to have had great skill in the knowledge of simples, and that he was skilful in dressing of wounds: both his name sheweth, (for it is likely he was called Chiron, because he was skilful in the manual part: 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek is a hand) and Achilles his practice in curing wounded persons: for he cured Telephus king of Mysia, whom he had overcome and hurt, and from him the herb Millefole is called Sideritis Achilaea. Of this, which hath been spoken, we may gather that these eminent and worthy men did more practice chirurgery, than Physic. Hypocrates is the first we have, who committed to writing precepts concerning the practice of Physic: He did not only practise chirurgery himself, but wrote sundry treatises concerning sundry operations of it: as of fractures, lib. 1. of joints, lib. 1. of reducing bones by instruments, lib. 1. of ulcers lib. 1. of fistulas, lib. 1. of wounds of the head, lib. 1. of drawing out of the womb a dead child, lib. 1. All these are in the sixth section of his works. Galen succeeded him about six hundred years after, a man worthy of eternal memory, who did illustrate Hypocrates with his learned commentaries, and by adding of those things, which were wanting, did perfect the art. In his works are sundry Treatises, concerning chirurgical subject. The rest of the Greek writers follow him, as Paulus of Aegina, Aetius, Alex. Trallianus, Oribasius, Actuarius and the rest. Amongst the Latins Celsus excelleth, who hath written acurately of all chirurgical operations, whom all modern writers do exceedingly commend; as Fallopius de tumoribus praeter naturam, cap. 1. And Fabricius ab aqua pendente in sundry places, and the rest. Of some, who went before him, thus he writeth: lib. 6. c. 1. And in Rome sundry reasonable good professors (he meaneth of chirurgery, which he calleth vetustissimam most ancient) But chief of late Triphon the father, and Euelpistus added somewhat to that discipline. The Arabians follow; amongst whom Avicen is the chiefest, who lived 1100 years after Christ: of chirurgical matters he discourseth in the third book of his canon, and in the fourth part of his Canticles. Races 2. Continent. Albucasis. Amongst our modern writers these excel, Guido de Cauliaco, whom Tagaultius hath expressed in good Latin: Fallopius, with whom none is to be compared: Ambrose Paraeus, johannes de Vigo, Hieronynous Fabricius ab aqua pendente, Guilielmus Fabricius in his centuries & Master Gale, Master Banister, & Master Clowes, while they lived, brethren of this worshipful company, who by their writings have commended themselves to all posterity. So much I thought good to deliver of the antiquity, dignity, and of the chief professors of chirurgery; which aught to stir up your diligence in labouring, to excel in the particular operations of it, and to resolve to contemn the obloquys and calumnies of rude and ill bred persons, who shall seem to slight this excellent art. If you inquire for the beginning of it, it is vetustissima most ancient, according to Celsus in the place above mentioned: If you require certainty, it is grounded upon experience, and offereth itself to the eye: If you ask who did of old practice it, you shall find that either they were numbered amongst the gods, or were renowned persons, called heroes, as Hercules, Chiron, Achilles, or men of eminent learning and worth, as Hypocrates, Galen, Avicen, and sundry others. 
The subject of chirurgery.  It hath for its subject the body of man, and in this point no whit inferior to Physic itself. And whereas many will stick to take a dangerous medicament; yet they will not stick to admit chirurgical operations, although they be full of peril, as incision for the stone, and dropsy, 
To what part of Philos phie chirurgery is to be referred.  dismembering and such like, as we may see day by day. Now to know to what part of Philosophy chirurgery is to be referred, we must consider that there be two parts of Philosophy: whereof the one is speculative, whose end is knowledge; 
Parts of Philosophy.  The other practic, whose end is practice. Now practice hath two differences, Action, and Effection. Action leaveth no work behind it. Effection doth. 
Arist. 6 Ethic. c. ● & li. 1 mag. moral. c. 35●  Of the active part of philosophy, there be three parts; Ethick, which frameth the manners of a private person: Oeconomick, which showeth how a family is to be governed, and Policy, which teacheth how a Commonwealth is to be ruled: These we will leave, because they belong not to our purpose: as neither those arts, which are merely factive, commonly called mechanical, and so unworthy of a Philosopher. The speculative part of philosophy comprehendeth under it the Metaphysics, 
Arise. 6. Metaphys c. 1.  natural philosophy, and the Mathematics: Of the first and last we will speak nothing, because they belong nothing to that subject which we have in hand. The subject of natural philosophy is corpus naturale, or a natural body: Now of all natural bodies, the body of man is the chiefest & most excellent, which moved the kingly Prophet to burst out into this resolution: Laudabo te, quia mirabiliter formatus sum: I will praise thee, because I am wonderfully framed: The admirable composition of the body of man drew from Galen himself, not the best master of piety, a hymn to his Creator. Now natural philosophy considereth the body of man, 
The parts of Medicine.  as it is a species or kind of natural body: but medicine as it is curable by art. Of Medicine there are two principle parts, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. The first teacheth the preservation of health by convenient diet, exercises, and such like: The second teacheth, how health lost may be recovered: There be two means to repair health: for this is done either by medicaments, or manual operation. The first is performed by that art, which here is called physic; the second by chirurgery. So that chirurgery is the second branch of the curative part of medicine, without the which neither country, city, town, village, hamlet, yea not private family can well continued or subsist. This we must confess, if we consider unto how many external injuries the body of man is subject, as to scaldings, fractures, luxations, wounds, ulcers, ruptures, stone, and to what not: So that the use of chirurgery is by reason of absolute necessity more often required, than the ministration of medicaments. And seeing the operation of a Chirurgeon is more subject to the eye and other senses, than the exhibition of medicaments is, it behoveth every one to be well versed in that which he taketh in hand, seeing his practice is more subject to censure: There be a number of empyrical knaves, filthy bands, and bold queans, who daily minister medicaments boldly, who ●●twithstanding dare not meddle with any curious operation in chirurgery. Such impure hands dare not touch such a chaste and undefiled Lady. Now it is time to come to the fourth point, 
iv Point.  which I intended in my proposition: which is to show what chirurgery is: Now there is a double quid, or what, quid nominis, & quidrei: The first showeth the reason why this term was found out to express this art: The second delivereth the nature of the art itself. 
The Erymon.  Chirurgia is a Greek term composed of 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifieth a hand, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 to work: Because it restoreth health to the bodies of men by manual operation. 
The definition of chirurgery.  chirurgery then may be thus defined: It is a branch of the curative part of medicine, which teacheth how sundry diseases of the body of man are to be cured by manual operation. It is not a science properly, because it resteth not in only knowledge; but an art as Physic itself is: for it leaveth an effect after the operation, to wit, health: So that for the genus, it hath the same with Physic itself: Both Physic and chirurgery propose to themselves one end: yet the means are divers. Physic restoreth health by ministration of medicaments; but chirurgery by manual operation: Seeing then the definition which I have assigned to chirurgery doth consist of genus and differentia, according to school terms, it must be an essential definition, fully expressing the nature of it. The fift point whereof I intended to speak of this lecture, 
V The parts of chirurgery.  was of the parts of chirurgery, which must be assigned according to the main differences of operations. Those are four in number, and consequently so many parts: for either by chirurgery, solution of unity is removed, and union restored; or things unnaturally united are separated & disjoined; or things superflous taken away: or last of all defects supplied. 
The kinds of solution of unity.  Now solution of unity is either gathered by reason, or deprehended by sense. In tumours although the parts seem to the eye united; yet reason teacheth us, that there is a divulsion of ●hem: The doctrine of tumours therefore aught to be the first particular treatise. Solution of unity apparent to the senses, to wit, sight and touch, are either in the soft parts, or in the more  and hard. In the soft or fleshy parts there be two differences of solution of unity: vulnus & ulcus, awound, and an ulcer: In the hard parts there are found a fracture, and a luxation; two distinct sorts of solution of unity to fill up the fourth and fift places. This part may be called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or pars compositrix, 
1. Part of chirurgery.  the part joining together. The second part of chirurgery opposite to the first, teacheth to separate parts unnaturally united: where either the comely composition of the body of man is defaced or impaired, or the actions of the same hindered. Sundry have been brought into the world with the anus and vulva quite shut up. The consideration of that membrane, which is found in the neck of the matrix of some women, is in this place to be noted and considered: Seeing there have been and yet are so many concertations amongst both skilful Physicians and Surgeons. Here also is the cure of the wry neck to be set down. In this grief the head on the one side by reason of one or more tendons of the muscles of the neck shortened, the head is drawn towards the claves more than on the other whereby it cometh to pass that the face groweth awry and distorted: and so the beauty of the countenance is much impaired. To this part belonged the curing of tongue-tied children, in whom sucking and speech are hindered. Not only fingers and toes cleave together in the same person: but twins also, and double members of one person. The consideration of such doth belong to the history of Monsters; not to any art: seeing such things are to be ranged amongst rarò contingentia, and so belong not to art, which is of things necessary. 
2. Part of chirurgery.  This part may be termed 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or separatrix pars, the separating part. 
3. Part.  Now followeth the third part of chirurgery, which showeth the means to remove from the body things superfluous, which may fitly be called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or ablatrix pars, the nipping or removing part. Things superfluous are such, either by event, or by their own nature. Things superfluous by event are sundry: And first a dead child in the womb, or staying too long to the prejudice of it own and the mother's life. Here shall be set the manner how to bring women to bed (as we term it) artificially and safely. Secondly, a falling of the small guts into the cod by enlarging or renting of the production of the Peritonaeum, which we call a rapture. When I come to this point, I will set down the diversities of ruptures, and the means of curing of each: which are either incision, or truss, or application of medicaments, sometimes used solitary, sometimes concurring most or all together. Thirdly, the amputation of a limb by reason of a mortification, or some other accident. Here shall be set down the most accurate method of dismembering. Fourthly, the exstirpation of any part, as the breast, when a cancerous either tumour or ulcer doth possess it. Here you shall be acquainted with the safest way of exstirpating a cancer and a lupus. Fiftly, blood offending either in quantity, or quality is drawn by phlebotomy, leeches, ventoses, of all which I will particularly discourse. Things by their own nature superfluous, are either somewhat familiar to nature, or altogether adverse: Of the first sort, are Wens, and Strumae: when I come to them I will set down the diversities of them, and how they also are to be cured. Secondly, the couching of a cataract offereth itself. Here I mean to set down the variety of cataracts, the prognostics of them, whereby it shall be known which are curable and which not, and the most exquisite manner of couching of such as are curable. Things adverse to nature, are stones in s●●dr●● parts of the body; but chiefly in the bladder. The incision for extracting of it, is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉: of it I mean diligently to discourse, because it is a dangerous operation, and many times scandalous. Last of all, I come to the fourth and last principal part of chirurgery, 
iv Part of chirurgery  which is the supplying of the defects of the body, which may be called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or additrix the supplying or adding part. Now things which are added, are either of the body itself, as restoring of the Nose lost, or curing of the hare lip. Of the first, I will set down the method of the Bononian Physicians, and Surgeons: Of the second, my own and other famous men's experiments in curing both the single and the double harelip. The matter of things, which is used for repairing of the losses in other parts, as the eye, the eat, arm, and leg, is no ways of the nature of the body. Nevertheless when I am come so far, I will make an end of the course of chirurgery with touching these so much as shall seem sufficient, to instruct such as have not been versed in these practices. I have run through those five introductory points of chirurgery, to wit of the antiquity and dignity of it: of the professors of it, of its place amongst the liberal arts, of the definition and parts of the same. As concerning the two last points, I have varied from all who have written of this subject: Nevertheless I have the light of nature on my side, and the experience of all skilful practitioners. So that it is needless to take further pains, either to confirm those things which I have alleged, or to refute that which hath been said by others; Seeing I intent rather to frame an able operating Chirurgeon, than to set out a contentions disputing theorician: Besides, reprehending of others doth not so much instruct the hearers in the knowledge of the truth, as showeth that, which is not to be learned, but shunned. Neither is a Chirurgeon contented to have performed so many duties to the body of man while it is alive and the instrument of the soul, for performing actions; but when it is dead the spirit returning to God, who gave it, he ceaseth not to be officious to it, in dissecting of it, for the instruction of himself and others, and preserving it from putrefaction and annoyance, until time and place fit for burying of it be offered: which he compasseth partly, by encearing of it, partly by embaulming: of the which two last, I mean also to discourse: That the Chirurgeon, which I mean to frame, may be complete. I have now presented to the view of the eyes of your understanding, this chirurgical Canaan: Into the which I mean to bring you, not to use the native inhabitants hardly, as joshua did the Canaanites and their things: but mutually to enjoy the use of those good things which you shall found with them. If I proceed orderly, I must enter into the doctrine of Tumours, which will be both pleasing and profitable in my first lecture. It is a subject, which is most frequently offered, and from whence the meanest of all the brethren, which practiseth, is not exempted. Wherefore it behoveth every one to be well grounded in this point: Howsoever I shall be willing that the Governors of the worshipful Company set down the matter, whereof I shall reader:  

The Treatise of Tumours doth deliver things either  
General to all Tumours, and those are in number three. 

1. The description of a Tumour.  
2. The causes of a Tumour according to the 

Dogmatists.  
Chemists.    
3. The differences of Tumours.    
Special, belonging to every Tumour particularly. How all Tumours are either 

Simple, and those are 6. which proceed from either 

Humours, and those are four. 

Phlegmone, caused of blood.  
Erysipelas, of choler.  
Oedema, of phlegm.  
Schirrus, of Melancholy.    
Or from 

Water, an aqueous Tumour.  
Flatuositie, a flatuous Tumour.      
Compound Now the Combination of the Tumours proceeding from the mixture of the material causes, causing the simple, I have set down in every particular Tumour.      

LECT. II. The general doctrine of Tumours.  
SEeing according to Aristotle in cap. 1. lib. 1. physic. acroas. in every methodical tractation, that which is most general aught first to be set down, then that which is more special; because the general points being set down, they exceedingly further the knowledge of the particulars: I will begin from those things which are common to all special Tumours, and those I make in number three. First, I will declare what a Tumour is. Secondly, which are causes of Tumours: Thirdly, which are the main differences of Tumours.  

The appellations of a Tumour.  Before I come to the essential definition of a Tumour, I Will set down the denominations of it. A Tumour in Greek is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, that is, a prominence or protuberance in the body. And from hence the Latin words uncus a crook or hook, and aduncus bended or crooked, are derived: Because things bended cause a sticking out. The Arabians and barbarous Physicians, who follow them, call all Tumours unnatural Apostemata, in Latin abscessus: this word is derived from the greek verb 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, abscedere: Because in apostemes there is a collection of humours in any place, which have left their own proper seat etc. For humours, which cause Apostemes, come from the veins, and so leaving there own natural receptacle, seat themselves in other parts of the body, being dependant and weak. And Chirurgeans commonly call Tumours wherein there is collection of matter Apostemes. Tumour, which is a Latin word, and by frequent use made familiar in English conferences and discourses, is derived from the Latin word Tumeo, to be raised or puffed up: And from Tumour cometh Tumulus a grave: because it is raised up higher than the ground adjacent to it. Now bunchings or stickings out of parts of the body, are threefold: 
Differences of Tumours 〈◊〉 the body.  for either they are natural, and then they serve for the comeliness of the body are threefold: for either they are natural, and then they serve for the comeliness of the body, and further the actions, as we may see in the head, belly, joints; the thighs, calves of the legs, and arms: or they only pass the ordinary dimensions of some parts, such are the dugs full of milk, and the bellies of women which are with child: Or they are altogether unnatural, not only marring the comely composition of that part of the body which they possess; but hindering the actions also. Such a tumour, or eminence of the body, is called by Galen 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, id est, tumour praeter naturam, a Tumour contrary to nature. Having set down the denominations of a Tumour, I must come to the definition of it. Seeing so many as have written of tumours have set down one definition, or another, if I should set down all the several definitions, which are by divers authors set down, and insist in the refutation of such definitions as offend against the conditions of a good definition, I should rather seem to the judicious, to make an ostentation of reading, and wit, than a care of the profiting of the hearers. Of all the definitions, two are chief to be noted: the one of Fallopius in his treatise of tumours: c. 3. The other of Hieron. Fabricius ab aqua pendent. in Operibus Chirurgicis, part. 2. lib. 1. de tumorib. cap. 1. That of Fallopius is gathered out of Galen, cap. 1. lib. 13. the method. medendi: and it is thus. It is a disease, whereby the parts loose their natural bigness, exceeding it. So that extenuation is contrary to a tumour. He will have it to be a disease of the instrumentorie parts: for quantity is only an instrument, whereby the organical parts perform their actions, more strongly, or weakly, as we may see in dwarves, and tall men. Galen lib. 1. de tumorib praet. nat. c. 1. affirmeth that in tumours contrary to nature, all dimensions, that is, length, height and breadth are increased. But the former definition cannot be ascribed to every particular tumour, and so it is not large enough: for in an Erysipelas extreme heat rather offendeth, than the bigness enlarged, which very often cannot be deprehended by the senses. 
The definition of Fabricius.  The definition set down by Fabricius ab aqua pendente is this: A Tumour against nature, is a disease for the most part compounded, which is to be named of that thing, which hindereth the actions. And seeing to a crow, her own birds seem fairest, for if any one set under her, hens eggs to be hatched, that they may have cocks of the game, they must watch for the time of disclosing, jest she kill them: So he to make his definition plausible to his readers, will have all to mark some remarkable points in his definition. And first of all, in that he calleth a Tumour against nature morbus, or a disease, he will not have bushes in the face, and such small eminences of the skin to be Tumours, because they hinder not the actions: he cannot deny that the equality of the skin is altered, and besides this, the action of the skin, which is perspiration, in that place is hindered. Let no man think it harsh, that I ascribe action unto the skin, being a simple and similary part of the body: it cannot be denied that all similary parts have an use, which use sometimes is an action, as this of the skin; to sand out by the pores of it fuliginous vapours, and superfluous serositie of the blood by insensible perspiration and sweat. And although such small eminences commonly are denied to be diseases, because they hinder not the actions; yet they be passions, and affections, which require the skill of the Physician and Chirurgean: yea those bushes of the face are sometimes more hard to be cured than great Tumours, and Artists many times gain more by those, than these: besides this, by reason of the matter they are to be referred to one or other of the main Tumours. Howsoever they are not to be neglected. According to Aristotle 1. Rhetoric. c. 5. & Galen. ad Thrasibulum, 
Three gifts of the body.  there be three gifts of the body, to wit, Health, Strength, and Beauty, all which medicine is to direct: Health is preserved by wholesome nourishment, Strength by convenient exercises: of the which 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 intreateth, whereof Hieron. Mercurialis hath written a volume; 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 hath care of the beauty: now seeing by reason of the face, a man is called beautiful or ugly, who can deny that they deserve the care of the Physician, and Chirurgean. He addeth that a Tumour is a disease most commonly compounded; if he had said ever compounded, he had spoken a truth: for in every one of these Tumours, there is a Tumour conspicuous or latent; or a solution of unity, either sensible or imaginary. In an Erysipelas itself, wherein there appeareth neither quantity of part increased, nor solution of unity procured; yet in it there are undoubtedly both: for the first, seeing there is so great a heat in the part possessed with this grief, the Humours must be rarified, and the part dilated, which will require a more spacious place than it had before, which is an evident argument, that the quantity is enlarged. As for the second, the parts before arctly united must be somewhat separated by stretching: Reason must teach us that which cannot be deprehended by the senses. The last clause of the definition, That the Tumour is to be named from that which hindereth the action, as Erysipelas a disease of distemperature, because heat doth most hinder the action of the part: this is frivolous, because not heat only, but the bedewing of the skin with choler, by the which it is stretched, hindered the contraction and extension of the skin, and so by a necessary consequence, the hindering of the motion of the part organical, wherein it is seated. To conclude, this definition may be applied to other griefs than a Tumour, as to the head-ache, which is a disease most commonly compounded of distemperature of the humours, and solution of unity, and may have its denomination from the diversity of the humour causing it. Wherefore, seeing neither the definition of Fallopius out of Galen, nor the definition of Fabricius ab aqua pendente, can abide the trial of the laws of a good definition, we must assay to give another, which shall be this: A Tumour against nature is most frequently a disease, sometimes a light affection, for the most part incident to the organical parts, increasing their quantity above nature, by reason of receiving of superfluous humours sent from other parts. Here I will labour to yield a reason for every point of this definition. The genus is a grief, 
The definition of the author.  because it hindereth the actions, sometimes it is a passion or light affection, which hindereth not the action of the part, as appeareth in small adomatous Tumours, and scirrhosities: and therefore these modifications frequently, and sometimes are added. The subject of a Tumour is a part organical, sometimes by its own nature organical, as a finger or toe, sometimes organical only by office, as when the use of a similarie part is performed by an action: as it appeareth in the skin, one of the uses whereof, is to sand forth by its pores insensible perspirations, fuliginous vapours, superfluous serosity of the blood by sweat, and ichors of humours in the beginning of Tumours, and declination by discussive and resolutive medicaments. The form of a Tumour is quantity increased, whereby it differeth from all other griefs. 
The cause of quantity increased.  The cause of increase of quantity, is receiving of superfluous humours, which is done two manner of ways, to wit, affluxion, and congestion. Affluxion is, 
Affluxion.  when a humour offending either in quantity or quality, suddenly with violence seizeth upon any member, either by reason of the weakness of it, the rarity, looseness, dependency, heat, or pain, or because the whole body is full, or cacochymical, and the parts sending strong. Congestion is, 
Congestion  when a humour is collected in any part by little and little, by reason of the weakness of the concocting and expelling faculty of the same: so that a Tumour against nature is a disease always compounded, against Fallopius in his Treatise of Tumours, c. 3. For there is always a solution of unity, either manifest, or latent and occult, and this he granteth; for he saith, & de hoc conveniemus: we shall agreed concerning this. Besides this, the quantity is increased, and that always to reason and imagination, although not to the sense, as hath been said of an Erysipelas. Moreover, you shall hardly find a Tumour without some distemperature, either simple, or compounded. I have insisted somewhat too long in clearing the Problem of the definition of a Tumour against nature, because there is great contention concerning it amongst Authors, both ancient and modern.  

Causes of Tumours.  Now order of doctrine requireth, that we speak somewhat of the causes of Tumours: these are either external, or internal; 
Externall.  The causes external are in number eight. I. The air, if it be contagious, it causeth Tumours, as Carbuncles, and Botches in the plague time. II. The touching of things exceeding temperature in the active qualities, as we see in the application of Veficatories, and sitting long upon any cold seat. III. Too hard binding of the part, which causeth sometimes Gangrenes. iv The application of an attracting instrument to the body, as Cupping-glasses, and Horns. V Whatsoever may 'cause solution of unity, as wound, fracture, luxation, or contusion. VI Biting of beasts, whether they be venomous or no. VII. Taking inwardly things offensive to nature, whether it be by the excessive quantity, as when by too liberal drinking wine, an Erysipelas seizeth upon the head, or by a malign quality, as we may see fall out after the taking of Arsenic or Mercury sublimate. VIII. Immoderate motion, whereby immoderate heat is procured, whereby the Humours become more subtle, and the passages to the weaker part more patent.  

Causes of the weakness of a part.  Now the part is weak: First, by nature, and that either by reason of its substance, it being spungeous, and lose as Glandules: so we see frequently Parotides behind the ears, and Bubones in the groynes, or by reason of the natural humidity of the part; so Tumours more often appear in the flesh than in the spermaticke parts. A part also naturally is weak by reason of the situation, for the dependant parts are more apt to receive influence of humours, as the more high are to receive Halitus; so it is often seen, that it rising from the stomach, or some inferior part, causeth in some the falling sickness. A part, secondly, is weak by accident, and that by reason of errors committed in the things not natural, as air, meat and drink, exercise, and such like, whereof much is spoken in that part of Physic which is called Physiologia. 
Things required in a Tumour.  So that to the causing of a Tumour in a part, there be required, the weakness of the part which receiveth, patent passages, preparation of the Humour, and the strength of the part sending.  
The internal, causes of Tumours are either Humours or Flatuosities: The Humours are either natural or unnatural: 
Internal  The natural are either sincere, as choler, phlegm and melancholy; or mingled, as some of these with blood, for blood is no where sincere, but according to the humour mingled with it, which is predominant, it is called choleric, phlegmatic, or melancholy blood. The Humour unnatural is water, as in the dropsy, for it never can become nourishment. Of Tumours which are caused by reason of strange things, as worms, lice, bones, nails, hair, grissy substances, and such like, I will speak when I come to the third part of chirurgery, called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or Ablatrix, which taketh away superfluities. But time admonisheth to come to the setting down of the principal differences of Tumours. In this matter I will leave all needless and fruitless distinctions of Tumours, from time, as that some are new, some old, some short, some long enduring: from the quantity, as that some are small, some great, some of a mean bigness: from the condition of them, as that some are mild, some malign, some curable, some uncurable, and such like; which either do not greatly further the knowledge and curation of Tumours, or else are to be set down to some purpose in the explication of every particular Tumour. Only now in my general discourse of Tumours, which is to show light unto that which shall hereafter be spoken in the special doctrine of each, I will meddle with the differences taken from the material cause of Tumours, from whence spring the main principal Species of Tumours, unto which all other may be reduced.  

The main differences of Tumours.  All Tumours than are either simple or compounded. The simple are caused either of Humours or Flatuosity: the humours are either natural, or unnatural: the natural Humours are four, Blood, Choler, Phlegm and Melancholy: If blood, which neither in the veins, nor without, is found sincere and unmixed (as hath been said) 'cause a Tumour, it is called Phlegmone, or Inflamatio, according to Galen lib. 2. ad Glaucon. cap. 1. Of the divers kinds of it, which have their denominations from their places, and of the diversities which arise from the complication of it with other Humours, I mean to discourse when I come to the particular tractation of it: for I mean not to confounded particulars with generals, because this would breed confusion, and so deprive the memory of fruit of that which is delivered. Of all other Tumours a Phlegmone deserveth the first place, because it is caused of blood, which is the son of nature, first begotten, and the treasure of life. If choler cause the Tumour, it is called Erysipelas; these two are hot Tumours. If phlegm cause a soft and white Tumour like itself, it is called Oedema, unto which divers pituitous Tumours are reduced, of the which I will speak in their proper places. If a Tumour very hard be produced of the melancholy juice, and without pain, it is called Scirrhus; these two last are cold Tumours. If a Tumour be caused of water contained in any part, it is called Tumour aquosus: If from flatuosity Emphysoma; these two last Tumours are the offsprings of crudity, caused by the weakness and defect of the natural heat. And seeing these have the material cause different from that of others, I will speak of these in several Lectures, as was done in every other particular Tumour. Besides this, they require other medicaments than the rest of the main Tumours do, as shall be showed when we come to the curation of them. Differing then from the rest, I see no reason why they may not be accounted several Tumours; one cannot truly say that either Hernia aqu●sa, or flatuous Tumours of the joints, can be reduced to the aforesaid four principal Tumours, or that they can be cured by the same indications of curing, and medicaments which are applied to the other. You see how I have set down six simple Tumours, for lesser I cannot, if you consider either the diversity of the material causes, or the diversity of the topical applications, or the evidence of doctrine. The combination of these beget the compound Tumours; in these compound Tumours, 
Compound Tumours.  what Humour is predominant, that carrieth away the denomination: As for example, if blood abound more than choler, the Tumour is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. If choler be predominant, it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and so in all other combinations of Humour in Tumours, which shall be presented to your view. When you have noted the Pathognomonical signs of each of the simple principal Tumours, it is an easy matter at the first sight to discern the kind of Tumour, and what compound medicaments are to be applied to it. Hitherto have I declared unto you the opinion of Hypocrates, Galen, and of the rest of the Grecians, as also of the Arabians concerning the material causes of Tumours. Now to fulfil my promise, I will show you what Paracelsus and his followers think of this point: First than they acknowledge but two elements, water and earth; for if they should not grant so much, they could not be accounted in the number of the faithful; for in the very first Verses of Genesis mention is made of both. Secondly, 
The Humours are not parts of the body.  they accounted the Humours parts of the body, and so the causes of no griefs, but erroneously, for if they were parts, they would be endued with life, which they are not. Thirdly, they would have some action, whereof they also are deprived: only they have an use, which is to nourish the parts. Besides this, they maliciously dissemble the doctrine of the rational Physicians and Surgeons, for they make each Humour, contained in the mass of blood, either natural, or against nature: the natural they make, either alimentary, which nourisheth the parts, or superfluous, which nature reserveth for some other uses: of this abounding, diseases proceeding of fullness are engendered, called Plethora: of the Humour against nature, causing impurity, Cacochymia is caused; so choler in the veins and arteries is natural, and alimentary. In the Cystis fellis, and in the Porus biliarius, the superfluous is contained: if it leave the appointed receptacles, and pass to the habit of the body, it causeth the yellow jaundize; if by adustion, it become Bilis atra, it procureth Cancers and Wolves; 
What Humours 'cause diseases.  so that they hold not the natural, but those that are unnatural to be causes of diseases.  

The principles of all things according to Paracelsus and his followers.  The Paracelsians appoint three principles of all things, Sal, Sulphur, and Mercury, and not only by resemblance, or allegorically, but really: By Sulphur, they understand the fatty substance; by Mercury, the waterish substance; by salt, the earthy substance: Distil Cloaves, there come two humidities, the oil and spirit: in the bottom the earthy substance stayeth, which hath two parts, Terra repurgata, the crystalline salt, and Terra mortua, the black earth. The life of the salt is a strong water, 
The life of salt.  which if it be by distillation drawn, it leaveth but a Terra damnata, only fit for the dunghill. 
The effect and benefit of salt.  This salt preserveth the body from putrefaction, wherefore Christ called his Disciples the salt of the earth, because by the preaching of the Gospel, and administration of the healthful Sacraments, they procured to the unfaithful the life of grace, who before were but Terra damnata; and by a wonderful transmutation of terrestrial creatures, made them spiritual, representing the Angels, yea God himself, by restoring his image. From defects in these three, 
The causes of diseases according to the Chemists.  they will have all diseases to proceed: and concerning Tumours against nature, the hot they will have to proceed from Sulphur and Mercury, and the hotter it is, the more Sulphur to concur. The cold Tumours they will have to proceed from Mercury and Salt, and according to the looseness, or firmness of the Tumour, the more Salt or Mercury to be required, as in Oedema more Mercury, in Scirrbus more Salt. This is their doctrine concerning the material causes of Tumours, in my judgement it is the salfest course to insist in the footsteps of the ancient, for their way is plain and easy; no man can deny that there are four Humours in the mass of blood, as may appear when it is drawn out of the veins: Choler swimmeth about the blood, which is known by its bright redness; Melancholy is in the bottom, which is deprehended by its grossness and blackness; now Phlegm uniteth these two last Humours, and maketh them tough. The Paracelsian doctrine is full of difficulties, which he maketh more obscure by coining strange words, as his Reader will perceive; so that his discourses are but a kind of canting Philosophy. Nevertheless, I thought good in plain terms to acquaint you with it, that when any Empiric shall make a show of learning, by using these terms, you may find him out, and esteem of him as he is: that is, like that head which the Wolf afar off espied, representing the head of a living man, but coming near, and seeing it but curiously carved, affirmed it to be Pulchrum caput, sed sine scientia, A comely head, but without wit.   

LECT. III. Of the general Indications of curing Tumours.  
OF the general points whereof I intended to speak before the handling of every particular Tumour, having set down the definition, causes, and differences of Tumours, now I am called upon to set down the general indications of curing Tumours.  

Indication what it is,  Now an indication is that which showeth what course is to be taken for the recovery of health: The general indications are taken either from the matter, or from the times of every Tumour; In the matter, we are to consider the motion of it, and its nature: As concerning the motion of the matter, it is either in flowing, or it is received already into the part. The causes of fluxion are two, Plethora, or fullness, and Cacochymia, an ill complexion: Plethora or fullness is twofold, Ad vasa, and Ad vires: Ad vasa is when the veins are only full, and the body notwithstanding quick and nimbless this is twofold, Pura, when there is a due proportion of the Humours of the body, and Impura, when there is an excess of any of the three Humours besides blood, as Choler Phlegm, or Melancholy. Ad vires is when there is such a fullness, as causeth sluggishness of the body: this requireth evacuation of Phlebotomy, as Cacochymia by purgation. As for Phlebotomy, three things are to be observed concerning it. I. The manner: In fullness, Quoad vasa, at one time so much blood is to be drawn as is requisite; but in fullness, Quoad vires, because strength is somewhat abated, you are to draw blood by repetition, and not all at one time. II. Is the quantity, how much then is to be drawn, the weakness or strength of the party will inform you; for in a weak body you are to draw less, in a strong body more, strength and weakness are to be discerned by the functions: the weakness of the natural faculty is discerned by crudity of Urine, and excrements of the body: the weakness of the vital, by a weak and small pulse, as also breathing weak and thick: the weakness of the animal function is found out by defect in moving and feeling; by the integrity and perfection of these three faculties the strength of the party is perceived: But we must diligently distinguish beweene languishing and weakness indeed, 
Weakness and oppression differ.  and oppression of faculties by reason of fullness, making them dull and slow; for as in weakness, great moderation is to be used, so in oppression we may more bountifully and boldly suffer the vein to run. The third thing to be observed in Phlebotomy is the end of it, whereof it is instituted; the scopes of blood-letting are two, Derivation and Revulsion: Derivation is the drawing of the Humour to the part adjacent, or of the same side, by opening of that vein, or a branch of it, which is inserted into the part affected: as for example, if in diseases of the head or neck, we open the Cephalica in the same side: and even in this there is a kind of opposition, to wit, high and low; or in Tumours of the groin, we open Vena poplitis: this they do also who open this vein in Podagra, if the gout invade the foot. This kind of interception we use, not only because there is a plentiful fluxion to the part affected, but because a speedy interception is required, jest the natural heat of the part be oppressed, or the rapture of a vessel ensue: so in inflammation of the lungs, and side, we open the liver vein of the same side, and draw blood plentifully. Revulsion is a drawing of the Humour to a part opposite: of this there be four differences: I. From the higher to the lower parts, as from the head to the feet. II. From the right side to the left. III. From the fore part to the back, which we shall do if we apply Leeches in diseases of the breast or belly. iv Is when we draw from the centre unto the circumference, as in applying Ventoses with Scarification to the neck in diseases of the brain, as in the Apoplexy, and Lethargy Vesicatories perform the same.  
But one may ask which we to be accounted high, 
Quest.  and which low.  
I answer, That all those parts which are above the navel, 
Answ.  including also the liver and stomach, are accounted high; but the parts below the liver, are accounted low, as the kidneys, and genitalss in man and woman.  

The ends of Revulsion.  This kind of interception we use in two cases: First, if the matter flow but flowly, and so a sudden interception is not required. Secondly, if we are to open a vein to prevent a disease, as Vena cubiti for to free one of a fit of the gout. But this kind of drawing hath no place in contagious Tumours, if they appear either in the upper or lower parts; for whether they appear either behind the ears, and armpits in the upper parts, or in the groynes in the lower, revulsion must be by the Vena cava, which is inserted into the right ventricle of the heart: now whether any contagious vapour or Humour can be sent by this passage safely, let every judicious person consider.  
Now there is a difference between Revulsion, Derivation, and Evacuation, for in the former two, motion is required, as you have heard, but in vacuation the Humours must be quiet. In the translation of Humours flowing from any part, we must mark according to Hypocrates, that it be done 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, Secundum rectitudinem, by observation of a strait course; and that is done two manner of ways:  
First, by the rectitude of the parts, as the left with the left, and right with the right, and the hinder with the fore parts. Secondly, by the rectitude of the vessels: as for example, The liver vein of the arm hath a kind of straightness with the veins ascending to the head: so if one bleed immoderately at the right nostril, by applying a Ventose to the region of the liver, the flux ceaseth: if it flow from the left nostril, it must be applied to the region of the spleen.  
Having set down how Plethora is to be abated, if it cause fluxion, we are to show how Cacochymia is to be removed, which is not so much by reason of the quantity oppressing, as by reason of an evil quality offending a part. Now this matter offending in quality, it either moveth from place to place, or it resteth where it had its first invasion; if it move from place to place, it is the safest course to abate the Humours wherein this quality is resident by Phlebotomy, jest it seize upon some principal part: if it be quiet, resting contented with the first place, then let us use by purging, expelling the Humour, whether it be choler, phlegm, or melancholy, with appropriate medicaments, which Physic prescribeth in that branch of the curative part of Physic which restoreth health by the administration of inward medicaments. Having set down the indications which are taken from the motion of the Humour, we must come to those which are taken from the nature of it.  

Indications from the nature of the humour.  Now the humour itself is either not contagious, or contagious: If it be not contagious, the fluxion of it doth proceed from three causes: The first is the strength of the part sending the humour, which it doth, either because it is burdened with the quantity, or pricked on by the quality; we have showed what is to be done in these cases. The second is the thinness of the humour. The third is the attraction of the affected part. If fluxion be caused by reason of the thinness of the humour, if we cannot use phlebotomy or purging, as in children, decrepit persons, and in women with child in the last month: then we must use revulsion, and this is done six manner of ways. I. By Ventoses region of the liver, when one bleedeth too much at the right nostril. II. Painful constriction, or binding of the parts, as arms, and legs: but we must first rub hard the parts which are to be bound; and if we bind the arm, we must use a Ligature in three parts: 1. near the armepit. 2. A little above the elbow. 3. About the wrist. In the legs we must use a Ligature near the groin, a little above the knee, and near the ankle. III. Painful frications when we mean to revel from the centre to the circumference. iv Bathing of the parts with very hot water: for first by reason of the pain it doth revel. Secondly, it doth discuss because it openeth the poors. And in fevers by bathing of the limbs sleep is procured, the vapours ascending to the head. V Vesicatories which are used in the Apoplexy, Lethargy, and such like. VI Fontanels, and they are in great use to be applied to divers parts, for the preventing and curing sundry griefs. If the fluxion be procured by the attraction of the part affected, there be two causes of the attraction: First, the distemperature of the part. Secondly, pain. If distemperature of the part be the cause, it must be removed by its contrary: but seeing it is most commonly a hot distemperature, things cooling are to be applied, as by applying clotheses moistened with oil of Roses, or violets cold: but when the clouts become hot, the● are to be removed, and cold to be applied, or  moistened in the juices of cold herbs. If we apply unguents, as infrigidans Galeni, Rosatum Mesuis, de cerussa Rasis, Populeon, we must not apply the unguent immediately to the skin; but a thin linen cloth: for it keepeth the unguent from drying, and doth not hinder the breathing out of the vapours, which the immediate application of the unguent would do, and so by stopping of the pores, would increase both the heat and pain.  
And in application, of pulteses, they are to be spread between the fold of a cloth, dipped in some convenient oil or lineament; for so it doth not hinder perspiration, and the applications are removed more easily from the part. This in your pratice is to be noted, and the invetorate error to be shunned, if the ways by the which the humour passeth, be too ample and patent, and a hot distemperature joined, than things astringent and cooling are to be applied, roulers and other  being moistened in them. Wherefore in this case myrtils berries, read rose leaves dried, pomegranate rinds and flowers, sumach, sloes, oaken and owlar bark boiled in read astringent wine, or vinegar and water, or new and fresh Tanner's woose, and strained are effectual. The parts therefore by the which the humour passeth, are to be rolled somewhat straight with the rouler, , stupes, or pledgets and bowlsters being moistened in this liquor, and wrung: you may also apply astringent and defensive emplasters drawn upon leather; such an one is this, ℞ rad. torment. bistort. symphyti. ros. rub. gallar. ballast. malicor. sang. drac. boli. Armen. santal. rubr. cerass. an. ʒ j cerae albae ℥ iij. ol. myrtill. ℥ j mice. fiat ceratum. So much then shall be sufficient to have been set down, concerning the attraction of the affected part, by reason of the distemperature of it: now we must come to the second cause of the attraction, which is pain or dolour. There are two causes of pain, solution of unity, and a venomous quality: if the solution of unity proceed from the affluxion of Humours hot or sharp distending the parts, the pain is to be eased with medicaments convenient: these are of two sorts, Anodine, and Narcoticall: Anodynes gently contemperate the part, by reason of the conformity which they have with the nature of man. They are hot in the first degree, and of subtle parts; such are milk, old salad-oil, butter, the fat of swine, hens, ducks, geese, eels, man, badger, bears: the oil of camomile, lilies, earthworms, lineseed, dill, sweet almonds, eggs, the pulp of Cassia tempered with the oil of roses, the pulp of swect apples with the powder of saffron. Narcoticks, are which deprive the part of the faculty of feeling, such are Opium, hemlock, henbane, the deady nightshade, mandragora, and the apple of Peru, or prickly apple: 
When narcoticall means are to be used.  these we are to use when the former will not prevail, and when by reason of watching, a fever or faintness is to be feared. Sometimes in extremities they are used solitary, sometimes with their correctives, to wit, things hot, if we fear stupefaction of the part, unto the which they are to be applied: such things are castoreum, saffron, cinnamon, cloves, pepper, and such like. If the biting of a venomous beast, 
What is to be done in biting of venomous beasts.  as of a mad dog, or a viper, or adder: or the stinging and pricking of any beast, as of a scorpion, or insect, as a hornet, be the cause of a Tumour, we must address ourselves to meet speedily with the poison. If therefore a venomous beast bite or sting, first, the part is to be scarified, and ventoses to be applied: then the part is to be fomented with Theriaca Andromachis, dissolved in strong wine vinegar, and stupes moistened in the same, applied to the same; or it is to be fomented with the oil of scorpions, and a pledget wet in it to be applied: and above the pledget, this emplaster of Fallopius is to be spread warm, 
De tumoribus c. 14.  ℞ pic. naval. ℥ j sal. nitri. ℥ ss. semen. synapiʒ ij. cepar. allior. sub. prun. coctor. an. ʒ iij. assae foetid. sagapen. an. ʒ ij. stercor. columbiniʒ j ss. aristol. rotund dictamni albi an. ʒ j ol. lil. albor. ℥. ss. fiat emplastrum: pigeons also, and hens, and cocks divided in two parts, and applied hot are avallable. Sometimes the actual cautery is to be applied, to tame the malignity of the poison, if the poison hath continued above three days: Besides this, two things more are to be done, first, according to Galen, the member is to be bound hard, 
3. de loc. affect. 7.  three or four inches above the part bitten or stung: secondly, Antidotes inwardly are to be given; but chief Theriaca Andromachis, for many days together in a liquor, fit for the constitution of the diseased person: now if the matter of a Tumour be contagious, 
Indications in contagious Tumours.  we are by all means to draw it out of the body, jest if it go in, it deprive the person of life, as in the plague, or infect the liver, as in the pox, wherefore ventoses are to be applied, and medicaments attractive to be applied: such is Fallopius his emplaster set down before, for the attraction of poison. In the plague, we must not fail to minister Antidotes, even to three times in a day, and to procure sweat: such are Theriaca, Electuarium de ovo, Electuarium Orvietani, or this of Fallopius: 
De Tumour. c. 9  ℞ baccar. juniper. caryophyll. nuc. muscas. rad. enul. an. ʒ ij. rad. aristol. utriusque, gentian. an. ʒ vj. semen. portul. acetoes. doron. been rub. an. ʒ j spodii, oss. de cord cervi. ligni aloes. coralii albi & rubri, rasur. ebor. baccar. lauri, mastic croci. an. ℈ ij. rut. morsus diabol. au. ʒ j pulp. ficuum & dactylor. an. ℥ j cinamoni liquirit. an. ℥ ss. tormentil. card. benedict. dictamni albi an. ʒ iij. amygdal. dulc. & pinear. excort. an. ℥ j agaric. trochiscat. ʒ vj. rad. peuced. ʒ ij. terrae sigillat. & bol. erient. an ℥ j zedoar. ʒ ij. caphur. ʒ iij. spec. 3. santal. spec. diarrhod. abbot. an. ʒ ij, cort. citri, pulv. smaragdi an. ʒ j moschi ℈ j Theria●. Andromach. & Mithridat. an. ℥ j fol. mali Arm●niaci ℥ ss. cum syrup. de cort. citri, & de acetositatecitri an. triplopondere ad pulveres fiat Electuarium. 
Coquendo em●ias●a.   Electuarium fiat magis efficax addi possunt cornu rhinocerotisʒ iij, & cornu cervi praparat. ℥ ss. does. aʒ j adʒ ij, in convenience liquore.  
The stinging of wasps or bees is cured with mallows stamped and mingled with cold water, or chalk applied with the same.   

LECT. four Of the four times of a Tumour, and the Indications taken from them.  
HAving spoken of the Indications curative, taken from the matter of a Tumour, now it followeth that we speak of the Indications taken from the times of a Tumour: the times of a Tumour are four, the beginning, the increase, 
The times of a Tumour.  the state and declination. The beginning is thought to be, when a part beginneth to swell, although the actions be not hindered: in the beginning repelling medicaments are required: repelling medicaments are cold, and of gross substance, for they are to thicken the part affected, and to cool the inner parts of it; such are the whites of eggs, plantine, nightshade, house-leek, prick-madam, purselain, rose buds, dry roses, myrtil berries, pomegranate flowers, and rinds, gales, sumach, quinces, sloes, bowl, sanguis draconis, terra sigillata, sour wine, Tanner's woose, which you may apply either single, or mingled according to your scope. 
When repelling medicaments are not to be used.  But in six cases we are not to use repelling topics, first, if the matter be venomous or malign: lest it being repelled, should assault some principal part. Secondly, if the matter be critically turned to a part, so that it be not a principal part by the error of nature: for than it aught to be repelled, as when in a burning fever, the matter being sent to the meanings causeth raving. Thirdly, when the body is either plethoric, or of an ill habit. Fourthly, 
(a) 6. a con p med. 2. m. loc a. 2.  when the humour floweth to the emunstories. Fiftly, if the part have but little natural heat, we are not to use repercussives, lest the natural heat be extinguished, and the part mortify. Sixtly, when the dolour 
b Id. tod. lib. c. 7. & 13 method.  is vehement, 
13. method. c. 16.  and the part exceedingly pained, for then Anodyns are only to be used. We are to think the Tumour to increase, when the part is stretched, and symptoms are increased, and seeing in the increase the matter partly floweth, and partly possesseth the part, you are partly to repel, and partly to discuss: but if the matter flow with such force and plenty of humour, that it threatneth corruption of the part, (e) or if the humour which floweth be thick, and so hot, that the part feeleth a burning, as in a carbuncle, then are you to use sensible evacuation by scarification; but where we cannot conveniently scarify, the leeches are to be applied as in the hemorrhodes, and other griefs of the anus. 
Discussion.  Now discussion is an evacuation of a thin matter gathered in a part, by insensible evaporation, procured by the natural heat increased by proportionate medicaments. In this description, insensible is added to distinguish it from evacuation by incision, scarification, or leeches, which evacuate sensibly to the eye: the principal efficient cause is the natural heat; the adjuvant discussive medicaments, the matter which is to be resolved must be thin; for it is in vain to go about to discuss a thick substance: because it is not apt to yield vapours. In the description, 
The effects of discussive medicaments.  discussive medicaments are said to help natural heat by increasing of it, which being done: First, the humour is made thin: Secondly, it is resolved into a vapour: Thirdly, it is drawn from the centre to the circumference, and lastly expelled by the pores of the skin. 
The qualities of these medicaments.  Such medicaments than must be familiar to nature, and these perform their office, by consuming superfluous humidity: and so they must be hot and dry. 
Degrees of them. Gal 6. de comp. medic. 2. in loca c. 1.  They must then be subtle, that they penetrate to perform these offices. There be three degrees of discussive medicaments, they in the first degree are hot and dry in the second, as dry figs, bran, camomile, Ammoniatum, galbanum, leaven, lily roots, melilot, the roots of the marsh mallow, goose grease, and old hen's grease: and because such assuage pain, we aught 
c Id 6. de compos med. 2. in. loc. c. 2  
d Id. 2. ad Glaucon c. 9 Id. 14. method. 20.  always to begin with them. In the second degree, are calamint, Isope, penniroyall, ments, cumin-seeds, and dill-seeds, bean flower, the flower of vetches, fenugreeke, horehound, the root of Peucedanum, the roots of both the birth woorthes, lions fat, old bearer fat, old badgers, cats, dogs, and man's fat: these are somewhat drier, and hotter than those of the first. In the third degree, are those which are dry and hot in the third degree, as nitor, unslaked lime, sulphur vive, assa foetida, etc. These are to be applied according to the constitution of the party, as the skilful Chirurgean shall see cause. The state of a Tumour is, when it is come to such a degree, 
What is to be done in the state of a Tumour. It's signs.  as that it can go no further in bigness, the signs of it are these: first all symptoms, as tension, pain, redness, and fever symptomatical are at the height, and remain uniform, neither increasing nor decreasing: secondly, the veins of the parts adjacent continued in this same fullness and dilation. In the state, we are to use Anodyns with discussives by reason of the pain. 
Of the Declination.  We are to think that the declination of the Tumour beginneth, when the aforesaid symptoms begin to abate, and then strong discussives only are to be applied, whereof we have spoken before. In necessity we may use these which are found in the shops, diachylon cum gummis, diachylon magnum Mesuis, diachylon ireatum. 
The termination of Tumours.  Tumours end not only by resolution, but often by maturation; and sometimes by induration and corruption: and as discussion is better than apostemation; so induration is better than the corruption of the part: fifthly, Tumours do end changing the place, 
The matter.  as when in a pleurisy the matter falleth upon the midrife, and causeth Empyema.   

LECT. V Of curing of a Tumour come to suppuration.  
HAving in my former Lecture set down, that all Tumours end in one of these five ways, to wit, discussion, apostemation, induration, corruption of the part, and passing from one part to another.  
Having showed the method how they are to be discussed: Now order requireth that the means be set down, how a Tumour is to be handled, if it tend to suppuration, or maturation: which by our usual term is called Apostemation. Thus we are enforced so to go to work: 
When naturation of a ●umor is to be procured.  First, if the humour be too plentiful; for then the natural heat cannot well rule it, and so it must be seconded by foreign and external heat, which working upon superfluous humidity, causeth putrefaction according to the Philosopher. Secondly, when it is crude; for than we must labour to concoct it with the medicaments, which are peptica or coquentia. Thirdly, when the matter is hard; and then we must use emollient medicaments. The medicaments which procure quittour, they are temperately hot and most: and these help natural heat, that it may the more easily elaborate the matter, and make it fit for expulsion, and this we call concoction. Emollient topics are used to soften any matter indurated, and such are dry in the first degree; and hot in the first, and in the beginning of the second. But it is to be noted that there is a difference between tension and hardness, and relaxation and softness: a part stretched will yield to the finger pressing it; if it be hard it will not: and where there is any tension, relaxing medicaments are to be applied, which attenuate and open the pores, and therefore they must more discuss than dry, and so be drying in the first degree, and hot in the second. A part indurated must have emollient means applied to it: whereof we will speak, when we come to discourse of a schirru. 
Indications in curing of Apostemes.  In the curation of Apostemes, we are to do two things: first, we are to prepare the matter, and make it fit for expulsion: secondly, we are to evacuate it, when it is prepared. To accomplish the preparation of the matter, first, 
Removing of accidents.  we are to remove accidents: secondly, to procure the maturation of the matter. The accidents are these, pain, tension of the part, hardness, and heat. 
assuaging of pain.  As for the asswaging of pain, narcoticall or stupefactive medicaments have no place here: for first, they extinguish the natural heat of the part, 
The inconveniences of narcoticall medicaments.  which is the principal efficient cause of coction: secondly, by thickening of the matter, they make it more rebellious; wherefore we are to use Anodine medicaments, whereof we have spoken already: you shall do well to apply such a cataplasm as this. Take of white bread crumbs jiiis ℥, of new milk three quarters of a pint, of mallow and violet leaves pounded small of each an handful: boil these to the consistence of a cataplasm; then add to it of saffron a dram, of unguentum populeum iij ℥: let the aposteme be dressed with this, or such a medicament, morning and evening.  

Against tension. Simples.  If the part be stretched, use relaxing topics, such are those which are temperately hot, not drying much, and of subtle parts, as white horehound, archangel read and white, mullen, dill, camomile, fenygreek, mercury, melilot, turnips, the leaves of the marsh mallow, the flower of barley, beans, and vetches; of these you may frame to your purpose such a cataplasm: Take of camomil-flowres beaten to powder ij pugils, of barley, bean, and flower of vetches, of each ij ounces, of marsh mallow leaves and flowers pounded a handful: boil these in beef, or mutton broth strained, and the fat taken away, until they come to the consistence of a poultice: Then add to it of the oil of dill, camomile and rape-seed, of each j ounce: dress the aposteme with this or the like, morning and evening.  

Against hardness. Simples.  If hardness hinder, use those things which are emollient, as all manner of fats, the dregss of oil, all sorts of mallows, colts-foot, bugloss and borage, quince seed, milk, the white lily, linseed, figs, raisins, the marrow of beasts, the oil of sweet almonds, march violets, Ammoniacum, Bdellium: of some of these you may frame a cataplasm after this manner: Take of linseed meal or powder, 
Compounds.  iiij. ℥, of marsh mallow roots, and white lily roots boiled in water, and well bruised, of each ij. ℥, of the violet leaves, and flowers, and colts-foot leaves, of each an handful; boil these in new milk, until they come to the consistence of a cataplasm: unto the which add of ammoniacum dissolved in muscadine, of the pulp of figs and raisins, of each j ounce;, and so make up your cataplasm.  

Against heat.  If immoderate heat trouble you, apply things cooling: but let them be cold either in the second degree, or beginning of the third: for the reasons yielded against narcoticks, when I spoke of pain, such are umbilicus veneris, or navel wort, prickmadam, singreene, barley meal, endive, the pulp of the pumpeon, sea-tong lettuce, ducksmeat, the water lily, the water archer, plantine, garden nightshade: of these herbs with barley meal boiled in fair spring water make a poultice; and to every lib. of the poultice, add ij ℥. of populeum unguentum, and one ounce and an half of unguentum rosatum Mesuis.  
You may demand of me, 
Quest.  how long the application of these topics prescribed, for the removing of accidents, are to be continued.  
I answer, 
Answer.  until the accident be almost gone, with the which you encountered, and then you may proceed to assist nature, by increasing natural heat by ripening medicines, which was the second intention of curing apostemes set down by me. 
Maturation of apostemes.  Now those medicaments which help nature, aught first to stop the pores reasonable, only suffering the sharp vapours to breath out, and to detain those which are mild, and somewhat thick, which are the secondary cause of coction. In this respect, than they aught to be viscous and tough in substance, such are temperate oils, and mucilages, 
Gal de simplic. ●acult.  which by Galen, are called Emplastica: secondly, they aught to be familiar to nature, and so temperately hot and moist. One thing is to be noted, that hotter simples are to be chosen, according to the temperature of the part, if the Tumour seem somewhat cold: wherefore if the Tumour seem hot, only maturatives in the first degree are to be used, and those of the second degree to be shunned: But if the matter be somewhat cold, than you are to use maturatives of the second, yet always mingling with them some of the first degree. And the reason is this, because the medicaments of the second degree dry too much, wherefore those of the first degree are to be added, in the which there is much moisture, which is requisite to coction and producing of quittor. These medicaments are called Concoquentia, and Pus moventia, and Suppurantia: such aught to be hot and moist, as the body of a temperate man is, and so they aught neither to dry or moisten, or to heat or cool immoderately, but only to preserve and increase the natural heat; for a suppurative medicament aught to answer the constitution of him unto whom it is applied.  

Degrees of suppurative medicaments.  Of these suppurative medicaments there be two ranks: In the first, are Mans-grease which assuageth pain also, Duckes-grease, Goose-grease, Hensgrease, oil of sweet Almonds, sweet salad Oil, Mallows, sweet Butter, Figs, 
Simples of the first degree.  Fenugreeke, Lily roots, Linseed, Wheat-flowre; a Cataplasm made of Wheat-flowre, Water and Oil, an Emplaster made of yellow wax, and oil called Cerelaeum, Violet leaves and flowers, saffron. For an example, 
Compound.  I will set down the description of a suppurative Cataplasm compounded of some of these of the first rank: Take of Milk a pint, in the which boil of Wheat-flowre a quartet of a pound, of Violet-leaves, and Mallow-leaves stamped, of each a handful, of Lilly-roots, and Figs boiled in water, until they be soft, of each two ounces; when they are come to the consistence of a Pultice, add of Saffron beaten to powder a dram, of the oil of Linseed, sweet Almonds, Lilies, and Mans-grease, of each one ounce; and so make up your medicament. If the Tumour be immoderately hot, mingle always with your suppuratives those things which are cold and moist in the first degree, as Violet-leaves, Lettuce, the pulp of Pompions, Grownfill, Succory, Dandelion, and such like. If of a sudden you be called, and be required to dress a Tumour tending to suppuration, you may have recourse to the Apothecary's shop, and with these things dress it. First, beaten some oil of Violets and fair Spring water, together, taking two spoonful of oil, and one of water, with the which embrocat the Tumour, then apply a pledget moistened in this, upon the part which is like to break, or be opened; and above the pledget, Diachylon simplex if the Tumour be hot, or Diachylon cum gummis if it be but a little exceeding the ordinary temperament.  

Suppuratives of the second degree. Simples.  Suppuratives of the second degree are these; Terebinthina, Ammoniacum, Galbanum sagapenum, Gummi elemni, Pix navalis, Burgundy pitch, Saffron, Leaven, Fenugreek, Onions and Garlic roasted under the emberss, old Butter, oil of Camomile, and Dill, old Hensgrease, Badgers-grease, and Bears and Dogsgrease, Wheat-flowre, Flower of Linseed. In the shops there are Emplastrum de mucilaginibus, Dialthaea cum gummis, Diachylon cum gummis, Diachilon magnum. 
Compound.   
As before I have done, so now I will set down a compound medicament, framed of these Simples: Take of the roots of the white Lilies, of the roots of the marsh Mallow, of Onions boiled and bruised, with the liquor of each iiij. ℥. of Leavens ij. ℥. of Linseedmaeale j ℥. and a half, of Saffron beaten to powder a dram, of Ammoniacum & Galbanum dissolved in Muscadine, and the pulp of Figs, of each j ℥. of oil of Camomile and Lilies so much as will make a Cataplasm of a good consistence.  
In Strumes, and Bubos venereal, use this: take of Diachylon cum gummis, and Emplastrum de muci laginibus, of each j ℥. of Garlic and Onions roasted under the emberss of each ij. dams, of Dialthaea cum gummis, Mans-grease, and Beares-grease of each j dram, make a medicament. One thing I would have you to note, that suppuratives of this degree are fittest for all contagious Tumours, and that to all such, Onions and Garlic roasted, and mingled with other medicaments, are to be applied; for being thus prepared, they lose their sharpness, attract, and become familiar to the natural heat.  
How Apostemes are to be opened.  
Hitherto you have heard how that Tumours that cannot be discussed are brought to suppuration: Now I am to deliver unto you, how the matter, which is suppurated, is to be discharged. This is done by opening the part: Now some things are to be considered before the action, some in the action, and some after the action: Before we go about to open an Aposteme, First, we must be certain whether it be ripe enough; Secondly, we must resolve how to open it.  

Signs of maturity.  The signs of maturation are; I. The Tumour, by contracting itself, seemeth less than it was in the state; for while the natural doth concoct the matter, vapours are raised by the heat, and so the part is distended; but when the matter is concocted, the elevation of vapours ceaseth, and the Tumour falleth somewhat. II. The Tumour draweth itself to a point, or prominence; because when nature overcommeth the matter, it draweth it together, and draweth it to the skin. III. Hardness and tension are much abated; for maturation being procured, many vapours are discussed, which before stretched; and made hard the skin. iv By pressing the matter with the finger, we find a fluctuation, or coming and going of it: but we must be circumspect when a Tumour in a great joint is offered unto us, as in the knee; for if we press lateral parts of it, a certain undation will appear. V The party feeleth much ease in the part; partly, because some of the sharp vapours are resolved; partly, because the matter concocted doth make the parts more lose. VI The vehement heat ceaseth; for the Humour being come to maturation, the unnatural heat abateth, and the natural heat resteth. VII. If the part inflamed hath changed the colour, and of read is become white, and chief in the pointed place. VIII. The scarf skin becometh shrivelled, and ruffled; and this is a good sign, for it showeth that unnatural heat hath left it.  

instruments fit 〈◊〉 opening.  The second thing which we said was to be resolved upon, was the instruments with the which the Apostemes are to be opened. They are three; I. The lancet or incisionknife, of the which there be divers forms set down by the ancients: of the which we will speak, when we come to discourse of particular operations for the which they are required. II. Is the caustic or pyroticall medicament. III. The actual cautery, which we will leave willingly to horse Leeches, unless we be destitute of other means: and when we are to make a fontanel, or to stay a great flux of blood, or to dry a carious bone, or to correct a cancerous part after that it is extirpate.  

Steel instruments.  As for steel instruments, we are to use them, First, Apostemes be in the face, to avoid the filthiness of the scar, after the curation. Secondly, in small Tumours: for so they will be the sooner whole.  
As for the caustic medicaments, 
caustics.  we use two sorts of them: the first is made of the strongest soap leeses, boiled to the consistence of a soft stone. The second is made of the like lee, and unslaked lime, boiled to the form of a firm unguent. The first is best in Tumours which possess the convex part. The second is most convenient, if they be in parts concave or hollow.  
These Pyroticall medicaments are most fit to be used in five cases: I. If we intent to keep the Tumour long open, as is requisite in all contagious Tumours, in the plague, & pox: for where the caustick is applied, there is always loss of substance, and by it we may make the orifice round, which of all other figures most slowly is cured. II. In large Apostemes caustics are fittest; for by them, making as large an orifice as we will, we shall spare tenting and enlarging of it; besides, the stretched parts will the sooner be contracted. III. They are to be used in deep apostemations, such as happen in the belly and back, for so the matter shall have a readier way for evacuation. iv They are best, when a flux of blood may be expected. V We apply them, when we will gratify timorous persons.  

Things to be done in the opening.  When we are come to open the part, than these things are to be observed: I The nature of the part: this teacheth us, to shun veins and arteries by reason of hemorrage, and nerves, tendons, and membranes by reason of the pain which ensueth. II. If the skin only be to be divided, than the apertion is to be made strait; but if a muscule also be to be incised, it must be done according to the fibres of it. III. Apertion must be made in the depending part, because the matter will be more readily so drawn out. iv It must be done where the part is thinnest, for so less pain is caused. V The apertion must be proportionate; for if it be too little, than the matter, especially if it be thick or grumous, cannot be well drawn without expression, which maketh way for callosity, and fistulation. If it be too large, first, the scar will be the more ugly. Secondly, the parts subjacent will be made more apt to be altered, by receiving the impression of the cold air. VI We are to know how much matter is to be evacuate at one time: In great Tumours, and those which are in the joints, great moderation is to be used; for with the matter many spirits breathe out, and so are spent: from whence extenuation of the body, yea and death sometimes ensueth. The Chirurgeon who is to do this, aught to be resolute, cheerful in countenance and speeches, and no ways scrupulous: otherwise he shall make the Patient dismayed, and fearful, 
“ Gal. 2. de Sympto caus. 2.  which doth much weaken and abate the courage of the Patient.  

Things to be done after apertion.  Things to be observed after the opening of an Aposteme, are these: First, the removing of accidents which most commonly fall out. Secondly, the manner of dressing. The accidents are most commonly three, fainting, chief if the parties be children, women, but above these, effeminate men. Secondly, pain. Thirdly, a flux of blood.  

Against fainting.  As for fainting, we may labour to prevent it, by ministering unto the Patiented a Caudle, Aleberrie, or some styptic wine with a toast, as Alicant, and tent; or if it be like to ensue, we may minister unto them some cordial water with sugar, as Cinamome water, treacle water, or Aqua coelestis. If dolour and pain ensue, 
Against pain.  let the part be embrocat with oil of Roses, and the third part of wine beaten together: yet the oil is not to touch the brims, if apertion hath been made by incision, jest it 'cause spungeous flesh to grow. 
Against bleeding.  As for staying of blood, I will set down the sittest, and most effectual means to perform this, when I shall come to discourse of wounds, for in them it doth most commonly fall out.  

Dressing after opening.  As concerning the manner of dressing after opening: If this hath been done by incision, either a tent, if it be small, or dosels with pledgets armed with some restringent powder, as bowl, frankincense, and flower tempered with the whites of eggs, if it be large, are to be used: and so it is to remain for the space of four and twenty hours. If the caustick be applied, than Dialthea simplex, or sweet butter melted in a saucer, are fit to be used until the eschar fall; then the cavity is to be incarnate: If in the mean time spungeous flesh appear, it is to be removed with cathereticall medicaments, as ☿ precipitate alone in gentle bodies, or mingled with alum, taking the third part of this in harder bodies: yea, you shall be enforced sometimes to use Pulvis sine pari. & other Fistula powders with some medicaments, which cool and assuageth pain, as Vnguentum populeum, and Rosatum Mesuis: take my word, Basilicum and Aureum are not so fit.  
Last of all, it is to be sealed up with epuloticall medicaments, as Diapalma, Emplastrum de minio, Vnguentum comitissae, and Desiccativum rubeum. If a Tumour end into an Induration, it must be cured as a Scirrhus, whereof I will speak in its proper place. If it end into the corruption of the part, the way of dressing this shall be set down in my discourses of and Gangraena and Spacelus. If a Tumour cease, because the matter removeth from one place to another, as when Pleuritis endeth in Empyema, neither doth this belong to this place.   

LECT. VI Of a Phlegmon.  
HItherto I have delivered a general rule or method, common to the curation of all particular Tumours: Now it resteth, that the use of the general documents be showed in every special Tumour. Of all which, 
Phlegmon.  a Phlegmon doth first offer itself: First, because it is caused by the most excellent humour, to wit, blood; the matter of spirits, and the store-house of life. Secondly, because it is most frequent. Thirdly, because very often, as a Symptom, It accompanieth other griefs, as wounds, contusions, ulcers, luxations, and fractures, as Galen noteth. 
a 2. ad Glau●. c. 1. & 13. method c. 1.   
The word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 is drived from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from whence flagro, to burn, by reason of the heat of it.  
A Phlegmon is a Tumour hot, proceeding from the affluxion of blood to any part. In this description, 
A description of it.  where it is said to be hot, in this it is distinguished from Oedema and Schirrus; and in this that it is pronounced to proceed from blood, it is severed from Erysipelas of caused of choler: the differences are taken either from the material cause of it, or else from some parts which it possesseth. The differences of it taken from the matter are these: 
Differences from the matter.  It is either Legitima, or Notha, either truly bred, or else bastardly.  
A proper Phlegmon, is caused of good blood, only offending in quantity: Good blood is discerned by colour, 
Good blood.  taste, and consistence: In colour it is read, in taste sweet, in consistence mean, between thick and thin: of all other humours it is most plentiful in the body, because it affordeth nourishment to all the fleshy parts, as they have their being by it. Next unto blood, 
Moore phlegm than choler or melancholy.  there is more of sweet and alimentary phlegm, than of choler and melancholy; because it is blood half concocted, and in extreme hunger nature turneth it unto nourishment. But it is not so easy to determine of the other two humours, choler and melancholy; Alex. Aphrodisaeus thinketh that there is more choler than melancholy, 
a. 2. problemat.  for by reason of choler being hot and thin, the blood being made thin, doth pass the more readily, even by the capillar veins, to nourish the most outward parts: but in truth, 
Moore melancholy than choler.  and by all likelihood, there is more melancholy than choler, if you take melancholy for the grossest part of the blood: for first, seeing the bones which by ancient computation are 246. but more in number indeed are nourished by this humour, it being cold and dry, answerable to their temperature, it must be more plentiful than choler. Secondly, because the spleen appointed to be a receptacle of melancholy, is larger than the gall. Thirdly, because choler is not so familiar to nature as melancholy is: for as by a small quantity of choler, a great deal of milk becometh bitter, even so it is in blood. Now things bitter are unpleasant to nature; wherefore it is probable, that provident nature hath in the mass of blood appointed more melancholy than choler. Lastly, if we diligently note blood drawn out of the veins by phlebotomy, we shall evidently see more feculent blood in the bottom of the the saucers, than yellow choler fleeting in the top.  

Signs of a true phlegmon.  The signs of a true Phlegmon are six. I. This Tumour beginneth suddenly, and increaseth speedily, because the matter is plentiful, and the ways by the which it is sent very patent and large. II. It is very hot in respect of Oedema and Schirrhus, but yet not so burning as Erysipelas. III. The colour of the part is of a fresh ruddy colour. iv In this Tumour there is great pain with pulsation. V There is a great tension in the part, because the unnatural heat raiseth plenty of vapours which distend the part. VI The veins which before lay hid become conspicuous, and appear either ruddy or blackish.  
Now as I said, there be many differences of Phlegmons taken from the parts which they invade: for if it seize upon the meanings or membranes of the brain, 
Differences of a phlegmon taken from the parts.  it if called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, if the conjunctiva of the eye, than it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, if the muscles of the throat, it is termed Angina, if the Pleura, it is named 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, if the lungs, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, if the kidneys, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, if the emunctory of the heart and liver, Bubo, of the brain, Parotus, of the gums, Parulis, of the almonds, Paristhmia, Tonsillae: Phlegmons in other parts have no proper names, and even these I will refer to the particular practice of Physic, wherein they are handled, and rest contented with the doctrine of external Tumours.  
These inflammations, if they possess the external parts, and be but moderate are healthful; 
Prognostics.  as those which either by reason of the plenty, or malignity of the humour, threaten a gangrene, and mortification are to be suspected. A phlegmon which happeneth in a young body, in a hot and thin part, the body being not very plethoric and in the summer time is more speedily cured; but quite contrarily if the conditions be opposite. The indications curative of a true phlegmon are taken from the times of it: The means by the which we cure are two, a convenient diet, and artificial application of apt means for curing of the Tumour.  
In the beginning therefore, we must prescribe such a diet as is able to hinder the increase of superfluous blood, and the fluxion of that which is already bred: wherefore the diet must be spare and slender, only sufficient to sustain nature, and withal cooling: the patiented than shall rest contented with chicken, and veale broth with bread, calves-feets and trotters stewed, and seasoned with vinegar, thin oatmeale-gruell, panadoes, salads made of sorrel, spinach, purslane boiled in thin chicken or veal broth, seasoned with some vinegar, verjuice and sugar; let his drink be small beer or ale, altered in the summer with barrage, bugloss and burner; barleywater, fair spring-water, wherein the crust of a loaf hath been boiled, and made pleasant with oxie saccharum, or oximel diureticum, mingling with a pint of the water, one ounce and an half of the syrups. If the party be weak, Almond-milk made of barleywater, or the thin broth of a chicken may be permitted: If we intent to make the blood unapt to motion, and to detain it in its own receptacles, than we must institute a diet, having these three qualities: For first, it must cool: Secondly, it must make a constriction, and pursing up of the vessels: Thirdly, it must be diuretical, or move urine; for much serosity being carried away by the passages of urine, the blood must be made thicker, and therefore not so apt to flow. But we must take heed, that such a diet be only prescribed to such as are in their constant age, and have large veins; otherwise, we shall 'cause new obstructions, and multiply griefs: now to this purpose, you may ordain broths, wherein lettuce, sorrel, spinach, purselain, marigold-flowers, and columbine-flowers and leaves have been boiled, calves, sheep, and lambs heads boiled, with greensauce made of sorrel, or alleluia, be ware of alliaria, jack of the hedge, or those simples which are hot, young chickens with gooseberry-sawce, are good, and such like. We must forbidden wine, flesh, eggs, fat things, and such as breed too much blood; and spices, because they heat the blood; & piercing drinks, as stolen beer or ale, 
Wardens and pears rested, stewed, or baked are good.  because they further the fluxion of blood. To procure urine, an almond-milk may be made of a ptisan, having the emulsion of the seeds of the pompion, gourd, musck-melon, cucumber, lettuce, purslane, and plantain. Now the humour flowing immoderately, 
Evacuation.  we must labour to stay by abetting of it, and that by two manner of ways; by phlebotomy, and purgation.  
As for phlebotomy, 
Phlebotomy.  if the inflammation be great, the party young and strong, and full of blood; in the spring time we may take a lib. at a time, yea more, and iterate it if occasion be offered: in others, moderation is to be used, according to the strength of the patients. 
Which veins are to be opened.  If a phlegmon possess the parts which are above the liver, than the veins of the arms and upper parts are to be opened: but if it invade the parts which are under the liver, as the kidneys & genitalss, than the branches of the vena cava descending are to be opened in the hams or ankles. One thing is to be noted in Phlebotomy; that we open not veins too fare distant from the part affected, as Vena frontis in diseases of the feet: for we should evacuate too great a quantity of blood, before we should intercept any tending to the part affected. If a Phlegmon hath succeeded the staying of the evacuation of blood from any part, as from the nose, the womb, the hemorrhodes, means must be used to procure these accustomed evacuations: but seeing these may be found in all who have set down the manner how to cure particular diseases, I will leave them to diligence and industry of yourselves, being unwilling to misspend time.  
As for Purgation, 
Purgation.  one may doubt whether it can do any good; seeing no blood, the matter of a Phlegmon, can be by this mean spent. I answer, that it helpeth by accident, and two manner of ways: for first, purgation drieth the body, and so depriving the blood of moisture, maketh it more unapt to flow. Secondly, by purging sharp humours, the part which sendeth the humour is not pricked forward. But in this case, lenitives are better than eradicatives, 
What purgatives most sit,  because they rather cool than heat, and cause no ebullition in the humours: such are Diacatholicum, Electuarium lenitivum, Electuarium de sebesten, or a bowl, or cassia, tamarinds and sugar of violets.  

Local medicaments.  As for the Topical means, which respect the part, and the humour, they are of three sorts: Revellentia, Defensiva or intercipientia, & Repellentia: now medicaments appointed for revulsion, must be hot & attractive, 
Rep ●en●ia.  and applied to the parts opposite and remote, as I have set down in the general method of curing of Tumours. Of this kind are fomentations, 
Fomentations.  made of all sweet smelling and hot garden herbs boiled in strong wine, as calaminth, penniroyall, mints, lavender, tansy, time, smallage, feverfew, sage, savoury, pellitory of Spain; the fomentation must be very hot, the use of them must be continued until the part become read. Sometimes, if the as●laction of the humour be fiere, 
〈◊〉  and plentiful, we are to apply Vesicatories, as in inflammations of the eyes to the neck: but seeing there is none, who hath been but initiate in the practice of chirurgery, who is not fitted with a medicament for this purpose, I mean not to lose labour, and misspend time in setting down any descriptions of them. ●ut let me tell you, that some sorts of ranunculus, 
〈◊〉 in ●●●se o● the 〈…〉.  or crowfoot green beaten and applied to the part, are more secure than cantharides; but the bull-foot, which is found in most pools by the high way, is most excellent, being beaten and applied in a wall●ut-shell, or muscles or cockle shells, choosing the ampleness of the shells, according to your purpose. If in the winter time you apply cantharides, you must correct them with Euphorbium, mustard seeds, and seeds of amie, or dill: for if a vesicatory of them be applied to thin and tender bodies, it will 'cause difficulty of urine, which will be removed speedily, if the party drink of an almond-milk, made of barleywater, wherewith the emulsion of the great cold seeds hath been drawn, and that warm. Besides these local medicaments, we are to use Cupping-glasses, 
epping g●●s●●●.  sometimes without sacrification, if the party be timorous, and not very plethoric; but if the affluxion of humour be great, and the party strong and courageous, let scarification be used. 
●●ctions.  Frictions also are not to be omitted; but in this exercise we must begin at the extremities, as hands and feet, and end at the trunk of the body, to move the humour, and then to labour again from the trunk to the extremities, to bring it downwards.  
As for Ligatures, in applying them, you must begin at the trunk, 
Ligatures.  as about the shoulder, and articulation of the thigh, and end in the hands and feet, making three ligatures in each extremity; above the elbow, and about the wrist in the arm, and above the knee and ankle in the leg.  
After revelling means, 
Defensives.  Defensives succeed: These are applied to stay the humour from flowing to the part these must be cold, dry, and astringent, fit to purse in and contract the vessels: these are applied to the parts adjacent, and which have less flesh, as to the joints, and parts above the joints; for there the vessels are most conspicuous, and so are most apt to receive the impression of the medicament: so if the foot or hand be inflamed, let the defensives be applied to the ankle and wrist, and so forth.  
Of these defensives there be two sorts, for some are more mild, as Plantine, the whi●e Rose, Nightshade, 
The divers kinds of defensives.  read Poppy or water of the spawn or Frogs, read wine, vinegar and water, vinegar and oil beaten together called Oxylaeum, verjuice, and such like, and these are to be applied to tender bodies, and who have but small veins. Others are stronger as Bowl, Sanguis draconis, Terra sigillata, Pomegranate flowers and rinds, the decoction and pulp of Sloes, Sumach, Myrtill berries. These are to be applied to bodies or a strong constitution, of ripe age, and who have large veins, and in the summer time, and when the inflammation is fierce. Of such simples we may make composition fitting our purpose: as, mingling Mastic, and boil with the oil of Myrtils, and whites of Eggs: The juice of Houseleek with Milk is good, or a decoction made of read wine, and Tanners woose, wherein are boiled read Rose leaves, Myrtil berries, Sumach, and pomegranate pills & rinds; Ceratum Santalinum is good. It is not amiss to have in readiness, such a defensive as this: Take of white wax ten ounces, of the oil of Myrtils, and Quinces of each one ounce, of Mastic powdered ʒ iij. of Bole, and Sanguis draconis beaten to powder of each j ounce and ij drams, make up an Emplaster: in the winter you may add more oil.  
Last of all, Repellentia offer themselves, 
Repellentia.  which beaten back from the part affected, the humour: The differences of such medicaments, taken from their substance are these. 
Differences of repelling medicaments.  Some are cold and moist, as Housleekes, Lettuce, Purselain, Succory, Duck's meat, the white of an Egg, Navel wort, Nightshade. These are mild, you may use either the juice of these, or a Cataplasm made of barley meal, and these juices. There be some simples, which more strongly cool, as the Henbane, Mandrake, Hemlock, the deadly Night shade, and the apple of Peru: but these are only to be used, when the party is of a flourishing age, in the summer, and the veins large.  
Again, some of these repelling medicaments are astringent, cooling and drying: these repel more strongly, than the cold and moist, for besides cooling, whereby the natural heat flying its contrary, doth carry with it the blood, they draw together the part, and as it were wring out the humour: of these some are weaker, as. Vine leaves, Plantain, Horse-tail, Perwinkle, buds of read Roses, oil of Myrtils: others are stronger, as Bole, pomegranate pills and rinds, the pulp of Sloes, Oaken and Owlar bark, read Wine with Alom, Galls, the husks of green nuts: these if they be untimely used, wrinkle the skin, increase 〈◊〉 pain, indurate the humour in the part, and sometimes return the matter to some principal part.  

Things to be observed in the use of medicaments.  Wherefore if we will use aright the simples, and make good compositions of them, we must diligently consider the temperature of the party and part, the measure of the inflammation, the quantity of the humour flowing, the sense of the part, the passages, and air. Wherefore the hot constitution of the party and part require gentler topics, because the excess is not great, only heat being added to heat; but if the part be cold, and less fleshy, it requireth stronger medicaments, because the cause must be greater: so in children end women we use milder than in aged and strong bodies: so the greater the inflammation is, the stronger aught the topic to be: so if the part be very sensible, gentle means will serve; but if it be dull it will suffer stronger: so if the veins be large, stronger medicaments are to be applied; because plenty of blood must needs flow. Last of all according to the constitution of the air the local means must be stronger or weaker.  
Now it is time to determine, what medicaments are to be used in the beginning of a phlegmon: 
Beginning of a phlegmon.  If therefore the party be offered while the blood is wholly yet in the small veins: then repelling medicaments are to be applied. I. Because the humour as yet is but little and thin. II. Because nature as yet is strong. III. Because the matter is not as yet settled or impacted: If some of the humour be in the small veins, and some be without them in the distances of the musculs, and parts, or in the porosities of the similarie parts, we are to apply medicaments partly repelling, partly discussing; but more of the repelling.  
Nevertheless, in cases repelling, medicaments are not to be applied unto phlegmons beginning. I. If the parts be weak, left their natural heat be quenched: such are glandulous parts, for they are lose, and flaggie. II. When there is intolerable pain: for then repelling medicaments would 'cause greater pain, and so perhaps cause fainting and swooning. III. When the cause is external, and causeth a malignity, as the biting of a mad dog, or of an adder: for so the matter should be driven to the principal parts. iv When the fluxion is vehement, and much matter floweth: for then repelling medicaments should be fruitless, the part not being able to resist.  
But seeing I have set down both the simples, and some forms of compounded medicaments of the two kinds of Topics, I will abstain from all idle repetition, and pass to to the augmentum, or increase of a phlegmon. In it then we are to apply discussing medicaments mingled with repelling, yet the repelling during the whole course of the augmentum, aught to have the dominion: 
Increase.  because until the latter end of the increase, the greatest part of the matter is within the vessels, and may be repelled; for when blood is once slipped out of the veins, it cannot be evacuate by repelling, but discussing topics: These are called also 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉: They aught to be hot and dry in the third degree, and of piercing substance: For first, they must make the blood thin and fluxible: 
●. 8. Simpl. 5. ●. 9 Simpli de paronych. ●3. method. 16.  Secondly, they must convert it into vapours: and thirdly, they must evacuate by the poors of the skin by insensible perspiration. In thin and tender bodies in the summer time, mild medicaments are most convenient, as camomile, dill, fenugreeke, beane-flowre, and such like. But in compact, and thick bodies, strong are required, as, Sulphur vivum, Opopanax, Galbanum, mints, horehound, wormwood, calamint. etc.  
When the phlegmon is come to the state, 
The state.  or height of pain, tension, and heat; medicaments equally repelling, and discussing are to be applied: because a great deal of the humour is yet in the veins, and much without them.  
When a phlegmon is come to the declination wherein pain, 
The declination  tension, and heat begin to abate, a discutient fomentation made of camomile leaves and flowers, melilot, dill, tansy, sage, lavender, mints, scordium, and such like, and the application of Diachylum cum gummis will serve, or a cataplasm of bean flower, camomile, dill, melilot boiled in strong ale leeses, adding to the cataplasm oil of camomile, dill, and white lilies: but if the inflammation be great, the pain vehement, the heat intolerable, the tension and swelling notwithstanding the following of the former course, than suppuration or apostemation is to be procured. 
Apostemation.   
If the natural heat in the body of man be prevalent, it turneth all things to nourishment, if they be familiar unto nature; if any excrementitious part be in them, it turneth that into vapours, and expelleth them by insensible perspiration; but if the natural heat be enforced to enter in single combat with the unnatural heat upon equal terms, than the natural heat discusseth some part, and the unnatural heat not able to corrupt the part, suffereth a mean to be wrought, 
The signs of the dominion of natural or unnatural heat.  that is, generation of quittour. Now unto which of them the victory inclineth, may be gathered by the qualities of the quittour. If the quittour be good, it is white, because it is caused by the coats of the veins, arteries, nerves, and membranes, which are in colour white, and t●asmute the water into the same colour. Secondly, 
The signs of laudable and ill quittour.  thick, because concoction is performed by thickening. Thirdly uniform, because the natural heat hath an absolute dominion over every part of the quittour. Fourthly, not stinking, the natural heat enduring no putrefaction: If contrariwise the quittour be pale, read, or black, thin, unequal, of divers substances, and stinking; then the unnatural heat is prevalent. Now how a phlegmon, which must be suppurate is to be dressed, I have set down at large in the former lecture of apostumations of hot Tumours: hitherto I have spoken of a true bred phlegmon, engendered of sincere blood.  
Now I am to give you notice of a bastard phlegmon, 
Of a bastard phlegmon.  which is caused by the admixtion of some other humour with blood: If choler be mingled, it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉: If phlegm 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 If melancholy 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Seeing compounded diseases are to be discerned, esteemed, and cured by the diseases and simples solitary, I shall not need to spend any time in discoursing of these: If choler abound, we are to cool and moisten in a higher measure than in a true phlegmon: If phlegm be joined we must heat more; if melancholy, we are to use things warming and softening. They who have written of Tumours after a phlegmon, have set down discourses of a gangrene, carbuncle, and a pestilential bubo, but a methodically: For a Gangrene is an accident, which doth not only accompany Tumours, but wounds, ulcers, fractures and dislocations, and that more often; of it therefore I will discourse in its proper place. As for a schpacelus a mortification or a sideration of a part, it belongeth to the third part of chirurgery called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which teacheth to take away superfluities: such as a member is by accident, when it is deprived of life, and threatneth corruption to the whole, unless it be taken away.  
A carbuncle and a pestilential bubo are symptoms of the Pest. as a venereal bubo of the Pox. Of these I shall be willing to discourse, when occasion shall be offered to read of the griefs, unto the which they are to be referred.  

Tumours to be referred to a phlegmon.  Unto phlegmon 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that Tumour which is called Panus, Panis, or Panicula in Latin, from the figure in Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 is to be referred: It is a Tumour most commonly in the glandulous parts, 
Celsus li. 5. c. 25.  somewhat flat, in the top whereof there is a representation of a pustle: It hath a greater heat and pain, than the bigness of the Tumour showeth, it is commonly most discussed without apostemation: because it hath more choler than blood. But contrariwise 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 hath more blood than choler, for it quickly cometh to suppuration: In form it is like to Panus a weaver's roll or touchwood, and hath this same seat, to wit, the glandules in the emunctories. As for furunculus or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, it is engendered of gross humours mingled with blood in fleshy parts most commonly: 
See Galenti. 5. 2. in loca.  If it be mild and come to maturation without any great difficulty, it may be referred to 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. If it be hard and stubborn to medicaments, it is to be referred to 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉.   

LECT. VII. Of an Erysipelas.  
HAving in my former weekly lecture delivered what I thought pertinent concerning the first general Tumour, a phlegmon, the cause whereof was said to be blood without the vessels offending in quantity or quality. Method now warneth me to discourse of the second general Tumour called Erysipelas, proceeding for the most part from choler: not so much because it surpasseth either phlegm or melancholy, whereof Oedema and Schirrus are bred, in dignity or quantity, as that it more representeth a phlegmon in accidents, to wit, heat and colour.  
But before I enter into a particular discourse of an Erysipelas, give me leave to touch three points briefly, which will make all things which I shall deliver, more plain. The first, is the signification of this term choler: The second shall be of the divers kinds of choler: The third shall set down the signs of a choleric person: for such an one is most subject to this Tumour. Colera then in Latin, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek signifieth not the humour, which in English is called choler or the gall; but a disease, whereby this humour is expelled vehemently by vomit and siege. Nevertheless in our vulgar speech, and with the barbarous late writers, it is taken for the humour itself, and so I shall be enforced to use it. Thus much I thought to insinuate to you, that you should not be ignorant of the proper and learned significations of the terms of Art.  
Now Bilis or Fel in Latin, in 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek, choler or gall in English is either alimentary, or superfluous: the alimentarie is the fourth part of the mass of blood dry and hot, which more property might be called bilious blood: the superfluous, which serveth not for the nourishing of the body, is either natural, or unnatural: the natural is that, which in the liver is separated from the blood, and turned to vesicafellis. The unnatural comprehendeth four sorts. under it. I. is the Vitelline, like unto the yolkes of eggs yellow; but thicker and hotter than that of the gall: II. is Potracea, which in colour representeth the leek, it is engendered in the stomach by reason of crudity, and eating of such meats as engender it: as gartick, onions, leeks, and milkin Infants, who often by siege discharge such an humour: III. Aeruginosa, like verdigrece engendered of more vehement heat, and corrupt aliments in the stomach: IU. is 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, like unto woad; it is more green, than that which resembleth the leek: it is caused of the aruginosa more burned, and cometh near to atrabilis.  
Now, a man is thought to be of a bilious constitution, if he be watchful, nimble, hasty, angry, and dream of fire and thunder, his urine is thin and yellow, his pulse strong, swift, and hard, his veins are large, the habit of his body is lean, and dry, his colour yellowish: cold things refresh him.  
These things being permitted, now I am to discourse of the Tumour Erysipelas itself, of it I will set down five things: the Etymon of the word, the nature of the Tumour, the signs of it, the prognostics of it, and last of all the indications of curing of it. i. As for the Etymon of the name of this Tumour, it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek quasi 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉: for the ancient for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which signifieth read, used and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signifieth near: wherefore 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 is nothing else but a Tumour in colour, coming near to read, and tainting often the adjacent parts: for thin and hot blood, or blood with the which yellow collar is mingled, dyeth the skin with the colour of a pale rose: the nature of Erysipelas is discovered by setting down the description, and kinds of it.  
An Erysipelas than is a hot Tumour proceeding from most of choler, in this description Tumour is the genus: for this is common to Erysipelas with all other Tumours. In that is said to be hot, it differeth from Oedema and Schirrus: and whereas it is affirmed to proceed of most choler, it is distinguished from all the rest of the Tumours.  
But here it may be demanded, whether Erysipelas be caused of alimentary, or of superfluous choler: unto the which question I answer, that it is to be thought that it is caused of the alimentary choler, if it be exquisite: otherwise how could the yellow jaundice, and Erysipelas so much differ, if they both did proceed from excrementitious choler: for first the yellow jaundice possesseth the skin of the whole body; but Erysipelas one part only: secondly, an Erysipelas hath always a symptomatical fever annexed to it; but the yellow jaundice is most commonly free from it: thirdly, in an Erysipelas there is always pain; but in the jaundice none: fourthly, in the jaundice the skin is of a yellowish colour; but in an Erysipelas it is of a bright read colour.  
There are two kinds of Erysipelas, for it is either exquisite, or not exquisite, or a true, and a bastard one: as for an exquisite Erysipelas it is a Tumour of a bright read tending to yellow, causing little swelling, very hot with a pricking pain, caused of alimentary choler: this choler abounding in the body if part of it be turned into any part, it causeth an exquisite Erysipelas. The parts which it most commonly invadeth, are the nose and face, for much thin blood floweth to these parts: secondly, the legs: for nature being moved by the plenty of this choler sendeth it first to the emunctories of the groynes, and from thence it descendeth to the legs, it happeneth in the summer; because then choler is multiplied; but in the winter, because the pores of the skin are shut by cold, and so insensible perspiration hindered: and because this humour is thin, it spreadeth to a great part of the skin.  
As for the signs of an exquisite Erysipelas, they are either taken from the qualities of the humour which causeth it, or from the differences between it and a phlegmon. The signs taken from the qualities of the humour are these: The pain is great and urgent, the heat notable, the colour a bright read tending to a yellowness, the tumour is small, only possessing the skin, the pulsation is very small, and less than in a phlegmon. First, because the parts in a phlegmon are more compressed, and it reacheth deeper: secondly, because in a phlegmon the humour is thicker, and cannot so easily be breathed out as in an Erysipelas. The differences between a phlegmon and an Erysipelas are these. I. A phlegmon possesseth the skin, and the flesh lying under; but an Erysipelas the skin only: the cause in an Erysipelas is the thinness of the humour, which rather disperseth itself through the skin than heaveth it up. II. The heat in an Erysipelas is greater than in a Phlegmon: for sometimes the cuticula is blistered. III. The symptomatical fever is greater in an Erysipelas, than in a Phlegmon: because choler is hotter than blood. four The pain in an Erysipelas is lesser; than in a Phlegmon: because in it there is only a hot distemperatute; but in this a solution of unity, besides the parts being stretched. V In a Phlegmon, the colour is of a dark read, by reason of thick blood lying deep; but in an Erysipelas the colour is a brighter red, tending to a yellowness. VI In an Erysipelas there is a pricking pain but in a Phlegmon, a heavy & stretching. VII. The skin in an Erysipelas being pressed, yields; but in a Phlegmon it doth not: The causes are the thinness and thickness of the humour. VIII. In an Erysipelas the redness vanisheth away from the skin, and it becometh white if it be press with the singer; but in a Phlegmon it doth not so. IX. In an Erysipelas there is no stretching of the akin; but in a Phlegmon there is: Last of all, a Phlegmon settleth itself in one place; but an Erysipelas maketh the parts adjacent red by spreading. As for the Prognostics of an Erysipelas: I. That which proceedeth from natural yellow choler is mildest: for no vehement symptoms succeed: and besides seeing it appeareth in outward parts, it is to be thought that the inner parts are discharged of this humour. two, As it is a good sign, if an Erysipelas be driven to the outward parts, so it is fearful, if it return from the outward to the inward parts. Aphor. 25. sect 9 III. An Erysipelas appearing in the head is mote dangerous, than in other parts: because if the matter pass to the meanings, it causeth phrenitis or raving, if to the muscles of the neck, the Squinancy. iv An Erysipelas appearing in wounds, ulcers, fractures and dislocations, is commonly mortal: if it proceed not from the application of too hot local medicines. V If an Erysipelas tend to suppuration, it is not good: for then the humour must be thicker than ordinary, and the obstructions stronger, and so the solid parts are in danger to be corrupted VI If a bone being bore, the adjacent fleshy parts be possessed with an Erysipelas, it is ill: for first, the body must be troubled with sharp humours, secondly, flesh cannot be restored by such blood.  
Now it is time to draw out our forces, to encounter with this grief: we are to meet with it with four kinds of helps, diet, chirurgeri●, internal medicaments, and local means. As for the diet, our nourishment must be cooling and moistening. Let the patiented then care thin chicken broths, altered with the cooling herbs, panadoes, thin oatmeal gruel, salads of lettuce, sorrel, puishine, and spinach boiled. If the choler be very thin, the party may eat fresh fish, which live in clear sandy, or rocky waters, as trout, small pickrells, perches, and of sea fishes, the whiting-maps, and smelts, he may eat also of the brain of a pig or it petittoes, or trotters with vinegar, and sorrel, let him refrain from all meats which are fat and sweet: let his drink be spring-water, boiled with the bottom of a loaf, made pleasant with some Oxysacchar. or the distilled waters of endive, or sorrel, he may use a plain ptisan: Galen permitteth the patiented to drink as much cold water as he will, for this cooleth the body, quencheth the thirst, 
Lib 9 method. c 5.  abateth the heat of the choler, and cooleth the liver: but in this case the season must be hot, and the stomach good: with us small beer bottelled is best, all forts of wine are forbidden. In the Summer, let the air be cool and moist, in Winter, let it be rather hot: for in this season an Erysipelas is caused of the constriction of the pores of the skin, by reason of cold: let all perturbations of the mind be banished, let sleep be procured; for watching drieth the body. But if an Erysipelas be in die face, watching is best: for immoderate and long sleep filleth the head full of vapours, whereby the grief is increased.  
As for the chirurgical helps, it may be doubted whither Phlebotomy be necessary or not, for the decision of this doubt, these propositions shall serve: I. If an Erysipelas invade the head, neck, or face, the Cephalica always is to be opened: jest a phrenitis or angina ensue. II. In an Erysipelas Phlegmonodes wherein blood increaseth the heat in what part of the body soever it be, a vein is to be opened. III. In an exquisite Erysipelas in other parts of the body we aught not to draw blood: for first, by drawing of blood, the blood which remaineth, moveth more, and becometh more subtle: Secondly, the stay of choler is taken away: Thirdly, by taking away both good and bad blood together, the party is weakened.  
As for the internal medicaments, they aught always to go before the local, if yond except two cases: I. If an Erysipelas be procured by an outward cause, as a blow: II. If the heat be vehement, and the Tumour be far from any principal art. In these cases we may apply a medicant cooling and moistening, before we minister any purging medicament. If an Erysipelas appear in the head or face, we must open a vein, apply the Leeches, minister a purging medicament, prescribe a slender diet, and use revulsions by frictions, ventoses, blisterings, and vomiting if it appear in the legs.  
As for local medicaments, we must look about us, for if we apply cold medicaments, the matter may be repelled to the brain, from whence Phrenitis may proceed, or to the throat, which may cause Angina: If you be enforced by the importunity of the patiented, or standers by to apply a local medicament. Aetius counselleth to apply a Swallows nest beaten to powder, 
lib. 14 c. 5.9.  and tempered with honey, that it may represent a lineament with a feather. This is a safe medicament, for it only drieth and repelleth not: We may also apply the decoction of mallows with some oil of violets, or sweet Almonds. Now the purging medicaments which discharge choler, these or such like will suffice, Rhewbarb, Tumarinds, Cassia extracted, Electuarium lenitivum, Diacatholicon, Diaprunum solutivum, Electuarium de succorosar. Caricostinum. If it be but a mild inflammation, sharp clysters made of the decoction of cooling herbs, with the aforesaid Electuaries will serve the turn.  
Having set down the helps taken from the diet, phlebotomy, and the ministration of internal purging medicaments, I must hasten to set down convenient local medicaments: for in these you are most employed and busied: one thing is to be observed, that we must not in any case apply astringent medicaments, which are cooling and drying: For seeing the vapours in this Tumour are sharp, 
Gal. de comp. ●ed f●genera●l. 1. c. 4.  if they be kept in, th●● might erode and corrupt the part. Now as concerning local medicaments, first, I will set down which they are: Secondly, how long they are to be applied. These medicaments aught to be cooling, and moistening: but before I name them, let me warn you, that first you refrain from narcoticall simples, unless exceeding great pain, and in a part fare from a principal part call for them. Secondly, that you apply not unctuous and fat medicaments, for First, they most easily are inflamed: Secondly, they stop the pores. Now the medicaments which are to be employed, are either simple or compound: The simples are Navelwoort, Horse tail, Knotgrass, both the Plantines, Ducks meat, garden Nightshade, Lettuce, Purslane, the Poppies: First, the juice of them expressed may be applied: Secondly, the distilled waters drawn from them, some powder of myrrh having been infused in them. We may also apply clours wet in the juices of the aforesaid herbs, being mingled with verjuice or vinegar. The compound medicaments are Ceratum infrigidans Galeni made of lb j of oil of Roses, and ℥ iiij. of white wax: 
i Simpl. 13. & 14. method 13.  this is to be washed with water and vinegar. You may add to it the juice of Nightshade. He●r●ius hath three good medicaments, the first is Castle-soap dissolved in Spring water: The second, is Bull's dung boiled in a frying pan with vinegar, and a few flowers of Camomile, and Elder, until it come to the consistence of a lineament: The third is made of two parts of aqua spermatis ranarum, and one part of Rose vinegar, wherein some myrrh must be infused: these may be safely applied to an Erysipelas of the head, neck, or face; the juice of horse dung is not only good, being applied to this Tumour, but in sealdings and burnings also, if a little Camphyr be added to it.  
The medicaments which are to be applied to an Erysipelas must be very liquid, actually cold, and often changed: for when then become hot, they will rather offend than profit, if they be not removed. The last thing which I promised to set down concerning the local medicaments was, how long they were to be applied: this we may found out by two signs. The first is, if the heat be altogether abated, or almost: the second is, if the skin hath recovered it own colour. When you perceive these two signs, you must desist from applying cooling topics, jest the skin become livid, or black which threaten a gangrene, and sometimes mortification. If this appear, what then is to be done? first, a fomentation is to be used, made of Calamint, Scordium, Wormwood, Peniroyall, the lesser century, and betony boiled in a weak lie made of ordinary ashes: after the part is sufficiently fomented, you are to apply Hypocrates cataplasm made of Barley meal, vinegar and oil of Roses warm: or this, take of the flower of Barley, Beans, and Vetches of each iiij ℥. of a weak lie iiij. lb. boil these to the consistence of an emplaster, then put to it iiij ℥. of Oximel: if the discolouring of the part pass through the skin, and the part be immoderately cooled, it will not be amiss to scarify the part which only remaineth. I am but in a few words to discourse of a bastard or a spurious Erysipelas: such an one is to be thought, when with alimentary choler an other humour doth concur.  
Now seeing four other humours may associate themselves to choler, so many kinds of a bastard Erysipelas may be accounted. If therefore some blood be mingled with choler predominant, than 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 is caused: in this kind of Tumour the redness is more dark, and the swelling not so spreading: If waterish phlegm be mingled with choler, than 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 ariseth: If gross blood or thick phlegm concur with choler, than 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 is caused: lastly, if choler associate itself with the corrosive salts of the serositie of blood, it causeth Erysipelas ulcerosum, which breaketh the skin. But seeing the compound Tumours are to be discerned by the doctrine of the simple, and that the medicaments are accordingly to be applied, not distrusting your observations or judgements, I will end.  
Of that Erysipelas, which breaketh the skin, there are two kinds, Herpes miliaris, and Herpes exedens: Herpes miliaris is caused of a salt waterish humour mingled with unnatural sharp choler: the signs of it are these. I. Many pustules rise in the skin like to millet seeds. II. When they break, a matter issueth out representing quittour and sanies. III. The place hath a mingled colour between read and pale; this is without danger: the medicaments which are to be applied to this, aught to be cooling and drying, as the Knotgrass, Horse-tail, Plantain, Owlar, Willow and Oaken bark, pomegranate flowers and rinds, Myrtill berries, read Rose leaves boiled in Tanner's woose, Vnguentum album rasis, de cerussa, de minio, Diapompholigos.  
Herpes exedens, called by Celsui, ignis sacor, 
Lib. 5●. 28.  and by some ignis Sancti Antonti: it is caused of unnatural choler, hot and sharp, corroding the skin only, by the which sign it is discerned from Phagedoena, or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Wherefore if many small ulcers appear not passing deeper than the skin, you may pronounce this to be Herpes exedens. In the curing of this, minister the decoction of Sarsa, and after the fomentation of it, with Tanner's woose, wherein cooling and astringent simples above mentioned, have been boiled; apply this local medicament. ℞ cerae flavae ℥ ij. resinae pini ℥ j ss. terebinth. ℥ j ol. myrtiniʒ vj. sucei Nicotiana ℥ iij. Coq. in ceratum molle. But here a question may be moved, why the choler which causeth the yellow jaundice doth not ulcerate the skin? This falleth out, first, because the choler which causeth the yellow jaundice is dispersed; but in Erysipelas united. Secondly, because the choler is natural and only excrementitious in the jaundice, such as is contained in the Vesicula fellea, and discharged into the guts. Thirdly, because thin phlegm is mingled with choler in the jaundice: for this disease endeth with much sweeting.   

LECT. VIII. Of an Oedema.  
IN the subsequent discourse, which I am to deliver of an Oedema, the third general Tumour caused of phlegm, I will use the same method which I did in the doctrine of an Erysipelas. First then, I will set down what phlegm is. Secondly, the differences of it: and Thirdly, the signs of a phlegmatic person: and then I will deliver the doctrine of Oedema, for such an one is most subject to this Tumour.  
Phlegm then is the fourth part of the mass of blood, cold and moist: as concerning the sorts of it, it is either alimentary or excrementitious. The natural, as it is cold and moist, so it is without any foreign taste: as oil and butter are accounted sweet, when as they have no rank taste. This humour by the natural heat increased (as in famine) may become blood, and serve for the restoring of natural humidity: it aught rather to be called pituitous blood, than phlegm.  
Unnatural phlegm is that which cannot be turned into aliment: of it there are three kinds. The first is pituita acida, sour phlegm, so called from the taste which it leaveth in the mouth, when it is spit out: This is a raw phlegm and bred in the stomach by reason of the defect of natural heat: so that being drawn into veins, it hardly can be altered. The second is pituita salsa, salt phlegm, this is caused by the admistion of thin salt moisture: for of bitter things as Aloe, and Coloquint, mingle them with thin humours as you will, a salt taste never can be procured. In sweat, tears, and urine this taste is manifestly deprehended: a very novice in Alchemy is able to make the salt of urine, & one laboured to procure a Patent for making saltpetre of urine, in the time of the last Parliament: but I never heard that he made any; being, as it is likely, deceived by his imagination. The third kind of unnatural or excrementitious phlegm, is pituita vitrea, representing in colour and substance, molten glass. This is very cold, thick and tough, and causeth great pain, 
2. de loc. affect. c. 5.  if it be detained in any part. Galen affirmeth of himself, that being troubled with a vehement pain of the belly, by injection of the oil of Rue, was discharged of such an humour, and so the pain ceased: whereas before he thought that a stone had stuck in one of the ureters.  
Phlegmatic persons are slow and sluggish, their senses dull, they are sleepy, they dream of waters, rain or snow, they are not easily moved to anger, their pulse is soft, small and slow: their appetite is not great, they are seldom dry, they by the mouth and nose voided many phlegmatic excrements: their urine is white or pale, sometimes thick; sometimes thin, the sieges often are raw and phlegmatic: the blood by what means soever it flow from the body, is petuitous: their body is whitish, soft and coldish, they are subject to cold and long diseases, as the dropsy, lethargy and such like, lastly they endure fasting well. These signs show natural and sweet phlegm to abound in the body.  
Having set down the description of phlegm, and the differences of it, as also the signs which discover a phlegmatic person, I am to discourse of Oedema, or a phlegmatic Tumour, of it I will deliver these five points: first the signification of the term Oedema: secondly, the differences of it: thirdly, the prognostics of it: fourthly, the indications of curing of it: and lastly, what Tumours are to be reduced to it. As concerning the term 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek, in Latin Oedema, with Hypocrates and all other ancients, it is the same with 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which signifieth eminentia, eminence or bunching out: and so every particular Tumour may be called Oedema. But with Galen and later authors it is taken more strictly for that Tumour which is caused of phlegm. Oedema is either exquisite or not exquisite: an exquisite is either primary or symptomatical: the primary is caused of the natural phlegm, 
Gal. li. de atra bile cap. 5.  which is contained in the mass of blood, and by reason of the too great quantity of it, setteth to work the expelling faculty to discharge it into the weaker and depending parts. Natural phlegm is cold & moist, thin in consistence, in colour white, in taste sweetish or insipid. The signs of an exquisite Oedema are five. I. It is soft and lose, because it is caused of thin phlegm. 
Lib. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 6.1.  II. If it be pressed with the finger, it hath either no pain, or very little. III. If it be pressed down with the singer it yields and leaveth a pit, which is the most proper sign of an Oedema. iv It is white, representing phlegm in colour, whereof it is bred. V It is cold without heat, because the pituitous humour is cold and moist. Avicen calleth this Tumour Vndimia. The material cause then of this Tumour is the pituitous humour redounding in the whole body. This humour is caused either of external, or internal causes: the external causes are air cold and moist, phlegmatic meats, idleness, too much sleep, stinging of wasps, and such like: the internal are a cold and moist constitution of the head, stomach; but chief of the liver. This Tumour invadeth not promiscuously all parts; but such as are cold, weak, and lose, such are the feet and hands, the cod, as in hernia aquosa, the eyelids: and then in them appeareth an outward Tumour lose, without pain, not altering the colour of them, which being pressed with the finger quickly yields and returneth, the material cause is a waterish humour mingled with flatuositie: so the heart and liver cannot suffer any such Tumour, as neither the kidneys: because these parts are firm and hot. As for the presages, Oedema is a long continuing disease, because it is cold, and therefore the natural heat of the parts affected, must be weak. II. It is not very dangerous, because the pain is either none or very small. As concerning the curation, it is performed either by diet, or internal medicaments, or local means: as for the diet of such as are subject to an Oedema, if it proceed from external causes they must be removed: the air which is to be chosen must be hot and dry, the food must be drying: wherefore roasted meat is better than boiled, fowls and birds which live in dry grounds; are better than water fowls, rabbits, chickens and veal are good, mutton is better than lamb, swine's flesh and fishes are to be shunned, as also heads, brains, and feet of beasts: salads of cold herbs are hurtful, use biscuit bread, or good household bread baked with Anise seeds, Fennill seeds, and Coriander seeds. Let the drink be altered with the rasping of Quajack, Sarsaparilla, Radix chinae, Sassafras, yellow Sanders Cummin seeds, Coriander seeds, Fennill seeds, Anise seeds, Galingal, Nutmegs, Calamus aromaticus, some Ginger, Cinnamon, Rosemary and Sage. The drying diet made of these, especially in the summer time is good: sweeting in this case is very effectual, every other morning after the taking of the diet: fasting is good as also watching, studying, and labouring: for all these dry the habit of the body.  
If an Oedema possess the hands, then walking is good; if the feet, than we are to prescribe sitting and working with the hands. Seeing then an exquisite diet will not serve to surprise this disease alone, we are to entertain purging medicaments for the expugnation of it. We need not to trouble the patiented with many preparative medicaments; seeing the pituitous humour which causeth this disease is thin, waterish and in motion; First of all, no medicaments internal are so effectual in this grief as Mercurius vitae, and safe medicaments of antimony: for, First they discharge the stomach of crudities by vomiting, and so correct the cold and moist distemperature of it: Secondly they dispatch the obstructions of the mesaraical veins and liver: Thirdly they mightily evacuate waterish and phlegmatic humours, and so correct the distemperature of the liver, and kidneys.  
As for ordinary internal medicaments, pilulae de hiera cum agarico acuat, with a grain of Elaterium are good: diaphaenicon, diacarthamum, diaturbith, pilulae de hermodaclylis, de aromatibus, cochiae. And the pills of Galen made of coloquint aloe, and scammony with syrupus Augustanus. As for the doses of these medicaments, and how they are to be exhibited I will refer you to those, who have diligently handled these things, chief to the practice of Martinus Rulandus.  
But here you may demand of me what is to be thought of phlebotomy? 
Quaest.   
To this demand I answer, 
Answer.  that in an exquisite Oedema opening of a vein is to be shunned. I. Because in a body cold and moist we open not a vein, such is that which is tainted with an Oedema. II. Because in this grief there is always cacochymia, seldom plethora: III. Because in an Oedema there is neither a malign matter, nor a horrible symptom and so it cannot be called m●rbus magnus, or a fearful disease: and so phlebotomy is not required. As for the local medicaments, which are to be applied, they aught by drying and strengthening to altar the part.  
In the beginning than we are to apply such medicaments as repel, and digest: but more digesting than repelling because the humour is cold: for in the beginning some part of the humour is in the small veins, some in the pores of the skin; but more in the cavities, and greater veins: towards the state of the grief we are to use digesting means. Galen useth four things, I. A rowlar with two ends, 
lib. 2. add Glauc. c. 3. et 14. n. ethod c 4,  such as is used in fractures, first the rowler must bind the Tumour itself more straightly; but the parts on every side adjacent more slackly, for so the humour is wrung out from the part affected, to the parts adjacent above and below. II. Is a Sponge, but in the use of a sponge we must see that it cover all the affected part, otherwise at the next dressing we shall see that the humour hath flowed to the bore part: in steed of a sponge we may use pledgets of hemp-tow; yea and double . III. Vinegar, for it doth consume phlegm, and because it is subtle it peirceth, IU. Some water to moderate the sharpness of the vinegor: If an Oedema be above sinews and tendons in a tender body less vinegar is required. But in hard bodies and in other places more vinegar is to be applied: if you mingle some allome with the vinegar and water, the medicament willbe the more effectual. Avicen counselleth to apply lime water with the juice of mirtils: but instead of the juice we may boil myrtle berries in lime water.  
If you boil scordium, myrtle berries, sumach, read rose flowers dried, calamint, wormwood and pennyroyal, in equal quantity of read astringent wine, vinegar, tanner's woose and lime water adding to every pint of the decoction strained 3. dams of allome, you shall have an excellent medicament. You may apply also an unguent made of unslaked lime, and old swine's grease.  
One thing is to be noted, that the Oedematous part is to be rubbed well with a cloth before the medicaments be applied, that they may penetrate more easily, _____ If an Oedema in the belly according to Hypocrates after 60 days tend to suppuration: which cometh to pass because the phlegm by long staying in the part, is altered by heat, and turned to quittour: then we are to hasten suppuration by the application of Diachylon cum gummis: then to open it, Thirdly to mundify it. Fourthly to incarnate it, and last of all to procure skinning. And seeing I spoke of these things in the curing of a phlegmon tending to Apostemation, I will remit you to that discourse, because I distrust not your memories.  
It falleth out many times that an Oedema, is a symptom of an other disease as I have said: but chiefly of the cough of the lungs, dropsy, and cachexia or ill habit of the body, and doth possess the legs and hands: First because they are furthest from the heart, the well spring of heat: Secondly, because they are framed of cold parts: seeing this accident cannot be removed, unless the disease which is the cause of it be cured, and seeing these diseases are for the most part mortal, I will suffer such as are empyricks, and prodigal of their own credits, to follow their own courses, and to undertake such cures.  
An Oedema is thus engendered: when nature is troubled with phlegm the expelling faculty thrusteth the pituitous humour from the great vessels to the lesser, and being kept in by the density and coldness of the skin, is gathered in the musculous part, and so causeth this Tumour. Hitherto than I have discoursed of an exquisite Oedema. Now it remaineth that we briefly dispatch that Oedema which is not exquisite. This is caused when some other humour is joined with the pituitous: if blood then be joined with it, it causeth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉: if choler concur it procureth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉: If melancholy, or thick and glutinous phlegm it causeth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. In all these kinds of a not exquisite Oedema the thin pituitous Tumour must be predominant. The other humours concurring are found out by their own proper signs which are set down in the discourses of every principal Tumour, so that I should misspend the time if I should go about to set them down here. Some things I would have you to note. The first is, a primary Oedema is caused by congestion, for it creepeth on by degrees: But that which is Symptomatical, an accident of other diseases, as tabes, asthma, cachexia and dropsy is procured by fluxion: for it suddenly appeareth. The second is this: If by reason of long keeping bed, either because one hath had a long and lingering disease, or because he hath received a hurt in the leg, the feet swell and become Oedematous, when by motion afterward the natural heat is increased, this flatulent phlegm is discussed, and the Tumour ceaseth. 
Quest.  One thing may be asked why Galen affirmeth that the liver may be possessed with a schyrrus, and not Oedema: To this it may be answered; 
Answ.  that the liver by its paranchymas or property of substance turneth thin phlegm whereof an exquisite Oedema is caused, into blood; but if it receive any thick phlegm, of that then a schirrus, and not Oedema is caused. But it is time to address myself to set down those Tumours which are referred to an Oedema: of those some are enclosed within a cystis or a membrane; and some have no proper membrane: those which have a proper membrane are in number 3. Atheroma, Steatoma, maliceuris. But it may be doubted from whence this cystis, 
Dub.  membrane, or folliculus doth proceed. 
Sol.  Undoubtedly it is framed of the teyes of the cutis and membrana carnosa: for seeing the natural heat cannot concoct the matter of these abscesses, nature doth providently separate it by its proper cystis from the parts adjacent jest it should corrupt them.  
The matter which causeth these abscesses and feedeth them, proceedeth from a vein, which is not accompanied with an artery, and so being destitute of vital heat, it is altogether unnatural, and cannot be assimilat to the parts unto which it floweth. Atheroma then containeth a substance like unto rice▪ pottage, or curds: the matter of this Tumour is thick and gross phlegm.  
Steatoma is a Tumour not so high as Atheroma, containing a matter like unto grease, or that which we call the sweet bread pancreas: blood flowing by the vein which hath no artery, and so is destitute of vital heat is easily turned into this fatty substance. Meliceris containeth a matter representing honey: so the phlegm which causeth this Tumour is thinner, than that which breedeth an atheroma, and hath some choler mingled with it the heat whereof maketh the matter fluid, and liquid.  
The Tumours reducible to Oedema which have no cystis, are three, psydracium, ficus, and talpa. Psydracium is a pointed white pustale containing in it a waterish humidity. Ficus is a Tumour so called, First because it hath a root like unto a fig: Secondly because it containeth small grains as a fig hath. It is a Tumour read, round, and somewhat hard and painful; from whence issueth a matter, like unto the seeds of a fig, if it be broken and wrung. The matter of this Tumour is gross blood, mingled with phlegm and some waterish moisture. Talpa or testudo is so called, because as a mole heaveth up the ground, so this Tumour the skin from pericranium, this Tumour is larger than sicus, and is caused of more gross humours; wherein there is little moisture.  
So you have a brief description of the Tumours which are reducible to Oedema: As for the cure of them I will reserve it until I come to that part of chirurgery called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which showeth how superfluities of the body are to be taken away. The modern authors add to these Nata, which is a large Tumour so called; because it representeth the buttocks called nates, without pain, consisting of soft and pituitous flesh; caused of congestion of pituitous blood: it is seated most commonly in the neck, shoulders and back: it is only cured by excision.  
Ganglium and lupia are round Tumours of the nervous parts without pain: yet they differ; for Ganglium is hard, but Lupia soft: 2 Lupia may be moved every way, upwards, downward, and side ways: but ganglium toward the sides only. Thirdly Ganglium is like to a knot of the sinew; but Lupia possesseth not the sinewy parts only, but other solid and hard-parts in hands and feet.   

LECT. IX. Of a Schyrrus.  
NOw are we to enter into the contemplation of a Schyrrus, the ugly progeny of muddy melancholy, as we have discoursed of a phlegmon, Erysipelas and Oedema, who deduce their pedigree from blood, choler and phlegm and ascribe their being to them. But that you may hereafter discern the better the nature of a Schyrrus, I will first set down the description of melancholy: Secondly, the divers sorts of it: and thirdly the proper signs of a melancholy person: which will both lead you to the knowledge of the grief, and open the way of curing the person possessed with this grief. Because the English tongue doth promiscuously use Melancholy, both for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, melancholicus succus, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 atra bilis, I must give you warning, that these two do much differ; for melancholicus succus is the feculent part of the blood like unto the leeses of thick wines as Alicant, and is drawn from the purest part of the blood by the Spleen. It is nevertheless one of the 4. nutritive humours natural to the body, and gentle having no corrosive or stinking quality. But Bilis atra is caused of immoderate heat, and is malign: 
Bilis atra.  for it burneth and corrupteth the flesh, it is sour and sharp, and being poured upon the ground it boileth and raiseth it up, as leaven doth dough, and hath an unpleasant smell. 
The kinds of it.  There be 3. sorts of this: the First is caused of blood burned, and of all others is the mildest: the Second it is engendered of saccus melancholicus burned; and it doth differ so much from the natural black, as leeses burned from the unburned: the Third is caused of yellow or vitellin choler more burned, which of all others is the worst; because choler whereof it is bred is more hot and sharp: than melancholy juice.  
None of these are engendered in a sound and healthful person, whereas the succus melancholicus is found in all persons of what temperature or estate soever they be. 
The description of succus melancholicus.  Wherefore Melancholicus succus may be thus described: It is the fourth humour in the mass of blood black and thick, yet natural cold and dry. 
The differences of it.  This humour natural is either alimentary or excrementitious. The alimentarie nourisheth the melancholic parts, which are cold and dry; as the bones, cartilages, and ligaments. The excrementitious or superfluous is drawn by the Spleen.  

Signs of a melancholic person.  Now these signs discover melancholy persons; they are silent, pensive, constant in their purposes, slow to anger; but if they entertain it, they turn it unto hatred: their sleep is troublesome by reason of fearful dreams, as of black things, dead bodies, death: they are sad and given to fear, without cause; their pulls is small, slow and hard: their colour is dark, their appetite to meat and Venus is more than ordinary: they seldom thirst, because they abound with much superfluous phlegm, their blood is thicker and blacker than ordinary, from what part soever of the body it flow, the urine is thin and whitest, if no melancholy be mingled with it; but if Melancholy be mingled than it is thick, black, or of a leady colour, they sweated much in their sleep; the habit of their body is lean, rough and hard: they are subject to varices and haemorrhoides: if such a one be presented to you possessed with a Schirrus, it is easy to discern the disease, and of what humour it proceedeth, and how the party is to be dealt withal. So you have the description of melancholy, the divers sorts of it, and the marks of a melancholic person: which things show no small light to attain to the knowledge of a Schirrus. In my discourse of a Schirrus, I will set down first the description of a Schirrus: Secondly the signs of it: Thirdly the differences between it and other Tumours: Fourthly the kinds of it: Fifthly, the prognostics of it, and lastly the manner of curing of it.  

The description of a Schirrus.  To begin then with the description of a Schirrus, it is a Tumour hard, and without pain, caused either of natural melancholy, or thick, tough, and cold phlegm. If the cause be melancholy, it hath a leadie colour; if phlegm, it changeth not the colour of the skin: for phlegm is white; As for the signs of it; I. It is hard.  
Now there are four causes of hardness: the first is coldness, as appeareth in Ice; this is removed by moderate heat, as by the sun. The second cause, is dryness, as we may plainly see in the hands of Sailors, and Feltmakers. The third cause, too great repletion, which doth appear in the stomaches of gluttons. The fourth cause, may be the combination of these, and indeed all these concur to procure hardness in a Schirrus. As for coldness, it may be induced either by things external, as cold air, and narcoticall medicaments: secondly, from the part affected, 
Because those parts are very thick. 2. in. Gal. 1. simp.  for schirrosities chief appear in the beginnings of the muscles, ligaments, and tendons, and other cold parts: thirdly, from the humour: so the melancholic juice, and thick and viscous phlegm: the material causes of a Schirrus are very cold.  
The second sign of a Schirrus is, that it is without pain: and this cometh to pass, either because the animal spirit cannot pass through an humour so thick and glutinous, as that is which causeth a Schirrus, or because it is benumbed by the coldness of the humour. This is the third sign, that it is fixed, and as it were nailed to the part, and doth not move by pushing, as Scrophula or Ganglium.  
Now I will show you how it differeth from other Tumours. It differeth from a phlegmon, for in this, there is great pain: from Erysipelas, because this is not hard: from an Oedema, because this yields to the touch, and leaveth a pit. It is discerned from waterish and flatuous Tumours, because they have a thinner, and more clear matter. The differences between it and a cancer are these. I. A cancer is always painful, because it is caused of bilis atra, or a dust choler; but a Schirrus is without pain. II. A Schirrus is cold, but a cancer hot: this is caused by reason of the humours whereof they are bred. III. A Schirrus invadeth the solid and hard parts, as the joints, tendens and ligaments; but a cancer the lose and flaggie parts, as the breasts, the privy parts, and such like. iv In a cancer, not in a Schirrus, the veins appear full of a black humour: which for the likeness, one may call the legs of the crab, as the round Tumour the crab itself. It is high time to set down the predictions of the success of curing, which schirrosities are like to have, that when such Tumours are offered to you to be cured, you may be made circumspect and wary in taking of them in hand: an exquisite Schirrus is uncurable, for seeing it is senseless, it is manifest that the part is deprived of the influence of the animal spirit; and seeing this humour doth distend the sinews, veins, and arteries, the faculty itself is strangled and choked, so that it neither can direct, nor help the natural heat to concur with the means, to be applied for the dispatching of this grief. Secondly, this being a cold Tumour, and the natural heat extremely weak, what hope can there be, that it can at any time triumph over so great an infirmity. A Schirrus not exquisite, although it be not mortal, unless it be very great, yet it hardly admitteth any cure, and by much difficulty. A Schirrus which is extreme hard is altogether uncurable: for gentle means avail nothing, and those which are strong make it more hard: a Schirrus from succus melancholicus is warily to be dealt withal: because it hath a great affinity with a cancer, and so may degenerate into it, if improper medicaments be applied. If a Schirrus be caused of thick and glutinons phlegm, you may be the more bold: for this cannot easily contract any malignity. The differences and divers sorts of a Schirrus are to ensue: a Schirrus then is either primary, or Epigenematicall. A primary Schirrus is that, which is a grief of itself, and not caused by reason of any infirmity preceding. This is twofold, for it is either exquisite or not exquisite: a primary exquisite Schirrus is that which at the first, is caused by collection of the melancholy juice in a part. A Schirrus is thought to be not exquisite, when an other humour is joined with melancholy. If therefore some laudable blood be joined with it, it causeth Schirrus phlegmonodes, if choler, Schirrus erysipelatodes: if phlegm Schirrus oedematodes. Nevertheless, seeing these are compound Tumours, and are to be dealt withal according to the doctrine delivered of the simple Tumours, whereof they are bred: I will leave these to your own considerations.  
A Schirrus epigenematicall or Symptomatical is that, which ensueth after an other Tumour, not handled according to art, as a phlegmon or an Erysipelas: this happeneth two manner of ways. I. It may fall out by the immoderate use of local medicaments too cold, and narcoticall or stupefactive: for these condense, and as it were congeal the humour. Secondly, this may happen by the too continual application of resolutive topics: for so only the subtle and thin parts are breathed out, and the thick and glutinous remain. The last point, which in the beginning I promised to deliver unto you concerning a Schirrus, was the manner of curing of it, receive it then, which I hope you will well like of.  
The indications of curing are taken from three things, to wit the diet, internal medicaments and external applications. As for phlebotomy it is here fruitless, because the humour is cold, unless the veins be very full, the blood black, and age and strength conspire: for than it is expedient, for so the humours in the mass of blood will be more fluxible; and the quantity being diminished, the natural heat will the more easily rule the residue. If a Schirrus be caused in a man by reason of the hemorrhods stopped, than the leeches are to be applied, if in a woman by reason of the menstrues suppressed, than Saphena is to be opened.  
As for the diet then, the meat must be of easy digestion, moistening, and affording a thin juice: such are Chickens, young Pigeons and mountain fowl, Lamb, Veale, young Pullet's and Cockrells, fed Rabbits, poched Eggs, asparagus salad, spinach, Borage, Purslane: bread of good wheat not too much leavened is convenient, let the drink be small white wine, or reasonable strong beer well boiled, clear, and neither too old, nor too new, good Cider also with Rosemary, Borage, bugloss burned, and Sugar is good. Meats which afford a gross juice are to be shunned, as old beef, all meats dried in the smoke, venison, fish living in muddy waters, all salt meats, course bread: the immoderate use of vinegar is hurtful: apple tarts, and warden and pear pies baked with Fennill-seeds and Anniseseeds will serve instead of other sweet meats. Let the habitation of the diseased party be in a pure, hot and moist air: too much sleep, idleness, grief and pensiveness are to be shunned. As for internal medicaments, they aught to purge melancholy, and thick and glutinous phlegm: but both of these are to be prepared before they be evacuate. Those medicaments which prepare melancholy aught to attenuate or make thin, and moisten: such are the syrups of the juice of Borage, bugloss, the syrups of Fumiterry, Hops, and Apples, with the decoction of Balm, Harts-tongue, Scolopendria, Tamariske, and such like. Those medicaments which prepare phlegm aught to be of an attenuating, and mundifying quality, as the syrup of Isope, of betony, of Stechas, Oxymel, and Mel rosatum in the decoction of Calamint, horehound, Pennyroyal, and such like. The humours being prepared, than they are to be purged: melancholy is to be purged with confectio Hamech, Electuarium, Indum, pills de lapide lazuli, the extract of black Ellebor, Electuarium lenitivum, and the like, which may be ministered in the infusion of Sena-leaves and Polypodie. Phlegm is to be purged with Diaphaenicum, Diacarthamum, Hiera Pachii, Pilulae de agarico, et hermodactilis, diaturbith and the like. The electuaries are to be ministered in a decoction of those simples which prepare phlegm.  
One thing is to be noted, that nothing is more effectual in discussing these schirrosities, than the continual taking of the decoction of sarsa parilla, and guajack instead of other drink, using a convenient diet, and procuring every other morning sweeting: for lignum vitae warmeth, and sarsa dissolveth the hardness: if it perform this in nodes, which are fare harder than any Schirrus possibly can be; why should it not perform this office in a Schirrus?  
Here it is no wonder if few be cured: for sundry are impatient if their expectation be not speedily answered, and besides this, they are unwilling to gain the loss of their health by foregoing their sensuality and pleasure, being ventris mancipia; more careful of their taste than health.  
But time calleth us to speak of external applications, which are fit to be used in the cure of a schirrus. In these you are to consider three things, their faculties, their differences, and the right use of them. As for the faculties then of the local medicaments they aught to be discussing and softening, emollientia and discutientia. Repelling medicaments are not to be used, because the humour is thick, and hard, and so unapt to motion.  
Of emollient medicaments there are four degrees: in the first are those which are gentlest; such are man's grease, capon's grease, the marrow of hearts, and calves bones, ducks grease, swine's grease, sweet butter. 
Li. 7. c. γ.  Galen adviseth to apply to gentle Schirrosities, a medicament made of sweet butter, black rosin, and new wax, Dialthea simplex, is of this degree. In the second degree are these, goose grease, badgers grease, dog's grease, old rank oil, oil of Linseed. In the third degree, are the fat of lions, bears, wolves, foxes, libards, and the marrow of horses, and man's bones. In the fourth degree, are Ammoniacum, galbanum, bdellium, caranna, tacamahaca, opopanax, of these simples you may frame unto yourselves such compositions as the quality of the schirrus, 
7. ad Almans.  which you are to take in hand shall require. Races in all schirrosites, commendeth a certain cataplasm and it is excellent indeed.  
The description may thus be framed, take of bdellium, ammoniacum, and galbanum, of each 1. ounce, dissolve these in a hot martar with oil of lilies, add of the mucilage or pulp of roasted figs ij. ℥, of the mucilage of Linseed and Fenugreeke, vj. ℥, make up a cataplasm, dress the schirrus with this cataplasm once a day. Diachilon cum gummis, and emplastrum de mucilaginibus are convenient. Riolan the father commendeth this medicament, take of unguentum de althaea, of diachylon cum gummis & emplastrum de mucilaginibus of each 1. ounce, of the oil of Lilies vj. dams: mingle these well together, you may add to these medicaments some vinegar to help penetration. If a Schirrus be above a nerve or a tendon, instead of vinegar you may use the spirit of wine.  
One thing is to be observed, that before you apply any medicament, the part affected is to be fomented with the decoction of Mallows, marshmallows, Camomile, Melilot, and Cowslip flowers in vinegar, unto which after it is boiled, some spirit of wine is to be added.  
As concerning the right use of the local means, these observations following are worth the noting, the first is, If a Schirrus be caused of the melancholy humour which is cold, thick, and dry, you are to apply a medicament which warmeth, attenuateth, and moisteneth, II. If the Schirrus be engendered of cold, thick, and tough phlegm, than the medicament aught to be warming, attenuating, cutting, and mundifying. III. Tender persons and parts require milder; but parts and persons harder and stronger, require more forcible means. iv If a Schirrus hath been procured, because an unskilful person hath applied medicaments too much repelling, or discussing to an inflammation: then apply this mollifying lineament. take of yellow wax, and duck's grease tried, of each j ℥. of oil of Lilies ij ℥. of the marrow of ox's bones ij ℥. mingle them well together. V If immoderate use of drying topic hath procured hardness, than medicaments moistening are to be used: such is a catapsalme made of mallows boiled and capons grease, or swine's grease.  
Unto a Schirrus these tumours may be referred strumae, warts, corns, leprosy. As for Strumae and the leprosy, they will require several tractats.  
Warts, if the root be small and the top broad, may be taken away by ligature; if the root be broad they must be exterpate with medicaments. There I commend unto you, strong aqua fortis, or lapis infernal●s relenred, these must be applied to the warts with a rush or a straw. The third is an experiment of Faebricius, ab aqua pendente, and that is this; of Purslane bruised, and the powder of Savin make a cataplasm and apply it.  
Corns first must be artificially cut, and then one of these medicaments which I shall name, must be applied: Ammonaicum disolved in vinegar, and brought to the consistence of cerot, emplastorum de mucilaginibus, and diachylon cum gummis.   

LECT. X. Of aqueous Tumour.  
I Have delivered in my Lectures penned before the last Easter holidays what I thought most material concerning the four principal Tumours, Phlegmon, Erysipelas, Oedema and Schirrus, which are caused of the four humours in the mass of blood; to wit blood properly so called, choler, phlegm and melancholy, and so might have concluded the doctrine concerning the differences of Tumours, as sundry others have done who have written of this subject.  
Nevertheless seeing aqueous or watery and flatuous Tumours are often presented to you to be cured, I think it expedient to discourse of these, that the doctrine of Tumours may be complete.  
First then I will discourse of the Aqueous, and then of the flatuous Tumour. The material cause of the Aqueous Tumour by the Physicians is called serum or serosus humour. Of this humour there is but a small quantity in a healthful person; no more than is fit to make the blood thin, that it may be the more readily carried unto all the parts of the body to afford them nourishment. This being done it is discharged through the pores of the skin, either by sweat or insensible perspiration.  
Wherefore Galen not without reason affirmeth all serositie to be an excrement. 
●. d●nat. sa●●●tat. c. 9   
This serosity is not only of a moist and waterish substance; but of a salt quality in like manner, yea, this serositie, urine and sweat have the same matter: 
The difference of mine, sweat, and the waterish humour.  yet they differ, for Serum is that aqueous humidity, which is contained in the blood: and although blood be drawn, yet it cannot be discerned unless the blood grow cold and congeal, and this thin part by the concretion of the blood be separated from the thicker. 
Urine.  But urine is nothing else but the superfluity of this serositie of the blood mingled with the waterish humidity of meat and drink, and near the root of Vena cava separated from the mass of blood and drawn by the attractive faculty of the emulgent veins & kidneys, and by the ureters sent to the bladder, there to be detained until the convenient time of excretion. So that this kind of excretion purgeth the blood from waterish humidity, whereby it is made more firm, & so more fit to nourish the parts. As for sweat and insensible perspiration, 
Sweat.  they are nothing else but the excrements of the solid parts. Nevertheless, they carry with them some obscure signs of the constitution and temperature of the body: hence it is that a dog can find out his master, and discern the tract of the Hare, from that of a Fox, and of one fowl from another. 
The causes of the increase of the waterish humour.  Some preternatural causes will increase the serositie of blood: as meats affording plenty of waterish humidity, as most fruits, cold herbs, and immoderate use of water, and other drinks: for although some drinks be hotter than others, yet all of them have more waterish humidity than spirit: and by reason of the distemperature and obstruction of the parts appointed for sanguification, often times this serositie is not separated from the alimentary humours; but is detained and increased, and not expelled by urine and sweat: from whence the dropsy, fevers and pustules of the skin do proceed.  

The causes of an aqueous Tumour.  An aqueous or waterish Tumour than is caused of the superfluity of this serositie detained in the body, after that it hath performed its office, which if, when it hath carried the nourishment through the narrow passages: such are the mesaraical veins, and those which are dispersed through the substance of the liver. Wherefore when the liver sendeth the blood by the branches of the vena cava to the parts of the body, it hath not need of such store of humidity. If too much of this waterish humidity be sent to the habit of the body, & move the expelling faculty, than part of it is sent to the skin, which causeth waterish Tumours. Those which heave up the Cuticula are called Sudamina. 
Sundry differences of waterish Tumours.  Those which arise in the night time are called Epinyctides. If waterish humidity be gathered in the cod, it causeth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, if in the navel 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, if in the head, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. And although neither Fallopius nor Tagaultius have made any mention of waterish Tumours, thinking perhaps, that they may be reduced to pituitous Tumours, yet these Tumours wherein nothing else but waterish humidity is contained, do plainly evince, that an aqueous Tumour is one distinct from all others. 
What causes move the sending of this humour to the circumference of the body.  Superfluity of this serositie is sent to the habit of the body: partly because the weakness of of the kidneys doth not suffer them sufficiently to draw it: partly, because the liver is too cold, and lastly, by reason of some error committed in the use of the things not natural, as immoderate taking of water, and other drinks, as Wine, Ale, Beer, Cider.  

The signs.  The signs of a waterish Tumour are these: First, it is sometimes more, sometimes less swollen: yet it yields when it is pressed hard, whereby it is discerned from Schirrus. It is distinguished from a phlegmon, and Erysipelas, because these are painful; but it not. It is discerned from an Oedema by this, that it being pressed, it admitteth no pit as Oedema doth. It being beaten, it yields no noise, as a flatuous Tumour doth, as appeareth in a tympanic. Last of all when it breedeth, there is always an itching in the part, by reason of the saltness, which is in the waterish humidity. These Tumours appear in the navel, 
The places most subject to this Tumour▪  cod, and the habit or compass of the body; yet most frequently in the joints of the arms and legs: because these parts being weak, cold, and thick, are aptest to admit such waterish Tumours. 
The predictions.  As for the Prognostics, that waterish Tumour which happeneth by reason of any imperfection of the liver is dangerous: not so much in consideration of the Tumour itself, as of the infirmity of the liver. Other waterish Tumours although they be not so dangerous, yet by reason of the weakness, coldness, and thickness of the skin are not so easily cured. As for those Tumours which rise in the compass of the body, like to blisters or small bladders and are called sudamina, as they are no ways dangerous, so they are easily cured. 
The indications of curing this Tumour.  As for the curation of this grief, reason and experience have found out five means to meet with it, to wit, a convenient diet, internal medicaments, external applications, and manual operation. If then an universal humidity possess the whole body, 
D●et.  the diet must be drying: wherefore roasted meat is better than boiled. Immoderation in drink is by all means to be shunned: for,  
jejunet, vigilet, fitiat qui rheumata curate.  
Watch he must, and thirst, and fast,  
Who means to cure a rheum in haste.  
And as temperance and sobriety have a promise of prolonging our temporal lives, so are they powerful helps in curing diseases: but chief those which are caused by the superfluity of moist and waterish humours. Flesh then is better than fish, and of flesh meats, those are best which are driest: Kid then is better than Lamb, Veale than Mutton, Rabbits and Coneys are good, land fowl are better than water fowl. Hypocrates himself commendeth Pork above Pig's flesh: but neither of both is good: for Pig's flesh is exceeding moist, and in Pork the fat is moist, and dissolveth the stomach; but the lean is hard, and not easily concocted. All supping meats are to be shunned, for they multiply moisture. Ludovicus Cornarus his diet recorded by Lessius in his Hygiasticon or treatise concerning preservation of health, is fit for such persons. For above the space of forty years, he rested contented every day with xij ℥. of bread and meat, and xiv ℥. of drink: when he was eighty years of age, so able he was by the observation of this moderate diet, that without any advantage of ground, he usually backed the fairest Italian horses. 
How the liver and kidneys affected are to be cured.  One thing is to be noted, that seeing superfluous humidity seldom possesseth the body, unless there be some fault in the liver and kidneys, you must by all means labour to reduce them to their natural temperature. The means to compass this, are set down by every one, who hath penned the practice of physic, unto whom I remit you, being unwilling to trouble you with impertinent discourses.  

Internal medicaments.  The internal medicaments appointed for the expugnation of this grief, are of three sorts: for either they purge by stool, or by urine, or by sweat, and insensible perspiration. To touch the Catharticke medicaments, 
Catharticall medicaments.  such are one grain of El●terium which a scruple of pilulae coehiae, or de Euphorbio, or Alepha●gmce: two drams of the seed of the dwarf Elder, or Ebulu● beaten to powder, and ministered in white wine, & a spoonful of the juice of Ebulu●, the flower deluce, of soldanella mingled with ij ℥. of the syrup of damask Roses dissolved in ij ℥. if white wine. The purging diet is excellent if you add to the ordinary purgatives in it, the roots of Esula major, the berries of the bucke-thorne, and Carthamus seeds. Amongst all the simples Mechoacan and Jalop are most commended, both for their efficacy in working, and safety in ministering. 
Diuretical medicaments.  As for diuretical means, I commend unto you this medicament: take of the ashes of Broome, and Beane-straw burned, of each a good handful: strain through those ashes iiij pints of Rhenish wine three times: then infuse in this wine of the root of Sassafras sliced ij ℥. of Nutmegs and Cinnamon, of each two dams, of Bay berries, and Juniper berries of each six in number, of Cumin-seeds ij ʒ, of Fennil-seeds and Anniseseeds of each one dram and an half, of Sugar iiij ℥, of the spirit of Salt j ʒ. Minister every morning iiij ℥. of this wine strained, and so much about four of the clock in the afternoon: the decoction also of Penniroyall, Time, Calamint, with seeds of the Melon, Pompey, Cucumber and Purslane made pleasant with the syrup of Althaea, de quinque radicibus, and of I soap ministredas the former, is good.  
As for diaphoretic medicines, the decoction of Guajacke, Sarsaparilla, 
Diaphoretic medicaments,  Sassafras, and the China root with agrimony, Betony & Coriander, sweet Fennil-seeds, & Anniseseeds carry away the bell. How effectual these medicaments are, being judiciously used, not in this grief only; but in moist ulcers also, and other diseases contagious, I need not to labour to persuade, seeing there are few of this company, who have not often made trial of them: when these decoctions are ministered, a strict diet must be enjoined, and plentiful sweat procured, according to the tolerance of the diseased party.  

The local applications.  The topical remedies aught not to be repercussives, although the humour be thin, because seeing nature can make no use of it, it is to be evacuated: wherefore the remedies aught to discuss, and rarify the skin, that vent may be given to the humour. Fabricius ab aqua pendente commendeth this medicament, 
De Tum p. n. p. 2. lib. 1 c. ●0.  take of Mallow leaves on handful and an half, of the meal of Lupins j ℥. of the oil of Dill and Camomile of each ij ℥. with s. q. of white wine make up a cataplasm. The Ice of unstaked Lime, and branches of the vine are good. Avicen out of Galen, against waterish Tumours describeth thus the emplaster of Mustard, & affirmeth, that if this medicament prevail not, that there is but small hope that any other william. Take of Mustardseed, Nettle-seed, Brimstone, Aristolochia rotunda, of the foam of the sea, or Brine and Bdellium of each j ℥. of Ammoniacum, old Oil, and Wax, of each j ℥. make a cerot according to art. Let me advertise you of one thing, that the part is to be fomented before either cataplasm or emplaster be applied. The fomentation is to be made of a lee made of Beane-straw, Broome, and twigs of the vine burned, with some ordinary ashes, wherein you are to boil common Wormwood, sea Wormwood, the lesser century, Calamint, Cumin-seeds, Bay berries, Juniper berries, Scordium, Camomile flowers, Melilot flowers, and tops of Dill: unto the decoction strained, add the sixth part of sheres Sack. But seeing I have discoursed sufficiently of all degrees of discutient remedies in my lectures of other Tumours: I will cease to trouble your patience with idle repetitions, commending unto you only these few specifical remedies before mentioned. Now to come to the last remedy appointed for rebellious waterish Tumours, to wit, manual operation: If they cannot be discussed, as oftentimes Hydrocephalos and Herria aquosa: then the humour is to be let out, sometimes by incision, sometimes by a canstick medicament: then the part is to be mundified, thirdly it is to be incarnate, and last of all cicatrized. But seeing I have handled these points, when I discoursed of an aposteme, and that I am to set down what is singular in every chirurgical operation, whereby superfluities are taken from the body, in that part of chirurgery, which is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, here I desist, referring every thing to its proper place.   

LECT. XI. Of a flatulent Tumour.  
HAving set down the doctrine of a waterish Tumour, I am to fulfil promise, to speak of a flatulent Tumour: In Latin it is called Tumour flatulentus, 
The names of it.  in Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, for the Grecians call flatuositie sometimes 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, sometimes 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉.  

Persons most subject to this grief.  The person in whose body flatuosities are multiplied, is often troubled with gudlings in his sides, he belcheth often, he is troubled with singing of the ears, his excrements come forth with flatuosity, his urine is frothy, he findeth a stretching of his belly, yet without any heaviness.  

The causes of this grief. Differences of weak heat.  The causes of flatuosity are crudity and weak heat. The heat may be accounted weak two manner of ways. I. Of it own nature, & so it hath some power and do●●●ion over the humour, and doth in some sort dissolve it, but imperfectly; and so it produceth halituous vapours, which are called flatuosities, but is not able to discuss them, and so they remain in the part, and distend it, and that because the flatuosities are gross, and the part thick: this appeareth often in the knees, and troubleth Surgeons and Physicians much. II. Heat may be accounted weak by reason of the matter itself; when as the matter is so plentiful, that the heat cannot wholly overcome it, but leaveth some vapours undiscussed.  

The differences between a waterish and flatuous Tumour  The causes of crudity are ebriety, gluttony, a sedentary life, and flatuous drink and meats; such are beer or ale not well boiled, pease, beans, chestnuts, turnips, radices, green fruit, swine's flesh, water fowl, salt fish, and such like. It is discerned from a waterish Tumour, whereof we have spoken, by the lightness of it; for an aqueous Tumour is heavy, but this not. Secondly, by distending the membranes, and stretching of them, it causeth often intolerable pain, whereas in waterish no pain is felt. It is discerned from an Oedema by this, that it admitteth no pitying, although it be pressed: it is distinguished from Schirrus, because this is hard, but it not: it is discerned from a Phlegmon and Erysipelas, for in it the skin is not discoloured, neither is there any extraordinary heat felt; but in those both appear.  

The prognostickes.  As for the Prognostics, receive these; If these flatuosities possess parts very sensible, as great joints, such are the elbows, or knees, which are compassed with thick membranes, they are hardly cured, and will busy the most skilful.  
As for those which invade other parts, they are not very easily cured. First, 
Why those Tumours are hard to be cured.  because these halituous spirits are gross. Secondly, because the parts thorough which they are to be discussed are thick. Thirdly, because the natural heat is weak. 
The indications of cu●ing.  Whosoever goeth about to cure these flatuous Tumours; First, he must prescribe a strict diet to the Patient, such as I have set down in the cure of a waterish Tumour. Secondly, he must bar him of the use of all flatuous aliments, whereof I have made mention, and prescribe unto him meats of easy concoction, and which afford a laudable juice. After meals let him eat a slice of the marmalade of quinces, with some coriander, and anniseeds comfits, having but one covering of sugar. The stomach a little before bed time is to be embrocated with the oil of mastic, wormwood and rue.  
As for the Topical remedies, the part first is to be fomented with Shears sack, wherein Dil, Rue, Bayleaves, 
The topical remedies.  Camomile; and Melilot-flowers, Cumin-seeds, Annisseeds, Fennill-seeds, and Bay-berries have been infused. Then the part is to be embrocated with the oil of Camomile, Lilies, Dill, Rue, Bays mingled with Aqua vitae. Thirdly, apply to the part the Cummin emplaster, or that of Bay-berries: if the Patient do feel inflation in his stomach, or in region of the spleen, minister unto him of the confection of Bay-berries ʒ. two. in iii ℥. either good Hippocras, or Canary wine, wherein Cinnamon hath been infused two hours before supper. iij. or iiij. drops of the oil of Pepper, or vj. of Fenill-seeds oil in the wig of a Sacke-posset are good. Digestion is furthered in such persons, if they take a cup of Sack having a toast in it, and afterward eat the toast, being first besprinkled with sugar. To such a remedy the meanest may attain unto: you and they will better like of it, than of an●●emedy sold in the Apothecary's shop. The Sack is to be taken two hours before supper.    

A Table of the Treatise of Ulcers.  

In this Treatise of Ulcers are set down  
First those things which belong to ulcers in general, and those are either 

The differences of ulcers, & so they are either 

Simple,  
or compound, & these are either 

Mild, which are either 

Plain,  
or Sinous, and that 

Without callositei.  
Or with callosity, which are called Fistulae.      
Or malign, and these are either 

Less malign, and these are three. 

Herpes exedens.  
Phagedaena.  
Nome.    
Very malign, of these are 2. kinds. 

A cancerous ulcer.  
A leprous ulcer.          
Or the accidents: & these are taken from things either 

Familiar to nature, from hence spring four differences, to wit, an ulcer. 

1. With superfluous flesh.  
2. With cariositie of the bones.  
3. Having the natural colour altered.  
4. Varicous.    
Estranged from nature, and so an ulcer is called 

Verminous.  
Lousy.        
Secondly the doctrine of ulcers of some parts in particular, as of the ulcers. 

1. Of the hairy scalp.  
2. Of the ears.  
3. Of the eyes.  
4. Of the nose.  
5. Of the mouth.  
6. Of the lungs.  
7. Of the back, belly, and joints.      

A TREATISE OF ULCERS. The second Treatise.  

LECT. I. Wherein the Authors, and Definition of Ulcers are set down.  
BEfore I addressed myself to discourse of any particular matter belonging to the course of chirurgery, I allotted in my first Lecture, four parts to chirurgery: whereof the first was 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which teacheth to unite parts disjoined. 
The differences of the solution of unity.  Solution of unity I made two fold: either intelligible, to be apprehended by reason or understanding, or sensible, which may be perceived by the very senses. The intelligible I named a Tumour, in the which very often no solution of unity doth offer itself, either to the sight or touch, as in many choleric Tumours, and others in their beginning. Sensible solution of unity, I affirmed either to be in the soft parts, or in hard. As for the solution of unity in the soft parts, I appointed two differences of it; to wit, Vlcus and Vulnus, and ulcer and a wound.  
But here, 
Quest.  not without a cause, a question may be moved, which of those two, in methodical proceeding, aught to have precedency. It is an undoubted truth, that the first man that lost his life was Abel, and that by wounds; so that by all likelihood, men first of all bend their wits to find out means to cure hurts received by external violence: for the nearer they lived to the creation, the more pure their bodies were, no hereditary diseases being left by parents, if you except mortality by reason of old age, which no man could escape by reason of the sentence of death pronounced for the sin of disobedience against Adam and his posterity by Gods own mouth: and so being little troubled with either inward griefs, or outward sores, they troubled not themselves about the invention of medicaments to cure these; so that by the right of time, the treating of wounds aught to precede the handling of ulcers. 
Answ.  Nevertheless, in our times my opinion is, that the discourse of ulcers, for sundry reasons, aught to go before. For first of all, an ulcer doth proceed from an inward Humour corroding, but a wound from an outward instrument dividing: so that a silly Empirick, yea a doting old woman, may go about the curing of wounds in fleshy parts, and compass it; but to the curation of ulcers, the knowledge of Humours, and the constitution of the bodies affected are required, which require a man well versed in that part of Physic called Physiologia. Secondly, greater variety of medicaments is required in the curing of ulcers, than there is in the curing of wounds, & so still greater skill is required in the curing of the one than of the other. Thirdly, greater estimation doth accrue unto those who take upon them the curing of ulcers, than unto those who deal with wounds, and that by all sorts and degrees of persons, whether they be rich or poor, rude or civil, learned or Idiots; so that I need not to retract my opinion in ascribing unto the tractation of ulcers the precedency, before the discourse of wounds.  

The scope.  In my proceeding, I will handle these ten points: First, I will point out the Authors who have written laudably of this subject. II. I will set down the definition of an ulcer. III. The causes of an ulcer. iv The differences of ulcers. V The general signs of ulcers. VI The general prognostickes of ulcers. VII. I will set down such medicaments as are fit for all ulcers in general. VIII. Of the general indications of curing of ulcers. IX. Of their times. X. I will discourse of every particular sort of ulcers.  
To make the tractation of ulcers perfect and complete; First then to come to the Authors, 
Point.  I mean not to name all who are come to our hands, and have written of this subject; but such as are famous for their skill and experience. Hypocrates and Galen, although they have not left to posterity particular large monuments of this matter, yet when occasion is offered, they omit not to set down both the indications of curing, and medicaments effectual to cure. Hippoc. in his 6. Sect. of ulcers and fistulas. Galen in those excellent books of his which he penned, De methodo medendi, Lib. 3. of a simple ulcer, Lib. 4. or an ulcer with accidents; of the orderly way to cure diseases, for the most part doth illustrate his precepts by examples borrowed from the Practice of chirurgery.  
If you demand why he did so? 
Quest.   
I will tell you the cause in Fallopius his words, 
Answ.  in his first Chapter of ulcers, Quoniam ut ait Celsus, lib. 7. c. 1. Quum eadem est. Seeing according to Celsus, the means which Physicians use in curing, sometimes take effect, sometimes avail not, it may be doubted whether health may be ascribed to the good constitution of the body, or to the means applied, but the effect of chirurgery is most evident. O pregnant testimony to evince the certainty and excellency of chirurgery. Let those Physicians who slight the practice of chirurgery, thinking themselves to be chicks of the white hen only, consider and weigh the weight of this testimony of Celsus and Fallupius in the impartial balance of reason. Avicen the chief of the Arabic Physicians, handleth this matter in the fourth Book of his Canon, and the third Treatise: although he doth writ confusedly, yet the reading of him will profit such as understand him, and will not be fruitless. Albucasis hath some good things, but the number of the trifles are many more. Paulus Aegineta in his fixth Book of the Art of curing, only toucheth some points of this matter, as a dog doth Nilus when he drinketh. Gabriel Fallopius followeth, who hath written an excellent Treatise of this matter; but whosoever shall peruse him, shall find him in sundry things intricate enough: I will bring him a new companion, but fare surpassing all other modern Writers, Minadou●, one of the famous professors of that renowned University of Milan, in his three Books which he penned of the curing of the deformities of the body of man: whosoever he be who shall go about to make a parity between these two and others of the late Writers, I shall judge him worthy of Midas his ears, and after that he hath proceeded, & been promoted in Germany, to be saluted a Doctor with four feet. To these two Italians, I join the Germane Samuel Hafenrefferus, in his four Books of the affections of the skin, in whom there are many varities, if one with judgement discern them. The rest that can be named are of the lower bench, as Guido a Cauliaco, and he who hath only taught him to speak a little more eloquently, joannes Tagaultius, in the third ●ooke of his Institutions of chirurgery. joannes de Vico accounted the father of Empirics. Marianus Sanctus in the third Treatise of his compend of Chirurgeric, and Angelus Bologuinus in his two Books of ulcers, shall bear him company. I must not omit that painful and judicious Chirurgeon Ambrose Parrey, unto whom chirurgery is much beholding. Vesalius also deserveth praise. The two latest who have written are the two Fabricii, Jerome and William: Hieronymus Fabricius in the third Book of the second Part of his chirurgical works: Guiliel●●●● Fabricius in his learned chirurgical observations, who in this course outstrip all their fellows. These Authors of all others are most to be perused, for in reading of them one shall become both more understanding, and more able to perform the cures which shall be committed to his care and skill. As for the rest, I leave them unto those who rather choose to feed upon acorns, than pure manchet. Riola● the father, jaques Guilmeau, Peccetius and Pigra●●, although they deserve their own praise, yet in my opinion they are to give place to those whom I have named. If any one would misspend good hours, let him read Paracelsus his great and little chirurgery, which are like clouds without rain. If you would be furnished with forests of Chirurgecall medicaments, peruse the Treatise of the learned Hollerius de materia Chirurgica, of chirurgical means, and jacobus Dondus in his enumeration of chirurgical remedies, both simple and compound.  
As for those medicaments which in my proceed I shall from time to time set down, they shall not be a confused heap, but a choice of the best approved, to ease you of the labour of election.  
Now are we to descend to the definition of an ulcer, which was the second point: 
Point.  I will not stand upon the setting down of sundry descriptions of sundry Authors, and the examination of them, because this labour would take up too much time, and little edify you, which was appointed the end and scope of these Lectures. An ulcer in English is derived from the Latin ulcus, and this from the Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, because it disjoineth the part which it possesseth, and so this term, in its general signification, comprehendeth every solution of unity: and so Hypocrates in his Treatise concerning wounds of the head doth entitle it.  
But seeing solution of unity may proceed from two causes, to wit, an external instrument dividing, and a sharp humour eroding, 
De cause morb. cap. ult.  according to Galen: there must be two differences of solution of unity likewise according to the same Author, de constit. art. c. 6. Vulnus, a wound, procured by an external instrument, and ulcus, an ulcer, caused of an inward cause eroding. Thus than an ulcer is to be described: It is a solution of unity proceeding from an inward cause eroding the part. 
The description.  The subject of an ulcer, I make not only the fleshy part, (whereby I understand, not only all the parts which cover the bones) but the bone itself also. Unto the ulcer of a bone the Author of the book de constit. art. cap. 6. giveth a peculiar name, calling it Teredo, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which properly signifieth the little worm which pierceth wood, and consumeth it. I see no reason why the name of an ulcer may not be ascribed to the solution of unity in a bone, if it proceed from an inward cause eroding, as the term of a wound is, if it be divided by an external instrument, as a sword or hatchet. An ulcer than is a compound disease: for in it there is both solution of continuity, and loss of substance.   

LECT. II. Of the causes of ulcers.  
IN the third general point concerning ulcers is set down by me the causes of ulcers. 
Point.  These are either antecedent or conjunct: The antecedent causes may be reduced to four, to wit, Cacochymia, or the evil habit of the body, Contagium, or the communication or imparting of an infecting quality, vapour or humour, by the which an ulcer is caused in any part; a venomous moisture, as in biting and stinging of serpents.  
As for Cacochymia, the speculation of it doth belong unto 
Or lastly the distemperature of the part itself.  the practice of Physic: yet in my discourses of Tumours I set down the signs of every humour, redounding as much as was requisite for any to know, who only meddleth with the practice of chirurgery. While any of the three humours (blood being excepted) in the mass of blood contained in the veins, is faulty and peccant in quality, it is accounted the cause antecedent of an ulcer. Sometimes these humours are solitary, sometimes they are associate together.  
Contagium, or infection, it is communicated sometimes by a rotten and corroding vapour, and so very often, if one visit often one having Pthysis, such vapours being mingled with the air, infect the party who visiteth, especially if he draw too near to the diseased party. So ulcers of the yard come from dealing with women whose secret parts are touched with venereal ulcers: yea the itch itself, and scabbedness, is gotten by either lying with one troubled with it, or sleeping in a bed where a scabbed person hath rested.  
As for the distemperature of the part, it may be procured either by cold, as appeareth in kibes, or by heat, as we may see in a gangrene; because the blood flowing copiously to the part pained, and not being concocted, it putrefieth and erodeth the part. Last of all, by biting or stinging, as of a mad dog, or a venomous serpent, a corruption of the humours may be caused, the conjunct cause of an ulcer: so that every humour that is changed from it own natural temperature, whether it be by putrefaction, adustion, or commixtion of any thing unnatural, may procure an ulcer in whatsoever part it seateth itself.  

The opinion of dogmatic Physicians concerning humours.  But the followers of Hypocrates and Galen, speak otherwise of these humours than the Chemists do. The Galenists, make the three humours of the mass of blood, to wit, choler, phlegm, and melancholy, to be the causes both antecedent and conjunct of all ulcers, if they become contrary to nature. So they will have rheumatic ulcers to be caused of salt phlegm, Herpis exedens to be caused of eruginous choler; cancerous ulcers of Bilis atra, which are the worst and most deplorable of all others.  

The opinion of Chemists.  The Chemists on the other part, affirm that the discourse of humours doth not manifest unto us the essence, and proper nature of any disease. So Quercetan in his advice of curing the gout, bringeth in the stone, which he affirmeth not to be engendered of the galenical humours. Petrus Severinus the Dane in his Idea medicina philosophicae, or Portraiture of the philosophical Physic, wondereth at the folly of those, who make those fantastical humours, blood, choler, phlegm, and melancholy the causes of diseases: wherefore they out of minerals, salt, sulphur, and mercury, fetch out the causes of all griefs. Although Galen call sometimes humours salt, nitrous, and eruginous, yet the Chemists have no reason to reject the ordinary names of humours, and to call contumeliously dogmatic Physicians Humorists, and to deny any disease to proceed from the ordinary humours of the body becoming unnatural: for seeing that according to Galen 1. de loc. affect. c. 2. that is to be accounted the cause of a grief, 
That the ordinary humours of the body are causes of diseases.  which being present the disease continueth, and which being removed the grief ceaseth: and seeing we perceive diseases to be caused of vicious humours abounding, and these being expelled the grief to vanish, I see no reason why these humours may not be accounted the true causes of griefs; and that it is a mere folly, and an affection of novelty, to baptise these by names of minerals fare fetched; as to call that which in fevers is cast up by vomit, rather sulphur than choler. Besides this, the Chemists are injurious to dogmatic Physicians, in labouring to persuade men that they by the name of a humour understand nothing else, but a waterish substance voided of all other faculty, which should be the principles of all bodies, 
What a Humour is.  and the causes of all diseases: whereas every rational Physician, by the term of a humour, understandeth a liquid body mixed with blood: which seeing it is a several body of its own kind, and is more compound than water, so it hath fare more excellent qualities than water. The Physicians their own selves have set the Alchemists at work, while talking of humours, and the causes of diseases, so much talk of the first qualities, heat, cold, moisture, and dryness. For although sundry diseases are caused of heat, 
The first qualities are not the only causes of diseases.  cold, moisture, and dryness, yet we shall find other qualities in the Humour, which may as well hurt the body as these: for Hypocrates in his book de prisca medicina, or ancient physic affirmeth, not that which is hot, cold, moist, or soft, to be most powerful, but that which is bitter, salt, sweet and sour, unsavoury, and sharp with some sourness; these and a thousand such, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 being exalted in their faculties, he will have to be the causes of diseases, and not the first qualities only: and from these the differences of symptoms in fevers of this same kind do depend. These whilst they are exquisitely mixed in the body are harmless, yet when one of these is severed from the rest, and is exalted in its quality, it manifesteth itself, and annoyeth man; so the corrosive salt doth bewray itself in cancers, and corrosive ulcers. 
Minerals are in the body of man.  Neither is it to be thought absurd, that minerals are in the body of man, for seeing man is fed by plan●s, and beasts, which feed also upon the plants; seeing also the herbs have their aliment from the ground, which is not alike in all places, but often is mingled with a salt juice, and other mineral spirits, which the beasts and herbs cannot perfectly convert into their own substance; one can hardly think that a man can live upon these, & have no such thing participate. So we see what variety of wines the diversity of the soils bring forth; & that in every wine there is tartar or argol, which appeareth also very often in podagrical persons. In vomiting, sundry times substances like to leeks, green, and eruginous, exceeding hot and sharp are thrown up, which being received into basins, dry them with a bright eruginous colour. See histories in Shenki●●●ed. obser. lib. 3. ob. 62. in the third book of his physical observations, the 62. observation. Michael Dor●●gius lib. 1. de ●edico & ●●●●●ci●a, in his first book of the Physician and physic reporteth, that a certain Lawyer made such urine, as did fret the linings, as if it had been the spirit of vitriol; such humours appear plainly in scabbedness, fretting ulcers, but specially in a cancer. Wherefore Bertinus is his third book and eleventh of his Physic, doth rashly and inconsiderately affirm, that not one whit of mercury, salt or sulphur, lieth hid in the body; for in the itch, scabbiness, some catarrhs, inflammations of the eyes, and fretting ulcers it may be perceived; but in urine, which is also an excrementitious humour, the salt may be separate, & presented to the sight: yea, besides the salt in urine, another substance the cause of diseases may be marked: for if you take a clear urine, and suffer it to settle, a matter like unto the powder of brick, and sometimes a white muddy substance will so cleave to the sides of the chamber-pot or urinal, that it can hardly be sometimes washed away; of such a matter tophes in gouty persons, and stones in the bladder, are engendered.  

The ordinary humours are not the causes of all diseases.  Whosoever shall go about to reduce the causes of all diseases to blood, choler, melancholy and phlegm, shall wrap himself into a number of difficulties: I will desire him to yield me a reason, why he calleth salt phlegm so, seeing phlegm is said tobe cold, but this hot? Why is Atrabilis comprehended under melancholy, seeing it is very hot, but this cold? Besides this, if any Physician go about to cure diseases procured either by contagion, or poison, without any great respect to the humours, he presently goeth about to minister either a Lexipharmaca, as in the plague which is gotten by contagion, to abate the force of it, and then he addresseth himself to the preparation and evacuation of the humours. If poison be ministered to any one in meat or drink, which according to Cardan, commenting upon the 62. aphor. of the 4. sect. may be suspected, if he find gripping in his stomach, if he vomit and go to stool, if within six hours the akin become greenish or spotted, than Antidotes are ministered, and not such as respect choler, melancholy or phlegm. Let the Humours then which are engendered in the body retain the accustomed names, but if an external cause make them degenerate from their nature, let these be distinguished from the ordinary, and have their denomination from that which altereth them. If salt, niter, alum, vitriol, verdigrease be mingled with any humour, let it be called from the mineral mingled with it, salt, nitrous, alominous, vitriolate or eruginous. And for this cause some late judicious Physicians writing of malign and pestilent fevers, and considering their notable differences, have affirmed some to participate the nature of arsenic, some of mercury, some of hellebore, some of opium, some of the leopards bane, some of the hemlock, some to participate of the poison of a viper, scorpion, mad dog and such like, noting the variety of symptoms in sundry persons.  

Of the superfluous melancholy Humour.  One doubt doth remain concerning the melancholy humour, whether it be only thin and waterish, as Reusnerus affirmeth in his book of the Scurvy, exercit. 4. out of sundry places of Hypocrates, who calleth melancholy 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, as in his book 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, in his book de worh is, and in his first book de worh is mulierum, or whether it be thick and earthy, according to the vulgar and received opinion. Before this doubt be solved, some propositions are to be permitted. I. In the Chylus there are two substances, one liquid and thin, the other thick and terrestrial, which can no more nourish than ashes. II. Nature doth mingle these which are not sent away by stool, with part of the aqueous and superfluous humidity caused of drink and liquid meats. So in a lie the fault and some adust parts are so mingled, that they are not discerned before separation.  

That the spleen draweth superfluous melancholy.  I say then, that this thick and feculent humour tempered with much moisture, is to be accounted the superfluous melancholy humour, and that it is attracted by the spleen. For first, seeing this feculent humour is altogetherunapt to nourish, it must be separate from the Chylus, which cannot be performed by any other part besides the spleen. Secondly, the spleen is of a darker read colour than the liver is, which proceedeth from the thick, feculent, and terrestrial humour which it imbibeth. Thirdily, Hypocrates de aere, aq. & loc. affirmeth, that such persons as devil in fenny places are subject to passions of the spleen. The cause is, because the waters are not pure, but muddy. Fourthly, if the spleen did draw only thin and waterish humours, it could not be so subject to obstructions as it is. The feculent humour mixed with much humidity, is the cause of sundry diseases: the thin part sometimes ascendeth to the upper parts, the gross to the lower parts of the body, as we see in the scurvy, wherein the gums are ulcerated, and the legs tumify. The spleen being spungeous draweth much humidity to it, wherefore spleenetick persons aught to drink sparingly, for if they bib too much, the natural heat of the part is easily oppressed, 
The qualities of the waterish Humour of the spleen.  and so they become hydropic. The waterish humour of the spleen is not insipid, but sharp and biting, and copious: so we see those who are troubled with quartanes, about the end of each fit to sweated plentifully; and those who are oppressed with melancholy to spit much. In the thick, feculent, & terrestrial blackish matter, sometimes there is no excess of the spleen: in qualities, sometimes there is, and those are two: Acerbitas, an astringent sharpness, such as appeareth in green unripe fruits; and Aciditas, sourness: from these qualities intended and exalted, atra bilis becometh so corrosive. So much I thought good to set down of melancholy, to clear the doubts which are moved of it, and to show one use of the spleen.  
To return then to the carbonary crew of unlearned Alchemists, 
Object.  They object thus, The rational Physicians affirm the body to be nourished by the four humours, how can they then be causes of the diseases?  
It is strange that any men should wilfully shut the eye of the mind, 
Answ.  understanding I mean, that they may not see the truth, seeing man, as Aristotle in the very first words of the book of his Metaphysics affirmeth, naturally coveteth knowledge, and witnesses are our first parents to their own and our loss. Not dogmatic Physician ever affirmed any disease to be caused of any humour of the body, as long as it continueth in its own natural estate; but then to stir up griefs, when it is separate from the rest, when it doth putrify, when foreign substances and qualities are added, which make it of a familiar humour, a processed enemy to health, consisting of the natural constitution of the body, resulting of the laudable commixtion of the four humours natural. I have insisted somewhat long in the setting down of the causes of ulcers, because he (whosoever he be) that goeth about to cure ulcers without the knowledge of the causes, is like one, who being blindfolded, is set to thrash a cock.   

LECT. III. Of the general differences and signs of ulcers.  
OF the ten Points, within the limits of which I resolved to include all my discourses of ulcers, in my former Lecture I dispatched three; in the first I nominated the prime Authors, who have written of this subject: in the second, I set down the description of an ulcer: in the third, I discoursed somewhat largely of the causes of ulcers in general.  
Now the fourth Point, concerning the differences, 
iv Point.  and sundry sorts of ulcers, offereth itself to be handled, and in truth the course of nature so requireth: for the form of every particular ulcer doth spring from the cause conjunct of the same: for example, a cancer ulcerate is discerned from all other ulcers by its proper and pathognomonicall signs, all which as effects, are ascribed to Atra bilis, impacted in the part the cause conjunct of the same.  
Here of purpose I omit the idle and fruitless distinctions of ulcers, 
Differences of uncers.  set down by sundry Authors, which neither better the understanding, nor further the curation. These only I will set down, 
I. From their nature  which are material. The material differences then of ulcers are taken either from the nature or constitution of an ulcer, or from the subject or part affected. From the nature and constitution, an ulcer is either simple or compounded.  
In a simple ulcer, nothing is offered which may stay the Chirurgeon from going about the consolidation of it, as the cause conjunct, a cruel symptom, adjuncts, or some disease.  

Differences of a compound ulcer.  A compound ulcer wherein either some of these, or all are found, which must be removed before unition be procured, is either of the milder sort, or malign.  
The more milder sort of ulcers yield to ordinary and usual medicaments, if they be judiciously applied.  
The malign yield not, and besides have fearful symptoms: those malign ulcers proceed either from inward, or outward causes.  
From internal causes spring a cancer ulcerate, Phagedana, Nome, fretting ulcers, and others which are called Chironia, or Telephia, which denominations insinuate nothing unto us concerning the nature or curation of an ulcer, but bring only unto our memory the names of these who are celebrated by Poets, which belong more to Grammarians than Physicians or Surgeons to be known.  
The external causes which procure ulcers are two, to wit, Contagium, contagion, or a venomous quatity, vapour, or humour, comprehended under the name of Venenum, or poison.  

II. From the parts  The differences taken from the subjects or parts affected are two, for either an ulcer possesseth the outward part, and is called Externum, or outward, or it afflicteth the inner parts, and is named Internum, or inward. Other differences are taken from the continuance, figure and quantity, are here impertinent, and further only predictions, of the which I will speak in the prognostics of ulcers.  

V The signs of ulcers.  As concerning the signs of ulcers, an internal ulcer is found out and discerned by the excretion or matter expelled. As for example, if the urine be purulent we conjecture the kidneys or bladder to be ulcerate. 
Signs of the lungs ulcerated  If purulent matter be voided by coughing, it is like that the lungs are ulcerate; if much of such matter be rejected, and signs of an aposteme have gone before, it is an apostematous ulcer; if the purulent matter be but little, and no signs of an inflammation have been noted, than it is but a primary ulcer proceeding of erosion, by reason of a sharp humour separating the unity of the substance of the lungs. These internal ulcers I will leave to the consideration of Physicians, unto whom they are most commonly presented to be cured, who very often purchase fees with no small discredit to the Art and themselves. Only I will set down such things as tend to the curation of ulcers of the external parts. I need not to busy myself about the setting down of the general signs of such, seeing they are presented to the view of the Chirurgeon by the parties grieved. Only let me give you warning, that you mistake not a wound for an ulcer: into this error you may easily fall, if you admit the most ordinary description of an ulcer, set down even by judicious Physicians and Surgeons; which is, 
Riolan. Chiru●. sect. 2.  that it is a solution of continuity in a fleshy part, yielding quittor; it skilleth not, they think; Whether it be laudable or illaudable. It is strange that there should be set down no other difference between a wound & an ulcer, than this, that the one is bloody, and the other purulent. Doth not, I pray you, a wound become purulent of itself, although no Chirurge on deal with it, and may not an ulcer become bloody if incision be used, as it may daily be seen? Frivolous it is also in my judgement, that a solution of unity inflicted by an instrument that woundeth in a bone, as a sword, may be caned a wound, and that a solution of unity in a bone, procured by an eroding humour, may not be termed an ulcer.  
Seeing the causes conjunct make the true differences of an ulcer and wound: 
The causes conjunct of wounds and ulcers.  which are an external instrument dividing, & a sharp humour eroding the parts. Who can imagine that in a venereal ulcer, wherein these is corruption of the bone, there should be two sorts of ulcers specifically differing, to wit, one in the fleshy part, and another in the bone, the same humour causing both.  
But a solution of unity in the bone by a corroding is called Teredo, say they.  
What then? 
Object.  Must a malign ulcer in the face, because it is called Noli me tangere, be exempted out of the list of cancerous ulcers?  
No. 
Sol.  Let this then be accounted an undoubted truth, that a solution of unity procured in the body by a humour eroding, whether it be in the flesh or bone, may be, yea aught to be called an ulcer, as a solution by an instrument separating, is called a wound in both.   

LECT. iv Of the general prognisticks of Vleers.  
NOw I am to descend to the sixth point touching Ulcers, 
VI Point.  proposed by me in the beginning, which is of their general prognostics. 
The presages.  The consideration of these will make one circumspect, when an ulcer is offered to him to be cured, in the election of his cures: for whosoever taketh in hand a grief uncurable, he discrediteth himself, and causeth the art to be contemned by those, who are simple and ignorant, imputing the error of the practiser to the insufficiency of the art. Let this be the I. predication: an ulcer in a body of an evil complexion which may be conjectured by the colour of the skin, if it be of a tallowie whiteness, yellow or swartish is not easily cured: for it is likely, that corrupt phlegm, vitellin choler, and feculent melancholy do abound, which humours hinder the regeneration of flesh: but by the contrary, an ulcer is easily cured in a person of a good complexion, who digesteth well and doth not increase superfluous moisture. II. ulcers in bodies, which are either very moist or dry are hardly cured. This is plain in the bodies of hydropical persons, and those which are aged, for as superfluous humidity contrary to desiccation hindereth the healing in those: so in these the defect of radical moisture. III. ulcers in children by reason of their excessive humidity, and in women with child, because the most laudable part of the blood is turned to the nourishment of the child, are not easily cured. IU ulcers which fall out after critical apostemes in the spondils of the back, or great joints of the body, for the most part are mortal: because after sickness, and apostemation, nature must be exceedingly weakened, the natural heat much abated, and the radical moisture almost spent. Such apostemes do fall out when as sharp fevers end not crittically in the decretory days by some evacuation, as bleeding at the nose, vomiting, sweeting, purging by stool and urine, but extend themselves to the fortieth day. V If the place wherein the ulcer is seared be blackish, blowish, or greenish, it hardly can bet cured: for the blood must be naughty, and the flesh corrupt. VI Ulcers of around figure are cured with difficulty, the reason is this, Consolidation is procured by unition of the parts; now the farther the parts are asunder, the more slowly it is procured: but a round figure, of all other within the same bounds, is most ample. VII. Painful ulcers in children are dangerous, because their bodies being raw, and the spirits subtle, they are easily spent, which is the cause that they are much weakened, and so disposed for death itself. VIII. If an ulcer become either bluish or pale, the party being ill, death is not fare off; for these colours show the mortification of the part; and dryness showeth that the natural moisture is gone. IX. If an ulcer be complicat with a disease which maintaineth it, the ulcer, according to the nature of the disease, is either of easy or hard curation. So a venereal ulcer in a succulent and strong body is easily cured, but if the party be in a Marasmus, neither the ulcer nor the disease can be cured; because the use of desiccatives, which only avail in these infirmities, will only hasten death increasing the extenuation of the body: in like manner ulcers in hectic and hydropic persons are hardly cured; in these because superfluous humidity hindereth desiccation of the ulcer; in those because laudable juice floweth not to the part ulcerate. X. If tumours in ulcers suddenly vanish without any evident and manifest cause, as bleeding, or application of a discussive medicament, they portend no good: but convulsions; if they appear in the hinder parts, because the Spins is very nervous: and madness, pleurisy or suppuration if they were read, and in the forepart. XI. Soft tumours in ulcers are laudable, because they will yield to medicaments, but hard, not easy to be cured, because the humour is more rebellious. XII. If the hairs fall in places of the body about the ulcer, it is an evil sign: for then there must be great acrimony, and corruption of the humours, as in quartane ague●, the pox, and leprosy. XIII. If in an ulcer where there is cariosity of the bone, the colour of the flesh be of a livid colour, the party must be in danger: for it is a sign of the extinction of the natural heat. XIV. Ulcers which afford quittor, which is white, smooth, and uniform, and not stinking, promise' an easy cure, for these qualities in the quittor, show the dominion of the natural heat, and the soundness of the  parts. XV. A flux of blood coming in an ulcer after strong pulsation is ominous, according to Hypocrates Sect. 7. aph. 21. for there must be a strong phlegmon, and the arteries must be much pressed, so that a gangrene may be expected: howsoever of such furious blood no flesh can be regenerate. XVI. If an Erysipelas appear, the bone being bore, it is no good sign, Hipp. Sect. 7. aphor. 19 for neither can flesh be regenerate by such a sharp humour as this, that causeth so hot a tumour. XVII. From malign ulcers two forts of quittor flow; One thin, and it is called Ichor, or Sanies; such a virulent matter issueth also from the pricking of the nerves, and corruption of the periostion. The other sort of quittor is thick, and is called Sordes. XVIII. In ulcers which have continued a twelvemonth or longer, the bone must be scaled, and the skinning be hollow, Hipp. lib. 6. aph. 45. But to make good this Aphorism of Hypocrates, some conditions are required: The first is, that much flesh above the bone be not in the part ulcerate. Secondly, the humour which floweth to the part must be very corrasive. Thirdly, it must not have been dealt withal by any Physician or Chirurgeon. If one or more of these conditions fail, the Aphorism must miss of its prediction. What Galen and late Writers have set down in the explication of this Aphorism, clear not the truth of this Aphorism: only these conditions set down by me do. The signs which lead you to the knowledge of a bone corrupted are these: 1. If the ulcer having been skinned, 
Signs of a corrupt bone.  breaketh out again, for it is likely that the bone casteth out an ichorous substance, which is the cause of this recidivation, 2. If the ulcer yield more and thinner matter than the bigness of it requireth. 3. If the brims of the ulcer will not come in. 4. If the brims become reddish. 5. If the bone, being presented to the sight, it appear rugged, and of a blackish colour, not smooth, or a ruddy white colour. XIX. Whatsoever ulcers cast out much Sanies or Ichorous matter, which is too thin, of a leady, pale, or black colour; or glutinous, or stinking, and which fretteth the skin adjacent, are hard to be cured, for this humour keepeth the ulcer moist, and cannot easily be dried, even if you apply powerful Topics. XX. Inveterate ulcers which cast out a quittor, called by the Grecians 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, like unto white oil, are hardly cured: for this signifieth a colliquation of the part, and an extenuation of the rest of the body.   

LECT. V Of the general curation of ulcers and their times.  
HAving set down the general prognostics of ulcers in the sixth Point, now the seventh Point concerning the general method of curing of all ulcers doth offer itself.  
The universal curation of ulcers is comprised in this one proposition: All ulcers ever desire desiccation, so Hippoc. in princ. Lib. De ulcer. & Galas. Lib. 3. method. c. 3. for whether we go about to engender flesh, or to seal up an ulcer by cicatrisation, desiccative medicaments are still required.  

Four times of ulcers.  There are four times to be observed in ulcers.  

I. Principium, the beginning; In it the quittor is thin and waterish.  
II. Augmentum, the proceeding; In it the quittor floweth more sparingly, and thicker.  
III. Status, the consistence; In it there is no ichorous matter, but 〈◊〉, yet somewhat thinner it appeareth.  
iv Declinatio, when the ulcer is in the mending hand, then laudable Pus showeth itself. 
The qualities of laudable qu●ttour.  It is white, being altered by the natural temperature of the veins, arteries, nerves and membranes, whose substance is white. Secondly, it is uniform, not grumous or cruddy, natural heat working equally upon every part of it. Thirdly, it is without all ill smell, seeing the natural heat hath corrected all the evil qualities of it.   

The means of curing of ulcers.  The curation of ulcers is performed by two means: The 1. is the removing of the causes antecedent. The second, is the artificial dressing of them.  

Causes antecedent.  The causes antecedent are four: Cacochymia, Contagium, Venenum, and the distemperature of the purt.  
The ill habit of the body is to be removed by alteration and evacuation, if the humour abound.  
Contagion is to be overcome by Alexipharma.  
Poison is to be contemperate by Aeidota.  
The distemperature of the part is to be removed by things contrary unto it. And that we may the more easily attain to these scopes, a convenient order of diet must ever be prescribed.  
The cause conjunct, which is the eroding humour, 
The cause conjunct.  that is settled in the part, is surprised by such medicaments as suit for the four times of an ulcer before mentioned by.  

The use of suppurative medicaments.  In the beginning then Suppuratives or Digestives are to be applied. First, because the matter which hath left the vessels, and hath insinued itself within the porosities, putrefieth: wherefore it aught to be concocted, that it may become laudable quittor.  
Secondly, good flesh cannot be procured by sarcoticall medicaments, unless the matter be concocted; for so the ulcer is made apt to admit the generation of flesh. These Suppuratives aught in the first qualities to be proportionate to the temperature of the part unto the which they are to be applied, so to parts hot in the first or second degree Suppuratives hot in the same degrees are to be applied: for if they exceed, they are so fare from strengthening the natural heat, that they rather pervert it, making it aguish and unnatural: if the part be temperate let temperate Suppuratives be applied.  

In what ulcers Digestives are unfit.  But Digestives aught not to be applied, First, to putrid ulcers; for seeing Suppuratives are hot and moist, if they should be applied, they would 'cause the greater putrefaction.  
Secondly, they are not fit for rheumatic ulcers, for such medicaments relax the part, and make it more subject to receive the matter that floweth, and so a tumour might be caused. And as Suppuratives are to be applied to the parts ulcerate, because the humour which is hot and sharp would inflame the part if it were not suppurared and cleansed. 
The uses of repelling medicines.   
Sorepelling Topics are to be applied to the parts about the ulcer to repel the matter which floweth. I. That the heat of the Suppurative medicament draw nothing from the parts adjacent.  
II. To strengthen the parts that they may resist fluxion.  
III. Because by the repelling of the humour, the desiccation of the ulcer is furthered.  
iv Because the heat of the part ulcerate is intended and strengthened, it being kept in by the coldness of the repelling medicament.  

The mixtion of medicaments when profitable.  And for as much as I affirmed that ulcers always require desiccation, it is not amiss to mix with the Suppuratives some driers, yet that in the beginning the Suppuratives have the upper hand, but in the end the desiccatives.  
After that the ulcer is well digested, and yields laudable quittor, 
Mundificatives  Mundificatives are to be applied: for if you apply farcoticall medicaments, before the ulcer is well digested, spungeous and naughty flesh will grow, which will admit no cicatrisation. In mundifying we must not use too sharp medicaments, for these may 'cause an unskilful Physician or Chirurgeon to believe that it is a corrosive ulcer. The pain which the Patient feeleth in the part ulcerate will bewray this error. These three scopes being compassed to overcome the cause conjunct, nothing remaineth, but to seal up the cure by cicatrisation.  

How fluxion is stayed Revulsion.  Seeing most ordinary ulcers proceed from fluxion, it is to be withstood, First, by Revulsion. Secondly, by Repulsion. In Revulsion, wherein the matter is drawn to parts fare distant, the rectitude of the part, and vessels is to be observed. So if the ulcer be in the right leg, Revulsion is to be procured in the right arm, if you respect the rectitude of the part; but if you consider the rectitude of the vessels, Revulsion is to be used in the left leg, if the ulcer be in the right: for so the communion of vessels is kept.  

How revulsion is to be procured.  Revulsion is performed by attractives, and these are three; Heat, pain, and the shunning of vacuity. Hot thing which procure attraction, are hot inunctions, and baths: strait ligatures 'cause pain; but both pain and heat are caused, Ventoses, and Vesicatories. Fontanels attract by reason of the shunning of vacuity; for they sending out sill some substance, some other must be drawn to fill up the place of that.  
Repulsion, wherein the humour is stayed in its passage, 
Repulsion.  is performed by applying those medicaments, which commonly are called Defensives: 
Defensives.  these medicaments are astringent and cold, and rather dry than moist in ulcers. Now that you may know whether you proceed according to Art in the curing of ulcers, receive this Aphorism: 
To know good medicaments.  When medicaments applied to ulcers do good, or at lest hurt not, it is a sign that they are convenient; but if they do harm, by making the ulcer hotter or colder, drier or moister than is fit, than you may gather that such are to be changed, 
Albucasis.  and their contraries applied.  

Things which make ulcers long in curing.  To conclude this Point, nine things make ulcers hard to be cured.  

I. The defect of good blood in bodies extenuate.  
II. The impurity of blood in cacochymical persons.  
III. Is the filthiness of the ulcer.  
IU. Soft and cadaverous flesh about the ulcer.  
V The malignity of the humour.  
VI The hardness of the brims of the ulcer.  
VII. A secret cause in the air of some places, they being hot and moist.  
VIII. When the bone is corrupted.  
IX. The application of unfit medicaments.    

LECT. VI Of the medicaments be fitting ulcers in general, and first of repelling medicaments.  
NOw at the last I am come to the last general Point, set down by me in the first Lecture concerning ulcers, of the which I intended to discourse, which is, of the medicaments befitting ulcers in general. I mean to spend this Lecture upon this subject, to the end that you may be so furnished with good and approved medicaments, as that you shall not need either to envy or wonder at such as brag of secrets.  
It is not unknown to yourselves how many saucy and malapert Empirics there are here in London, who basely and irreverently speak of those who are skilful indeed, and deserve well of the Art of chirurgery, (purchasing unto it credit, and to their own selves profit and renown, by their methodical and successful practice) and so impudently boast of their secrets, and exalt themselves as if they had no forehead. But surely it is to be thought, that there is too great a distance between it and their tongue, that the forehead cannot stop the tongue from uttering Thrasonical speeches of themselves: it is great pity such are so countenanced as they are. The Magistrates let them proceed in their extravagant courses, thinking it not fit for an Eagle to stoop to a gnat. The ruder and ignorant sort, rather consider the promise, than the performance, thinking that there can be no cloud without rain.  
That you may be the more able, not only to encounter with these confident cowards, but to overthrew them also; I will endeavour, according to that talon of skill which I have, to furnish you with competent both Theory and Practice. It is a shame for a Chirurgeon not to be furnished with admirable variety of medicament, seeing nature hath been so provident for him. Turn your eyes whither you will, and behold the fertility of nature, and you shall see and find that in her works she hath not been unmindful of you. As for plants, you have Dioscorsdes and Galen, yea all who have written of them, witnesses; that the greatest part of them have fallen to your share. As for the things which lie hid in the bowels of the earth, as metals, spirits, marcafites, do they not serve your turn? The metals for your instruments, the rest for your medicaments. Let no man think then, that a skilful and industrious Chirurgeon can by his Art perform no other cures, but such as may be compassed by the compositions in his Salvatory. These he must have in readiness, other medicaments he is able to fetch out of the treasure of nature, which he hath at his command. This I will make good by the setting down only those medicaments which are known to belong to the curation of ulcers. Of these there are two orders or ranks: for some serve for ordinary ulcers, some for those who have a malignity annexed. Those that serve for ordinary ulcers are of five sorts, for some are Repelling, some Digesting, some Mundifying, some incarnating, and some Cicatrizing, and the Medicaments which perform these offices, are either simple or compound.  

The Simples repelling are these that follow.  
Of these, some are of an Aqueous substance, as Water itself, Lettuce, all sorts of Succory, Knotgrass, Horse-tail, Perwinckle, Nightshade, Comfrey, Purslane, Navell-wort, Houseleek, these four yield not their juice easily; wherefore they must be beaten in a mortar, and some verjuice, vinegar, or juice of Quinces mingled with them. There be some Simples not so waterish as these are, as the Plantain, Millefole, Vine-leaves, astringetred Wine, Verjuice, Vinegar, the fruit of the Barberry, the fruit of the Quickbeame, Sloes, Mirtle-berries, Pomegranate-rindes, and Flowers infused in read Wine which is astringent, Tanner's Woose, which will be more effectual if these Simples together with read Rose-leaves dried be boiled a little in it; but the Woose must be taken when it is newly made, and before any leather be put in it. The Leaves and Apples of the Mandrake, the Henbane, the Leaves of Stramonea, she black Poppy, and the deadly Nightshade are more cooling than the former, but they must be left before the part become livid, or of a leady colour. If you use the juices or decoctions of the aforesaid Simples, which you shall be enforced to do, if the curation of ulcers and wounds be presented unto you, being in the country, where no Apothecary is by whom you can be furnished with medicaments which are fit to repel, than you missed apply to the parts adjacent to the ulcer, pledgets of wool or tow moistened in them, then above these stups of linen or woollen , according to the temperature of the party, and season of the year, moistened in the same and wrung; are to be applied.  
Last of all, the part ulcerate is handsomely to be rolled, the rowler having been moistened in these juices or decoctions. One thing is to be noted, that it is the best course still to mingle some astringents with those which have a waterish juice: for as these cool best, and repress the fluxion and inflammation, so these by wrinkling of the skin repel more effectually. As you roll up fractures, so must you roll parts ulcerate. Of this kind of rolling I will speak in its proper place.   

The compound medicaments that repel are these.  
I. Oils, as the Oil of Roses made of green Oil, the Juice of unripe Grapes, and the Juice of read Roses, boiled together over a simpering fire until the Juices be consumed. Last of all, infuse some Roses picked in the Oil: the Oil of Myrtles, the Oil of Quinces, the Oil of Mastic, the Oil of Henbane, Poppy, and Mandrake. The salad Oil whereof these compound Oils are made must not be old, or rank. If an inflammation hath possessed the parts adjacent, use not Oils▪ for they are easily set on fire.  
II. Cataplasms, made of the aforesaid Juices, and Barley-flowre, with some of the aforenamed Oils, or Bole, Terra sigillata, or Amber tempered with some of the aforenamed named Oils, and whites of Eggs beaten, Vinegar, or Verjuice.  
III. Unguents, as Triupharmacum, Vnguentum album, Camphoratum either of itself, or mingled with Vuguaztum Populeum.  
IU Emplasters, as Emplastrum de minio, the Soap Plaster, Diapalma made with the juices of Plantain, Horse-tail, Knotgrass, Yarrow, Comfrey, and Perwinkle. When you make your Diachalcithes, reserve one part for the juices, which must be added by little and little, as you bring your Emplaster to the consistence. This medicament is second to none.   

Of Suppuratives or Digestives.  
Being furnished with medicaments repelling, which are to be applied to the parts adjacent to the ulcer to hinder fluxion, you are to look for medicaments which are to be applied to the ulcer itself: Amongst them Suppuratives offer themselves first; Those as the former, are either simple, or compound.   

The Simples are these, which are to be temperately warm and moist.  
The flower of Wheat and Barley, Swines-grease, sweet Butter, Capons-grease, Calve-tallow, ripe Oil, black Rosin, the juice of the flowers of white Lilies, the pulp of Figs, and Raisins, the mucilage of the Marsh-Mallow, Fenugreek, and Linseed: these are convenient, if any hardness or callosity be in the ulcer, Saffron, Birdlime, Pitch, Storax, Galbanum, Gummi & Lemni, the Burre-Dock, Melilot, the Flower deluice, new Wax.   

of Compounds.  
Tetrapharmacum of the Ancients, which is made of Pitch, Rosin, Wax, and any of the forenamed fats; Dialthaea simplex, Basilicum majus & minus, Vuguentum aureum; if a little Mercury precipitate washed in Plantain, and Rose-water, be mingled with these unguents, as a scruple with an ounce, they will be the more effectual: for the precipitate doth excellently thicken and digest any ichorous matter. Above these, applied unto the ulcers, either upon Lint or Tow, lay Emplastrum diachylon simplex in the summer, and Cum gummis in the winter, if the brims of the ulcer be hard: otherwise use your Diapalma cum succis, for there is no Emplaster comparable to this.  
Of the aforenamed Simples, as your Flowers, or Meals, Pulps, Mucilages, and Juices, you may frame unto yourselves sundry Suppuratives, according to the temperature of the party, the condition of the ulcer, and season of the year. Let this be an example, Take of the pulp of Figs and Raisins, of each one ounce, of the Mucilage, of the Marsh-mallow, Linseed, and Fenugreek, of each two drams; of the juice of the flowers of the white Lily, two drams and a half; of Barley-meal, three drams; of Saffron beaten to powder, half a scruple, make up a medicament. This is powerful in callous ulcers.   

Of Mundificatives.  
When the ulcer is well digested, which you shall conjecture if the quittor be somewhat laudable, if the brims of the ulcer be soft and well coloured; and lastly, if you find no ill damp to rise from the ulcer; than you are to address yourselves to the application of Mundificatives, for if you use sarcotick or incarnative medicaments before mundification, only lose flesh will arise, which will admit no cicatrisation.   

The Simples that mumdifie are these.  
Aristolochia or Birthworth, whereof there be two sorts, the long, and the round; Horehound, Smellage, Vitriol calcined to redness, Verdigrease, Orpiment, Arsenic natural and sublimed, ☿ sublimate and precipitate, the yellow Turbit, if you use it before it be washed, it is as powerful as Arsenic, or Mercury sublimate; but much more safe, for it dispatcheth its operation sooner, causeth not so great inflammation, and is more familiar to the body of man. Honey also mundifieth, Savin, Cockleshells burned, Alum burned or calcined, the flower of Verches. All Vegetables calcined mundify, by reason of the salt in the ashes, but some more powerfully than others, as the ashes of Tobacco, the Vine-stalkes, and the stalks of Beans: join to these, the juice of Celandine, the root of the Cuckowpit, Wormwood, century the les●●, Cardum benedictus, the Beete, Colewort Gentian, bitter Almonds, Scordium, the white and black Hellebore.   

Compound mu●difying medicament.  
l. 15. of Fabricem ab aqua pendente: ℞ Terebinthʒij. syrup. Ros. Vel mell res ℥ ss suci apii, ℥ iss farin. hord. & lupin. aq. q. s. ut inspicentur. That which is call Paracelsus mundificative, is second to none: It receiveth these things, Take of Honey iiij ℥. Of Turpentine ij ℥. Boil these with a very soft fire, until they come to the consistence of a solt ●●guent; then take them from the fire, and mingle with it the yolk of an Egg; incorporate all well together. If a foul ulcer be offered unto you, mingle with an ounce of this unguent a dram of Mercury precipitate, washed with Plantain and Rose-water, and you shall find it to excel all other Mundificatives. In the shops you have Vaguentum Aegyptiacum, and Apostolorum: Aegyptiacum is good to be injected into sinewous ulcers, being mingled with White-wine, and Melrosatum: Vnguentum Apostolorum is best for plain, and superficial ulcers. If you mingle with your Basilicum and Aureum precipitate, mingled with Alum calcined, you shall have a medicament which will both digest and mundify. Take of your precipitate two parts, and one of Alum, and grind them upon a Painter's stone until they come to an impalbable powder. Of the enumeration of these medicaments you may gather of what qualities Mundificatives aught to be. They are drying without astriction, without any notable cold quality, or great heat; but of a subtle substance: by reason of the dryness, they consume the humidity of the ulcer; and by reason of their siccity & tenuity, they take away the glutinousnesse of the quittor. These must not pass the second degree of dryness; otherwise they would consume the flesh itself. Extersion then is the removing of filth cleaving to the ulcer, by drying of it, and abating the viscosity by the which it cleaveth to the part.   

Of Incarnatives.  
When the ulcer is sufficiently mundlfied, which you shall learn of Celsus lib. 5. cap. 20. If the ulcer appear read, sensible and clean, and neither too dry nor too moist, than it is sufficiently mundified: but by the contrary, if it appear pale or whitish, or of a livid or black colour, and want sense, and be either too moist or too dry, than it is not cleansed sufficlently. These signs may be seen in a plain and open ulcer.  

Quest.  But you may ask, how shall we know when a sinewous ulcer is sufficiently mundified?  

Answ.  Galen will tell you, l. 4. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 cap. 2. That you shall conjecture a hollow ulcer to be clean, when the part beginneth to be more sensible of the mundificatives than it was before.  
When these signs of sufficient mundification appear, than you must go about the incarnating of the ulcer. And although incarnation be the effect of nature principally, that is, of the temperature of the part, from whence the faculty of the part, the cause of all the ordinate actions of the part do flow: yet it is requisite that the Physician & Chirurgeon should help nature now, being weakened by the grief, by removing the impediments and lets which hinder the natural constitution of the part. Nature when she is in her vigour cannot totally convert the aliments into the substance of the solid parts, but after she hath had a care of the preservation of them, hath a task to expel both a waterish or thin, and a thick excrement by the pores of the skin to the outward superficies of it, (as is manifest in the morphew,) when she is disabled by a solution of unity, much less can she effect her purpose, where of the thin excrement a humid ulcer is procured, but of the thick a sordid. Wherefore if you will go about to cure an ulcer, you must labour to dry the humid ulcers by desiccatives, and the sordid by mundificatives: and because in all solution of unity, nature is ever vigilant and busy; and in ulcers to regenerate flesh, in perfecting of which work, these two excrements must be separated; it is manifest that there cannot be one moment defigned in the curing of ulcers where drying and mundifying medicaments are required. Now medicaments endued with these two qualities of desiccation and mundification in a temperate degree, are called Sarcoticall or Incarnative Medicaments.   

The Simples are these.  
S. john's. wort, the Clownes-panax, Millefoile, Knotgrass, Horse-tail, the garden and mountain Avens, our Ladies-mantle, Sanicle, Salomons-seale, fresh Gales, Barley-flowre, Mastic, Myrrh, Aristolochia rotunda, Hartshorn calcined, Bones calcined, Sarcocol, Rosin, Pitch, Gummi Elemni, Butter, Turpentine, Swines-grease, Sheep's, Goats and Deeres-suet, sweet Tallow, Olibanum. Frankincense, the powder of Snakes and Adders: these most effectually. The green Tobacco.   

The Compound are these.  
And amongst the first of these, suffer me to commend unto you this of mine: Take of Swines-grease eight ounces, of Rosin iij ℥ of Wax, and Gummi Elemni, of each one ounce, of the juice of the aforesaid Vulneraries one pound, of the leaves of Tobacco stamped two handful: boil all these over a soft fire until the juices be consumed, then strain the Unguent. Make trial of this, and leave it when you have found out a better. You have in the shops Vnguentum Basilicum majus & minus, and Aureum set out with glorious titles: and why not, seeing the Farthing-tokens bear the Arms and Crown. I will show you anon, how these cannot fit all bodies: Vuguentum de tutia is in much use. You may use these compositions if you will, or you may frame unto yourselves, of sarcoticall simples, such compositions as you shall think most fit for your purpose.  
But let me warn you, 
Conditions to be observed in applying of Desiccatives.  that your Incarnatives must not exceed the first degree in drying: yet seeing there is a latitude in this degree, for some are mild, some more harsh; you are to apply them according to the constitution of the party, temperature of the part, and the quality and quantity of the ulcer itself. So if the party be of a tender, and soft constitution, milder driers are required to engender soft flesh: but if a party be offered to you to be cured, who hath a firm and dry flesh, more strong desiccatives are to be applied. If the ulcer be in a place not so fleshy, as in the joints, the beginning or tail of the muscles, than your desiccatives must be forcible. Last of all, if the ulcer be large and moist, more strong desiccatives are to be used in it than in small and not very moistulcers.  
When you go about your compositions of Incarnatives for ulcers, observe these rules: The first is, that they be neither too soft, nor two hard; for if they be hard, the weak part cannot easily take benefit of them; if they be too liquid, the heat of the part will 'cause them to spread, and fall from the ulcer: besides these are apt to engender spungeous flesh.  
The second is, that they be smooth, and equal: otherwise they will 'cause pain in the part.   

Of skinning medicaments.  
The ulcer being filled with good and laudable flesh, now are you to skin the part ulcerate. Nature in the womb doth frame first the skin, but it being afterward lost by any accident, she cannot repair it any more lacking seminal matter: wherefore here, there is need of the help of Art to supply this defect. This is done by hardening and thickening the upper part of the flesh regenerate, until it be able to supply the office of the skin.  
The Epuloticall medicaments which bring this to pass, must be, I. Cooling, for so the thin parts are wrung out, and the thick parts are brought together, as we may see in the ice.  
II. They must be drying, for these consume the thin parts; so the hands of Sailors, and Feltmakers, become dry and hard. Then a Cicatrix is nothing else, 
What a Cicatrix is.  but flesh thickened, dried and made callous.  

The qualities of Epuloticall medicaments  These medicaments aught to be drying in the third degree: for incarnatives are dry in the first degree, because they only are to dry the excrements, which are superfluous in the generation of flesh. Glutinative medicaments are dry in the second degree: for they are not only to dry the excrements, but whatsoever else floweth to the part, although it be alimentary. But Cicatrizing medicaments are dry in the third degree: for these are too dry not only excrements, and what floweth from other parts; but the natural humidity of the part itself also. But Cathereticall or corrosive medicaments are drying in the fourth degree: for these consume not only the excrements, and that which floweth to the part, and the natural humidity of the superficies of the part; 
The differences of epuloticall medicaments.  These Epuloticall medicaments are in the like manner simple or compound.   

The Simple are these.  
Aes ustum, Led made to powder, the Amalgama of Lead and Quicksilver beaten to powder. When you would make this melt two ounces of Lead in a Crucible, then take it from the fire, and put to it an ounce and a half of ☿, these will incorporate together: when the mass is cold you may beaten it to a powder. The Pumick-stone, and Cuttellbones' calcined, Stags-horne calcined white, all Bones well calcined, the dead of Vitriol after the spirit is drawn, well washed and dried; it is called by the Chemists, Henricus Rubeus, and indeed it is a potent desiccative. Talk powdered is good; to drive it into powder, you must rub it upon a broad file somewhat fine, and then searce it; otherwise you shall hardly do it. Terra sigillata, Bole-Armeniack, Umber, are good; and unslaked Lime, well washed and dried, Alabaster beaten to powder, Minium, lethargy, Cerusses, Calaminaris, Tutia, the Regulus of Antimony, Crocus Martis, Gales, Pomegranate-flowers and rinds, the Comfrey roots, Sandarach of the Grecians, Egge-shels calcined, the roots of Tormentill and Bistort, Swines-grease, Deers and Sheep-suet.   

Skinning Compound medicaments.  
Sundry very effectual medicaments may be made of the aforesaid Simples; wherewith I mean not to burden you at this present, only I will commend unto you one of Fallopius, and another of my own. That of Fallopius is thus described, ℞ ol. ros. & ol. ompliacin. an ℥ vj. ol. myrtin. & unguent. popul. an. ℥ iij. fol. plantag. & solan. hortens. incis. an. man. 2. Bulliant ista ad consumpt. succorum ac colentur: colaturae adde cerae ℥ iiij. Spatha liguea misceuntur: Quum incipiunt frigere add, lytharg. aurivel argenti ℥ vj. cerussae ℥ ij. tutiae praparat. ℥ ij. plumbicalcinati ℥ i ss. Ducantur ista in mortuary plumbee per hor. 2. The ingredients do show what is to be thought of this medicament. That which I use is this, ℞ sevi evilli lib. ss. axung. porc. ℥ iij, cera, vernicis, colophon. an. ℥ ij. liquescant istasimul. Amotis ab igne ac coeuntibus add, litharg. auri, cris usti, tutiae praeparat. Henrici rub. an. ℥ ss, calaminaris, ℥ j fiat ceratumexl. a. You have in the shops Diapalma, Emplastrum de minio, Vnguentum comitissae, Desiccativum rubeum, & Emplastrum contra rupturam Fernelii. Now seeing amongst these, some do more weakly, some more strongly dry, the gentlest are to be applied to tender and moist bodies, but the strongest to solid and hard bodies: wherefore neither are mild skinner's to be applied to the bodies of clowns, and artificers; nor strong to the bodies of children, and dainty women: to these use Emplastrum album coctum. Before I conclude this Point, two things are to be set down: the first is, when these Epi●oticall means are to be applied. Secondly, how they are to be applied.  
As for the first, they are to be applied before the flesh be even with the skin, according to Galen 13. method. cap. 5. otherwise the cicatrix will be higher than the natulrall skin, which will 'cause deformity: wherefore they are to be applied while there is some cavity.  
As for the second, seeing always in skinning there is left a greater cavity in the middle, than about the brims of the ulcer, stronger desiccatives are to be applied to the brims, but milder to the middle, that the flesh be not too soon dried. Wherefore powders and cerots are to be applied to the brims, but only cerots or unguents to the middle. When you have cicatrized an ulcer by methodiall proceeding, there be some persons, who will not rest so contented, as Ladies, who make much of their skins, and whores, who gain much by theirs; but will desire to have the Cicatrix made by any means somewhat beautiful to the eye. I will furnish you with two medicaments, that you may be the more enabled to fulfil their desires.  
The first is this, ℞ unguent. rosat. Mesuis ℥ j ol. de Been. ʒijs, talci pulv. ʒiij. fiat li●ementum.  
The second make thus, ℞ Axung. porc. aqua furum fabar. lotae ℥ j spermatis ceti, ʒij, ol. amygdal. dole. ʒi ss. talcipreparatiʒij ss. fiat linementum.  
Every night a little before bedtime anoint the Cicatrix with some of either of these linements, and apply a soft linen rag moistened with the same.    

LECT. VII. Of the curing of a plain and hollow ulcor, being Simple.  
HAving passed thorough the ten points whereof I intended to speak, before I was to meddle with the curing of any particular ulcer, now it is time to deseend to the setting down the method of curing of ulcers in particular. I would have you to call to remembrance the material differences of ulcers delivered by me in the third Chapter, which were taken either from the nature and constitution of an ulcer, or from the parts affected: from the nature of the ulcer I deduced two sorts of them: some I called simple, some compounded. Now the simple ulcer is to be accounted such an one, as hath neither a disease, cause, or symptom annexed to it, or complicate, besides the solution of unity caused by crosion. Of these simple ulcers there are two kinds: for some are plain, and equal to the natural skin, wherein only the Cuticula and Cutis are lost. 
Galen. lib. 3. meth. c. 3.  Some are hollow, cav●, wherein besides the Cuticula and the Cutis, a part of the flesh is lost. It is not needful severally to set down the curation of ulcur planum, or aequale, a plain, or even ulcer; because in prosecuting the indications of curing of ulcur cavum, a hollow ulcer, I must set down the means of curing a plain one: for this is contained as a part in the other.  
Seeing then there are two affections in a hollow ulcer, 
Indications of curing an hollow ulcer.  to wit, solution of unity; and cavity, three scopes of curing offer themselves, unition, incarnation, and cicatrisation. Wherefore if the quittour be white, smooth, 
Secundum. Gal. comm. ult lib. Prognost. 10.  small in quantity, reasonable thick, and not evil smelling: If besides the ulcer itself be read, and sensible, than we may go about to gender flesh, by applying sarcoticall medicaments: But by the contrary, if the Pu● be black, uneven, grumous, rough and stinking, and if the ulcer itself be not read and sensible, the ulcer cannot be incarnate, before it be prepared by suppuratives and mundificatives. 
Excrements in ulcers.  Besides Pu● which is reasonable thick, three sorts of excrements appear in ulcers.  
The first is thin, waterish, like to water wherein flesh hath been washed: this hath received no alteration, but hath flowed pure, as it is in the veins and flesh; this is called Ichor. The second is thin too, but it hath received some alteration by the temperature of the part, this is called Sanies, or Virus. The third is very thick and glutinous, and is called Sordes.  
Now the excrements which are thin moisten the part ulcerate, that it cannot sufficiently discharge itself by breathing out the humidity. Wherefore Desiccatives are to be used to consume this superfluous moisture: but the excrements which are thick cleave to the part, and hinder the addition of flesh. 
After Mundisication, Incarnation  These are met withal by abstersives or mundificatives. The ulcer being prepared by suppuratives and mundificatives, you are to engender flesh by incanating medicaments. 
Two causes of the sleshingen 〈◊〉.  There are two causes of this flesh which is to be procured: 1. Is the efficient cause: This is nature itself not only of the whole body; but of the part itself also, which is called Temperies, the natural temperature or constitution of it: whereby it attracteth, concocteth, applieth and assimilateth the nourishment to itself. 2. Is the material cause: this is sincere and pure blood. If the part ulcerate enjoy such, than nothing remaineth but to maintain it: If the blood be not pure, ●hen it is to be altered, if it be too hot it is to be cooled, if too cold it is to be warmed, if it be too thin it is to be thickened, if it be too thick it is to be attenuate; if there be too great plenty of it, it is to be diminished; if it be too little, than it is to be increased by convenient order of diet.  

The Indications of curing a simple ulcer.  To come necrer to the curarion of a simple ulcer: First, we must discreetly order those things which are called not natural: seeing a convenient diet preserveth and maintaineth the good constitution of the whole body, and temperature of the part: 
Diet.  Wherefore all those meats and drink which make the blood too hot, too sharp, too thin, or too thick, are to be shunned, and those only to be permitted which afford good juice, and are of easy concoction, especially if the diseased party be tender and weak. Besides this they must be taken moderately, and at convenient times. The part itself must be kept quiet: 
Quietness.  for motion heateth the part. Care also is to be had of sleeping and watching: for as watching drieth the body, and consumeth superfluous humidity, so sleeping moisteneth the parts; but those chief which are nervous or sinewy, as membranes, tendons, ligaments. If then the ulcer be humid, enjoin watching; if it be dry, command sleeping. As concerning vacuation of the excrements, let it be appointed that they may answer in quantity the food which the diseased party taketh. If he prove costive, either minister unto him a clyster, or give him an ounce of Electuarium lenitivum in chicken broth. As perturbations of the mind change the state of the whole body, so the tranquillity of it maintaineth the same. A special care is to be had of the air; for it wonderfully preserveth the temperature of the part. Southerly and Northerly winds or not fit for ulcers: for as the first moisteneth and heateth, so the second doth much cool and dry: but cold is an enemy to ulcers. So it is observed that the air in Angieu is hurtful to ulcers in the legs, but in Paris good. So in Pisa and Ferrara it is hurtful; but in Florence wholesome. 
Prognostics.  As for the prognostics of simple ulcers: If I should set down any, you might justly think I did abuse the time: for there is none so simple, who may not gather out of the very denomination of them, that they are most easy to be cured, and that great skill is not required to compass the same: only let me give you warning that the cure may be either more easy, or hard, according to the nature of the part ulcerate, and the diet of the patiented. So simple ulcers are more easily cured in a fleshy part, than in the joint or a nervous part; for in these stronger desiccatives are required, and in them the natural heat is not so powerful to make use of the medicaments applied. In like manner a simple ulcer is more easily cured in the body of a temperate person, than it is in the body of one given to deboshry. Having set down the right use of the things not natural, as diet, sleeping and watching, evacuation of the excrements, the perturbations of the mind and air, I am to deliver unto you some local medicaments for the accomplishing of the curation of these ulcers, according to the general indications of curing set down in the fifth Chapter.  
As for the digesting, mundifying, and incarnating of a simple ulcer if it be hollow, 
Digesting, Mundifying, Incarnating.  these intentions and scopes shall be performed by the application of my Basilicum: The description of it is this: ℞ Cera & resin. an. ℥ vj. picis navalis ℥ iiij. gummi Elemni ℥ ij. Ol. Olivar. ℥ v. & semiss. vernicis clare ℥ iiij. Seviovill. ℥ ij. Terebinth. ℥ iiss. Olib. myrrh. pultaes an ℥ j fiat unguentum ex l. a. If you make trial of this you shall find it not a little better than the ordinary two bearing this name, to wit, Basilicum magnum and parvum: If an hollow simple ulcer prove sordid, mingle with an ounce of this my Basilicum two scuruples of the cathereticall power made of Precipitate and Allom calcined: or if you apply Paracelsus mundificative tempered with the same, you shall haply mundify it; but if a plain or equal ulcer be unclean, the yellow Turbith or Precipitate washed, besprinkled, and covered with a pleadget of lint will serve. Above these medicaments apply Diapalma cum succis, and above this a double cloth moistened in read astringe wine, having some Allome dissolved in it. If you be in the country, apply to the parts adjacent to the ulcer, clouts moistened in the juices of cooling and astringent herbs, as Plantain, Garden Nightshade, Knotgrass, Purslane: If you a●bint these parts with: Triapharmacum, and Vuguentum populeam mingled to gether, you shall prevent fluxion and instammation.  
When you have filled an hollow simple ulcer with flesh, 
Cicatrization.  nothing remaineth but to cover it. Now the cover of the flesh is the skin itself: and as the flesh lost is to be repaired, so that which covereth it. But seeing the skin is framed in the womb of a seminal matter, it being lost it cannot be restored by reason of the defects of matter: Wherefore we must find out another cover. This cover is called by Artists Cicatrix: This is nothing else but the uppermost Superficies of the flesh so dried, that it doth represent the skin. And as in engendering of good flesh in the ulcer, laudable blood was the material cause of it, so good flesh is the material cause of the Cicatrix. 
How the Cicatrix is procured.   
This Cicatrix is procured by three means, by nature it self, the air, and epuloticall medicament. That nature hath an hand in this business it doth appear many ways: for we may see daily ulcers skinned with these same medicaments by Empirics, which they used in incarnating: so that nature must be the chief efficient cause. Secondly, many times a scab covereth such ulcers being incarnate, which being removed, or falling away of itself, the place appeareth skinned: only nature is the cause of this: for no medicament was applied. Thirdly, if nature had not a hand in this business, such an order would not be observed, that the brims of the ulcer should first be skinned, and then the middle. Fourthly, nature worketh in her actions to the period appointed: so in an ulcer she not being hindered filleth the ulcer with flesh even unto the uppermost Superficies, which being done she ceaseth from affording any more matter of flesh, whereby it cometh to pass that the upper Superficies being deprived of further nourishment must become dry.  
What power the air hath, doth manifestly appear in the bodies of infants newly borne, their whole skin is soft and read: the cold air afterward doth repel the blood, drieth the skin, and maketh it more hard.  
But seeing nature very often in such an action proveth slow, so that if you should wholly rely upon her, and expect her leisure, you should seem of purpose to protract time, & be endanger to loose your patient, it is the safest & best course to aid nature by bringing to aid convenient & good epuloticall or skinning medicaments. In the monuments both of ancient and modern writers one shall find great variety, whereof notwithstanding a discreet and judicious choice must be had, if he mean to make good use of them; for I dare be bold to affirm, that there are almost infinite descriptions of medicaments, where of the: first describers never made any trial, but set them down, being inducell only by imagination. And amongst these medicaments, you shall find not a small number, which are either ridiculous or superstitious, 
Epuloticall medicaments.  or both. Seeing then the case so standeth, I will only commend unto you three medicaments fit for skinning of simple ulcers: The first is, Diapalma cumsuccis. The second my Epuloticum, which I described in my former Lecture. The third shall be Heuruius Sparadrop. The description of it is this, taken out of his Method to Practise Lib. 1. pag. 81. of the Leyden edition. ℞ ol. omphacin. & axung. porcin. an. ℥ iij. lythargyr. auri vel argent. ℥ iiij. cerussae ℥ j Goq. ista lento igne ad emplastri consistentiam: tum: add cerae, picis an. ℥ i ss. colophon. ℥ ij. plumbi pulverizati ℥ i ss. fiat emplast. see. art. Sparadrops made of this, not only simple ulcers, but parts of the body excoriat by reason of long lying in bed caused of weakness brought by chronical diseases.   

LECT. VIII. Of the Compound, but milder ulcers, in general  
IN my former Lecture, I set down what did belong to the curation of simple ulcers, as well plain, as cave or hollow, wherein no other offence besides the loss of the skin and flesh is found. Hereafter I am in like manner to discourse of ulcers compounded, 
What a compound ulcer is.  wherein besides solution of unity, caused by erosion, there is somewhat else that hindereth the consolidation of the ulcerated part.  

The differences of compound ulcers.  These compounded ulcers are either of the milder sort, or else malign. Those of the milder sort, have annexed either a disease, or a cause, or symptoms, which hinder the Chirurgeon from going about the unition of the part ulcerate. 
Diseases complicate with ulcers.  Sundry diseases in the body of man may keep ulcers from healing: some from corrupting the humours, as the leprosy & pox. I mean the French: some hindering of laudable blood in sufficient quantity to be sent, as Pthysis, and a Hectic f●ver: some by sending too much waterish humidity with blood, hinder the unition of the part ulcerated. If ulcers in such persons be presented to you to be cured, you are seriously to ponder in your mind, how hard a task is put upon you, if any of the former diseases be complicat with the ulcers, if you only except the French-pox in a reasonable strong body: but if the body of one troubled with the French-pox be extenuate much, then permit the cure of him also amongst the rest, to the charge of such as are only 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or citizens of the world, having no permanent habitation; and resting contented at the first with half of the bargain made for the cure, willingly, although nor honestly, commit the second payment to the arbitration of fortune. They during their life time, continuing scandals to Art and Artists, it is strange, if at the hour of their death, their consciences for the present seared, grow not tender, and fearfully accuse them. Seeing the practice of Physic and Chirurgery are severed within the Liberties of the city of London, I hold it to be the safest course for you to leave the cure of the diseases to learned Physicians, and to assume only to yourselves, the methodical dressing of the ulcers: for so the whole discredit, (if any redound) will fall to the Physicians share, who cured not the grief, the only stay of the curing of the ulcer. This is my advice, if an ulcer complicat with a dangerous disease, come at any time to your handling: (It is not your desire (I know) that I should set down the manner of curing of any inward disease: for than I should be bu●ie with my siccle in the harvest fields of other men) that then in this case, you have recourse unto some Author, who hath written most learnedly of the manner of curing that disease which is annexed to the ulcer, and follow his indications in dealing with the disease, if you have not the opportunity of a Physician, whose advice you may follow.  

Author's to be followed in curing the French-pox.  In the cure of the French-pox, if you in't end to use the unction, be directed by Ambrese Parrey, or Master Clowes, who, while he lived, was a famous member of this Company If you resolve to insist the kingly, and cleanly way of curing this disease by diet, then follow renowned Fallopius or Capivaccius. There is a Volume in foli● wherein are contained the monuments of such as have written of this disease, according to the talon of skill granted unto them: I rather would have you acquainted with these, than to range much, and imitate the swallow, which flieth much, but prayeth only upon flies.  
As concerning the Dropsy, the Cough of the Lungs, the Hectic fever, or Maras●●us, the extenuation of the body: if these being complicat with an ulcer, hinder the curation of it, have recourse to the learned Works of the famous modern Writer, Daniel Sennertus, the late Professor of Physic in Wittenberg, who hath couched in his learned books, what almost can be spoken, either by Galenists, or Chemists, concerning these and other diseases. The Plagiary Barow in his Method of Physic, and Bruel, are but like unto rotten reeds, appointed for the ruin of impotent, and lame persons, if they rely upon them.  
From a disease joined to an ulcer, 
Of the causes annexed.  I will descend to the causes hindering the cure of an ulcer. These are two, the humours that flow, and the distemperature of the part.  
As for the humour, 
How causes in flowing are to be met withal.  if it be in flowing, than you are to meet with it with the ordering the things called, not natural; as air, meat and drink, sleeping & watching, evacuation and such like, and by purging of the humour offending: whereof I spoke sufficiently in the doctrine concerning Tumours. 
How humours flowing are removed. Gal. 4. method. 2.  If it hath flowed to the part, and be impacted in it, than it is to be removed by three means: to wit, by drying, expressing, and removing of the causes of the fluxion.  
You shall dry the humour, if you use sarcoticall medicaments, drying at the lest in the third degree, as Bones calcined, Harts-hornes calcined, and made up in Trochisces with Plantain, and Rose-water, Aesustum, the Pumick-stone calcined, Calaminaris, Borax, the powders of Tormentill, Bistorts, Comfrey, and such like; whereof I have spoken sufficiently before: yet Nunquam satis dicitur quod nunquam satis discitur, a thing remarkable can never be too much pointed at; so fluxible and gliding are the objects of our memory.  
You shall express the humours: First, by using such repelling medicaments as I have often spoken of, which are to be applied to the parts adjacent to the ulcers.  
Secondly, by rolling the ulcer, as Hypocrates prescribeth in his Treatise of Fractures, that it begin about the ulcer, using so many revolutions, or windings of the rowler, as are fit, and ending in the sound part.  
As for the causes of fluxion they are three; transmission, attraction, and the furious motion of the humnor itself. 
Galen. 2. de differ. feb. 11. & 12. method. 3, 4, 5.  A part sendeth either moved by the superfluity of the humour, or urged by the offending quality, or both. If the humour offend in quantity abounding, than it is to be abated by phlebotomy, purging, slender diet, and such means as have been delivered by me in the Treatise of Tumours, to lessen plenitude, or Plethora, the signs whereof I delivered there also, so that I need not to repeat them here. If the humour offend in quality, urging and pricking the part to the expulsion of it, as the liver, which being tainted with the French-pox, sendeth the humour to the groynes, yard, matrix, the fundament and throat. When we have observed and noted the quality and nature of the humour, than we are to go about the expulsion, or alteration of it, or both.  
If the humour offend both in quantity and quality, then are we to use both purging and altering. Now to find out the humours in quality offending, seeing I have set down their pathognomonicall, & proper fignes, when I discoursed of every special Turnor, I will remit you, at this time, to the places where they were set down. If humours do flow by reason of the attraction of the part; it is procured either by the heat, or the pain of the part. 
Gal. 4. meth. 2. & 13. meth. 13.  If a humour flow to the ulcer, neither being sent from a part, nor received by a part; but because the humour itself is eliquat, either by the vehement perturbations of the mind, or an aguish constitution, or the exhibition of an eradicative, or strong medicament: then the tranquillity of the mind is to be procured, the aguish heat to be abated, and the exhibition of such medicaments to be stayed. Having spoken of the fluxion of humours so much as is fit for our present purpose, now I am to touch briefly the other cause of mild, yet compound ulcers: to wit, the distemperature of the part.  

The distemperature of the part.  The single distemperatures are in number four: to wit, toodry, too moist, too hot, too cold. A dry distemperature is found out by these signs: the colour of the ulcerate part is ill-favoured, not lively, little or no matter floweth from it, in touching it seemeth hard and dry.  
This distemperature is removed by two means: First, by drawing out the natural humidity to the part affected, by opening the passages, which before by reason of immoderate dryness were drawn together. In this case friction is excellent.  
Secondly, dryness is removed by the application of humecting medicaments. Two such are commended by the Ancients, pure Spring-water, and Water and Oil mingled together.  
As for the use of Spring or River-water, it must be applied luke warm, not very hot; for if it be very hot, it discusseth; because the humours having been attenuate by it, they are turned into vapours, and so resolved: but if it be temperately hot, and the part fomented by it, it moisteneth.  
The second medicament composed of Water and Oil, by the Ancients is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. The ulcerate part immoderately dry, is to be fomented with this medicament warm: Take either two parts of Water, and one of Oil, or equal; warm them in a single Viall-glasse, then shake them well together, that they may be mingled, and apply the medicament. This is a convenient Topick in the winter, for although warm water warmeth the part during the time of fomentation, yet after fomentation it leaveth the part cold, because it drew out the heat to the Superficies of the body: wherefore oil is excellent, for it stoppeth the pores and keepeth in the heat. These two medicaments are to be applied to the ulcerate part by ●●upes, sponges, or pledgets.  

An observation.  One thing you are to look unto you, and to provide before fomentation, that the body of the party unto which they are to be applied be neither plethoric, for then too much moisture may be attracted; nor cacochymical, for then corrupt humours may be drawn, both which will hinder the curation of the ulcer: use therefore first of all phlebotomy, or purgation, according as you shall see cause.  

Quest.  But you may not without cause ask, When fomentation Quefl. is to be left?  

Answ.  I answer, that two things shall declare unto you the period of fomenting: the first is the substance of the part, the second is the colour: wherefore when you see the part a little tumified, soft and moist, and of a ruddy colour, desist from fomentation, otherways the humour attracted will be discussed.  

The curation of a moist distemperature.  If a moist distemperature hath possessed the part, than the flesh of the part will be moist, spungeous flesh will be apt to grow, and plenty of excrements will flow from the ulcer: In this case strong Desiccatives, or Sarcoticks mingled with Basilicum aureum, or Arcaeasliniment are to be used: with an ounce of any of these unguents you may use one dram and an half of these Desiccatives: such are the Regulus of Antimony, Led calcined, Calaminaris, Bones and Horns calcined, the powder of the root of Iris, Mastic, Olibanum, and such like. Aes ustum, the Pumick stone calcined, and Henricus rubeus are excellent. 
The curation of n hot distemperature.  If the part be distempered with heat, than the part ulcerate will be somewhat tumified, hard and read, and besides the relation of the diseased party, your own feeling will assure you. In this case use Aqua calcis viva, so called; but more properly Lixivium calcis vive, wherein some lethargy of silver hath been boiled: you may use also snow water, wherein some of your Vitriolum album or white Copperas hath beened dissolved: In a quart of Apsame water dissolve two drams of Roman Vitri●l, you shall have a water of the colour of a light Emerald colour fit for your purpose. In a pint of Plantan●● water dissolve two drams of ordinary Vitriol or Allome, and this also is a fit medicament. Let me acquaint you with one thing, that in Redriffe a Copperas is made of Mars or Iron, which is most sit in the cure not only of ordinary ulcers, but of those also which are in the eyes, bladder, throat, and the Intestinum rectum. Make trial as I have done, and you shall find that true which I say. You see how plain I am with you concealing nothing, which may purchase unto you credit and gain.  

The curation of a cold distemperature.  If cold distemper the part, which you shall discern by its colour, hardness, sense of the patiented, and your own feeling, then apply to the ulcerate part Basilicum magnum, my Basilicum, Arcaeas his lineament upon pledgets, and above these Diachylon cum gummis, Emplastrum de mucilaginibus, or Paracelsus his Stictick Emplaster. But before the application of these, foment the part with, a fomentation made of Sack and March-beer, wherein Calamint, century, Wormwood, Spike, Camomile, Tansey, Scordium, Rue, and Bayleaves have been infused and boiled.  
The third thing which we affirmed to make up a compound ulcer was a symptom annexed to an ulcer. 
Of an ulcer witlrasymprome.  Now of all other, Pain is the chiefest: for first, pain by attraction bringeth much moisture to the part, and so hindereth the curation: 
Of pain.  Secondly, it inflameth the parts: Thirdly, it causeth watching, fainting, and oftentimes convulsions. 
How it is ceased.  Pain is removed two manner of ways: First, by raking away the cause of pain, which is affluxion of humours: How this is to be done we have spoken already: Secondly, by application of Anodine medicaments. These aught to be temperately hot, & subtle. Simples of this kind are the waters of warm baths, Camomile, Dill, Millet, Linseed, Fenugreeke, the marish Mallow, the pulp of Cassia, Raisins, sweet Apples, and Turnips, with a little Saffron they are effectual, Milk, Butter, Oesypum, or the greasinesse of wool, Sapa, new wine boiled to the third part, Swine's, Hens, and Man's grease, the fat of Ecles and Calves, Oil of Eggs, Earthworms, Foxes, Swallows, Rue and Elder: the oil of Wax, & Salad oil, wherein Sulphurvivum hath been boiled, are excellent in painful ulcers of the joints, Oil of Camomile, Dill, and Roses: Of these you may frame unto yourselves compositions, as occasion shall require. Take this for an example; ℞ Farin. hord. Milis, Furfur. an. ℥ ij. Lact. recent. lb. ss. coq. ad consistentiam cataplasmatis, tumadde Pulp. Cass. & Passul. mayor. an. ʒuj. Pulp. Pomor. redol. ℥ j Ol. ℞ of. Lumbric. aneth. Cam●wil. & Overum an. ℥ j O●sypi ℥ j ss. Crociʒj. Make a Caraplasme. Sometimes the pain will be so great that you shall be enforced to use narcoticall medicaments: 
Narcoticall medicaments.  The simples are Opium, Henbane, Hemlock, the Apple of Peru, Mandrake: Of these adding white Bread crumbs, Milk and Saffron, you may make Pultices: I will set one down as an example, after which you may frame others: ℞ Lact. rocent. lb. ss. Mic. pax. albiss. ℥ iiij. Fol. Hyosciami, Solani, Cicut. Contus. an. man. 1. 〈◊〉 ista ad cataplaswatis consistentiam: tum add ung●●●. popul. ℥ ij. Dress the ulcer with Plantain water, wherein some Allome is dissolved, or Roman Vitriol. Then apply Diap●●●●cumsuccis, and above it this Cataplasine. Dress this ulcer at the lest morning and evening until the pain be gone.   

LECT. IX. Of the Differences of the milder sort of compound ulcers, and first of a sinewous ulcer without any callosity.  
HAving discoursed in my former Lecture of those things which make the milder sort of ulcers to be accounted compound, to wit, a sickness, cause, or symptom complicate with an ulcer. In this Lecture I will set down the differences of milder ulcers, and the curation of them. These differences are taken either from the figure or adjuncts: from the figure these. Of the milder compound ulcers some are plain, some sinewous. I call that a plain ulcer, wherein the skin is eroded, and the subjacent flesh, and the whole ulcer is presented to the sight, being bore and uncovered. No compound ulcer is to be accounted of an easy curation: because both skill and experience are required in performing this.  
And although these plain ulcers be subject wholly to the sight, yet let no man imagine that all of them are of equal facility to be cured; for according to the nature of the grief, the quality of the cause, and the invasion of the symptoms, the ulcers with the which these things are complicate, are either of more easy or difficult curation. A plain compound ulcer hath three scopes in curation of it: for first, 
Indications of ●uring a plain compound ulcer.  that must be removed which maketh it compound, whether it be a disease, cause, or symptom: secondly, that which is by erosion lost must be repaired: and thirdly, the part must be cicatrized: How all these three indications are performed, I have set down at large in the former chapter, so that I need not to repeat any thing.  

A sinewous ulcer. Sinus.  Vleus sinuosum, or a sinewous ulcer, I call that which is like to a Cony-burrow; for sinus, or sinuositie, is a cavity or hollowness of parts under the skin, separate by afflux of an eroding humour, which according to nature were united. There be two causes of these sinuous ulcers, to wit, 
The causes of it.  Apostemes lying deep along time, or not timely opened, although they be not so deep: and wounds not well cured: for quittour lurking a long time, either in a tumour suppurate, or in a deep wound not well cleansed, must needs corrupt and get a sharp quality, which maketh to itself these cavities, which are not so easily filled with flesh and united: for unto the part affected, now weakened, excrementitious humours flow, not only from the parts adjacent, but from the whole body also, which make the ulcer hard to be cured. These burrows are found out by probes of silver, or lead, & wax-candles: If there be more orifices than one, by injections. They sometimes are superficial, 
Their figures.  sometimes deep, sometimes strait, sometimes obliqne, sometimes there is but one caverne, sometimes there be more.  

The differences of sinuous ulcers.  Of these sinuous or cuniculous ulcers, some have either hardness nor callosity, such I will term Vlcera cavernosa, hollow ulcers; some have both hardness and callosity, these are termed Fistulae. 
The manner of curing cavernous ulcers without opening.  First then I will show you how cavernous ulcers are to be cured, and then how Fistula's. There are two ways of curing of a cavernous ulcer: the first is by injection of medicaments: the second is by opening & dressing, according to Art. If you go about to cure such an ulcer by medicaments, without opening, then two scopes offer themselves, to wit, the filling of the cavity with flesh, and the agglutination of the parts disjoined. The Incarnatives must be drying without erosion, and the Glutinatives must have astriction, besides desiccation. Both these intentions you may perform with the injection of this medicament following, ℞ Aq. decoct. hord.. lb j Mollis rosat. ℥ iij. sarcocol. ʒijss. Myrrh. Thur. an. ʒij. Rad. Tormentill. 
Local medicaments.  Bistort. Symphyt. a●. ʒjss. ballast. ʒj. Baccar myrt. ʒijss. Sumach, ʒjss. Vini od●rifer. ℥ vj. Bulliant ad consumptionem tres parts, ac coletur decoctum, cui add Spirit. vini ℥ j If you perceive that the ulcer is not sufficiently mundified, which you may conjecture if the quittour be either stinking, reddish, pale, blackish, or thin and warrish; then apply this medicament: ℞ Vini in quo infusa fint marrhubium album, Centaurium minus, Absynthium, Flores Hyperici, & Carduus Benedictus lb. ss. Vnguenti Aegyptiaciʒij. Mol ros. ℥ ss. misc. inject this. You can hardly device more effectual medicaments than these are for agglutination of a cavernous ulcer: 
The manner of dressing.  Yet whosoever shall apply them, not dressing and binding the ulcer artificially, shall hardly cure any such ulcer: wherefore I think expedient that I show you the way of dressing: First, lay upon the whole process of the cavity Diapalma cum succis, or, Emplastrum album coctum, or Emplastrum contra rupturam: Then inject your medicament warm. Thirdly, in the orifice put in a leaden tent, or pipe; but short, hollow, wider in the upper than lower part, & having the brims of the upper part turned, that it may be kept from slipping in, shut the orifice and the upper part of the tent or pipe with an emplaster; let it be one of those named before: the emplaster must be snipt, that it may give way to the quittour which floweth out of the cavity: above the emplaster apply a piece of a sponge, which must be soft, moistened with the medicament with the which you dress the ulcer, and wrung out: for the sponge sucketh into itself the quittour, keepeth the brims of the orifice dry, and preserveth them from excoriations: above the sponge lay a pledget of tow: the lower cavity, or from the bottom of the ulcer to the orifice it must be bonistered. Above all lay a double soft linen cloth. Begin your rolling at the bottom, where it must be somewhat straight, to bring the sides of the ulcer together, both to express the quittour, and to procure agglutination, but let it 'cause no pain; for it would distemper the part: towards the orifice the rolling must be somewhat slack, that the quittour may have way to issue out. Every third day (if much matter doth not flow) dress it, lose first the rowler, the turnings whereof are about the orifice, take away the sponge and emplaster; first, that you may come to cleanse the ulcer; secondly, that you may make trial whether nature doth go about to agglutinate the parts: which you shall discern, 
Signs of agglutination.  if the excrementitious matter abate, be laudable in colour and consistence, and have no ill smell, and if the cavity be without pain, and without any remarkable tumour: By the contrary, if the quittour be plentiful, ill-coloured and stinking, if the cavity be painful, and a conspicuous tumour appear, you may persuade yourselves that no unition is procured. Dress the ulcer according to this manner, until perfect agglutination be caused, which you shall know by the signs aforesaid going before, if no quittour or very little appear in the orifice, if the cavity be equal without tumour, and no pain be felt: when you perceive these signs, then address yourselves for the cicatrizing of the ulcer. If after a dressing or two, thin gleeting matter appear, yet despair not; for often times such matter is wrung out of the parts by reason of the medicament drying: the nature of the part, as being nervous, membranous, or glandulous; or lastly, by compressing of the ulcer by bolstering and rolling. As for the emplaster applied to the cavity itself, it is to be renewed when it is defiled with quittour, or leaveth cleaving. Dress the ulcer as seldom as you can, 
Why such an ulcer is not to be dressed often.  contrary to the practice of Empyricks; for often dressing doth give way to cold air, which is hurtful to ulcers, and hindereth unition. Thus you may proceed in curing of cavernous ulcers, if the excrementitious matter have way to flow from them freely, which will be if the orifice be in a depending part, or lateral, the cavity or sinus being lateral also; for then, such a posture may be appointed, as will further the evacuation of the matter: But if by reason of other figures of the cavity, the cavity cannot discharge itself of the filth of the ulcer, 
The manner of curing of these ulcers by opening.  then until this impediment be removed, no expurgation, incarnation, or agglutination can be expected: wherefore way is to be made by incision or caustick.  

In what cases you are to use these means.  This you must do, first, if the cavity be lower than the orifice, either directly or obliquely; but not very deep. Secondly, if it go very deep also, as in fistulas, and such ulcers penetrating in the breast, where the cavity most commonly is lower than the orifice. Thirdly, if the hollowness be very broad. In these cases way must be made by these means for the matter, that it may be expurged; otherways if it be kept in, it will erode the parts adjacent, and no incarnation or consolidation can be looked for. We may make way for the quittour two manner of ways: first, by opening the lower end of the sinus only; Secondly, by opening the whole cavity.  

When the ulcer is to be opened only in the depending part.  The first course we are to take, if the sinus be of an enorm business, or if it be in a great joint; for great wounds in such joints are mortal, according to Hypocrates: or if there be great vessels, nerves or tendons of muscles in the way, which are like to bring fearful fluxes of blood, or lameness: which things skill in the Anatomy will teach you. If none of these cases hinder you, than it is the surest way to lay open the whole cavity, which is the second way. These two scopes we may attain unto by two means, to wit, by caustic and incision.  

When the caustick is to be used.  The caustic we are to use, first, if the party be timorous, and will not admit section: Secondly, if the cavity be in a part, wherein a great scar may 'cause deformity: Thirdly, if there be fear of a great flux of blood: Fourthly, if the diseased party be sick and weak.  

The manner of applying caustics.  If the caustic be to be applied, if the situation of the part wherein the sinus is be in the upper side, then apply your Lapis infernalis: for it corrodeth soon, deepest, with less pain, and will not be so apt by running and spreading to burn the parts adjacent, or to 'cause a greater solution of unity than we intended. But if the sinus be in the lower fide, as in the sole of the foot, or in a part very depending; then I advice you to use the caustic made of strong soap leeses, and unslaked lime, which will not run. It is an ordinary practice of some to rub the part with the caustic stone, and when the part is mortified then to open it: First, this is not to be done, but when the skin is very thin; besides this, this rubbing causeth fare greater pain, than the application of it to the part being defended: Be ever of this mind in your practice, to use the mildest means; the fruits which you reap by so doing will be respect, love, credit and gain. When you have perceived that the force of your corrosive medicament hath mortified all to the very cavity, then procure the fall of the eschar, with the application either of Dialthaea simplex, or Butter without salt: there is no substance comparable to this in this purpose. When the eschar is gone then proceed in curing of the ulcer, as hath been said, by mundificative, incarnative, and cicatrizing medicaments.  

when Incision is to be used.  If the party be courageous and strong use incision: this is sooner performed, hath less pain, and sooner will be cured. When you have made incision, arm dosils and pledgets with a medicament which strongly drieth and mundifieth; such is this: Take of Aloe Hepatica two drams, of black Rosin and Amber, of each a dram and an half, of Mill-dust two drams, of unslaked Lime two drams and an half; with this powder, and the white of an Egg, and the yolk beaten together, make a medicament in consistence representing an unguent: then apply the medicament to the Sinus incised, filling it well that the brims may be kept asunder. Open not the sore till the end of the second day, at the lest; for this medicament will both dry the superfluour humidity of the ulcer, and will excellently digest it. Afterward dress the ulcer as the methodical indications of curing shall move.  

Internal medicaments.  If you find these ulcers thus handled not to heal to your mind, then hold your patient to the decoctions of Sarsaparilla, Guajacke, and the China root, with the which mingle some of your most effectual Vulneraries, as agrimony, S. john's wort, Sanicle, Avens, our Lady's mantle, Virga aurea, Salomons seal, the roots of Comfrey, Tormentill, Bistort, Horehound, borage and bugloss. I will not conceal from you the description of a decoction, whereof I have made often proof in ulcers of the breast, joints and belly: ℞ Sols. parill. ℥ vj. Rad. Sassafrus ℥ jss. Scob. Guajac. ℥ iij. Eupator. Scahies' Tussilugin. Sanicul. Hyper. an. man. 1. Rad. Sin phyt. Tormentill. Bistort. an. ℥ ss. Rad. Borrag. Bugloss. an. ℥ j Passul. mayor. enucleatar. ℥ iij. Liquirit. ℥ ij. Infundantur infundenda per noct. in aq. font. fervent. lb. xxiv. sequente die coquantur lento igne cum reliquis ad consumpt. lb. viij. Bibat aeger singul. dieb. lb. iiij. hujus decocti: Hauriat lb. ss. mane, ac tantundem hor. quarta pomeridiana: In prandio bibat lb. j ac tantundem in coena: Quum sitit superest lb. j haurienda. The simples of this composition may pled for the efficacy of it. Let him continued the taking of this decoction for the space of 21. days: during which time he is to use a spare diet, and to eat flesh affording a good juice, and of an easy concoction. As for the local medicaments which are to be applied to the ulcer, I have spoken of them already: too much repetition will breed loathing.   

LECT. X. Of the palliative cure of a sinuous ulcer with callosity in general.  
IN my last Lecture which I delivered from this place, the vacation from these exercises being at hand, I spoke of a sinuous or hollow ulcer, without a callosity or hardness of the inner Superficies of the parts disoyned: Now the order of doctrine requireth that I discourse of a sinuous ulcer, which hath a callosity in these same parts. In times past it hath been accounted a masterpiece in the practice of chirurgery to cure such: In so much that Master Boovie the Counselor's father, a brother of this Company while he lived, dwelling in Tower-street, set up above his door a new sign with this inscription; Here dwelleth one who can cure a Fistula: young Hall having acquainted him with his father's practice. And in truth not a small skill, or ordinary proceeding is required to effect this matter: for the greatest part of such an ulcer lieth hid, and little is offered to the eye. Besides this, ordinary means are for the most part here ineffectual, and so magistral means are required. Wherefore I have diligently laboured to couch in this my discourse whatsoever can be required in the curing of such an ulcer, as you shall perceive in my proceeding.  
First then, I will deliver the general doctrine of this kind of ulcer: then I will set down the manner of curing of such in some particular parts of the body. A sinuous or hollow ulcer with a callosity or hardness in the inner superficies of the parts disjoined and separated is called in Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, from the similitude which it hath with the long and hollow windy instruments of Musicians: in Latin it is called Fistula, and so in the English tongue for this same cause.  

The definition.  A Fistula than is a sinuous ulcer, narrow and long with callosity. Here you are to observe, that a Fistula besides sinuositie, must have callosity and narrowness. It happeneth most commonly, when apostemes having been opened, 
The cause material.  the inner Superficies of the parts kept asunder by a sharp humour, become in progress of time callous. The humour which causeth this callosity must be more astringent than sharp; for it rather tanneth the part by reason of its acerbity, than erodeth by reason of its acrimony: besides this, Fistula's are for the most part indolent, unless they end in parts very sensible, as nerves, tendons, membranes and joints. Wherefore the Chemists will have this humour to be the Salpeter of the little world, or man, separate from the natural salt of the Balsam, or radical moisture of the body: that this salt is cooling and anodine, the Practisers of Physic do bear witness: for in burning fevers it is added to Juleps, which are appointed for cooling, and assuaging of pain under the name of Sal prunellae: It doth also, by reason of its stypticity unite the spirits, and stay the immoderate exhalation of them.  

The signs.  The signs are taken either from the essence of a Fistula, or from the accidents. callosity then with a Fistula, or whistle-like figure, is the pathognomonicall sign of a Fistula. The signs taken from the accidents are twofold: for they are taken either from the quittour, or the manner of pain. In a Fistula the quittour is ever virulent, ugly and stinking; as for the manner of pain it is but small, unless it be by reason of the sensibleness of the parts named by me before.  

The differences.  As for the differences, or divers kinds of Fistula's, I will only set down those, which further either curation, or prediction. Let this then be the first difference: Fistula's either go shallowly alongst under the skin, or they pass deeper to the subjacent parts. Secondly, Fistula's end either in the fleshy parts, or they pass to the bones, or to the cavities themselves. Thirdly, some are strait, some crooked. Fourthly, some are single, some manifold, yet proceeding from one orifice. These are the material, or profitable differences of Fistula's.  

The signs of the differences.  Now followeth that I speak of the signs of these differences. 1. Whether there be more callous sinuofities than one, you may conjecture by the quantity of the quittour; for if more copious quittour flow from a Fistula than can be expected from one Sinus, it not passing to any remarkable cavity, it is likely that there are more than one. The changing also of the position of the body, and compression of the part will show this; for the flowing of the matter having ceased, if after the changing of the position of the whole body, or one member, it run out again, it is probable that there are more sinuosities. Moreover, if variety of quittour flow, it is an argument that sundry parts are affected, and more sinuosities like to be. But to what parts the Fistula passeth, receive these signs: If it pass to the fleshy parts, the quittour appeareth white, smooth & plentiful; besides this, the part whereon the end of the probe stayeth seemeth soft. If it pass to a nerve, a fatty & oleous matter doth issue out, the motion which is caused by that sinew is impaired, and the Fistula is more painful than others are; besides, the probe touching the sinew, causeth a pricking pain, with a certain numbness. If the Fistula pass to the veins and arteries, yet so that the coats of them be not eroded, than the matter which it yields is like unto the leeses of Claret wine; for blood swearing thorough the coats of porosities of the vessels mingled with the quittour, causeth such a substance.  
If the coat of a vein be corroded, blood issueth thick, of a dark colour, and without quavering and leaping; but if the tunicles of an artery be pierced, than the blood is redder, of a more bright colour, and cometh forth with ejaculation. If a Fistula reach to the bone, that which the end of the probe toucheth appeareth hard, and yields not to the probe, neither is any pain felt. If the probe being pressed slip, no cariositie hath seized upon the bone; for a sound bone is smooth and slippery: If the probe stay upon it appearing smooth, it is disposed to cariositie; but if the bone appear unequal and rough, than it is undoubtedly carious. Besides this, the quittour which floweth from a corrupt bone is thin, yellow, and ill-smelling. So much then concerning the signs, which show us the divers kinds of Fistula's.  
Now let me deliver unto you some remarkable presages or predictions, touching the curing of them, that you may become circumspect in undertaking the curation of such as shall be presented to you. Let this then be the first:  
Not Fistula is of easy curation. First, by reason of the unaptness of the part to admit the convenient application of medicaments: for unless they reach to the very extremity of the Fistula, which is not so easy a matter, as you shall find by practice no good can be done. Secondly, by reason of the quality of the medicaments, which are able to remove the callosity; for these must be sharp and biting, and so cause pain: from whence come symptomatical fevers, and fainting very often, especially in tender and young bodies. And thirdly, by reason of the humour, which causeth a Fistula, which yields not to ordinary and vulgar medicaments. Let this be the second.  
Fistula's which are shallow, passing no deeper than the Membrana carnosa, or at the furthest than the membrane of the muscles, or muscule subjacent, are more easily cured than those which pierce deeper; for those by incision may easily be cured, but these not so.  
The third shall be this: Fistula's wreathed, or with multiplicity of sinuosities, require incision, that medicaments may be conveyed to all the parts.  
The fourth: If a Fistula no passing further than the fleshy parts, be not of a long continuance, and that in a young and a strong body, it affordeth good hope of curing: Imagine the contrary event, if contrary circumstances be accompanied.  
Receive this as the fourth: If the extremity of a Fistula end in the tunicles of veins or arteries, or both, (the signs whereof I have delivered, when I spoke of the differences of Fistula's) than you are to meet with the symptom of hemorrage, the coats being eroded: for if you labour either to enlarge the orifice, or to take away the callosity by sharp medicaments, the flux will be increased. This accident happeneth most commonly in Bubo's of the groin not speedily cured, and Parotides under the ear, and Phlegmons in the armpits: These parts being emunctorous, and ne'er to the divarication of the great vessels, to wit, the Vena cava, and the Aorta descending and ascending.  
Fistula's ending in very sensible parts, as nerves, tendons, the bladder, the Intestinum rectum, and the like, are carefully and mildly to be handled, by reason of the symptoms which often ensue, as accidental fevers, Lipothimies, loss of appetite and sleep: all which are apt to bring an extenuation unto the whole body, and so to defraud the part of more than requisite nourishment, without the which consolidation cannot be effected.  
Fistula's in remarkable cavities, as the throat, breast, belly, are hard to be cured, because the end is more dependant than the orifice, which hindereth exceedingly consolidation.  
If in Fistula's of the back the Spina be carious, shun the care; for these at the length bring an extenuation of the body, the animal spirits not being with requisite plenty communicate to the extremities of the body.  
Fistula's in the joints are dangerous; for if great wounds of the joints, even in bodies of a good habit, be pronounced by Hypocrates to be mortal: what shall we deem of Fistula's in these parts, where besides the enorm dilatation that must be procured in curation, there is of a necessity an ill complexion of the body. Secondly, seeing the joints are framed of parts very sensible, as tendons, nerves, membranes and ligaments, exceeding great pain must be caused by the application of corrosive medicaments, without the which a Fistula cannot be cured, and so the party exceedingly be troubled and perplexed. Thirdly, seeing the joints are seated in depending parts, and are not fleshy: and so as they are apt to receive humours attracted by pain, they are less able to discuss the humours received, partly by reason of the thickness of the membranes, partly by reason of the weakness of the natural heat: who may not easily perceive the difficulty of curing of Fistula's in these parts?  
Fistula's having sundry sinuosities are more hardly cured than those which have but one, both because the labour is the greater, and the medicaments cannot so conveniently be applied.  
Fistula's which have continued a long time seated in a depending part, remote from any principal, by the which nature hath been accustomed to discharge superfluities of the whole body, and not painful, but rather slovenly or sluttish, are rather to be kept open than cured; for they preserve the health of the body, and hinder the assault of other diseases.  

An history.  I knew a Gentleman who had a Fistula in ano about 20. years, yet unknown to his wife, who lived notwithstanding very healthful to the last period of his life: having sent for me a few days before his death, he acquainted me with it: having taken a view of it, and perceived that it was dry, and of a livid colour, I pronounced his end to be at hand, which accordingly fell out.  

Indications of curing.  Now it is time to hasten to the setting down of the curation of Fistula's in general. In the sixth Section of the Treatises ascribed to Hypocrates, there is one of Fistula's: In it he doth speak somewhat particularly of a Fistula in ano, and of the curing of it by ligation. Whatsoever is delivered in that Treatise, seemeth to be an exscription of notes out of his Adversaria or Notebook, rather than a deliberate or methodical discourse of the subject. Howsoever, it is to be embraced rather as a pledge and sign of his willing mind to pleasure his posterity, than a patrimony to enrich the knowledge, and further the practice of any one, who shall go about to cure any mean Fistula. Peruse the Treatise, and you shall find me to speak a truth, if you show yourselves impartial censurers.  I have delivered unto you in the presages of Fistula's, that sometimes it is most expedient to leave some Fistula's uncured, I must make mention of a twofold manner of curing of them: The one shall be called palliative or cloaked; 
Two kinds of curation.  the other true and real. The first affordeth some consolation and ease to the patiented; but the second procureth perfectest health. A palliative cure, I would have you to understand, to be when sinuositie is inwardly dried for a time, and the orifice seemeth to be shut up by a thin skin, until fresh and new humidity bedew the inward sinuositie, and open the orifice again. This kind of curation is most fit to be used towards those, in whose bodies a Fistula supplieth the place of a fontanel, to discharge superfluous humours, which nature turneth out from the principal parts, for the preservation of the health of the body.  
You shall know this manner of curing to be used, if the party immediately before the opening of the orifice find some distemperature, and afterward the orifice being opened, ease. To compass this manner of cure three intentions are required.  
First, convenient diet must be observed: This is performed by feeding upon such meats as are of easy concoction, and afford good juice, and in such measure as Leonardus Lessius in his 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 prescribeth, and Ludovicus Cornarus observed from his constant to his decrepit age. They advice moderation both in meat and drink. Patient's now adays would think themselves hardly dealt with, if they should be stinted every day to eat no more bread and meat than a pound, and to drink no more drink than fourteen ounces. It is an easier matter to satisfy nature, than the appetite.  
Secondly, the body is to be purged not by any eradicative medicament, wherein Scammony, Ellebore, or Colocynth entereth; but a purging diet, or a purging Ale; I will deliver unto you a pattern of both. Let your purging diet be thus dispensed: ℞ Sars. ℥ iij. Rad. Tormentillae, Bistortae, & Symphyti, an. ℥ j Polypod. querc. ℥ iij. Hermodactyl. fol. Sen. & Semin. Carthami, an. ℥ ij. Rhab. ℥ j Semin. Anisi, Coriandri, & faenicul. dulc. an. ℥ iiij. Glycyrrhiz. ℥ jss. Infundantur infundanda in aq. font. fervent. lb. x. per noctem: deinde additis reliquis lento igne coq. ad med. atque aromatizetur decoctum cinam. ℥ j ac coletur: Stumat ager mane. lb. ss. calid. hyeme, ac tantundem hor. quarta pomeridiana. As for the purging Ale receive this description. ℞ Scob. Guajaci & Sars. parill. an. ℥ iiij. Rad. Tormentill. Bistort. & Symphyti, an. ℥ jss. Polypod. ℥ iij. Eupat. Sanicul. Alchymill. an. man. j Fol. Sen. Hermodactyl. an. ℥ v. Rhab. ℥ j Semin. Anisi, Coriand. & Fenicul. dulc. an. ʒuj. Glycyrrhiz. ℥ ij. fiat ex omnibus pulvis crassiuscalus indendus sacculo lan●o rara texturae, qui suspendatur in gallon. duobu● Zythi non lupulati recentis & fortis. Let the Patient begin to drink of this Ale the fourth day. He is to take half a pint in the morning, and to sleep upon it; and so much about four a clock in the afternoon. When either of these purgatives are ministered, let the Patient about ten a clock in the forenoon take some broth without bread, made of a Chicken, Mutton, or Veal, wherein Mallow, Parsley, Fennill, and Succory roots, with some Raisins, Prunes and Dates have been boiled. Let him dine on the boiled meat; but sup with roast meat. The purging Ale is more convenient for aged persons, than the decoction, and for such as have a weak stomach.  
Thirdly, convenient local medicaments are to be applied, to further the drying of the sinuositie, and skinning of the orifice. I will only set down two injections for the first. The one is this: Take of Aqua calcis, wherein some lethargy either of gold or silver hath been boiled iij. oh ℥. and of the Syrup of read Rose leaves dried, or of the Mirtill berries one ounce: mingle these together. The other is this: Take of Plantain water iij. oh ℥. of Roman Vitriol beaten to powder, a dram and an half: let the Vitriol dissolve in the water: inject these medicaments warm; apply to the orifice a pledget of lint wet in either of these medicaments, and above the lint Diapalma cum suceis. Dress the Fistula every other day only, unless the quittour which floweth from the Fistula be plentiful. So you have the palliative cure of a Fistula. In the next Lecture I will deliver the true and real curation of Fistula's in general, wherein you shall hear sundry things worth the noting.   

LECT. XI. Of the true curation of Fistula's in general.  
NOw am I to accomplish and perform my former promise in setting down the method of curing truly and really Fistula's in general, and the practice of the same in the curing of some Fistula's of some special places of the body, which require some extraordinary considerations. Such are Fistula's in the great corners of the eyes, Fistula's in the breast, Fistula's in ano, and Fistula's in the joints.  

The means to cure Fistula's.  The means to attain to this manner of curation are threefold; dietetical, pharmaceutical, and chirurgical.  

dietetical means.  As for the dietetical, I have set it down amongst other points, which are required in the curation of an ulcer in general. It shall be sufficient to insinuate now only, that the diet of those who are troubled with Fistula's must be very sparing, and of meats and drinks which afford a laudable juice, and are of easy concoction, that crudities and sharp humours flowing to the affected part, hinder not the euration. And undoubtedly too liberal a diet, unto the which the Inhabitants of these parts are too much accustomed, is the cause of the recidivation of these, and other griefs.  

pharmaceutical means.  As for the Pharm●ceuticall means, they are of two sorts, to wit, Purgative and Consolidative.  
If the body of the diseased party be cacochymical, with some Plethora, minister the purging decoction, 
Purgatives.  or Ale for the space of a week, described by me in my former Lecture. And while these are in preparing, you may make for the better operation of these, minister this or such like a portion: ℞ caric●stin. & Electuarii de succ●●of. an. ʒiij. Syrup. ●os. solut. cum Agari●o ℥ j Aq. cichor. ℥ iij. mice. ut fiat potio, sumenda cum cerp●ri● custodi●. These two Electuaries purge the body of thin, hot, and sharp humours; the syrup and water correst the malignity of the humours.  
The Consolidatives are either Rsimple or compound. The principal simples set down by most authentic Authors, 
1. Consolidatives.  and tried by practice are these; Gentian and the roots of the round Birthwort, a dram of either of these mingled with iij. ℥. Of white wine, and ministered every other day in the morning, and fasting three hours after the taking of the medicament. The lesser century, Osmunda regalis the root of it, agrimony, Virga aurea, the white horehound, the roots of borage, Tormentil, Bistort, and Comfrey, Sarsaparilla, the rasping of Guajack, Plantain, Vinca, Pervinca, and Equisetum. Of the juices of these herbs mingled with Ale, you may make possets; the wig whereof strained and sweetened with some Saccharum rosatum, or the Conserve of read Roses, you may minister morning and evening to young persons, and those who are either weak, or abhor all physical means, whereof there is no small number now adays, who hasten by their own misdemeanour to bring on griefs; but when they are to use means, esteem them harsh: not knowing that God of his infinite goodness and providence towards mankind, hath appointed the means of recovering of health to be unpleasant to nature, that man should refrain from sin, the primitive cause of griefs.  

2. Compound consolidatives.  Of these simples afore-named, you may frame unto yourselves sundry compositions: for a pattern I will set down one decoction: ℞ Sars. parill. ℥ iiij. Scobis. Guajaci. ℥ vj. Rad. Tormentill. Osmund. Regal. Bistor. Symphyt. an. ℥ j Eupat. Virga aur. & si uil reslat prater consolidationem & cicatrizationem, Summitat. Hyperic. & Sigill. Solomon. an. man. j Passular. Major. Exacinat. ℥ iij. Liquirit. ℥ ij. Semin. Coriand. & Fenicul. duleis, an. ʒv. Infundantur infundenda in aq. font. fervent. lb. xx. deinde coq. Lento igne additis reliquis ad consumptionem lb. viij. ac coletur decoctum. If the party be strong, let him drink three pints a day: One half pint in the morning, and another about four a clock in the afternoon, for dinner and supper there remaineth a quart. If the party be young, or cannot take such a quantity, by reason of the weakness of the stomach, make half of this quantity, which being vj. lb. add to the decoction of Sugar and Honey, of each lb. j and by gentle vaporing away some humidity, bring the decoction to the consistence and taste of a pleasant Julep, which minister according to the toleration of the party. This pharmaceutical course you shall (I dare assure you) find effectual to your own credit, and comfort of the patiented.  

chirurgical means to cure a Fistula.  The chirurgical means afford unto us five intentions.  
First of all then the Fistula is to be dilated; for seldom doth it fall out otherways, that this indication is not requisite, unless it be in a Fistula in the cheek, which was caused and maintained by a corrupt tooth, which being drawn, the Fistula will heal of itself, a consolidative emplaster being applied to keep out the air.  

How to dilate a Fistula.  The Fistula may be dilated three manner of ways, by Incision, by putting in tents framed of such things as swell, after they have imbibed the humidity of the Fistula; and last of all by the Fistula tent.  

Incision when it is to be used.  As for Incision, it is to be used in strong bodies, if the Fistula be not deep and only runneth alongst under the skin, no deeper than the membrane of a muscule, if it be in a fleshy part. Secondly, if the Fistula have many sinuosities: before the Incision is made, the Fistula is to be dilated by some of the three other means, which I will deliver presently: secondly, the medicaments which remove the callosity (whereof anon must be applied) both these intentions must be performed before Incision, otherways you shall hardly know how far your Incision is to be extended, and shall leave some part of the Callus still, which will make way for recidivation and relapse.  
The second way to dilate a Fistula, is to use instead of tents such things as swell, whereof there be sundry, as the Gentian root, the pith of the Elder, or Dane-woort; but the sponge twisted with thread, 
The use of the sponge.  after that it is wrung hard and wreathed, far exceedeth all these; for it both imbibeth more moisture, and dilateth much more. I will acquaint you with a preparation of the sponge, which is excellent, and this is it: Melt a roll of your simple Melilot emplaster; when it is yet very hot, let a thick sponge imbibe it. This sponge having so drawn unto itself the emplaster, put between two trenchers, which trenchers with the sponge put into a strong press, and press them hard. After an hour or two, when you think the sponge to be cold, unscrue the press, and take out the trenchers with the sponge, you shall find the sponge become a firm substance, resembling green cheese. Of this substance you may cut out tents of what fashion you will: This will not only exceedingly dilate the Fistula, by sucking unto it the humidity; but will also digest the callosity.  
The third way of dilating a Fistula, I set down to be by the Fistula tent. It is this way to be made; Make good store of fine lint, from the which draw away all the threads, that nothing remain but the fluet, or the soft down of it; of this down with the white of an egg beaten, make your tents of what thickness or length the sinuositie of the Fistula requireth, by adding still some of down: do this upon a piece of a Deale-board smooth and even: If you still enlarge the quantity of the tents, you may dilate the Fistula as much as you will; for these tents being dried, will pierce unto any cavititie as a probe without bending (if they be well made) by reason of their stiffness. Of this manner of tent there is great use, in taking away the callosities of some Fistula's, and in healing of them, besides this use, as you shall hear anon.  

The second chirurgical attention.  The second chirurgical intention is to remove the Callus: this is bred by reason of the influxion of an humour, not of an uniform substance; for besides the thin parts, which are discussed or dried, 
The material cause of a Callus.  by both natural and extraneous heat, it must have a thick substance to 'cause this callus, it being indurated: this must be either phlegm, if the callus be white, or melancholy if it be livid, according to the dogmatic Physicians, the Chemists appoint it to be Saltpetre, as I have said.  

Why the orifice first contracteth a Callus.  In the beginning this callosity is bred rather in the external orifice, than in the inner sinuositie: for first, the skin which is thick of itself, sooner groweth heard than the flesh which is soft: Secondly, because nature still laboureth to thrust out excrements to the skin. In progress of time Fistula's having become inveterate, the whole passage contracteth callosity.  

To know where the passage hath also a Callus.  You shall know by this, whether the passage be fistulated or no: If by the intrusion of the probe great pain is felt, and blood issueth out, the Callus is not confirmed; but if no blood follow, an little pain be felt, be sure then that it is confirmed.  

How the callosity is to be removed by medicaments.  The callosity is removed either by medicaments, or the actual Cautery. The medicaments are of three degrees: for some are more mild, and these are of an emolliating and digesting quality, fit if the callosity be but small in a fleshy part and a young body: such are Diolthaea cum gummis, and Vnguentum de poeto. Every ounce of either of them having a dram of the Turbith mineral, or Precipitate mingled with Allome with it, is effectual.  
Secondly, some are more harsh; for they must mundify strongly, if the Callus be somewhat hard, and the party somewhat aged: such are Vnguentum Apostolorum, Avicen. having Precipitate and Allome, or the Turbith with Allome mingled with it, Aegyptiacum is stronger than this; but I should rather use the Vnguentum Apostolorum than it, adding more of the aforenamed cathaereticall powder to it; for it causeth greater pain, and procureth not so good quittour as the Apostolorum.  
Last of all, the medicaments which are to remove an inveterate Callus are Caustick: and even of these some are more gentle, some exceeding fierce. The more gentle are these. I. ℞ Auripigment. Sulphur. vivi, & Calcis vivae, an. ℥ j fiat pulvis-subtilis. II. is Pulvis sine pari, cujus haec est descriptio. ℞ Auripigmenti, & virid. Aeris, an. ℥ ss. Vitriol. calcinat. ℥ j Alumin. usti, ℥ ij. fiat pulvis subtilis. III. ℞ Turbith. mineralis non loti, V●trioli v●mitivi, & Boli orient. optimi. an. parts aequales.  
Of the strongest of all I will deliver unto you two magistral descriptions only, fare surpassing all others. I. is M. Hale his powder, who was famous in his time for curing of Fistula's: this is the composition of it, ℞ Aquil. mineral. Vitrioli vomitivi, & Terraerubr. oriental. an. part. aequales. II. is this which juse in Fistula's and Struma's: ℞ Realgar. albi, Auripigment. & Calcis vivae, an. part. aequales.  
You may inquire how these are to be used: If you have dilated the Fistula by incision, besprinkle the Callus with some of the powders; but if you have done it by the second way set down by me, then use the powders mingled with Vnguentum Populeon, wherewith arm your Fistula tent: or apply a Trochisk made of these powders and Populeum, and afterwards dried.  
After the application either of the Fistula tent armed with the unguent, or of the Trochisk, two things you are to observe: I. That you apply an anodine caraplasme, the fellow to this which I shall now deliver unto you shall not be found. It is also matchless in raging pains of the Gout: ℞ Lact. Vaccin. lb. j Mic. Pan. albi, ℥ vj. coq. ad cataplasmat. consist. tum add Vuguent, popul. ℥ ij. Gummi Hyose. ℥ ss. Croci pultiʒjss. fiat cataplasma, quod applicetur parti affectae mane & vesperi. IJ. You must not force out either the tent armed, or the Trochisk, before they pop out of their own accord: for so they bring the Callus out with them, and the tent with the Callus will represent a finger within a glove. If there be many sinuofities, yet do not pierce to any remarkable cavity, as of the breast and belly, than you are to dissolve these powders in some liquor, as in Aqua calcis, Plantain water, Metheglin, a gentle Lee, Allome water, or Vitriol water. Alchemists exceedingly commend in this case the spirit of Niter.  
The second way to remove a Callus by an actual Cautery is an invention of ab Aquapendente: He will have an instrument like to a setting Iron to be made, the case to answer the wideness and length of the Fistula, and to be thrust into the bottom of the Fistula, then must the other round Iron fill the cavity of this, toward the point only, and be round an inch long, and be put in read hot. It is not to stay long where pain is caused, because there is no Callus; but to be rubbed up and down where the place is indolent, until pain be caused by reason of the removing of the Callus by the fire. And although he highly commend actual sire, and discommend the potential; yet I am not of his mind in sundry cases: As for this invention, whosoever shall go about to practise it, I shall hold him much like to him who is to throw at a Cock blindfolded.  
The third chirurgical Intention is, to mundify the part: 
3. Intention.  this medicament will performs this: ℞ Vini albi. lb. ss. Unguent. Aegyptiaci ℥ ss. Spirit. vini, ʒuj. misc. Inject this this warm, but once a day. You shall conjecture that the Fistula is sufficiently mundified, if the quittour have no ill smell, if it be uniform, thick, and white.  
Then you are to address yourselves to the fourth Intention chirurgical, 
4. Intention.  which is to unite and consolidate the parts disjoined. To accomplish this: 
The description of the consolidative Syrup.  first draw first draw by an Alembick the spirit of these herbs following, putting so much spring-water as will be three inches above the simples to them: the roots of Aristolochia rotunda, Tormentil, Bistort, Comfrey, the lesser century, Virga aurea, Burnet, Plantain, Knotgrass, Yarrow, and Salomons seal. Reserve the spirit by itself: take the decoction remaining in the pot from the herbs by straining; for every quart of this decoction take half a lb. of Honey, and so much Sugar: This mixture being clarified with the whites of Eggs, and strained again, let it be boiled by a soft fire to the consistence of a Syrup. 
The use of it.  Take two ounces of the spirit, and one ounce of the Syrup, which mingle, and inject into the sinuositie, and deal with it as I prescribed, when I delivered the manner of dressing a sinuous ulcer. If any man deliver a more probable way than this to consolidate a Fistula after the extirpation of the Callus, I shall willingly lend him mine ears.  
The last intention chirurgical is to skin the orifice, 
5. Intention.  which requireth no new directions. You shall know a Fistula to be near whole, when the humour which floweth is little, thick, concocted, and the place void of pain and tumour: If it be altogether dry, you may pronounce the orifice to be skinned, and the Fistula perfectly cared.  
From the premises you may gather that four things hinder the curation of a Fistula. I. Is the afflux of a vicious humour. II. Is the narrowness of it, which hardly admitteth the application of convenient medicaments. III. Is the deepness which hindereth the conveying the medicaments to the bottom. iv The callosity which contemneth ordinary medicaments. Seeing I have showed you the way to remove these lets and impediments; I hope you will give me leave to conclude this point, of the curation of Fistulas in general. In the next Lecture I shall discourse of the curation of Fistula's in particular places, which when I have done, I will put an end to this Treatise of Fistula's.   

LECT. XII. Of Fistula lachrymalis.  
IN my two last Lectures I discoursed amply enough of the nature of a Fistula, by setting down its description and pathognomonicall or proper signs, and the general method of curing all Fistula's indifferently. This only resteth to be done before I put an end to this point, to set down the curation of some particular Fistula's differing only in subjects, which are the parts wherein they are seated, wherein some special directions are required. I will only speak of three, to wit, of Aegylops in the great comer of the eye, of a Fistula in the breast, and last of all of a Fistula in ano.  
First then I will deal with Fistula lachrymalis, the Fistula in the great corner of the eye. In Paulus Aegineta, De Arte medendi, lib. 3. c. 22. there are words in sound much like 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; but in signification different: He will have 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 to be a tumour or Aposteme before it is opened; but 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 he affirmeth to be when the tumour is opened, whether it be fistulated or no: his words are these: Aegilops abscessus est, qui inter majorem oculi angulum & nares fit: qui ruptu● si negligatur, usque ad os Fistulam aperit. I demprinsquam ruptum exulceretur apostema anchilops appellatur. So according to the version of Albanus Torinus, Thus it may be Englished: Aegilops is an Aposteme between the great corner of the eye and the nose: which if it be neglected, it maketh way to a Fistula, even to the bone: this aposteme is called Anchilops before it is broken. All modern Authors, who left any monument of chirurgery, follow him. This kind of Fistula is called by the neoterick Surgeons, Fistula lachrymalic. 
Because it doth happen in the place from whence tears flow.  By Avicen lib. 3. can. fen. 3. tract. 2. c. 14. the aposteme is called Kakilus, or Akilus, and the Fistula itself, Garab, or Algarab. Fabriciu● ab aquapendente, de operat. chirurg. part. 1. c. 21. purposely handleth this matter, and Ambrose Parrey, lib. 16. c. 15. and Taliacotius in chirurg. curt●r. lib. 1. c. 21. The place then wherein this kind of Fistula is seated, is the inner corner of the eye: although it beginneth first at the holes of the upper and low eyelid, from whence the tears flow.  

The signs.  The signs are manifest to the senses: for first, the orifice doth offer itself to the view: secondly, by compression the quittour issueth out: thirdly, a small probe may be thrust within the cavity to the very end of the Sinus.  

The Progno. sticks.  As for the Prognostics: First then, all these Fistulas are of hard curation, for the moistness of the place much hindereth desiccation, which is required in the curation of ulcers. Secondly, the part (while one is awake) is in continual motion. Thirdly, by reason of the niceness of the part, choice of medicaments must be had. II. If the quittour hath made way for itself to the inner passage of the nose, by that hole which passeth thorough the bone of the nose from the corner, than we are only to procure the shutting up of the upper orifice, and not to go about the scaling of the bone by a fruitless labour, which will notwithstanding cost the patiented great pain and grief. III. If a Fistula in this place become cancerous, which you shall conjecture by the hard and livid brims, a stinging pain, and stinking virulent matter, you arc only to use a palliative cure, applying those medicaments which are fit for a cancerous ulcer, whereof in the curation of a cancer I will speak at large. iv If this continued long, it causeth a consumption of the eye, called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, sometimes blindness of that eye, and corruption of the air, which we draw by the nostrils, if the quittour pass from the glandule, thorough the bone of the nose to the nostril.  

The diversities of these Fistula's.  Now to come to the differences of these Fistula's: Some are malign, the signs whereof I have delivered in the Prognostics: Some are not malign. Of these wherein there is no malignity, some are without cariositie of the bone, and some with cariositie of the bone: you shall know that there is no cariositie of bone: First, if the aposteme was not long continuing before it broke; for if the tumour was first an Oedema Scirrhodes, and continued a long time so before it broke, than it is likely that the humour corrupted the bone before it broke. Secondly, if the probe rest not upon a part hard and rugged. Thirdly, if after dilation of the Fistula, the cariositie be not presented to the sight. If circumstances contrary to these be offered, you may conjecture that there is a cariositie in the bone.  

The curation.  To hasten to the curation of these Fistula's: If a Fistula lachrymalis, without corruption of the bone, be offered to you to be cured, proceed after this manner. First of all, you are to dilate it: secondly, you are to remove the callosity: thirdly, you are to mundify it: fourthly, you are to consolidate it: and lastly, to cicatrise it.  

The manner of dilatation.  You shall dilate it by the Fistula tent framed (as I taught in my former Lecture) according to the proportion of the sinuositie in the beginning: than you shall enlarge it more by sponges prepared with the Melilot Emplaster, which I likeways set down, when I taught here last. This manner of dressing will discover all corners of the sinuositie. The Fistula having been thus dilated, you are to go about the removing of the Callus. Now in performing this there is not so great liberty granted, as is in Fistula's of other parts. For first, fluid and running means having a remarkable acrimony are not safe: for passing unto the Conjunctiva, and from thence to Cornea, they are able to erode it, from whence an ulcer may ensue, and so the grief be doubled. Secondly, even means solid carefully must be applied, that they go no further than the sinuositie of the Fistula. It is not unknown unto you, what horrible symptoms oftentimes afflict the eye, by reason of a familiar humour only exalted in degrees of acrimony: What mischief then is to be expected, if heterogeneal bodies, endued with extraordinary sharpness, as these must be which remove a Callus, do seize upon the membranes of the eye, adjacent unto the part affected.  
Some there are who cure these lachrymall Fistula's with liquid medicaments, as with the water of Elder, or Wall-woort flowers; in every pint of these dissolving two drams of Mercury sublimate, or more, according to the hardness of the callosity. The proportion of mixture you must conjecture by the continuance of the Fistula, by the age of the party, and constitution of the body. If therefore a Fistula be offered to be cured in a body young, of a short continuance, and of a tender constitution, than the water is to be mild; if contrary conditions do offer themselves, than you are to make it more strong, according to discretion. If you take two parts of Plantain water, and one part of the spirit of Niter, you shall have an excellent Topick according to the principles of the Chemists.  
One thing is to be observed, 
Observation.  that these liquid medicaments be sparingly applied to the sinuositie, that no part of them touch the membranes, to avoid the accidents whereof I spoke before.  

Why solid medicaments are better than liquid.  As for mine own part, I more commend the solid mediments than these fluid: for first, their faculty is more durable: secondly, they are more secure, because they are not so apt to spread. If the body be young and tender, this medicament will serve: Take Mercur. Praecipitati, aut Turbith lotiʒij. Aluminis calcin. ℥ j Exquisite misceantur. postea ℞ Unguent. popul. ℥ j Pulveris praedictiʒij. Misceantur ut resuliet unguentum. When you apply this medicament, arming a tent with it: pull it not out forcibly; but suffer it to pop out of itself. Continued the application of this medicament until the Callus be removed, which you may guess if the process of the sinuositie appear soft, and the quittour which cleaveth to the tent appear laudable.  
The Callus being thus removed, 
Mundification.  you must mundify it: To this purpose you shall use this local medicament: ℞ Aq. Chelidoniae aut Rutae, ℥ ij. Syrupi è succorutae, aut Mellis rosatis ℥ j Misc. applicetur calefactum. Dress the Fistula but once a day.  
The part being mundified, 
Consolidation.  which you shall know by the redness and tenderness of it: Then go about the consolidation. This you shall procure by this medicament: ℞ Aq. Plantag. ℥ ij. Syrupi Mirtillorum, aut Ros. rub. siccat. ℥ j Misceantur. Apply this, and renew it but every other day; 
Cicatrization. How an Aegilops, with cariositie of the bone, is to be cured.  if no remarkable store of quittour flow.  
As for the skinning: Diapalma cum succis, de minio, or Emplastrum rubrum astringens will serve.  
If in an Aegilops or lachrymal Fistula the bone of the nose be corrupted by the humour staying in the embosment, than two ways of curing are offered unto you: The first is by actual cautery, the second is by Incision. Peruse all who have written of the curing of this kind of Fistula, and you shall find that all with one accord subscribe to the actual cautery.  
The actual cautery must represent in figure the stone of an Olive: The parts adjacent must be defended from the fire, either by an hollow plate according to Parrey, or a cane according to Ab aqua pendente: you may make choice of which you will: you must effectually impress it, to dry the humidity, and the sooner to procure the scaling of the bone. And although Authors, after the application of the actual cautery, prescribe fatty things to hasten the separation of the eschar, yet I advice you not to use them; for the part is moist of itself, and so the application of such medicaments would procure a sordid ulcer: Apply therefore only pledgets, or tents dipped in read wine, and above all Diapalma, or Emplastrum de Minio, or the Smegmate. When the bone hath cast a scale, than consolidate and skin it, as I have set down before.  
It is not unknown unto you, with what difficulty patients admit the application of an actual cautery, to a part much distant from any of the principal, and wherein there is but small sensibility. What will a patiented troubled with this grief do, if you make mention of cauterization to be made in this place, so near the eye and the brain itself? If at any time you make mention of such a kind of curation to a patiented, to try how he doth stand affected to this operation; let me entreat you not to urge it too much, as if the cure of the Fistula could not otherways be compassed, if you find the patiented averse, jest you drive him away, and so you loose both credit and gain. When in the Country I practised chirurgery, sundry times this kind of grief having been presented unto me, I ever found the patients strucken into a terror and amazement, as soon as mention was made of cauterization; wherefore I set my imagination at work, to find out a way to cure a Fistula lachrymalis, lesse, terrible, but more sure and effectual, which I will not conceal from you, because this grief doth often come to your hands, and both great credit and gain is purchased by performing the curation.  

My manner of curing Aegilogs.  My manner of curation is this: First of all, having with a small probe bended, found out the cavity both upwards and downwards, I draw a line with ink between the Glandule of the eye, & the Trochlea or the pulley, through which the small tendon of the first obliqne muscule called superior, or mayor, the uppermost and greatest passeth, and endeth obliquely in the uppermost part of Cornea: then I make incision to the bone; the part incised I divide with the nails of the fore-fingers, until the incised be so much dilated, that it will without difficulty admit a pretty pledget: this being done, I thrust in a small Trochiske made of the Turbith mineral before it be washed, the vomitive Vitriol, and the best Terra sigillata wrought with Populeum to the form of a stiff paste, and afterward dried. About the Trochisk I apply a pledget armed with Populeum, which I keep to the Fistula by an Emplaster of Diapalma cum succis, malaxed with the oil of Henbane. Afterward filling the orbit of the eye with little bolsters made of soft linnen-cloth folded, and moistened in Aqua spermati● ranarum caphurata, I roll up the eye. These same dress I use morning and evening, until the Trochisk with the Callus fall out of it own accord: which when I perceive, I diligently view the bone, to see how much is carious: unto it I apply the powder of Euphorbium, if the diseased party be aged, and of a firm constitution of body; but if the party be young, and of a tender constitution, I besprinkle the bone with Pulvis Cephalicus. The cavity of the part incised I fill up with a piece of the sponge dressed with the Melilot Emplaster, as I delivered in my former Lecture: about it I apply a pledget armed with Populeum, all which I couch down close, with the emplaster and bolsters kept to the eye with a rowler.  
This manner of dressing I continued until the scale of the carious bone cast, which most commonly falleth out about the twentieth day. When the scale is removed, I mundify the part with Mel rosatum, or Melrutaceum, than I procure consolidation by the Syrup of Myrtles, or of the read Roses dried. And last of all I cicatrise the part affected with some epuloticall Emplaster, whereof I have set down sufficient store heretofore, and shall hereafter when I shall discourse of an ulcer which hardly admitteth skinning. I have made sufficient experiment of this manner of curing an Aegilops in sundry persons. And I truly affirm, that I never miffed of the cure of any one with whom I thus dealt: neither shall you (I hope) if punctually you observe these observations in your proceed.  

When the bone of the nose is to be pierced.  It may fall out that the whole substance of the bone of the nose subjacent to the Fistula may be carious, being of it own nature thin, and the head of the party besides very rheumatic, so that being often cured in the opinion both of the Chirurgeon and discased party, yet it doth break out again. In such a case you may demand of me, how you shall fall off from such a cure with your own credit. To this I answer, that there is yet a Subterfuge, and a way left to give contentment to the afflicted patient: To compass this, first dilate again the sinuositie, until the corrupt bone appear, as hath been showed heretofore: Secondly, pierce the bone of the nose with a gimlet, that the quittor may have recourse to the nostrils, which are appointed as shores to discharge the phlegmatic excrements of the brain, and to draw in fresh air for the refrigeration of the lungs: & then cure the superjacent fleshy and skinnie parts, as I taught you, when I set down the palliative manner to cure a Fistula. This manner of curation being the last refuge, it will undoubtedly give contentment to the patiented: for the eyes of the beholders shall observe no deformity external in him, and he himself shall not be able to discern the turning of the quittor from the glandule outwardly, to the nostril inwardly: besides this, he himself shall perceive no smell that shall offend him; the smell of Garlic is not offensive to those who have eaten of it.  
Now to conclude this my discourse of a Fistula lachrymalis, if you perceive any such Fistula malign, or to tend to a cancrosity, which you shall discern by the signs set down, when I delivered unto you the Prognostics: then use this medicament of Heurnius the father, set down in methodo ad praxin. lib. 1. pa. 106. which he purchased both with money and entreaty, of one who got much money by it.  
This is the description of it: ℞ calaminanter usti, atque in vini aceto extincti ℈ j myrrha, plumbi usti ac loti an. ℈ ss. croci gr. v. opii gr. ij. aeris usti ℈ iiij. decocti fenugraeci ℥ j Misecantur exquisite omnia super lapidem pictorum. If you mean to make an oinement to continued long, instead of the mucilage of Fenugreeke, use new Swines-grease washed in Rose-water. This is admirable eie-salve in all ulcers of the eyes: (whereof I have made often trial) whether they be malign or no.   

LECT. XIII. Of Fistula's of the Breast.  
HAving spoken in my former Lecture of Fistula Lachrymalis, I am now to set down the method of curing other particular Fistula's, according to my promise. Of these, Fistula Thoraeis, a Fistula of the breast doth fist offer itself. Of the which Cornelius Celsus l. 7. Ambrose Param l. 9 ca 31. and Fabricius ab aqua pendente de operat. Chirurgic. part. 1. c. 47. have written.  

How it happeneth.  This kind of Fistula happeneth by two manner of ways: First, by reason of a penetrating wound of the breast.  
Secondly, by a Phlegmon possessing the intercostal Muscules, and the Pleura.  
It is a superfluous matter to set down any signs, seeing they appear to the eye, and are easily found out by applying the signs set down in the general method of curing of Fistula's, to every Fistula in particular.  

The differences.  As for the differences, a Fistula ensuing a wound penetrating to the cavity of the breast, hath but one orifice, the passage and sinewosity whereof is according to the penetration of the wound; but a Fistula following after an Aposteme hath frequently more orifices than one, whereof some pass to the cavity of the breast directly, some windingly.  

The Prognostics.  To come to the Presages. All Fistula's of the breast are hard to be cured, and that for seven reasons; for first, the breast is in continual motion by reason of its dilatation and contraction caused by the intercostal Muscules: now that motion hindereth the curation of any sore, it is so manifest, and confirmed by experience, that it needeth no probation.  
Secondly, because in penetrating Fistula's of the breast, the Pleura is always ulcerate; which being thin, without blood, and membranous, as the bladder hardly admitteth any consolidation.  
Thirdly, seeing the Virus of the Fistula doth often corrupt the rib; and seeing the internal substance of the rib is cavernous, and so apt to lodge corrupt matter, the difficulty of curing is increased.  
Fourthly, in Fistula's of the breast, the end of the Fistula is often lower than the orifice, which hindereth the expurgation of the superfluous matter.  
Fifthly, the sinewosity within, in penetrating Fistula's doth frequently extend itself between the Pleura and the upper rib, to the distance between it and the lower rib. Now how hard a matter it is to cleanse this cavity, I refer it to your own consideration.  
Sixthly, that liberty of applying of medicaments, which is permitted in sundry other parts of the body, is here denied; the lungs and heart being lodged in this cavity, whereof special regard is to be had, seeing from the safety of these parts the life of the Individuum dependeth.  
Seventhly, because these Fistula's bring an extenuation of the body, and a Hectic fever.  
Let this be the second Prognostic: If the party afflicted with a Fistula in the breast be fallen unto a Hectic fever, 
2. Prognostic.  and his body begin to be extenuate, pronounce the grief to be incurable: for if you use deficcative means, which are required in curing of ulcers, you shall increase these symptomatical griefs, and hasten death.  
The third Prediction Celsus delivereth unto us in these words, Solent quoque, etc. Fistula's use sometimes, when they have passed by the ribs, to corrupt the midriff; which may be gathered by the place affected, and the greatness of pain, in this case there is no hope of cure.  

The curation.  As for the curation of a Fistula of the breast; to it three means are required, a convenient diet, pectoral decoctions, and local applications. 
The diet.  In a Fistula, which hath caused neither a Hectic fever, nor extenuation of the body, a greater variety of meats is permitted, than when these symptoms are annexed. Howsoever meats of easy concoction, and which afford laudable nourishment, are to be appointed for the Patient, and a moderate use of them is to be prescribed: of these two means I have spoken amply enough, when I set down the general curation of ulcers.  

pectoral decoctions.  As for pectoral decoctions, upon the use of which, the greatest part of the cure of such Fistula's dependeth, you shall find divers descriptions of them in divers Authors. The Simples whereof these Decoctions are made are these; 
The Simples of them.  The flowers & leaves of Colts-foot, Maidenhair, the white Horehound, Comfrey, Tormentill, & Bistort-roots, Violet-flowers, Borrage-roots & flowers, Ellacampane-roots, Hyssop, Germander, the flowers and roots of Mallows, the roots of Parsley and Fenell, Liquorice, Scabious, Valerian, Burnet, Sarsaparilla, Guajak, the China root, Raisins of the Sun, and blue figs: of these Simples you shall find sundry decoctions set down by Authors who have written of wounds and Fistula's of the breast.  
Amongst all others, the pectoral Decoction of Franciscus Arcae●● you may most safely and securely trust unto: He white he lived, was so fortunate in the practice of chirurgery, that he drew that eminent Linguist and Divine, Arrias Montanus, very often to be a spectator of his operations. The Decoction I need not to set down, because you may fetch it out of the Author himself, who is translated into the English tongue.  

My own.  I will not stick to commend unto you one of my own, whereof I have sundry times made experiment. This is the Composition of it: ℞ Sars. parill. ℥ vj. scob. guajac. ℥ v. rad. Chin. ℥ iij. rad. enuh. campan. ℥ j capill. ve●●r. scabios. fol. tussilag. scolop●nd. sumitat. hyper. an. man. 1. f●or. borrag. buglos. viol. beton. an. pug. 1. polypod. ℥ iij. liqu● it. ℥ ij. passul. mayor. exacinat. & ficu●●● pinguinu● incisar. an. ℥ two ss. Infunde●tur ista per noct. i●aq. font. f●rventis lib. 24. deinde lento ig●● coq. ad consu●p. lib. viij. a● col●tur decoctum. Bibat ager singulis di●bu●lib. iiij. Let the Patiented every morning about five a clock drink half a pint of this Decoction warm, and so much about four a clock in the afternoon: at dinner let him take a pint, and at his Supper another: the third pint he may drink between meals, 
The reason of the quantity of the decoction to be taken.  Marvel at not this quantity, for a less will little avail; for strong desiccation is required in this cure.  
Three things vehemently hinder the curation of these Fistula's: The first, is the inconvenient situation of the orifice, 
Things which hinder the cure  when it is higher than the ending of the Fistula.  
The second extenuation of the boyd.  
And the third is a Hectic fever: of these in order.  

The manner of incision.  If then the ending of the Fistula be lower than the external orifice, a lower orifice is to be made by incision. In this incision. operation two things are to be diligently noted: The first is the place. The second, the cautions to be observed in the section.  

The region of the breast fittest 〈◊〉 incision.  As for the regions of the breast: The left side is more safe than the right: for in this side the liver by its gibbosity beareth up the Diaphragma, and doth insinuate itself to the cavity of the breast: If then either one of these, or both should be wounded imprudently, it is an easy matter to prognosticate the tragical event of this operation.  

The place.  As for the determinate part of the breast, which is to be opened, let it be about the beginning of the next rib, and not at the lower end of that rib, above the which the orifice of the Fistula showeth itself; for under it are couched a vein, a nerve, and an artery.  

The manner of section.  In your Section proceed thus: First, divide the skin towards the upper part of the lower rib, then make way throughout the incostall muscules: These things being done, dry all things with a sponge, and put into the new orifice a swelling sponge, both to dilate it, and to draw to itself the quittor. If you go thus to work, you need not fear any danger, if you pass no farther than the division of the Pleura: so that neither the Diaphragma, nor the lungs, or the Pericardium be touched.  

What is to be done if a Marasmus or Hectic fever be complicate with a Fistula of the breast.  If with a Fistula of the breast, a Marasmus or Hectic fever complicat, the difficulty of curing is exceedingly increased; two diseases jointly conspiring to the ruin of the diseased party, which notwithstanding for their curation require advers indications, the Fistula requiring desiccation; and Marasmus and the Hectic fever craving humectation. If then a Fistula of the breast be offered to any one of you, first of all be sparing in your promises, jest you be accounted clouds without rain: who but an ignorant will give free reinss to liberal promises to cure a Fistula of the breast complicat with other Deutoropatheticall griefs of their own nature hard to be cured; when as it is a difficult matter to cure a solitary Fistula of the part?  

What a Marasmus is.  Marasmus, in Latin● Authors Marcor, is an immoderate dryness and consumption of the whole body, by reason of the defect of the substantial humidity, according to Trallianus. According to Galen li. de marc. 
Lib. 12. cap. 4.  there are two degrees of it: 
The degrees of Marasmus.  The one is when this extenuation of the body is in Fieri, in consuming; The other is, when it is in Facto effe, or consummate.  

Signs of it in fieri.  If it be in Fieri only; the muscles begin to fall, the skin becometh flaggie and lose, strength and agility decay, and the party findeth a manifest defect, and impotency in all the actions of the body, whether they be animal, vital, or natural. Againt this degree, you may contend by instituting a diet moistening.  

The curation of this degree.  If a Marasmus be in Facto esse, or consummate; then the eyes grow hollow, and seem to be hid in pits▪ the lively colour of the skin fadeth, 
The signs of a Marasmus consummate.  the skin of the forehead seemeth dry, and stretched like the head of a drum; the eyelids seem heavy, and scarce able to lift themselves up, as it happeneth to those who are wearied by reason of watching; the temples are hollow: in the cavities of the breast and belly, one would think, that there neither Viscera members contained, or guts: for the muscles are so consumed, and the cavities so drawn in, that nothing seemeth to remain besides the fibra and the skin. To conclude, one having a consummate Marasmus, seemeth to be nothing else, but a walking scel●t●s. Whosoever shall undertake the curation of such a one, and perform it, I will give him leave to give himself out for another Saviour, and to publish a fifth Gospel, which the itching cares of our age would willingly perhaps entertain.  

2. Differences of a Marasmus.  A Marasmus is twofold: For one is accompanied with heat, and may be called a dry Marasmus, and this is nothing else but a Hectic fever, which hath consumed the radical moisture of the solid parts, and it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or an extenuating fever.  
The other is accompanied with cold. This is twofold: The one is natural, 
The differences of a Marasmus caused of cold.  and it is decrepit old age: for old age is defined by dryness, and coldness.  
The other is unnatural, and it is called Senium ex m●rb●, a decay by reason of sickness: old age cometh by the course of time.  
This last of a violent cause, for it followeth after a burning or a Hectic fever; and that by reason of the sickness it sefe, or by reason of the medicaments used in the curing of the aforenamed griefs: for a Hectic fever doth not only waste the natural humidity, but the natural heat also seated in the humidity: wherefore the heart itself, the wellspring of this heat must become colder than it aught to be. In this case the pulse is small & weak, and slow: in like manner the breathing is weak, slow, & cold. By reason of the use of refrigerating medicaments appointed by the Physician in curing of a Hectic, or a Febris Morasmodes, many times Senium ex morbo succeedeth: and this is more tolerable, because the heart being somewhat immoderately cooled, the less of the radical moisture is spent, than would be if the Hectic had its full course.  

What a Hectic fever is.  A Hectic fever, is an unnatural heat which hath seized upon the solid parts, and wasteth the moisture of them: But seeing there is a threefold moisture in the body: to wit, blood in the small veins and arteries of every part, a dewy substance in every part, by the which it is nourished; and gluten, which keepeth together the terrestrial substance of each part, moisteneth it, and keepeth it from falling to dust.  

The degrees of a Hectic.  There are also three degrees of a Hectic. In the beginning, when the two first humidities begin to fail, the Hectic fever is not easily discerned, although it may be without great difficulty cured: But if the radical moisture be consumed, as it is easily discerned▪ so it is hardly cured. As long as this moisture is somewhat plentiful, sufficient to ●ntertaine the natural heat, the body feemeth well coloured, of a comely figure, and of a decent quantity.  

What 〈◊〉 to b● done in 〈◊〉 suma● co●sumpti●●.  If therefore you perceive the body of any one having a Fistula in the breast, by reason of the defect of this gluten, orradicall moisture to become discoloured, the figure to be altered, some parts bunching out, some growing hollow and the thickness of the members to become slenderer, the flesh colliquating; leave such a one to himself, that he may march peaceably to the period of his life. Having delivered unto you of a Marasmus or extenuation of the body, and a Hectic fever, so much as is expedient for you to know in your chirurgical practices; without the knowledge of which, you cannot possibly proceed, warily and circumspectively, in curing Fistulas of the breast. I am to show you what uses you may make of what hath been delivered.  

The uses of the discourse of a Marasmus, and a Hectic fever.  If therefore one having a Fistula in the breast be brought unto you, whose body seemeth to be nothing else but skin and bone, (as the vulgar proverb is) acquaint him with the danger wherein he is, jest death seize upon him unprepared. Nevertheless, if he implore your aid, of Christian charity withdraw not what comfort you are able to procure unto him: appoint then a diet moistening and nourishing, if no Physician be at hand, which I will set down anon; and dress him with those medicaments which are anodyne & healing. Inject into the Fistula Plantane-water, having some of the syrup of read Rose-leaves dried, mingled with it; cover your tent and pledget with Diachylon simplex. If you perceive that there is so much of the radical moisture remaining as is able to cherish the natural heat, which you shall discern, if the colour of the body be fresh, if the figure be decent, if the proportion of the parts be according to nature, and the diseased party can In some good measure perform all actions; you may conceive some hope of his recovery.  

Remedice against a Marasmus.  Wherefore if a Marasmus hath extenuate his body, appoint for him a diet, which is likely to repair the natural moisture impaired. Let him then take broths made of Mutton, Veal, or Chickens, wherein Damask Prunes, Raisins of the Sun stoned, Currans washed and bruised, Mallow-flowers and roots, Marigold-flowers, Cinquefoil, Cowslip flowers, and Colts-foot leaves and flowers have been boiled: Jellies are good, made of young Cockerels, and a knuckle of Veal; use no other spice to it than a little Mace, and Nutmeg. Let him between meals take Almond-milks, made of the broth of a Chicken boiled with French-Barley. It is good for him also every morning and evening, to take a draught of Asses or Goats-milk; or in want of these, of Cowes-milk, milked thorough the Conserves of borage, and Buglosse-flowers; Calves and Sheeps-feets stewed with Curranes are good: sometimes let him eat Pigs-flesh. If he have a mind to fish, grant unto him Whiting-mops, Smelts, Perches, young Pickerels, Trout, yea sometimes Eeles: the Sole, Flounder and Plaice, may also be permitted; poched Eggs, and sweet Butter without any Salt, or Almond-Butter, are good for break fast.  

Remedies against a Hectic fever.  If an extenuation of the body do proceed from a Hectic fever, than you must not only moisten the body; but cool it also. In the broths then-boyle borage, and Succorie-roots, common Sorrell, wood Sorrell, Primrose, Violet, borage and Buglosse-flowers▪ let his Salads be Lettuce, spinach, & Purslane, boiled in Chicken-broth. An Almond-milk made of the Decoction of French-Barley, wherewith the emulsion of the seeds of the Pompion, Muskmelon, Cucumber, Purslane, and white Poppy hath been drawn, is excellent taken morning and evening. Permit no Milk but Buttermilk, and that when it beginneth to be a little sowrish, with a little of Sugar, of borage, or bugloss. If the diseased party complain of immoderate heat, and watching, minister unto him twice a week Philonium Persicum, with the syrup of white Poppy, read Poppy, Gillie-flowers, Maidenhair, Colts-foot, or of the juice of Lemons, or Citrons, in Aqua Spermatis Ranarum, or read Poppy. If you perceive that by the following of these courses, the party hath recovered his strength, and a good habit of body, than you may conceive a good hope of his recovery, and put him in good comfort: and so boldly proceed in the Cure, still endeavouring by following the indications (as Theseus did the thread of Ariadne to come out of the Labyrinth) to restore perfect health to the Patient. In the beginning of the Lecture, Lappointed three indications for the curing of Fistula's in the breast; to wit, a convenient diet, pectoral decoctions, and local applications: I have sufficiently discoursed of the first two; the third than remaineth of local applications.  

Local applications.  In setting down of these I will be brief, because they little differ from the general, if you except a few observations. You may safely dilate a Fistula of the breast, with the Fistula tent and spnnge; but in removing of the Callus you be wary, for if you apply the Trochisck, it must not reach to the cavity the breast, for the point of it will relent, break, and fall upon the Septum transversum, which undoubtedly will crode it, cause an inflammation, procure a sharp fever, a P●raphre●i●is, and at last death itself. Apply then a tent armed with Populeon, wherewith the Fistula powder must he mingled, as hath been taught: The Calus being removed mundify the ulcer with Aqua calcis, and Mel rosatum mingled together: Take heed that you inject no better medicament, for such medicamen●● are easily sucked in by the lungs, from whence by the Tracha● Arteria, they easily pass to the throat and mouth, from whence there is felt a horrible bitterness, a desire to vomit, and an overthrow of the appetite. Para●● lib. 9 c. 31. affirmeth this to have happened unto him twice t● be you ware by the example ample of others. The ulcer having been mundified, proceed to consolidation, for sores in this part are not to be long kept open. This you shall procure by injecting two or three days the syrup of read Rose leaves d●yes, mingled with Plantane-water; and then only moistening a pledget wet in this syrup, or the syrup of Myrtles. Above the pledget apply Paracelsus his Stictick Emplastrum, for in this case it exceedeth all others; for it doth not only draw the brims together, but it skinneth also.   

LECT. XIV. Of Fistula's of the belly and joints.  
Having infisted so long in discoursing of the nature and curation of Fistula's, you may think, not without cause, that I aught to hasten to an end. In this Lecture I will set down the indications of curing Fistula's of the belly and joints, and so I will conclude this point.  

The differences of Fistula's of the belly.  The Fistulas of the belly are twofold: for they are either in the juguinal parts, or else in An●.  
Of these in the groynes I will discourse; because they most frequently fall out, being accidents, for the most part, which ensue after Venereal Bub●'s, either neglected, or ill cured: yea, they fall out in plethoric and cacochymical bodies very often, wherein there is no Neapolitan seed: and that somewhat above the emunctory itself; the matter not coming to the emunctories themselves, which receive the excrements of the liver; but being hindered, either by reason of the weakness of the expulfive faculty, or by the crossing and thwarting of the muscles, obliqne and transvers in those places, as you, who are skilful in the Anatomy, well know. It is no wonder that both Abscesses, and Fistula's often fall out in these places, seeing the belly is as a draught or a sink in a house, or a keel in a ship, whither all imparities flow. Yea, such plenty of sharp humours sometimes floweth to these parts, that perforation of the guts is caused, and that the excrements come out at the orifice of the Fistula; a lamentable case, noisome to the diseased party, and intolerable to the company. It falleth out sometimes that some of the Vertebra of the Spina are corrupted.  
As for the Presages: The Fistula's in these places, which pass not to the cavity of the Abdomen, are hardly cured.  
First, because the liver is still apt to afford new matter.  
Secondly, because great circumspection is to be used if you shall use either incision, or corrosive medicaments, by reason of the fibra of the muscles, and the branches of the Vena cava, and Aorta descending.  

A history.  I visited once in Smithfield, a Preacher who had a Fistula by reason of a Venereal b●be ill cured, who entertained for his Surgeons Master William Clowes of famous memory, Master Authony Spademan, & William Bray, brothers of this worshipful company while they lived. Although no convenient means were omitted, yet the Cure came but slowly on. The diseased party impatient of delay, and not being comforted by any certain hope of recovery, addressed himself to one in the country, who was accounted famous for curing of Fistula's: for Master Hall at that time had acquainted sundry with his practice of curing of Fistula's. After the Chirurgeon had applied his corrosive to remove the Callus, it corroding, the tunicles of the great vessels descending, the eschar parting from the sound parts, in the night a strong flux of blond ensued, which deprived him of life before the curer c●●● come. Wherefore let me advice you, diligently to obs●● whether the bottom of the Fistula doth reach as deep as the great vessels, that you may avoid the like fatal event.  
The second Presage is this: If the Vertebra of the Spina be corrupted, pronounce the Fistula to be incurable: you shall conjecture the Vertebra to be soul, if extraordinary store of stinking sanies issue out of the Fistula, and the party daily grow weaker, and more extenuate, notwithstanding that you use all convenient both internal and external means.  
The third Presage shall be this: If the guts be eroded, & the excrements come out at the orifice of the Fistula, the life of the diseased party is in great hazard, because the guts are thin, membranous, and destitute of store of blood.  
Secondly, because the Fistula is apt to ereepe thorough the distances between the muscles, which in those places are many; to wit, the obliqne and transvers, one placed above another.  
Thirdly, because in curing such Fistula's, we find little help of hand and eye.  
Fourthly, because topical means can hardly be kept to the guts to help consolidation.  

The cure.  As for the curation of these Fistula's: If they be not deep, 
The removing of the Callus.  but run alongst superficially, the best course is to make incision, and then to apply one of the Fistula powders described by me, care had of the age and constitution of the party.  

The mundification.  As for the mundification, consolidation, and cicatrisation of such, seeing no special observation is required, you are to have recourse to that, what I have copiously delivered heretofore. If the Vertebrae of the Spina be foul, you are to promise' no cure.  
Nevertheless, if persons of worth will (upon good consideration) entertain you to dress them, they finding a comfort by your pains: Make an injection of Plantain, or Carduus Benedictus water, adding some fragrant water of Medow-sweet, the syrup o●●● Rose leaves dried, and the spirit of Wine, having the tr●●ture of Aloe, Myrrh, Mastic, and some Saffron. Let your emplaster be Diachylon cum gummis, or Paracelsus his Stictick. If the guts fall out to be perforated, having acquainted the friends of the party with the danger, yet despair not, but go on, and use methodical means. Let the party eat Calves and Sheep's▪ feet stewed, Sheep's and Calf's heads, for they afford a glutinous juice; Rice boiled in Milk, wherein steel hath been often quenched, is also good. Every morning and evening let the party take a draught of Allagant, warmed with a wheat tossed, when he hath drunk off the wine, let him eat the toast. Make injection of read Wine, having a little Alum dissolved in it, & some of the syrup of the Mirtles-berries: keep the orifice open with a sponge, until the gut be consolidate; then proceed to the extirpation of the Callus, mundification, consolidation, and cicatrisation, as hath been often heretofore taught. Event oftentimes falleth out above expectation.  

A history.  Not long ago a country youth, who had an Enterocele, was bound to a Barber in Aldersgate street; one applying to the Rupture a Truss somewhat straight, caused and sideration or mortification of the part, so that the excrements came out plentifully, with much stinking matter, out of the cavity of the belly. Notwithstanding, by diligence, and application of convenient means, the gut was consolidate, and the youth kept alive. So much I thought good to deliver concerning the curation of Fistula's which happen in the inguinall region.  

Of the Fistula an●.  Now it followeth, that I speak of Fistula's in An●, which was said to be the second kind of Fistula's invading and possessing of the Abdomen; or the lower belly.  
This kind of Fistula very often followeth after a Phlegmon in the Anus, broken and ill cured.  
There be two sorts of these Fistula's, for some pierce not the Intestinum rect●●●, and some do: and both these are either shallow or deep.  

Signs of a Fistula piercing the gut.  You shall conjecture the Fistula to pass thorough the Intestinum rectum: First, if after breaking of wind, part of it make way thorough the sinus of the Fistula.  
Secondly, if the excrements appear mingled with the quittor, or if the quittor smell as the excrements use.  
Thirdly, if injection being made at the outer orifice of the Fistula, part of it pass within the Anus.  
Fourthly, the forefinger being put into the Anus, if you feel the probe bore it being thrust thorough the sinnus of the Fistula, this is an infallible and certain sign.  
As for the Presages of these Fistula's: 
Presages.  First, no Fistula any is of an easy curation: for this part being the jax of the body, it affordeth great plenty of impurities, and much superfluous moisture, which hinder the curation.  
Secondly, if a Fistula in this place be not very painful, and noisome, by reason of much & stinking quittor, but shutteth and openeth itself sundry times, it is expedient for the health of the Patient, if such a one be left uncured; for by this means the body is discharged of superfluous humours, and the body kept in health. I have known this accident to have happened to sundry, and to have continued to the end of their lives. Some I know yet living thus affected, neither do I doubt, but that sundry of this worshipful Company have observed the like.  

The curation.  Now to come to the curation of these Fistula's: The means to attain to this are sive: to wit, Diet, Internal medicaments, Incision. Deligation, and Topical means.  
As for the Diet and Internal medicaments, I have discoursed sufficiently heretofore, so that I need not, distrusting your memories, to repeat any thing.  
As for Incision and Deligation; they have place when the Fistula is shallow, but if the Fistula be deep, neither of these means are to be attempted.  

The curing of Fistula's not passing to the gut.  If therefore the Fistula be shallow, and pass not to the Intestinum rectum, after you have dilated it, and removed the Callus, upon a tent incise all the hollowness: then fill it with dosels, armed with a medicament made of a restrictive powder, and the white of an egg, to keep the brims of the incised parts asunder; for if you go about to unite the parts too soon, it may be feared that a cavity will still remain, and make way for recidivation: wherefore it behooveth you, to see that sound and laudable flesh be engendered in the bottom. Let not your incarnative medicaments be fatty, for such will 'cause lose and spungeous flesh: use therefore the sanative syrup made of the vulnerary plants, having some Pulvis cephalicus mingled with it. If the Fistula go deep inwardly, so that you cannot use conveniently incision, dilate the Fistula with the Fistula tent, and the sponge; then remove the Callus with a Fistula trochisk: the trochisk being come out, and the Callus quite spent, mundify it with Mel rosatum, mingled with Aqua calcis: when you perceive laudable quittor, endeavour to consolidate the part, by applying die sanative syrup, and Pulvi● cephalicu● upon the tents, which you must day by day shorten, until at the last the whole sinus of the Fistula is shut up; which you shall conjecture by the little and laudable quittor which the Fistula yields. Then nothing else remaineth, but to cicatrise the part with your Dia●alma, or Vuguentum de minio. 
The cure of a Fistula piercing the gu●.  If the Fistula penetrate to the Intestinum rectum, then cutting asunder of the whole sinus of the Fistula by deligation is most sit. But first of all, you you must dilate the sinus, and remove the Callus, (as hath been said) for so the part which is to be bound will be more thin, and so more easily cut asunder. As for the thread wherewith you are to bind the sinus, two I commend unto you; first, sealing thread, which is made of the best hemp, unboyled, and unwhitned: for it is exceeding strong, and will not rot before it hath wrought its effect. The second, is a strong thread of silk, twisted; there is no great matter in the colour, whatsoever scrupulous Authors affirm: you may use either of these as opportunity shall be offered.  

The manner: of binding.  When you go about to bind the sinus, put in one end of the thread in the eye of a small and flexible probe, than thrust the eye with the thread thorough the sinus into Intestinum rectum: this being done, put into the Anus your finger, and with it pull the thread out of the eye of the probe, and draw it out at the Anus, or having bend the eye of the probe, bring it without the Anus; and then putting the thread into the eye, draw that end thorough the outer orifice of the Fistula, If the sinus be not very thick and long, you may by one strong deligation bind off all the sinus, but if the sinus be thick and long, you must use sundry constrictions, tying still the ends of the thread with a running knot, that it may be the more readily loosed. Some after one deligation only, more and more draw in the ends of the thread, with a round piece of a stick turned about. When all the sinus after division, by deligation, lieth open, go forward in the cure, as hath been set down when the sinus was incised. Now nothing remaineth to conclude these discourses of Fistula's, but to speak somewhat of the curing of the Fistula's in the joints. These griefs, what pains they procure to the Patients, and troubles to the Surgeons who dress them, it is so well known to those who have been employed in such businesses, that I need not to use many words to persuade any to believe this: experience bearing witness.  
The differences of these Fistula's are these. Some are without corruption of the bones and cartilages, and some have these annexed.  
Again, some of these are without any tumour of the adjacent parts, and in some there is a remarkable swelling of the parts adjacent; so that the skin itself is either brawny and hard, or lose and oedematus; and some of the tendons of the muscles are foul, and corrupted very often: such tumours often fall out, when Fistula's happen in the wrists and ankles.  
Thirdly, in some of these Fistula's the joint abideth firm, but in some it becometh lose and weak, by reason of the relaxation of the membrane which covereth it, and the ligament by the which it is strengthened.  

The manner of searching.  Before I come to prognosticate of the events, let me acquaint you with one thing, and that is this; that if you be called to children or young persons troubled with a Fistula, or Fistula's in the joint or joints, that you make trial of the sinus with a Mallow stalk answerable to it: for this kind of probation is of all others less painful, and will encourage the diseased persons to commit themselves to you care, when they perceive that you searched the sores so easirs hoping that your proceed will be according to you-beginning. The small stalk of the Mallow next to the leaf is always slimy and flexible, and so is apt to slip into the sinus, causing ei●her no pain, or very little.  

The presage.  As for the presages: I No Fistula of the joint, although it be without corruption of the cartilages or bones, is of an easy curation: for first by reason of the pain which is caused by reason of sensibleness of the part, and the increase of it by reason of the sharp medicaments which must be applied to remove the Callus, symptomatical severs, loss of appetite, watching, and at last extenuation of the body; and at last a Hectic fever may be procured.  
II. If a Fistula of the elbow or knee, have corruption, either of the cartilages or bones annexed, it will require a long time to have it cured: for the joints themselves being very sensible, it must be gently dressed.  
III. If in Fistula's of the wrist, the bones of it, or of the back of the hand, be carious, you shall find the cure to be difficult: for these bones are very spungeous, apt to receive superfluous humidity, and so are hard to be scaled.  
iv For these same reasons, the bones of the joint of the foot and the instep are hard to be cured.  
V If Fistula's in the wrist or instep be accompanied with large and hard tumours of the hands and feet, pronounce the cure to be uncurable: for then the membranes, tendons of the muscles, and bones most commonly are corrupt.  
VI If an extenuation of the body, or a Hectic fever do accompany Fistula's in the great joints, shun the cure: for the indications of curing, which prescribe drying and cooling, in drying increase these griefs. Besides this, complicate diseases are more hardly cured than those which are solitary.  
If you shall demand of me, 
Object.  what course is to be taken with those who are possessed with such uncurable Fistula's, if you be entreated of the diseased party, or the party's friends to do your best?  
I answer, that if after some trial, 
Answ.  you perceive the party to be uncurable, you aught to move the party to suffer exstirpation, and dismembering of the limb, whether it be foot or arm, before he grow weak, and become unable to endure any such operation. In young persons you may attempt this operation; for I have adventured it with good success; but in aged and crazy persons be not too bold: for the loss of the radical moisture is more easily, by diet and medicaments, restored in those, than these: the other may, but these must die.  

The topical means.  Now to come to the Topical means, which are convenient for the curing of Fistula's in the joints, (for as concerning the diet, and internal medicaments, I have spoken of them sufficiently already) you must note that you must have good anodine Cataplasms to assuage pain, and good, easy, and effectual means to remove the Callus. If you apply Mercury sublimate, or Arsenic to remove the callosity of Fistulas in the great joints, you shall always 'cause a symptomatical fever, and sometimes a mortification of the part, if the party be of a cacochymical constitution.  

Anodine means.  As for the means which mitigate pain, I commend unto you Fallopius his Cataplasm which he describeth in his Treatise of Ulcers, cap. 17. And it is this: ℞ ol. ●umbrie. chamemel. & aneth. an. ℥ ij. furfur. flor. chamem. farin. hor. esypi. an. ℥ two ss, vius allagant. ʒ x. fiat cataplasma. Renew it every twelfth hour.  

How the Callus is removed.  As for the removing of the callosity, no medicament is comparable in parity with the powder of Turbith mineral, before it be washed, being mingled with Terra Lemnia, sigillata, oriental bowl, and the vomitive Vitriol; this composition may be applied, being made up in form of a trochisk, or mingled with populeon, and applied upon a tent. This medicament neither procureth extraordinary inflammation, or any horrible symptom.  
As for the mundification, consolidation, and cicatrisation of any Fistula in the joint, after the removing of the Callus, seeing these intentions may be compassed by the means which I delivered in my former Lecture, I will cease to trouble you with the repetition of them, and so will conclude this Treatise concerning Fistula's.  
If in Fistula's of the joints there be carosity of the bones, I will deliver the means to meet with this accident, when I shall discourse of the accidents of ulcers, before I make an end of this subject.   

LECT. XV. Of Herpes Exedens.  
HAving delivered unto you, what I thought pertinent of compound ulcers without malignity, method doth require, that I speak fully in like manner of malign ulcers.  

What a malign ulcer is.  Malign is that, which differing from ordinary ulcers is not easily cured. By Gal. de erisib. l. 1. c. 3. not ulcers only, but all diseases which have a malignity annexed to them, all called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. As a mild grief hath a mild cause, and no horrible, or extraordinary symptoms, and yields to ordinary medicaments: so that which is malign hath a fierce cause, extraordinary symptoms, and yields not to ordinary medicaments. These malign ulcers doc happen, when such a 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 hath possessed the ulcerate part, that it doth corrupt the good nourishment which is sent to the part affected. The aliment sent to the part is corrupted, 
How the aliment of the part is corrupted.  either by putrefaction, or a venomous quality communicated.  
Then the signs of a malign ulcer are three: First, it corrupteth the part which it invadeth, either by putrefaction, or a malign fretting quality.  
Secondly, It causeth extraordinary symptoms, as pain, and plenty of virulent and stinking matter.  
Thirdly, It yields not to ordinary medicaments.  

Differences of ●●●lig●●● ulcers.  The differences of malign ulcers are these: First, these ulcers are either ancient or modern. I call those ancient, whereof mention is made by the ancient Authors: those I call modern, which were only known to late Writers: such are those ulcers which appear in scorbutical, and pocky persons, whereof I mean not to speak in this doctrine of ulcers, because they are symptoms of the scurvy and pocks, which cannot be cured unless the griefs themselves be cured. Now the setting down of the curation of these diseases, will require large and particular Treatises.  
Of malign ulcers known to the ancients, some are less malign, some more malign. Of the less malign there are three sorts: Herpes exedens, Phagedana, and Nome. Herpes exedens 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek, 
〈…〉  being caused of thick and sharp choler, it corrodeth the skin even to the subjacent musculous flesh. It differeth from Phagedaena, because it erodeth the skin only; but Phagedaena, both the skin and subjacent flesh. Celsus lib. 5. cap. 28. thus describeth it: Herpes fit cum cutis exulceratione, & est sine altitudine, latus, sublividus, inaequalis tamen, medium que sanescit extremis affectis, &c That is, a Herpes is caused when the skin is ulcerate. It is not deep, but broad, of a livid colour, uneven; notwithstanding, the middle doth heal, the brims remaining sore. Wherefore if you perceive an ulcer to spread, and 'cause sundry other small ulcers, which reach no deeper than the skin, you may pronounce it to be Herpes exedens, or Formica ambulativa, or Corrosiva.  
One thing is to be noted in the words of Celfu●, 
●o●a.  that a Herpes exedens may be of a livid colour; & so with thick and corrupt choler, that melancholy must be joined, which is bred of Bilis atra, and so it must somewhat participate with a cancerous ulcer. And in truth, such ulcers often show themselves in old persons about the beginning of the tails of the muscles of the legs; and from these a moist noisome and stinking virulent matter will flow, and the ulcer itself will be very painful, and rebellions.  

The signs  The signs then of a Formica corrosiva are these: It only corrodeth the skin, and so is not deep, but broad; uneven it is, and sometimes of a livid or leady colour, if melancholy caused of Bilis atra be joined with thick and putrid choler: otherwise the brims of this ulcer, and the parts adjacent are of a yellowish colour, bewraying the humour, which is the material cause of this kind of ulcer.  

The Proguosticks.  As for the Prognostics: First, that Herpes exedens, which is caused only of thick and putrid choler, is not easily cured. For first, the body which is troubled with such an ulcer, is not so soon altered; for the liver, the gall itself, and the Porus biliarius must be much out of frame, when they cannot make shift to dispatch this humour by the passages appointed for the evacuations of it; to wit, by the guts, and passages of the urine; but suffer it to pass to the habit of the body by the vessels which carry nourishment; to wit, veins and arteries.  
Secondly, because this humour being altogether contrary to nature, it causeth a 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or ill constitution of the part; by the which the profitable nourishment which is sent to the part, for preservation of it, is corrupted: and so not only the part affected is defrauded of aliment, but the parts adjacent also are drawn to the same society of corruption.  
Let this be the third Prognostic: If a sincere Herpes exedens, proceeding only of thick putrid choler be hardly cured, as hath been proved; then if Bilis atra be annexed, surely the curation must be much more hard; for this is a humour which causeth more fearful symptoms; as extreme pain, greater corrosion, and rebellion to ordinary medicaments: and if the body hath gotten a habit of breeding of it, it is hard, without regeneration, to reduce it to its natural constitution, and to hinder the provent and increase of it. Alchemists promise' much, but for the most part they prove clouds without rain.  

The causes of ulcers according to the Spagyricks.  The Alchemists will have the efficient and material causes of all ulcers, to be the superfluity of the salt of the natural balsam of the body, consisting of a due proportion of salt, sulphur, & Mercury. This superfluous salt being separate from the natural balsam by the expelling faculty, it is turned sometimes to one, & sometimes to another part of the body, according as it is apt to be moved, according to its thinness or thickness, volatility or fixation. It settling in the part, it is more coagulate and calcined (the expelling faculty not being able to expel it by the pores of the skin) and so it acquireth able to expel it by the pores of the skin) and so it acquireth a certain corrosion, and is the cause of those ulcers, which luxe no malign quality accompanying the salt. They will have a volatill and subtle salt, such as is in the nettle, and crowfoot to be the cause of an Erisypelas, and Herpes miliaris; but a thicker and more fixed salt, such as that is of the Vitriol, to be the causes of these ulcers, which corrode the parts adjacent: such a salt then as it, not very thick, and throughly fixed, they will have to be the cause of Herpes exedens: but such a salt as is dense and thick, and throughly fixed, having some malignity, to be the efficient cause of a Phagedaena and Nome. This is their Philosophy of the efficient, and material causes of these ulcers. And in truth it doth fitly represent to the eye of the understanding the nature of the humour, which dogmatic Physicians will have to be the causes of ulcers. It is no heresy to maintain either opinion; but he deserveth both credit and gain, who shall perform the curation of those ulcers which the taketh in hand. Most Patients require rather speedy and easy curation of their griefs, than learned discourses of them. Howsoever, these discourses are requisite for you, who meeting sometimes with scrupulous Physicians and Patients, shall be drawn to show your Theorical as well as your Practical part.  

The curation of Herpes exedens.  As for the curation: Three intentions are required to cure a Herpes exedens: The first is, that the humour which floweth to the part be stayed. The second is, that the humour which is impacted in the part, be evacuate. The third is, the curation of the ulcer itself by convenient means.  

1. Intention purging of the body.  The first intention, which is the staying of the humour from flowing to the part affected, is performed by purging of the body from thick choler, and Bilis atra, if the Formica corro siva be of livid colour. To this purpose prescribe such a Potion ℞ electuar. lenit. ʒ vj. pulver. sanctiʒ j aq. endiviae ℥ iij. Misc. ut fiat potie. Or if the Patient be of a dainty taste, and loathe electuaries and powders, than such a potion as this which I will set down will be convenient: ℞ rhab. ʒ j fol. sen. ʒ iij. ziij. zinzib. ʒ ss. spicae ℈ ss. Infundantur istaper hor. 2. in aq. font. serventis ℥ vj. deinde lento igne exhalent ℥ iij. ac coletur decoctum, in quo dissolve mannae, & syrupi decichor. cumrhab. aut syrup. Augustan. an. ℥ j Misc. ●t fiat potie. If the body of the party troubled with the ulcer, be plethoric and cacochymical, it is convenient that he take a purgative decoction for sundry days together. I will set down such a one as a pattern; according to which you may frame unto yourselves others like unto it in efficacy. ℞ rad. eichor. malvar. horrag. an. ℥ i ss. polypod. querc. 
The d●●●tion of a decoction purgative.  ℥ ij. flor. borrag. bugloss. viol. an. pug. 1. fol. sen. & hermodactyl. an. ℥ ij. semin, anisi & faenicul. dulc. an. ʒ vj. rhab. ʒ vj. liquirit. ℥ i ss. Infundantur infundenda per noctens: in aq. font. fervent. lib. viij. sequente die adjectis reliqui● coq. ad medias ac coletur decoctum, quod aromatizetur cinan: ʒ vj. sumat ager mane lib. ss. ac tantundem hor. quarta pomeridiana. Between ten and eleven a clock in the morning, let the patient take some broth without bread, or a caudle, or aleberrie. These medicaments must be ministered cold in the summer time, and warm in the winter.  
The second intention in curing of Herpes exedens, 
●. Intention  was said to be the vacuation of the humour impacted in the part. This is effected by cathaereticall medicaments, or such as correct spungeous flesh: they are sharper than the strongest mundificatives.  

The ●●●●●ing di●●●ents of the 〈◊〉  In the momuments of the Ancients, we find the trochisks of Audron, Polyides, and Musa, exceedingly commended in such fretting and creeping ulcers: which I will set down both to case you of the enquiring of them, and the better to apprehended and understand them. The Trochisci Andronis are thus described: ℞ malicoriiʒx. alumin. ʒiiij. vitriol. ʒxij. myrrh. ʒiiij. thur. aristol. rot. gallar. an. ʒviij. sal. armoniac. ʒiiij. fiat ex omnibus pulvis. Trochises Polyida are thus set down: ℞ malicor. ʒuj. myrrh. ʒviij. alumin. ʒv. thur. ʒiiij. vitriol. ʒiij. The Trochisci Musae receive these things: ℞ alum. aloes, myrrh. vitriol. an. ʒuj. crociʒiij. malicor. ʒiiij. I should advice to calcine both the Alum and Vitriol, which enter into these Trochisks, because they more strongly dry than those which are uncalcined. No substance is so fit as Vnguentu● populaeum to make up the Trochisks. When you are to use these Trochisks, you are to beaten some of them to a subtle powder, and to mingle some of the powder with some convenient unguent, taking a dram of the powder for every ounce of the unguent: but what unguents are most fit you shall hear anon. These are the magistral means, which the Ancients used in curing spreading ulcers.  

The Topical means of the modern Surgeons.  The modern and neoterick Surgeons, not contented with these, have found out other means not inferior to these: The one is Mercuric precipitate, first nobilitate by john de Vico, and fithence his time much used by all famous Surgeons. This powder being washed with Plantain and Rose-water, and mingled with sarcoticall unguents, doth admirably heal rheumatic ulcers in tender persons. If it being unwashed be mingled with alum calcined, taking ʒ ij. of it, and ʒ j of Alum, it is a cathereticall medicament, and fit to be applied to foul and spreading ulcers, such as Herpes exedens, Phagedaena, and Nome are. The other medicament invented by the late Chemists, is the Turbith mineral precipitate by the oil of sulphur, or Vitriol; it is now much used both in the practice of Physic & Chirurgeric; it is ministered with good success to persons infected with the Neapolitan lues; if they have either Cephalas Gallica, extreme pains in their heads, or venereal ulcers. As for the use of it in the practice of Chirurgery, I dare ascribe to myself the invention of it (in these parts) without suspicion of any arrogancy. After that is precipitate and calcined, it is very white, and is an excellent escharioticall medicament, fare surpassing either Mercury sublimate or Arsenic: for it is more safe, and is not so painful: besides this, it doth not 'cause such inflammations as these do, neither doth it procure so promptly symptomatical fevers. Being washed, it is used to work these effefts which Mercury precipitate doth, but much more effectually. To 'cause these medicaments to evacuate the peccant humours out of the parts affected, you are to mingle these with Paracelsus his mundificative; taking for every ounce of the unguent, a dram either of the Mercury precipitate, or of the Turbith mineral washed, if the parties grieved be of a tender constitution: or a dram of either, washed and mingled with Alumen ustum, in that quantity as hath been said, if the bodies of the persons who are troubled with the ulcers be firm and hard, such as labouring men have. You are to continued the use of these topical means, until the ulcer spread no more, and be read, and very clean. Having the two first indications required in curing of Herpes exedens, the third indication so followeth: which is the curation of the ulcer itself.  
To effect this, two scopes are required: The first, is to fill up the cavity caused by the loss of the skin. The second, is to cicatrise the ulcers.  

How the cavity in such ulcers is filled up.  As for the first scope, those medicaments are to be used which dry strongly, yet have no corrosive faculty. Paulus Aeginet. de art. wedond. lib. 4. cap. 20. hath sundry medicaments for this grief: if you peruse the Author, and confider the descriptions, you will esteem them but sorry ones. Tagaultius in institut. Chirurgicis lib. 1. de tumoribus praet. naturam, 
cap. 8.  hath transcribed them, whom you may see: he hath done this, for no other cause (as I suppose) than this, that he had no better of his own. Ambros. Para●● lib. 6. c. 14. hath some medicaments for this grief, which are not to be contemned. The first is this: ℞ ceruse. & tut. praepar. an. ℥ j ol. ros. & adipis caprae a ℥ ij. cort. pini ℥ ss. cer. q. s. fiat unguentum. If you add to these things some lead calcined, Pomegranate-rindes and flowers beaten to powder, the unguent will be more effectual. The second is, unguentum enulatum Mercurio, which he commendeth as an infallible medicament: if to every ounce of it you add ʒ j of the flowers of brimstone, you shall not miss of your purpose. He doth give one good note, that if you perceive the brims of the ulcer more and more to be eroded, you touch them with Aqua fortis, Oleum vitrioli, or Sulphuris, for by these means, sores which seem uncurable are often healed. Hieron. Fabric. ab aq pendent. part. 2. lib. 1. cap. 28. adviseth to minister inwardly either Goats-milk, or the decoction of Sarsa pariglias, and without all doubt both are good; but there is no parity between the Goats-milk, and the decoction of Sarsa: there is none of this company, who is ignorant of the faculty of Sarsa in curing all malign, and creeping ulcers: Goats-milk may have some place, if the party be extenuare, and a Hectic fever feared.  
As for the local medicaments, he commendeth this cerat. ℞ succi depaeto ℥ iij. cera citrinae ℥ ij. rosin. pini ℥ ss. ol. myrtini ℥ ss. terebinthin. ℥ j Bulliant ista donec consumptus sit succus tabaccae, ae fiat coratum molle. I will not stick to communicate with you the description of an unguent of Tobacco which I use mine own self, neithe●●m I ashamed to prefer it before all others of this kind: the descriptions whereof I have seen. Thus than it is to be made: ℞ axung. porcin. ℥ viij colophon. ℥ iiij. cer. ℥ iij. succi de pato lib. 1. paeti contus. man. ij. coq. haec ad succi consumpt: tum adde gani●●i Elemni, vernicis alb terebinthin. an. ℥ j ac coletur unguentum. It is an excellent incarnative in wounds as well as ulcers: besides this, no better mundificative can be devised in tender bodies, if one dram of Mercury precipitate washed, or of the yellow Turbith be mingled with an ounce of it. When you perceive the ulcers to be filled up; 
How 〈◊〉 ulcers are skinned.  then skin them with this Desiccative of mine: ℞ Sevi dmar. lb. ss. Axung. porcin. ℥ iij. Cer. veruic. colophon. an. ℥ ij. hisce ab ●gne amot is insperge calaminar. in vino albo ter extinct. ℥ j Lythargyr. Plumbi calcin. Aeris usti, Henrici rub. an. ℥ ss. fiat ceratum. The two prime medicaments which are set down in Anndotaries to effect this, are Deficativum rubrum, and Vnguentum de minio, otherways called Vuguentum rubrum caphuratum. Your Emplaster de Minio doth not come near to these in efficacy. Let this which I have delivered serve for the discerning and curing of Herpes miliaris, or Formica ambulativa, or corrosiva.   

LECT. XVI. Of Phagedena end Nome.  
HAving discoursed in the former Lecture of the first kind of the less malign ulcers, which were said to be Herpes exedens, or Formica ambulativa, or corrosiva, I am to procced to the other two, to wit, Phagedaena and Nome and because they have not a small resemblance, by reason of the similitude of Symptoms, I will jointly speak of both: and because what latter barbarous writers have delivered of them is confused, I will labour diligently to distinguish them, that you shall not need to fear to talk of them before the most learned, if occasion shall be offered. These late writers, in the number of whom are Gordonius, Buyrus, Valescus de Taranta, joannes de Vigo, Petrus de Argelata, Guido de Cauliaco, and sundry others, who lived in our forefather's times, when barbarousness had exiled eloquence, and ignorance learning: and when all liberal Arts and Sciences had suffered a strange and fearful eclipse, although they set down sometimes medicaments not to be rejected; yet I would not have you to trust much to their discourses, or to labour to imitate their phrases. And as the Arabian Physicians do fare exceed these, so the Grecians are to be preferred unto the Arabians in their discourses, although they come not near unto the Arabians in seeting down remedies for the griefs.  
If you consider either the variety or pleasantness of them: for many ages together here in the West, Hippecrates, Galen, Paulus Aegineta, Oribasins, Alexander Trallianus, and the rest of the Greek Authors lay unrespected, and the Arabians only were in request, although most rudely and barbarously translated; which no judicious and impartial Preader of their monuments will or can deny. Wherefore concerning these griefs, I will deliver unto you what the Grecians, the parents of Physic, and all other liberal Arts and Sciences, have delivered methodically: As for the medicaments which are to be applied, I will pick out the best, which either the ancient or the modern writers have revealed to us: neither will I conceal from you what I have found effectual in mine own practice.  

The Etymon of the name.  〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 than is a Greek denomination, derived from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which is edo, to eat: so that 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 may be called in Latin Vlcus exedens: in English an eating ulcer.  

The significations of it.  It signifieth two things: First, it is taken for all manner of corroding ulcers, which seize not upon the skin only, but upon the subjacent flesh also: In this signification it is taken by the ancient Physicians, who flourished before Galen● time. Secondly, it is taken for a special kind of ulcer by the later Physicians, as Galen. Comment. In aphor. 45. lib. 6. aphor. Hippoc. witnesseth. And it is fit that in discourses and writings all things be set down distinctly; for this much helpeth the memory.  

The descripion of it.  It being taken thus for a particular kind of ulcer, it may be described an ulcer tumified without putrefaction, deep and corroding the parts adjacent: In that it is said to be an ulcer tumified, it is distinguished from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the third kind of eating ulcers, which corrodeth the sound parts near unto it, without any remarkable tumour, as morat large you shall hear anon. It is said to be deep, because It fretreth not only the skin, but the fleshy part also unde the skin. And by this circumstance it is distinguished from Herpos exedens, which is an exulceration of the skin only. So this kind of ulcer is not without cause called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or ulcus exedens, because it eateth and fretteth the sound parts near unto it, making them of this fame condition with the diseased.  

The mater●● cause of it.  It is caused of the bilious humour adust inclining to that melancholy humour, which is superfluous and not natural; yet it is not to be thought that it it very thick, as is that which procureth a cancer: or so thin as that which causeth Erisypelas and Herpes. This humour, by reason of the plentifulness of it, doth fill the brims of the ulcer, and causeth a swelling to appear; but by reason of its malignity and acrimony, it fretteth the parts adjacent which are sound. Nevertheless this humour is without putrefaction, which is always in the ulcer called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or ulcus depascens, an ulcer which feedeth upon the parts adjacent that are sound; for in Phagedaena there is erosion proceeding of a malign quality without putrefaction, or corruption of the whole substance, which is always joined with malignity in a 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉.  

The signs.  Then the pathognomonicall signs of a Phagedaena are these: First, it corrodeth not the skin only, as Herpes exedens doth, but the subjacent flesh also: The second is this, that in Phagedaemicall ulcers the brims are tumified: The third is, that although there is erosion of the sound parts adjacent, yet there is no putrefaction: And by these two last signs it is distinguished from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, ulcus depascens, a consuming ulcer.  
〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek, in Latin Vleus depascens, 
〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 . in English a feeding or consuming ulcer. It is derived from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, 
The Etymon,  Depascor, I feed upon: for it passing from the diseased parts, it seizeth upon the sound and whole parts, and feedeth upon them by communicating unto them both malignity and putrefaction. It may be thus described.  
〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, it is a corrosive ulcer; without any tumour in the brims, 
The 〈…〉  endued not only with malignity, but putrefaction, or corruption of the part, also feeding upon the adjacent sound parts, and that deeply. In that it is termed a corrosive ulcer or malign, it agroeth in this with Herpes miliaris and Phagedaena. But whereas it is said to be without any tumour in the brims, I mean remarkable, and to have putrefaction annexed, by these two signs it is distinguished from Phagedaena, or Vlcus oxedens, an eating ulcer: for so I think fit to name it; that in denomination also it may be known from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 ulcus depascens, a consuming or feeding ulcer. Last of all, where it is affirmed that it doth corrode not superficially only the skin, but the subjacent fleshy parts also: as it hath this common with Phagedaena, so by this it is known from Herpes exedens; for this causeth exulceration only in the skin.  

〈◊〉 and ●●lephian ulcer;  But seeing there is often mention made in the monuments of the ancient Physicians, of 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, of Chironian and Telephian ulcers, as of Galen, Paulus Aegineta, and others who follow them, it will not be amiss to discourse a little of such ulcers: that you may know what is meant by these denominations, and be able to answer any, if you be demanded what is meant by these terms.  
Of these ulcers thus speaketh Galen. de tumorib. praeter nat. c. 13. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, etc. whose discourse may be thus Englished: Those ulcers which consume, and meddle with the sound parts adjacent, or about, corroding them; all these are called Phagedaenica. So that Phagedaena is framed of the ulcer and the tumour. Herpes in like manner doth erode the parts about it; but it resteth in the skin only: but Phagedaena doth extend itself as well to the subjacent parts as to the skin. But it is to no purpose to call ulcers Chironian, or Telephian. It is sufficient to call all such ulcers 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, Maligna: that is, of an ill condition or quality. By this passage of Galen translated by me, you may gather three conclusions.  
The first is, that in a Phagedaena there is an erosion not only of the skin; but of the fleshy parts subjacent also, by the which it is distinguished from Herpes exedens, or Formica ambulativa, whereof I discoursed in my former Lecture.  
The second is, that in a Phagedaena there is a tumour in the brims of the ulcer, whereas there is none in a 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or a consuming ulcer, called by Latin Authors Vlcus depascens, to distinguish it from Vlcus exedens, an eating ulcer.  
The third is, that the denomination of Chironian and Telephian ulcers, do only signify malign ulcers in general; but no special kind of ulcer in particular. In Paulus Aegineta de art. medend. lib. 4. c. 46. bearing this inscription of ulcers of an evil condition, which are called Chironian and Telephian by Physicians: these words are read as I have translated them. Old and inveterate ulcers, which hardly admit skinning, which are named 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or malign, some call Chironian, as if they did require the hand of the Centaur Chiron, the most excellent in the Art of curing: others call them Telephian, such as Telephus was troubled with, which require the helpful hand of Achilles, who cured him. So he jumpeth with Galen, that these titles were ascribed to all malign ulcers; but did point at no particular kind of ulcer.  
Now it cannot be amiss briefly to show unto you what men Chiron and Telephus were, seeing they are so famously recorded by the Poets: They who are Scholars amongst you, cannot but be delighted when the studies of the youth are brought to remembrance. 
Chiron.  Chiron then was one of the Centaurs, which were a people who inhabited the places near to Pelion, the hill of Thessaly. These first began to break great horses, and to fight on horseback: wherefore the neighbouring people, when it first saw them, believed them to be strange creatures, composed and framed partly of humane, partly of horses members: O strange simplicitie● This Chiron was the son of Sa●●ne and Phillyra. It seemeth that he was called Chiron, because he had a singular dexterity in the manual operations of chirurgery: for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, in Greek is an hand. He taught Aesculapius the Art of curing: Pelcus, Achilles his father, was his son in law, of whose daughter Thetis he begat Achilles, so much commended for valour and strength by the Heathen Poets. He taught Achilles being his grandchild, chirurgery, playing upon the Cithern, and horsemanship. The two kinds of century, the greater and the lesser, Centaurium majus & minus, are named of him, whereof there is great use in the practice both of Physic and chirurgery. It is like that he was fortunate in the curing of malign ulcers, by reason of the great skill which he had in the knowledge of the faculty of plants. He lived but 2690. years after the creation of the world, that is, 77. years before the destruction of Troy, which fell out Anno mundi 2767. Then 2685. years are expired sithence famous Chiron lived. This may serve to prove the antiquity of chirurgery. Posterity for his worth named the ninth sign of the Zodiac Sagittarius, who ruleth the thighs, from him: From whence Virgil of the twelve Signs:  
Armatusque arcu Chiron, & corniger hircus.  
Chiron armed with bow, and the horny goat.  
By this we may gather how virtue and learning were regarded in the rude and simple ages, which are very little esteemed in these civil times, wherein most men are given to enjoy their pleasures, which will cost them too dear, when the general account shall be made.  
Telephus was one of Hercules his sons, 
Telephus.  who being adopted by the King of Mysia who then reigned, after his death succeeded him in government. When he would have hindered the Grecians marching towards Troy, from passing thorough his country, in combat he was wounded by Achilles; but afterward being reconciled to Achilles, he was cured by him, he mingling with either an unguent or a cataplasm, (for Malagma signifieth both) the rust of his spear, and it is not unlikely; for there is none here (as I suppose) who knoweth not the faculty of Crocus Martis in cicatrizing of rheumatic ulcers, it drying strongly without any sharpness; unto which the rust of old iron washed and prepared cometh very near. So Achilles made sufficient proof of his skill in the Art of chirurgery, which he learned of his grandfather Chiron. Go to then, let effeminate Hind-calves despise the Art of chirurgery, which so eminent a person as Achilles was, was not ashamed to practise. From Achilles' Millefole is called Sideritis Achillea, Achilles his Starwoort: and it may be that it was one of the chiefest ingredients of the cataplasm: surely it is an excellent healing plant. To conclude then this point: malign ulcers who are not easily cured, are called Chironia, because Chiron was able to cure them, and Telephia because Telephus was troubled long with such an one.  
Now time calleth to go forward in the handling of these corrosive ulcers: but before I set down the manner of curing, the predictions of the events which are like to fall out in the course of curation are first to be set down. I 
Presages.  Neither of both these corrosive ulcers are of easy curation, what body soever they light upon; and for three causes: for first, there is a 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, an ill constitution and temperature of the part, by the which the aliment which is sent to the part, although it be good, is corrupted. Secondly, a fresh supply of noxious humours is sent most commonly to maintain the grief. Thirdly, because the ordinary medicaments which are applied with good success most commonly to other ulcers, in these ulcers are ineffectual. II. If these ulcers light upon a cacochymical body, the case is yet worse: for the constitution of the body must be altered before these griefs can be cured, which is a matter of no small difficulty. III. If these seize upon decrepit persons, the case is in a manner desperate: for in such the natural heat is weak, and the radical moisture almost spent: so that great store of corrupt and saltish humours are bred in the bodies of such, which being sent to the weak parts ulcerate, increase these griefs.  

The intentions of curing.  The curation is performed by three means: to wit, a convenient diet, internal medicaments, and local applications: As for the diet, 
Dict.  those meats and drinks must be used which afford a laudable juice; whereof I have spoken before: and in that measure that the natural heat may be able to concoct them, that no superfluities be bred. Besides this, meats which are easily corrupted in the stomach are to be shunned, as milk meats, summer fruits, and salt meats: slimy fishes, and Swine's flesh are to be shunned, because they afford no good nourishment.  

Internal medicaments.  Of internal medicaments I mean not to speak much, because this would require a longer time than now can be permitted. If a person be troubled with an ordinary Phagedaena or Nome, be of strong constitution and plethoric, you may minister unto such Hiera Diacolocynthidos magistralis, 
Apud Rinedaeum de hieris cap. 4.  or Pilulae aggregativae majores: If the party be weak, you may minister Piluae stomachicae: Those which I use are these: ℞ Aloesʒij. Rhab. Agar. Trochiscat. an.ʒj. Mirrhae, ℈ ij. Mastich. ℈ j Syrup. Augustani, q. s. ut fiat massula. does. Pilul. 2. pond. ʒss. à primo somno: vel sumat unam paulo ante coenam, alteram paulo antequam ineatur somnus. Whether the parties be strong or weak, who are troubled with these corrosive ulcers, they are to use decoctions made of Sarsaparilla, Guajack, Radix Chinae, Tormentil, Bistort and Comfrey roots, with the which you are to join some Vulneraries, as Agrimony, the tops of S. john's wort, Sanicle, our Lady's mantle, mountain and garden Avens, Salomons seal.  

Nomae verenderum.  Nomae of the privy parts were known to the ancient writers, as we may perceive by Paulus Aeginetae de Art. med. lib. 4. c. 44. sub finem. In our times they seldom are seen to proceed from any other cause, than impure copulation. Such are often seen, in the which the whole Praepatium doth sometimes rot away. These corroding venereal ulcers require the general cure of the Neapolitan disease, besides effectual Topics.  

The application of Topical means.  Now followeth the last indication of curing these corrosive ulcers, which is the application of local medicaments. In a Phagedaena wherein there is a tumour of the brims, you are to apply Vuguentum populeum, and Vnguentum album caphuratum, mixed together in equal quantity to them. The second thing which I would have you to observe is this, that Nome, or ulcus depascens doth require stronger Topics than Phagedaena, or ulcus exedens. Mark then these medicaments which I have picked out of Aegineta: I ℞ Calcis viva, Vitriol. Vomit. an. ʒij. Auripigmentiʒj. fiat pulvis subtili● ex his. For a Phagedaena apply the unguent of Tobacco, having some of this powder mingled with it, as ʒij. for an ounce of the unguent. If you have to do with a Nome, make a lineament of this powder and Oxymel, and apply it to the ulcer. II. ℞ Vitriol. albi ℥ jss. Croci Martis, ʒuj. Gahar. ʒviij. Crocus Martis well prepared fare exceedeth their Squamae ferri, the scales of iron. Receive this medicament of my description: ℞ Calc. viv. Vitriol. albi, Auripigmenti, an ℥ j Malicor. Balanstior. cornu Cervi ust. Gallar. Pumicis calcinati, Alum. usti, rad. Aristol. rot. an. ℥ ss. Croci Martis, Plumbi calcinati, aris usti, an. ʒuj. Cum melle despumate fiat Electuarium. Let me commend unto you an Aegyptiacum which is not the vulgar: Primo infundantur absynthium, Cardum benedictus, Centanrium minus, Scordium, Chamaedries, Malicorium, Balaustia, Gallae, & rad. Aristol. rot. in aceto fortiffimo: ℞ hujus Aceti colati ℥ seven. Aerug. ℥ v. Mell. ℥ xiv. coq. lento igne ad unguenti consistentiam. This medicament is effectual in venereal ulcers of the throat, and privy parts, and in all sordid ulcers.  

How long you are to use these medicaments.  You are to continued the application of these medicaments until you see the corrosion stayed, and the ulcers read and well mundified. When you have perceived this, incarnate the ulcers with some of the consolidatives before set down by me. Last of all, cicatrise the sores with such epuloticall means as I set down in my former Lecture.  

In admonition.  But to shut up the delivery of these ulcers, which are of the mildest sort of the malign, so much as concerneth the knowing and curing of them: let me advice you that you promise' no sudden cure of any ulcer, if it hath continued but one month: for the bodies of the inhabitants of this Island, are for the most part plethoric, they will observe no good diet, and will not be estranged from the sacrifice of Venus. It is a strange thing to see what corrupt and ugly stuff is covered by the curtains of a beautiful skin, in a number of them. I make no doubt but many amongst you, who are lest employed in practice, have had sundry patients, who have come to you pretending that they were only troubled with a pimple of the forehead, a read eye, a difficulty of swallowing, shedding of the hair, watching in the night time, and pains between and in the joints: whereas indeed these griefs were venereal pustules, the Neapolitan Opthalmia, virulent ulcers of the throat, Alopecia Gallica, the vigils of Venus, & last of all the pocky joint ague. It is no hard matter to those who are judicious, to find out the symptoms of that grief, which Vigo, the father of Empyricks, doth affirm to be able to bring the accidents of all diseases in particular, according to the diversity of the constitution of the bodies upon the which it seizeth. If therefore you see any ulcers, in what part soever, more painful than the solution of such an unity requireth, that it yields not to ordinary medicaments apppointed for ulcers, than suspect that there is a latent malignity. Value not therefore your credit at a trifle, be not too bountiful in promises, jest they be required at your hands: suspect and pronounce in doubtful cases always the worst; for the best will save itself. Thus doing, you shall bring in no new practice. Many practisers there be, it is uncertain whether of ignorance or policy, who aggravate the grief of those who wholly commit themselves to them, that the greater credit and gain may redound unto themselves, if the persons diseased escape, and the less blame may be laid to their charge if they die. In these proceed there are two excellent teachers, Skill and Conscience: The first is to enable, the second is to direct practice. So much I thought good to deliver unto you of the three mildest kinds of malign ulcers, to wit, Herpes exedens, Phagedaena, and Nome.   

LECT. XVII. Of a Cancer and a cancerous ulcer.  
WHen I ceased from reading last, I put an end to the doctrine of ulcers less malign. Now am I to discourse of these ulcers which are accounted most malign, and are to indeed. Of these there are two sorts, a cancerous ulcer, and a leprous ulcer: of purpose I referred the handling of a Cancer and a cancerous ulcer to this place, because it fitteth them best, as you may perceive anon. First then, I will discourse of a cancerous tumour, and then of a cancerous ulcer. A cancerous tumour is called by Galen, de tumour. praet. nat. c. 12. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, in Latin Cancrosus tumour; It may be thus defined:  

The description of a cancerous tumour.  It is a tumour proceeding of Bilis atra, round, hard, unequal, of a leady colour, hot, very painful to the patiented, and having full veins implanted in the adjacent parts. For as a crab, in Latin Cancer, 
The cause of the name.  hath a body and feet of a livid colour, and whatsoever it claspeth with the claws, it holdeth it firmly, so this grief is of a livid colour, and so girdeth the part which it possesseth, that it seemeth to be nailed to the part, and about it the full veins exquisitely imitate the feet of a crab: and from these similitudes the tumour hath its name.  
In the description the tumour is said to proceed from Atra bilis, or melancholy, or choler adust; for it signified both: 
The differences of atra bilis.  for there are two sorts of Atra bilis: the one is caused of natural melancholy adust: the other is caused of yellow choler burned, and it is much more malign than the former. See Galen, lib. 3. de atra bile.  

The efficient causes.  There are sundry efficient causes which engender these humours in our bodies: First, a strong hot distemperature of the liver, which burneth the natural melancholy and yellow choler, and so hatcheth this Bilis atra. Secondly, according to Galen, c. 10. lib. 2. ad Glaucon. the spleen by reason of its weakness and distemperature, doth not draw unto itself the superfluous natural melancholy, and so staying long without it own proper place it is inflamed and burned. Thirdly, sometimes this humour is caused of the menstrual courses, and Hemorrhodes stopped. Fourthly, very often an ill diet breedeth this humour, as when one useth meats of an ill juice, and of a thick substance and hot quality, as garlic, onions, leeks, snails, venison, pease and beans, and such like. But there is nothing more pernicious than the immoderate use of potent and strong wines, such are all kinds of Sacks, and Greek wines, which exceedingly burn the humours in the mass of the blood. An hot air and perturbations of the mind set forward also this humour. But seeing there are degrees of malignity in Atra bilis; 
The cause of a Cancer not ulcerate and ulcerate.  the cancerous tumour, or Cancer not ulcerate, is caused of the milder sort of it; but a Cancer ulcerate is procured of that kind which is most malign.  

Why a Cancer is not bred of natural melancholy.  Take heed that you imagine not any sort of Cancer to be engendered of natural melancholy, which Galen, de art. curate. ad Glaucon. c. 10. lib. 2. affirmeth to be that part of the blood which representeth the wine leeses, when it is made by the liver, which is drawn by the spleen, wherewith it is nourished: for superfluous natural melancholy causeth only Scyrrhus.  

The material cause of a Cancer.  Of the material cause of a Cancer thus speaketh Galen, De tumour. praet. not, c. 12. When Bilis atra seateth itself in the flesh, if it be sharp it corrodeth the adjacent flesh, and doth 'cause an ulcer; but if it be milder, it procureth a Cancer without ulceration. Aeginet. lib. 6. c. 45. hath these words: A Cancer is a tumour unequal, with tumified brims, ugly to behold, of a leady colour, indolent, sometimes not ulcerate, which Hypocrates calleth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or hidden; sometimes ulcerate: And seeing it hath it beginning from Atra bilis, for the most part it becometh ulcerate: So he.  

That a Cancer can hardly be without pain.  Where you are to note, that he affirmeth a Cancer to be indolent, or without pain, which is contrary both to experience and reason: Celsus also, lib. 5. c. 28. seemeth to grant some Cancers to be without pain. For first, there is a solution of unity, by reason of plentiful matter stretching the parts, and pressing the sensible parts. Secondly, there is a very hot distemperature, by reason of the humour which cannot be discussed, which of a necessity must 'cause pain. The explication of the rest of the particles set down in the description, shall be set down in the delivery of the signs, to avoid tedious repetition of the same things.  

The signs of a Cancer.  The signs then of a cancerous tumour are these. I. According to Galen, lib. 14. method. c. 9 A Cancer in the beginning is hardly discerned: for the symptoms are but mild, and sometimes it is no bigger than a pease, or a bean, or a filbert-nut. II. It is hard, by reason of the thickness of the humour, which withstandeth the touch. III. It is of a leady colour, representing the colour of the humour whereof it is bred, yea the more malign it is, the more livid and black it appeareth. iv The tumour is very painful: First, because Atra bilis the material cause of it is hot: Secondly, because no heat can breathe out, the substance of the Cancer being so compact. V It is round, because the matter being thick, is not so apt to fleet abroad. VI It is unequal, by reason of the ebullition of the humour, which notwithstanding is not equally active in all parts of the tumour. Last of all, a Cancer bathe black or livid veins extended to the adjacent parts; for this atrabilious humour cannot sweated out of the veins, which is the cause that they appear very full.  

What parts a Cancer may possess.  As for the parts which a Cancer invadeth, although it may breed in all parts of the body, yet it is most often seen in the breasts and matrices of women, and in the lips and nose of the face. I have seen it also in ano, and in the top of the yard.  

Why it doth possess the breast.  The breasts most promptly receive this atrabilious humour, because they are of glandulous and lose substance: Besides, the Mammariae veins meet with the Vterinae under the strait muscles of the belly; so that the matrix may discharge itself of adust and feculent melancholy blood by regurgitation, which may 'cause a Cancer if it pass to the dugs.  

Why the matrix.  A Cancer in like manner doth appear very often in the matrix, by reason of the detention of the menstruous blood, which staying above the ordinary time is burned. The lips also are spungeous & soft, and so apt to receive atra bilis, the material cause of a Cancer. Galen, de art. curate. ad Glauconem, lib. 2. c. 10. hath these words: Cancerous tumours may be in all parts of the body, but chief in the paps of women, which have not their purgation according to nature. Aeginet. lib. 6. c. 45. saith; A Cancer doth happen to sundry places of the body, but chief to the matrix and paps of women.  
As for the predictions before curing, 
Prognostics.  receive these: I. Although Cancers may appear in all the quarters of the year, yet most commonly they show themselves about the ending of the summer, and during the whole time of the harvest: because in these seasons, the melancholic exceedingly increaseth, and humours become adust. II. Not Cancer is easily cured; for if all ulcerate Cancers be incurable, according to Galen, c. 5. lib. de atra bile: no cancerous tumour can easily be cured, it having the same efficient cause. III. A Cancer not ulcerate, if it hath possessed any deep cavity of the body, as the matrix or anus, it is not to be dealt withal, according to Hippoc. lib. 6. aphor. 38.  

The explication of Hypocrates.  You must understand that he meaneth the curing by excision, causticall means, or ustion: for the ulcer will not admit cicatrisation, and so the diseased parties live in continual pain and filthiness, and at the last die miserably. But he forbiddeth not the application of local means, which assuage pain and gently mundify. IU. Cancerous tumours in the outward parts, and only superficial in the beginning, may be cured according to Galen, lib. 2. c. 10. ad Glaucon. V When cancerous tumours are come to a remarkable bigness, they only can be cured by extirpation. VI If a Cancer not ulcerate hath possessed the matrix, the party feeleth great pain in the groins, and hath often a difficulty in making of water: If the Cancer be ulcerate, it sendeth out a loathsome and cadaverous smell, the vapour whereof ascending to the heart and brain, causeth sometimes fainting. VII. If the afflicted party be weak, and the cancerous tumour be inveterate, or of along continuance, it is not to be dealt withal with excision, adustion, or potential cautery: only lenitives are to be used to procure a palliative cure: for sundry have continued even to their decrepit old age, with a Cancer not ulcerate.  

The curation of a cancerous tumour.  Now it is time to address myself to the setting down of the curation of a cancerous tumour: The means appointed for it are three, dietetical, pharmaceutical, and chirurgical.  
As for the dietetical means, all thick and strong wines are to be shunned, course bread, Cabbage, and Colwoort, Cheese, old and salt flesh, old Hares, and Venison: Watching, immoderate labour and grief are to be shunned; as also all other things, which thicken the blood, and inflame the humours. Let the diet be cooling and moistening. Barley cream is good, and Ptisan, Mallow flowers and roots, Succory flowers and roots, borage, bugloss, Violet vinegar. Many commend a cataplasm of Raisms stoned, Rue, and the leaves of Nightshade. This Fabricius, ab aqua pendent. commendeth: ℞ Solan. hort. virg. aureae, sonchi, an. man. ij. coctis in aqua & contusis add far. siligin. lb. j Ol. ros. ℥ v. fiat cataplasma. The Surgeons in Italy had in Fabricius his time, a medicament of green Frogs effectual against a Cancer, and in the Gout: thus it is made; Take a good number of green Frogs, whose mouths fill with sweet butter, afterward put these Frogs in an earthen pot well glazed, having a cover, and the bottom full of holes: place this pot in the mouth of another earthen pot placed in the ground; lute these well together, and the cover of the upper pot: then for the space of three hours, let a gentle fire of Charcoal be set about the upper pot, to drive down all moisture and fat to the lower: when the pots are cold, take out the Frogs out of the upper pot, and beaten them until you feel no roughness between your fingers: Last of all, mingle the fat and moisture in the lower pot, with this substance, and keep this mixture in a clean galley-pot. Receive also this medicament from Parrey. Lib. 6. the tumour. praet. nat. c. xxx. ℞ Theriac. veter. Succi lactuc. & o. Ros. an. ℥ j Succi cancrorum ℥ ss. Vitellos ovorum induratos numero 2. Ducantur in mortario plumbeo ad unguenti consistentiam. He also in this same chapter commendeth a thin plate of reed anointed with quicksilver. 
How often the Cancer is to be dressed.  The Cancer is to be dressed morning and evening. So much then of a cancerous tumour, or a Cancer not ulcerate, now am I to deliver unto you the curation of a Cancer ulcerate.  

Of a cancerous ulcer.  A cancerous ulcer is an ugly ulcer, having a most stinking smell, thick lips, and turned outward, greenish and fretted, which yields a Sanies black, or of a dark yellow colour, and is exceeding painful Riolan the father in his chirurgery, in the second Section of ulcers, c. 13. affirmeth this sanious matter to be a strong poison. No death could be devised too cruel for such an one as should give it to a man.  

The signs.  The partials of the definition contain the signs of a Cancel ulcerate, so that I need not to insist longer in the explication of this point.  

The differences.  Of a cancerous ulcer there are two mean differences, Lupus and Noli me tangere: that is in the thigh or leg, this in the face. A Cancer in other parts of the body hath no particular denomination; but doth retain the general appellation, with addition of the part affected, as a Cancer of the breast.  

A Note.  One thing is to be noted, that in other countries, if a Lupus be troublesome, they apply the flesh of an hen, chicken, pigeon, whelp, or kitling cut asunder, according to the length: for so the fury of the disease ceaseth, the malignity of the sanies is eased, and the corrosion is stayed: Sec Riolan and Ambrose Parrey in the places before cited.  

The Prognostics.  As for the prognostics: First, if a Cancer not ulcerate be of hard curation, an ulcerate must be of an harder: Secondly, if the party be weak and feverish, the matter is desperate.  

The curation.  As for the curation, the diet, phlebotomy and purging, which I have set down for the curing of a cancerous tumour will serve here also: wherefore this only remaineth to set down the local medicaments.  

Local means.  This than shall be the first: ℞ Plumbi usti & loti, Tutiae & Thuris, an. ℥ v. Absynthii. ℥ j ol Ros. lb. ss. Cerae, ℥ jss. Succi Solani, q. s. Ducantur in mortario plumbeo ad unguenti consistentiam. Apply this upon pledgets of lint, or fine tow: above this, to assuage pain, apply a cataplasm of the leaves of Succory, marish-Mallow, and the white Poppy beaten, and tempered with oil of Roses.  
The second shall be the application of the juice of Nightshade out of Tagaultiut, tractat. de ulcer, c. 19 Moisten a double cloth in the juice of the Nightshade, and apply it to the ulcer; then apply above this cloth a pledget of tow or wool moistened in this same liquor. You may keep the juices of herbs all the year long, 
How the juice of herbs is to be kept.  by putting them in a glass, having a faucet in the bottom, and pouring oil upon the juice, that it may be three inches thick above the juice.  
You may also use the juice of our English Tobacco, and those which I named in curing of a Cancer not ulcerate.  
The distilled water of the herbs with Camphir, applied after this manner is effectual.  
If you dissolve the Camphir first in the spirit of wine, it will mingle the better with the waters: ℞ Mellis verbascini, ℥ ij. pulv. Malicor. ʒiij. ol. Nuc. ℥ j Misc.  
This medicament of Fallopius is excellent: ℞ ol. Ros. & Omphacini, 
De ulcerib. c. 12.  an. ℥ vj. ol. Myrtini & unguent. popul. an. ℥ iij. fol. Solan. & Plantag. an. man. ij. Bulliant lentissimo igne ad Succorum consumptionem, tum colentur: colatura adde cera ℥ iiij. hac eliquata omnia amoveantur ab igne: Quum adhue tepent add lithargyr. ℥ vj. Cerussae. ℥ ij. Tutiae, ʒij. Plumbi ustiʒijss. Ducantur in mortario plumbeo per duas horas. All these medicaments which I have set down only are to stay the increase of a Cancer, and to abate the raging pain in those Cancers which are large and deep.  

The use of corrosives.  If a Cancer be but superficial, it may be eaten out with Arsenic sublimed: The manner of the sublimation of it and use I did show, when I discoursed of Fistula's.  

The curation of a Noli me tangere.  A Noli me tangere in the lip, if it hath not eroded a great quantity, it may be cured as an harelip, with little deformity.  

For a Cancer in the matrix or anus.  As for a Cancer in the matrix or anus, use this medicament: ℞ Stercor. bubul. lb. iiij. herb. Robert. Plantag. Sempervivi, Hyoscyami, Portular. Lacturend. an. man. j Canc. fluviat. numero 12. Contundantur omnia, ac distillentur in Alembico plumbeo, imbuatur caphura, ac frequentèr injiciatur aut sola, aut cum aqua spermat. ranar. As for the method of the extirpation of a Cancer, I will reserve it to that part of chirurgery which teacheth the way to remove things inconvenient to nature, called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉.  

Medicaments in the shops.  The medicaments in the Apothecary's shops fit for Cancers are, Vnguentum de tutia, de lithargyr. de minio, De siccativum rubrum. 
empyrical means.  Fabricius ab aq. pendent. de tumour. c. 3. setteth down a method whereby an Empiric cured sundry Noli me tangeres, and Cancers in other places: and it is this, ℞ Vitriol. lb. jss. Auripigment. Sulphur. vivi, an. ℥ iiij. Sal. gemm. ℥ iij. cum aceto fiat pasta. In ollaterrea probè lutata siccetur in furne. With this powder he consumed the Cancer, but by divers applications.  

How we shall know a Cancer to be exstirpate.  You shall know that the Cancer is quite extirpate, if laudable flesh appear, like to the seeds of the Pomegranate, if it yield good quittor, and no sanious and stinking matter: then he healed it with this unguent: ℞ Mell. despumat. ℥ iiij. Sevi hircin. limatur. capri, an. ℥ jss. Litharg. auri, ℥ j Misc. Another in Essex about thirty years ago, in curing of Cancers, used only the green Treat, and white Vitriol, for every ounce of the Treat taking ℥ j of the Vitriol: and by all likelihood the medicament of pain the Smith, with the which he went about to cure Noli me tangeres, was but a medicament composed of Arsenic, Orpiment, unslaked Lime, Bole and sweet Butter. You see how I conceal nothing from you.  

The cause of Cancers according to Chemists.  The Chemists will have arsenical, realgarian, and orpimentall substances separated from the natural balsam, or composition of the body, to be the causes of these cancerous tumours and ulcers, when they settle in the parts, and cannot be discussed: howsoever, they represent fitly the nature of a Cancer: for as it is, so are they of a putrefactive quality. Let no man marvel, that sundry minerals may be in the body, seeing we see stones in the gall, kidneys, and bladder  

The manner how to cure Cancers according to Alchemists.  For the curing of Cancers they commend Antimony so prepared, as it doth not vomit, or trouble they body; but either procureth sweat, or purgeth downward: and indeed it is an excellent medicament: for it changeth the constitution of the body, and mundifieth the mass of blood.  

Their Topics.  As for the Topics, use the oil of Arsenic, or whereof Mercury's vitae is made, mixed with oil of Roses in due proportion, and these two have no fellows; for I protest, I have often made experiment of both. If any the desirous to know, and make use of any thing which I have delivered, I will not be nice to impart it.   

LECT. XVIII. Of the Leprosy and a leprous ulcer.  
NOw followeth the second kind of ulcers most malign; to wit, a leprous ulcer. But first of all, I will discourse of the Leprosy itself, and then of the nature of a leprous ulcer.  

The names of it.  The Leprosy in the Greek and Latin tongue is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, scaber, rough: for it maketh the skin rough and uneven: or from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, squama, or cortex, a scale or bark, because it sendeth our scales, & maketh the skin rough like to the bark of a tree. 
The divers kinds of leprosity.  There be two sorts of leprosity: to wit, the Graecian and Arabian Leprosy.  
The Graecian leprosity may be thus described: It is a tumour with a confirmed hot any dry distemperature of the skin, both in the outer and inner part of it, wherein scales, like those of fishes, are sent out: so that Pruritus, Scabies, and Lepra Graecorum, the itch, scabbiness, and the Grecian leprosity differ only in degrees of tumifaction, and distemperature.  

The difference between itching, scabbines, and the Greek leprosy.  In itching there is no remarkable tumour, neither doth any thing fall away from the Cuticula, unless it be fetched away by hard scratching. In scabbiness there is a remarkable tumour, and whether we scartch or not, both sanious matter, and scales like to the cast skin of a snake. In the Grecian Leprosy, there are greater tumours than in scabbines, and bodies like unto the scales of fishes, fall from such as are possessed with this grief: so that Avenzoar fitly calleth scabbiness Pruritum vesicalem, a blistery or powckie itching, but the Grecian leprosity Pruritum squamosum, a scaly itching.  

The signs.  The signs of this Leprosy are these: the skin is dry, rough, and full of small knobs, which itch exceedingly, and sendeth out bodies like to the scales of fishes.  

The causes.  The causes of it, are either the external efficient causes, or the internal material.  

The efficient.  The external efficient, are I. unwholesome meats and drinks.  
II. slovenliness, sluttishness, and filthiness. Serenus the poetical Physician hath comprised these two causes learnedly in two Hexameter verses thus:  
Illotus sudor & inopia nobilis escae  
Sape gravi scabie correptos asperat artus.  
Sweated not washed away, and want of good food, often do make rough the limbs, being taken with noisome scabbiness.  
III. The menstrual courses, or hemorrhodes which were wont to flow, being suppressed, may 'cause this disease.  
IU fontanelles which have long been kept open, being shut up may procure the same.  
V Varices, the veins tumified by reason of melancholy blood, being cured, sometimes are the causes of this grief.  

The material cause.  The material causes are discerned by the colour of the grief: for if the knobs be of a livid or leady colour, superfluous impure melancholy is the cause; if they be white, or of a grayish colour, than salt phlegm is predominant, which is mingled with melancholy: and because aged persons multiply salt phlegm, they are often troubled with this grief.  

The presages,  As for the Presages, let this be the first: this grief if it be habitual, and of a long continuance, it is not easily cured.  
Secondly, if it be neglected, it may turn to the Leprosy of the Arabians.  
pointed for them: for throughout the whole year they eat cabbage salted, much cheese, old butter, and flesh dried in the smoke, but most of all bacon. In like manner it is familiar to Egypt: because there they eat much asses-flesh, and drink standing and corrupt waters, if you except those who inhabit places near to Nilus. Lucretius learnedly expresseth this, lib. 6. the nature. rerum.  
Est Elephas morbus qui propter stumina Nili  
Gignitur, Aegypti inmedio, neque praterea usquam.  
The Leprosy is a disease which is bred by the River of Nilus, in the middle of Egypt, and no where else.  
Hence it is that Moses threateneth the disobedient jews thus, Deut. 28. vers. 27. The Lord will smite thee with the botch of Egypt, and with the emerods, and with the scab, and with the itch, whereof thou canst not be healed. In the Hebrew Text, it is with the ulcer of Egypt, whereby is meant the Leprosy; by the scab, he meaneth the Greek Leprosy, whereof I have spoken. In Spain and afric it is more common than any where else. In the Province of France, Delphinat, Languedock, and in Aquitane it is more frequent than in other parts of the country, Paraeus l. 19 ca 6. Before the time of Pompey it was not seen in Italy, as witnesseth Plin. nat. hist. l. 26. c. 1.  
Secondly, the Leprosy may be taken by having carnal copulation with an infected person, see Gordon. l. wed. particul. 1. ca 22. and Philippus Schopfius in his Treatise of the Leprosy.  
Thirdly, the Arabians, Avicen, Albucasis, and Averoes, think that if a woman conceive while her courses flow, the child will prove leprous, but it is not likely: for that blood in sound women is good, and after conception it is retained to nourish the child: so that if that blood were veromous (as some think) no man or woman could be sound.  
Fourthly, this disease being often heredetary, it is propagate from the parents to the children.  
Fifthly, continual conversation with leprous persons cannot be but very dangerous, for if one may become Pthisick, by often receiving the breath of one who is troubled with that grief, according to Glassick Authors, much more may one be infected by receiving the air infected with the breath of a leprous person, which is most corrupt and stinking: wherefore lazarous persons, in every well ordered place, devil by themselves, that they infect not others; and so God himself commanded, Levit. 13.4. and Numb. 12.14.  

The material cause and differences of the Leprosy.  The internal material cause, by all is concluded to be Bilis atra. Now seeing this humour is caused of three several humours altered from their natural qualities, three kinds of Leprosy do spring.  
First, it is caused of the superfluous melancholy juice burned; this Leprosy causeth the skin to be of a ruddy black colour: this kind of leprosity cometh on but slowly, and hath milder symptoms.  
The second is of yellow vitelline choler adust: This speedily corrupteth the inner parts, chief the liver and spleen, and from thence palling furiously to the habit of the body, produceth horrible symptoms: in this kind of Leprosy the skin is of a yellowish colour, tending to green.  
The third is caused of salt or nitrous phlegm burned: In this the colour is a palish white colour, the Leprosy which is caused of this humour, is not so fierce as the former. There be two other differences taken from the progression of the disease: for a Leprosy is either in the beginning, or consummate.  

The signs of the Leprosy beginning.  The signs of a Leprosy beginning, are these: The face seemeth to be of a livid reddish colour, the breathing is with some difficulty, the voice seemeth to be somewhat hoarse, livid spots appear in sundry parts of the body, the skin beginneth to lose its exquisite feeling, the urine is muddy and thick. 
Nat. hist. l. 26. cap. 1.  Pliny affirmeth, that it was not seen in Rome before the time of Pompey, and began first in the nostril, not exceeding the bigness of a lentil, and from thence passed to the whole body, producing spots of divers colours, making the skin unequal, and raising scurses, and hard scabs.  

The signs of the Leprosy confirmed.  The signs of a confirmed Leprosy are these: I The skin loseth altogether its feeling, so that you may thrust a needle thorough it, without any offence to the diseased party; this happeneth because the humour, by reason of its thickness, stoppeth the sinews, and so hindereth the animal spirit to pass. Nevertheless, the muscles move, although sluggishly; because they have veins and arteries, by whose blood and spirit they are fed.  
II. Knobs appear in sundry parts of the body, but chief in the face, about the forehead; the ears become thin, the nose flat upward, the lips thick.  
III. The face is of a leady reddishnesse.  
iv The voice becometh very hoarse, the lungs and windpipe being affected.  
V The eyes become round, the thickness of the humour bearing in the corners.  
VI When the grief is consummate, warts very often do appear throughout the whole body, like to hailstones, as we see in measly hogs.  
VII. Levinus Lemnius affirmeth, that the powder of lead calcined will swim in the urine of leprous persons, 
De occult. nat. mirac. l. 2. c. 52.  but sink in the urines of all others.  
VIII. They are troubled with much belching.  
IX. Their sweat and breath is most stinking; their breathing is with difficulty and stinking, by reason of the constriction of the breast.  
X. The hair of the head beginneth to fall, that of the beard to grow thinner, and those of the eyebrows and eyelids to fall also: this falleth out, because corrupt nourishment is sent to the hair, for if you pull out a few of their hairs, you shall also pull out with the roots a fleshy substance.  
XI. The nostrils without are tumified, but within they are narrow, and ulcerate.  
XII. The veins under the tongue seem varicous, small knobs also like to hailstones appear there.  
XIII. The skin is unctuous, and will not admit water.  
XIV. The skin is wrinkled, and full of wrinkles and chaps, as an Elephant's skin is.  
XV. The muscles of the thumb waste.  
XVI. If the body, the fingers, and toes have stinking ulcers, and chaps, you need not much to doubt.  
XVII. If you open a vein, it will be thick, burned, feculent, and have as it were fat upon the top, and it being strained thorough a cloth, leaveth a greety substance behind it.  
Now it is time to address myself to the Prognostics, whereof this shall be the first: A leprosy in the very beginning is hardly cured, for the material cause of it is Atrabilis: now all disease? of Bili● atra are of hard curation.  
Secondly, a Leprosy consummate is altogether incurable by Art.  
Now the means of curing a Leprosy beginning, 
The means of curing.  are three: dietetical, pharmaceutical, and chirurgical.  
As for the diet: 
The diet.  That which I delivered for a cancerous tumour and ulcer, in the former Lecture, in this grief is also effectual, so that I need not idly to spend the time. It is fit that leprous persons eat of the biggest Snails dressed as Wilks, or Perwinkles; and Frogs, and that for a month together; for this food doth exceedingly contemperate the heat of the blood: the water also distilled of them is good to be drunk. Rodericus Fonseca commendeth this drink: 
Consult. 66.  ℞ rad. chin. ℥ j succi limon. ℥ iij. aq. cichor. lib. vj. Infund. per diem natural. deinde coq. in B. M. per hor. iiij. vase bene clauso, decoctum postquam refrixit coletur: This same China will serve the second time, but to the third decoction you must have new China. The flesh of Vipers or Adders eaten, is good: let them be boiled in water, with some salt and oil; eat both the flesh and broth, but the heads, tails, and  must be taken away: the trochisks of the Vipers or Adders are good, being ministered in Succory water: Poultry also fed with paste made with the flesh of these, and Barley-flowre is good, if it be used a long time; Coral and Pearl prepared, ministered in broths, are excellent; young Hares in March are good. 
Isagog. c. 12.  Galen commendeth the Viper wine, and setteth down the histories of sundry who were cured by the use of it. And Aretaeus lib. 4. cap. 12. de signis ac causis acutorum: but that preparations of vipers ministered in a confirmed Leprosy, Erust. part. 4. disput. count. Paracel and Palmarius lib. de morbis contag. witness to be ineffectual, for they made trial of them.  
The pharmaceutical means are of two sorts: for either they are Catharticall, or Specifical. Amongst the Catharticall means, ℈ j of the extract of black Ellebore is excellent: the next is the purgative, or Diaphoretic Antimony: the third is the flowers of the Regulus, ministering gr. viij. in conserve of Roses: the fourth is the infusion of the glass itself, mingling with it a spoonful of the syrup of Violets; Mercury precipitate with gold is admirable, gr. iij. are enough for a dose.  
As for Specifical means, these are commended: the decoctions of the Elm, Larix-tree, the roots of Tamarisk, Caterach, Fumiterrie, and Juniper-berries, boiled as Guajack is, and drunken for a long time; three ounces of Strawberry water, or of the Cuscuta, Dodder taken morning and evening. Crollius commendeth ℈ j or ℈ ij. Spiritus tartari in aqua conveniente, or gr. 7. of the spirit of salt ministered after the same manner, gr. vj. Bezoar similiter laudantur, for it withstandeth malignity.  

chirurgical means.  As for Chirugicall means, they are two; Phlebotomy, & local applications: If Phlebotomy be required, open the Saphena about the change, or the Hemorrhodes, but take not much blood at a time, for leprous persons are weak.  
As for the local means, they are either baths or liniments; this bath is commended, Take of Crowfoot ten 
Baths.  handfuls, of Colts-foot five handful, of Tobacco two handful and a half; boil these in a sufficient quantity of spring water: use this morning and evening, until the body yields no filth.  
Of all other liniments, Roderic. Fonsec. consult. 1. 
Liniments.  commendeth this: ℞ viperas duas quas nulla parte rejecta inde phialae vitrea continent. lb. ij. Ol. ol. veter. exponatur rubru●● & fatens, hoc ●leo inunguentur axillae, inguina, carpi. Intu● autem exhibeaturʒj. Trochis. Exviperis, velcolubr. in ℥ iij. aq. card. benedict. & ℥ j syrup. aceto fit curi, per dies 14. To these ulcers apply a linement made of this oil, and Goats-suet, taking eqnall quantity of both. We may make an effectual Oil of our Adders to this same purpose. 
Oil of Adders.  Gardanus used to anoint the Spina, Joints, and Pulses of hands and feet with the fat of Vipers, for the space of seven days in a hothouse, & affirmeth, that be not only did mitigate the Leprosy, but did cure also consumptions of the body, and the Pthysis itself. If you have not these medicaments at hand, you may apply such as I set down for the curing of a cancer, in my former Lecture: which require no repetition.   

LECT. XIX. Of the abating of superfluous flesh.  
HAving set down the main differences of ulcers, and the method and means how to cure them, I must discourse in like manner of the accidents of ulcers, which may hinder the prime intentions of curing of them, and so prove a let and impediment to you in your proceed.  
to those medicaments which are called Cathaeretica, 
The nature of cathaereticall medicaments  Auferentia,. which take away the superfluous fungous' flesh. These are not so hot as either escatoricall, or septick medicants, and those which blister: yet hot they are, and burn, although gently; being then hot and dry in the fourth degree, they are of a thick and astringent substance: wherefore such medicaments pierce not deep, partly by reason of their thick substance, partly by reason of their rebated heat; wherefore these only superficially dry and corrode the flesh. Neither do they 'cause any great pain, because their heat is not very Intense, unless they be graduate by the admixtion of some other things. So we see Mercury precipitate, or burned Alum, if either of them be applied to any sore, to 'cause no great pain; but if they be used being mixed, both to 'cause pain, and a small eschar. Such are Alum calcined, Shells burned, the powder of Hermodactils, Asphodill, Vergidrasse, but Mercury precipitate excelleth, and exceedeth all these: for it doth work with small pain, and doth by concoction make thick, thin, and ichorous quittor: yea it being washed, and mingled in small quantity with incarnative unguents, furthereth their operation. The yellow Turbith mineral exceedeth it in faculty, for the oil of Vitriol or Sulphur, whereof the Turbith mineral is precipitate, is more familiar to nature, and astringent, than the Aqua fortis, or Aqua regis, whereof the precipitate is made.  
Two Cathereticall unguents are much used, Vnguentum Apostolorum, and Vnguentum Aegyptiacum.  
Of these two, the Aegyptiacum is the strongest: 
Vnguentum Aegyptiacum.  In plain ulcers I would not advice you to use it, for it spreadeth, and by touching the sound part causeth great pain. It is effectual in fretting sores of the mouth, and sinewous ulcers, being dissolved, either in decoctions, or distilled waters convenient tor the kind of sore.  
As for Vnguentum Apostolorum, 
Vnguentum Apostolorum.  if it be made according to Art, it is a cathereticall medicament in tender bodies; but only a mundificative in those who have a firm and solid constitution of body.  
It falleth out many times, 
How hard and stubborn proud flesh is to be abated.  that the superfluous flesh is so hard and compact, that it contemneth all cathereticall medicament, and cannot be abated by them. In this course we are to have recourse to those medicaments which are called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or Putrefacientia, or rotting the part; and to those which are named 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or Crustam inducentia, which leave an eschar or crust after they are applied.  
As for the Escharoticall medicaments, 
〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉  which are called Exedentia, or eating medicines, seeing they corrupt the natural heat, they must be hot above the third degree, and have a thick, viscous, and terrestrial substance; wherefore by reason of their heat in the fourth degree, they burn the part, and by reason of their thick and terrestrial substance, the heat is kept durable and permanent. And we see that Pepper, Onions, and such like, although they be hot above the third degree, yet they are not caustick; and the reason is, because although they inflame, yet because their heat is placed in a thin and subtle substance, it is more easily dissolved, and at last overcome by the natural heat of our bodies.  
So when a Caustick is applied, notable pain is caused: 
Why caustick medicaments are painful.  First, by reason of their extraordinary and exceeding great heat.  
Secondly, because by reason of their terrestrial substance, they are long in piercing thorough the part.  
Of these medicaments two are most used: the Lapis infernalis, 
Lapis infernalis.  and the white Caustick. I mean not to trouble you with the setting down of their preparations, because they are sufficiently known unto all who have profited any thing in the study and practice of chirurgery.  
Of these two, the Lapis infernalis is most effectual, & worketh most speedily; wherefore it is most fit for making of fontanels, where it may be conveniently applied to the upper part of the member, and be hindered from spreading: 
The white Caustick.  but if a caustick medicament be to be applied to a depending part, and where there is fear of running, than the white Caustick is most convenient. Besides these, two other escharoticall medicaments I will commend unto you.  

Mercury sublimate.  The first is Mercury sublimate, mingled with Roman Vitriol calcined, until it become read, and the true Terra sigillata.  

Turbith mineral unwashed.  The second, the Turbith mineral mingled with these same; but whilst it is white and not washed. These do work more gently, if they be mingled with any narcoticall or anodine unguent, than when they are applied to any fore without mixture. But the Turbith mineral far exceedeth the Mercury sublimate, because it is more familiar to nature, & doth not 'cause such pain; besides, it is not so volatile and piercing as the sublimate is, which in tender bodies assaulting the heart itself, doth cause sharp diaries, although they be but symptomatical.  

Of the nature of Septicall medicaments.  For the suppressing of rebellious excressing flesh in ulcers, the second means I appointed those to be which are called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or putrifacentia, corrupting medicaments. These are not so hot as those medicaments which procure an eschar, or crust, they have a more thin substance, and subtle, and have not so much terrestreitie, or astriction. These do more easily pierce, and so 'cause not so great pain: the pain which these medicaments cause is pungitive, as if needles did prick being made read hot, and it quickly ceaseth. And as caustick medicaments leave the part corrupted in manner of a crust, so these leave that which they corrupt soft, 
Septick Medicaments.  moist, and of a blackish colour. If you will require medicaments moist, endued with such a faculty, have recourse to the oil of Vitriol, the oil of Sulphur, Aqua fortis, and Aqua regis. But if you will have solid and hard medicaments, then call to aid all sorts of Arsenic, as the white, yellow, and read, passing under the names of Ratsbane, Orpiment, and Roses-ager.  

Septick Vegetables.  As for the Septick Vegetables, because they rather mortify the inward parts, if they be ignorantly or maliciously ministered, then abate proud flesh in ulcers, as Dryopteris, the Ferne of the Oak, and Aconitum, or Leopards-bane, and such like, I will leave them to the consideration of the Italian and Spanish poisoners.  

Whether superfluous flesh may not be taken away by instruments.  But being appointed to read a chirurgical Lecture, and having only made mention of abating of superfluous flesh in ulcers, by the application of topical medicaments, you may demand of me whether this may not be effected by chirurgical instruments, as actual cauteries, and incision-knives and razors. Truly hitherto I have deferred the mention of this kind of curing, because God of his bounty in these later times hath in all faculties revealed many things which were kept from our forefathers. If a patiented resolute offer himself to a skilful Chirurgeon to be cured, let the Chirurgeon, 
When instruments are not to be used.  in God's name, in extremities use iron and steel: yet let me advice him not to be too forward in three cases. I. If the party be of a tender constitution, and unwilling for if a Chirurgeon do altogether urge these extremities, he may loose his patiented, who is prompt to harken to the Syrenian speeches of deluding Knaves and Queans. II. If you cannot handsomely come to the part, as if the ulcer be sinuous. III. If the superfluous flesh require not only abating, but drying also, it being marvellous moist, than the medicament is better than the instrument, because it drieth more powerfully.  
Now to end this Lecture, I will deliver unto you a medicament of famous Fallopius, which is effectual both in correcting of stubborn superfluous flesh, and in curing of Cancers: the description of it is this: ℞ Arsen. crystalline. 
De ulcerib. c. 18  & Citri● an. ʒss. Aristol. rot. Aerugin. an.ʒj. Opii, ℈ ij. Axung. porcin. ℥ jss. Misc. Ut fiat unguentum. One thing I had almost let pass, to wit, the description of cathereticall lint; use this of Fallopius his description: ℞ Aq. Plantag. Ros. 
Ibid.  Solani an. ℥ iiij. Opii, ℈ j Medullapanis, ℥ ij. Mercur. ssublimat. ℈ iiij. super porphyritidem triti. Omnia haec commixta bulliant ad consumptionem medietatis: deinde colentur per pannum crassi●sculum. Fila excerpta bulliant aliquandin in hoc liquore, postea eximantur, exprimantur, siccentur ac serventur ad usum. So much then concerning abating of superfluous flesh in ulcers.   

LECT. XX. Of the scaling of corrupt bones.  
Having in my last Lecture set down the fountains from whence all the accidents of ulcers do spring, and having discoursed of the manner of curing of an ulcer, wherein there is excrescense of superfluous flesh, which was set down to be the prime accident flowing from things according to nature, I must be carried to the second accident, proceeding from things according to nature, which is the cariositie of the bone.  
Now seeing the bones are the stays and props of the body, appointed not only for local motion; but for the parts also which further this action, as muscles, veins, nerves, arteries, I am with the greater care to set down the curation of an ulcer, with the cariositie of a bone, seeing so many things of importance do depend upon the curation of such an ulcer. In running over the whole course of chirurgery, I have resolved upon this first trial, to set down only the general practices, which they who are judicious may apply to all persons and parts in special. In handling of this accident, I will set down these four points. I. The causes which procure the cariositie of the bones. II. The signs of a corrupt bone. III. The prognostics or an ulcer, wherein there is a cariositie of the bone: And four Of the means which are to be used for removing of this accident.  

The causes of the corruption of the bones.  Now the causes which procure the corruption of the bones, are either external, or internal. The external causes are two, to wit, too great cold, 
1. Externall.  and too great heat: for as too great cold doth quench the natural heat of the bone; so immoderate heat, by discussing the natural humidity, drieth and corrupteth the bones. 
2. The internal.   
The internal causes which most frequently produce this accident, are in number three. The first is a glutinous and superfluous humidity, first softening, and then corrupting of the bone, which oftentimes doth cause a distortion of the member, and a protuberance of the bone, which I have sundry times seen, and have noted not to have proceeded from any venereal cause. Such an humour seized upon one, whose name was james Wilkinson, who dwelled near to me when I practised in the city of Chester, and caused a bending outward of both the shinbones, or Ossa tibia: this happened to him when he was above sixty years old: neither did this accident either cause nocturnal or diurnal pain, or hinder his going. Before this did befall him, he had a great evacuation of blood (by reason of the rapture of a vessel in his left kidney) together with his urine, of the which I cured him by the decoction of some of the Myrobalans.  
The second inward cause of the cariositie of bones, is a sharp and malign matter, which by touching doth corrupt the bone: this happened) most commonly in old and inveterate ulcers: the Periostium being once croded by the acrimony of the Sanies, it presently corrupteth the bone. It is no marvel that a sharp humour is able to corrupt bones in other parts of the body, when we see the teeth to be hollowed by a sharp rheum, which a file of tempered steel doth with some difficulty raze.  
The third inward cause is an hidden and strange qualify of the humour, adverse to the bones, seizing not only upon some particular bones, but upon some parts also of these bones: for if it did with any manifest quality corrupt the bones, it would first have eroded the flesh: this being most subject to the impression of any fretting humour. But the bones very often are found to be carious, when the parts covering the bones, as the Cuticula cutis, and Membrana carnosa are found whole. So when Nodes invade the Citizens of Naples, they appear most commonly in the Os frontis, or in the Vlna, or Tibia, and that between the joints: Who is able to give a demonstrative reason of this invasion? He undoubtedly who is able to show why the Loadstone draweth Iron, and the Amber and Jet Chaff.  

The signs of the corruption of the bones.  The signs discovering the cariositie of a bone, are either sensual, or intellectual.  
The sensual are in number five.  
I. Is if the bone appear black and fretted: 
1. Sensual.  Blackness is caused by the corruption of the natural temperature, by the which it is kept always white with a ruddy glimpse, or of an horseflesh colour almost. Cariositie is caused by the acrimony of humour fretting the substance of the bone.  
II. Is, when the bone being felt with a probe, doth not appear smooth, but rugged.  
III. Is, if the probe slip not being guided into the bone; for then the Periostium must be gone, and so the bone either more or less corrupted, partly by reason of the air, partly by reason of the quittor settling upon the bone.  
iv Is, if the flesh ulcerate above the bone appear soft and spungeous, or of a livid colour, it is to be doubted that the bone is corrupted: for when the bone is carious, the flesh is made soft and corrupt, so that any one may thrust a probe thorough it, without any great annoyance to the party.  
V Is this: if a tent or pledget reaching to the bone stink the next day when it is taken out, there is just occasion offered to suspect that the bone is carious.  

2. Intellectual.  The intellectual signs are in number four.  
I. Is, if more quittor doth flow from the ulcer, than the bigness of it seemeth to afford.  
II. Is, if thin and stinking sanies doth flow from the the sore, it is probable that the bone is foul.  
III. If an ulcer admit skinning, and often break up again, it may not without cause be doubted that the bone is foul: for an humour still flowing from the corrupt bone, doth cause a new inflammation, whereby the skin of a new is broken.  
iv Is this. If an ulcer hath continued a long time, and is rebellious to proper medicaments, it may be thought that the bone is carious being much moistened, and so made soft by the quittor: and therefore must be scaled.  
As for the Prognostics: 
Aphor. 45. sect. 6. Prognoses. 1.  Of such ulcers as are accompanied with cariositie of the bone, receive these.  
I No ulcer accompanied with the cariositie of the bone is of easy curation: for it hath a malignity annexed to the solution of unity.  
II. If there happen a cariositie passing the first table in either of the bones above the eyebrows, it will be an hard matter to cicatrise it: If this be a true Aphorism in wounds dividing these parts, how much more true in ulcers: those ondy causing a solution of unity by an external cause; but these eroding the parts by an internal humour: which for the most part is still supplied by some notable distemperature of some noble part.  
III. Shall be this: If any of the Vertebrae of the Spina prove foul, shun the cure: for first the substance of the Vertebrae being hollow, they will hardly scale: Secondly, it is an hard matter to come to apply a medicament unto them, by reason of the muscles placed above them. Thirdly, because it is an hard matter to shun the pairs of sinews, which spring from the transverse processes of them.  
Let this be the fourth: If in ulcers of the breast, the Sternum or ribs be foul, be not too forward to meddle with them; for the acrimony of the quittor may easily corrode and pierce thorough the entercost all muscles, and the Pleara, and so lay open to the air the vital parts, which ere it be long, must 'cause an extinction of the natural heat, and so death itself.  
The fifth shall be this Ulcers in the great joints, as the elbows, knees, or ankles, wherein there is a cariositie of the bones, with loss of the cartilages, are for the most part uncurable, because the pain in the joints is great, depriving the diseased persons of their natural rest and sleep, and so of good digestion and concoction of their food: besides this, they seldom fall out alone, but bring with them a Marasmu●, or extenuation of the body.  

How the ●tio●● o● a bone 〈…〉 is to be cured.  Having set down the causes, signs, and presages of the cariositie of a bone, I am to show the way how the cariositie is to be removed. To perform this task, two things are to be done: First of all, the bone is to be laid bore, and no less of it than is to be sc●l●●: Secondly, the scaling of it is to be procured by conv●●●●●● means.  

How the bone is to be laid bore.  The discovering of the bone is to be procured three manner of ways; to wit, by Incision, Exesion, or Dilatation.  
As tor Incision: 
〈◊〉 By incision.  we are not to use it where the bones lie deep, and have muscles, tendons, veins and arteries above them, as in the thighs & arms chief to the inner parts. Secondly, although the bones lie not deep, if they have many tendons above them, we cannot use Incision safely: such ate the bones of the Metacarpium, or the upper distance between the wrist and fingers, and the bones of the Metapedium or Metatarsus, which are articulate with the toes.  

2. By exesion.  Exesion is performed by potential cauteries; as Lapis infernalis, the white Caustick, the powders set down by me, when I discoursed of Fistula's and cancerous ulcers.  

Where potential cauteries are not to be used.  These are not to be used where many tendons or nerves are, jest they deprive some parts of their motion, and cause convulsions, by reason of the great pain which they, procure, as also symptomatical fevers. Potential cauteries are most convenient, when there is cariositie in the Cranium, the Ulna, or Tibia.  

3. Dilatation.  Dilatation, or enlarging of a narrow sore, by stretching out the circumference of it, is performed by such things as swell, when they have imbibed any moisture, as the roots of Gentian, the pith of the Eldar, and sponges brought close together, either by thread, or the Melilot Emplaster.  

When this is convenient.  These are fit to be used in ulcers which possess the back of the hand, or the instep of the foot. The bone being by some of these means laid bore, I am to show you how the bone is to be scaled.  

How the bone is to be scaled.  This is to be performed three manner of ways, to wit, by medicaments, instruments, or actual cautery.  

1. Desquamatorie medicaments.  The medicaments which procure the scaling of a bone aught to be very drying, and of a subtle and thin substance: for the found bone, being assisted and strengthened by such drying medicaments, sendeth forth of itself flesh, which being increased, separateth the corrupt bone from the sound.  

Degrees of desquamatorie medicaments.  These Desquamatorie medicaments are of three degrees. For some are mild, as the root of Peucedanum, or Sowfennill, Aristolochia rotunda, the root of Iris, and Myrrh: these will serve if the cariositie of the bone be but superficial, and the constitution of the party soft and tractable.  
Some again are yet more drying and strong, as that medicament of Avicenna, which is composed of equal parts of Aristolochia rotunda, Iris, Myrrh, Aloe, the rind of the plant Opopanax, whereout the gum issueth, the Pumick stone calcined, the refuse of brass melted, and the bark of the Pinetree. All these being beaten to powder may be applied alone, or mingled with honey. Of this nature also are Aqua vitae, and the root of Dracontium or Dragons. 
De ulcerib. c. 22.  Fallopius hath two medicaments to this purpose: the first is this, ℞ Rad. Peucedani, Indis, an. ℥ j Euphorb. ℈ j fiat ex omnibus pulvis: qui excipiatur pasta panis molli, atque ossi corrupto applicetur. The second is this: ℞ Rad. Peucedan. Aristol. rotund. Opopanac. Enphorb. an. ʒss. Terebinthiae ℥ j Cera ℥ ss. Acetiʒj. fiat cerat. ex p. a. These and such medicaments are to be used, when the cariositie is somewhat deep, and the party of reasonable firm constitution of body.  
Lastly, some are strongest of all, as Euphorbium beaten to powder, Aqua vitae having the tincture of Euphorbium, the oil of Cloves, or Petroleum wherein some Camphir is dissolved, Aqua fortis, Aqua regis, the oil of Sulphur, and the oil of Vitriol, and Roman Vitriol calcined. These are to be used when the cariositie is deep, and the constitution of the diseased party stubborn and strong. When these medicaments are applied, the fleshy parts adjacent must be very well defended, otherways pain and inflammation will be caused. If the sores be well dressed, and these medicaments judiciously applied, the bones will scale within the space of forty days.  
Sometimes the cariositie of the bone is very deep, so that a long time would be required for the scaling of it: 
The scaling of the bones by instruments.  wherefore in this case we must have recourse to instruments: the chiefest of these instruments are the Mallet, and Cheesels, 
the sign of the cariositie removed.  and Raspatories: First then, the corrupt part of the bone is to be knocked off with the Mallet and Cheesell until you come to the sound bone; which you shall know if the bone bleed, and appear white and firm, according to Celsus. 
Lib. 8. c. 2. What mallet best.  Secondly, the bone is to be made even with the Raspatories and smoothed. In this case a leaden Mallet is best; for it is weighty, and causeth a lesser noise: this being done, some of the aforenamed medicaments must be applied according to the constitution of the party; 
How ulcers of the head, wherein both the tables are carious aught to be handled.  for by it you must be led.  
In ulcers of the head it often falleth out, that both the tables of the soul are so●le, so that you shall be enforced to remove a great piece of the C●anium: here you must use the Trepan & head-saw, the use wherofshall be delivered, when I shall set down the curation of the wounds of the head. 
How bones corrupt are to be scaled by the actual cau●●●●.   
The third way to scale bones, I named to be the actual cautery: Of it I will set down three documents: The first shall be, when it is to be applied: The second shall direct where it shall be applied: The third shall teach, how the sore is to be dressed after the application.  
As for the first: 
When it is to be applied.  It is to be applied when superfluous humidity floweth to the bone; this you may conjecture; First, by the moist and cold constitution of the body of the person affected: the signs of such a constitution I delivered unto you, when I discoursed of a waterish tumour: whither I remit you.  
Secondly, if after the application of your desquamatorie medicaments, the bone still appeareth moist and soft, not changing its colour.  
The second document shall be, where it is to be applied: 
Where it is to be applied.  you may apply it safely to the Ulna and Tibia laid bore.  
Secondly, you may use the actual cautery in those places, where dilatation only is permitted, and not incision, or potential cautery, as in the back of the hand, and instep of the foot: but this operation you must do thorough a pipe of white iron, to save the circumjacent parts from burning.  
Thirdly, you may apply the actual cautery to the joints, if the cartilages be foul, and way be made. This practice Ambrose Parrey used when he had dismembered one in the joint of the elbow: the dismembered party found great ease and comfort by the application of it: See the History, Lib. xj. cap. Xxu. What forms of cauteries you are to use, the figure of the ulcer will show you. When the actual cautery is applied, you are to be acquainted with the manner of dressing of the bone, which was the third document.  
How this is to be done, 
3. How the bone is to be dressed after cauterization.  Guido a Cauliaco teach you in his own words: I (quoth he) after the application of the cautery, apply for the space of three days oil of Roses tempered with the white of an egg, & for three other, it mingled with the yolk of an egg: and afterward Butter with. Mel rosatum, and ever above these applications some mundificative until the bone scale. Afterwards, I incarnate and consolidate the part with Avicens' medicament, which I delivered unto you amongst the medicaments exfoliative of the second degree. Fallopius counselleth after cauterization to use pledgets moistened in Rose-water and the white of an Egg, to hinder inflammation for some few dress: then to apply to the bone the medicaments exfoliative.  

Where the actual cautery is not to be used.  Beware of the use of the actual cautery, if the Scull, or any of the Vertebrae of the back be foul, by reason of the brain contained in the first, and the Spinalis medulla contained in the second; which being inflamed by the heat of the actual cautery, will bring alienation of mind, and convulsions.   

LECT. XXI. Of a discoloured and varicous Ulcer.  
THe two last differences of ulcers taken from things according to nature, were said to be an ulcer, wherein the natural colour is altered, and an ulcer varicous. First then I will discourse of the ulcer, wherein the colour is altered, and then of an ulcer varicous.  

〈◊〉 An ulcer having the colour of the part altered.  As for an ulcer having the skin adjacent, and the substance of the part altered. The unnatural colours which possess the part altered are most commonly four; the read, yellow, livid, and black colours.  
The read colour proceedeth always from heat, 
I. The read colour.  causing, an inflammation.  

The efficient causes of it.  The external efficient causes of it are superfluous hot garments, too thick bolsters, rulers made of wool, or of hard and stubborn linnen-cloth, the hot season of the year, too straight ligature, the use of hot meats and drinks, surfeiting, venery, troubling the mass of blood, extraordinary motion of the part, perspiration hindered by reason of the suffocation of the part, or incuneation of the humour, and solemn evacuations suppressed, as of the flowing of blood from the hemorrhoidicall veins in men, or the menstruous blood from the veins of the matrix in women, by the error of the Chirurgeon, applying things actually and potentially cold.  

The material cause.  The material cause of this colour is blood offending: 
How blood may offend.  Now the blood may offend two manner of ways, to wit, in quality, if it be too hot or fervid; or in quantity, if the body be plethoric. 
The curation.  In removing then this read colour, one of the symptoms of inflammation, our first care must be to remove the external efficient causes.  
The diet must be moistening and cooling, 
The diet.  until this accident be removed: wherefore broths made of Chickens, or Veal, wherein Sorrell, the sour threeleaved Grass, or Allejujah, Endive, Succory, Purslane, Lettuce, and such like have been boiled, are very convenient. If the diseased party delight in roasted meat, let him use for his sauce, sippets with the juices of the common and wood Sorrell, with a little vinegar and Sugar.  

The season of the year.  If the season of the year be extreme hot, let the room wherein he remaineth be hung with sheets, which must be still moistened with spring-water: In this case it is good to garnish the windows with the Meddow-sweet, called in Latin Regina prati, and Gaul called Myrtus Brabantica.  

Of the garments. Rulers.  Let his  be neither heavy, nor heating: Let the rulers be of soft linnen-cloth, and moistened in Rose, Eldar Vinegar, and fair Spring-water, taking two parts of the water, and one of the Vinegar: 
Rolling.  Let the rolling be somewhat slack, only to keep the local medicaments to the ulcer; for straight ligure doth cause pain, pain attraction of humours, and the attraction of hot humours inflammation. 
Venery. Violent motion. Suppression of solemn evacuations.  The party must abstain from sacrificing to the Cyprian Dame: yea, he must abandon every violent motion. If this symptom be caused by reason of the suppression of any solemn evacuations, as the staying of the menstrual courses in women, or the suppressing of the Hemorrhodes in men, the accustomed flowing of these are to be pro●●ed again.  

How the menstrual courses are to be procured.  The menstrual courses are to be brought down; first, by opening of the Sap●ena in what foot it is most conspicuous; and secondly, by exhibiting the powder of steel, either in form of Lozenges, or of an Electuary or in infusion in whi●e wine.  

How the Hemorthodes are to be opened.  The Hemorrhodes must be opened by application of the Leeches, and ministration of Aloeticall medicaments. That medicament, which by Paracelsus is called Elixir proprietatis, and by others Pilulae pestilentiales Arabum; composed of Aloe, Myrrh, and Saffron, are excellent. These may be taken sundry mornings together. But seeing these things are at large set down by those who have written of the practice of Physic, I have only pointed at the best indications, which serve for the curing of these griefs, and the rather because the sp●●lation of them doth belong to another Faculty and Art, to wit, Physic.  

How the material cause i● to be dealt withal.  If the material cause of this symptom, which is blood, offend in quality, being too hot, than it is to be cooled by a refrigerating diet, which I at large set down, when I discoursed of a phlegmon, to the which place I remit you. If in quantity it offend, first Phlebotomy, or opening of a vein is to be used, and blood drawn, as the age, constitution of the party, and nature of the grief shall require. Secondly, the part itself is to be scarified, and other Ventoses or Leeches to be applied, that the blood may issue out plentifully to discharge the part.  

Of the livid colour. It's causes.  A livid, or leady colour in an ulcer followeth. Two causes produce a livid colour in ulcers: the first is black blood impacted in the part: The second is external cold, or defect of the natural heat.  

How lividitie from black blood is to be cured.  This livid colour doth happen most frequently by reason of black and corrupt blood settled in the part, for as a bright read colour under white, causeth a lively blue, or azure colour, as we may see in the veins of sound and healthful persons; so black under white causeth a livid, or a leady colour. This accident is to be removed by scatification, and application of the Cupping-glasses, Horns, or Leeches. Afterward the scarifications are to be somented with Oxymel dissolved in Cardum Benedictus water.  

How lividitie from cold is to be cured.  If the lividitie proceed from cold, you shall perceive it by the cold constitution and temperature of the part. In this case you are to apply such local medicaments as are able to reduce the natural heat and complexion. Fallopius in his Treatise de tumoribus, c. 26. de Gaugraena, affordeth a notable one, and parible, which is this: Take an ordinary Turnip, and a Rettish-root of reasonable bigness, grate or scrape these two, and add to them of the powder of Mustardseed one ounce, of the powder of Cloves three drams, of the oil of Lin-seed, and Walnuts very old, so much as is sufficient, and make a pultice, which apply warm; he calleth this cataplasm, Medicamentum optimum & divinum, A most excellent and divine medicament; with the which he affirmeth himself to have cured many: so that you need not to doubt of the efficacy and certainty of it: and the ingredients seem to promise' no less.  

Of a black colour  The last unnatural colour is a black colour: this may proceed either 〈◊〉 heat or cold. If it hath proceeded from heat, than an inflammation went before; if from cold, than lividitie did precede. The first betokeneth adustion; but imperfect: so we see wood, before it be perfectly burned, and incinerate, or turned to ashes, to become black. And in a Carbuncle, the lower part is of a darkened, the middlemost black, and in the top there is a white pustule, the heat beginning the adustion in the lowermost, increasing it ill the middlemost, and perfecting the adustion in the top: for it is the property of fire or heat to mount up, and to be most effectual aloft. If before blackness lividitie did appear, it is to be feared, that the part beginneth to be mortified at the lest, if any feeling or heat remain: If these cannot be perceived, than you may boldly say, that a Spacelus or Mortification hath possessed the part.  

How this accident is to be removed.  In both these cases, first, the parts are profoundly to be scarified: Secondly, they are to be fomented with the decoction of Wormwood, the lesser century, Scordium, Carduus Benedictus, the flowers of Camomile, Melilot, and tops of Dill boiled in a gentle Lixivium. Thirdly, fill the incisions of the scarifications with some of the medicament following using a feather: ℞ Oxymell. simple. ℥ ij. Vuguent. Egypt. ʒiij. Spirit. vini, ʒij. Miseeautur. Fourthly, this cataplasm is to be applied warm: ℞ Farin. fab. hord. & erobi, an. ℥ iiij. Lixiviimitioris, lb. iiij. coq. haec ad cataplasmat. consistentiam: tunc add Oxymell. simple. ℥ ij. Unguent. Aegyptiaci, ℥ j Omnia probe misceantur. Continued the use of this medicament, until the parts be brought to their natural temperature and colour: then proceed as hath been set down, when I spoke of the curing of a compound ulcer.  

Of Varices.  Having set down the methodical curations of the three first accidents taken from things according to nature; to wit, of abating superfluous flesh, removing of the cariositie of the bone, and reducing the natural colour to the parts, I am to show how the fourth accident Va●●●●s, or the tumefaction of the veins, by reason of supernuous gross blood are to be cured.  

It's names.  This accident is called in Latin Varix, from the similitude and likeness which it hath with the protuberances which are seen in trees above the bark, called Varices: according to Avenzoar, lib. 2. tract. 7. c. 25 Albucasis Chirurg. part. 2. c. 93. calleth this affection Vitis, or the Vine, because these pass alongst the parts by windings, as the vine doth: In Greek it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or as it is found in Pollux 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. It is called by Hypocrates 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and by Aristot. 3. the histor. animal. 11. and in sundry other places.  

The description.  This affection may thus be described: A varix is a dilatation of a vein causing a tumefaction of it, with windings and tortuositie arising in one or more parts of the body. It is called the dilatation of a vein, because the dilatation of the artery is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. This particle (causing a tumifaction) is added, to exclude veins, which are naturally big. Galen de Method. medend. lib. 14. c. 13. numereth this affection amongst the diseases which proceed from the quantity increased. It may be accounted a disease, because the actions of the parts which it possesseth are hindered; for if it possess the legs, they become extenuate, and by reason of the heaviness of the humour, they become flow in motion. If this affection invade the stones, the party becometh barren.  

It's causes.  The causes of it are either internal or external. According to Aristotle, the material cause is blood, 
The material.  being impregnate with spirit, he doth affirm it to proceed from blood, Lib. 3. the histor. animal. c. 19 
Aristotle's opinion.  where he noteth that women are not troubled with varices; because they turn out their superfluous blood by their natural fluxes, and that they are less troubled with the hemorrhods in like manner. And although this doth prove true in most women, yet there may be sundry women found, who both have varices, and are subject to the hemorrhods. He thinketh that the blood in the varices is full of spirits; and therefore pronounceth, Sect. 6. problem. 3. & Sect. 4. problem. 21. that they who have their testicles varicous are barren, because the spirits of generation pass to the varices, and so leave the seed unfruitful, being deprived of spirits. 
Galen and Hypocrates his opinion.  But Hippocrat. 3. de articul. text. 4. & 6. aphor. 21. & Galen. 4. de compos. medicament. 2● gnran, think that the material cause of varices, to be gross and flatuous melancholy blood: yea, both Galen and Avicen are of the opinion, that the vatices may sometimes be caused of laudable blood, only offending in quantity, and dilating the coats of the veins.  

The antecedent causes.  The antecedent causes are in number four.  
I. Is a melancholy and pituitous temperature: so they who have a bad spleen, are most subject to this disease.  
II. An hairy and an hard habit of the body.  
III. The masculine sex: for women are not so frequently troubled with this affection, because monthly they discharge all superfluous blood, if they be healthful: as hath been said out of Aristot. 3. the histor. animal. c. 11. & sect. 10 probl. 29.  
IU. Either ripe or old age: for according to Hippoc. in Coac. praenot. they happen not before the fourteenth year of the age, in the legs; although even children may have varices in the testicles. Why Eunuches are not troubled with the varices, Arist. sect. 10. probl. 29. yields a reason; because they are deprived of seed and spirits. Avicen doth add to these sharp diseases going before: for in these the thinnest part of the humours being spent by sweat, insensible perspiration, and discussion procured by Art, the thicker part being turned to some particular places, may procure the varices.  

The primitive causes.  The primitive causes are these.  
I. A thick and impure air; because it doth weaken the legs, and maketh them the more apt to receive superfluous humours. And for this cause Hypocrates affirmeth, that men who devil in the Western parts, are frequently troubled with this affection, and ulcers in the legs.  
II. Immoderate exercise: so we may see Footmen and Porters often to have varices.  
III. Long standing: according to Averr. 6. collect. 2. From hence juvenal saith; Fiet varicosus aruspex: He shall become a varicous Soothsayer: for they who took upon them to find out future contingents by the flying of birds, were enforced often to stand along time.  
IU. Thick wine and gross food: such are old flesh salted, or smoked, pease and beans.  

The presages.  As for the presages, let this be the first:  
I If varices appear in those who are mad, by reason of the melancholy humour, the grief ceaseth.  
II. The varices mitigate gibbosities, or bunchings in any part of the body: for the humour which causeth them, is by these means averted from maintaining of them.  
III. The varices appearing either in the right or left testicle, help a squeaking voice; the humour being turned from the breast to the testicles, according to Hypocrates, in the 5. Sect. of his Epidemicks. This may happen for two causes. I. By reason of the content which is between the spiritual and genital members. II. Because baldness, stutting, lisping, and a squeaking voice, according to Hypocrates in the same book, are melancholy affections.  
iv They who never become bald, have not large varices. And again, if in those persons who are bald, large varices appear, hair will grow again, Hippoc. 6. aphor. 34. & Arist. 3. the histor. animal. 11. But you must understand this of the varices of the testicles, called Hernia varicosa. The cause of this is the consent of the brain, and of the genital members, which is so great according to Avenzoar, lib. 2. tract. 3. c. 1. that castration doth impair both wit and courage. Then humours melancholic being gathered in the testicles, vapours ascend to the head, which afford sufficient matter for producing of the hair. And in women their courses being stopped, vapours ascend to the chin, from whence a beard doth bud out. As Hippoc. 6. Epidem. sect. 8. doth report of Pha●tusa the wife of Pythe●●, who got a beard by reason of her husband's absence from her.  
V Varices caused by reason of some grief of the spleen, are not to be cured, jest the diseased party fall into some melancholy disease, according to Avicen 22.3. tract. 2 c. 8. for seeing the matter is lodged in the spleen, and the varices of the legs are stopped by curation, the humour must be turned to some other parts.  
VI The varices are hardly cured by medicaments, according to Avenzoar, lib. 2. tract. 2. c. 2●. Although they may be cured by chirurgery without danger of life, according to Celsus, lib. 7. c. 22. This is true, if the varices be caused of too copious laudable blood, otherways not for the reason before assigned. 
The curation.  The curation, which is the last point, is performed by two indicutions, to wit, by discharging the body of the thick and melancholic humours, and taking away the tumified veins.  
The first is performed by appointing a convenient order of diet, and the administration of fit medicaments.  
The second is performed by chirurgery.  

The diet.  As for the diet, gross, tough, and flatuous meats are to be shunned; as Beef, Goats-flesh, Venison, Oysters, Fishes fed in muddy waters, old Cheese, Beans and Pease, Lettuce, Coll-wort, Cabbage, and all those things which Galen doth forbidden in melancholy diseases, 3. de loc. affect. c. 7.  
As for Phlebotomy, 
Phlebotomy.  the liver or median is to be opened in the arm directly opposite to that leg wherein the haemorrhods are, or Leeches are to be applied to the haemorrhodicall veins, chief if blood was wont to issue from them.  
As for purging, 
Purgation.  Lenitives mixed with those which purge gross humours are often to be ministered: Take this for a pattern, ℞ electuar. lenitiv. ʒuj. pulv. sanctiʒj. syrup. de cichor. cumrhab. ℥ j misc. ut fiatpotio.  

The chirurgical curation.  The chirurgical curation of the varices is performed by two means, ustion, and exsection; ustion is to be used when the varix is strait, and not much tumified.  
The manner of ustion is this: 
ustion.  Incise the skin until you come to the vein, and separare it from the parts adjacent, then shunning the brims of the wound, cauterise the coat of the vein: four inches from this ustion do the like, and so still until you come to the end of the varix. This being done, dress these ustions as you use to dress parts burned.  
Excision is to be used when the varix is crooked, 
Excision.  and hath windings, according to Celsus: but in my judgement a strait varix is better cured by excision than that which hath windings and creeks, because it is more easily separate, and will admit a more beautiful cicatrix: whereas in cutting the other there must be horrible pain, and an ugly cicatrix must be left.  
The manner of excision is this: 
Excision.  you are to begin at what end of the varix you will, and to separate the vein from the adjacent parts, until you come to the other end, then bind the vein hard at each end, and cut off what remaineth between the two ligatures: this being done, the brims of the wound are to be brought together, and to be healed with glutinative medicaments. Plutarch in the life of Marius writeth, that he having this grief in both his legs, submitted himself to this manner of cure; and when he had put forth one, did constantly endure the excision of the varix in it, that no man should have doubted of his valour: but when the Chirurgeon would have done the like in the other leg, Marius answered flatly, that he meaned not to buy beauty with such pain: it is not to be thought that any in this our tender age will admit either of these two operations.  

The Auchors way of curing.  If a varicous ulcer be offered unto you, which contemneth ordinary means, my counsel is, that you take up the varix above and below, as you do the veins of the temples in inflammation of the eyes, and open it between the deligations, that the blood may be discharged out of it. This operation any one will admit, if he be not too tender.   

LECT. XXII. Of a verminous and lousy ulcer.  
IN my last Lecture having delivered unto you the two last differences taken from things according unto nature, yet changed from the natural constitution, to wit, of a discoloured and varicous ulcer; now I am to set down the differences of ulcers taken from things alien to nature, and strangers. These are two; worms, and lice; from the first, an ulcer is called verminous; from the second, lousy. 
How the worms are called.  The worms which breed in ulcers may more fitly be called Maggots, in Latin Termetes and Galbae, as those of the guts are called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek, or Lumbrici in Latin; as we finde set down in a learned Epistle of Alexander Trallianus entitled 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, de lumbricis, of worms in the belly, translated by that famous and learned Physician Hierony●●us Mercurialis, which he annexed to his Treatise written of the diseases of children.  

Their generation.  They are engendered of putrid humours, in unclean and sordid ulcers negligently dressed, but most frequently in hollow, deep, and sinewous ulcers: for in such the quittor is longest lodged, and the putridinall heat is greater. And for this cause they are seen often in ulcers of the ears, for the quittor is there long detained by reason of the windings and labyrinths of the care.  

The material cause.  The matericall cause of these maggots for the most part is a pituitous excrement, as Paul. Aeginet. witnesseth, lib. 4. cap. 17.  

The efficient.  The efficient cause is heat, and that of two sorts: The one is extraneous, and putrifactive, causing corruption of the humours.  
The other is natural: Seeing, according to the Philosopher, lib. 3. de generat. animal. cap. 2. nothing can be produced of putrefaction only, unless concoction put to its helping hand. Then in a verminous ulcer which is preternatural, there is putrefaction, heat, and the ulcer itself, besides the worms the effects of the first two.  

The signs.  As for the signs, they are three: The first is the sense of sight, for oftentimes they are seen if either the cavity of the ulcer be ample, or that they are voided with the quittor.  
The second is the motion of them felt by the Patient: their motion is called Motus undosus, like unto the waves of the sea, contracting and extending itself.  
The third is a pinching pain now and then: for living they must be fed, and their feeding must of necessity cause more or less pain.  
The fourth sign is horrible stink, by reason of the great putrefaction.  

Against the use of instruments.  When you go about to cure such an ulcer, attempt not the taking out of the maggots with any instrument, for your labour will be fruitless, and the pain of the Patiented great: and grant that you take many away with your instrument, yet you must leave the putredinall heat, and the corrupt humour, for the breeding of more.  

Against the use of the actual cautery.  I wonder that even great Authors make mention of the application of the actual cautery in this case: they might be borne withal, if these ulcers were plain, and shallow; for so the superfluous humidity might be dried, and putrefaction removed: but they with an unanimous consent confess, that these maggots are most commonly bred in sinewous and hollow ulcers, (as hath been said) and most frequently in the Summer time, and Southerly winds blowing; and so a great heat would be induced, and the Patient put to great pain, if they could reach to the cavity of the ulcer, which cannot be.  

The curation.  These worms than must first be killed, and then they will issue out of the ulcer without any difficulty.  

The medicaments.  Those things which kill these worms, do it either of a manifest, or hidden quality.  

From a manifest quality.  They which kill them by their manifest quality must be bitter, such are Wormwood, Southernewood, Calamint, Aloe, the Ferne, Buls-gall, the Meal of Lupins, the Leaves of the Peach tree, Capers, the Roots or distilled Water of the Roots of the Couchgrass, called Gramen canarium, Horehound, Scordium, Mugwort, century the lesser, Mints. Of these you may make decoctions, whereof you may find sundry descriptions in the monuments of those who have written of this subject. Ambrose Parrey, lib. 12. cap. 8. setteth down this medicament: ℞ absynth. centaur. minor. & marrhub. an. m. 1. decoq. in lib. 1. aq. font. ad lib. ss decoct. coletur: In quo dissolve aloes ℥ ss. unguent. Aegyptiac. ʒiij. he putteth in the decoction ℥ ij. of Aloe, and ℥ j of Aegyptiacum: but who may not perceive the quantity of these to be too great? This of Riolan the father, in hi● chirurgery, the ulcerib. cap. 8. is excellent: ℞ Ellebor. alb. rad. cappar. gentian. dictamni, alb. an. ʒij. centaur. minor. scored. absynth. marrhub. calaminth. an. man. ss decoq. in sufciente quantitate aquae font. ac coletur decoctum. In lib. 1. colaturae dissolve mellis ℥ ij. Aegyptiaci ℥ j Above the ulcer he adviseth to lay Vnguentum Apostolorum. If a tent may reach to the bottom, use this commended by Fallopius in his Treatise de ulceribus cap. 21. ascribed to Archigenes, as also Ambrose Parrey, in the place afore named: ℞ cerussae pol●●montan. an. ℥ ss. picis liquid. q. s. ut fiat linimentum: 
Pellamountain.  This cannot choose but be effectual, for the faculty of Tar is known even to huntsmen and shepherds.  

Medicaments killing worms from a hidden quality. 〈◊〉 Minerals.  As for those medicaments which kill worms from a hidden quality in ulcers; they are taken either from Minerals, or Vegetables.  
Amongst the minerals, all waters endued with the qualities of Mercury or Antimony are effectual: wherefore you may use Aqua aluminis magistralis of Fallopius, set down by him in his Treatise of the French-pox thus; 
Cap. 93.  ℞ aq. plantag. & ros. an. lib. 1. alum. & Mercur. sublimat. an. ʒij. pulverizat. 
Aqua alu●●●in●● magistralis.  These are to be mingled together, and being put into a separating glass, the half of the water is to be breathed away: Pallopius counselleth the glass to be set upon a gridiron, and coals to be put under: but the safest way is to have this done in a pan, with some sand set upon a little furnace. After that the half is breathed away, the separating glass is to stand five days, and then the clear water is to be poured off, and kept for use.  

The use of it.  It is not to be used alone, but mingled sometimes with a double, sometimes triple, sometimes quadruple quantity of Rose, Plantain, or Night-shade-water. The ablutions of Crocus metallorum precipitate, and the Turbith mineral, are effectual: Vitriols of all sorts, dissolved in fair Spring-water, and having some Camphire added, are very good: for they not only kill the worms, but powerfully correct the putrefaction in ulcers.  
Amongst the vegetables which kill worms, 
Vegetables.  by a hidden and unknown quality, the Tobacco doth carry away the bell, and not only the juice of the green, but the decoctions of the dry also, do effect this, being applied to the ulcers by injection, or moistening the tents or pledgets with the same. Seeing you may find this medicament, whose faculty and operation are certain, I will not trouble you by setting down a rabblement of uncertain toys: unguentum de Paeto, having some Mercury precipitate mingled with it, is excellent in such ulcers.  

Of worms in the belly.  Seeing worms in the belly, by eresion, cause ulcers in the guts; in so much that worms have often come out at the navel and groynes, whereof you may read memorable histories set down by Schenkius in his third book Pag. 407. titul. de lumbricis, it will not be a thing impertinent to discourse briefly of them, seeing they often trouble children, and procure sometimes death.  

Their names.  These worms are called in Creek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, f●rae, because they cruelly torment the body; in Latin Lumbrici.  

Their efficient cause.  The efficient cause is the temperate heat of the guts, for the intemperate heat rather doth burn the humours, than produce any thing of them.  

The material cause.  The material cause, is the inconcocted part of the Chylus, sent away to the small guts from the stomach, and left undrawne by the mesaraical veins to the liver, there to receive the form of blood. This part of the Chylus being crude, and left in the intestines, mixed with the pituitous humour, is elaborate by the temperate heat of the guts, and the form which lay hid in this matter before, is brought forth afterward by this heat: and according to the diversity of the latent forms, sundry sorts of worms are bred. In the aforenamed title of Schenkius, you may read of the stupendious figures of worms, set down by learned and famous men, in their monuments, who have seen them.  

●he differences swarms.  As for the differences of them: they are either ordinary, or extraordinary.  
Of the ordinary there are three sorts: 
〈◊〉. Ordinary.  The first is Teretes, the round ones, not unlike to the earth worms in figure, but in colour different: for they are whitish.  
The second are called Ascarides: these are like unto the worms which grow in cheeses, and maggots in flesh: they are for the most part bred in the Intestinum rectum.  
The third kind is called Lumbricus latus, 
Taenia,  the broad worm; and Taenia, which in Greek is called a swaddling band, by reason of its figure, for it is broad and long, and it hath sundry joints. This worm will be of a strange length. Plin. lib. 11. nat. histor. cap. 33. affirmeth that some have been thirty foot in length. Conciliator. diff. 101. saith, one avoided such a one fifteen foot in length. Alexand. Benedictus, in prooem. lib. 21. practica, saith he saw the like. If you desire greater variety of such histories, peruse Schenkius his observations, Lib. 3. pag. 411. I myself when I was in the Newrie, a town in the North part of Ireland, being desired to visit a young man who had a Fistula in Perinaeo, and whose body was exceedingly extenuate; when I had ministered a dose of 2. gr. of Mercur. vitae to him, he avoided such a worm, tucked like a crabtree cudgel, about the thickness of a child's finger, and fifteen foot in length, he kept it in a little pewter basin for my coming: when he was in voiding of it he was in great fear, thinking that his guts came out.  

The signs. Of round ●●●mes.  As for the signs of worms: You shall know any one to be troubled with round worms by these signs: The party finds gnawing, and pinching pain in the belly, hath gnashing of the teeth, chief in the sleep; is troubled with a dry and continual cough, the nostrils itch, wherefore children having them, are still picking their nose; the face is evil coloured, the cheeks are sometimes of a read, sometimes of a livid colour; the eyes are hollow, the mouth is waterish, the breath is strong, there is a desire to vomit, the hicket oftentimes, hunger, pain, and heaviness of the head, drowsiness, convulsions, starting in the sleep, stretching of the belly; but an extenuation of the rest of the body; horrible dreams, looseness of the belly, ugly and stinking excrements do fall out. This is holden for an experiment, if water be poured upon the stomach in the morning, the party being fasting, he or she shall find a drawing on of the belly, by reason of the shrinking of the worms, shunning cold. All these fignes are not found in every person, but some in sundry.  

Of Ascarides.  If Ascarides, or small worms, be bred in the Intestinum rectum, a horrible itch troubleth the party, and they are often seen in the excrements.  

Of Tania.  If Tania, or the long broad worm be in the guts, the party hath an insatiable appetite, the body consumeth, and some substance doth come from it like to the seed● of a cucumber. The falling sickness oftentimes proceedeth from the round worms, but seldom from the broad, and the Ascarides.  

The predictious.  Let us now come to the presages which the diversity of worms afford.  
I. The Ascarides, if they be small, they are of all sorts less dangerous, for they are farthest from the noble parts, and are most easily killed, by clysters, or injections of bitter things. It is otherwise if they be big, for than they are engendered of a worse matter.  
II. The Tania is of all others the worst, because it is biggest, and hardest to be killed.  
III. The bigger are worse than the lesser, and many more dangerous than few, and the read are worse than the white.  
iv If in the beginning of sharp diseases round worms come out alive, they betoken pestilent diseases.  
V It is good if round worms come out, either when the crisis is at hand, or in the declination of the disease.  
VI If in persons not sick, worms come out either at the mouth or nose, it betokeneth no harm, because this they do for lack of food.  
VII. If this happen in sick persons, it is an ill sign, for it argueth the malignity of the matter, which the worms labour to shun.  
VIII. If worms expelled seem to be be sprinkled with blood, it is an ill sign, for it showeth the guts to be ill affected.  

The curation.  As for the curation, it is performed by two indications; the first is by killing of them; the second by expelling of them killed.  

Medicaments that kill worms.  They are killed either by internal medicaments, or external applications.  
The internal medicaments are either simple or compound; the simple are either Vegetables, or Minerals, or Animals.  
The most powerful amongst the simple vegetables are these: Corallina, the dose of it is ʒj. The seeds of tansy, and the common wormseed, the dose of them is ʒj. the juice of Vervine; give a spoonful, the juice of Scordium, Wormwood, the lesser century, Carduus benedictus, or Beer or Ale brewed with these, Garlic, the roots of grass.  
As for compound medicaments, let this be the first: ℞ corallin. lumbric. terrest. nasura corun cervi, semin. santonicis, & tanaceti an.ʒj. rad. dictamnialbi, rhabarb. agaric. trochiscat. an. ℈ ij. fiat ex omnibus pulvis: does. ʒj. The second shall be that medicament, which Quacksalvers in Germany, call Panis vitae, the composition is this: ℞ mustacei ℥ iiij. semin. santoniciʒ v. mellis puri q. s. ut fiat pasta: does. ℥ ss. ad ℥ j  
The medicaments taken from minerals: Mercur. crudus, does. ℈ ij. Mercur. dulcis, does. a. gr. iiij. ad 20. secund. rationem, atatis & virium, Mercur. vita, cujus does. a.gr. ss. ad gr. ij. vitrum antimon●i, crocus metallorum, inpulvere vel infusione.  
As for external applications receive these as patterns: 

I ℞ aloes hepat. ʒij. fellis taurini ℥ iiij. absynthii contus. ℥ iiss. fiat cataplasma applicandum umbilico.  
II. ℞ farin. lupin. ℥ j myrrh. aloes an.ʒj. pulp. colocynth. ℈ iiij. croci ℈ j fell. boum ℥ iss. aceti acerrimi ℥ ss. mese. Applicetur cuminum pultum cum fell tauri, quod commendat. Sebastian. Austrius lib. demorb. infant. morb. 42.    
The death of Herod by worms is extraordinary, 
Act. 12.  which is set down by Saint Luke, undoubtedly to show what subjects may offer to honour their Princes, and what Princes aught to assume unto themselves of right. Herod having begun to persecute the Church, caused Saint james to be killed, and Saint Peter to be laid up in prison. After he had done this, the third year of his reign (as witnesseth josephus antiquit. lib. 19 cap. 7.) he went to Caesarea to keep some plays in honour of Caesar. The second day of his plays, when he had given an answer to the Tyrians and Sidonians, who sued after his favour, he being offended with them: the people cried out, The voice of God, and not of man. O Herod, why didst thou accept of this gross flattery? Had it not been sufficient to thee to have assumed subordinate Majesty, and truth in thy declamation, which was (I make no doubt) in some points of it failing? Lo, whom prosperity could not bring to the consideration of his carriage, God's visitation did. Worms, not presented to view of men, begun inwardly to torment him, and eat up his entrails; which caused him to burst out into these lamentable speeches; En ego ille etc. Behold, 
Iose●h●●a●●● lib. 18. cap. 13.  I whom you called God, am by fatal necessity commanded to leave life, it proving you to be liars, and I, whom you saluted as immortal, am violently drawn to death. Being horribly tormented, he died the fifth day, although the people put on sackcloth, and made supplication for him. So much josephus. O that Christian Princes would not so much labour to delight the ears of the people by eloquent speeches, as to administer justice. And although they think themselves secure enough from such a judgement in this life as befell this tyrant: yet let them not doubt, but that there must be an account made after death, where every debt must be paid with interest. I have delivered unto you what I thought fit concerning a verminous ulcer, now I will in few words deliver the doctrine of a lousy ulcer. 
A lousy ulcer.   

The efficient muse.  The efficient cause of louse, is the natural temperate heat, mixed and concurring with the heat putrefactive.  
The material cause, is the excrements of the third concoction, or assimilation, which are hot; but not sharp, or malign. This is the opinion of Galen lib. 1. de compos. medicam. secund. loca cap. 7. and Avicen. lib. 4. fen. 7. tractat. 5. cap. 26. That you may the better understand this opinion, you must understand, that when blood is turned to the nourishment of the parts, divers excrements are produced: of the which, some are discharged by insensible perspiration, some by sweat, some cleave without to the skin, as the morphew, and the filth which cleaveth to the soles of the feet, called Strigmenta; and scales in the head and other parts: some stay within the Cuticula; and these are either sharp, and of a malign quality; and these cause shedding of the hair, or they are destitute of both these qualities, and they produce louse.  

The differences of the louse.  The differences of these lice are two: For some are most commonly without the Cuticula, and some within the Cuticula; of those that are without, some are familiar, as the common sort; some are called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, feri, wild and cruel ones.  

The ordinary.  As for the ordinary and familiar, most commonly in boys and girls, they swarm in ulcers in the neck below the future Lambdoides: but sometimes, and in some persons, they possess the distance between the Cuticula and the Cutis, divelling and separating the one from the other. If one will know what store of these moveables may issue out of the Cuticula one person, let him read Amatus Lufitanus cent. 3. curate. 58. & schol. ad curatione●● ea●de●●, where he reporteth, that one of good note in Lisbon called Tabora, was so troubled with them, that two Negroes had enough to do to discharge him of them, and to carry them to the sea; and that at the last they procured his death.  
The 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or feri, the crab-lice, 
Crab-lice.  are most commonly engendered in the armpits, and in the forests of Venus in nasty men and women.  
Those which are always found under the Cuticula, are called Syrones', unknown to the Graecian Physicians: 
Syrones'.  they draw a trench, as Moles do in the earth, under the Cuticular, leaving watery pustules behind them, as they march: their seat (when they rest) is easily discerned at the end of the trench, where when the Cuticula is opened, they may with the point of a sharp pin or needle be taken out: they resemble nits in cheese, and if you place them upon the cover of a book of black leather, in the Sun, they will pass alongst the cover with a marvellous agility; as often I have made trial myself.  

The Prognostics.  As for the Prognostics. I. They who are troubled with any kind of lice are nasty persons.  
II. In a Hectic fever, they show that one is entered into the third degree of it, and so is uncurable.  
III. In persons not diseased if they abound, you may advice them to keep their hands from their mouth, and to labour to be cleanly.  
When the lice swarm over the whole body, the disease is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, à pediculis, from louse.  

The curation.  Three intentions are required for the curation of them: Phlebotomy, Purgation, and local applications.  
As for Phlebotomy, the sex, age, 
Phlebotomy.  constitution of the party, and strength, with the rest of the indications are to be observed.  
When you purge, use rather minerals than vegetables, 
Purgation.  because they more strongly evacuate, and are of a more subtle, durable, and penetrating faculty. These same will serve to hinder the increase of these, which I set down as powerful to kill worms.  

Local medicaments.  As for local applications, Amatus Lusitanus in the place afore-named, affordeth two: The one is a medicate vinegar; the other a lineament: The description of the vinegar it this: ℞ Lupin. amar. pug.. iij. Staphisagriae pug.. ij. Let these be boiled in a sufficient quantity of vinegar, with it moisten the whole body: The lineament is thus made: ℞ Staphisagr. part. 2. Sandarach. Grac. part. 1. Salis petrae partem dimidiam, postquam ista fuere infusa in Oleo Raphanino, part. 2. & Aceti acorrimi, part. 3. fiat linimentum, quod illinatur toti corpori. 
Lib. 3. c. 3.  Paulus Aegiveta affirmeth, that he found good success in the application of oil and vinegar.  
As for the Crab-lice, the waiting-maids of Venus' rest contented with the application of an unguent made of sweet Soap and Quicksilver. If any one be desirous to know more of the mystery of these movables, I will advice him to repair to the Pilgrims of the tribe of Gad, in the Summer time to be found by Coleman hedge, and throughout the whole year in Batne-Elmes barn. If any be desirous to read a learned and philosophical discourse of this subject, let them have a recourse to Minadous, lib. 2. c. 9 de turpitudinibus.   

LECT. XXIII. Of Ulcers of the Hairy Scalp.  
SEeing I have set down the general doctrine of ulcers, sufficient to instruct any one how every ulcer in particular parts is to be cured; yet seeing some ulcers in these parts require some special considerations, I will run thorough them to shut up the Lectures of this year: Nevertheless, I mean not to omit any thing which shall seem material. I will begin at the ulcers of the head, partly because some are uncurable of them, & that it is necessary that you know which be such; partly because it were a foul shame, that women should go beyond a Chirurgeon in this business, who confidently take upon them the curation of these ulcers.  

Differences of ulcers of the head.  The ulcers of the head are of two sorts: for some are moist, and some are dry.  

The nature of these griefs and names.  The moist are two, Anchor and Favus. These dispositions of the head are called by the Arabians Sahafati, by Avicen. 7.4. tract. 3. c. 1. Serap. lib. 1. tract. 1. c. 3. Avenzoar, lib. 1. tract. 1. c. 7. and they are nothing else but small ulcerate tumours of the whole skin of the head, caused of sharp excrementitious humours. All small tumours, in Latin Tubercula, by the Arabians are called Bothor. So then as the Cuticula, or the scarf skin, is the seat of Pthiriasis or the lousy malady, so the place of these griefs is the whole skin, both the Cuticula, and the Cutis.  

The material causes. The divers kinds of sharp humours.  The material cause is a sharp excrementitious humour.  
Now sharp humours are of two sorts: for some are sharp of their own nature, as choler: and some by accident. By accident, humours may become sharp two manner of ways. First, by exustion and putrefaction, as Bilis atra, and melancholy not natural excrementitious. Secondly, by admistion of a sharp humour. These ulcerous tumours of the head may be caused, not only of simple sharp humours of their own nature, but also of humours made sharp by accident.  

The Chemist's opinion concerning the material cause.  The Chemists will have the salt of Vitriol to be the material cause of these ulcers. See joan. Faber Chirurgia Spagyrica, c. xv. Anchor so called according to Alex. Trallianus, lib. 1. c. 8. because from it a sanious quittor called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth flow. Galen in his book of tumours thus discourseth of it: Anchor also is a small ulcer in the skin of the head, 
Anchor, what it is.  you may think that it is caused of salt and nitrous phlegm, out of it floweth a sanious matter, which is not altogether waterish, nor so viscous and thick as honey, which appeareth in those ulcers which are called Favi; for in these there is a certain tumour, and sundry holes, out of which floweth a matter like unto honey. He also in his Lib. 1. de co●●pos. Pharmacorum secund. loc. affirmeth the holes in this tumour to be less than are those which are called ●●avi, and that out of them floweth a thin humour with some clamminess. Oribas. lib. 4. ad Eunap. c. 4. thus speaketh: Anchor is seated in the skin of the head, and hath but small holes, out of which a thin and reasonable viscous Sanies doth flow. That affection which is called Favus is like to this; but it hath greater holes, which contain a matter like to honey. Trallianus lib. 1. c. 9 subscribeth to these in these words: We must know also that Cerion, (which is Favus in Latin) is a grief like to Anchor, yet differing in bigness: for the holes out of the which the humour issueth, represent the honeycomb: wherefore by Ancients it was called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. The like hath Paulus Aegineta, lib. 3. c. 3.  

The differences between Anchor and Favus.  So that Anchor differeth in three points from Favus: for first, in it the tumour is lesser: secondly, in it the holes are lesser: and thirdly, the holes in Favus are conspicuous; but in Anchor not. Aetius lib. 6. c. 68 hath these words: Anchor is seated in the skin of the head, and hath but small holes, out of which a thin and viscous Sanies doth flow. The grief called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or Favus, is like to this, wherein there are large holes, out of which issueth a matter thick, like unto that which is contained in honey-combs: wherefore it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. 
Favus, what it is.  As for Favus, or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek, Actuar. lib. 2. the dignose. morb. c. 5. thus describeth it: Small ulcers arise in the head thick, and read like little dugs, of the which, that which is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 hath but small holes, which sendeth out a clammy Sanies; but 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or Favus hath greater holes, which contain an humour like to honey.  
Out of these passages, which have been alleged out of these ancient and learned Authors, these descriptions of these two ulcers may be gathered: 
Anchor.  Anchor is an ulcerous tumour of the skin of the head, red and dug-like, having small holes, 
Favus.  out of which issueth a thin and viscous Sanies. Favus is the like ulcer, yet wherein the holes are larger, containing an humour in thickness resembling honey, from whence it hath its name.  

The primitive causes.  The primitive causes are in number two: corrupt nourishment, and contagion: of the first I have discoursed heretofore, of the second there is no doubt to be made: for it may be daily seen, that these griefs are communicate by contract and frequent conversation.  

The material cause.  The material cause is a sharp and fretting humour, viscous in both these ulcers yet thinner in Anchor, than it is in that which is called Favus. Galen and Aegineta in the places , affirm it to be a salt and nitrous phlegm. The Chemists affirm them to proceed from the salt of the vitriol of the lesser world, or man.  

The conjunct cause.  The cause conjunct is the same humour impacted in the skin of the head.  
The signs of these two are these: First, 
Signs.  in both these tumours there is an itching, and a tumour. Secondly, holes appear in both, but in Anchor lesser, in Favus greater. And although Lice are often seen in both, yet it is proper for Favus to have scales.  

The presages.  As for the Prognostics, receive these.  
I. Young persons are most subject to these griefs, and amongst these children most frequently: The causes of this may be two. First, because they may have received many impurities in the mother's womb, which when they are come to the light, the natural heat increasing, they lat our to expel; or it may happen by reason of the corrupt milk of the Nurse, who useth an ill diet.  
II. These ulcers, if they have continued long, and have much altered and corroded the skin, when they are cured, they leave behind them baldness of the parts affected.  
III. These griefs free children from the falling-sickness, according to Hypocrates, Lib. de sacro morbo, and Avicer. 1.3. c. de Epilepsia. For the humour which might 'cause this disease, is sent from the inner to the outer parts.  
iv If these griefs be hereditary, they hardly can be cured: seeing this is true in all other maladies, how much more certain, when to the humour a malignity is joined, as in these, as all must confess.  

The Indication. of curing.  The means which are apppointed for the curation of these griefs, are of two sorts, Physical and chirurgical.  
The Physical are three; 
1. Physical.  A convenient order of Diet, Phlebotomy, and Purgation.  
As for the Diet, 
dietetical.  that is most fit, which was set down in the Lecture delivered concerning the curation of Leprositie: for by some this is accounted a particular Leprosy. All surfeiting, strong and sweet wines, sharp, and salt, and fried meats are to be shunned; and such as afford a gross and impure juice, as hard Eggs, Fishes living in muddy waters: Purslane, according to Avenzear, exceedingly furthereth these griefs.  
As for Phlebotomy, 
Phlebotomy.  two indications may induce you to use this: First, a Plethora of the whole body: Secondly, much corrupt blood settled in the vessels of the head. If there be a fullness in the whole body, than it is fit to open the Medians of both the arms: it skilleth not much at which you begin: Let some days pass between the opening of the one and the other: Let the strength, age, time of the year, and the like circumstances show you, what quantity of blood is to be drawn. If much impure blood be congested in the head, open the Cephalica, the veins under the tongue, the Vena frontis, yea and the arteries of the temples; for they powerfully derive corrupt blood and foul spirits from the head.  

Purgation. General.  As for Purgation: If this must be general, than no medicament is better than Confectio Hamech, or Hiera Diacolocynthides, with the syrup of Rose solutive with Agarick in Betonie, Eye-bright, Strawberrie, Cowslip, or water of the black Cherries. Receive this description as a pattern: ℞ Confect. Hamech, aut Hier. Diacolocynt. ʒiiij. Pulu. sancti ℈ ij. Pulu. Holland. ℈ j Syrup. ros. solut. cum Agarico ℥ j Aq. predict. ℥ iij. Miso. ut fiat petio. If the party affect pills, these or such like you shall find very effectual: ℞ Pilul. aurear. & aggregat. an. ℈ j Trochiscor. alhand. pultorumgr. seven. spirit. Vitriol. gut. 5. Formentur pilul. ʒj. quae de●ureatur. These purgative medicaments are to be ministered once every week, until the pa●●●e be cured.  
If you go about particularly to purge the head, 
Particular.  use Sternutatories made of white Hellebore, and the best and strongest Tobacco, with a little of the powder of the seeds of sweet Marjerome and Lavender; or use Gargarisms: This water drawn by a quill into the nostrils, which I will set down, is very effectual: ℞ Pulu. Lap. magnet. amp; calamin. an. ʒij. Virid. aeris & Euphorb. an. gr. vj. Lap. haematit. ʒj. Succini albiʒss. Aq. mayor. ℥ j Misceantur. Let this medicament be kept in a glass, and drawn into the nostrils every morning, or every other morning, as the patiented is able to endure.  

chirurgical means.  The chirurgical means are the artificial dress of the ulcers with local medicaments. To attain to this, two things are to be noted: The first is, what medicaments are to be applied: The second is, how they are to be applied. As for the qualities of the medicaments, they aught to be astringent and repelling: when I discoursed of tumours, I set down an ample catalogue of them, whither I sand you, because I hare idle repetitions.  

How persons of ripe age are to be dressed.  But seeing some magistral compositions are required in the curation of these griefs, which often prove very obstinate and stubborn, I will not leave you unfurnished, but will deliver unto you some which are very effectual. 
Compound unguents.  The first is this of mine own: ℞ Butyri recent. lb. ss. Axung. porc. ℥ iiij. ol. Scorpion. ℥ ij. Sulphur. vivi, Helleb. alb. & nigri, Rad. Enul. pulveriz. an. ℥ ss. Calcis vivaʒiij. Mercur. crudi ℥ jss. Misc. ut fiat linimentum. The second is that of Gordonius, described by Rinodaus, Dispensator. medic. lib. 5. sect. 1. thus: ℞ Elleb. alb. & nigr. Sulphur. viv. Auripig. Litharg. Calc. viv. Alum. Gallar. Fulig. Ciner. Clavellat. an. ℥ ss. Mercur. & virid. ar. an. ʒij. pulveriz. and pulv. coq. in Succ. Borrag. Scabios, Fumar. Oxylap. & Aceti, an. ℥ iij. ad Succorum consumpt. deind. addantur Ol. veter. lb. j Piccis liquid. ℥ ss. Cer. liquat. q. s. ut siat linimentum. I have made trial of it, and have found it effectual. If you but consider the ingredients, you cannot but allow of it. The Author commendeth it in a scald head, all manner of scabs, and in Mulum mortuum itself.  

The artificial dressing. The pulling out of the hair.  When you are to apply these unguents, which was the second point of the chirurgical means: First, you are to mark whether the roots of the hairs be corrupt or no; for if the roots be corrupt, they must be pulled out: you shall know this by pulling out of a few, and observing the roots: for if the roots be thicker than ordinary, & moist, you may in be assured that they are corrupt: they are to be pulled out children, that you may the better apply your Topics: In aged persons not only to this end; but to open the skin also, and to make it more perspirable, that the corrupt humours may be the more easily corrected and spent.  

Pulling out of the hairs.  The hairs are readily pulled out, by application of an Emplaster of read wax newly made, drawn upon leather, and lying to the ulcers twelve hours. Secondly, above the unguents you are to apply Sparadrops made only of wax, to save the unguents, and keep them to the sores without much waste. Thirdly, you are to foment the sores with read wine, or Tanner's woose, wherein Pomegranate flowers and rinds, Myrtill-berries, and Sumach, with read Rose-leaves dried, have been infused in a pot set by the fire side, before you use the unguents.  

How children are to be handled.  If children be offered to you to be cured, you must have a care that you use gentle medicaments to them, and that their caps be so tied to their heads, that they cannot pull them off. For children receive these Topics: the first shall be that of Minadous, in his Treatise De turpitudinibus, li. 2. c. 10. which he learned of a woman, who professed the curarion of these griefs: 
Of the Mastickt ee.  ℞ Sulphur. vivi. Litharg. Argent. pulverizat. an. ℥ j cum aceteros. teranturac levigentur, tuus add Terrae l●●●●ae pulv. ℥ ss. Succi Plantag. & Limon. an. ℥ j Ol. Lentiscin. & Myrtini. an. ℥ j Misc. ut fiat linimentum. If the ulcers in children prove obstinate, use this of mine: ℞ Pomati, ungnent. Popul. & Vng. albi caphurat. an. ℥ j Ol. de vitell. ovorum ℥ ss. Ol. Scorpion. ʒij. Mercur. crudi ℥ ss. Misc. in unguentum. You may add ʒjss. of Alum calcined and beaten to powder, if you will have it stronger. These ulcers are to be dressed once in 24. hours, and towards the night: for then the medicaments will prove most effectual. If these ulcers be very moist, and apt to be inflamed, by the application of an unguent, than you are to use a medicament made of the abstersive powders, which the Ancients called Smegmata contempered with Oxymel simplex: such are the Ellebores, Sulphur vivum, S●aphesager, the Pumick-stone, Cuttle-bones, the roots of Iris, and Aristolochia rotunda, and Barley-meal: these being beaten to powder, and by the admixtion of Oxymel simplex brought to the consistence of a liquid Electuary, must be applied to these ulcers, and above the medicament a cap of Ivie-leaves sowed together be set.  
Having spoken sufficiently of the two kinds of moist ulcers, which are found in the head, Anchor and Favus, it is time that we reason of the dry ulcer of the head, which properly is called Tinea.  

Of Tinea.  This is a crusty ulcer, fretting the skin like a Moth (from whence it hath its denomination) without any great store of moisture, corrupting the roots of the hair, and sending out of the skin a dry filth which stinketh: Videatur Hieron. Mercurial. c. 14. the morb. cutan. But Petrus joan. Faber, in his Chirurgia Spagyrica, thus describeth it, c. 15. de Tinea: It is a peculiar phagedaenicall and cancerous ulcer of the head, caused of the salt of the Vitriol of the body of man, which fretteth the skin, and produceth scales, sometimes white, and sometimes yellow. The material cause, and the manner of the generation of it, he thus prosecuteth. The Vitriol in the great would, while it is calcined in the fire, it is coagulate into a mass; either white, if the calcination be but moderace; or yellow, if the fire be increased. So in the little world (he meaneth the body of man) the Vitriol, when it is separated from the Balsam of the body, it marcheth towards the skin of the head, which it corrodeth, and above it produceth a crusty and scaly substance. Thus he: and I protest very probably.  

The material cause.  And if it be true which Galen and Aegineta affirm of the material cause of Anchor and Favus, that it is a sharp nitrous phlegm, as hath been said, it may very probably be affirmed, that the material cause of Tinea is Phlegma vitriolatum, Phlegm endued with Vitriol, yet grosser than that which is the cause of Anchor and Favus. 
Cap. de Tinea.  Avicen, Mercurialis, and the rigid Galenists affirm the melancholy humour to be the material cause, accompanied with some sharp humidity, which pricking the expulsive faculty, moveth it to drive out the humour to the skin of the head, and so to 'cause this ulcer: but this opinion carrieth no show of truth: for first, this grief most commonly seizeth upon phlegmatic persons: secondly, it cannot be apprehended, how melancholy, either by the admixtion of any humour, or by any degree of heat in the body of man, being of itself black, can produce such a coloured ulcer▪ to wit, white or yellowish.  

Primitive causes.  The primitive causes are four; Errors committed in the things not natural, Hereditie, the corrupt Milk wherewith children are fed, and Contagion or Infection.  
The signs are dry crusty scales most commonly white, sometimes yellowish, or of an ash-colour, or greenish, never black altogether.  
As for the presages: let this be the first.  
I. This ulcer is hard to be cured, because it is malign and venomous.  
II. Inveterate ulcers of this kind are more malign, and harder to be cured, than those which have but lately invaded any person.  
III. When they are cured, they often leave behind them Alopecia, or Ophiasis.  
iv Sometimes they end into the Leprositie, and pedicular or lousy disease.  
V If in a Tinea the skin be hard, or of a shelly substance, and sand out many scales, and the hair fall by reason of the corruption of the roots of them, it is of all others most hard to be cured.  
VI If this ulcer being once cured, return, pronounce it to be of hard curation: for there must be some seed of this malign malady firmly impressed in the brain.  

The curation.  In the curation of this grief, two indications offer themselves: The first is the removing of the causes; but seeing the causes are either primitive or conjunct: The primitive causes are removed, by rightly ordering those things which are called Res 〈◊〉 naturales: The cause conjunct is taken by purgation and phlebotomy. As for Phlebotomy and purgation, although that may suffice which I have delivered in setting down the healing of Tinea and Favus, yet let the insinuate this unto you, that it is expedient that once a quarter you open the Cephalica, two days before the full of the Moon, and that for purgation you call Mercurial medicaments to aid, when Vegetals will not serve. Parrey is of the opinion, 
Lib. 16. c. 2. de Tinea.  that the means which are used in curing of the French Pox, are effectual in curing this grief: Use these then, Mercurius sublimatus dulcis, Turbith mineral, Mercury precipitate dulcified, Mercury coagulate, and fixed by gold and silver.  

The application of the Fopicks.  The second Indication is the curation of the ulcer itself by local means.  

Things to be noted before the application of lo●●ll medicaments.  But before you go about to apply any local medicaments, observe these passages: First, that you meddle not with tender children, if they have a malign Tinea, until they be able to abide sharp medicaments; for you shall vex both them and their parents, and so shall procure a dimission to yourselves. The mean time you may use a lineament espying things which might hurt the body, 
The excellency of the hearing.  that we may prevent and shun them: yet the hearing excelleth it, for it is Disciplinae sensus, the Sense of learning, according to Aristode, and the entertainer of faith: for faith is bred by hearing, according to the Apostle. And as the sight furthereth invention, so by die hearing, things invented are communicated to others. Besides, by hearing, the perturbations of the mind, as anger, envy, wondering and such like, are most stirred up.  

The causes.  The causes of the ulcers of the ears, are either antecedent, or conjunct.  
The antecedent is either external, or internal.  
The external causes are two; 
Externall.  to wit, a blow, or a fall: for by reason of either of both these the parts may be contused, and from hence quittor bred, which being stayed long within the cavities of the ear, and having the eare-wax, and other sharp excrements of the brain, mingled with it, may erode the parts.  
The internal cause is a sharp humour sent from the brain to the cavity of the ear, 
Internal.  which first of all causeth apostemation.  
As for the Prognostics, 
●●ciages.  let this be the first: These ulcers are not to be neglected; for if the curation be prolonged, deafness may ensue.  
II. If greater plenty of matter issue out of the ear than the part of its own self is likely to afford, than you may pronounce that the greatest part of it is sent from the brain ill affected.  
III. If before matter issue out of the ear, the party feel pulsation, and great pain, you may pronounce that a Phlegmon hath invaded the part.  

The differences.  These ulcers are either without any excrescence of flesh, or they have excrescence.  

The curation.  In the curation of ulcers of the ears, it is requisite that ever before the application of any local medicaments the head be purged by cephalical pills. 
Purgation.  Receive a description of those which are very effectual. ℞ pilul. aggregatar. & an. rear. an. ℈ j trochiscor. Alhandal. & diacrid. an. ℈ ss. spirit. vitriol. q. s. ut formetur nassula. Ex hoc massa efformentur pilul. iiij. deglutiat. duat hor. 5. Matur. sequente dio sumat totidem. Exactis 4. horis à sumptione pilularum capiat●● sculum sine pane, prandeat autem hora consueta.  

Application of local means.  In the application of local medicaments, these five points are to be observed, according to Petrus à Largelata Medicus Bononiensis. 
〈◊〉. 5. tract. 9 c. 9   

I. Let no sharp medicament be put into the ear before the body be well purged, jest we procure a fever, and 'cause an attraction of humours.  
II. Let all medicaments which are poured into the ears be neither too hot, nor too cold; for they being (for the greatest part) framed of spermatick parts, they can hardly endure any excess in heat or cold.  
III. Let all the medicaments which are to be poured into the ear be of a liquid substance, that they may enter the deeper.  
iv After the party is dressed, let him or her lie upon the sound ear, the ill affected ear being stopped with cotton or wool for a good space of time.  
V Let not fatty medicaments be either poured, or injected into the ear, for it is composed of spermatick parts, and such things will 'cause a sordid ulcer.   
The local medicaments which are fit to be applied to ulcers of the ears, wherein there is no superfluous flesh, are these: Trochisci Andronii in aceto sambucino dissoluti: Haec autem est corum descriptie: ℞ delayest. vitri●l. aristol. gallar. an. ʒij. alum. myrrh. sali● Ammon. anʒj. Excipiantur omnia melicrate & fiant trochisci. If you boil Crocus Martis in strong wine vineges, nutill both come to the consistence of a lineament, it is a good medicine. The Sanative syrup made of the vulnerary plants, as, Selfe-heale, our Ladies-Mantle, Avens' sanicle, Salamons-seale, Plantain, Horse-tail, Yarrow, Knotgrass is very effectual, not only in ulcers of the ears, but in all hollow ulcers in like manner, if Balaustia, Pomegranate-pils, Sumach, Mirtle-berries, and read Rose-leaves be added. These medicaments are sure, and such as you may trust into. In the winter time, if you boil a sufficient quantity of dry Tobacco in strong Ale, and boil the decoction strained, you shall have an effectual medicine, chief if the ulcer be foul, and have worms, which you may conjecture by intolerable itching, which they will 'cause by their motion. If these ulcers afford great store of quittor, they must be dressed every four and twentieth hour; but if they yield but little matter, it will be sufficient to dress them once in two days.  

The curation of the ulcer of the ear with excrescence of flesh.  If falleth out sometimes, that if ulcers in the ears continued long, that superfluous flesh doth so increase in them, that it filleth up all the cavities of the ear, and causeth deafness. This happened to a gentlewoman of the race of the Fittens in Chester, when I practised Physic and Chirugerie there.  

An experiment of the Authors.  I thus cured her: First, I ministered unto her Cephalickpils.  
This being done, I consumed the spungeous flesh by often application of the Fistula-powder, so that it did not not touch any part in the circumference. This powder I set down in that Lecture, wherein was set down the methodical cure of a Fistula.  
Thirdly, I made in jection into the ear, made of two ounces of white Wine, one dram of Aegyptiacum, and half an ounce of Mel rosatum.  
Last of all, I healed, and cicatrized it with my vulnerary syrup dissolved in Plantane-water.  
If such an accident come to your hands, proceed thus methodically, and you shall undoubtedly bring to pass that which you shall go about. So much I thought good to deliver unto you concerning the dignotion, and curation of ulcers of the ears, which often prove troublesome to the Patient and Chirurgeon, and loathsome to others, who approach to the party grieved, by reason of the evil smell, which the ulcer sometimes sendeth forth.  

Of ulcers of the eyes.  Now I will come to the ulcers of the eyes, which aught exquisitely to be handled, seeing the sense of sight, the instrument whereof is the eye, is so pleasing and necessary to all persons. Of all the ulcers of the eye, Fistula lachrymalis, or Aegylops, first doth offer itself, but seeing I amply discoursed of it, when I delivered the doctrine of Fistula's, I will remit you to that Lecture.  

Three points of the general doctrine.  In this my discourse of the other ulcers of the eyes, I will first set down the general doctrine of them, and then descend to the particular handling of each one of them.  
In the general doctrine, I will deliver three things: to wit, their causes; secondly, their prognostics; and thirdly, the indications of curing of them.  
The causes, are either external, or primitive, or internal.  
The external causes are two; to wit, a blow, or a contusion by reason of a fall.  
The internal causes are sharp and eroding humours.  
As for the Prognostics, let this be the first: Ulcers of the eyes in persons of an ill habit of body, seldom end without leaving some scar, or infirmity.  
II. For this cause be wary what you promise', for bountiful promise can hardly be called back, and the Patients, being for the most part careful of the comeliness of their parts, will undoubtedly expect the performance of them.  
III. If children, or disordered persons, be presented to you to be cured of ulcers in the eyes, ever pronounce that the cure will prove difficult and hard.  
The methodical general intentions of curing these griefs, are in number four; Good order of diet, Phlebotomy, Purgation, and the application of the Seton or Fontanell for revulsion and derivation.  

The manner of curing these three ulcers in particular.  Having dispatched the three points which the general doctrine of ulcers doth contain, I am come to set down how each one of these ulcers in particular is to be cured.  
As for the differences of them, they are either mild, or malign. The mild are either of the Adnata, or Conjunctiva, or Cornea, or uvea. The ulcers of Conjunctiva most commonly proceed from Ophthalmia.  
Of it then I will speak, because it most frequently seizeth upon the eye: 
Ophthalmia what it is.  〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek, but Lippitudo in Latin, according to Galen 4. de medicam. local. cap. 4. is an inflammation of that tunicle of the eye which is called Adnata.  

The differences of it.  There be two kinds of it: One properly so called, proceeding from inward causes.  
The other proceeding from external causes, which properly is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or Perturbatio.  
Again, Ophthalmia vera is either more mild, when only the Conjunctiva is inflamed or vehement, when as the eyelid besides is read, turned up, and somewhat ulcerate.  

How it is bred.  This grief is thus bred, according to Cassius Medicus 66. probls. medic. When humours are impacted in the eye, they stop the passages, and keep in the heat: the heat kept in, burneth when it cannot breathe thorough, and inflameth the humours; and these inflamed, cause Ophthalmia, and hinder the sight; for the Conjunctiva being inflamed, great pain and heat are felt in the eye. These draw humours into the eye: the humours attracted being dispersed thorough the eye, trouble the humours and spirits; and these being troubled, of a necessity hinder the sight. The eyes are subject to these affections, according to Arist. probls 7. sect. ultim. & Alex. 1. probl. 35. because they are moist, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, very passable.  

The causes of Ophthalmia vera conjunct.  All sorts of humours may 'cause a true Ophthalmia, but sundry ways; for hot humours, as blood and choler, of themselves cause great inflammations; but small inflammations may be caused of cold humours mixed with hot.  
The primitive causes are the heat of the Sun, 
Primitive.  pain of the head, a burning fever, dust, smoke, great cold binding the part, blows upon the head, blustering winds, ebriety, venery, and according to Paulus, oil. It bringeth an Ophthalmia, because it cleaveth fast to the tunicles, and so stoppeth the pores, and to the heat is kept in, and inflameth the eye.  

Why in hot regions the inhabitants are more frequently troubled with these inflammations.  Hippocrat. lib. de aer, aquis & locis, writeth, that they which inhabit the South, and hot regions, are easily assaulted by such diseases, and easily cured: and by the contrary, that they who devil in the Northern parts are not so easily tainted with this grief, but are more hardly cured: Avicen yields the reasons for this, saying, that they who devil under a hot climate, have their heads full of vapours and humours, which being resolved by the hot air, fall to the eyes, and being there stayed, 'cause an inflammation, which afterward is easily cured. First, because their bodies are more perspirable. Secondly, because they have still a lose belly. But in cold regions, although they have plenty of humours in their heads, yet they are congealed, and do not so promptly flow to the eyes; but if they come to the eyes, and be there impacted, they cannot so readily be discussed, by reason of the thickness of the skin, and constriction of the pores. So inflammations of the eyes happen more frequently in the Summer to those who have their heads stuffed with vapours and humours, the heat colliquating them, and turning them to the eyes. In like manner in those diseases wherein there is an ebullition of the blood, Ophthalmiae are forerunners, as in the small pox, measles, and sometimes the plague, hot and sharp vapours being carried up to the head.  

The general signs of a true Ophthalmia.  As for the signs of an Ophthalmia; they are general, or particular.  
The general are these: according to Galen. 4. de medio. loc. 4. & lib. de totius morbi temporib. & Rhazes lib. 9 ad Almans. a swelling of the eye, a redness of it, pain sometimes pricking, sometimes corrosive, sometimes tensive, flowing of tears.  

The particular.  The particular signs of a true Ophthalmia are these: a great tumour and pain, horrible heat, turning up of the eyelids, show a great inflammation.  
These accidents, in a more remiss degree, show a milder Ophthalmia: 
Signs of the parts sending.  if the humour proceed from the stomach, than the party will desire to vomit: if from the head, the headache, vexeth: and seeing the humour may be sent both from the vessels within, and without the Cranium, if the veins of the forehead, and the rest of the face be full, if the arteries of the temples beaten, and if the eyelids be heavy, than the humour cometh from the vessels without the Cranium; but if none of these symptoms appear, and yet the party often neezeth, and findeth itching in the nose, the humour or vapour is sent by vessels within the Cranium.  

Signs of the humours sent.  Signs of the humours sent are these: If blood be it, the eyes and face will be read, the veins will be full, the pain will be gravative, the matter that floweth will not be very sharp. If it be a vapour or flatuofity, there will be a finging in the ears, and a tensive pain. If it be pituitous blood, the tumour will not be very read, but whitish, less heat and mean, great heaviness of the eye and eyelids; the eyelids in the night time will be glued together. 
Why in an Ophthalmia the eyes cleave together in the night time.   
This happeneth for three causes: First, because in the day time the eye is still in motion, and suffereth not the humour to cleave to the eyelids.  
Secondly, because moisture is multiplied in the night time.  
Thirdly, because the humour doth concoct in the night time, groweth thick, and so is more apt to cleave to the eyelids, they then being . If choler be the cause, there will be but little redness mingled with yellowness, the humour which runneth from the eyes will be thin, the pain will be pinching. If flatuosity or a vapour, than none of these signs will appear, yet the eye will be somewhat swelled, and a noise will be noted in the ears, and no humidity flow from it.  

The predictions.  As for the predictions: I An inflammation coming of external causes, is more easily cured than that which cometh of an inward.  
II. When a continual pain of the head is joined with Ophthalmia, and coutinueth long, blindness most commonly ensueth.  
III. If in an inflammation of the eye, the humour which floweth from it be thick, it will not long continued: for it betokeneth the benignity of the humour, and strength of nature.  
iv If a mild sever, or a lask, 
6. Aph. 17.  seize upon one troubled with Ophthalmia, it ceaseth within a short time, the humour being discussed by the first, and reveled by the second.  
〈◊〉 If the tumour of the eye be great, the pain vehement, and the matter which floweth from the eye be copious and thin, the Ophthalmia is like to continued long; but short if signs contrary to these appear. Thus much then concerning the causes, signs, and prognostics of an Ophthalmia vera shall suffice.  

Ophthalmia spuria, what it is.  Now it remaineth, that we speak a word or two of Ophthalmia spuria, a bastard Ophthalmia: This is caused only by external means, whereof we have spoken sufficiently before, when we set down the primitive causes of Ophthalmia vera. And if the accidents, as inflammation, redness, and the like, be but moderate, it will easily cease, and without great difficulty, by removing the extrinsecall causes, and applying cooling waters, as Rose-water, or Plantane-water, with Camphire.  

The curation of Ophthalmia vera.  In the curation of Ophthalmia vera, some precepts are to be observed before the application of local medicaments.  

Precepts before the application of Topics.  I. The party must eat and drink sparingly, abstain from venery, and keep the body soluble.  
II. Let the party be kept in a dark room, and let the sleep be moderate; because immoderate sleep draweth vapours to the head.  
III. Let the objects, which the party beholdeth, be green, blue, or black.  
iv Let anger, serious cogitations, and motion be shunned.  
V If the hair be too long and heavy, let be polled.  
VI Let the drink be small Beer, or Barleywater, wherein have been boiled Fennell-seeds, Coriander-seeds, and eye-bright.  
VII. Let meats salt, vaporours', sharp, and hard of digestion be shunned.  
VIII. If the party be strong, open first the Median, than the Cephalica, than the Vena frontis, and those behind the ears, and in the temples, if the inflammation be great: if circumstances will not admit Phlebotomy, apply Ventoses to the shoulders, and thighs; and Fructions an●●●●gatures to the arms and legs.  
IX. Purge according to the humour offending, as choler with Pilulae cochiae, or electuar. de succo ros. phlegm with Diaturbith cum agarico, or Diaphanicum, or Diacarthamum.  
X. If you use fomentations, 
Fomentation.  these five things are to be observed: 

1. That the body be clean, otherwise the matter (being scattered by fomentation) will run to the eyes.  
2. The matter must be discharged into the eye, and not in motion.  
3. That it be used when the matter is thick, for it attenuateth it.  
4. That it be used in the declination of the grief.  
5. Not astringent fomentations are to be used; for they wedge in the humour, and exasperated the grief.    
XI. To stay the fluxion, you are to apply a strong defensive to the forehead and temples.  

Opiaticall medicaments.  XII. Opiaticall medicaments not well corrected, are not to be used; for if they be but weak, the may procure a little ease for the time, but the fluxion and pain will return more fiercely: if they be strong, they may 'cause inevitable blindness, by hindering of the influence of the visive spirit.  

The local medicaments.  The local medicaments must have three qualities; for they must be somewhat astringent, cooling, and anodine; such are the water of the white of an egg, the mucilage of Fenugreek, and Quince-seeds drawn with Rose and Plantane-water, with a little Saffron; Trochiset albi Rhasis sine opio (unless the pain be very great) dissolved in Violet, or Succory, or Eye-bright-water. What I have spoken, I would have you to understand it of an ordinary Ophtholmia.  

The venereal Ophthalmia.  If you perceive it to be venereal, or a symptom of the great Pox; than you must cure the grief, and then the accident will cease: If after the using of these means, the ophthalmia prove rebellious, you must blister the neck.  

The use of the Seton.  If this will not serve, you must apply the Seton, or make a Fontanell in the neck or arm; but the Seton is most effectual: for first, by reason of the great pain which it bringeth, it maketh a stronger revulsion: Secondly, it dischargeth the humour more plentifully, it having two orifices, but the Fontanell only one.   

LECT. XXV. Of the rest of the ulcers of the eyes.  
NOw order requireth, that I should set down the doctrine touching the ulcers of Cornea.  

superficiary ulcers of Cornea.  These are either superficial, or deep, corroding the substance of the Cornea.  
The superficial are four, whereof the first is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which signifieth a troubling of the air: and it is a very thin, and superficiary exulceration, of a bluish colour, resembling a dark air, and possessing the greatest part of the black of the eye: the Latins call it Caligo, a mist in English.  
The second is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, in Lain Nubocula, this is deeper than Achlis or Caligo, yet narrower, and whiter.  
The third is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; it is an ulcer which groweth about the circle Iris, possessing part of the white, and part of the black of the eye: without the▪ Iris it appeareth read, but within the Iris white.  
The fourth superficiary ulcer is called by Aetius 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 this is a superficiary ulcer also, which maketh the Cornea rugged by erosion, and to be of an ash-colour, resembling a lock of wool, for the which cause it is called of Avicen, the woolly ulcer.  

The three kinds of deeper ulcers of Cornea.  Of the deeper ulcers of Cornea there are three sorts:  
The first is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; and it is an ulcer of the Cornea▪ hollow, narrow, without filth, like to a round puncture: in Latin it is called Fossula; for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek doth signify Fovea, a pit.  
The second is called in Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and it differeth from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, in that it is wider, although not so deep.  
The third, of the deeper ulcers of the Cornea, is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by Aetius; by Scribovius, Largus ustio; and by others inustio; and it is an impure, and crusty ulcer of Cornea, thorough which sometimes the humours of the eye come out, when it is made clean, by cleansing medicaments applied.  
These ulcers of the Cornea of the eye, 
Prognostics.  whether they be superficiary or deep, are not to be slighted, but carefully to be dressed: but those especially which have deeply seized upon the substance of the membrane, jest they corrode thorough the whole membrane, and so the humours issuing out, the eye sink, and both deformity, and inevitable blindness ensue.  

The material cause of these ulcers.  For the material cause of these ulcers is a salt and nitrous humour, as Paulus Aegineta speaketh, Lib. 3. c. 22.  

The falling down of uvea.  It the Cornea be quite thorough corroded, than the uvea falleth down: this disease of uvea is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, uvea procidentia.  

Four kinds of it.  Of this disease there are four kinds:  
If it fall out but very little, it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, caput musca, the head of a fly, and of Avicen, Formiculis, like the head of a pismire.  
If it fall down yet more, and equal a grape in bigness, it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, uvea, or uvatio.  
If it fall down yet further, and hung out like a little apple, it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, m●lum, the apple-like rapture.  
But if the uvea fall down and grow hard, brawny, and flat, it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, clavus, the naile-like rapture. All these four kinds of the rapture of uvea for the most part are uncurable: 
Predictions.  only the apple-like, and grape-like rapture, if the roots be small, and the party be of a good constitution, may be by binding cured, to takeaway and mitigate the deformity of the eye. For if the sight be taken away before by these breaches of uvea, the deligations will not restore the sight, which must be intimate to the party before you go about these operations, that he think not himself deluded, having hoped for the recovery of his sight, as the reward of his patience, in enduring the manual operations.  

The alteration of the body.  Seeing all ulcers of the eyes argue a cacochymical body, for they are caused of sharp and corroding humours, the constitution of the body must be altered, not suddenly, by labouring to remove the whole cause at once; but 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and that is according to Galen. li. 9 meth. medend. when by little and little that is discharged which is faulty, that that which is good may succeed in its place. Wherefore you are to shun all strong catharticall means, jest they procure vomiting, which is very prejudicial to weak eyes, such as are those which are ulcerate. The body having been gently purged, nature very often doth correct the refidue of the humour, by turning that part which is benign into nourishment, and expelling that which is superfluous, by stool, urine, and sweated. Those twelve observations which I set down in the delivery of the curation of Ophthalmia vera, I commend unto you in the curing of the ulcers of the eyes also, which need not any repetition.  

Local medicaments.  To set down all the local medicaments, which are delivered by the Ancients in curing ulcers of the eyes, were a fruitless labour.  
Nevertheless, I will furnish you with a few approved medicaments. 
To superficial ulcers of Cornea.  Then in superficial ulcers of Cornea, use These: I ℞ su●xi tu●. fanicul. chelidon. ●uphragia an. ℥ ij. vini albi poten●i● ℥ iij. sa●chat. cordiʒiij. aloes, sarcocol. an. ʒ●●. fellis capan. ʒij. Distil these, and use the water.  
II. ℞ ●q. chelidon. & rutae an. ℥ iss. aq. ros. ℥ j croci metal. ʒj. fiat infusio.  
III. ℞ succi saenicul. ruta an. ℥ iij. mell. uptimi ℥ ij. exponantur soli inclusa vitro stricti orificii probe obturato per mensem tempore astive. Vtemdum ho● medicamento abjectis foecivus.  
iv ℞ axung. porci aq. ros. ublutaʒij. caphura ℈ ss. turiae praepurar. gr. x. al●●s pulv. ℈ j sacchars candi gr. xuj. fiat collyrium.  

For deep ulcers.  In deep ulcers of Cornea tunica use this of H●urni●●, which he bought at a deate rate, and which he hath set down method. ad praxin, lib. 1. pag. 106. ℞ bilaminar. ter. usti ac bis in vini aceto extincti ℈ j myrrhae, plumbi usti ac leti a ℈ ss. croci gr. v. opie gr. ij. aeris ust● ℈ iiij. decocti fanugraeci ℥ j terantur omnia supor lapidom pictorum ac fiat collyrium. Having first made clean the eyes with a sponge dipped in the mucilage of Fenugreek and Linseed, dress the ulcerate eyes twice in the forenoon, and so often in the afternoon.  
Collyrium de plumbo described by Rinodaeus, set down by him in Dispensatorio medico lib. 5. cap. 11. de collyriis, is an effectual medicament. ℞ plumb● uste, antimon. turiae lotae, aeris usts, gumm● Arabici, tragacanthi an. ℥ j opiiʒss. fiat ex omuib ut pulvis ex quo cum aqua resacea formentur trochises: dissolve one of them in Plantain and Purslane water, and dress with this medicament the eye. 
Purging of the body.  When you are a dressing the ulcers of the eyes, minister once a week a purging medicament. If you use Pil●, minister (according to the advice of the Arabiane) Pilula alephanginae, or Pilula lucis majores & minores, or the agaric, minister a dram made up into four Pills, which are to be covered with silver foil: or use this pill; ℞ Spcoier. hire. ℥ ss. Diacridiiʒij. Trochiscor. Alhaxdal. ʒv. Cum Syrupo Augustano fiat massa. One pill of this composition weighing twenty grains, will purge sufficiently. If the party cannot swallow pills, minister to him this potion: ℞ carieostin. & Electuar. lenitiv. an. ʒiij. Pulu. sancti ℈ ij. Fulu. Holland. ℈ j Syrup. ros. solutiv. cum Agaricoʒuj. aq. Beton. Faenicul. aut Euphrag. ℥ iij. Misc. ut fiat potin.  

The ordination of the things not natural.  To these medicaments both inward and outward, the, right use of those things which are called Non naturales must be joined, or else the curation will be protracted and prolonged.  

The Air.  The Air then must be temperate in its first qualities, as being neither too hot, nor too cold, too moist, or too dry. It is not good to abide in the heat of the Sun, nor the beams of the Moon, or any open air: the party is to shun Southern and northern winds: for the Southern wind, according to Hypocrates, troubleth the sight, 
aphor. sect 3.  causeth hardness of hearing, an heavy head, dull senses, a lazy body, because it begetteth gross spirits. And the Northern wind is very sharp, and therefore it stingeth and pricketh the eyes: neither must the air be too lightsome; for it scattereth the spirits.  
The bread must be made of clean wheat, 
Bread.  well-leavened, and somewhat salted, wherein may be put Fennill, Anise, and Coriander seeds: for unleavened bread is accounted hurtful to the eyes.  
As for fleshmeats these are good: 
Flesh.  Chicken, Capon, Hen, Partridge, Pheasant, Pigeons. Larks, the Pie, the Swallow, and the Goose-flesh are accounted good for the sight.  
As for fish, Trout, Rochets, Perches, and Pickerels, 
Fish.  of freshwater fish may for variety of diet be admitted: of salt-water fishes, Whiting-mops, and the Smelts are accounted the best. Baked and fried meats, strong spices, as Pepper, Ginger, Mustard, and the roots of the Horse-rettish are not to be used. To meats minister this composition in stead of salt: ℞ Euphragiae, Semin. Faenicul. an.ʒj. Cinamomi & Macis, an. ℈ j Salis communis ℥ j fiat ex omnibus pulvis. All bulbous roots, as Onions and Garlic; and Pulses, as Pease and Beanes, are to be rejected; as also moist and ●●w fruits: Stewed Prunes, and Pears, or Quinces preserved, are permitted after meat, to stay the ascending of vapours to the head, and the Marmalade of Quinces, with some Aniseeds, Fennill-seeds, and Coriander-seeds Comfits.  
As for drink, 
Drink.  no liquor is more convenient than six shillings Beer, neither too new, nor too stolen, having had a bag of boulting-cloth hung in it, filled with Eye-bright, Fennill-seeds, Betony, Rosemary, sweet Marjerome and Sage.  
If the party hath been accustomed to wine, 
Wine.  let him use some small wine, not sharp or vaporous, wherewith some good spring-water must be mingled, and Borrage-flowers, and Burnet-leaves are to be put into the cup: and this will serve for two purposes: for the colour will comfort the eyes, and the herbs by their property will repress the vaporousnesse of the wine. The less one doth drink the better will the Patient be, and the sooner cured. A small kind of Meath made after this manner will not be amiss: ℞ Aq. font. lb. xv. Mellis optimi lb. j Faenienl. Euphrag. an. man. j Macisʒj. Coq. adtertiae partis consumptionem semper spumam auferendo, 
Sleeping and watching.  actandem colando. Immoderate sleep filleth the head full of vapours, and immoderate watching doth spend the spirits, cool the brain, and hinder the sight. It is good to go to bed three or four hours after supper, and to rise early, and to walk softly up and down the chamber, to comb the head, 
Exercises.  pick the ears, and to empty the excrements. Much reading is not good, especially after meals, and weeping is very hurtful.  
The body must still be kept soluble with lenitive clysters of Diacathol. the syrup of Althaea, 
Solublenesse.  and the oil of Lilies dissolved in the ordinary decoction appointed for clysters. Take this for a parterne: ℞ Diacathol. ℥ jss. Syrupi de Althaea ℥ ij. ol. Lil. albor. ℥ ij. Decoct. communis pro clysterib. ℥ viij. Misc. ut fiat clyster. If the party will not admit a clyster, then minister half an ounce of Electuar. lenitivum, in seven spoonfuls of broth made of a Chicken. After meals use this or the like digestive powder: ℞ Semin. Faenicul. & Coriand. Saccharo semel incrustatorum, an. ℥ j Cort. Citri, & Myrobalan. Kebul. conduit. an. ʒiij. Euphrag. siccat. ʒij. Macisʒj. Sacchari rosat. Tabellat. ʒjss. fiat ex omnibus pulvis. Does. cochl. 1 à singulis pastibus.  
Hitherto I have delivered unto you the differences of mild ulcers; 
Of malign ulcers of the eyes.  now I will speak of the divers kinds of malign ulcers of the eyes. These are either not contagious, or contagious. The not contagious are two; Noma, and Vlcera cancrosa. The contagious are three; Carbunculosa, Venerca, Morbillosa. Of these in order I will discourse briefly.  
Noma, or Vlcera depascentia are malign ulcers, 
Noma.  which sometimes begin at the corners of the eyes, sometimes at the white, and sometimes seize upon the horny membrane. In corrupt bodies they fret exceedingly, and go forward in such sort, that oftentimes they consume the parts adjacent, as the muscles and lids of the eye: 
Signs.  from them floweth a stinking slimy matter: the pain is grievous, and the diseased party hath an accidental fever.  
This ulcer is dangerous, 
Prognostics.  and seldom cured without deformity and loss of the sight: wherefore my counsel is, that you foretell the danger, if such ulcers be offered to you to be cured.  

The local medicaments.  Only I will acquaint you with some local means, having spoken sufficiently of the general intentions. Apply then to the ulcer the juice of Plantain. Horse-tail, Knotgrass, Nightshade, and Yarrow clarified with Honey, and the whites of Eggs: Dress these ulcers morning and evening, dropping a few drops into the affected eye, covering the eye with a cataplasm made of Vngn●●●●um ros●t 〈◊〉, the pulp of a Quince boiled, and some ●y●e of P●pp●es. If these ulcers prove very malign and corroding, you may correct them by instilling some oil of Vitriol, or Sulphur, mingled with Plantane-water, taking only the fourth part of it. To assuage the pain use this cataplasm: ℞ Mala Cydonia numero 2. Sedi major. et Solani hortens. ana man. ij. coq. in ss. q. Lact. muliebr. vacc. capr. aut asinae, addatis Croci ℈ j ac fiat cataplasma.  

A cancerous ulcer.  Vlcus cancrosum, a cancerous ulcer followeth, which the Chemists pronounce to be caused of an arsenical salt, and it is like to be so: for in this ulcer, besides corrosion, there is a septick or putrefactive quality. It beginneth in the black of the eye.  

The signs.  In it the black and white of the eye are reddish, lines seem to be sent from the black to the temples: the Patient refuseth food, by reason of the exceeding great pain, a thin darkish and sharp humour floweth from it, and it is exasperated, by reason of the application of sharp medicaments.  
You an only promise a palliative cure of this malign ulcer, 
Prediction.  by the application of anodine means, after you have used the general indications before specified. Paulus Aeginet. lib. 3. c. 22. affirmeth it to be an uncurable evil. He counselleth to feed the Patient with milk, panadoes, and other meats of a good juice, and of an easy concoction.  

Local means.  Mild eye-salves are also to be applied, as this: ℞ Mucilag. Semin. Cydon. et Palicur. Aq. ros. extract. ℥ j Trochisc. albor. Rhas'. cum opioʒj. fiat collyrium quod tepidum applicetur. Renovetur mane et vesperi. Desuper applicetur hoc cataplsama. ℞ Pome cocta num. 3. Cassiae recent. extract. ℥ ss. Croci ℈ j Lactis mulieb. ℥ j Albumen ovi unius: fiat cataplasma. So much then concerning the handling of malign ulcers of the eyes, 
Malign ulcers proceeding of contagious diseases.  wherein there is no contagion.  
Ulcers which are caused of contagious diseases follow, as the Small Pox, the French Pox, and the Plague: If you fear that the Small Pox are like to 'cause ulcers in the eyes, which you shall conjecture if there was an inflammation in the eyes, 
Of ulcers caused of the Small Pox.  before any did appear in the body; if the party feel pain in the eyes, and cannot open the eyelids, then are you to apply gentle fomentations to the eyes, 
Topics.  as the brest-milk of a sound woman, having a little Saffron mingled with it; or the Mucilage of Fenugreeke, Lin-seed, and Quince-seeds, drawn with Rose-water, having some Saffron added to it. You shall not need to look for any other medicaments in these ulcers.  

Venereal ulcers.  If the ulcers be venereal, caused of the great Pox: then with all expedition are you to go about the curation of the main grief, jest blindness quickly ensue, and then to labour to cure the ulcers of the eyes, which are but only symptoms of the disease. Rinod. in dispensat. med. lib. 5. c. 11. it setteth down an excellent eyesalve for this purpose, ascribed to Lanfranck by the Neotericks, which he could not find in the works of Lanfranck (as he confesseth) so that by all likelihood it is a magistral receipt. The description of it is this: ℞ Vini albi lb. j aq. Plantag. & rosarum an. ℥ iij. Auripigment. ʒij. Virid. are. ʒj. Aloes, Myrrh. an. ℈ ij. Terrantur ista subtilosmè, & fiat collyrium.  

Of the ulcer caused of a pestilential Carbo.  I will add a little of the ulcer of the eye, caused of a pestilential Carbo, or Anthrax, and so end. In this case, first there ariseth a small tumour in the eye, hot, hard, painful, and contagious, caused of a thick, burned, and venomous humour: It is hot, the unnatural heat causing an ebullition of the humour: It is hard, because the heat burneth the humour: It is contagious, by reason of the venomous humour which causeth it: when it yields matter it stinketh, by reason of the putrefaction of it.  

The symptoms.  It is accompanied with watching, drought, internal heat, raving, and the urine is sometimes of a fiery colour, sometimes thick and troubled.  

The curing of it.  If these symptoms appear, then are you first of all to minister such Antidotes as are fit for a pestilential fever, as Th●riaca Andromachis, Antid●●m de sangui●ibus, Electuarium de ovo, and such like, to tame the venenosity of the matter, and then to proceed to the curing of it. If you perceive call the capital instrument, the gibbous or arched part being blunt, and having a back; but the belly being as sharp a a razor: when you have compassed all the part united, having turned the back of the instrument towards the eye lid, cunningly separate the parts united, neither offending the eyelid, nor any tunicle of the eye. But if either of these must be touched, it is best that the eye lid suffer, than any tunicle: for it may more securely suffer the injury. When this operation is performed, if you be not vigilant in keeping the parts separate asunder, they will easily unite again. as Celsus noteth.  
In setting down the operation, Celsus calleth the instrument Specillum: 
Specillum.  As for that instrument which goeth commonly amongst the Ancients, under the name of Specillum: It did absolutely represent your ordinary Spathula's, being on the one end narrow and round, to serve for a probe, ending in a round small button, to hinder it from offending, when you are to try the depth of an ulcer, or wound, and on the other broad and flat, to spread your unguents: of the broadest end Galen speaketh, Method. 13. c. 5. where he adviseth to besprinkle an ulcer with the powders, using lato Specilli mucrone, the broad end of the Specillum, or Spathula.  

A note.  One thing is to: be noted, that if (you fear that in putting in of the instrument into the eye, to comprehend the parts united) you fear to hurt any part with the point, than it is requisite to arm it with a little wax, that it may be like the end of a probe.  

The local medicaments.  To the parts thus separated, apply a Collyrium made of Plantane-water, and Tochisci albi Rhasis sine opio: dissolving in an ounce of the water, a dram of the Trochisces. Keep the parts asunder with small dosils of lint put between the parts disjoined, laying upon the eye a couple of bolsters cross-ways, moistened with the afore-named medicament, and then rolling it up: Dress the eye morning and evening, to hinder unition, and hasten the cure, until the incised parts be cicatrized, and no fear left of cleaving together again of those parts, which by manual operation were severed.   

LECT. XXVI. Of Ozaena.  
HAving set down the ulcers which ordinarily possess the ears and eyes, I must not let those pass which sometimes trouble the instruments of the other two senses, to wit, smelling and tasting, which are the nose and the mouth. Of all the ulcers of the nose, I will only speak of Ozaena, omitting the rest; because they require no singular consideration: for the general indications of curing of ulcers, will serve to lead any man to the curation of these.  

The Etymon.  Ozaena hath its denomination from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, which according to Celsus, lib. 3. c. 11. is Foetor oris, the stinking of the breath.  

What it is.  Of it Galen, de comp. medicam. sec. loc. lib. 3. c. 3. so discourseth: Polypodes are bred in the nostrils, which are tumours unnatural: but Ozaenae are a kind of ulcers, etc. First of all, I will speak of the Ozaenae, which are produced of the influxion of sharp, and putrid, or rotten humours. These humours, if they be only sharp, they produce ulcers hard to be cured; but not of a grievous smell: Out of Galen than you may gather, that Polypodes are only tumours in the nose, but Ozaenae are ulcers. Secondly, 
The differences of Ozaenae.  that there are two sorts of Ozaenae; the one is of these which erode, being caused of the influxion only of sharp humours, but stink not. The other is of these which smell grievously, and are caused not only of sharp humours, as the former; but such also as have putrefaction annexed to the erosion. Actuar. lib. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 c. 10. so speaketh of this kind of ulcer. Ozaena doth manifest itself by its very name, which corrupt and evil juice. Secondly, that he use great moderation in the use of wholesome and convenient food.  

How fasting is profitable.  Fasting often in this case is very requisite: First, because it drieth the habit of the body: Secondly, because it furthereth concoction: Thirdly, because by fasting those vapours are digested, which otherways would mount up to the head. And although in the beginning, while the body is fraughted with sharp humours, the sore may be exasperated by fasting: yet after that the body is clean, and discharged of such humours, by frequent evacuations, you shall find the commodity of fasting: howsoever, the dinner must not be riotous, and the supper very spare.  
The second Physical means is Phlebotomy: 
Phlebotomy.  If the body be plethoric: First, open the Cephalica of the right arm in the Spring and Summer; but of the left, in the Harvest and Winter: Then three or four days afterward open the veins under the tongue, which will serve for derivation of the humour, as the former did for revulsion of the same.  

The commodities of it.  This must much further the curation: For first, Phlebotomy impaireth the quantity of the humours contained in the mass of the blood: Secondly, it maketh way for the receiving of better blood into the vessels, which of a necessity must ensue after the appointing of a convenient diet, and exquisite purging of the body, which immediately after Phlebotomy is to be performed.  
The third Physical mean appointed for the curation of an Ozaena, 
Purgation.  was said to be purging of the body by catharticall medicaments: for vomitive medicaments are not so convenient as the catharticall, in the diseases of the head, unless the stomach be foul, and pestered with raw and corrupt humours, which require a long time for concoction: Vomitions (as is confessed by all Practisers) sand up vapours to the head.  

Their kinds.  These purging medicaments are of two sorts: for they are either vegetable, or mineral.  

The vegetable purgatives.  As for the vegetable medicaments, they must be of the strongest, which are appointed for disburdening of the head of ill humours: such are Agarick, Turpetum, Coloquint, Scammony, the black Ellebore. But seeing the purgative simples are seldom ministered alone, I will show unto you what compounded medicaments are fittest to be used in this case. The compounded purgative medicaments are either Pills or Potions.  
As for the Pills: 
Pills.  If the humours be mixed then use E●tractum Panchimagogic●● of Paracalsus, or the Pilula e●tracta R●u●●●; of them minister half a dram for a dose: Let the Patient use this medicament twice a week. If choler and phlegm corrupted be the material cause of the ulcer, then minister the pills called Sine quibus esse no●●. If thick and gorsse humours be the cause, ministe 1 Pilula a●●●a, & coctia. It corrupt phlegm be the cause, minister Pilulo de Agarito. Of these pills minister one dram for a dose: let the number of the pills be according to the swallowing of the Patient.  
If the Patients be hard to be moved to the stool, you may acuate, and make the pills more effectual, by adding to every dose of the pills some grains of the Trochisces of A●●andal, and three grains of Dacrydium.  
If the party cannot swallow pills, 
Potions.  than you are to minister potions. The Electuaries most fit for this purpose, are Diacatholicum, Caricosti●●m, Diaph●●●icum, Elect●ar●um de succo rosarum, Confectio Hamech, Diac●●rhamum. Of these Electuaries, and convenient syrups, and distilled waters, or decoctions, you may make potions fitting the constitutions of the parties grieved.  
For one of a choleric constitution minister such a potion: ℞ Caricos●i●. & El●●tu●●. de s●●c● res. an. ʒiij. Syrup. de C●●bor. cum 〈◊〉 ℥ j aq. Endivia ℥ iij. Misc. ne fiat potio.  
If the party be of a phleg●●●●● constitution, minister this potion: ℞ Diaph●●. & Diego 〈◊〉 〈◊〉, an. ʒiij. Syrupi ros. solut. cum Agarico ℥ j aq. Beton. ℥ iij. Misc. ut fiat potio.  
If the diseased person be of a melancholy temperature, then minister this potion: ℞ Confect. Hamechʒiiij. Diacartham. ʒiij. Syrupi Augustani ℥ j aquae Fumariae ℥ iij. Misc. ut fiat potio.  
Thus you may purge the body with vegetable medicaments, if the body of the diseased party be weak, or if you fear the use of minerals. But let me insinuate so much unto you, that the mineral medicaments, if they be well prepared, are most effectual, and if they be ministered by a skilful Practiser, howsoever they are slighted and despised by those, who glory of the denomination of Galenists, amongst whom some may be found, whose skill is inferior to the envy of an understanding man.  

Mineral medicaments.  The mineral medicaments are more subtle and piercing than the vegetables, and sooner altar the complexion of the party unto whom they are ministered. These medicaments are most commonly taken from Antimony and Mercury.  
The Antimony which purgeth most by stool is excellent. 
Antimony.  The Sulphur of Antimony drawn by Art from the recrements of the Regulus is good; as also the Regulus itself calcined and fixed with Salpeter, and brought to a white powder. The glass of it, and Crocus metallorum, are not so convenient and secure, because they procure strong vomitions.  
There be divers preparations of Mercury which are very effectual; 
Mercury.  as Mercury precipitate, with Aqua fortis, the oil of Vitriol, or Sulphur, with Gold or Silver, or precipitate alone, without the addition of any thing. There is none of any note amongst you, who is not able by one preparation or another of Mercury, to procure salivation.  
These Mercurial medicaments are effectual, as well in an Ozaena which is a primary disease, or of itself, as in that which is a symptom of the French Pox. You have heard what diet is most convenient, and what internal medicaments are most effectual in curing of an Ozaena: The last point which I propounded unto myself to attain to the curation of this ulcer, was the right use of the external medicaments.  

The external medicaments.  These are in number two; to wit, the local medicaments, and the actual cautery.  
As for the local medicaments, they are either waters, or decoctions, or unguents: But before you apply any medicaments to mundify, incarnate, or cicatrise, you must labour to remove the crusty substance, 
How the crusty substance is to be removed.  which doth fix itself in the forepart of the Ethmoides, or Os Cribriforme: and that for two causes: First, because the brain is hindered from discharging of the residue of the malign humour, which causeth the ulcer, and so the curation is protracted: Secondly, because the medicaments cannot touch the affected parts, and so no alteration can be procured.  
For the removing of the crusty substance, I commend unto you two medicaments:  
The first is this: ℞ Ol. A mygdalarum dulcium ℥ j Spermat. Cetiʒij. exquisitè misceantur:  
The second is this: ℞ Axung. Vrsi ℥ j Pinguedin. Taxi ℥ ss. ol. Semin. lin. ʒiij. Miso.  

The manner of the applying of these medicaments.  You must thus dress the Patient: Turn his face upward, and let his head be bend backwards, than morning and evening with three feathers tied together, drop still some of these medicaments warmed in a Saucer, into the nose, and let the party grieved still draw in his breath, until he feel the taste of them in his mouth.  
When you have perceived that the crust is soft, morning and evening let him snuff up into his nostrils some of this sternutatorie powder: ℞ Ellebor. albi, Nigilla, Tabacc. an. ℈ j Rorismar. Salu. an. ℈ ij. Moschi gr. ij. fiat pulvis subtilis. Let him snuff a little up into his nose every morning, after you have moistened the crust with some of the medicaments set down before. When part of the crusty substance is fall'n out, dress it still after this same manner, until all the crust is spent: 
The medicament, to be applied.  then proceed to the application of the medicaments named by name.  
Use these waters.  

I. Waters.  First, the pre-eminence shall be given to Aqua alumini● magistralis of Fallopius allayed with Plantain, or white Rose-water.  
The second shall be this: ℞ Aq. Plantag. Card. Benedict. Caras. nigror. & fragor. an. ℥ iii Spirit. Vitriol. ℈ i Misc.  
The third shall be this: ℞ Aq. aurifabror. & gemmar. quercus an. ℥ iiij. Alum. ʒij. Exquisitè misceantur & depurentur.  
The fourth shall be this: ℞ Aq. Alum. & Plantagin. an. ℥ iiii. Mercur. dulcisʒii. Digerantur in cinerib. calidis per her. 2.  

●I. Decoctions.  As for Decoctions, I commend unto you these:  
I ℞ Flor. ros. rub. pug. two. Balanstior. ʒss. rad. Tormentill. ʒi. fol. Plantag. Polygon. & Vinca pervinc. an. pug. 1. Boil these in six ounces of spring-water, until the half be consumed; strain then the three ounces remaining, and dissolve in them one ounce of Melrosatum.  
II. ℞ Rhois Coriar. lb. ss. Alumin. ʒii. coq. ista ac clarificextur albumine ovi unius, ac colentur. Colaturae adde mellis rosat. Syrup. Myrtill. & deroes. rub. sicc. an. ℥ i I will not trouble you with great variety, as I might out of the monuments of the Ancients; seeing these will suffice, or else none.  

The manner of using of waters and decoctions.  The waters and decoctions you must inject by a fyringe warm, to make your topics answerable to the air, which is drawn by the nostrils in the first qualities, to wit, moist and hot: moist, I say, actu, but potentia, drying; seeing ulcers require such medicaments: seeing both waters and decoctions being applied, do quickly evaporate, and leave the part affected dry, and thirsting for other topics.  

The unguents.  The unguents shall offer themselves; I will not supererogate in this point, but will only deliver unto you such as shall be effectual; and what is deficient in number, shall be supplied by efficacy. Receive this as the first, out of Daniel Sennert. med. pract. lib. 1. part. 3. sect. 4. c. 1. ℞ plumb. usti, lithargyr. an. ℈ i ceruse. bol. Armen. ballast. an. ℈ ss. ol. ros. myrtin. an. ʒ ss. cerae alb. ℈ i Ducantur ista in mortario plumbco, donec acquirant unguenti confistentiam. The second shall be this: ℞ unguent. de tutia, & unguent. albi caphurati, an. ℥ i ol. myrtill. et cydon. an. ʒii. Mercur. dulcis ʒ two. Mercur. dulcisʒ i ss. pulverizati. Misceantur. These ulcers are to be dressed twice a day, morning and evening.  

Cancerous ulcers.  Cancerous ulcers also seize upon this part. This grief hastened the end of that famous Mathematician, Mr. Hariot, with whom I was acquainted but a short time before his death; whom at one time, together with Mr. Hughes, who wrote of the Globes, Mr. Warner, and Mr. Turperley, the Noble Earl of Northumberland, the favourer of all good learning, and Maecenas of learned men, maintained while he was in the Tower, for their worth and various literature. But seeing those documents, which I delivered for the curation of cancers already, may suffice, I will only set down the description of an effectual water in this grief, which is this: 
A water fo●● cancer in the nose.  ℞ spermat. ranar. et limacum, an. lb two. gemmar. quercus, et hederae terrest. an. ℥ iiii. Extilletur aqua è stillatorio communi, unde prolici solet aquarosacea in recipiens, cui immissae sint caphurae calcinataeʒ two. Inject this water into the nose, and lay to the sores either double clouts, or lint moistened in this water, as you shall think most fit, morning and evening.  

The application of the actual cautery.  It resteth only now that I speak a little of the application on of the actual cautery, which was said to be the second external means in the curing of an Ozaena: this mean is only used when the sore is rebellious to powerful ordinary means; which happeneth either by reason of malignity, or too much, or superfluous humidity: 
When it is to be applied.  for according to Hypocrates aphor. lib. 1. aphor. 6. Against extreme griefs, extreme remedies are best.  

The uses of it.  The actual cautery is applied for two purposes:  
First, to 'cause an eschar by impressing of it upon the ulcer.  
Secondly, it is used only to dry the ulcer, by often applying of it, still desisting before the party feel any pain, by reason of extreme heat.  

The pipes.  If you mean to procure an eschar, both the ends of the pipe by the which the cautery is carried, must be open; but if you intent desiccation, the end which you apply to the ulcer, must be shut.  
If you have procured an eschar, the fall of it is to be procured as I did show in removing of the crust: this being done, proceed in curing of the ulcer as hath been taught.  
If only you have caused desiccation by iteration of the application of the actual cautery, the manner of curing is not to be altered.   

LECT. XXVII. Of the ulcers of the mouth.  
NOw am I to discourse of such ulcers as befall the instrument of taste, which is the mouth.  

The limits of the mouth.  It beginneth at the lips, and reacheth to the beginning of the windpipe, and the Gula, or mouth of the stomach.  

The uses of it.  It hath four uses: I. It serveth for breathing, it sending fresh air unto the lungs, and discharging fuliginous vapours sent from the heart by the Arteria venosa.  
II. It receiveth the food, and having prepared it by the chewing of the teeth, and the mandible, it sendeth it to the stomach there to be chylified.  
III. It serveth for speaking: the external and internal parts of it serving for the framing of the voice.  
iv It serveth for the discharging of the excrements of the brain, by spitting out of the excrements of the lungs by expectoration, and of the excrements of the stomach by vomiting.  
Seeing then the uses of it are so manifold and necessary, it behoveth me to discover such diseases (belonging to our purpose) as deprive us of one or more of these commodities which it affordeth to us. But seeing some of the parts of it are external, as the lips; and some internal, as the teeth, gums, roof, the tongue, the almonds, the uvula: I will only meddle with the ulcers of the lips, roof, tongue, almonds, uvula, and the ulcers of it beyond the uvula, as only being proper to my intention.  

Of the ulcers of the lips.  I will begin first with the ulcers of the lips: how hurtful the ulcers of the lips are, you may gather from the commodities, which they (being sound) afford to man.  

The commodities of the lips.  The lips afford a sixfold commodity to the life of man:  

I. They serve for the convenience of eating and drinking, for they keep in the meat until it be chewed.  
II. They beautify the face if they be well fashioned.  
III. They keep in the spittle of the mouth.  
iv They keep the teeth and gums from external injuries.  
V They serve for the framing of the speech.  
VI They serve for kissing, the earnest penny of lust.   
And although the benefits which do redound unto us by the lips, being well affected, may be hindered by sundry means: yet I will touch only but two sorts of solution of unity befalling to the lips, as proper to the subject which I have in hand, which are the chaps of the lips, and the ulcers of the same.  

The chaps of the lips.  Fissura labiorum, or the chaps of the lips, proceed from a salt, sharp, & drying humour, which causeth these narrow, but long small ulcers, 
Their cause material.  which are hot and painful, chief when the party speaketh, eateth, or laugheth.  
These chaps, 
●●●●ictions.  although they may without any great difficulty be cured in persons of a laudable constitution, yet in cacochymical bodies they will give you somewhat to do: in so much that the Patient will wonder and fret, that such toys and trifles cannot more speedily be cured; for so they term such griefs, considering not the quality, but quantity of the grief.  

The curation of these.  For the curation of these, I will commend unto you two medicaments of my own, which I familiarly use: The first is this: ℞ cer. flav. ℥ ij. ol. ros. mell. & axung. porc. in aq. ros. lot. an. ʒiij. litharg. argenti, myrrhae, zinzib. pulv. an.ʒj. fiat linimentum s. a. First, moisten the part with the parties own spittle, and then anoint the part affected with the lineament: it is effectual, not only in chaps of the lips, but in other chinks of Fissurae in what part of the body soever they be; and it cureth speedily.  
The second is a Pomatum, the description whereof is this: ℞ Pomae numero 3. quibus infige cariophyll. ℥ ss. styrat. calamit. ʒiij. benzoiniʒij. labdan. ʒiss. calam. aromat. cinnamon. an.ʒj. axung. porc. lib. ij. aq. lavendul. & ros. an. ℥ iiij. Moschi, civetae an. gr. iss. Indantur ista vasi terreo satis amplo, ac calore B. N. evaporentur aquae, & colatur pomatum, quoth in vase puro servetur. You may conjecture the efficacy of this medicament by the ingredients.  

Ulcers of the lips.  As for the ulcers of the lips, they are either mild, or malign.  

For the mild.  As for the mild ulcers, this ointment described by R●●odaus, Antidote. lib. 5. sect. 1. cap. 11. which he calleth Vnguentum de minio, or Vnguentum rubrum caphuratum, is very effectual: compos. haec est: ℞ minii triti ℥ iij. lithar. argent. ℥ ij. cerussae ℥ iss. tut. ʒiij. caphur. ʒij. ol. ros. lib. j cer. albi, ℥ iij. fia●ung. ut ●rsprascribit. This unguent is effectual against even old and inveterate ulcers, in what part soever of the body they be.  

For the malign.  If you perceive an ulcer of the lip to be malign or cancerous, which you may conjecture if the colour be livid, or blackish, if the brims be hard, if the heat and pain exceed the quantity of the ulcer, and if it yield a sanious and ill smelling quittor; then are you to look about, and to espy which are the most powerful medicaments.  
When I discoursed of a Cancer, a Nome, and a Phagedaenicall ulcer, I delivered unto you choice of local medicaments: for such ulcers, if they happen to invade the lips, at this time I will only deliver unto you a description of a distilled water, and of a magistral unguent.  
The water is thus to be made: ℞ fol. plantag. solani hortens. veronic. sempervivi major. & minor. an. man. iij. albumina ovorum conquassata num●ro xij. alumin. contus. lib. ss. caphur. ʒiss. Extuletur aq. calore balnei: fomentetur cancr●su●●, aut malignum●lc●● hac aqua, quae & facici ruborem tollit. The description of the unguent is this: ℞ plumbiʒiij. fundatur in crucibulo, eique addatur Mercur. ʒiss. postquam refrixit man. in pulverem vertatur massa, cui adde unguenti de tutiaʒuj. terebinthin. ʒij. terebinthin. ʒj. ol. myrtil. ʒiss. fiat unguentum quod ulceri post fotum applicetur. Deligetur ulcus singulis diebus quoties opus est. If you found the ulcer to be rebellious, and not to yield to these very convenient and effectual means, then are you to apply such medicaments as I have set down for the curation of Nome, Phagedaena, and Cancer, when I discoursed of them, whither I remit you, to shun tedious and fruitless repetition.  

The ulcers of the Palatum.  To the ulcers of the lips, the ulcers of the Palatum, the roof of the mouth must be annexed: It is rawted, that the air being repercussed, the voice should be the sharper: it is wrinkled and rough where it covereth the bone, 
It's figure.  that it might the more firmly cleave to it, and the better stay the meat whilst it is in chewing.  

The instrument of tasting.  Now seeing all the internal parts of the month are induced with the sense of tasting, but chief the membrane which covereth the tongue, 
The instrument of feeling.  and have the exquisite sense of feeling, by reason of the nervous fibres, whereof they have great store, you are to have a care that your local applications be not distasteful and loathsome, seeing the parts will abhor them. If then the wrinkled skin, which covereth the Os palati, be ulcerate: first, touch it with Aqua Fallopii, allayed with Plantane-water, if it be foul; or with this: ℞ aq. plantag. card. bonedict. & spermat. ranar. an. ℥ iij. melius ros. ℥ ij. ol. sulphur. aut vitriol. ℈ j Misc. Having touched the ulcer with either of these waters warmed sufficiently, apply this medicament: ℞ syrup. è ros. rub. siccat. è baccis myrts, & de succo granatorum an. ℥ j ol. vitriol. ℈ ss. Misc. Seeing the part is moist, and will not admit any deligation, you are to dress it the more often. If you perceive the Os palati to be bore, then mingle some of this powder following, mingled with these syrups: ℞ far. hord. rad. irid symphyti, tormentil. an. ℥ ss. mastiches, boraces, sarcocol. an. ℥ ss. fiat ex omnib us pulvis. If the rough skin unite, as I have often seen, then have you obtained your desire.  

What is to be done when Os palati falleth out.  If a small piece of the Os palati fall out, using these incarnative using these incarnative means, and keeping the brims of the ulcer raw, you may bring them together; but if a large piece of the bone come away, there is no hope of unition. In this case, you are to 'cause the party to wear a plate of silver to supply the defect of the bone, that his speech bewray not the loss of it.  
The third internal part of the mouth, which useth to be ulcerate, 
Of the government of the tongue.  is the tongue. The tongues of Angels are not able to express what benefits do redound unto man by the right ordering of the tongue, and what harms and inconveniences again, when we give it free reins to lash out. The frequent exhortations set down in the holy Scripture to the first, and dehortations from the second, may make us wary in our discourses & conferences. It is that part of the body by the which God is chief glorified; by it we praise and magnify him, as godless persons blaspheme him with it we confess our sins, by the which we provoked him to anger; and again, we pour out our prayers with the tongue to obtain remission for them.  

The uses of it.  The tongue affordeth four benefits to the body. I. It is the instrument of tasting, by the benefit of the membrane wherewith it is covered.  
II. It uttereth the speech, by the which we communicate our wants to others, and implore aid in time of distress.  
III. It helpeth chewing, by gathering of the meat together, and tossing it to and fro, it turneth also the meat down to the stomach.  
iv It serveth for licking. To omit that in our infancy we could not suck without it: so we see, that if the fraenum of it come too near to the tip of it, the sucking is hindered, and it must be cut. The children who have this infirmity, are said to be tongue tied. The flesh of it is spungeous, 
How mild sores of the tongue are cured.  that it might receive the qualities of the sapours, and the more accurately judge of them.  
If the sores of this part be but ordinary and mild, this medicament will serve if it be often washed with it: ℞ hord. mundat. ℥ iij. rad alth. ℥ ij. liquirit. ℥ iss. Bulliant ista in lib. vj. aq. font. ad mediat ac coletur decoctum, cui admisce syrup. viol. tussil●g. & scabiosae an ℥ jss. ac serva in mundo vase ad usum.  

Of malign ulcers of the tongue.  It falleth out sometimes, that sores in this member prove malign and very fretting, causing one of those ulcers which are called, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 as it happened to the late Lord Mayor of London, Ralph Freeman. He lacked neither Physicians nor Physic, yet old age, weakness, and the malignity of the sore hindered the procuring of his health, which his Physicians and Chirurgeans aimed at and wished for. The ulcer was so corrosive, that it fretted asunder the veins and arteries of the tongue, on that side which it possessed, and caused a great flux of blood, which exceedingly weakened him, for that present causing a strong syncope, so that afterward nature could not recollect herself. When such griefs befall great personages, their case is worse than that of the poorest in the like infirmities, because Physicians and Chirurgeons are not permitted to use the like liberty in the application of medicaments to the one, as to the other. If the like case fall out hereafter at any time, I advice you so to use medicaments borrowed of the vegetables, as that you contemn not the minerals: What hurt I pray you can come from the use of Merc. dulcis, and Merc. praecipitat with gold: None I assure you: for these medicaments are familiar to nature, and are true balsams for malign sores.  
Quest. But you may ask what was the reason that these medicaments were not used?  
Answer. I answer, because there was no mention made of these medicaments at the first, and it was too late to minister them at the last, nature being surprised; for this only would have made the medicaments odious, and the Physician, (who should have advised this course) obnoxious to calumny and reproach.  

Of ulcers of the Wula.  Now time admonisheth me to come to the ulcers of the Uuula, or gargarion.  

Of mild ones.  If they be mild and ordinary, the former medicaments set down for the curation of the tongue will suffice.  

Of fretting ulcers.  But if it be a fretting ulcer, first you are to admonish the patiented of some accidents, which may ensue: and those are two in number.  
The first is, 
Prognostics.  that if the Uuula be wholly fretted away, the party shall hardly be able to speak clearly and distinctly. Howbeit both Bauhinus in his Theatr. anatomicum, and Guillelmus Fabricius Hildanus cent. 2. observ. 21. do affirm that in some they observed it to have been lost, not leaving any defect in their speech.  
The second accident is, the danger of pthisis, or cough of the lungs, for this is to be feared, seeing the member which did hinder the roushing in of the cold air into the lungs, and put back from the breast humours distilling from the head, is wholly taken away. Having acquainted the patiented with prognostics, proceed to the curation.  

The curation.  This is performed either by the application of convenient medicaments, or else by cutting it away.  

1 By medicaments.  As for the medicaments, use first this gargarism: ℞ fol. plantag. veronic. et sigil. Salom. an. man. 1. scored. orig. centaur. minor. an. man. ss. Bulliant ista in lib. 2. aq. font. ad consumpt. lib. 1. & coletur decoctam, in quo dissolve oxymellis simplicis ℥ iij. Then touch the sore morning and evening with this lineament: ℞ ung. Egypt. ℥ ss. alum. pulv. ʒss. mell. ros. ℥ ss. Misc. applicetur mane & vesperi.  
If it proceed from a venereal cause, use this topic twice a day: ℞ aq. card. benedict. & plantag. an. ℥ vi. aq. fort. ʒi. Misc. you may also use the blue water, which you may buy for threepences a pint after the silver is separate, after solution, and hath no other mettle in it, but a little of Venus. If these means will not prevail, than you must wholly cut it away.  
But according to Valescus de Taranta, 
* Lib. 3. cap. 3.  you must observe these five things before you go about this operation.  

1. You must purge the body well.  
2. No humour must be in flowing to the part.  
3. You must not attempt this operation as long as there is hope that other medicaments will prevail.  
4. Go not about this operation, unless it be small about the root, for if it be thick, and read, or blue, such a flux of blood may ensue, as will strangle the party, and cause fainting.  
5. Mark how much of a necessity must be cut off, for a little remaining will both further the speech, and repel the cold air from the lungs. If after the cutting of it off, a flux of blood ensue, either apply astring or else cauterise it with the Uuula spoon made hot.   

Ulcers of the almonds.  If the Tonsillaes or almonds be ulcerate by reason of the influxion of sharp humours, which your eyes can discern, the tongue being pressed down by your spathula, carry in mind these prognostics.  

The Prognostics.  I. If the ulcers be without a fever, they are the more safe.  
II. If these ulcers happen in the summer, they sooner spread.  
III. If these almonds become scirrhous they are hardly or never cured.  
iv These ulcers as all other ulcers of the mouth, require stronger desiccatives than the ulcers of the external parts; First, to hinder them from spreading. Secondly, because they are still kept moist with the spittle.  
For the curation of these ulcers, I will deliver unto you two local medicaments: The first is the decoction of the root of the devils bitten to be used in steed of a gargarism. The second is a lineament to be applied after gargarization tried by Seanertus, and set down medicine. pract. li. 2. c. 22. ℞ centaur. minor. rad. irid. stercor. canini. an ℥ cum melle despumato fiat electuarium. As for the faculty of a white dogs turd read Galen. li. 10. the simple. med. facult, c. de sterc●re canino.  

Ulcers of the throat.  If the throat beyond the Uuula be ulcerated, use this water instead of a gargarism as a certain experiment. ℞ aq. plantag. li. 1. ros. rub. flor. arantior. an. ℥ j pulv. Merchant subli. ʒij. digerantur in arena per horam quadrantem ac coletur aqua, 
The curation.  quae in vase vitreo servetur ad usam. If by reason of these ulcers the party cannot swallow any solid meat, minister to the patiented mercurius duleis for four mornings together, and you shall perceive a wonderful effect. Give it in new milk.   

Lect. XXVIII. Of the ulcers of the lungs.  
SEeing the lungs very often become ulcerate, a solution of unity in the substance of them, or an apertion of the vessels of them which are the branches of vena arteriosa, and arteria venosa, being caused by a wound: I must not let such ulcers to slip untouched.  

The cause of the ulcers of the lungs after a wound.  The causes of ulcers of the lungs after a wound inflicted may be assigned two: to wit, a solution of unity in the substance, and vessels of the lungs, and the effusion of blood into the hollowness of the breast, you shall discern the lungs to be wounded,  

Signs of the lungs wounded.  I First, if frothy blood issue out of the wound, and mouth by coughing, which show some of the vessels to be wounded, and opened.  
II. Secondly, difficulty of breathing troubleth the party wounded.  
III. Thirdly, the pain of the sides is grievous, which he felt not before.  
IU. Fourthly, it is more easy for the patiented to lie upon the wounded, than the whole side: So that often he can speak readily so lying, but being turned upon his sound side. he can but with pain and difficulty speak.  

Signs of blood poured out into the capacity of the breast.  You shall perceive and gather blood to have been poured out into the capacity of the breast by these signs.  
I First, if a heavy weight seem to press down the midriff.  
II. Secondly if the party breath with great difficulty.  
III. Thirdly, if the fever increase.  
IU. Fourthly, if the wounded party voided blood at the mouth.  
V. Fifthly, if the breath of the party stink after a while, for that betokeneth the blood to be turned into quittour.  
VI Sixtly, the wounded person can only lie upon the back.  
VII. Seventhly, the party hath a desire to vomit, and striveth to rise, from whence ensueth fainting; for noisome vapours arising from the clotted blood turned into quittour assault the heart, and weaken it exceedingly, and dissolve the faculty of the stomach.  

Whether after a wound of the lungs an ulcer will ensue.  After that the wound is inflicted, and that you have dressed it so long a time as you have required in former times for healing of a penetrating wound of the breast, (which will be shorter in the summer, than in the winter: for heat helpeth digestion) you may fear than a fistula at the lest, or a putrid ulcer of the lungs will ensue: chief if a thin sanies, and not a laudable quittour do flow out, fare in quantity exceeding the bigness of the wound.  

Why wounds of the lungs sand out much quittour.  Why in wounds of the lungs, so much quittour every day is sent out these are the causes.  
I. The vicinity and nearness of the heart, which being the wellspring of the vital blood, doth sand too much of it to the part affected: And when as it cannot make use of all of it by reason of weakness, it turning the remainder by its natural heat into quittour, dischargeth it by the orifice of the wound.  
II. Because the sound parts sand unto the diseased blood and spirits without mean or measure.  
III. Because the lungs draw more nourishment to themselves by their motion, heat, and pain, than they are able to digest.  
iv Because the ulcer like a devouring wolf by its malignity and filth, presently corrupteth the blood sent for nourishment unto the lungs, turning the greatest part into quittour, and defrauding the part affected of maintenance: from whence ensueth the extenuation of the whole body.  

The prognostics.  Now that you may the better foresee and foretell to the patients the events of such ulcers, I would have you to mark these prognostics which I shall deliver unto you.  
1. All ulcers of the lungs are hardly, or with great difficulty cured, and that for four causes.  
1. Because the musculs of the breast, lungs and heart, are in perpetual motion: now motion hindereth consolidation, as all by experience know.  
2. Because the lungs are only environed by the Pleura, the skin inwardly investing the ribs, which is endued but by small store of blood, and being a spermatick part, to wit, a membrane, is not easily united; and that only by the second intention.  
3. Because local means cannot be kept to these ulcers, by rolling, bowlstering, and emplastering, as they may to the ulcers of the external parts.  
4. Because the orifice of the ulcer is not most commonly in a depending part; but either parallel, or higher than the ulcer. How hard a matter it is for quittour to ascend, I leave it to your consideration.  
5. If the party pine not away, if he expectorate easily, if he fleepe reasonable well, if he digest his meat, if his stools be orderly, if the quittour be indifferent good, you may conceive some hope of the cure.  
6. But if the diseased parties breath smell ill, if he consume, if the quittour which floweth from the ulcer stink, if he hath a grievous cough, and difficulty of breathing, if a lingering putrid fever troubling him chief toward night, and hindering his sleep, follow him, if his appetite decay, and the concoction of the aliments be impaired; if a rotten piece of the liver, or of the branches of the wind be thrown out at the mouth, if he have a whistling voice as if he spoke thorough a cane, his case is desperate.  
7. If his hair fall, which happeneth by reason of the want, and corruption of the nourishment: if the nails grow crooked, the flesh of the tops of the fingers being spent, if the cheeks grow to be of a leady colour; but when after meat they seem ruddy, vapours mounting thither, if the feet begin to swell, the natural heat being spent, if lice multiply by reason of the corruption of the humours, you may pronounce, that a diarrhea or humoral flux ensuing, the party shall departed.  
VIII. Although some have lived many years who have had an ulcer of the lungs, 
Lib. 3. sen. 10. tract. 5. c. 18.  as Avicen reporteth, that he saw a woman who lived twenty three years, or thereabout, with an ulcer of the lungs. And as Matth. de Gradil. in 9 Rhas'. c. 54. affirmeth, that he saw a woman who still was busied about the fire, who lived twenty eight years; yet be not you too forward to take in hand such persons as have ulcerate lungs: for the curation is uncertain, and that for four causes.  

Why the curation of the ulcers of the lungs is uncertain.  I. By reason of symptoms which ensue, as are a lingering fever, and consumption of the body.  
II. Because the quittour which is contained in the spongious substance of the lungs, cannot be voided by expectoration without coughing; which doth much trouble the lungs, and exasperated the grief.  
III. Because the medicaments which are ministered to cure these ulcers, cannot come to the lungs in their full force.  
iv Because the fever and consumption of the body require those things which are moistening, but the ulcer those things which mundify, and dry.  
If it chance that by Art and good luck you cure an ulcer of the lungs, charge the party that he walk circumspectly in the course of the residue of his life; for many times when the ulcer hath seemed to have been cured, yet the cicatrix being removed by the ill carriage of the patiented, the ulcer hath gotten footing, and been the cause of untimely death, as Galen witnesseth, 4. de loc. affect. c. 5.  

The indications of curing.  When you go about to cure such ulcers, you are to propose three indications curative to your self.  
The first is, the appointing of a convenient diet.  
The second is, the ministering of fit pectoral decoctions.  
The third is, the artificial dressing of the ulcer.  

The di●●▪  As for the diet: the party having an ulcer of the lungs, must eat meat of an easy concoction, because nature is much weakened; of good juice, jest putrefaction be increased; and lastly, of much nourishment, because the body in this grief is most commonly much extenuate: only I will briefly touch some kinds of food which are endued with these qualities.  
The first that offereth itself is Milk, 
Milk.  for it nourisheth the body, it affordeth matter to blood, it correcteth the acrimony of corrupt humours; with the wheyiest part it mundifieth the ulcer, with the cruddy part it consolidateth, and with the buttery part it moisteneth, and stayeth the desiccation of the body. Woman's milk is most familiar: By the sucking of a woman's breast I saw a Welsh Gentlewoman called Mistress Price, recovered of a P●hisis, who could not turn herself in her bed, by reason of weakness, and could not take any other food. Asses milk is thinner and more wheyish, and so more apt to mundify. Goats and Cow's milk obtain a mean between these two.  
But jest it corrupt in the stomach, you are to dissolve some sugar or honey in it.  
You are to minister it only when the stomach is empty, and no other meat is to be taken before it be digested; otherwise it will crud, become sour, and be corrupted.  
So much of it is to be given, as the stomach of the party can well digest: wherefore first prescribe the lesser quantity, and ascend to a greater.  
Abstain from appointing of it, If the party be feverish, have the headache, and be troubled with flatuosity.  

Snails, Crabs.  Snails and Crabs are much commended in this grief; nevertheless, seeing they are of a thick, terrestrial, and slimy substance, and afford a corrupt and excrementitious juice, it may be doubted whether they be good or no: to omit that they are of hard digestion; the broth of them boiled in milk, and sweetened with sugar, and mingled with other broths, may be good; for so the nourishment will be the more solid.  

pectoral decoctions.  As for pectoral decoctions, I will not trouble you with any great variety of them; only I will set down a few; but the paucity shall be recompensed with the efficacy.  
I. ℞ rad▪ enul. ℥ ij. scob. guaiaci lb. ss hyssopi, marrhub. albi, an. man. ij. polypod. liquirit. an. ℥ i ss ficuum incisar. passul. mayor. exacinat. an. ℥ iij. Infundantur infundenda per noctem in aqu. font. fervent. lb xviij. deinde additis reliquis coq. ad consumpt. lb vi. ac coletur decoctum, quod clarificetur additis sacchari & mellis an. ℥ ij. crociʒ i atque iterum coletur: utatur aeger hoc decocto loco consueti potus.  
II. ℞ rad. chin. ℥ iiij. symphiti, tormentil. irid. an. ℥ i capill. vener. tussilag. scabios. marrhub. albi. hyssopi, an. man. i. flor. viol. borag. buglos. an. pug. i. flor. herbae paralays. pug. ij. flor. alth. pug. i ss. caricar. ping. ℥ iij. liquirit. ℥ ij. semin. coriand. anis. an. ʒ vi. Infundantur ista ut superiora in pari quantitate aquae, ac decoq. ad consumpt. lb vi. ac coletur decotium, quo utendum loco consueti potus.  
Every morning the patiented is to take half a pint of either of these decoctions warm, and to eat a lozenge of saccharum rosatum tabellatum, or two dams of the conserve of read roses, being a twelvemonth old.  

The artificial dressing.  Now I am come to the artificial dressing of ulcers of the breast.  
The medicaments which are fittest for dressing, are Injections by a large syringe.  
As for the simples whereof the injections are made, 
Injections.  they must not be of bitter things, as Wormwood, the lesser Centory, or Carduusbenedictus; for as judicious and diligent Ambros. Paraeus noteth, Chirurg. lib. 9 c. 31. these bitter things being injected, are first drawn in by the spongious substance of the lungs, and from thence are sent by the trachea arteria, to the throat; where such a bitterness is felt, that it causeth a desire to vomit; so that they rather hurt than profit.  
These injections are either abstersive or consolidative.  

Abste●s●●● inject●●●.  Of abstersive injections I will set down a few, as a pattern, by the which you may make others.  
I. ℞ marrub. alb. hyssopi, scabios. an. man. ss. c●qu. in lb iij. aqu. font. ad medietat. consumptionem, ac coletur decoctum; quod postea clarificetur addit. mell. lb ss. atque iterum coletur.  
II. ℞ aqu. hord.. lb i mellis ros. ℥ ij. sacchari rubri ℥ iij. Miso. bubiant 3 aut 4 ebullionibus ut injectio clarificetur, quae postea coletur.  
If you perceive that the ulcer is sordid, and affordeth much matter, you may add either of ungnentum Aegyptiacum, or the oil of Sulphur, or Vitriol, so much as you shall find fit to cleanse the ulcer.  
When you perceive that the ulcer is sufficiently mundified; which you may gather, if laudable quittour flow, 
The consolidation.  and in no great quantity; then hasten to consolidate the ulcer: I will in this case furnish you also with effectual topics, and but a few: the first shall be this:  
℞ decoct. pectoral. ℥ iiij. syrupi è ros. rub. sicc. ℥ i ss. fiat injectio. 
Consolidative medicament●.   
II. ℞ head. terrest. flor. & fol. symphit. sanicul. plantag. polygon. millefol. vinc. pervinc. Equiseti, hyper. eupat. beton. valerian. an. man. ij. limaces numero 40. cancros fluviatil. numero 10. Addita aqu. pluviali: instituatur distillatio in alembico, ut extilletur aqua. ℞ aqu. hujus lb ss. syrup. myrtill. & è ros. rub. siccat. an. ℥ i ss. syrupi granat. ℥ i Misc. ut fiat injectio.  

The manner of dressing.  These injections must be warmed when they are to be used. Into the orifice which is in the breast somewhat must be put to keep it open: this than is to be performed either by a tent, or a pipe made either of gold or silver.  
The materials of the tents are three; 
Tents.  lint, fine tow, and a sponge. Lint is altogether unapt, for it is apt to fall asunder after that it is made up into a tent: if therefore a p●cce of it part and rest upon the diaphragma, it must putrify there, and sand noisome scents unto the heart, which cannot but bring faintings, and at the last shorten the life.  
Good tow than is better than it, because it cleaveth fast together; but the sponge is best of all, because it doth not only cohere firmly, but draweth also strongly the quittour, and doth imbibe it.  
It is good so to form the tents, that the outer end being broader than the inner, it may be stayed from slipping in: it is not amiss to halter them with thread for this same purpose.  

The use of a pipe.  A pipe is best of all; it must be of thickness proportionate to the orifice, having two stays to hinder the slipping in of it into the cavity of the breast; and sundry holes somewhat large about the end, to give way to the quittour. It must also be somewhat arched, jest the lungs butting against it, should suffer any hurt. The outer hollowness of it is to be stopped with a sponge dipped in aqua vitae and wine mingled together, and warmed, and wrung. Above the tents and the pipe apply emplastrum de minio, or diachalcithes.  
If the ulcer run much, it must be dressed twice a day; but if it run little, once dressing will serve.  
You may demand of me, 
Quest.  when the tents and pipe are to be left?  
I answer, when the ulcer yields but a small deal of quittour, 
Answ.  and that good; and seemeth to be almost dry: for siccum est sano proximum, that which is dry cometh near to that which is whole.  
If you keep the orifice of the breast too long open, it will fistulate.  

What course is to be taken if the body grow lean.  It falleth out many times, that in ulcers of the breast, the diseased person groweth lean. In this case you are to permit the party to drink some Almond milk made of chicken broth, wherein have been boiled Pompion, Cucumber, and Muskmelon seeds, with Mallow roots, Cowslip flowers, Succory flowers, and Marigold flowers, between meals, and in the night time after two a clock; or minister a dram and a half of this powder which I will set down, every morning and evening, in six ounces of one of the pectoral decoctions, which I described in the beginning of this Lecture.  
The description of the powder is this: ℞ semin. papav. albiʒ i ss. gu●●●●i tragacanth. far. ●robi an. ʒ ij ss. semin. alth. portul. cucum. melon. pepon. pla●tag. hyoscyam. alb. an. ʒ iij. coral. rub. praparat. perla●. pr●parat. succini albi praeparat. an. ʒ i ss. liquirit. ʒ iiij. sacchari r●sat. tab●llat. ad pondus ●mnium: fiat pulvis.  
If these courses being used faithfully, do not prevail, acquaint the diseased parties friends with the dangerous estate wherein he is; for no other medicaments are like to prevail.   

Lect. XXIX. Of the ulers of the back, the abdomen, and joints.  
NOw I am, according to my promise, to deliver the last Lecture appointed for this year, and withal to shut up this Treatise of Ulcers; that when I shall ascend to this place again, I may begin to handle a new subject, which will be of wounds. And although one might rest contented with that which hath been already delivered concerning ulcers; yet that none may justly say, that any thing absolutely necessary, hath been omitted, and to further the practice of those which are not so well versed in the curing of all particular ulcers, I will briefly set down some notes concerning the ulcers of the back, the abdomen, or lower belly, and of the joints.  

Ulcers of the back.  Vlcera dorsi, or ulcers of the back, most commonly fall out after 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or cedematous phlegmons, wherein morbi acuti ex decidentia end.  
Now that you may the better understand what I mean, I must digress a little, and briefly show you what diseases are termed morbi acuti, and how many kinds of them there are.  

Which are to be accounted sharp diseases. Three kinds.  Morbi acuti, or sharp diseases, are properly called such as with great expedition, force, and danger, go on to their status and extremity of the symptoms, as may be gathered out of Galen 2. aphor. 19 & 23.  
Now there be three kinds of these morbi acuti, or sharp diseases; for they are either peracuti, very sharp, or acuti simpliciter, simply sharp, or acuti ex decidentia, or sharp diseases ending into other griefs.  
Peracuti end at the furthest the seventh day, and they are of two sorts, exquisitè peracuti or perperacuti, or exquisitely very sharp, which end the fourth day, and non exquisitè peracuti, which are not exquisitely very sharp, which continued till the seventh day.  
Now the simpliciter acmi in like manner are of two kinds: for they are either exactly so, and end for the most part the fourteenth day, or not exactly so, which may continued till the twentieth day. You may, and (I make no doubt) do see examples of these in burning and pestilential fevers almost every week. Last of all are acuti 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, ex decedentia, which may be prolonged to the fortieth day: Diseases which continued longer than forty days are called morbi chronici, or di●ur●i, long or lingering diseases. Some of these chronical diseases may end in sixty, some in eighty, some in an hundred, some in two hundred days: some may continued a whole year, some seven years, some twice seven years.  
I saw a Scottishman whose surname was johnson, 
Histor. 1.  a sadler by profession, who followed the Court in Queen Elizabeth's reign, who was troubled twelve years with a quartan ague without intermission: neither can I affirm that it left him during his life time.  
I being in the I'll of Shepey in Minster street curing one Clover an aged man, 
II.  whom I dismembered, there was a girl brought to me, of seven years of age, which for the space of six years was grievously tormented with an exquisite quartan. The lifes of these personages may be well termed living deaths. Some of these lingering diseases again continued in boys until the fourteenth year of their age, and in maids until their courses flow: as the falling sickness.  

Apostemes and ulcers of the back.  Now to come to apostemes of the back, which leave ulcers after they are brought to suppuration and opened; They are for the most part critical translations of humours, sent in morbis acutis ex decidentia, sharp diseases which continued until the fortieth day, or on chronical diseases the continuance of which is uncertain, sent from the inner either noble or ministerial parts from within outward, the Physicians say this to be done, per diadosin: whereas if noxious humours be turned from without inward, as in pestilential and venereal buboes, they affirm this to be done per metastasin.  

Critical ending of griefs.  Critical ending of griefs, are either performed by excretion or translation of the grief.  
By excretion nature doth expel the peccant matter sundry ways, as by vomit, siege, sweeting, bleeding at the nose, the flowing of the menstruous course, and the apertion of the hemorrhoidicall veins, as you may observe every day in termination and ending of sharp fevers.  
II. In translation, the peccant matter is not altogether discharged out of the body; but it sent from the part affected unto another part by provident nature.  
But seeing the humour may be sent from the outward parts to the inward, and from the inner parts to the outward, this last translation is most secure; for if this first be done in malign and contagious diseases, as in the Pox and Plague, all understanding practisers pronounce either death, or protraction of the cure.  
When therefore these apostemes appear either in the back, or one of the great joints, which afterward degenerate into ulcers, the motion of the matter by nature is laudable doing it by translation, seeing she cannot by excretion, partly by reason of the weakness of the principal parts, or by the plenty, or hard concoction of the humour.  
But this is the misery, that the friends or kinsfolks of such a diseased person think him or her to be altogether safe and secure, when they see them eased by the translation of the humour, and therefore to spare charges call not for skilful Physicians, and Chirurgeans, by whose skill and diligence the motion of nature might be furthered. And so it falleth out many times, partly by reason of the thickness of the skin, as in the back, or by reason of the thickness of the skin, & compactness of the membranes as in the joints, that the vertebrae of the back are corrupted, & the cartillage, and tendons of the joints before remedy is sought for.  
But that you may meet with these hide bound patients, and keep yourselves from incurring danger or discredit, mark these prognostics which I will deliver unto you.  

The prognostics of the ulcers of the back.  1. If after inquisition you found that a tumour in the back continued a long time before it did break of itself, or was opened, suspect the ulcer to be of hard curation: for it is likely that the vertebrae of the back are foul.  
2. If the vertebrae be foul, which you may easily found out, by your finger or probe, the case is desperate: wherefore take heed that you promise' not curation.  
3. If in ulcers of the back you see the party's body day by day to become more and more extenuate, advertise the party's friends of the danger: for it is an evident argument that the principal parts are weakened, and cannot wholly discharge the humour which offendeth.  

Why ulcers in the upper part of the Spina are of easier curation, than those of the lower.  4. Ulcers in the upper part of the Spina dorsi are more easily cured, than those in the loins: Because the abdomen or lower belly sendeth out more superfluities than the thorax or the breast, which is the middle cavity. Secondly, because they are nearer to the heart, the sun of the little world, who by his heat it able to consume much superfluous humidity.  
I think it will not be unpleasant to you to hear me confirm that which I have delivered unto you in my last prognostic, 
Histories.  by true relation of the events which befell me when I practised in Wales in the like griefs: seeing examples leave a deeper impression in the mind, than precepts, and lead best to the curation of external griefs.  
In Denbigh town there was one Richard Price an Haberdasher, son to john Price, who kept the principal Inn of the town, who after he had been troubled with a chronical diseases, felt in his back a little below the shoulders blades, a tumour still increasing in the outward parts, as he was eased in the inward, until at the last it grew to the bigness of a penny loaf. I having been called unto it by opening of the Aposteme, & using methodical indications, cured the Patient. This man (as I hear) having given over his trade, still keepeth the Inn which his father did.  
In this same Town about the same time, a lusty young man, whose surname was Owin, whose father was a retainer to Sir john Salisbury, had the like tumour in the Vertebrae of the loins, after a lingering grief: I having been entreated by the truly worshipful, Sir john Salisbury, (who had not an ordinary skill in the knowledge of the plants, and in performing chirurgical cures) took a view of the young Gentleman. After mature deliberation, I told Sir john and the young man's friends, that there was much quittor in the tumour, which must be discharged; and that the event of the curation would be uncertain, if the matter were let out, for the reasons above specified. At the entreaty of Sir john Salisbury & the young man's parents & friends, I opened the Aposteme which was in the Vertebrae of the loins: And although no means were omitted, which seemed unto us effectual, for the recovery of the young man's health, and that the Vertebrae of the loins were not foul; yet he fell into a Marasmus, or extenuation of the body, being otherways a proper and valiant young Gentleman; and so ended his life before age called for his dissolution, to the great grief of his parents, having no other son but him, and the commiseration of the worthy Knight. I have delivered unto you my observations in this grief, whereof I hope you will make good use: you having occasion ministered to be wary, by the examples of others, which is no mean benefit.  

How the Haberdasher was cured.  How I performed the curation of the first Patients, now I will declare unto you: First, I purged his body with a gentle medicament: It was this; ℞ Electuar. lenitiv. ʒiiij. Electuar. de succo ros. ʒij. Syrup. ros. solutivi cum Agarico ℥ j aq. Cichor. ℥ iij. Misc. ut fiat p●tio. Secondly, I applied the Lapis infernalis to the depending part of the tumour: Thirdly, I opened the Aposteme, making but a small orifice thorough the eschar. Fourthly, every day I dressed the sore, still suffering a little of the quittor to flow out, until all was discharged. Fifthly, I used a mundifying injection, until I perceived the sore to be clean, not stinking, and to afford both laudable, and small store of laudable quittor. Sixthly, I used a consolidative injection, and bolsters somewhat thick, to compress the sore.  

The description of the injections.  The mundifying injection was this: ℞ Vini albi lb. j mellis rosatis ℥ iij. Vngi●en●. Aegyptiaci ℥ ss. ●isc. ut fiat injecti● usurpand● calid●. The consolidative injection was this: ℞ aq. Plantag. ℥ iiij. Syrupi ●yr●i●i & è ros. rub. siecat. a●. ℥ ss. Trachisc. albor. Rhos. sine ●pioʒij. Misc. ut fiat injectio applicanda item calida: All such injections must be warmed; for cold, as Hypocrates witnesseth, is hurtful to the Spinalis medulla. The Emplaster which I used was Diachylon cum gummis. By these means I cured the party in three week's space.  

Of the ulcers of the Abdomen.  Now the ulcers of the Abdomen, or of the lower belly, do offer themselves only to be but compendiously touched. Seeing there are three parts of it, Regio epigastrica, ●●●ilicalis, and hypogastrica, the upper, the umbilical, and lower region: I am to show unto you what parts in these regions most commonly suffer ulceration.  

1. Of an ulcer penetrating of the stomach.  I saw the stomach of one Mistress F●r●e, together with the muscles perforate by the erosion of a sharp humour, in the Howlt, a town distant from Chester five miles: the meat, drink, and chylus came thorough the perforation: the ulcer also smelled strongly. I being unwilling to deal with her, prescribed some local means, which wrought but small effect; for she died of a Marasmus, or extenuation of the body, within a short time: the ulcer hindering the chylification of the aliment, and so defrauding the body of nourishment. My opinion was then, and now is, that ulcers penetrating into the cavity of the stomach are mortal, although wounds of this kind be sometimes cured: for in the second there is but a bore solution of continuity; but in the former there is a solution of continuity, having annexed to it the sharpness & malignity of the matter. Here in London, 
2. Of an ulcer of the liver.  in the Inn a little above Fleet-conduit, one Richard, who was Tapster of the Inn, had for a long time a great pain in the right side of the epigastricall region of the Abdomen: in progress of time there appeared a great hard tumour, causing a sharp fever: at last the Phlegmon breaking of itself, sent out great store of quittor. I then being lodged within the sign of the Naked Boy, a little below the Conduit, and being of his familiar acquaintance, was sent for, finding him in a strong fever, and having difficulty of breathing, the tumour of the liver hindering the free motion of the Septum transversum, the instrument of natural respiration, I pronounced his grief to be mortal, and so it fell out: for although no rational means were omitted, fit to have recovered the party, if the grief had been curable, yet the party died. It were but a fruitless labour to set down the medicaments which were used, seeing they prevailed not.  
This history I thought good to set down, that you may imagine what the event is like to be, if you be called to the like grief.  

Of an ulcer of the navel.  If falleth out sometime, that superfluous flesh groweth above the navel, if it be slackly bound, and be left somewhat long, which doth become ulcerate: This I saw once in Tavestock, a town in the West Country, in Devonshire, in a child of Master Moons, a Draper of that town. I having been called to the cure, first bound off the navel by a strong ligature, afterwards I cured it by the application of Vnguentum de cerussa.  

A penetrating ulcer of the groin.  In the groin after a Phlemone of it opened, oftentimes an ulcer is left penetrating thorough the obliqne and transvers muscles of the Abdomen: If you perceive such an ulcer, pronounce it to be not of easy curation, chief if it fall out to be after a venereal Bubo: For first, there is morbus cum causa, a grief having the cause annexed: Secondly, it corrupteth the Fibres of the muscles: Thirdly, it corrupteth sometimes the Vertebrae of the loins, in which case all medicaments are fruitless, because the grief is mortal: This happened to a young woman, 
An History.  who dwelled with the Lady Lucy, whom Master Napkin dressed, and opened after her death. Both M. Doctor Gifford and I were called to view the sore sundry times; and although means were used for her recovery, yet they did not prevail; so that she died of a Marasmus, the body becoming extremely extenuate; although she seemed to be of a firm and thick habit of body, when the tumour first appeared. If any such tumours come to your hands, after they are brought to maturation, use the general means prescribed for the curation of Lues venerea, jest the like event happen to you.  

Of ulcers of the joints.  I will touch briefly the curation of ulcers of the joints, which differeth but very little from the curation of ulcers in other parts, saving that they require medicaments of more desiccation without any sharpness, and more powerful anodine cataplasms for assuaging of pain; which is an inseparable accident of ulcers, seizing upon these parts.  

The Topics.  Apply then to the sore Desiccativum rubeum, and anoint the brims with this lineament: ℞ Unguent. popul. & albi Caphuratian. ℥ j Ol. Cydonit. & Papaverin. an. ℥ ss. Misc. ac fiat lineament. ex arte. Before you apply your medicaments, foment the part with a fomentation made of Sumach, Pomegranate pills and flowers, read Roses dried, and Myrtle-berries infused in astringent read wine, being put into a long and narrow galley pot, and set in a warm place, or in a posnet having in it boiling water.  
In curing of these ulcers often purging is required, to stay the flowing of sharp humours; but seeing every purgative medicament is not of like efficacy, I will set down one as a pattern, after the which you may frame others: ℞ Caricostin. & Elect. de succo ros. an. ʒiij. Syrup. ros. solut. cum Agaric. ℥ j aq. Cichor. ℥ iij. Misc. ut fiat potio: You may either detract from the quantity of the purging Electuaries, or add to them what you shall think fit, after you have diligently considered the strength of the party: with this I will end the Lectures for this present, and finish the Tractation of Ulcers. When God shall permit me to ascend again into this seat, I will begin the Lectures of wounds.   
FINIS.