THE Practice of Physic, IN Seventeen several Books. Wherein is plainly set forth, The Nature, Cause, Differences, and Several Sorts of Signs; Together with the Cure of all Diseases in the Body of Man. By Nicholas Culpeper, Physician and ginger. Abdiah Cole, Doctor of Physic. And William Rowland, Physician. Being chief a Translation of THE WORKS OF THAT Learned and Renowned Doctor, LAZARUS RIVERIUS, Now living: Councillor and Physician to the present King of France. Above fifteen thousand of the said Books in Latin have been Sold in a very few Years, having been eight times printed, though all the former Impressions wanted the Nature, Causes, Signs, and Differences of the Diseases, and had only the Medicines for the Cure of them; as plainly appears by the Author's Epistle. The Names of the seventeen Books of the Practice of Physic, and the Principal Matters treated of in each of them, are printed in one sheet of Paper, and put before these Books. With these Books is bound a Physical Dictionary, explaining hard Words used in these Books, and others. LONDON: Printed by Peter Cole in Leaden-Hall, and are to be sold at his Shop, at the Sign of the Printing-press in Cornhill, near the Royal Exchange. 1655. THE COMPLETE PRACTICE OF PHYSIC, IN EIGHTEEN SEVERAL BOOKS. Wherein is plainly set forth, The Nature, Differences, Diagnostic, and Prognostic Signs. Together with the Cure of all Diseases in the Body of Man. By Nicholas Culpeper, Physician and ginger. Abdiah Cole, Doctor of Physic. And William Rowland, Physician. Being chief a Translation of THE WORKS OF THAT Learned and Renowned Doctor, LAZARUS RIVERIUS: Now living, and Physician to the present King of France. Above fifteen thousand of the said Books in Latin have been Sold in a very few Years, having been eight times printed. The Names of the seventeen Books of the Practice of Physic, and the Principal Matters treated of in each of them, are printed in one sheet of Paper, and put before these Books. The Eighteenth Book is a Physical Dictionary, explaining hard Words used in these Books, and others. LONDON: Printed by Peter Cole in Leaden-Hall, and are to be sold at his Shop, at the Sign of the Printing-press in Cornhill, near the Royal Exchange. 1655. THE PRINTER TO THE READER. READER, THY cheerful Acceptance of my former Endeavours in this kind for the Good of my Native Country, hath encouraged me, though with great Care, Labour, and Cost, to present thee with the Learned, Judicious, and Worthily renowned Riverius his Practice of Physic. He is an Author now living, and sufficiently known: And his Work will speak for itself, and praise him in the Gates. And if thou shalt show a Friendly Countenance to this worthy Stranger, who now speaks English, I shall be thereby encouraged by all other means to study to promote thy Good by bringing thee more acquainted with this, and other excellent Authors. And whereas some, either out of envy, or misunderstanding, do condemn Works of this Nature, published in our Mother Tongue, alleging chief, That such Books increase the number of Empirics▪ are a hindrance to learned and able Physicians; also occasion some to hurt themselves by rashly practising on their own Bodies. I shall Answer to these Objections in order. First, as for Empirics: These Books, and such as these published in English, are so far from making more Empirics, that they will spoil those that are, and make that we shall have fewer of them. For an Empiric being one that gives Physic (Hab Nab, as we use to say) relying only on Experience, and what he hath seen done before him, not being able to give any reason touching the Disease, its Cause, or Cure: These Books will teach such persons how to go upon good grounds, and to be able to give a solid Reason for what they do, and of Empirics, make them Rational Physicians, if they be men of good Natural Parts, though they be ignorant of all Tongues but their Mothers. As for the hurt which is hereby pretended to be done to learned Physicians, it is a mere Imagination, and no learned Physician that bethinks himself well, will so judge. For the use of these Books respects chief the Poor of this Nation, together with Seafarers, and Soldiers. But for the Rich that have Money to spare, and bide at home, no otherwise (in point of practice) than for an honest Curiosity; and delightful Speculation. What rich man is there so mad, who reading a Chapter in these Books, and seeing what a world of Considerations and Cautions do belong to the knowledge and orderly Cure of every Disease, but will be more fearful than ever he was before to commit himself to the Cure of any but a learned Physician. Now it is not by the Poor, but by the Rich, that the learned Physician maintains himself; the poor are but a trouble to him, only before such Books as these were extant in the English Tongue, Conscience (sometime) forced the learned Physician to take care of the poor, because the unlearned were wholly unable: whereas now there may be found Industrious men that know no more Languages than their Native one, who may in a rational way contribute to the Necessities of the Poor. Nay, these kind of Books are profitable to the learned Physicians; for many of the Gentry, especially of the Ladies and Gentlewomen, viewing the state of their own Bodies in such Books as these (as in Looking-Glasses) will perceive certain Diseases in themselves, either now in being, or likely ere long to seize upon them, which otherwise they would never have so much as dreamed of; and thereupon crave the Advice and Assistance of the learned Physician. Also the Ladies and Gentlewomen being well read in such Books as these, will better know how to demean themselves towards their Husbands, Children, or other Relations and Friends in their respective Sickness in point of ordering them, and will be more apprehensive of the Physician's Directions, and so better able to practise them; also more capable of his Reasons, and Prognostics, and so more confident and cheerfully obedient. All which will very much advance the Cure, and consequently the Honour and Gain of the learned Physician: for as Hypocrates notes in his first Aphorism, It is not enough towards the Cure that the Physician do what is fitting; but the bystanders and friends of the Sick must play their part, or all will not be well. And in the third place, Whereas it is objected, That people reading these Books, will practise upon themselves and hurt themselves. I Answer, If they do, they have none to blame but their own folly; for it is not the intent of the Publishers of these Books, that every one that can read English, should dare to take, of their own Heads, such Medicines as are described in the said Books. But our intent is, That where in the Country there is no learned Physician at hand; at Sea, in the States and Merchant's Ship, where the Chirurgeon is compelled to act both his own, and the Physician's part; In Armies and Leguers, etc. an ingenious and diligent Chirurgeon, Apothecary, or any other that hath from his youth been exercised in these kind of studies, and conversant about the sick, may attain such a competent knowledge in the Causes and Methodical Cure of Diseases, as they may with honour to themselves, and profit to the sick (by God's Blessing) supply the place of a more learned Physician. For the use of such persons, these Books are intended, and for diligent Midwives; and not that every Fool should turn Physician, or that every Reader should tamper with him or herself. Also divers Honourable Ladies and Gentlewomen, that out of a truly Christian and Charitable Disposition have not disdained, but counted it a great Honour to be helpful to the poor in the time of their sickness, may by perusal of these Books, and the like, confirm and increase their knowledge, and become honourable Instruments in the Hand of God, of much relief and comfort to many poor distressed Creatures in their respective Countries and places of Habitation. For the worthy sakes of which honourable Ladies and Gentlewomen in the first and chiefest place, and for the ease of all others unacquainted with the Greek and Latin Tongues, and consequently unable to understand divers terms of Art, and other words drawn from the said Tongues (which it was necessary to retain for brevity sake, and to avoid tedious Circumlocutions) I have caused a Physical Dictionary to be added at the end of these Books, explaining all such terms of Art aforesaid, as are used therein. When the Reader meets in these Books, with the names of Simple or Compound Medicaments, and desires a more full knowledge of them, let him have recourse to the London Dispensatory in English, where he may be satisfied; for it had been an endless and vain work, to repeat what hath there been said. If there occur accidentally the name of any Disease which the Reader would better understand, let him look into the Table of the Contents of the Chapters of these seventeen Books, and he shall find the Chapter entitled from that Disease; in the beginning of which Chapter he shall find the said Disease described and explained. Also the Reader may please to take notice, That many hard phrases in these Seventeen Books are explained in the Context, by more easy words following, which signify the same with the foregoing hard word. As for example, MASTICATORIES, or Chewing Medicines, giving the Reader to understand, that Masticatories, is as much as to say, Medicines Medicines that are only chewed in the mouth to bring away Rhewm by spitting. So GARGARISMS, that is, Medicines to Gargoyle in the Throat: A PLETHORIC, or full Body: EMPYEMA, or Corrupt matter gathered between the Chest and Lungs: HYPOCHONDRIA, or Parts under the short Ribs: A VESICATORY, or Plaster to draw Blisters. Many such passages there are throughout these Books, where the latter Clause is an exposition of the former. And that thou mayst know to whose great Industry and pains thou art obliged for the Englishing this most excellent piece of Art, know that (by reason of eight several Editions in Latin, of which there hath been fifteen thousand Books sold) it hath been three times translated at▪ my charge, By Nicholas Culpeper, Physician and ginger; Abdiah Cole, Doctor in Physic, who hath practised Physic twenty nine Years in the Service of three of the greatest Princes in Europe: and William Rowland, a Knowing Physician: and also by an eminently learned and pious Physician, who desires not to be named, being (as he says) content with the applause of his own Conscience, which tells him that while he was employed about this Work, he was doing that which would weigh down in profit to his Country, all the good that all the Physicians in London did or could do in the same time; a work that tends to profit many millions, not only of this Generation, but of all that shall follow, till the world become one great Bonfire; or this Nation and Language perish together. And it hath been (he says) a longtime his Opinion, That it is more rational, manly, generous, and Christian, whilst God shall please to afford him Food and Raiment, to employ his time and pains in Actions largely conducing to the good of Mankind, though little advancing his own Fortunes, than in matters of petty and poor Concernment, that bring great gain with them: In which generous Resolution, God (the Author of it) will, he hopes preserve him to his dying day; at which time the fruit and profit of his Labours will comfort him, but all the gain in the world will do him no good at all. Use our Labours with Diligence, Care, Ingenuity, Compassion towards the sick, and in the fear of God. Attribute the Success and Honour of all thy Endeavours to him: Bless him for the Light he discovers to this Generation, denied to so many Millions of our Ancestors: Bless him for the Piety and Noble Generosity of our Governors, that give us leave to Be as Good as we Will, and to Do all the Good we Can (though seeming to cross private Interest) Oh! what would we have given for this single Privilege a few Years since? Or what would the poor Protestants in France and Germany give for the like Favour? How many of them have been lately Massacred, or made fly from all that was near and dear to them for want of such a Mercy as this? Finally, Pray for those that have taken pains in the Work, and among the rest, for Thy hearty Wellwisher PETER COLE. From my Printing-house in Leaden-Hall, June, 2. 1655. The Names of several Books Printed by Peter Cole in Leaden-Hall, London, and are to be sold at his Shop at the sign of the Printing-press in Cornhill, near the Exchange. Right several Books, by Nich. Culpeper, Gent. Student in Physic and Astrology. 1 A Translation of the New Dispensatory, made by the College of Physicians of London. Whereunto is added, The Key to Galen's Method of Physic. 2 A Directory for Midwives, or a Guide for Wom●n. Newly enlarged by the Author in every sheet, and Illustrated with divers new Plates. 3 Galen's Art of Physic, with a large Comment. 4 The English Physician Enlarged; being an Astrologo-Physical Discourse of the vulgar Herbs of this Nation; wherein is showed how to cure a man's self of most Diseases incident to Man's Body, with such things as grow in England, and for three pence charge. Also in the same Book is showed, 1 The time of gathering all Herbs, both Vulgarly and Astrologically. 2 The way of drying, and keeping them and their Juices. 3 The way of making and keeping all manner of useful Compounds, made of those Herbs. The way of mixing the Medicines according to the Cause, and Mixture of the Disease, and the part of the Body afflicted. 5 The Anatomy of the Body of Man, Wherein is exactly described, the several parts of the Body of Man, illustrated with very many larger Brass Plates than ever was in English before. 6 A New Method both of studying and practising Physic. 7 A Treatise of the Rickets, being a Disease common to Children; wherein is showed, 1 The Essence, 2 The Causes, 3 The Signs, 4 The Remedies of the Disease; Published in Latin by Dr. Glisson, Dr. Bate, and Dr. Regemorter, translated into English. And corrected by N. Culpeper. 8 The Practice of Physic, containing seventeen Books. A Godly and Fruitful Exposition on the first Epistle of Peter. By Mr. John Rogers, Minister of the Word of God at Dedham in Essex. The Wonders of the Loadstone. By Samuel Ward of Ipswitch. An Exposition on the Gospel of the Evangelist St. Matthew. By Mr. Ward. Clows Chirurgery. Marks of Salvation. Christian's Engagement for the Gospel, by John Goodwin. Great Church Ordinance of Baptism. Mr. Love's Case, containing his Petitions, Narrative, and Speech. Vox Pacifica, or a persuasive to peace. Dr. Prestons' Saints submission, and Satan's Overthrow. Pious Man's Practice in Parliament Time. Mr. Symsons Sermon at Westminster. Mr. Feaks Sermon before the Lord Major. Mr. Phillip's Treatise of Hell. — of Christ's Geneology. Eton on the Oath of Allegiance and Covenant, showing that they oblige not. Eleven Books of Mr. Jeremish Burroughs lately published; As also the Texts of Scripture upon which they are grounded. 1 The Rare Jewel of Christian Contentment, on Phil. 4. 11. Wherein is showed, 1 What Contentment is, 2 It is an Holy Art and Mystery, 3 The Excellencies of it, 4 The Evil of the contrary sin of Murmuring, and the Aggravations of it. 2 Gospel Worship, on Levit. 10. 3. Wherein is showed, 1 The right manner of the Worship of God in general; and particularly, In Hearing the Word, Receiving the Lord's Supper, and Prayer. 3 Gospel Conversation, on Phil. 1. 17. Wherein is showed, 1 That the Conversations of Believers must be above what could be by the Light of Nature, 2 Beyond those that lived under the Law, 3 And suitable to what Truths the Gospel holds forth. To which is added, The Misery of those men that have their Portion in this Life only, on Psal. 17. 14. 4 A Treatise of Earthly-Mindedness, Wherein is showed, 1 What Earthly-mindedness is, 2 The great Evil thereof, on Phil. 3. part of the 19 Verse. Also to the same Book is joined, A Treatise of Heavenly-Mindedness, and Walking with God, on Gen. 5. 24. and on Phil. 3. 20. 5 An Exposition, on the fourth, fifth, sixth, and seventh Chapters of the Prophecy of Hosea. 6 An Exposition on the eighth, ninth, and tenth Chapters of Hosea. 7 An Exposition on the eleventh, twelfth, and thirteenth Chapters of Hosea, being now complete. 8 The Evil of Evils, or the exceeding Sinfulness of Sin, on Job, 36. 21. 9 Precious Faith, on 2 Pet. 1. 1. 10 Of Hope, on 1 John. 3. 3. 11 Of Walking by Faith, on 2 Cor. 5. 7. Twelve several Books of Mr. William Bridge, Collected into one Volumn. Viz. 1 The Great Gospel Mystery of the Saints Comfort and Holiness, opened and applied from Christ's Priestly Office. 2 Satan's Power to Tempt; and Christ's Love to, and Care of His People under Temptation. 3 Thankfulness required in every Condition. 4 Grace for Grace; or, the Overflowing of Christ's Fullness received by all Saints. 5 The Spiritual Actings of Faith through Natural Impossibilities. 6 Evangelical Repentance. 7 The Spiritual-Life, and In-being of Christ in all Believers. 8 The Woman of Canaan. 9 The Saints Hiding-place in time of God's Anger. 10 Christ's Coming is at our Midnight. 11 A Vindication of Gospel Ordinances. 12 Grace and Love beyond Gifts. A Congregational Church is a Catholic Visible Church. By Samuel Stone in New England. A Treatise of Politic Powers, wherein seven Questions are Answered, 1 Whereof Power is made, and for what ordained. 2 Whether Kings and Governors have an Absolute Power over the People. 3 Whether Kings and Governors be subject to the Laws of God, or the Laws of their Country. 4 How far the People are to obey their Governors. 5 Whether all the people have, be their Governors. 6 Whether it be Lawful to depose an evil Governor 7 What Confidence is to be given to Princes. The Compassionate Samaritan. Dr. Sibbs on the Philippians. The Best and Worst Magistrate. By Obadiah Sedgwick. The Craft and Cruelty of the Church's Adversaries. By Matthew Newcomen. A Sacred Panegyrics. By Stephen Martial. Barriffs' Military Discipline. The Immortality of Man's Soul. The Anatomist Anatomised. King Charles his Case, or an Appeal to all Rational Men concerning his Trial. Mr. Owen's steadfastness of the Promises. A Vindication of Free Grace; Endeavouring to prove, 1 That we are not elected as holy, but that we should be holy; and that Election is not of kinds, but persons. 2 That Christ did not by his Death intent to save all men, and touching those whom he intended to save, that he did not die for them only if they would believe, but that they might believe. 3 That we are not justified properly by our believing in Christ, but by our Christ, believing in. 4 That, that which differenceth one man from another, is not the improvement of a common ability restored through Christ ●o all men in general, but a principle of Grace wrought by the Spirit of God in the Elect. By John Pawson. Six Sermons preached by Doctor Hill. Vix. 1 The Beauty and Sweetness of an Olive Branch of Peace, and Brotherly Accommodation budding. 2 Truth and Love happily married in the Church of Christ. 3 The Spring of strengthening Grace in the Rock of Ages Christ Jesus. 4 The strength of the Saints to make Jesus Christ their strength. 5 The Best and Worst of Paul. 6 Gods eternal preparation for his Dying Saints. The Bishop of Canterbury's Speech on the Scaffold. The King's Speech on the Scaffold. The Magistrates Support and Burden. By Mr. John Cordel. The Discipline of the Church in New England, by the Churches and Synod there. A Relation of Barbadoes. A Relation of the Repentance and Conversion of the Indians in New-England; By Mr. Eliot, and Mr. Mayhew. The History of Montress: and his Actions for Charles the First. His passions for Charles the Second King of Scots. The Institutes of the Laws of England by John Cowel, Octavo. A description of the Grand Signors Seraglio; or Turkish Emperors Court. By John Greaves. Octavo. The reigning error Arraigned at the Bar of scripture, and Reason. By Francis Fulwood. Octavo. The state of Future Life. By Thomas White. Twelve. The Royal and delightful Game of Picquet, written in French, and now rendered into English. Octavo. De copore Politico: or, The Elements of Law, moral, and politic. By Thomas Hobbs of Malmsbury. The History of the Rites, Customs, and manner of life, of the present Jews throughout the World. Octavo. The London Dispensatory in Latin in Folio. The London Dispensatory in Latin in Twelve. A Poem upon the late Fight at sea, between the two great Fleets of England and Holland. These several Books of Physic and Chirurgery will shortly be printed in English. Riverius Observations, with fifteen hundred and seventy other Histories and Observations of other men. Riolanus Anatomy. Bartholinus Anatomy. All the Works of Daniel Sennertus, except some few, not proper for Translation. The Idea of Practical Physic, being a complete Body of Physic. And Fernelius his Works. These Books of Divinity will speedily be printed. Mr. Burroughs, on 1 Cor. 5. 7. and 18, 19 29. And fifty nine Sermons on Matthew, 11. 28, 29, 30. Seventeen Books of Mr. Thomas Hooker, being the substance of many Sermons preached in New-England. Several pieces of Mr. Bridge of Yarmouth. Viz. 1 Scripture Light the most sure Light: compared with, 1. Revelations and Visions. 2. Natural and supernatural Dreams. 3. Impressions with and without Word. 4. Light and Law within. 5. Divine Providence. 6. Christian Experience. 7. Humane Reason. 8. Judicial Astrology. Delivered in three Sermons on 2 Pet. 1. 19 2 Christ in Travel: Wherein, The 1. Travel of his soul. 2. The first and after effects of his Death. 3. His Assurance of Issue. 4. And His satisfaction therein. Are opened and cleared in three Sermons, on Esay, 53. 11. 3 A Lifting up for the Cast-down, in case of 1. Great sin. 2. Weakness of Grace. 3. Miscarriage of Duties. 4. Want of Assurance. 5. Affliction. 6. Temptation. 7. Dissertion. 8. Unserviceableness. 9 Discouragements from the Condition itself. Delivered in thirteen Sermons on Psalm, 42. 11. His Four Sermons concerning 1 Sin against the Holy-Ghost. 2 Sins of Infirmities. 3 The fifth Monarchy. 4 The Good and means of Establishment. Francisci Tayleri, Capitula Patrum: Hebricè & Latinè edita. Una cum Annotationibus sensum locorum difficilium Experimentibus. Francisci Tayleri, Lamentationes Jeremiae vatis, Denuo è fontibus Hebraicis translatae, cum Paraphrasi Chaldaica, Masora magna & parva, & Commentariis Rabbi Shelomoh, Jarchi & Aben Ezrae, è Buxtorfii Bibliis magnis excerptis. The Author to the Reader. FIfteen Years ago (Friendly Reader) to Satisfy the Desires of my Auditors, I undertook to explain unto them the Methodical Cure of all inward Diseases of the Body; which that I might accomplish the sooner, I meddled not at all in a manner with the Theory, knowing full well that any Student might with ease enough fetch the same from divers Authors: which notwithstanding they could not so easily do in point of Practice, because of the almost infinite Company & variety of Medicaments, wherewith the Books of those that have delivered the Practical part of Physic do swarm; with which Young Beginners are so confounded, that they remain amazed, not knowing which to choose. I conceived it would be most profitable for them, if out of such a multitude of Medicaments, I should select the most choice, and which were most frequently used, and dispose them into the same order which we are wont to observe in our Practice, when we attend the Cure of our sick Patients. This Method of teaching, gave such content to our Students of Physic, that as many as came flocking to this University to study, after that I had finished the same, did all earnestly desire to have written Copies thereof; and many of them did frequently exhort me, and earnestly Beg, that I would suffer it to be printed; and so for the future free all Men from the tedious Labour of writing it out. But I, who never had the thought (being very free from Self-Love) that my writings were of so much worth, as to be published in Print, especially this Method of Practice, which was slipped from me as a thing only begun with rude Notes, hastily huddled up to perform my daily task of Reading, and half maimed for want of the Theoretic part: I thought it better to believe my own Conscience than their too favourable Opinion. I pondered likewise in my Mind, that it was a very hazardous thing, to subject my Reputation to the Judgement of the whole world, and (as it commonly falls out) to the biting Teeth of envious detractors; especially in this polished Age, abounding with neat and pasing fine Wits, who are hardly pleased with such works as have been wrought with the greatest Industry possible, and who are wont to peep curiously to spy spots in the shining Sun. Nevertheless this unperfect Birth of mine; which I desired to keep close and hidden, was sent into the wide world by one of my Scholars, who without my knowledge, and against my will, gave that imperfect, homely and unpolished work to a Printer of Paris to print. And this Child of mine which I did count Abortive, was more pleasing and found greater Favour in the Eyes of Strangers, than in its Fathers; for all the Books of this first Edition, were suddenly sold off. A second Edition, and a little after a Third was procured by the same Printer, by which all Europe was filled with Copies. Nevertheless, some years after, there came out three other Editions within two year's time, one at Lions, and two other in Holland viz. at Tergow and the Hague In the mean while, I received very many Letters, out of the Chief Cities of FRANCE, GERMANY, HOLLAND, and ITALY, from Doctors of Physic, whom I was acquainted with, when they studied Physic in this University; seriously expostulating, that this Work was Lame because it wanted the Theory of the Disease, and withal advising me that it would be worth my pains, to spend some part of my studies that way. Conceiving at length that it was fitting to consent unto their just requests, I laboured with all my might as far as my Employments and Health would give me leave, to finish and publish this Theoretic part; insomuch that at last (Blessed and Praised be God) I brought the same to a conclusion. Accept it (friendly Reader) with a cheerful mind, being Joined to the foresaid Practic part, so that in one continued Discourse thou mayest Behold the Nature, Differences, Causes, Diagnostic, and Prognostic Signs, together with the Cure ofall Diseases. I Suppose this Child of mine will merit highly thy Favour, being now adorned in all its parts, and advanced to a far greater Degree of Perfection; and seeing that thou wert pleased with it in its Cradle and Swadling-Clouts; now that it is greater and hath attained its perfect Stature of Body, it will not, I hope, Displease thee. Enjoy it with God's Blessing, and whatever thou shalt learn therefrom, let Christian Charity cause the to employ it for thee Good of thy Neighbour. Also I desire thee to take notice, that many faults were crept into the former Editions through the negligence of Printers, all which I have carefully corrected in this Edition. And furthermore, I have added many and those very Choice Medicaments, to the Cures formerly printed, which will not a little conduce to the happy cure of difficult Diseases. Forewel. From my Study at Monpelier, the first of July, Lazarus Riverius. An EPIGRAM, showing who are Doctors of Physic, and who not. Doctors or Teachers they of Physic are (Whether by Pen they do it, or in Chair With lively Voice) that teach the way to know Man's Nature, Health, and Sickness, and do show Diseases, Cause, and Cure. But they who spend Their Life in Visits, and whose Labours end In taking Fees, and giving Paper-scrowls FACTORS of Physic are; and none but Owls Do count such Doctors, that no Latin know, From whence that Name did to our Language flow. W. R. Doctor and Factor of Physic. The Contents of all the Seventeen Books. The First Book of the Practice of Physic. Of the Diseases of the Head. The PREFACE. CHap. 1. Of the Cold Distemper of the Brain. 8 Chap. 2. Of Drowsy Diseases, called, Coma, Lethargy, Carus, and Apoplexy. 9 Chap. 3. Of Waking Coma. 16 Chap. 4. Of the Sleeping Diseases called, Catoche, and catalepsy, or Congelation. 16 Chap. 5. Of the Palsy, or Paralysis. 18 Chap. 6. Of a Convulsion. 24 Chap. 7. Of the Epilepsy, or Falling-sickness. 28 Chap. 8. Of the Falling-sickness in Children. 33 Chap. 9 Of Giddiness, called Vertigo. 35 Chap. 10. Of Tremor, or Trembling. 37 Chap. 11. Of Phrenitis, or Frenzy. 38 Chap. 12. Of the Imposthume, and Spacelus, or Mortification of the Brain. 44 Chap. 13. Of Mania, or Madness. 45 Chap. 14. Of Melancholy: 48 Chap. 15. Of a Catarrh, or Defluxion. 50 Chap. 16. Of the Headache. 56 The Second Book of the Practice of Physic. Of the Diseases of the eyes. The PREFACE. CHap. 1. Of Gutta Serena or Amaurosis, 62 Chap. 2. Of the Disease of the Vitrous, or Glassy Humour. 66 Chap. 3. Of the Diseases in the Crystalline Humour. 66 Chap. 4. Of the Diseases of the Watery Humour, and especially of a Suffusion. 68 Chap. 5. Of the Enlarging, or Dilatation of the Pupilla. 74 Chap. 6. Of the straitness, or Contraction of the Pupilla. 75 Chap. 7. Of Albugo, or the white Spot called Pin and Web, and of other Colours of the Cornea Changed. 76 Chap. 8. Of Ophthalmia, or Inflammation of the Eyes. 78 Chap. 9 Of Hypopyo, or Matter under the Cornea. 85 Chap. 10. Of Phlyctaenae, or Blisters in the Eyes. 86 Chap. 11. Of the Ulcers in the Cornea and Adnata. 86 Chap. 12. Of a Cancer in the Cornea. 87 Chap. 13. Of the Rupture of the Cornea. 88 Chap. 14. Of the Coming forth of the Uvea. 89 Chap. 15. Of Aegylops, and Fistula Lacrymalis. 89 Chap. 16. Of Rhyas and Encanthis. 90 Chap. 17. Of Epiphora. 91 Chap. 18. Of Pterygium, or Haw in the Eyes, called Unguis. 93 The Third Book of the Practice of Physic. Of the Diseases of the Ears. The PREFACE. CHap. 1. Of Deafness, and thick of dull Hearing. 95 Chap. 2. Of Noise in the Ears. 99 Chap. 3. Of Pain in the Ears. 101 Chap. 4. Of those things which come forth of the Cavities of the Ears preternaturally. 106 The Fourth Book of the Practice of Physic. Of the Diseases of the Nostrils. The PREFACE. Chap. 1. Of the Ulcer of the Nostrils, and Ozaena. 108 Chap. 2. Of Sarcoma, and Polypus. 110 Chap. 3. Of the loss of Smelling. 111 Chap. 4. Of the Stink of the Nostrils. 112 Chap. 5. Of Coryza, or Pose. 112 Chap. 6. Of Sternutation, or Neezing. 113 Chap. 7. Of Bleeding at the Nose, called Haemorrhagia. 114 The Fifth Book of the Practice of Physic. Of the Diseases of the Tongue. The PREFACE. CHap. 1. Of the Inflammation of the Tongue, and other Tumours of the same. 123 Chap. 2. Of the Tumour called Ranula under the Tongue. 125 Chap. 3. Of the Taste being Hurt. 126 Chap. 4. Of the Palzey of the Tongue, and the Hurt Motion thereof. 127 The Sixth Book of the Practice of Physic. Of the Diseases of the Teeth, Gums, Jaws, , and Windpipe, or Larynx. The PREFACE. CHap. 1. Of the Toothache. 129 Chap. 2. Of the blackness and rottenness of the Teeth. 134 Chap. 3. Of the Erosion or eating away, and of the Exulceration of the Gums. 134 Chap. 4. Of bleeding at the Gums. 135 Chap. 5. Of the Ulcers of the Mouth, and Jaws. 136 Chap. 6. Of the Relaxation of the Wula, or Falling Down of the Pallat. 137 Chap. 7. Of Angina, or Quinsy, or Squinvie. 138 The Seventh Book of the Practice of Physic. Of the Diseases of the Breast. The PREFACE. CHap. 1. Of Asthma, or difficulty of Breathing. 146 Chap. 2. Of Pleuritis, or a Pleurisy. 152 Chap. 3. Of Peripneumonia, or Inflammation of the Lungs. 158 Chap. 4. Of Empyema, or matter in the hollow of the Thorax. 160 Chap. 5. Of the Dropsy in the Breast. 163 Chap. 6. Of Haemoptysis, or Spitting of Blood. 164 Chap. 7. Of Phthisis, or Consumption. 169 The Eighth Book of the Practice of Physic. Of the Diseases of the Heart. The PREFACE. CHap. 1. Of Syncope, or Swooning. 178 Chap. 2. Of the Palpitation, or Breathing of the Heart. 182 Chap. 3. Of Weakness. 245 The Ninth Book of the Practice of Physic. Of the Diseases of the Stomach. The PREFACE. CHap. 1. Of Want of Appetite, or Loathing of Meat, 249 Chap. 2. Of Dog's Appetite, called Fames canina. 254 Chap. 3. Of Pica and Malacia. 256 Chap. 4. Of the Thirsty Disease, called Sat is Morbosa. 258 Chap. 5. Of the Hurt Concoction of the Stomach. 259 Chap. 6. Of Singultus, or Hiccough. 262 Chap. 7. Of Nausea, and Vomiting. 295 Chap. 8. Of Vomiting Blood. 269 Chap. 9 Of the Disease called Cholera. 272 Chap. 10. Of Pain in the Stomach, called Dolour Ventriculi. 274 Chap. 11. Of the Inflammation. Ulcer, and Imposthume in the Stomach. 277 The Tenth Book of the Practice of Physic. Of the Diseases of the Intestines, or Guts, The PREFACE. CHap. 1. Of the Colic. 280 Chap. 2. Of the Iliack Passion. ●85 Chap. 3. Of Astriction, or binding of the Belly. 288 Chap. 4. Of Lientery, and Coeliack Passion. 289 Chap. 5. Of Diarrhaea. 291 Chap. 6. Of Dysenteria. or Dysentery. 295 Chap. 7. Of Tenesmus. 303 Chap. 8. Of Fluxus Hepaticus, or Flux of the Liver. 305 Chap. 9 Of the Worms. 307 Chap. 10. Of the Immoderate Flux of the Haemorrhoids. 313 Chap. 11. Of the Pain of the Haemorrhoids. 316 The Eleventh Book of the Practice of Physic. Of the Diseases of the Liver. The PREFACE. CHap. 1. Of the Hot Distemper of the Liver. 320 Chap. 2. Of the Inflammation, Imposthume and Ulcer of the Liver. 323 Chap. 3. Of the Stoppage, or Obstruction of the Liver. 327 Chap. 4. Of the Jaundice. 333 Chap. 5. Of the Scirrhus of the Liver. 335 Chap. 6. Of the Dropsy. 336 The Twelfth Book of the. Practice of Physic. Of the Diseases of the Spleen. The PREFACE. CHap. 1. Of the Inflammation of the Spleen. 347 Chap. 2. Of the Pain of the Spleen. 348 Chap. 3. Of Obstruction▪ Tumour, or Puffing up of the Spleen. 348 Chap. 4. Of the Scirrhus, or Hard Swelling of the Spleen. 349 Chap. 5. Of Hypochondriack Melancholy. 350 Chap. 6. Of the Scurvy. 357 The Thirtenth Book of the Practice of Physic. Of the Diseases of the Mesentery, Sweetbread, and Caul. The PREFACE. CHap. 1. Of the Obstruction of the Mesentery 362 Chap. 2. Of the Inflammation of the Mesentery. 363 Chap. 3. Of the Imposthume, Ulcer, and Scirrhus of the Mesentery. 364 Chap. 4. Of the Diseases of the Pancreas, or Sweetbread. 365 Chap. 5. Of the Diseases of the Caul, or Omentum. 366 The Fourteenth Book of the Practice of Physic Of the Diseases of the Reins and Bladder. The PREFACE. CHap. 1. Of the Stone in the Kidneys, and Pain in the Reins, called Dolour Nephriticus. 367 Chap. 2. Of the Stone in the Bladder▪ 378 Chap. 3. Of the Inflammation of the Reins and Bladder. 382 Chap. 4. Of Pissing of Blood. 385 Chap. 5. Of the Ulcer of the Reins and Bladder. 387 Chap. 6. Of Diabetes, or extraordinary Pissing. 390 Chap. 7. Of Pissing the Bed, of Involuntary Pissing, or not containing of Urine. 392 Chap. 8. Of stoppage of the Urine, and Strangury. 394 Chap. 9 Of Dysuria, or Scalding of the Urine. 397 The Fifteenth Book of the Practice of Physic. Of women's Diseases. The PREFACE. CHap. 1. Of the Green-sickness, called Chlorosis. 400 Chap. 2. Of the stoppage of the Terms. 403 Chap. 3. Of the Immoderate Flux of the Courses. 409 Chap. 4. Of the Whites. 413 Chap. 5. Madness from the Womb. 417 Chap. 6. Of the Mother-Fits, or Womb-sickness. 420 Chap. 7. Of Inflammation of the Womb. 431 Chap. 8. Of an Ulcer of the Womb, 434 Chap. 9 Of a Scirrhus, or a Painlesshard Swelling of the Womb 490 Chap. 10. Of a Cancer of the Womb. 492 Chap. 11. Of Mortification, or Gangrenation, and Sphacelation, or Blasting of the Womb. 493 Chap. 12. Of the Wombs Wind-and-Water Swelling, or Dropsy. 494 Chap. 13. Of the falling down of the Womb 498 Chap. 14. Of the Womb shut up, or Imperforated 501 Chap. 15. Of Barrenness 502 Chap. 16. Of Acute and Chronical Diseases of Women with Child 509 Chap. 17. Of Abortion or Miscarriage 512 Chap. 18. Of Hard Childbirth 517 Chap. 19 Of a dead Child. 520 Chap. 20. Of the Afterbirth retained 521 Chap. 21. Of Immoderate flux of the Loches, or Childbed Purgations. 523 Chap. 22. Of Suppression of Childbed Purgations. 524 Chap. 23. Of Gripe after Childbearing 525 Chap. 24. Of Acute Diseases of Women in Childbed 527 The Sixteenth Book of the Practice of Physic. Of Diseases of the Joints, and Rheumatic Pain of the whole Body. The PREFACE. CHap. 1. Of Pain in the Joints, called Arthritis, or the Gout. 531 Chap. 2. Of the Hip-Gout, or Sciatica 544 Chap. 3. Of Rheumatic Pains of the whole Body 547 The Seventeenth Book of the Practice of Physic. Of FEVERS. The PREFACE. SECT. I. Of Simple Fevers. The Preface. CHap. 1. Of the Fever Ephemera. 553 Chap. 2. Of the Fever Synochus Simplex 554 Chap. 3. Of an Hectic Fever. 555 SECT. II. Of Putrid Fevers. The Preface. Chap. 1. Of Continual Putrid Fevers 560 Chap. 2. Of the Symptoms which accompany Putrid Fevers. 575 Chap. 3 Of a Tertian Ague 580 Chap. 4 Of a Quotidian Fever 585 Chap. 5 Of a Quartan Ague 586 Chap. 6 Of Compounded or Complicated Fevers, and particularly of a Semi-Tertian 593 SECT. III. Of Pestilential Fevers. The Preface. Chap. 1. Of a Pestilential Fever. 611 Chap. 2. Of the Measlles, and small Pox 637 THE FIRST BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Head. The PREFACE. IN this our Treatise of Head-Diseases, we speak first only of those which are in the substance of the Brain, and the Films which contain it: For although the Eyes, Ears, Tongue, Teeth, Gums, Jaws, and , go to the making up of the Head; yet we think it fit to speak of their Diseases in several Books for better Method sake; And to call the Diseases of the Brain and its Meninge, or Films, by the name of Head-diseases, most properly so from the excellency of the parts wherein they are. These come from the hindrance of the Action of the Brain, either in respect of Sense, Motion, or Nutrition. The Sense is divided into Internal, and External: The Internal hath the chief actions, as Imagination, Reasoning, Memory; as also Sleep and Waking: the Diseases of which are, Frenzy, Madness, Melancholy, Catoche, Coma waking sleep, and Coma long sleep, Lethargy, Carus, Apoplexy. The External Senses are five, namely, Sight, Hearing, Smelling, Taste, and Feeling: But because the first four have their peculiar Organs or parts, which have divers Diseases, which we shall treat of in several Books: We will in this Book lay down and declare those which belong to the sense of Feeling, because they come immediately from the Brain and its Membranes or Films disturbed, and are either termed Palsies, which come from Sense destroyed or diminished; or Headaches, which comes from Sense depraved. When the actions of the Brain are hindered in respect of motion, there ariseth Convulsion, Falling-sickness, Palsy, Apoplexy, Giddiness, or swimming of the Head, called Vertigo, and Trembling: Finally, When the acting or working of the Brain is hurt or hindered in its Nutrition, or Nourishment, the Disease is either in distemperature, or disorder of the excrement of the Brain, of which cometh a Catarrh, defluxion or distillation. We shall bring all these Diseases under their proper Heads and Chapters, in that order which is most usual for the way of Cure: Therefore we shall first declare the Cold Distemperature of the Brain, and then all Diseases that come from thence, because the ground of their Cure is in the Cure of that. Afterwards we shall lay down the Diseases that come from a Hot Distemper, and Hot Humours; which will all more clearly appear in their several Chapters. CHAP. 1. Of the Distemper of the Brain. ALL Distempers are usually divided into Simple, and Compound; Material, and Immaterial. Simple or single Distempers are seldom seen; as also immaterial distempers, for they come from Primary Causes, and either vanish of their own accord, or with very small Remedies or Medicines: But Material Distempers produce all the Diseases of the Head; therefore we will fall close to discourse of them; which few Authors have done, in handling them severally, because in the laying down of the Diseases which are produced of those Distempers, they are sufficiently explained. We therefore will transfer the handling of the Hot distemper of the Brain, and also the Moist and dry Distempers to the Chapters which contain those Diseases which are produced from them. But because the greatest number of Diseases of the Head come from a Cold and Moist Distemper of the Brain, we thought sit to discourse of that by itself in the beginning of this Treatise; that the Cure of that may be as the Foundation of the Cure of all Diseases coming from thence, and that the Medicines may be found in this Chapter which appertain to the Cure of their Cause: Therefore we will avoid the vain repetition of those Diseases, which is the Custom of almost all Writers of Practical Physic, who by that means enlarge their Volumes, and make the Art more difficult and tedious to young beginners. The Cold Distemper of the Brain which is Compound and Material, or joined with Matter, is for the most part waterish and moist; because the Brain is that Mother of Moisture or Phlegm, and Coldness long abiding draws moisture to itself. For albeit sometimes it is joined with a Melancholy Humour, yet that Humour is seldom begot in the Brain as Phlegm is, but it is for the most part lodged in the Hypochondria, or Parts beneath the Ribs, and sent from thence to the Brain, whereby most grievous Symptoms are produced. The Causes of a Cold and Phlegmatic Distemper of the Brain, are these: 1 Cold and moist Meats which easily turn into Phlegm; and also in the time of their Concoction, by cooling the Stomach and the Liver too much, produce abundance of Phlegm, which after is sent up to the Brain. 2 Too great a quantity, not only of Meats which are too cold, but also of good and wholesome, which destroyeth the Natural heat, and begetteth Crudities. 3 Eating presently after or before meat, and before the former meat is concocted; whence come many Crudities, which send Phlegm to the Head. 4 The ceasing of a Natural custom of vomiting, or purging phlegm; or the omitting the Custom of taking Purges, Sweats, Diuretics, or provokers of Urine, or omitting of accustomed Exercise. 5 To be born of Parents troubled with a cold distemper of Brain. 6 Old Age, which by reason of the decay of Natural heat, produceth much Phlegm: as also Youth by reason of Gluttony and disorderly Diet. 7 A Cold and Moist dweiling, near standing Pools, Marshes, Fens and great Rivers, open to the North winds, Snow and Rain. 8 Long and deep sleep, especially presently after Meat. 9 A sedentary idle life, without, or with too much Care, Study, or Sorrow, because by dispersing the Natural heat, especially in the Brain, they make it cold. 10 To these may be added a hot and moist Liver, which sends many Vapours to the Brain, which there condense or grow thick, and so turn into Phlegm. The Signs of a cold distemper of the Brain, are taken eithr from the Causes above mentioned, by the presence of which we may easily conjecture of the condition of the distemper; or they are taken from the effects of the distemper; which that they may be particularly examined and tried, we shall fetch from their Originals, namely, from Actions, Passions, Excrements, and Habit of the Body. 1 The Animal Actions, which declare a cold Distemper of the Brain, are these; A heavy and dull Mind, a slow blockish Wit, an unfortunate Memory, a great inclination to sleep, and long and deep continuance therein, except a Catarrh, or Defluxion, Pain of the Head, or Passions of the Mind do hinder it: Dreams of Coldness, of Waters, as Rain, Snow, Floods, Pools, Seas, and of white things A slowness and dulness of all the Senses: Slowness of Motion, yet continuance therein; because gross Spirits are more difficult to be diffused or dissolved. 2 The Passions which declare a Cold Diseases, of the Brain, are Cold Diseases, as Palsies, Lethargy, Catarrh, or Defluxion, and many others, with which if the sick party have been formerly troubled, we may well conjecture that he is subject to this distemper of a cold Brain. This will further appear if the sick man be better in clear, hot, and dry weathr, than in cold, moist, winter, and rainy weather. Moreover, an often and plentiful sending forth of snot and phlegm from the Mouth and Nostrils, is a clear demonstration of abundance of cold Phlegm and moisture in the Brain. 3 From the Habit of the Body, we may have signs both general and particular of this Distemper: The general Signs are taken from the whole Habit or Constitution; for if the whole Constitution be cold and moist, then without question the Brain, which is most cold and moist of all other parts, is the same: Therefore a Skin which is cold, soft, smooth, and white; a Body soft and slow, not fleshy, with small veins, declare a cold constitution o● temper. The particular Signs of a cold Brain are in the Head; as paleness of Face, no Veins to be seen in the Eyes, soft hair, smooth, and thin, growing slowly, red, and not curling, continuing the whole life without baldness; and when the Head is quickly offended with outward Cold, and refreshed with Heat. As to the Prognosis, or Prognostical part concerning this Distemper; It is hard to be cured, and often produceth grievous Diseases: that which hath been long breeding is most hard to be cured; that which is Natural, Hereditary, and from the Birth, is never to be cured; as also that which is in old folks, if it hath been of long continuance. Winter is not a sit time for the Cure of this Distemper but Summer. The Cure is wrought from two Indications or Intentions; namely by evacuating or discharging the phlegm abounding, and correcting or qualifying the distemper of the Humour by its contraries, which must be done by Diet, Chirurgery, and Physic. The Diet must be hot and dry; and first make choice of a pure Air, somewhat hot and dry, but not too hot, for that would dissolve and power forth the humours in the Head too soon, and so produce a distillation, and other diseases which happen to those who stay long in the Sun, or inflame their heads with too near approach to the fire: The Air cannot be too dry, so it be temperate in its active qualities, but it had better be too hot than too cold. Let not the Chamber of the sick party be too little, too low, nor too moist or filthy, but open to dry winds which may pass through: In moist, cloudy, cold times, the Chamber air may be altered with hot and sweet Herbs strewed upon floor; as Sage, Margerum, Lavender, Rosemary, Time; or by burning the same, or other dry Woods, and especially Juniper: let the fire be clear, and such as will dry the Air in the Chamber: Fumigations if they be not too strong, do well to consume moisture; but they must be carefully used, they must be very gentle and moderate, otherwise they do hurt by melting and pouring forth the cold humours too speedily, which cause defluxions: and also you must consider the Patient's Constitution in the use of them, for some men are presently brought to the Headache by any strong scent, having their heads presently filled with the vapour: A temperate and proper Fumigation is made of the purest Amber, putting little pieces thereof upon the Coals; it's no way offensive, dries well, and strengthens the Brain, especially the Indian Amber, called Gum. Animi; or you may prescribe this following, which is thus compounded. Take Wood Aloes and Benjamin, of each two drams; of Storax, called Styrax Calamita, one dram and an half; Frankincense and Sandarach, of each two scruples; Gum-Animi and Cloves, of each half a dram: Make a gross Powder of them to be thrown upon the Embers. Southernly winds, and those that cause Rain are to be avoided, night-air, and especially Moonshine, which much offend the Brain: Very cold and North Winds are to bewared of, especially when they suddenly are changed from the South; for such a wind doth squeeze a Brain full of moist excrements, and sends them down into the Body, even as a man's hand squeezeth a wet sponge. Secondly, A special care is to be had of Diet, for as Hypocrates saith in his Book of Humane Nature, Diseases are partly from Diet, and partly from the Air wherein we breath: Therefore let the Diet be of good Juice, easy concoction, neither cold, nor over nourishing: Therefore Mutton, Kid, Veal, are to be used, and which are better, young Pigeons, Chickens, Capons, Hens, Partridges, Blackbirds, Thrushes, and all kind of Mountain Fowl, and Yolks of new laid Eggs: roast Meats are better than boiled. Take heed of hard flesh, and of hard concoction, as Beef, Pork, Venison, Hares, Geese, Ducks, and Sea Fowl: as also of the Heads, Entrails, and Appurtinances of Beasts. Eat Fish but seldom, and make choice of those which have solid Flesh, coming out of swift Rivers, and stony places; boil them in Wine, adding Vinegar, Butter, and Spice, which Sauce is to be allowed with other meat, unless the Liver be over hot; of which principally use, Nutmeg, Cloves, Cinnamon: never or seldom eat cold and moist Herbs, as Lettuce, Purslain, spinach: but in Summer time we can allow a moderate use of Herbs which are gently cooling and drying, for the strengthening of the Body, and fixing the Blood that it may not evaporate, as Endive, Succory, Sorrel, but they must be taken boiled, not raw. Roots of Parsley, Carrots, Parsnips, Mints, Hyssop, Water-cresses, are very good. But you must avoid all things that easily disturb the Head, and fill it with vapours; and they are of two sorts: Either they are such as discuss and melt the Humours with their sharpness, as Onions, Garlic, Mustard, Rocker, Rhadishes: or such as fill the Head with gross vapours, as Milk, and all Milk meats: All manner of Pulse, as Beans, Pease, etc. of which the red Pease are the least hurtful, by reason of their opening and abstersive nature; therefore the broth of them is allowed. You must avoid all green raw Fruit, which are not lasting especially, and those which are very moist: dried Fruits may be used at second or last courses, as Raisins, Almonds, Pine-nuts, Dates, and the like; but you must use them sparingly, for they are for the most part hard of concoction. Pears boiled and Sugared, Citron Rinds Candied, Lemmon and Orange Pills Candied, may be eaten at the last course: but it is much better to take one spoonful of digestive Powder after meat, whose Aromatical sweet vapour ascending with the vapour of what is eaten doth strengthen and dry the Brain: It is made of Coriander Fruit, Annis seeds, Cinnamon, Nutmeg, with a double quantity of Sugar of Roses. Let your Bread be of the best Wheat, well baked and leavened, and made with Salt and Annis seeds: in a great distemper Biscuit is best. Let your drink be thin wine of small strength, which will not fill the Head with many vapours, well mixed with Water; and also it is profitable one hour before meat to mix wine and water that the vapours may be allayed, and to boil a little Coriander seed in the water that it may better strengthen both Stomach and Brain: in stronger Diseases use Hydromel, or Water and Honey. This is a good Rule in all Diet, To eat moderately, and to let the Supper be less and lighter than the Dinner. Sobriety, as in all Diseases, so especially in Head-Diseases is of great concernment; for the Head by much food is filled with Humours and Vapours: and contrarily, by little and slender Diet it is emptied of them. Thirdly, You must use moderate Exercise, and every day continue it, for too much rest weakens the Natural heat, and makes it so dull that it cannot well concoct, and fills the Body full of Excrements: On the other side, Motion and Exercise stir up the Natural heat, help Concoction, expel Excrements, and cheereth the Spirits, and purifieth them, but you must exercise before meat, and after meat rest for an hour or two, or at least move very easily. Fourthly, Use a mean in sleep and waking, for as with moderate sleep the strength is repaired, so with too long the Body is made cold, burdened with excrements, especially the Brain: but too much watching, makes the Body thin, spends the Spirits, and feeds upon the sound parts of the Body. Let not therefore sleep be too long, but according to custom commonly seven hours are allowed, but more or less may be taken according as age and custom shall require; if you offend in either extreme, it is better to offend in too much waking than in too much sleep. You must not sleep strait after meat, but two hours after at least, having taken a gentle walk. You must sleep with your head high, and upon one side; lying on the back is not allowed. Fifthly, All the Excrements of the Body are to be evacuated in their season, of the Brain especially; therefore every morning hawk from the , blow the Nose, comb, and rub the Head with a course cloth, or sponge, which will fetch the superfluities of the Brain through the sutures or seams of the Skull. The Belly must be kept open; and if it will not otherwise, use a Suppository, or a Clyster, or some gentle Lenitive at the Mouth. For the Excrements are not only taken away by so doing, but also by degrees something is fetched from the Brain, or at lest something is retained and derived thereby from the Head, which was, or would have been sent thither as to the weakest part. Lastly, You must have special care of the Passions of the Mind, from which our bodies are many times wonderfully altered and disturbed; especially of Anger and Sorrow: Sorrow diminisheth the Natural heat, wounds the Spirits, whence comes small concoction, and many Excrements: Anger makes a great boiling of the Blood, and motion of the Spirits, by which the Humours are diffused and dissolved, and then if there be any Excrements in the Brain, presently they are sent to the weak and infirm parts, from whence arise many dangerous Diseases. The other two Means for Cure, namely, Chirurgery and Physic, may be used as followeth: In almost all Diseases which come of the Humours, we use to make a general Evacuation by Blood-letting and Purging. Blood-letting is not agreeable with Phlegmatic Diseases; but if in other parts of the Body Blood do abound, the Liver be inflamed, and the age of the Patient be flourishing, and consistent with it, we may then let blood: for so will the ascension of vapours into the head be hindered, and superfluous Nourishment taken away, that Nature afterwards may more easily concoct what is raw and waterish in the blood; and then purging Medicines may be given more safe. But if Plethora, or two great repletion do not Constrain, it is better before blood-letting to give a purge for Phlegm by way of Potion, Bolus, Pills, or Powder. The Forms whereof are as followeth. Take of Senna half an ounce; Annis seeds, and Cloves, of each half a dram; Leaves of Mints and Bettony, of each half a handful; of the tops of Time, half a pugil: Boyl them to a quarter of a pint in Spring Water; strain it, and infuse in it two scruples of the best Agaric Trochiscated; of Cinnamon half a scruple; strain it again, and dissolve in it three drams of Diaphoenicon, and one ounce of Syrup of Roses. Let this be the Potion to be given with safe Government. Or; Take Diacatholicon, and Diaphoenicon, of each half an ounce; make it into a Bolus with a little Sugar. You may add two drams of Diacarthamum, and take away as much of the Diaphoenicon: or you may make it of equal parts of Diacarthamum and Diaphoenicon, without the Diacatholicon. Or, Take Pill. Cochie the less, two scruples; with the Water of Bettony make them into five or six Pills gilded; which let him take early in the morning, having eaten but a light supper over night. The Pills of Agarick, and of Cochie the greater, are very fit for this purpose. For a Powder. Take Senna, Turbith, Hermodacts, of each a scruple; Diagridium half a scruple; one Clove: Give this powder in Broth fasting. After Blood-letting, if it be necessary, we come to the preparation and purging of the Humours, which may be done with the following Apozeme, or opening Drink. Take the Roots of Cyprus, Flower-de-luce, Angelica, Zedoary, and of Elicampane, of each one ounce; the Leaves of Bettony, Margerum, Balm, Penyroyal, Organ, Calaminth, of each a handful; of the tops of Time and Sage, of each half a handful; Annis seeds, Seselis, or broad Cummin, Fennel seeds, of each three drams; Liquoris scraped, and Raisins stoned, of each one ounce; the Leaves of Senna sprinkled with Aqua vitae, two ounces; Carthamus' seeds bruised, and fresh Polipody of the Oak, of each one ounce; Agarick trochiscated, Turbith, Hermodacts, of each three drams; Ginger and Cloves, of Each one dram; Stoechas, Rosemary, Sage, and Lavender Flowers, of each one Pugil, or small handful: Boyl them in fair Water to two pints; strain it and add four ounces of white Sugar: clarify it, and aromatize it, that is, make it sweet with two drams of Cinnamon; let this be for four morning draughts. In the first and last draught dissolve of Diacarthamum, or Diaphoenicon three drams; and let him drink it with Physical Regiment. Or if you add no Electuary to the last dose the day following. you may give the purging Pills above mentioned. After Purging, that the Brain may be altered and strengthened, and the Medicines purging, not leave any offence, the Patient may take this Bolus following: Take of old Treacle one dram; Conserve of Rosemary and Roses, of each two scruples: with Sugar make a Bolus, which let him take in the morning two hours before meat, and drink after a small draught of small Wine. But because this is a stubborn Disease, and will not always yield to gentle Medicines, we must fly to stronger. And then after Purging, we must use a sweeting Diet, which dries and warms the Brain and the whole Body; concocts crude and raw humours, & makes the thick humours thin, cuts those which are slimy and clammy, cleanseth those that are foul and dull, and sends forth whatsoever is over moist by Urine, Sweat, or insensible transpiration. For the effect of all which it is very good to use a slender Diet at the time of taking it. This Diet drink may be made either of a Decoction of Guajacum, or Lignum vitae only, or by putting to it some Sassaphras, or Roots of Sarsaparilla, or those things which are most proper for the Head, as the Prudent Physician shall think fit that will consider the divers tempers and constitutions of Bodies; in respect of which he will prescribe a longer or shorter continuance of this Diet to fifteen, twenty, or thirty days. Now the Sweeting drink is made as followeth: Take of Chips of Guajacum, and Roots of Sarsaparilla, of each two ounces: infuse them twenty four hours in four pints of Water upon warm ●mbers: then boil them gently without smoke to the consumption of half; strain it through a Hippocras bag, and keep it in a glass bottle, and give half a pint warm in the morning, covering him warm, and provoking sweat. Take of Sarsaparilla two ounces; infuse them twelve hours in twelve pints of Spring Water; then boil them as before to the consumption of the fourth part; strain as before, adding Coriander seeds, Liquoris, Sugar or Cinnamon, as much as will make it pleasant. Use this for ordinary Table Drink at the time of the Diet; eating Biscuit made with Annis seeds, roast Meat, not boiled, Almonds roasted, Raisins, Pinenuts, Prunes boiled with Sugar, and the like. This is always to be observed in the use of Sudorofick or Sweeting Medicines: You must give a Purge once a week, and that day omit sweeting, by reason that sweeting expels only the thinner matter, leaving the thick which must be sent forth by stool. Moreover, because by the use of sweeting Medicines the Body is often bound, you must give a Clyster every third or fourth day. If the Disease be not yet cured, you may use these bags for the Head, in the time of sweat. Take of Annis seeds, Fennel seeds, Bay-berries powdered, of each three ounces; of Milium, or Millet seed, or Hyrse, one pound; of common Salt half a pound: Fry them in a Pan, pouring by degrees a little strong Wine upon them. With these fill two bags, apply them hot one after another to the mould of the head being shaved; do this presently after he hath taken the sweeting Potion. Then wipe off the sweat, and clap this strengthening Plaster to the Head. Take of clear Amber, Frankincense, Mastic, of each one dram and an half; Galbanum, Opopanax, of each one scruple; of Misselto of the Oak two drams; male Peony seeds half a dram; Oil of Nutmegs as much as is sufficient: Make a Plaster of them in an oval form. Or you may use the head strengthening Plaster in the Apothecary's Shops at Mountpelior, not in the Dispensatory, whose description followeth: Take of Storax, Benjamin, Laudanum, of each four ounces; Peony roots, Flower-de-luce roots, Misselto of the Oak, Mastich, of each one ounce; liquid Styrax as much as is sufficient to make a Plaster: of which one ounce upon Leather in an oval form may be applied to the Coronal Suture. If you desire a more drawing dissolving Plaster which is commonly called Epispastick, thus you must make it. Take of Emplaster de Mucilaginibus two ounces; Flower-de-luce roots, Hermodacts, Pellitory of Spain, Staphisagre, Cubebs, Pigeon's dung, Mustard seed, of each one ounce; Nutmeg, Cloves, Cinnamon, long Pepper, and black Pepper, of each half a scruple; Liquid Styrax as much as is sufficient: Make a Body of Plaster, and spread a little upon Leather in an oval form for the mould of the head. After General Evacuations, you may come to Particulars; which are made by Errhins or Juices, for the Nostrils, sneezing powders, Apoplegmatisms, or Medicines chewed in the Mouth. Take Leaves of Marjoram, Sage, and Bettony, of each one handful; beat them in a Marble stone Mortar, sprinkling by degrees Bettony Water, and white Wine, of each two ounces: Press out the Juice and make an Errhine, which you may make sharper if you add half an ounce of Flower-de-luce roots. It is a custom now adays to rub the dry Leaves of Tobacco between the fingers, and to snuff up the Powder: this fetcheth much humour from the Brain, and is at hand. But the best Sternutatories are made thus: Take the Leaves of Marjoram, Sage, Rosemary, all dried, of each half a dram; Pellitory of Spain and white Hellebore, of each one scruple; Musk three grains; which with a Quill may be blown into the Nostrils. Or, Take Ginger, and Flower-de-luce Roots, or Orrace, of each one scruple; Castor half a scruple; Euphorbium six grains: Make them into Powder. But the chiefest smelling Powder is made of black Hellebore, with an equal weight of Sugar Candy finely powdered. Which also is excellent for curing a defluxion. Apophlegmatismi, or Medicines drawing Phlegm out of the Head, are either called Masticatories, that is, chewing Medicines; or Gargarisms, that is, Medicines to gargoyle in the Throat. A Masticatory is th●s prepared. Take of Pellitory of Spain two drams; Mustard seed and Stavisagre, of each one dram: Make them up with white Wax into little Balls; of which let one be chewed every morning, holding down the head. A Flower-deluce root is usual for the same purpose, which will do good in small infirmities. Mastich alone chewed is the mildest Masticatory, and it attracts, and draws humours to the mouth without heat and inflammation, which others do not. A Gargarism is thus made: Take of Stavisagre half an ounce; Mustard seed three drams; Pellitory of Spain one dram: Boyl them in Water and Honey to three ounces, in which dissolve Vinegar of Squils' two ounces. In the use of these Medicines we must observe, That the Evacuation which is made by the , is more beneficial than that which is made from other parts, because it is ordained by Nature for the only way by which the Head is to be purged and cleansed. But the Nose is made for smelling and breathing through, and Nature doth oppress and abuse it, when she sends forth her superfluous Excrements by it. Moreover the way of Evacuation by the is more safe, neither is the Brain so much shaked by it as by sneezing. But Errhines, or Medicines that purge the head by the Nose, do draw forth the matter more violently, because not only the quality or vapour of the Medicine stir up the Brain as in Gargarisms, but also the very substance itself. We must also observe, That the use of Errhines or sneezings is dangerous when the eyes are sore, or the Nostrils are ulcerated or sore, and when the patiented is inclined to bleeding at the Nose, or to a giddiness of the Head, which sneezings will suddenly bring by shaking the Brain too violently. Liquid and moist Errhines are snuffed into the Nose from the palm of the hand, or by lying down are poured in; but the mouth must first be filled with Water or Wine, lest that Medicine come by the into the mouth, although that which passeth through brings the humours more forcibly out of the mouth. They must take heed of Gargarisms that are subject to Defluxions or Consumptions. Moreover, For particular Evacuations we may use Vesicatories, or Plasters that draw blisters, to the Nape of the Neck. In the Dispensatory of Mountpelior is this Receipt, though it be not in any other. Take of Galbanum and Ammoniacum, of each five ounces; of the Powder of Cantharideses, or Spanish Flies, one pound and an half; Mustard, Pepper, of each half a pound; Virdegreece and Pellitory of Spain, of each two ounces and an half; Euphorbium one ounce and an half; Wax one pound and an half; Pitch, Rozin, and Turpentine, of each one pound; Oil a small quantity. One ounce or two of this Plaster spread upon Leather, may be applied to the Nape of the Neck. The Brain is also strengthened by outward application of Powders. Rhewm-Caps, by which it is comforted and made warm, and the remainder of the Humour dispersed. Take Powder of Orrace half a pound; Storax and Benjamin, of each two ounces: powder the Head with them every night, and comb it off in the morning. This Powder is very refreshing by its scent, strengtheneth the Head, drieth the Hair: If you will make it stronger, put Cloves, Nutmegs, and Cinnamon thereto. Take of Stoechas, Rosemary Flowers, and red Rose Leaves, of each half a small handful; dried Bettony two scruples; Coriander seed, Lignum Rhodii, Frankincense, Orrace, Nutmeg, Mastic, of each one scruple; Benjamin, Vernix, Mace, and Cloves, of each half a scruple▪ Powder them, and wrap them in the thirds of Scarlet or sweet Cotton, and with a piece of red Taffeta make a Rhewm-Cap for the Head, to be sewed in another Cap, or to be worn by itself. The following Fumigation doth dry the Head. Take of Lignum Aloes, Frankincense, Mastic, clear Amber, yellow Sanders, red Rose Leaves, Bettony dried, of each one dram; Cinnamon, Mace, Cloves, Styrax Calamita, of each one scruple: make them all into gross Powder, which you must sprinkle upon coals of fire, and let the Patient take the fume or smoke of it fasting, covering his head with a large linen cloth to preserve the fume, and opening his mouth: Let him do this twice or thrice in a week. But if by Fumes he find pain in his head, you may only perfume his nightcaps every evening: For which use this following is easily prepared. Take of Frankincense, Mastic, Styrax Calamita, Benjoin, and Sandarach, of each half an ounce; Mace and Cloves, of each two drams: Make gross Powder of them. But because this is a stubborn disease, and useth to produce new Phlegm after both general and particular Evacuations, we shall prescribe those usual Medicines by which the humour may sometimes be drawn away, and the Brain preserved longer in that state, into which by Physic it is restored. To this end you may make a Magistral Syrup of those Drugs which are in the Apozeme, or opening drink above written, taking three times as much of the purging things as before, which he may use twice or thrice in a Month, the quantity of two or three ounces in a Decoction of Bettony and Margerum. Or instead of Syrups he may use to take these Pills. Take of the best Aloes half an ounce; Turbith that is Gummy, Hermodacts, and Agarick new made up, of each two drams; Diagridium one dram; Ginger and Cloves, of each half a scruple; Saffron and Salgem, of each seven grains. Powder them all, and sprinkle them with the Water of Margerum: then dry them in the shade, and make them into a Mass or Body with Oxymel of Squils'; of which let him take half a dram or two scruples once in a week, two hours before Dinner. The day after his Syrup or Pills, as also twice or thrice in a week, let him take a quantity of this Opiate, or Electuary. Take of Conserve of Acorus Roots, or of Ginger, and Citron Barks candied, of each one ounce; the Conserve of Sage and Rosemary flowers, of each six drams; Nutmeg candied half an ounce; one candied Myrobalan, old Treacle, and confection of Alkermes, of each three drams; of the Powder Diambra, and Diamoschi dulcis, of each one dram: with the Syrup of Citron Barks make it up: And let him take every morning two hours before meat, the quantity of a Chessnut; drink after it a little wine and water. This following Balsam doth more strongly corroborate the brain, of which he may take now and then three or four drops in wine or broth. Take of the Chemical Oil of Nutmegs three drams; Oil of Marjoram, Rosemary, and Amber, of each half a dram; Musk and Ambergreese, of each one scruple: with a little Oil of a Man's Skull mix them together. You may make the Oil of a man's Skull thus: Take the shave or raspings of a Skull that was never buried, put them in a Retort, or Still so called, in as much white Wine as will suffice: Let them stand in Balneo Mariae, that is, a kettle of warm water for some time; then distil it in Sand till it is dry; and you shall find the Oil swimming upon the Water which is drawn off. Anoint your Nostrils within with this Balsam every night, and it will strengthen the Brain wonderfully. There is another cheaper for to anoint the Nostrils with: which is, Take the Oil of Orange Flowers two drams; white Wax one dram; melt them gently, and put thereto Oil of Amber half a dram; of the Chemical Oils of Sage and Rosemary, of each fifteen drops; Oil of Spike five drops; mix them together. It is also very good for the drawing away of the matter which breeds continually in the Brain, by an issue in the hinder part of the neck. Lastly, The Baths which come out of Brimstone, Niter, Bitumen, as those called Bellilucanae, are very good for the drying and strengthening of the Brain if it be washed therewith for some days, after general evacuations are made. Daily experience teacheth us that most grievous Head-Diseases coming of cold Distempers are thereby cured. It is profitable also to drink those Waters for the strengthening of the stomach which always doth sympathise with the head. Therefore I set down this digestive Powder. Take of Coriander seed prepared one ounce; Annis seeds, and sweet Fennel Seeds, of each three drams; Cinnamon and Nutmeg, of each two drams; Coral, Ivory, and Pearl prepared, of each one scruple; Sugar of Roses as much as all the rest, or for rich folk twice as much, of which let him take a spoonful after every meal, not drinking or eating for three hours after. CHAP. II. Of Drowsy Diseases, called, Coma, Lethargy, Carus, and Apoplexy. THere are four kinds of Preternatural sleep, namely, Coma, Apoplexy, Carus, and Lethargy. We will speak of them together in this Chapter, because they proceed from the same Causes, and are cured all the same way. These four Diseases differ one from another after this manner: In the Disease called Coma, Cataphora, or Subeth, according to Avicen, is a deep sleep; but such an one as from which the Patient is raised, openeth his eyes, and answereth, but presently he is again in a deep sleep. In a Lethargy, the sleep is like that of Coma, but it is joined with a Fever and Frenzy, or Dotage. In Carus there is no Fever as in Lethargy, but in Carus the sleep is more deep and profound, so that when the sick party is roused up, he scarce opens his Eyes, and answers not, as in the former, but yet being pinched he is sensible, and his breath comes freely. In Apoplexy the sleep is most deep, and a total privation of sense and motion, except breathing: and so therefore the sick doth neither open his eyes, answer, nor feel when he is hurt; as also he breatheth very difficultly. There are many Causes of these Diseases. The first and chief cause is Phlegm and waterish humour contained in the brain; of which (when there is but a small quantity, that moisteneth and cooleth the substance of the brain, stopping up its ●ores and passages) cometh Coma. But if the same quantity of Humour so gathered together, become putrified and corrupt, or grow into a tumour or swelling, or be dispersed throughout the brain, it procureth a Lethargy. When it is gathered in a greater quantity without corruption, and that the humour is sucked up into the substance of the brain, it causeth a Carus. And lastly, When the humour is in so great a quantity that it doth not only fill the brain, but also the ventricles thereof, stopping and straitening them, and also when it doth offend the Original of the Nerves which comes from the brain, and is placed in the basis or bottom of the Skull, and when it hindereth the passage of the Animal Spirit, it begets an Apoplexy. Secondly, Sleepy Diseases spring also from abundance of blood in the brain; for if the store of blood contained, be more raw, waterish, and cold, it thickens the Animal Spirits, and makes them unfit to move; as also the abundance of humour charging the brain, hindereth the free passage of the Spirits, and according as the humour is more or less in quantity, more or less in coldness, it produceth a greater or a lesser Disease: So that both Coma, Carus, and Apoplexy may be caused thereby. But drowsy Diseases, especially the Apoplexy, are usually caused by blood out of its Vessels, stopping and compressing the Ventricles of the brain, and that falleth out either from a vein broken in the brain, or from an over fullness of the Vessels, or from some great bruise or contusion of the head, or from some cut or punctured wound, by which the veins of the brain are divided, and so send forth much blood. And the Fracture only of the Skull, compressing of the brain may produce a dulness, drowsiness or sleeping Disease. Thirdly, It is without doubt that a Tumour in the brain, burdening it with its weight, may produce a sleepy disease. This is reported by Platerus to be found in a certain Baron, who for a long time was sortish and sleepy, did nothing rationally, nor desired meat, neither did eat any thing but what was forced into him; went not to bed but by compulsion, but would sit all day at the Table leaning on his arm, with his eyes shut, neither did he answer at any time without much ask and importunity, and then very little to the purpose. After his death his Skull was opened, and there was found in his brain, a great Kernel, hard, and of a callous body; the cause whereof might be some stroke upon the head, which he had received long before the beginning of his Disease. Fourthly, Many Vapours flying into the Brain may be the cause of a sleepy disease: for if the vapours be many and gross, that they burden the animal Spirits, and darken them as with a mist, even as the clouds in the greater world darken and obscure the beams of the Sun. But if they be overmoist they do so wet the Brain that it becomes weak and faint in its functions and performances: Therefore Drunkards sleep profoundly from the vapour of the Wine, and the abundance of crudities sent up into the Brain. So Children that are troubled with the worms are often taken with sleepy diseases from the abundance of gross and thick vapours which arise from crude and waterish humours. Soin intermitting Fevers or Agues, sometimes in the beginning of the Disease there is sleep, by reason of the crude and stinking humours which are contained in the veins, especially in the Meseraick veins, which humours being made thin by the heat of the fit of the Ague, send many vapours to the head, and produce such a sleep as ends with his cold fit sometimes, and at other times continues to the end of the fit, according as the vapours are more gross or thin; or as they are more or less in quantity, and so are longer and sooner discussed and dispersed. Fiftly, Many times so great a sleeping Disease is begot by the too frequent use of Medicines called Narcoticks, that do produce sleep; that many unawares by the unskilful use of Opium have slept their last. There is also the same stupifying force in some living Creatures: as in the Torpedo, or Cramp-fish. So Plutarch reports in the death of Cleopatra, That the sting of a Viper causeth deadly sleep. But in man's Body this stupid sleeping condition comes from the putrefaction of humours, which is seen in malignant and pestilential Fevers; hence it is that in those diseases they are very sleepy oftentimes, which is a certain sign of venenosity and malignity, and sometimes of death. The Diagnosticks or Signs which show the differences of these sleeping Diseases were set down in the beginning of this Chapter. But the Signs of the Causes that produce these Diseases are these: When sleepy Diseases come from watery humours putrifying in the Brain, these are the signs: A Phlegmatic Constitution, Old Age, Infancy, a cold and moist dwelling and season, a stopping of an accustomed spitting and blowing of the Nose, and when the sick man before the coming of the disease was troubled with heaviness of the Head, dimness of sight, and dulness of the whole Body; and when in the Disease there is a defluxion of Rhewm from the Nose or Mouth; or when the sick party feeleth it trickle down his Throat. That sleeping Diseases are bred of blood, appears by a plethoric or full Body, red Face, pain of the Head going before the Disease. A Tumour or swelling in the Brain is scarce by any signs to be known, but is only manifest after death by opening of the Skull as was before mentioned. That the Disease comes from vapours flying into the Brain, appears from those signs which show the particular Diseases of those parts, from whence the vapours are sent up to the Brain. A surfeit going before, with crude and sharp belchings, and other signs of crude humours in the Stomach, and other parts of the lower Belly, show that the Disease comes from vapours which are sent from the Stomach. But if the Vapours come from Worms, you shall know that in the Chapter of them. As for the Prognosis or foreknowledge of things in these Diseases, Every sleeping Disease is dangerous, but by how much the deeper the sleep is, and the sick man harder to be awaked, by so much greater is the danger; and therefore a Carus is more dangerous than a Coma, or a Lethargy; but an Apoplexy is worse than a Carus, for if it be violent, it is altogether incurable, as Hypocrates observeth in his 42. Aporism of the Second Section; which is thus: It is impossible to cure a strong Apoplexy, and not very easy to cure a weak one; a strong Apoplexy is when the breathing is uneven and disorderly, and sometimes intermitting, and if such a breathing is very violent the disease is stronger, if the breath be stopped it is most strong; but when there is some order in the breathing, the Disease is weaker, which is declared by Galen in his Comment upon the said Aphorisms. A sleeping Disease is very dangerous which comes upon an acute Disease, for it either signifies the extinction of the Natural heat, or a poisonous malignant quality which hath seized on the Brain. That Disease which comes by consent of the lower parts, and from vapours which arise from them, is less dangerous. Men sick of a Lethargy, die within seven days; if they live longer, they recover. Hypocrates in his Book of Diseases. Sleeping Diseases in old men, are for the most part deadly; for in regard of their want of Natural heat, they having a weak concoction, and weak expulsion, it comes to pass that they cannot overcome and expel that humour which causeth the Disease, much less can they expel that humour which aboundeth in the Brain, for since the Brain is the coldest part of the Body, it must needs in old people have its heat diminished and extinguished sooner than any other parts. In a Lethargy, if a Tumour happen under the Ears, or if matter or filth come forth of the Ears, and the symptoms abate, it is a sign of health, for it showeth the strength Nature hath got over the cause of the Disease, which it expels before perfect concoction out of the Emunctuaries under the Ears, or purgeth it out being turned into matter by the Natural passages. They who are preserved and cured of the Lethargy do use after to spit matter and blood, Hypocrates in Coac. and Third Book of Diseases. This Opinion, say some, agrees not with Experience, for few have seen a true Empyema, or corrupt matter between the Breast and the Lungs, follow a Lethargy: But the Interpretation of Mercurialis upon the Aphorism is very right, for he saith, That Hypocrates meaneth by Empyema and Empyicus, not the disease of the Breast, but when filth is discharged by the Ears and Nostrils. And Galen hath taught us in his Commentary upon Aphorism 8. Sect. 5. and Aphorism 44. Sect. 7. That Hypocrates by Empyema understands there, not only that suppuration and breeding of matter, which is in the Breast, but also that which is in all other parts. It is good sign when a Frenzy followeth a sleepy Disease coming of a cold cause, because by that violent heat which causeth a Frenzy, the watery matter which begets a sleepy Disease is concocted. Men in Apoplexies die in seven days, except a Fever take them, Hippoc●ates 2. of Diseases, and Aphor. 51. Sect. 6. but that Fever must be a violent one, and essentially springing from the inflammation of the Humours and Spirits, otherwise it will not discuss the matter which causeth the Apoplexy: for if it be gentle, and only symptomatical, or happening to the Disease as an accident, as in an Apoplexy, coming from the burning disposition of the head through too much blood contained in the veins thereof, than the Fever doth not diminish the Disease, but rather cause some symptoms of madness, which weaken the Animal Faculties: and in this case a Frenzy coming upon a sleepy Disease▪ is not good; as we said in the Prognostic before mentioned. Moreover, a Fever that must dissolve a sleeping Disease, must have another condition, namely, That it come in the beginning of the Disease, whiles Nature is in some strength to put forth strong endeavours. For that Fever which comes after the Disease hath long continued is not healthful, as Hypocrates in Coacis, saith, Apoplexies being like to be dissolved, it a Fever come upon them after they have long continued, are deadly. A faint Sweat in an Apoplexy is evil, for it shows great oppression of Nature. For the Cure of these Diseases, as of all other, three necessary means are required. First, Order of Diet. Secondly, Manual Operations, or Chirurgery. Thirdly, Medicines, or Physic. The Diet in the beginning of these Diseases must be very slender; because they are very acute, or violent and sharp; therefore the Patient must be fed only with thin broths now and then: But in the time of the declination of these diseases we may use the same Diet which is prescribed in the Chapter before going, treating of the cold Distemper of the Brain. The other two means are to be used by this following Method. And because sleeping Diseases are sudden, and full of danger, they require the Physicians chief diligence, and quick application of Medicines. First therefore, when the Physician is called to one taken with a sleeping disease, he shall endeavour to raise the Patient from his deep sleep, by offering violence to all his Senses? and laying his eyes towards the Sunbeams, and clearest light; he must make a great noise in his Ears, and he must be called aloud by his own Name. He must put sharp things to his Nostrils, as Rue, Castor, Vinegar, and sharp things into his Mouth also. He must stir up his feeling with pinching, pulling of hair, by ligature or binding, bending of the fingers, and the like. Make first a Clyster of the common Decoction which is most ready, after this manner. Take of common Decoction for Clysters, one pint and an half: Hiera picra, and Diaphoenicon, of each one ounce: Oil of Rue, and of Lilies, of each one ounce and an half: Honey of Roses two ounces: Salt one dram: Make a Clyster, give it presently. While these things are doing, the Physician ought seriously to consider whether Blood-letting be fit or not; for in these Diseases, as Celsus said, Blood-letting either kills, or cures; and blood-letting is good, if blood be the principal cause, or the assisting cause, or if it be sine quanon, that is, a cause wirhout which the disease would not be, if strength permit. But his strength is not to be looked upon as he is in his fit, when his Animal Actions are hindered, but as it was before the Disease came. For if the Patient was formerly strong, he will endure blood-letting, except the Apoplexy be very strong: and if his strength be not taken away by resolution of the parts, but by oppression of them, than is blood-letting good. But if Blood offend no way, or if the strength be quite gone, or the Patient very old, you may omit blood-letting, but otherwise presently. The first thing to be done either by night or day to one in any of these Diseases, is blood-letting, nay, before the Clyster, if it be not already administered: But his Arm must first be well rubbed and chafed. And this is to be observed, That it is more profitable and safe, not to let out so much blood at once as you require, but by degrees in some hours distance; for by the repeating of blood-letting, the matter is more easily moved, and the strength more preserved. Look in the sick man's face after his first loss of blood, and feel his pulse; for if his face be better coloured, and more lively, and his breath more free, and his pulse good, there is much hope, and you may let blood the second time with more confidence. Make the Orifice large, otherwise he will not bleed, his blood is so thick. The more plenty of blood he hath, the more he may lose: But if phlegm abound you must bleed sparingly, lest the vital heat be lost, which is so absolute necessary for discussing and dissolving of this Disease. A singular Example of large and often bleeding in an Apoplexy, is laid down by Zacutus Lusitanus, in his First Book of the Chief Physicians, and his 33. History, in these words: A certain Noble young Maid, fell first into a general forgetfulness of all things, and then into a true Apoplexy, with the flowing of her Courses: Unto whom when they had applied many Medicines both above and beneath, as Ligatures, sharp Clysters, Cupping with Scarification: the Indication which comes from the flowing of the Terms being neglected, and danger coming on through continuance: I perceiving her strength to be sufficient for it, having first rubbed her Thighs very well, and placed Cupping Glasses thereon; in the space of eight hours, opened the head Vein four times, and then she began to speak, and so recovered. Some of our late Practitioners, are so bold as to open the Jugular Veins in Apoplexies, and say they cure also: and in so doing they take this course: First they bind the Neck gently with a linen cloth, after the Vein is opened, they presently lose it, and the blood flows well without a Ligature, which might attract it to the head: after they heal up the wound with a sticking Plaster, without binding, and so they affirm the blood will easily stop: which Zacutus Lucitanus confirmeth (though he useth Ligatures) in his 79. Observation in his first Book of the Admirable Practice of Physic, where he relates a Story of a most sharp Squinancy; in which, by the advice of most skilful Physicians, the Jugular Veins were opened; from whence followed (as he says) a most dangerous flux of blood not to be stopped, which brought the Patient very weak. Zacutus being sent: for, applieth Galens Plaster, which he in his 5. Book of Method, and 4. Chapter, useth with good success for stopping blood in Arteries and Jugulars, and bending the Patient's Neck gently, he comes to his strength, and is cured. This Plaster is made of Frankincense, Aloes, the hairs of a Hare mixed with the white of an Eglantine, having twice as much Frankincense as Aloes, as Galen teacheth in the place mentioned sometimes an equal part of each, when the Bodies are harder. And Galen commends the operation before written, when he saith, This Plaster stops the flux of the Jugular Veins without a Ligature or binding. But this I would take notice of, That the blood doth not flow forth so violently in one that hath an Apoplexy, as in one that hath a Squinzy, because the blood is congealed; as Hypocrates shows in his Second Book of Diseases, in the former, from whence the Veins and Arteries called Caiodites or Jugulars, are stopped: but in the latter the blood is hot and thin, because they who have the Quinzy have always an acute Fever withal. A few hours after bleeding you must purge without respect of time. Neither let the Physician be too curious or fearful in purging, since the Disease doth much require it, and the time of the disease is not usually long. And that purge aught to be very strong because the humour is stubborn, and the Senses so drowned that they cannot be roused or stirred up without strong Medicines. And that Medicine is usually one ounce of the Electuary Diacarthamum, dissolved in Bettony Water with half a scruple of Castor. Or, Take Turbith four scruples: Agarick two drams: Ginger two scruples: Fennel seeds one scruple: Castor six grains. Infuse them in a sufficient quantity of Bettony Water: and in three ounces of it strained, dissolve the Electuary Diacarthamum three drams: Syrup of Roses one ounce. Let him drink it. Take of Cochie Pills the less, one dram; Castor three grains: With Bettony Water make seven Pills, and if the party cannot swallow them, dissolve th●● in Sage, Lavender, or Bettony Water. Or, Take of Cochie Pills the greater, and Pills of Agarick, of each half a dram: The Troches of Alhandal, Diagridium, and Castor, of each three grains: With Honey of Rosemary, make Pills, or dissolve it in Sage Water. Or this Potion Take of Senna half an ounce: of white Agarick one dram and an half: of Turbith one dram of Ginger and Galanga half a dram: Boyl them in Sage and Rosemary Water. In two ounces and an half of the strained Liquor put two drams of Diacarthamum the Electuary; and of Castor half a scruple; of simple Oxymel half an ounce. In a Lethargy, the purging Medicines must be milder from the beginning by reason of its continual Fever accompanying; made of Agarick, with Rhubarb or Scammony; or of Pills of Hiera with agaric; because Choler is that which carrieth the humours to the Head: Yet in the progress of the Disease, when the matter is flown to the Head, and sticks there, we may use the Purges above written. Trallianus gives one scruple of Scammony with two scruples of Castor in Oxymel, by which he hath cured many desperate Lethargies. And Oribasius saith, That there is no better Medicine for a Lethargy to purge away that phlegm which Choler brought to the Head, than Scammony and Castor. It often happens that the Faculties are so oppressed that Physic will not work, which is an evil sign, and such seldom recover. But because Celsus saith, when things so fall out, we must use such Medicines as are at hand; if they be proper for the Disease; which is so desperate that we may use desperate Medicines. For as Serenus saith, The Physicians think such Medicines better in desperate cases, than for the Patient without trial to die an easy death. And as Celsus saith, Many things may be done in time of danger and necessity, which may well be omitted at another time. Therefore when we have used those Medicines without any success, we may well rise higher, namely, To those Medicines which are made of Antimony; especially to those which are less vehement and furious, as Aqua Benedicta, of Dr. Ruland, made of the Infusion of Crocus Metallorum; which purging both upwards and downwards, bringeth such a quantity of Phlegm, not only from the stomach, but the brain also, as sometimes the Patient is cured only with this Evacuation. And I can witness upon my own Experience, That I saw a Noble man thrice in two years cured from the Apoplexy with this only Medicine. Although some learned men do forbid the use of Vomits in these Diseases, yet we must yield to Experience, which daily teacheth us, that Children affected with sleeping Diseases are more readily and safely cured by the vomiting Salt of Vitriol, than by any other Medicine. The Tincture of Tobacco drawn with Aqua vitae, and taken in the quantity of two drams, with Honey poured down the Throat doth excellently. After you have given a purging Medicine, before it gins to work, and also while it worketh, you must think of all those things which cause revulsion of humours, and bring them into practice, not only frictions or rubbings, and ligatures or bindings, mentioned before, but also Cupping glasses to the back, shoulders, arms, and thighs, without scarification if he was formerly blooded, and with scarification if blood-letting was omitted. In an Apoplexy you must not apply Cupping glasses to the Breast or Hypochondria, or parts under the Ribs, lest the Muscles of the Breast and Belly being contracted, the Breath be hindered. The chief and only Remedy in an Apoplexy especially, is to apply Cupping glasses to the head: Which kind of Cure the famous Physician Fracastorius being taken with an Apoplexy, did direct for himself by his Nods and signs; but for want of their understanding of them, he died. Zaeutus Lusitanus in his 33. History, and the first Book of the Principal Physicians, reports that he cured a desperate Apoplexy by setting a Cupping glass twice upon the hinder part of the Head with deep Scarification. A Vesicatory, or Plaster to draw Blisters to the Neck behind, and to the Shoulders. Let two or three sharp Clysters be given every day. Take of Pellitory of the Wall, Hylop, Calamints, Organ, Sage, Rue, and the lesser Centaury, of each one handful; of Carthamus' seeds half an ounce; of Fennel and Cummin seeds, of each three drams; of white Agarick tied in a linen clout two drams; of Coloquintida tied with it, one dram and an half. Boyl them to one pint, strain them, and ad to the Liquor of Hiera Picra half an ounce; of Diaphoenicon one ounce; of Oil of Rue two ounces: Make a Clyster. The Chemical Physicians do usually add two ounces of Aqua Benedicta of Dr. Ruland, made of the Infusion of Crocus Metallorum, and then it will work strongly. You may give four or six ounces of the same infusion at a time, and also you may take it out of the glass wherein the Infusion was made, shaking it before, that it may have some of the fecies or residents of the Powder in the bottom to make it more strong. Therefore for the most part we do prescribe Clysters of Aqua Benedicta, or Vino Emetico, that is, the Infusion of Crocus Metallorum, because in many Diseases, especially Chollicks, it doth wonders. Take of Emollient Decoction for Clysters one pint; of Diaphoenicon one ounce; of Infusion of Crocus Metallorum shaked together, four ounces, make a Clyster. If the Clyster come not away in due time, give this Suppository: Take of the powder of Hiera Picra of Galens prescription, two drams; of Coloquintida and Agarick the best, of each half a dram; of Diagridium one scruple; Salgem two drams; Honey boiled to a sufficient consistence or thickness, as much is sufficient; make Suppositories. It often falls out that the Muscle of the Arse called Sphincter, is so weak, that a Clyster is given in vain because it cannot be contained, which is a desperate condition. Apply Castor and Vinegar to the Nose, which are said to have a special quality against sleep. It is also very good to sprinkle sharp Vinegar upon a red hot Iron, that the Patient may receive the vapour in his Nostrils. And it will be better to put Nigella or Pepper-wort seeds, Rue seeds, or Castoreum to the Vinegar. But Vinegar itself warmed and applied to the Nose, if it be sharp, stirs up the Patient powerfully; and more powerfully if you put to it Pepper and Castoreum. The Fume of Brimstone doth also raise from sleep. The Hairs of a Goat burnt, or the horn of a Deer or Goat burnt, held to the Nose, are most strong for the raising up of him that is in a deep sleep. The fume or smoke of white Amber, is excellent for the awaking of men in sleepy Diseases; as also the Oil of it often applied to the Temples and Nostrils. Rub also the sols of the Feet with Salt and Vinegar, anoint the hands with Oil of Rue, and of Castorium; touch the tongue and with old Treacle dissolved in Aqua Caelestis, or Apoplectica. But take heed that your Treacle be not new, for then Opium will cause more sleep. The Medicine called Aura Alexandrina, or Confectio Anacardina. You may also boil Mustard seed in Vinegar or strong Wine, and wash the therewith. Roots of Pellitory of Spain boiled in Oxymel, that is, Honey and Vinegar do the same thing. But with all these Medicines you may safely use Castoreum. When you have purged the Body generally in all parts, you must then purge the Head either sensibly or insensibly. Sensibly, by the Nostrils and , by Errhines or Neesing, which are prescribed in the Cure of a cold Distemper of the Brain, and by the touching of the as before. To all these you may add Rue, Castoreum, and Vinegar. Concerning Sneezing, It is to be observed, That if the Disease remain and increase; and if the Patient be hard to be raised, it is very profitable: but we must not use them too long, lest they clog the Brain, and move the humours too much. But in the beginning of the Disease we must abstain from unseasonable sneezing, because it disperseth the humour which will fix in other parts; from whence come stubborn Diseases, or a small sleeping Disease turns into a strong Apoplexy. Last of all you must use those things which resolve the humour insensibly, which are compounded in this manner: Take Bay-berries and Juniper Berries, of each one ounce and an half: Roots of Angelica, Zedoary, and Master-wort, called Impatoria, or Pellitory of Spain, of each one ounce: Leaves of Bettony, Sage, Rosemary, of each one handful: Rue, Savory, Margerum, Lavender flowers, of each half a handful: Boyl them in Vinegar. Dip a Sponge or linen cloth in this Liquor, and apply it warm to the Head. It is a wonderful thing to see what good this doth in sleeping Diseases: But you must rub the Arms and Hands, and the Legs and Feet with the same. Take of Castor half an ounce: of Man's Hair burnt, three drams: of the Juice of Rue, of Vinegar and common Oil, of each two ounces. Boyl them to an Ointment, and then anoint the Head therewith, after the Fomentation. Take of Oil of Pepper-wort called Oleum Costinum, of the Oil of Castor, and of Euphorbium, of each one ounce: of the Powder Mustard seed, and Euphorbium, of each one dram: of Vinegar one spoonful: of Wax as much as will serve to make an Ointment. If the Disease doth not decrease after all these are used, than you must apply a great Cupping glass to the crown of the Head, and to the hinder part of the Head. But a Vesicatory is best if Euphorbium be in it, for that will draw the humour outwardly which lieth deep. Some are so bold in the height of the Disease to burn the hinder part of the Head, between the first and second Vertebra, or Backbone with an actual Cautery. Zacutus Lusitanus applied many in his time with good success, as he witnesseth in his first Book of Wonderful Practice, and the fourteenth Observation, in these words: I being called to visit a sick man, who was for the space of thirty days taken with drowsiness and irresistible sleep, with a small fever, not able to hold open his eyes: He had used many evacuating, and diverting or repelling Medicines, but they perfected nothing; therefore I applied the Cautery with much benefit; for with a red hot Iron I scorched the crown of his head till it was hard and crusty, as also the hinder part, and almost every where about his head, by which means be awaked, and the places burned beginning to matter, he arose and came to himself. By this means I remember I cured two sleepers contrary to expectation, after all other means had been used in vain: and these were cured by the heat of the fire, melting, dissolving the humour which came forth at their mouths and nostrils many days after. Others have an Ancient Custom, to hold a red hot Frying-pan so near the Head that it may burn the Hair, and not the Skin. It is good in these Diseases to give the Patiented a little Aqua Coelestis, or Apoplectic Water; or other strong Water, which by its piercing quality do very much good, and have freed many from Apoplexies present and approaching, if Blood be not predominant or chief in the Body, which will be hurt by the use of strong Waters. Now there are many sorts of Apoplectic Waters, in Langius, Wickerus, Quercitanus, Crollius, and others. But we shall here only lay down one Water invented by myself, and made of the most proper Ingredients. Take of Peony Roots, and Misleto of the Oak, of each two ounces: Calamus Aromaticus, Galangal, and Cyprus, of each one ounce: Bettony, Sage, Margerum, of each one handful: Peony, Annis, Fennel, and Caraway seed, of each three drams: Lavender, Stoechas, and Rosemary flowers, of each a pugil: Nutmeg, Mace, Cloves, Cubebs, Grains of Paradise, cardamom, of each half an ounce: Cinnamon two ounces: Saffron, one dram and an half: the Species of Diambra, and Diamoschu, of each two drams: Cut and beat them according to art, put them in a glass still, and then power in as much of the best Spirit of Wine as is sufficient. Let it stand in Balneo Mariae, or a kettle of warm Water with Hay in it for the space of eight days; afterwards draw it off, and keep the Water in a close stopped glass bottle. Now if the Disease decline, and his deep sleep begin to cease, you must omit all other Medicines and follow those things only which strengthen the Brain: which may be very well done by the use of that Opiate or Electuary which I prescribed in the Treatise of the cold distemper of the Brain. But if you will use stronger than that, take the Aqua Apoplectica above mentioned. Continue the use of Castor above all things, if the Disease continue, giving every morning three or four grains of it in the Oxymel of Squils', or simple Oxymel. Trallianus affirmeth that many overcome with this Disease, have been recovered only with this Remedy. Outwardly you may use some Chemical Balsams against Apoplexies, of which there are divers. We will only discover one of the best unto you. Take of the Oil of Nutmegs by Expression, half an ounce: Ambergris, Musk, and Civit, of each one scruple: the distilled Oils of Spike, Amber, Cinnamon, Rosemary, Cloves, of each half a scruple. With this Balsam touch the every morning, and drop some into the ears, and snuff some into the nostrils. For this purpose the distilled Oil of Nutmegs used in the same manner is much commended. Lastly, We must observe, That in the Cure of these Diseases, we must use less hot things, and lose more blood, when the Disease is caused of blood; and also we must mix Medicines that purge Choler with those that purge Phlegm. They which have been troubled with any of these Diseases, and are cured, do use many times to relapse and fall into the same again; which that you may prevent you must correct the cold Distemper of the Brain, as before is taught; by which Method you may prevent either Apoplexy, Carus, Lethargy, or Coma. And if the Brain be very cold after general Evacuations, you may often use Aqua Apoplectica; or these Tablets or Lozenges following: Take of Ambergris half a scruple; the distilled Oil of Annis seeds, Cinnamon, and Nutmegs, of each three drops; Oil of Cloves one drop; Sugar dissolved in Orange-flower-water, four ounces. Make these into Lozenges, and let him take a dram or two of it every morning. Pills to strengthen the Head, are thus made: Take of Cubebs, Mastich, Nutmeg, Cloves, of each one dram; Ambergreese half a dram; of Musk six grains. With Juice of Margerum make Pills, and let him take one scruple at a time twice in a week at his going to bed. This Powder is much in use, and is much commended: Take of White Amber half an ounce; of the Powder of the Electuary called Diarrhodon Abbatis, two drams; of Peony Roots, one dram and an half. Make a Powder of them, and take a dram at a time in any Water for that purpose before every New Moon. It is good to hold Nutmeg in the Mouth, and to chew it very often. Sweet Perfumes are to be used to the Nose, especially the Apoplectic Balsam. Use Spices with Meat, after Meat a digestive Powder, mentioned in the Cure of the cold Distemper of the Head. If you fear a sleepy Disease will come from too much blood, you must first take some away by the Arm, and use all means to make the Piles or Hemorrhoid Veins to bleed, which is very good; for which you must purge with Senna and Rhubarb, and with cooling things. If you fear an Apoplexy from Melancholy you must purge Melancholy, and provoke the Hemorrhoids, and give the Medicines prescribed for the strengthening of the Brain, especially that powder which is made of white Amber, Diarrhodon, and Peony Roots. CHAP. III. Of Waking Coma. THE Disease called Waking Coma, or Coma vigil, is put among sleeping Diseases; yet because it is of another Condition different from the rest, we will treat of it in this Chapter by itself. This Coma vigil, is a Disease in which the Patient lieth with his eyes shut as if he were asleep, when he is awake and distracted; and if you touch him, he presently openeth his eyes, and looks strangely, and falls asleep again, which is hindered by divers strange imaginations and fancies. This Disease Galen placeth as a mean, between a Frenzy and a Lethargy, and calleth it Typhomania. The usual Cause of this Disease, is Choler mixed with Phlegm, by which humours the Brain is made too moist, or it is swelled or inflamed; from whence, either the Tumour called Erisypelas oedematosum, or oedema Erisypelatosum. But because those humours are diversely mixed, sometimes a greater proportion of the one than of another, it comes to pass that the Diseases from them are divers: for if Choler be chief, than it is a Delirium, or Dotage, and the sick man sleepeth but little though his eyes be shut; but if Phlegm prevail, the Patient doth sleep more, and is less doting, and being raised makes less noise, and is not so foolish. This Coma vigil comes by sympathy from Choleric vapours mixed with Phlegmatic that fly into the Head; which happens in Fevers that come from mixed Humours, especially in half Tertians, which are made of a Tertian and a Quotidian. We may safely affirm that this Disease cometh from Vapours, simply hot and moist in strong Fevers, because sleep comes from moisture, and waking comes from heat. The Diagnosis, or knowledge of this Disease, is plain enough by what hath been said, That they which have it, lie with their eyes shut, and seem to sleep, yet they cannot sleep, but toss and tumble, lift themselves up suddenly, strive to get out of the bed, and then fall again asleep. The divers Causes are easily known from what hath been said. This Disease is accounted dangerous if the Brain have a Swelling or Inflammation, or if it be overcome with the humours above mentioned, namely, Choler and Phlegm; or if it come of vapours which arise from the malignant Humours of a Pestilent Fever. If the Dotage, or Delirium be strong, it produceth a Convulsion, for it comes of a Humour or vapour which is very sharp, which falling upon Nervous parts causeth a Convulsion. A true Coma vigil is cured as a Frenzy and Lethargy; and if it incline most to a Frenzy, than the Medicines proper for that are most to be used; if to a Lethargy, than the Medicines proper for that. But a Coma that cometh by Sympathy, is cured by curing the Malignant Fever from whence it cometh; but the more peculiar Remedies must also be used which draw and keep humours from the Brain in the beginning of the Disease, as bleeding in the Arm and Foot, Vinegar of Roses applied to the Forehead, Clysters, Cupping glasses to the Shoulders, Back, Buttocks, Thighs, opening the Head Vein, applying Leeches to the Temples, and behind the Ears, and laying living Creatures to the Head to dissolve the Humour. CHAP. IU. Of the Sleeping Diseases called, Catoche, and Catalepsis, or Congelation. THere is some Confusion among Authors about this Catoche; for some take it for Coma vigil, Waking Coma; others for Catalepsis: Paulus gave them the cause of their difference; in his Third Book, and the Eighth Chapter, he treats of a twofold Catoche; and first under that name, he speaks of a Coma vigil; in the end, under the same name, he speaks of Catalepsis. Custom hath brought it to pass, that Catoche, and Catalepsis, are taken for one and the same Disease in all Authors; the Latins call it commonly Congelation, or stiffness of the Body. It is a Disease seldom seen, and to be admired, and those Authors which have seen the Disease do think it so much worth the observation, as to describe the whole passage and History of it. First of all, Galen in his first Comment, Prorrhet. Sect. 2. Part 56. mentioneth a story of a School-fellow of his, who when he had wearied himself with long Study, fell into a Catalepsis, or Congelation; He lay (saith he) like alog all along, not to be bend, stiff, and stretched out, and seemed to behold us with his eyes, but spoke not a word: and he said that he heard us what we said at that time, although not evidently and plainly, and told us some things that he remembered, and said all that stood by him were seen of him, and could remember and declare some of their gestures at that time but could not then speak or move one part of his body. But Fernelius in his third Book of the Parts of Diseases, Chap. 2. relates two Stories, which are these; One while he being very studious and writing, was so suddenly struck with this disease, that sitting and holding his pen, with his eyes open, and looking upon his Book, you would have thought he had been hard at study, till he was by calling and jogging found to want alsence and motion. Another I saw like a dead man, lying along, with neither seeing, hearing, nor feeling when he was pinched: but he breathed freely, and whatsoever was put into his mouth, he presently swallowed; if he were taken out of his bed he did stand alone, but being thrust he would fall down, and which way soever his Arm, Hand, or Leg was set, there it stood fixed and firm: you would have taken him for a Ghost, or some rare Statue. You may read the like Stories i● Schenkius, Marcellus, Donatus, Rondeletius, Jacotius, and others: From whom you may gather, That in this disease there is found a destruction, or hindrance of the internal and external Senses with a stiffness of all the Members; and sometimes the Senses are not so much hindered but the sick party heareth those that speak unto him; sometimes the Members are not so stiff, but they may be bend and bowed by them that stand by, and put into divers Postures. The Causes of this Disease are divers: Galen in his Comments, Aphor. 3. Sect. 2. says that a Catalepsis comes from a cold distemper of the Brain, which distemper chief seizeth upon the hinder part of the Head, makes it stiff and thick, from whence the Nerves proceeding are also made stiff, and such a distemper may seize upon all the Nerves, whether it come of an external or an internal cause: but some question this cause, supposing that no living body can be so cold as to have such a Congelation: But Galen answereth this in his 5. Chap. of his Book of the Difference of Diseases, by a Reason taken from Experience, in these words; For those who in a journey are taken with cold, which is unto death, are thus stiff, whom the Greeks call Emprostotonos, or Bowers forward; Opistotonos, or Bowers backward; Tetanoes extended straight: and others that are killed with cold are taken with this Catoche or Congelation. Therefore Galen teacheth us, that a Catalepsis may be got by external cold, and Reason may easily persuade us to it; for they which are killed upon the way with great cold, do first grow stiff, they have a stiffness or Congelation before they die, therefore cold may bring a less stifness than that which bringeth Death. So we see that Congelation of the Nerves, or Catalepsis, may come of a cold Distemper, and the sooner if it be mixed with a dry distemper. But this Disease is most often gotten by a cold and dry distemper joined with matter, that is an Humour or Melancholy Vapour▪ from which cometh a Constipation or Congealing of the hinder part of the Brain, and extension of the Nerves, and also a stiffness of the same; from this humour it cometh (I say) not only in respect of its quality, which is cold and dry; but also in respect of its quantity, which by repletion makes a distension, or stretching forth of the Nerves. Aetius in his sixth Book, and fourth Chap. saith, that a Congelation may be caused of blood: Unto which thing Rondeletius consents, saying, that it comes to pass when the Veins and Arteries of the Brain are so full, that the Body groweth stiff, and distended or stretched out like those bodies that are congealed with cold weather: he confirms his Opinion by a History of a Noble woman taken with a continual Fever, called Synochus, who had in the ninteenth day a Congelation, which was cured by a large flux of Blood from her Nose. Sennertus hath found out a new cause, which he saith is a congealing Spirit, by which the Animal Spirits are fixed, and made immovable: he denies that the force of congealing and fixing depends upon a cold and dry distemper, but riseth from some hidden quality. Such Congealing Spirits are found in the greater World, as in Thunder, when men are thereby made stiff, and as it were congealed: As Cardanus reports of eight Mowers, which supping under an Oak, were struck with Thunder so as they kept the same shape of Body, the one seeming to eat the other, to lay hold of the pot, another to drink, when they were all dead. It is usually reported that Wine will be congealed in the Vessel by the spirit of Thunder: In Earthquakes, many times such Spirits break forth suddenly out of the Earth, as make men and other living Creatures to be stiff and stark. Moreover, Sennertus addeth, that there is great congealing force in Nitre and other Minerals; he brings no Examples: We shall only bring one Instance taken from Lead, whose Vapour doth so fix and congeal Mercury, or Quicksilver, that it becomes thereby malleable, or to be beaten with the hammer. This Opinion of Sennertus were not wholly to be rejected, if he had not made this the only cause of the disease, and cast off all the rest; which when they are allowed and confirmed by Galen, and the best of Authors are not easily to be cast off and denied. Nor is it needful that we fall to hidden Causes when there are enough visible and manifest, able to produce such effects as is before declared. And when Sennertus says that this his congealing spirit is caused of a melancholy humour, he seemeth to differ from the common Opinion, which is, That a Congelation cometh of a cold and dry or Melancholy vapour. The Knowledge of this Disease, or Diagnosis, is manifest from the Stories of Galen and Fernelius already mentioned; for the evil befalls a man quickly, and leaves him in that posture in which it found him; and keeps him unmoved as if he were congealed: The diversity of Symptoms which we propounded before, is seen plainly. We foretell this Disease by the same signs as we do other sleeping Diseases, as the Symptoms are greater or less, so is the Disease more or less dangerous. The way of Cure is Twofold either in the time of the fit, or out of the fit: In the fit you may use those Medicines which are set down for sleeping Diseases: Out of the fit you must labour to cure Melancholy, the disease so called, if the Congelation come from a Melancholy humour or vapour, which is the most common cause of it; but if a cold distemper either inward or outward give this Disease a beginning, the Remedies which cure it are to be taken out of the first Chapter of this Book. And lastly, it plenty of blood have begot this Disease, or doth maintain and nourish it, it is very proper to diminish it by opening a vein. You must advise the Patient to a hot and moist Diet, as in all Diseases that come from a Melancholy humour. CHAP. V Of the Palsy, or Paralysis. A Palsy, is the loss of Sense and Motion in some parts of the Body, by reason of the stopping of the Passages of the Animal Spirits. There are many kinds of Palsies; for either it is in all the parts of the Body below the Head, and then it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; or else it possesseth only one side of the Body, and then it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; or it possesseth but one part of the Body, and then it is called a Particular Palsy; although some Authors use all these terms, as Paralysis, Hemiplegia, Paraplegia, Paresis, and Resolutio, promiscuously for one and the same disease, which is a loss to Sense and Motion in any part of the Body. There is therefore a double Palsy; one called Perfect, in which Sense and Motion is quite gone; another Imperfect, in which Sense and Motion are decayed and diminished, and if it be a small diminution, it is not a Palsy, but a Numbness or Dulness, called Torpor, or Stupor, which is the way to a true and perfect Palsy, and the forerunner thereof. There is another kind of Palsy, which is, When the Motion is hurt, and the Sense not; or when the Sense is hindered, and the Motion not. The Causes of a Palsy are generally all those which hinder the passage of the Animal Spirits into the Nerves and Muscles. The chief of all is a waterish Humour, which by stopping, compressing, condensing or making thick, refrigerating or making cold, hinders the passage of the Animal Spirits. This watery Humour comes from the Brain, and falls upon the Nerves and Marrow of the Back: So a light Apoplexy turns into a Palsy, when the Humour that caused it falls from the Head upon the Marrow and beginning of the Nerves, and so gets into the substance of them, and shuts up those insensible Passages through which the Spirits come to the Parts; or descending by the hollow of the Backbone, and by the Marrow of the Back and running upon the Nerves, it compresseth and streightneth them, whereby the Animal Spirits are hindered in their Motion. Moreover, The same Humour may so thicken the substance of a Nerve by its coldness, that it cannot be passed through by the Animal Spirits. And lastly, The Passage of the Animal Spirits to the parts of the Body may be so hindered by a simple distemper in cold and moistness, that the Native temper of a Nerve, and the heat in it may be destroyed, and the Animal Spirit not perform his office; for the heat of the Animal Spirits must be joined with the Natural heat of the part, for the performance of its Office. There is a Controversy whether other Humours may be the cause of a Palsy which we will not omit though they are very seldom mentioned by others. Trallianus in his▪ first Book, Chap. 6. reports of a certain man that fell into a Palsy through sadness and grief, and after taking of Hiera he became immovable without motion, and had died if he had not used all moistening things for his meat and drink, and other things to bring him to a temperate condition, especially many Baths and Ointments of Hydroetrum, that is, of Water and Oil beaten together. Paulus in his Third Book, Chap. 28. and 43. talks of a Palsy which came of a Choleric Colic, which is cured by cooling means: and in our time the Colic of the People of Poicteurs in France is very remarkable, for it turns for the most part into a Palsy; and all men of understanding acknowledge it to proceed of a Choleric matter, of which I shall speak more at large in my Treatise of the Colic. An example is given by Forestus in his 97. Observation, and his tenth Book, of a young man who had an extenuation for want of nourishment in his Limbs; and when he grew worse by hot and dry Medicines, which Physicians prescribed for him, was at last restored only by the taking and applying of moistening Medicines. And Reason doth clearly show this: for Choler, Melancholy, or any other Humour falling upon the Nerves; if they fall upon them inwardly, they may stop the insensible passages of the Nerves, or if they fall upon them out wardly, they may so press upon them that they may bring a Palsy. Nor do the Reasons which Rondeletius gives to the contrary any way convince; when he saith, That Choler and Melancholy do rather dry, than soften and mollify the Nerves; and Choler is more likely to produce a Convulsion by his sharpness and griping, than a Palsy: For although commonly a Palsy be called a Resolution and softening of the Nerves, which is always in a Palsy that cometh of phlegm, yet it is not requisite that a Resolution of the Nerves should be in every Palsy, because it comes more properly and essentially from a stopping and hindering of the passage of the Animal Spirits; which when it may be caused by a compression or straitening of the Nerves, and the like; it doth not always proceed of softening and mollifying. But the opinion of a Palsy coming from a relaxing and softening of the Nerves came from hence; namely. Because the parts which have the Palsy being not able to be stretched forth, seem as it were to be relaxed and softened; for the motion of parts is by the extension or stretching forth of the Muscles, and by the contraction of drawing together of the same to their Original; which extension when the parts do want, they are said to be relaxed although they have neither been extraordinarily moistened nor softened. Moreover, Since there are divers sorts and degrees of Choler, it is not necessary that every sort should have such acrimony and sharpness as is able to beget a Convulsion. Furthermore, There is a various mixture of Humours, and phlegm, or water may be mixed with that choler which produceth the Palsy, and so contemperate or mitigate his sharpness. Such a mixture doth often happen in Bastard Tertain Fevers, which are probable to be those which Fernelius saith turn into Palsies. Finally, This is very manifest from the Scorbutic Palsy, or that which is joined with the Scurvy, which hath often a Convulsion accompanying it (as Galen in many places, and Sennertus in his Book of the Scurvy, the fifth Chapter) and albeit a true Scorbut or Scurvy is seldom seen in our Country, yet we often see certain Scorbutic infirmities, in which some symptoms of the true Scorbut do evidently appear. And therefore in our 74. Observation, and the first Centaury; and in our 98. Observation, and the second Centaury, were given two examples of Scorbutic Palsies accompanied with Convulsions. There may be divers other Causes of a Palsy which are little observed. As first, A cold and moist Distemper simple and without matter, may by congealing of the Spirits, not only hinder their passages and influence upon the parts, but also by destroying the temper of the Nerves, make them uncapable of receiving the animal Spirits whereby they have Sense and Motion: and this cold and moist distemper from overcoldness of the air, or from the touching of a cold thing; as Galen teacheth 4. the Loc. Aff. Chap. 4. of a certain man who (when in a cold season, and a great storm, he had wrapped his wet Cloak a long time about his Neck) fell into a Palsy in his hand, the Nerves which come from the Neck and Marrow of the Backbone, being thereby made too cold and moist. Some of our late Writers have reported, That a Palsy may be procured by a stupifying or numbing quality, which is inhaerent in some Medicines and Poisons and sometimes in the humours themselves. And hence they say comes that Palsy which is caught by touching of the Torpedo or Cramp-fish: but it is not so much to be termed a Palsy which cometh by that way, as a Stupor or Stupifaction and numbness: such like as that which Goldsmiths and Gilders have often by the touching and much using of Quicksilver; and Looking-glass makers also which is often seen in Venice. And Platerus supposeth that Wine by narcotick or stupifying quality begets Palsies and Numbness: although others differ from his Judgement, yet Fernelius seems to favour his Opinion, affirming in the place above cited that he once saw a man whose skin by gluttony and drunkenness was all over stupefied and insensible. And Petrus Fabius in his Notes upon Altimar, Chap. 14. relates a story of a certain Barber, who after he had been strongly tippling of Wine, awaked at midnight, and fell suddenly into an universal Palsy of all the parts of his Body beneath his face, so deprived of Sense and Motion that he felt not when he was cut and scarified with a knife, nor when he was pricked deeply with needles: But his surfeit and drunkenness being past, he was cured in the space of three days, only by revulsions, and resolving Ointments applied to the back: Notwithstanding this Author doth not impute this Palsy to the Narcotick or stupifying quality of the Wine; but to those gross vapours which arose from his surfeit, and stopped the Nerves, and this cause may be accounted among otheres that produce this Disease. We have showed in our Treatise of sleeping Diseases, That there is a stupifying quality in corrupt and malignant Humours, which being carried to the Nerves, may hinder their Actions: and since the Humours which produce the Scorbut have a venomous and malignant quality, they may also have a stupifying for●e which may cause also a Palsy with the Scorbut, or a Scorbutic Palsy, although (as we said before) an obstruction or stopping or pressing of the Nerves may be sufficient to cause a Palsy alone. Moreover, Tumours growing by the Backbone, and its Nerves, may without doubt cause a Palsy by pressing upon the Nerves. So the cutting and pricking of a Nerve may produce the same effect. The dislocation, luxation, or making lose of any of the Back bones, or other Joints, may cause the same by pressing upon the Nerves. And lastly, The Condensation or thickening of the Nerves may hinder the influence and passage of the Spirits which comes either by too much exsiccation, or drying, or of a gross Earthy Humour which is taken into the substance of them. So in those that have the Leprosy called Elephantiasis, the sense and feeling of many parts is lost by reason of their growing too thick and hard by an Earthy and gross Nourishment which they receive. The Causes of different Palsies are these: In a perfect Palsy, which supposeth a perfect privation of both Sense and Motion, there is more plenty of the matter, which causeth it by a general obstruction, or stopping and binding of the Nerves. But in an imperfect Palsy there is less matter to stop and bind the Nerves, whereby it comes to pass that the passage of the Animal Spirits is not altogether so closed up, but it will suffer some portion of them to have their recourse. Sometimes the Motion is hindered, and the Sense not; because there is more virtue to cause Motion than to cause sense or feeling, in regard feeling is a kind of passion; but Motion consists altogether in action. Sometimes the Sense is hindered, and not the Motion, for in some parts of the body those nerves and their branches which serve for sense, do not serve for motion: as those nerves which are in the skin, if they only be hurt, the Sense only is hurt, which is seen in a particular Palsy, which is in one part only of the Body: But if the chief nerves which are carried to the Muscles be hurt, the sense cannot only be hindered, but the motion also. The Diagnosis or Knowledge of this Disease is directed to three things; namely, The kind or sort of the Disease to the part affected, and to the cause that produceth it. We may easily know what kind of Palsy it is, because the want of motion, and the privation of sense, are to be discovered by the eye. It is harder to know the part affected; but it is found out by the knowledge of Anatomy, which declareth the original and joining of the nerves. For if the right side of the face or left hath the Palsy, and no other part be hurt, the Brain is only hurt in that part from whence the nerves are brought that come to those sides of the face: But if the parts under the head be hurt, together with the Face, than it is a sign that the Back bone is hurt as well as the Brain: And if the parts beneath the Head are hurt, and not the face, the fault is only in the Back bone: If half the Body have the Palsy, only one half of the Back bone is affected; but if the whole body suffer, then is the original of the Back bone hurt. When the Palsy is in the Legs, the part affected is about the bottom of the marrow of the Back, and the Vertebrae, or turning Bones of the Os Sacrum, and so we must search out for the place whence the nerves spring, which are brought to that part which is troubled with the Palsy. Sometimes also the searching into the outward Cause doth much avail for the knowledge of the part affected: Two examples whereof are brought by Galen; one whereof we mentioned before out of his fourth Book, de loc. affect. chap. 4. concerning a man in a cold stormy time wrapped his wet cloak so long about his neck till he fell into a Palsy in his hand. Another is in his first Book, de loc. affect. chap. 5. of Pausinias Syrus, who lost the sense of three fingers; and when Galen understood that he fell from his Chariot upon his back, he concluded that some part was hurt in the original of that nerve which comes from the seventh Vertebrae, or Spondil; therefore (after he had in vain applied Medicines to the fingers) he used means to the back, and so wrought a brave Cure. The Diagnosis, or knowledge of the Causes of this Disease, if fetched from the primary Causes, the Diseases afore going, and the temperament and constitution of the sick party: And therefore when external cold Causes and moist went before, when the patiented is old, when he is phlegmatic of Constitution, the weather cold, diet cold and moist, and an Apoplexy hath formerly been, it signifies that a disease is approaching from a Cold Distemper, and Phlegmatic Humour. But when a Palsy is caused of a Choleric Humour, or Melancholy, these signs declare: Fevers did go before, or are present, a Choleric temper and Constitution, or else a Melancholy one; the coming of the disease in hot weather, Summer or Autumn; the use of Spices, Salt, and other hot Meats; heavy and long passions of Mind, avoiding of choleric or melanchollick humours, sharp and sour; many sharp defluxions falling upon divers parts, and putting them to pain; and lastly, when pain and a convulsion accompany the diminishing of Sense and Motion, and the patiented is the worse when he takes hot and dry things, but the better by the use of cold and moist. When Tumours, Luxations, or Dislocations, or Wounds, cause a Palsy, they are evident of themselves. As for the Prognostic part in the Treaty of this Disease, you may foretell events as followeth: 1 A Palsy coming of phlegm fixed to the substance of the nerves, is hardly cured because it will not be easy to discuss or divide the Phlegm from the nerves, by reason of their coldness, and their weakness in expulsion or sending forth of that which offendeth, which must cooperate, or work together with the Medicine, and in regard of the deep situation of the Spina and Nerves, so as the whole force of the Medicine cannot reach them, and because the Patient must of necessity continue long in the use of Medicines, which for the most part people cannot endure, and therefore will not be cured. 2 A Palsy coming after an Apoplexy is seldom cured, and often returns into an Apoplexy, by a new flowing of the same matter into the Brain, which is made weak by the former disease. 3 A trembling coming upon or after a Palsy is healthful, for it signifieth that the passages of the nerves are somewhat open, by which some of the Animal Spirit beginneth to pass, for to move the Muscles. 4 If the part affected hath an actual heat in it, there is hope of health; but if it be always actually cold, it is difficult to be cured. 5 An Atrophy, or want of Nourishment in the Paralytic part, with great paleness, takes away all hope of cure; for it doth not only signify a decay of the animal Spirit, but a near extinction of the shows natural heat. 6 If the Eye on that side which the Palsy happeneth be hurt thereby, there is little hope; for it a great want of Spirits in that part. 7 A Palsy in the Legs and Feet is easier cured than in the upper parts, because those Nerves are harder and stronger. 8 In old men the Palsy is incurable, by reason of their want of natural heat. 9 In Winter a Palsy cannot be cured, but in the Spring and Summer it may, if other things agree. 10 A strong Fever coming upon a Palsy is good; for it may consume the matter which causeth it. 11 A Diarrhoea, or looseness coming upon a new and weak Palsy is good, for Rhasis saith 1. Cont. that he hath seen many Paralyticks cured by a Diarrhoea. The Cure of this Disease is to be altered according to the variety of the Causes: And since for the most part it cometh of phlegm and a cold distemper, we must labour chief to take away that cause; which we must begin to do by a general cleansing and emptying of the whole Body. As for bleeding it can scarce do any good, because the fault is not in the Blood, but Phlegm; and this disease comes for the most part to old men, such as are phlegmatic and cold by nature. But if plenty of crude blood unconcocted seems to produce phlegm, and to feed it, we may open a vein in his Arm on the sound side of his Body, but take but little blood lest his weak natural heat should be extinguished. After we have omitted blood-letting, or taken a very little away, we must go on to take away the antecedent Cause, which is a cold distemper of the Brain; which must be done as before was showed by Apozemes, or opening drinks, by Pills, sweeting Diet, Bags for the head, Emplasters, Errhines for the nose, sneezings, Masticatories, Gargarisms that draw phlegm, Vesicatories or Blisters, or Cupping head powders, Caps, Fumes, Magistral Syrups, ordinary Pills, a strengthening Opiate or Electuary, by Caustick or burning, by digestive Powder and Baths. A Diet Drink in this disease ought to be made of Guajacum alone, and his Bark; and after he hath taken a draught, he must have hot bricks applied to the diseased parts, but first they must be quenched in a Decoction of this, good for the head made with white Wine and Vinegar, and be wrapped in a linen cloth, for the stirring up of the weak heat which is in the parts; and every fourth or fifth day you must purge; but it is better to give a purging drink fif●een days before you give the sweeting, that all the load of crude humours may be better cast out, and afterwards the relics and remainder may be discussed by the habit of the Body. Which may be thus made: Take of the chips of Guajacum, three ounces; of the bark of the same, one ounce; of spring Water four pints: Infuse them twenty four hours: then let them boil to the consumption of half, adding in the conclusion one ounce of Senna: Turbith and Hermodacts, of each two drams. Let him take half a pint of this strained every morning for fifteen days, not sweeting. Apply a Caustick to the hinder part of the Head, or to the sound Arm if the other be affected. If the Legs be affected, apply a Caustick to them both. After his Diet, let him use for his ordinary Drink, a Decoction of Guajacum, or Water and Honey, wherein hath a little Rosemary been boiled. Let him abstain from Wine, which is very hurtful in this Disease; but if he desire to drink Wine, let Bettony and Sage be boiled therein. And it is far better if in the Vintage time those Herbs are put into a full Vessel of new Wine. If the Disease be perverse and stubborn, omitting the usual Pills and Magistral Syrup; after his Diet, use stronger Medicines, made thus: Take of Pill. Foetida the greatest, and Pill Cochie the less, each half a dram; of Troches of Alhandal four grains: Let him take them once every week. But because the humour must be prepared before every purge, therefore for two or three days before he takes the Pills, let him take three or four ounces of this following Water every morning two hours before meat. Take of the chips of Guajacum, four ounces: of the bark of the same, one ounce: of Sarsaparilla one ounce and an half: of China Root one ounce: of Sassaphras six drams: of Lignum Aloes, Galangal, of each one dram and an half: of the Roots of Angelica, Peony, and Fennel, of each three drams and an half: of Peony seeds two drams: Infuse them for twenty four hours in six pints of Water, and four pints of white Wine: After add the Leaves of Bettony, and Ivy, and Sage, of each one handful: of the Flowers of Tile Tree, Primroses, Stoechas, or French Lavender, and Rosemary, of each two pugils: of Lavender one pugil: of old Treacle half an ounce: of Citron seeds and bark, of each two drams and an half: of Polipody half an ounce: of Cinnamon six drams: Distil them in Balneo Mariae according to art: and to every two pints and an half of the Liquor, put of Manus Christi Prepared with the Oil of Cinnamon, four ounces: Or instead of this Water you may use the Opiate prescribed in the Chapter of the cold distemper of the Brain for the strengthening of the Head: but you had better use the Opiate of Montagnanus described in the Cure of the Epilepsis. When other Purges do little good, it will not be amiss to come to the use of Chemical Vomits, if the Patient be strong: and they are mentioned in the Chapter of sleepy Diseases: For they draw the stubborn Humours from the Root, and cure Diseases which cannot be rooted out with ordinary Medicines. In the days wherein he takes no other Medicine, let him take the Cephalick Opiate mentioned in Chap. 1. or the Apoplectic Water, or Tabellets, or Lozenges, for sleepy Diseases formerly mentioned. After Universal Medicines we must proceed to Topical or particular Medicines, for the part, for the stirring up of heat, and recalling the Spirits, and for drying and discussing in the Spinal Marrow where for the most part the Cause of the Disease lieth. Therefore let the part affected be daily rubbed with warm , but gently, lest that the Natural heat and spirits drawn thither should be again dispersed. Also let Cupping glasses be applied to the heads of the Muscles of the part affected; and let them be narrow mouthed, and applied very hot; but let them not stand on very long lest they disperse too much. After apply a Plaster of Pitch, and the Rozin of the Pine tree, that what is drawn thither may be preserved. Or rub gently the part benumbed with green Nettles, or lay on Sinapisms, or Medicines of Mustard, while the part gins to grow red; but you must not let them lie while they make Blisters, for so the Spirits and Blood would be dispersed, but only till the part made red will not grow white by the impression of the finger, but remain red still. Afterward anoint the part, and the Spinal Marrow with Oils, Ointments, and Balsams, of which there are many forms in Authors. The Balsam of Guido which is prepared by the Apothecaries, is excellent for this purpose. This we use alone, or mixed with other Medicines. It is made after this manner: Take of Oil of Foxes, Earthworms, and Castor, of each one ounce: of Guido ' s Balsam, three ounces: of Aqua vitae half an ounce: of Oil of Rosemary distilled, one dram and an half: Mix them for a Lineament. With which anoint all the Spinal Marrow very hot, and the parts also resolved covering them with warm . This following Ointment of Valeriola in his Observations, is much commended. Take of Sage Marjoram, Bettony, Bayes, Rosemary, and Primrose leaves, of each one handful: of the Roots of Time, Acorus, or great Galangal, and Flower deluce newly gathered, of each three ounces: of the Oil of Foxes, of Indian Nuts, and Rue, of each one pound: of Oil of Terepintine, half a pound: of the strongest Wine one pound: of Aqua vitae half a pound: Boyl them till the Wine be consumed, then strain them, and ad of Serapinum, or Sagapenum, Opopanax, and Bdellium, of each two drams: Castor half an ounce: Mace, Nutmegs, S●yrax Calamita, Benjamin, of each three ●rams: long Pepper and Pellitory; of each one dram: the grease of an old Cat, of a Serpent, and a Goose, of each one ounce: the Marrow of an Ox Bone, two ounces: the Juice of Dwarf-Elder, Sage, and Balm, of each four ounces: of the best Wax, or Bee-glew which the Bees make at their entering into the Hive to keep▪ out the cold, two ounces: Mix them, and with a sufficient quantity of Wax melted into the foresaid Oils, make them into the consistence of a thin Ointment; with which anoint all the back bone warm, laying soft wool or linen cloth warm thereon. But an Ointment of greater effect, and less trouble, is made in this manner: Take of the Juice of Squils' or Sea Onions, four ounces: the Juice of Cowcumber and Rue, of each one ounce: Euphorbium, Castor, Sagapenum, Ammoniacum, and Bdellium dissolved in Vinegar, of each one dram and an half: Myrrh, Frankincense, Pellitory, and Niter, of each one dram: the Oils of Elder, Turpentine, and Euphorbium, of each half an ounce: Wax as much as is sufficient: Make an Ointment. You must chief use the Ointments in the time of his Diet, after the sweeting is wiped off, and after the time of bathing; for then the pores and passages of the Skin being open do more easily receive the Ointment. Let the Linen that are used after anointing be warmed with this Fumigation. Take of Amber, Mastic, and Myrrh, of each one dram: Frankincense two scruples: Cloves, Nutmegs, Cinnamon, and Mace, of each half a dram: Wood of Aloes half a scruple: Powder them, and sprinkle them with the spirit of Wine, dry them, and do so five times, and then make a powder to be thrown upon Embers. If the Disease do not yield to these, Cerats and Emplasters must be laid to the Back. Take of the Emplaster of Bettony, Melilot, and Bay-berries, of each one ounce: Frankincense half an ounce: Castor and Euphorbium, of each one dram: the seeds of Nigella or Gith, the seeds of Water-cresses and Mustard, the Roots of Pellitory, and of Sal Niter, of each half an ounce: with the Oil of Bricks make them into the form of an Emplaster, which apply upon Leather. But this following is better. Take of Pitch, Galbanum, Sagapenum, and Ammoniacum, of each one ounce: Pellitory, and Mustard seed, of each half an ounce: Euphorbium two drams: yellow Wax three drams: With as much Oil of Turpentine as is sufficient make a Plaster. You may also provoke sweat in the part by the fume of the Decoction of Herbs and Roots proper for the Head boiled in white Wine, which you must do by putting it into such a Vessel as the Patient being fasting, may sit so covered over it, that the Water may not touch him, but the vapour only. Or you may sweat him with a dry Bath, called commonly Stuphes. Let the vapour of the former Decoction be received from red hot flints, upon which it hath been sprinkled▪ A Decoction of Burdock and other Dock Roots, is much commended for provoking sweat: But our women use the Decoction of Danewort, called Ebulus, for this, and diseases of the joints, by which they provoke sweat violently. When the Patient hath sweat enough, get him to bed, and give one dram of Treacle with any proper Water distilled: He must bathe thus twice or thrice in a week. In Autumn he must hold his Limbs in the hot Grapes, or Wine-press an hour or two; and afterwards anoint them with a proper Ointment before mentioned: this is to be done all the time of the Vintage. Lastly, Sulphur or Brimstone, baths of Niter and Bitumen before mentioned, are very agreeable, and many times go beyond all other Medicines; if the Patient use them some days for drink, bathing and washing the head; after that anoint it with one of the Liniments prescribed. The Chemics ●ave many Remedies for the Cure of this Disease: Among which, the best are, Elixir Prop●ie●a●is, Spirit of Tartar, and Ballom of Galbanum. All the time of the Disease, let the parts affected be wrapped in the skins of Foxes, Hairs, or Lambs. A Pal●ey which comes from Choler or Melancholy requires the same Cure which is prescribed in the Cure o● Hypochondriack Melancholy: but when the Disease is more Choleric, you must make choice of those Medicines which are more cold. CHAP. VI Of a Convulsion. SPasmus, Cramp, or Convulsion, is an involuntary and continued retraction of the Nerves and Muscles to their Original. Convulsion is twofold: The one Proper, to which the Definition mentioned agreeth: The other Improper, which is called a Convulsive Motion: and they are thus distinguished: In a true Convulsion, the retraction of the Muscles is always; but in a Convulsive Motion, the retraction is every time new. Moreover, in a true Convulsion the Limb is immovable, in a Convulsive Motion it is moved divers ways, as in the Falling-sickness, which is the chief of Convulsive Motions. They differ also in respect of their Causes; for a true Convulsion, is either from Fullness or Emptiness; but a Convulsive Motion is from Irritation or provocation. Lastly, they are distinguished, in that the true Convulsion comes from the Disease only; the Convulsive Motion from the faculty alone. Which, that Novices may rightly understand, they must know that Galen in his Second Book; the sympt. cause. chap. 1. hath thus distinguished the symptoms of a depraved Motion: Some (saith he) are only the work of Nature, which is constrained to move so from some violent cause: Others accompany diseases, Nature not assisting their production: Others are by the agreement and concurrence of Nature and the Disease. Now Galen by the name of Nature, understands a Faculty: the Operations of the Faculty are, Sneezing, Coughing, Yawning, Reaching, and Hiccoughs: But the operations of the Disease only, is Palpitation and Convulsion: But the operation of both the Disease and Faculty, is Trembling, and imperfect Palsy, or Resolution. From Galens words above mentioned, there ariseth a great difficulty, when he mentions the Hiccoughs in the operations of the Faculty; for it continueth by Irritation, or provocation, and is a Convulsive Motion: But Galen recites a Convulsion among those operations which come only from the Disease. Yet Hypocrates in his 39 Aphorism, and Sect. 6. affirmeth that the Hiccough and Convulsion come of fullness and emptiness, and repletion and inanition, or fullness and emptiness make only a true Convulsion. For the resolving of which difficulty, we say that the word Repletion or fullness, in its large sense comprehends Provocation, according to many Authors, because the provoking causes are material, and therefore do in some sort fill the parts in which they are contained; but thus Repletion is not the immediate cause of Hiccoughs, but the mediate, because it doth provoke the part in which it is to expulsion, by its quantity or quality. Lastly, We must know, and observe, Hypocrates and Galen do declare a Convulsive Motion by the general name of a Convulsion; so that they cannot be distinguished, but by the differences mentioned. Again, A true Convulsion is divided into a total one, by which almost the whole body is contracted; and a partial one, which is only in some one Member. An Universal or total Convulsion, is caused either from the Brain, when the Muscles of the Face are plucked together as well as the whole Body: Or from the Spinal Marrow, when the Muscles that move the Head, and Spina or Back, either before or behind, or both, are plucked and drawn together. Whence arise three kinds of Convulsions. The first called Emprostotonos, when the Body with the Neck and Head, is violently contracted and drawn forward, so that the Chin is joined to the Breast, and the Body looks like the keel of a Ship; nay, it is sometimes like a Bow, and sometimes round, and the Head of the Patient is joined to his Knees, and then the two Muscles which bend the Head forward are chief affected. The Second is called Opistotonos, when the Body is drawn backward, and in that, either the twelve Muscles which extend the head, or some of them are drawn together. The third is called Tetanoes, when the Muscles both before and behind, are equally contracted, and the parts drawn by the opposite Muscles being balanced remain stiff and strait, and that is called Motus Tonicus, which is a most violent springing from the contention of all the Muscles. A Particular Convulsion is made from the contraction of the Muscle of some part coming from the hurt of that Nerve which is ordained for his motion, and sometimes it hath a peculiar name from the effect or symptom. So the Convulsion of those Muscles which move the Eyes, is called Strabismus: of the Jaws and Temples is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. The Convulsion of the Mouth by Contraction of the broad Muscle on the one side, is called Spasmus Cynicus, a dog Convulsion, and a wresting of the mouth; but if the contraction be on both sides, it is called Risus Sardonicus, or a grinning. But the wryness of the mouth may be without a Convulsion, namely, from the Resolution of one Muscle, which being resolved, the muscle on the other side draws it to the sound part, and there is a distortion or wryness which is improperly called a Convulsion: The Convulsion of the muscles of the Yard is called Satyriasis, or Priapismus. Other Convulsions want proper names. But the immediate causes of a Convulsion according to the Opinion of Hypocrates and Galen, are Repletion and Inanition, or fullness and emptiness as above mentioned. And this Opinion is confirmed by the Example of a Lute or Harp strings, which use to be stretched; which Instance Galen doth bring most elegantly in his Book of Palpitation, of trembling and shaking, chap. 8. and his third Book of Parts affected, chap. 6. and his second Book of the Causes of Symptoms, chap. 2. and his Comment upon Aphor. 39 Sect. 6. For saith he, while the strings are moist and filled with humour, as it falls out when the wind is Southernly, they are stretched, and so broken; and when they are over dry, as it happens in Northern weather, they are contracted, and also broken. So the Reins of a Bridle drying too near the fire, are contracted when they were before extended with too much moisture: the same befalls the Nerves, which being either too full of moisture, or too dry, are stretched and contracted; and the Muscles into which they are united, are so drawn back to their principal or original, from whence all the Body hath a Convulsion. The Mediate Causes of a Convulsion, which make Repletion and Emptiness, are divers. And first the Causes of Repletion are recited by Galen in his Book of Trembling, chap. last, to the increase of phlegm, and inflammation, a waterish Humour flowing to the Nerves, is supposed to stretch them in their breadth, which must needs make them shorter. But here is a very great difficulty which is propounded by divers Authors, but is resolved perfectly and plainly by none: namely, what difference there is between the cause of a Palsy, and of a Convulsion, when both come from a water flowing upon the Nerves: why that matter which makes a Palsy (which so fills the Nerves that it stops all their passages or pores, whereby the Animal Spirits are hindered in their motion) doth not also stretch the Nerves in breadth, and cause also a Convulsion; and why the matter causing a Convulsion, filling the Nerves, doth not also stop the passages, and cause a Palsy, when contrarily in a Convulsion the feeling remaineth, and the part affected for the most part is very much pained? For the resolving of this doubt, Authors are much divided; and the most ingenious of them all, confess that is beyond their capacity. Most witty Averro considering of this Point, breaks forth in this expression: I would I knew the reason (saith he) why the Nerves are extended in their breadth, and not in their length. And presently after he saith: Know ye that the words of all Physicians that writ of this Symptom, are more proper to Fiddlers and Singers than to Demonstrators, or such as should make things plain. And Ingenuous Argenterius in his Comment upon the 26. Aphor. Sect. 2. speaks thus: It is not easy to render a reason of all things, and especially why Water which is said to be the cause of the Palsy, or resolution of Nerves, and of the Convulsion, should sometimes bring one, and sometimes another, when it is the same matter, and the same parts are affected, namely, the Nerves; why should not the same Disease be always produced? Thus Argenterius. The great difficulty of this matter hath distracted all Writers into divers Opinions, so that some have left the Doctrine of Hypocrates and Galen, among whom are Averro, Erastus, Platerus, Cesalpinus, Sennertus, and others, whose divers Opinions, and long Disputations we cannot attend to repeat, for we desire to be very short, and lay aside all Controversies, only adhaering to those things which are most necessary for Cure. The Opinion of the soundest Writers, which are unwilling to descent from Galen, comes to this: That a Convulsion is caused of a thick matter, which extendeth the Nerves in their breadth, and contracteth them in their length: and that a Palsy comes of a thin humour which runs through the substance of the nerve, and softeneth it, but doth not open the pores and passages. But this doth not satisfy a soul that is greedy of Truth: For if a thick humour by filling the Nerve, doth stretch it broader, why doth it not also fill its pores and stop the insensible passages, and hinder the coming in of the Animal Spirit? and so bring a Palsy? and why doth not a Convulsion follow a Palsy in process of time, when a thin humour long sticking upon a part, must needs grow thick, even as the serous matter which makes the Arthritis, or Joynt-gout by long continuance upon the part, causeth the matter which makes the stone. Others say that in a Convulsion, only the external part of the Nerve which is Membranous and tender, is possessed with the humour; but in a Palsy, the Internal: but this giveth less satisfaction: For when the Nerves are for the most part slender, it is not easy to conceive how the humour should only possess the external part, and not the internal; or the internal, and not the external: Or leastwise (if this could be so) a Convulsion would follow a Palsy, and a Palsy a Convulsion, by the increase of the matter; and that which at first did only possess the outward or the inward part, in process of time would seize upon the whole Nerve. Therefore we, although we cannot satisfy ourselves in this great Difficulty while better Arguments are propounded, suppose that those Objections may be taken off thus: A Convulsion and a Palsy differ in this; A Palsy is made of a pure watery humour without mixture, which doth not extend the parts, but softeneth them, as we may see in the tumour called oedema; but a Convulsion is caused of the same humour, but not pure and simple, but mixed with much wind, by which wind the Nerves are stretched, and the Muscles also which are contracted to their Original: For no cause can be thought upon more fit to make so great a contraction, than wind, which Galen acknowledgeth in his second Book, the sympt. cause. chap. 2. and Experience teacheth us, that the greatest distentions are made especially by wind, as we may see in the dropsy called Tympanites, and the Colic. And in Convulsions, those are the greatest which are caused of wind, which stretcheth and distendeth the parts. By this Argument, all the aforesaid Objections are answered: For if it be demanded, Why that phlegm or water which maketh a Convulsion doth not bring a Palsy by hindering the passage of the Spirits? we may answer, That it is in so small a quantity, that it cannot stop the insensible passages of the Nerves, and that it is so extenuated and made thin by much wind, that it cannot produce a stoppage or obstruction. Or we may say that wind is the chief cause of Convulsions, which Galen acknowledgeth in the place mentioned: And in his 6. Book, de loc. affect. cap. ult. he makes the only cause of a Priapism (which is the Convulsion of the Yard) to be wind. The other Cause of a Convulsion coming from Repletion, which Galen mentions in the place cited, is the Inflammation of the Nervous parts, especially in the Original of the Nerves, or near to its original, by which they are stretched; and that Inflammation is either from a cause only internal, namely, from a flux of blood upon the part; or of an outward cause, as of a wound, contusion, or bruise, or a puncture of a Nerve. The Causes of a Convulsion by Emptiness or Inanition, are all extraordinary or immoderate Evacuations, by bleeding at the Nose, or any outward part, by vomit, flux of the belly, or sweat, as also all great consumptions of the Radical moisture which happen in strong Fevers, immoderate exercise, watch, cares, immoderate Lechery, hunger and thirst, and the daily use of Food and Medicines which heat and dry. This kind of Convulsion from Emptiness is rejected by many; who suppose that so great a drought cannot be brought into a living Body, as may contract the Nerves; but that is usual in a Hectic Fever, or a Marasmus: these men are thus answered: Every emptiness or dryness cannot make a Convulsion, but that which is made suddenly and unequally; by which means there is a sudden Evacuation or emptying of the Radical moisture, which makes the parts cling and close together for the avoiding of a Vacuum or emptiness which Nature abhorreth: but if the moisture be equally drawn from all parts, and by degrees, there is no contraction because the parts made empty are filled with Air. A Convulsive Motion, is of a sharp pricking matter which provokes the Nerves; and it is for the most part, a humour or vapour full of acrimony or malignancy, this comes often in malignant Fevers: These Convulsive Motions are caused for the most part from the Brain and Nerves, suffering by sympathy or consent, and then it is called Convulsio Sympathica: And this Sympathy is either by their plain suffering together in respect of their likeness in substance and office, and their vicinity or nearness; or from an evil quality, or poisonous air sent to the original of the Nerves. And it is often caused by consent from the mouth of the stomach through an aeruginous or rust like Choler, through worms, poison, or other sharp matter which gripeth: and also from consent with the womb, as it happeneth in Hysterical passions, or the Mother. The Diagnosis or knowledge of a Convulsion is easily learned from those things which we propounded in the beginning of this Chapter: For in a true Convulsion, the part is contracted, stiff, and immovable, that it cannot be bend at the pleasure of the Patient; but in a Convulsive Motion the part is shaken and tossed hither and thither. As to the Prognostic; A Convulsion which is in many parts, especially those near the Brain, is dangerous; as also that which is in the Muscles of the Breast, which giveth us to fear a suffocation, by reason of the shortness of the Patients breathing. A Convulsion coming of too much bleeding or purging, is deadly, as Hypocrates saith in his Aphorisms: for as Galen showeth in his Comment, that a Convulsion comes of emptiness; but it may so fall out as it may come of irritation or provoking by the motion of sharp and choleric humours to the Nervous parts, or of the malign quality of a venomous Medicine, as it happens after the taking of Hellebore. A Convulsion from a Frenzy is deadly. Aetius affirmeth, that he never heard of, or saw any so taken, that recovered. It is better that a Fever follow a Convulsion, than a Convulsion a Fever, Aphor. 37. Sect. 2. for a Fever coming upon a Convulsion, takes away its cause: but a Convulsion coming upon a Fever, shows a malignant matter which threatneth death. Whosoever are taken with the Tetanus, or Cramp so called, die within four days; but if they continue longer, they are cured, Aph. 6. Sect. 5. for the great stretching of all the Muscles hinders breathing, so that they are suffocated. And we must observe, that a Convulsion is not the cause of death in respect of what is done to the Nerves: for a Palsy coming of the like cause continues many years: but in respect of the suffocation it brings by the Convulsion of the Muscles ordained for breathing. The Cure of this Disease is divers, as the Cause is divers. That which comes of Emptiness is seldom and incurable, therefore we shall not insist upon the Cure of it. Authors do prescribe all kind of moistening Medicines, and opening Ointments. That which comes of provoking or irritation, is from other Diseases, and is comprehended under the Cure of them. It remains therefore that we treat of the Cure of a Convulsion by Repletion, which when it comes of phlegm and wind, must be cured by removing of them. This is done first by blood-letting if it abound, and the party be strong; but it is better to take too little than too much; for blood is an Enemy to that principal Cause, which is phlegm. After Blood-letting, or it being omitted if need do not require, you must purge with pills which are strong (but have an eye to the Patient's strength) according to those forms in the first Chapter, you must add to them three grains of Castor. If the Patient will not take pills, he may take Potions, Powders, and other Medicines prescribed in the first Chapter. After Purging, if you have not let blood before, apply Cupping glasses with Scarification; otherwise without: first to the remote parts, then to the parts near the part affected. But if the Thighs, or Legs have a Convulsion, apply them to the Buttocks and Loins: if the Arms, to the Neck and Shoulders; labouring always to bring the humour back to its original. You may also with profit apply a Vencatory to the parts opposite to that which is affected. After the first purging, the matter is to be prepared with an Apozeme, prescribed in the Cure of the cold distemper. Make it purging, if strength and other things will permit; otherwise leave out the Purgatives. The Apozem done, give him Pills again, putting Castorium to them, and to all his Purges. If you u●e only an altering Apozeme, which changeth the Humours, you must in that time give several sharp Clysters, such as are prescribed in the Chapter of sleeping Diseases. Also anoint the part with this Lineament, Take of Ointment of ●arsh-mallows, six ounces; Oil of Turpentine and Chamomel, of each one ounce; Oil of Spike three drams; and of Foxes half an ounce; Liquid Storax two ounces: Anoint the part and backbone often therewith. Take of Oil of Dill, and Chamomel, of each one ounce; Unguentum Ma●●iatum half an ounce; Oleum Petroleum, and Spike, of each one dram; Spirit of Wine three drams Ducks or Goose Grease prepared as followeth is much commended. Take a Goose or Duck that is fat, pluck it, and draw it; then fill it with these things following: Take of Sage, Margerum, and French Lavender, of each one handful; Gum Ammoniacum and Bdellium, of each one ounce; Calamus Aromaticus, Nutmeg, Mace, and Cloves, of each half an ounce: Beat them in a Mortar, and moisten them with the Oil of Earthworms; after, put them into the belly of the Goose sowed well together, and roast it upon a Spit. Receive the Dripping into a Vessel half full of Vinegar, and anoint with it. But it is stronger thus▪ Take of the dripping aforesaid six ounces; the Chemical Oils of Wax, Nutmeg, and Sage, of each two drams. After you have anointed, you must cover the part affected with a hot Sheep's skin; and when it is cold, i● you have not a fresh one, make it warm again with the Oil of Dill, or the like hot Oil. We apply successfully to the part affected, the hot Lungs of a Sheep, as also young Pigeons, Whelps, and chickens slit in the middle. Put the p●rt a●fected into an Ox or Sheep's Belly, or other great Creatures newly killed, and let it remain there ●hile it is warm. Baths of Head herbs are good, putting to them a third part of Oil, or anointing afterwards. Some commend this Emplaster: Take of Colophony two ounces; Rozin and Pitch, of each one ounce; Frankincense, Mastic, Ceruse, of each ha●f an ounce; Sanguis Draconis, common Salt, Ammoniacum, and Terepintine, of each two drams; new Wax, two ounces; white Vitriol, two drams; Mother of Pearl, two ounces; Loadstone half an ounce; yellow Amber one dram and an half; Oil of Eggs and Roses, of each two drams: Make a Plaster upon Leather. Baths coming of Brimstone are excellent, especially in constant Convulsions. Also dry Baths of the fume of the Decoction of Sage, Rosemary, Stoecnas, Chamepitys, or Ground-pine, Origan, and the like, in white Wine sprinkled upon stones fire hot, or Iron. It is very good to foment the hinder part of the Head and the Neck with hot Aqua vitae. Penotus doth wonderfully extol the following Medicine for quite Curing of a Convulsion. Take Oil of Turpentine, half an ounce; Oil of Cloves six drops; of the Mucilage or slime of Briony, so much as is sufficient to make a Limment: Anoint the part affected, and the root of the Nerve which comes unto it. Others say they quickly cure a Member with the Oil of Turpentine, of Wax, Chamomel, and the like, mingled with Spirit of Salt. The following Lineament is very powerful. Take old Butter, and Bacon, of each a quarter of a pound; Bdellium, and Ammoniacum, of each one ounce; Myrrh, and Castor, of each two drams; Stoechas and Rosemary flowers, of each one pugil; Nutmeg and Cloves, of each one dram; a Kitten or young Cat, flayed, bowelled, and cut in pieces: Stuff a Goose with these, and roast her; cast away the first dripping which is watery, the next which is fatty receive in a Vessel half full of Vinegar: Anoint the parts affected, and the backbone therewith. Sometimes the pain is so intolerable that it must first be cured: For which this is good. Take of Oil of Violets, Lilies, and Chamomel, of each an ounce and an half; Oil of sweet Almonds, Mastic, and Roses, of each one ounce. If you will have stronger, make this Bath: Take of Marsh-mallow Roots, and Lilies, of each one pound and an half; of the Leaves of Origan, Violets, Mallows, Sage, and Wormwood, of each two handfuls; Linseeds and Fenugreek, of each one pound: Boyl them for a Bath; in which let the party fit, not long, but come ou● as soon as he finds ease: It is sufficient if the parts affected be only bathed therewith. Others make Baths only of Oil, and if the Patient be rich, they boil a Fox or two in it. While these are doing, purge the Head with sneezing, and chewing, described in the first Chapter. As also you must strengthen with the Cephalick or Capital Opiate, Apoplectic Water, Treacle, and the like. Rondoletius speaks thus of his Water of Swallows: A Water made of Swallows and Castor, presently cureth a Convulsion coming of Repletion: You may find the description of it in his Chapter of the Epilepsy. CHAP. VII. Of the Epilepsy, or Falling-sickness. THe Epilepsy, is a Convulsion of the whole Body, not continually, but by fits, with a hindrance both of the Mind and Senses. The Word Convulsion, is not here taken properly and strictly for a true Convulsion; but improperly, for a Convulsive Motion: For an Epilepsy is a Convulsive Motion, not a true Convulsion. But we keep the name of Convulsion in imitation of Galen, who calls an Epilepsy always a Convulsion. This Definition is taken out of Galen, 3. de loc. off. cap. 7. and lib. de diff. sympt. cap. 3. and defines a perfect Epilepsy, in which all the Body is contracted, and all the Senses both internal and external are abolished. Yet there are imperfect Epilepsies, in which only the Head, or Arm, Leg, and Thigh, or half the Body is only contracted. There is also an Epilepsy in which the mind remains sound, and the external senses, and also the voluntary motion of some parts. I saw a Nun, which in her Epileptic fits had divers contractions, sometimes of the Arms, then of the Legs, sometimes of the Head, afterwards of the whole Body; yet she saw those that stood by and spoke; nay, she also endeavoured a voluntary motion against the Convulsive, so as she did in a manner diminish the involuntary motion: sometimes she was in a small fit only, and walked about her Chamber, but with a disorderly motion, leaping and using strange antic postures, by which she caused the rest of the Nuns to be very merry, and she at that time laughed with them, and spoke when she pleased. Every convulsive motion (as I said in the former chapter) cometh of provocation, which proceedeth from the quantity or quality of the matter. The quantity of matter which causeth the disease, burdening Nature, stirs her up to expel that which is troublesome to her. Whence the Opinion of Galen is confirmed, which is so disputed by late Physicians, That an Epilepsy comes of an imperfect obstruction of the Ventricles of the Brain; for if the humour obstructing or stopping is burdensome to Nature, the Brain will labour to expel it. In the quality there is no difference, for all agree in this, That the expulsive faculty is stirred up by sharpness and acrimony, and by any quality which is offensive to Nature. The Causes stirring up or provoking, are either contained in the Brain, and make a proper Epilepsy, or come from other parts, and so make an Epilepsy by consent or sympathy. And that provoking or irritation makes an Epilepsy, when the Brain labouring to expel that which is offensive shakes its self, and by consequence all the Nerves which are adjoined to it. There is in Galen, and almost all Authors, a threefold Epilepsy. The first is that which hurts the Brain, in which the Disease is: The second is that which hurts the Brain by consent from the Stomach: The third is when the disease is sent from other parts of the Body to the head: And these have their proper names; The first, as being chief, is called Epilepsia; the second Analepsia; the third, Catalepsia: But (by Galens leave) that division is superfluous, and in vain is that Epilepsy which comes from the Stomach separated from those which comes by sympathy from other parts; when all aught to be called Sympathicae, or Epilepsies by consent. Neither is it sufficient to say that an Epilepsy from the Stomach is distinct from others, because it is most frequent since that which comes from the Stomach and Spleen, is as usual and as frequent, if not more. Therefore we divide an Epilepsy into a Proper one, and one by Consent. Again, we subdivide that which is by consent according to the divers parts from whence these sharp and malignant vapours are sent to the Brain, for there is almost no part in the Body from which a malignant vapour cannot be sent. Two Stories are related by Galen in the place quoted; the one of a Boy of thirteen years old, who at the first had the Epilepsy in his Leg, after that it ascended into his Thigh and Bowels, and by the sides into the neck till it came to the head, which at first touch made him not able to stand Another is of a Youth who in the beginning of his fit perceived as it were a cold air to ascend. But it is remarkable and well known, that an Epilepsy comes for the most part from the Guts, the matter that breeds worms, from the Matrix and other parts, and it is confirmed by many Authors. Therefore it is manifest from what hath been said, how Galens Opinion may be defended, who affirms, That a proper Epilepsy comes of an imperfect obstruction of the ventricle of the Brain; which we cannot defend to be the constant cause, as Galen seems to grant who lays down no other: but we are rather forced to confess, that it is less usual than the rest. Nor do the Arguments brought against Galen any way convince, the chief whereof are these: First, As Fernelius saith, if an Epilepsy comes from plenty of Humours, it would come most in the sleep, at which time there is plenty of Humour. I answer▪ That the humour of which sleep is begot, is in the substance, not the Ventricles of the Brain, and therefore doth not stir up the expulsive faculty which resideth most in the Ventricles. Secondly, Fernelius saith, That because an Epilepsy is quickly dissolved, it should turn into a Palsy, as an Apoplexy doth when the humour is cast into the nerves. I answer, That in an Apoplexy, by reason of the weakness of the expulsive faculty which is oppressed by many humours, they are cast into the parts adjoining; but expulsion being stronger, and more free in an Epilepsy, they are sent to those parts which are ordained by Nature for their discharge. And it is false which Fernelius saith, That an Epilepsy never ends in a Palsy; for we have seen a Palsy come after it. And sometimes Apoplexies at their first coming are turned into Convulsions before there be a perfect obstruction of the Ventricles of the Brain; and also many Epileptic men die by an Apoplexy when a little obstruction turns into a total stopping. Thirdly, Against Galen some argue thus: As a complete Obstruction of the Ventricles totally takes away the functions of the Brain in an Apoplexy: So an incomplete Obstruction would only diminish, not deprave the Functions, nor produce such convulsive motions as are sometimes more violent than sound motions. I answer, That Nature being wholly oppressed by a total obstruction doth not labour for expulsion; but she hath strength enough in a half obstruction to move and stir up the Brain to expulsion. This is confirmed by the Example of a defluxion falling upon the Lungs, which if it fill the whole Lungs, it makes great difficulty of breathing without a Cough, as cometh to pass in an Astma, or shortness of breathing: But if a small quantity only of humour do fall, the Lungs are stirred up to expulsion, whence cometh a Cough. The Signs of an Epilepsy are of three sorts: Either they are such as signify an approaching Epilepsy, or one that is present, or such as show the difference of Epilepsyes. The Signs of an Epilepsy approaching, are twofold: Either they signify the first coming of the Disease; or some Fit to be at hand. ●he same signs serve for both, but most surely in those who are actually possessed therewith, do they show the condition of it in its return; for in those who never had this disease formerly, these signs are doubtful for the most part, and may declare many head diseases; but all of them together may give some certainty. Therefore all signs of an eminent Epilepsy are to be propounded with this admonition, That all signs do not meet in all; but some in one, some in another, as the causes and constitutions do differ. But that they may orderly be laid down, we must search the originals of these signs, which flow from Animal, Vital, and Natural actions, from excrements, qualities changed, and proper accidents. In respect of the Animal Functions, and unaccustomed disturbance of the mind and Body, threatneth an Epilepsy, heaviness of head, headache, vertigo or giddiness, or much sleep, from whence the Body hath no refreshment; troublesome dreams, dulness of mind, or perplexity, forgetfulness, sorrow, fear, dread, sloth, graveness of actions, snatching and trembling of the parts, dulness of the senses, a down look, clouds and other things flying before the eyes, noise in the ears, a stink in the nostrils, a stiff tongue, and its inordinate Motion, yawning, and neezing. In respect of the Vital Function, these with others are the signs: Anger, Beating or palpitation of the heart, straitness of Breast, and alteration in Breathing. In respect of Natural Functions, these are forerunners of an Epilepsy; disdain of meat, or immoderate Appetite, Squeamishness, heartburning. In respect of Excrements, these are signs: Much spittle, thin and crude Urine, often Nocturnal Pollutions. In regard of qualities and proper accidents changed; Paleness of Face, and swelling of the heart. A present Epilepsy is easily known, if it be perfect; but it hath many differences which cause difficulty, as we shall show. In a complete fit all the Senses both internal and external are hindered. The party suddenly falls, and the whole Body, or at least some parts are diversely moved: Moreover, there is a staring and thrusting forth of the eyes, gnashing of Teeth, a difficult breathing, as in those that are hanged; the seed, dung, and urine are sent forth involuntarily, and about the end of the fit, he foameth at the Mouth and Nose, which happen only in a vehement Epilepsy, and the fit being ended, he forgets all things he then acted. Some of the Ancients make three kinds of Epilepsies: One which is like a deep sleep; another which doth shake the body after divers motions; a third which is made of both the former. The late Physicians deny the first kind, saying, That it is more like a Coma, or a Carus than an Epilepsy; and these two Diseases cannot be otherwise distinguished, but that in a Coma is a deep sleep without a Convulsion, and a Convulsion is a certain sign of an Epilepsy. But Avicen saith otherwise, namely, That an Epilepsy comes many times without an apparent Convulsion. And experience teacheth us, That many men in Epilepsies have fits like Coma: and it's known to be an Epilepsy, not a Coma, or a Carus by this; The sleep in an Epilepsy cometh and goeth by fits, when in a Coma it comes all at once. A true Epilepsy is distinguished from an Epilepsy by consent thus: In the true there appears many signs of the Brain affected; as heaviness of mind, and slowness, decay of memory, troublesome sleep with dreams, dulness of senses, slowness and idleness of Body, pain of the head, and other things. Moreover, the sick man doth not perceive the fit coming, but is suddenly taken therewith unawares, at the new Moon for the most part. The due proportion of the inferior parts being without blemish do confirm this sign. But we may know whether it come from the right or left side of the head most: By this, either the sight of one eye is more obscured, or the hearing more thick with the noise of the head on that side; or if the right or left side be more dull. But we may know from what humour, especially an Epilepsy cometh by those signs which declare when phlegm, choler, or melancholy abound. An Epilepsy by consent, is thus known: There appear no signs of a distempered Brain; the Patient perceives his Disease Coming, and a wind rising from the parts below: or some lower part is weakened, or else affected strongly in the time of the fit. These things following do show that the Cause of an Epilepsy is in the stomach: Disdain of meat, an inability to fast, loathing, vomiting, pain of the stomach, gnawing, pricking, and distension; sometimes beating of the heart, which ariseth from the Stomach. That the disease comes from the Liver or Spleen, appears by often belching and breaking of wind, a swelling of the belly with rumbling and noise, sour belchings, straitness of the Midrif, and pain sometimes reaching to the back, besides some distemper in inferior parts. An Hysterick fit, or the Mother, mixed with Convulsions, if a retaining of the Courses or Seed went before, shows that it comes from the Womb. If the Epilepsy comes from an external part, some wind is perceived to rise from that part, and the matter causing the Disease, sometimes tickleth and beateth in the part, which is a sign there is a fit at hand; and if that part be tied hard, the fit is hindered. Lastly, The Signs of worms, show that the disease come from them, as stinking sour Breath, itching of the Nose, pain of the Belly, earthy Excrements, grating of the teeth, sleepiness, and the like, especially if sometimes worms are voided. But the extraordinary Causes, as Imposthumation, foulness of a Bone, stopping of urine, and the like, may be taken from their proper signs. As to the Prognostic, An Epilepsy is a Disease of long continuance, and very stubborn and deadly in Infants. An Epilepsy coming haereditary is incurable; but that which comes from external causes, and evil diet, is curable. An Epilepsy coming before fourteen years of age in Boys, and twelve in Girls, is curable: after twenty five years of age it is incurable; out of Hypocrates, Aph. 7. Sect. 5. For in the time of ripeness of Age, there is great store of Natural heat, which is powerful to discuss-Diseases. Moreover at that time women begin to have their terms, by which the uncleanness of the Body is purged. Yet although Hypocrates supposed an Epilepsy to be incurable after twenty five years of age; yet this is not always true, for we find by experience that many have▪ been cured after, although but seldom seen; therefore we may say that the Aphorism is true for the most part, A strong Epilepsy often killeth the Patient in the fit, or it turns into an Apoplexy, or by reason of the strength of the symptoms, and the violent shaking of the Brain, the Fabric of the Body it is overthrown, and some parts thereof are broken, and it happens sometimes that pieces of the bones called Processus Mammillares, come out of the Nose. An Epilepsy coming of Melancholy turns sometimes into madness, when the humour is sent from the Ventricles of the Brain into the substance thereof. The same humour when it is only in the Ventricles of the Brain, stopping them and paining them, causeth an Epilepsy: But when it offends the substance of the Brain which is the seat of the chief functions, by defiling its Natural temper, and corrupting the Animal Spirits, and darkening them, it makes a M●lancholly doting. Hence Hypocrates, 6. epid. sect. 8. text 40 saith, that Melancholy men turn for the most part Epileptic, and Epileptic to Melancholy. But these Diseases thus change in a twofold respect; either by the change of the matter causing the Disease from its proper seat▪ and so when one comes, another goes, or by the propagation of the matter, and then both remain. An Epilepsy coming of phlegm turns either into an Apoplexy, or a Palsy. A Quartan Ague coming upon an Epilepsy, and continuing long, cureth it, by reason the matter of the Disease is by degrees co●●●●ned by the heat of the Fever if it be of phlegm; but if it come of Melancholy, it is sent from the part affected, to the place where the ground of the disease lieth, that it may supply matter to the new sits. The ●ure of the Epilepsy is twofold; the one in the fit, the other out of it. Physicians are seldom called to the Cure of the fit, except it continue over long: in which case those Remedies which we laid down in the Cure of sleepy Diseases, especially the Apoplectic Water, the Cinnamon Water, Aqua vitae, and other Spirits which are very proper to discuss the fit. Out of your fit you must vary your Cure as the Cause requires. And first we shall lay down the Cure of a proper Epilepsy, which consists in Evacuation of humours throughout the body, in the discussing of the matter of the Disease, and rectifying its evil qualities; as also in strengthening of the Brain. And since the matter offending in a true Epilepsy is for the most part Phlegm, we will direct our general Cure in opposition to that; admonishing young beginners that if Choler or Melancholy abound, they would prepare and purge them. But the specifical Remedies are always the same, of what cause soever the Disease doth come. For a perfect Cure we must thus proceed: First, Give him a Potion to purge phlegm, or some other Medicine to that purpose, which the Patient can best take, mentioned in the first Chapter. First giving a Clyster, if his body be bound. After, if there be signs of Repletion, or if the party be Sangume he must be let blood; otherwise not. Afterwards the Universal Cure, of the cold distemper of the Brain is to be followed, with this Caution, That to the Decoctions, Apozemes, Diets, Sweats, Syrups, Chewing, and head Powders, you add the Root and Seed of Peony, and Misleto of the Oak, which all ancient Authors hold to be most proper for the Cure of this disease. For his D●et, Guajacum is the best Sweater: By the use of which Jachinus reports that he cured many, but let it be continued thirty or forty days. To every Dose of the Sudorific Decoction, put some drops of the Spirit of Vitriol, which is thought very proper for the Epileply. You must often use the common purges, namely, the Pills, or Magistral Syrup once or twice a week if the Patient's strength will suffer them, and continue purging for divers Months: and sometimes use stronger purg●s, as Massaria ordains, who saith it comes from hence that Epilepsies are not, or seldom cured, because the Physicians always give weak Medicines. For this cause, the Chemics use Minerals, which draw the Humours from remotest parts, but not without much danger, especially if they be not well prepared. But if good success may be expected from these Chemical Medicines, it is to be found in Mercury or Quicksilver, either by its self, or with Gold calcined in a Furnace of Sand, with a long continuance of fire, watching narrowly lest any crude portion of him remain, which would make the Medicine very violent; otherwise it will work gently, if given in the quantity of four or five grains in Cochie Pills, or any Extract that purgeth phlegm, or all humours. A new Epilepsy is sometimes cured with Salt of Vitriol; as Angelus Sala saith, that he hath cured at thrice taking of it, an Epilepsy, giving it every fourth day. And after in his 77. Gurat. Gent. 2. he boasts that he cured a Girl of eleven years of age, of an haereditary Epilepsy, with Stibium calcined, given only thrice. Quercitan's Syrup of Tobacco, is very good for the Cure of the Epilepsy: But it is not to be used but by a wise Physician, it is so vehement. Instead of the Opiate before mentioned, this may be used, which is more Specifical. Take of the conserve of Rosemary flowers, Peony, and Bugloss, of each half an ounce: Citron barks candied, two drams: of the powder of Misleto of the Oak, Peony seeds, and Elks Claw, of each half a dram: Man's skull that was not buried calcined white one dram and an half: Coral, Pearl, and Hartshorn prepared, of each four scruples: right Bezoar stone, one scruple: Diamoscu dulce, Diatrion santalon, of each two scruples: old Treacle, and Confectio de hyacintho, of each one dram: Spirit of Vitriol fifteen drops: With the Syrup of candied Citron barks, make an Opiate; of which take the quantity of an Acorn, or Filbert, drinking a little Cinnamon water after it. But this following is most powerful for the rooting out of the Disease after the Body is well purged. Take of Conserve of Bettony Flowers and Rosemary Flowers, of each two ounces and an half: Eringus Roots candied, and Mithridate, of each one ounce: the powder of Sassaphras six drams: Castoreum three drams: Man's Skull not buried, and Elks hoof, of each two drams: of the roots and seeds of Peony, and Gith seeds, wild Rue, and Pellitory, of each one dram: Oxymel as much as is sufficient, make an Opiate, of which take two or three drams. The Opiate of Montagnus goes beyond all, by which many have been cured: It is made thus: Take of the Roots of male Peony, Stoechas, and Pepper-wort, of each ten drams: Agarick five drams: Pellitory, Carua seeds, Dill, Assafoetida, and Aristolochia or round Birthwort two drams and an half: of the juice of Squils', and Honey, of each one pound and two ounces: Boyl the Squils and Honey gently to a good consistence; then add the Powders, and make an Electuary: of which, take two, three, or four drams, as age requires, continuing it twenty or thirty days. After the use of the Epispastick Plaster, you must apply a Vesicatory to the fore part of the head, and a Cautery to the neck. But a Seton or Skein of Silk drawn through the neck, draws the Humours more strongly out of the Brain. And Fabricius Hildanus reports that he cured a Youth that had the Falling-sickness every day, and had used all means he could get, in vain; and a Girl of eighteen years of age, born so, only by the continuance of a Seton. If you conjecture that the vapours rising from the parts below, and flying into the Brain, produce this disease, and nourish it; it is good to apply a Caustick to the fore part of the head, avoiding the Sutures: for Carolus Piso reports that he cured two by so doing. Also if the Disease come from the inferior parts, the Waters of Germany called Aquae Acidulae do work wonders, and sometimes root out the Disease, if first evacuations have been sufficiently made, and the veins inferior have been opened. But an Epilepsy coming from the Matrix requires a special Cure. The Powder of Elder Berries described by Quercetanus, given three days together, the quantity of a dram with some Hysterical Water, is good. If all means fail, the last remedy is, to open the fore part of the Skull with a Trepan, at distance from the Sutures, that the evil air may breathe out. By this means many times desperate Epilepsies have been cured, and it may be safely done if the Chirurgeon be skilful. Let the Patient drink ordinarily Hydromel, or a small Decoction of Guajacum with Peony Roots. Let him carry a Bag about his Neck made thus: Take of Peony Roots and Misleto of the Oak, of each one ounce: Elks hoof two drams: Nutmegs, Cloves, and Mace, of each two drams: Rue and Hyssop, of each one dram and an half: Powder them and put them in red Sarsnet to be bung about his neck that he may often smell to it. After Universal Evacuations, among other Medicines you must use Specifical Medicines, which you may find in many Authors. We shall set down some of the best (besides those Opiates prescribed) which are of no small Consideration in the Cure of this Disease. Rondeletius commendeth much the Water of Swallows, which Quercetanus borrowed of him in his Dispensatory. Treacle Water is of no less value, and Aqua Cephalica, and Syrupus Antepilepticus, mentioned by Quercetanus. The Root of wild Valerian is much commended by Fabius Columna, that (once or twice taken) it cures the Epilepsy. And he reports he gave it to many of his friends, who affirmed that (under God) they were cured by it. The Dose is half a spoonful in Wine, Water, Milk, or any other proper Liquor; but it is given to Children in a less quantity in Milk. The Chemists commend the Spirital mixture, than which no better Medicine can be required (as they say.) The Composition whereof is as followeth: Take of the spirit of Vitriol, one part; spirit of Tartar, three parts; Treacle Water with Camphire, four parts: Mix them, and let them stand in a glass well stopped three or four weeks. The Dose is one dram in any proper Liquor, or Vehiculum to swallow it down with. Rulandus used much the Oleum ligni Heraclei (which the Chemists affirm to be of Coryline, or the Oil of the Hazelnut, or Filbert tree) And in his Centuries he relates some passages of them, which by the use of the Medicine were cured. The Dose is three or four drops in any proper Liquor for five days together. The Oil of white Amber is inferior to none, if not the best, being drawn by a good Artificer, and smelling of no fire, but sending forth a most fragrant scent. The Dose is from half a scruple, to one scruple. The Oil of Box-tree taken by four drops at a time, in four ounces of the Water of the Tile-tree flowers with four drops of the Spirit of Sulphur for some certain days together, is very powerful, and is thought by many to be the true Oil of Lignum Heraclei. Crato calls the Natural Cinnaber the Loadstone of the Epilepsy, and makes this Powder of it. Take of Natural Cinnaber, or Vermilion, which is clear, and finely powdered half an ounce: red Coral, and Pearls prepared, of each two scruples: Saffron one scruple: the Leaves of Gold five: Grind them all very finely upon a stone. The Dose is from six grains to a scruple in the time of the fit, in some proper Liquor. The Cinnaber or Vermilion or Antimony, which is taken after the extraction of Mercurius vitae, is thought by Chemists to be of no less virtue than the former: for if it be mixed with an equal weight of the Magistery of Pearl, Coral, and powder of a dead Man's Skull, it is a specifical Medicine in an Epilepsy; though it be old, the Dose is from ten grains to fifteen in a proper Liquor. The Cure of an Epilepsy by consent is first to begin with the part affected, and that part is to be cleansed and strengthened by convenient Medicines taken out or those proper Chapters wherein they are mentioned: not omitting Specifical and Antepileptical Medicines, which are always to be used in every Medicine. But if the Epilepsy come from any external part, besides the Universal Cure, we must have a special eye to that, and the malignant matter therein contained, is to be evacuated by Cupping-glasses with scarification, Vesicatories, and Cauteries. And if the Disease continue after the Ephar or Scab is fallen off, you must apply the Cupping glasses again; and at last, when necessity urgeth, you must apply an actual Cautery. If the disease come from a foulness of the Skull, that is to be taken away with the Trepan and burning. CHAP. VIII. Of the Falling-sickness in Children. BEcause this Disease is common among Children, and useth to be very dangerous unto them, therefore we shall add a peculiar way for their Cure by itself, because it is very much differing from that in elder People. First therefore make the Belly soluble with a Suppository or Clyster. After, or about the same time, give a purging Medicine proportionable to the strength of the child: We need not fear to give of the Electuary of Diacarthamum two drams to a child of one year old, if the Disease come of corrupt Milk. Take of Hiera Picra haly a scruple, or one scruple: Pulvis de gutteta half a scruple: Give it with a proper Liquor, or with Honey of Roses. Apply Cupping glasses to the Shoulders and Loins, and with Scarification, if the Child be one or two years old. Apply a Vesicatory to the hinder part of the Neck. If the Purgation have not done well, or little profited, you must vomit with white Vitriol prepared, or with Salt of Vitriol, which may be given twice, thrice, or four times, if the Disease increase. The Epileptic Powder commonly called de gutteta, may be given often with Milk or Broth, from half a scruple to a scruple. That Epileptic Powder is not found written in our Dispensatory; but in the Shops at Montpelior. It is usually compounded thus▪ Take of Peony Roots and Seeds, white Dictamnus, Misleto of the Oak, of each half an ounce: the seed of Atriplex or Orage, two drams: the Powder of Man's Skull, three drams: red Coral prepared, Hyacinths prepared, of each one dram and an half: Elks hoof prepared, half an ounce: Musk one scruple: Leaf Gold one dram: Mix them into Powder. Take it in a small spoonful of Water against the Epilepsy: or instead thereof in Cinnamon Water, or Imperial Water, or with some drops of the spirital mixture with a proper Liquor. Apply to the hinder part of the head, a Plaster of Ammoniacum, the hair being shaved; for it hinders a flux of humours that falls from the Head upon the back bone outwardly. Use this Powder to the fore part of the head. Take of Nutmeg half a dram: Peony seeds, one dram and an half: Lavender flowers, one pugil: Amber two scruples: Make a Powder. Or apply the strengthening Plaster prescribed in the Cure of the cold distemper of the Brain. Two or three drops of Oil of Amber with an equal quantity of Spirit of Vitriol given in Bettony Water, do presently free a child from a sit of the Falling-sickness. The same Oil is good to anoint the Nostrils. Instead of Oil of Amber, give the Oil of Box; as also the Water of Tile-tree flowers, and Bettony Water. The smoke of Tobacco doth free children from the Epilepsy, if you put in the small end of the Pipe into the child's Mouth, and blow in the smoke, or if you blow it from your mouth. Let the Back bone and the Members contracted be anointed with this Lineament: Take of the Oil of Rue, and of Earthworms, of each two ounces: Oil of Castor one dram: a little Aqua vitae, make a Lineament. Take of Old Treacle, one dram; Confection of Alkermes, and Hyacinths, of each one scruple; Bettony, Sage, Margerum, and Cinnamon Water, of each half an ounce: ' Mix them, and hath therewith the Nostrils, Temples, and Ears. You may also give a spoonful to be drunk. But it is better to anoint the Nostrils, Temples, and Crown of the Head with the Apoplectic Balsam described for sleepy Diseases; as also the Mouth and Pallat. Skenkius in his 5. Century of Exotic Experiments, num. 85. hath this Receipt out of George Kufner: This is an approved Medicine in children's Epilepsies: Give a little fine Musk in thin Wine, twice or thrice in a day, and it will cure perfectly. While these things are performing, you must give once or twice in a day, a Clyster, thus made: Take of the Roots of round Birthwort, of Polipody of the Oak, of Carthamus' seeds, of each half an ounce: Peony and Cummin seeds, of each three drams: the flowers of Chamomel and and Rosemary, of each one pugil: Boyl them to one pint; take half a pint of it strained; Hiera picra three drams; Honey of Rosemary one ounce; Oil of Rue and Lilies, of each three drams. Two special things are to be practised: The one is the Root of wild Valerian before commended by Columna; which he saith he hath given powdered in Milk, and thereby cured very many. Another is the Gall of a sucking Puppy, which is mentioned in Untzerus, thus: Take a little black sucking Puppy (but for a Girl take a bitch Whelp) choke it, open it, and take out the Gall, which hath not above three or four drops of pure choler; give it all to the child in the time of the fit with a little Tile-tree-flower Water, and thou shalt see him cured as it were by a miracle presently. If the Child suck, look that the Nurse's Milk be good, let her have meat of good juice, and light of digestion: Let her drink no Wine, but Water, or Water and Honey, and a small drink made of Sarsaparilla. Some Children are so subject to this Disease, that it will return again after it is once cured. Nay, in some Families all the Children use to die of this Disease. Therefore you must use preventing Medicines, not only to those which are newly born, but to those also which have recovered. First therefore give to Children newly born, before they suck, give one scruple of the Powder de gutteta, mentioned before, in a little milk, and give the same quantity thrice in two days. It is good both for them which have been cured, and children when they are a few days old to apply a Caustick to their Necks. But an actual Cautery is much better, which our Physicians will not use, because they abhor violent and terrible Medicines. Rondeletius affirms, that the Actual Cautery is so used in Florence, that the women do use to apply it themselves. And this doth Aquapendens witness in his Chirurgery Operations, and teacheth the way of applying them in his proper Chapter of the burning of the hinder part of the head in children. Let the Child be purged twice in a month, with Manna, Syrup of Roses, or of Cichory with Rhubarb. Every new Moon give it a dose of the Epileptic Powder de gurteta above mentioned. Make a Bag to strengthen the head, and a Fume for the Head-cloaths, as in the cure of cold Diseases of the head; and also powder its hair with the powder before mentioned. For the Cure of this Disease, this is a good Preservative: Take of Spirit of Wine, four ounces: Spirit of Castor, one ounce: Peony Roots, three ounces: Let them be infused and strained. Wash the whole body of the child with it warmed. CHAP. IX. Of Giddiness, called Vertigo. Avertigo is a false Imagination, in which all objects, and the head itself seem to turn round, so as the Patient often falls to the ground, unless he lay hold on some stay at hand. It may be objected, That in a Vertigo, the Imagination is not hurt; for if it were so, the Patients would think the objects truly turned round; as men in Madness and Frenzy do think what they imagine to be truly so. We answer, That in a Vertigo, the Reason is not hurt, which perceiveth the error of the Imagination; but in a Frenzy, or Melancholy, the Reason is hurt as well as the Imagination. There are two sorts of Vertigoes; the one simple, called in Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, in which the Sight remains unhurt: the other is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, a dark Vertigo, in which the Eyes are both darkened as it were with smoke, or a cloud. In both kinds the Sight is somewhat hurt, because the Spirits which use to go directly to the Eyes, are moved out of order by the visive Nerve, by reason whereof the Eye doth not so fitly enjoy them. But in a dark Vertigo there is a more violent Motion of the Spirits, so that they come less to the Eyes, from whence the sight is darkened or hindered. The immediate Cause of a Vertigo, is the circumvolution of the Spirits coming of a vaporous matter or wind, which coming into the Ventricles of the Brain, and Plexus Choroides, disturbs the Spirits, and makes them run round; whence the species of the Objects brought by those spirits are moved in like manner; and so the objects themselves seem to be moved also the same way. But here we may doubt, since a Vertigo is a symptom of a hurt action, and every action hurt depends immediately upon a Disease, how the Circumvolution of the Spirits can be the immediate cause of a Vertigo, when it can be referred to no kind of Disease. To which we thus answer, A Circumvolution of the Spirits, is a Disease in respect of Situation; for at that time the Spirits do not keep that place or position which they Naturally ought, but move preternaturally, and amiss. And this Answer hath a weighty instance: For a Disease is an affection of a true part, but spirits are not true parts. We answer, That Axiom is not always, but sometimes true; according to Galen that which is principal and hinders the action of its self, is the true Disease: We say that the word Part aught to be taken in a larger sense, comprehending all those things which go to the making up of the Body, and whatsoever hinders the action of any part, is called a Disease. So a yellow colour in the Eye, hurts the sight immediately, and therefore it is called a Disease in number; so a better savour in the tongue, and noise in the Ears, are Diseases in number, in regard there is something in those parts besides, which offendeth the actions. After the same manner is the Circumvolution of the Spirits, a Disease in Situation or Position, for the Reason above mentioned. But those Vapours are sent up from evil humours, not continually without intermission, but by compass and going about, and at a distance, namely, as often as they are raised up by an external cause; and the humours are such as use to produce vapours, namely, Blood, Choler, Phlegm, and Melancholy, and the watery Humour; because both a cold as well as a hot vapour, may cause a Vertigo; as Galen, 3. de loc. affect. chap. 8. and Comment. Aphor. 23. Sect. 3. These evil humours are either contained in the Brain, or in the inferior parts. Hence a twofold Vertigo ariseth, one Proper, the other by Consent. Waterish and flegmy humours heaped up in the Brain, send wind and vapours to its ventricles, which stirring about there, do cause a Vertigo. And so a proper Vertigo comes to be a forerunner of an Epilepsy, or Apoplexy. But Humours contained in the inferior parts, especially the stomach and the spleen, do easily send up Vapours to the head, which if they touch the Ventricles, and the Arteries, cause a Vertigo. The external Causes are all such things as will quickly dissolve the Humours, and turn them to Vapours, or make an inordinate motion in those Vapours. Among which are reckoned by Hypocrates, Aphor. 17. Sect. 3. a South wind, and sudden change of Air. To these add the heat of the Sun, windy Meats, Garlic, Mustard, Radish, Pease and Beans, Drunkenness, Gluttony, immoderare Exercise, and unseasonable, the suppression of a wont evacuation, Anger, Baths, Hunger, especially in those which are full of bitter Choler, often turning of the Body round, long looking upon Wheels and things that run round, and of Waters that run swift, looking down from a high place, a Fall, a stroke upon the Head, a Fracture, or depression of the Skull, compressing and lying upon the Brain. We shall lay down no Diagnosis, or general signs to know this Disease by, because it is of itself manifest. Yet in particular we shall declare those signs which show the part affected that containeth the mine or matter of the Disease; as also those which show the humour offending. Pain of the Head shows that a Vertigo cometh from a Disease of the Brain, which is a true or proper Vertigo. Also Heaviness, and the loss of some Sense; as Dimness of sight, noise in the Ears, thickness of hearing, decay of smelling and tasting; the beating of the Arteries of the Head when other parts are free. The signs that show what the matter is that offendeth, are these: That abundance of phlegm offendeth, is signified by a dulness of the internal and external Senses, heaviness of Head, slowness of motion, drowsiness, much spitting, want of Appetite, want of Thirst, white Urine, and crude, with the other signs of abundance of phlegm. But watch, wrath, nimbleness in actions, thirst, bitterness of mouth, quickness of pulse, a thin and yellow Urine, and the like, show that the Choleric matter offendeth. The signs of a Melancholy matter are, Fear, sorrow, troublesome thoughts, much watching, fearful dreams, sour belchings, and the like. The signs of Blood abounding, are, Stretching of the Veins with fullness, redness of face, and heat, beating of the Temples, heaviness and distension in the head, long sleep, dreams of red things, weariness, reaching, thick and red Urine, sometimes thin and transparent by the ascension of the blood into the head. A Vertigo by Consent is known by the want of those Symptoms, which come from the Head, when no disorder is found in the Brain, but rather some part beneath is sensibly hurt. These things show that a Vertigo comes from the stomach, want of appetite, loathing, sour belchings, pain of the stomach, or swelling with wind. That a Vertigo comes from the Liver, Spleen, or Matrix by Consent, the same signs declare which were laid down in an Epilepsy by Consent coming from the same parts in the Chapter aforegoing. The Prognostic, or foreknowledge of this Disease, is thus: A new Vertigo that comes but seldom, and which comes only from external Causes, is more light and easier cured: On the contrary, that which is old, and comes often, turneth for the most part into an Epilepsy, or Apoplexy. A Vertigo in an old man is most dangerous, because his Brain is colder and weaker, and phlegm doth more abound. A Vert go in which not only external things, but also the Head and whole Body seem to be turned about, and which happens with hurt to the sight, is more dangerous, for it signifies greater force in the cause of it; and if the sick man falls to the ground, it foretells an Epilepsy, or Apoplexy. A Vertigo coming of hot Humours, is sooner dissolved than that which comes of cold, because hot Humours are sooner dispersed. The Cure of the Vertigo is much like that of the Epilepsy, because both Diseases come almost of the same Causes: whence it comes that a Vertigo often turns into an Epilepsy. But because a Vertigo is a lighter Disease, it doth not need so many Medicines as an Epilepsy: but they will serve, which we will here lay down; and also we shall demonstrate in short what is that which this Disease most properly requireth for its Cure. In the first place, Therefore if blood abound in the whole body, or in the head, you must open a Vein, and let the blood out by degrees, giving before a Clyster that is somewhat sharp. After that, give the ordinary Purge which is prescribed in the Cure of the cold Distemper of the Brain. Afterwards we must come to the particular Evacuations of the Brain, by Errhines, Sternutatories, and Gargarisms, or Apophlegmatisms, mentioned in the first Chapter. Cupping glasses dry, and with Scarification; Frictions of the extreme parts, and opening of the Hemorrhoids are to be used for to cause revulsion. Apply Vesicatories and Cauteries for derivation, and at last use those things which strengthen the Brain, and disperse Vapours and Humours as well externally as internally, as Opiates, Powders, and Bags that are described in the first Chapter. And you must not omit the digestive Powder, because the weakness of the Stomach often causeth this Disease. And lastly, You must use those Medicines which are esteemed by special quality to cure the Vertigo; such as are those which were prescribed for the Cure of the Epilepsy; namely, Antepileptick▪ Waters, a Balsom to anoint the Nostrils, Temples, and Crown of the head, Oil of Amber, Powder of Cinnaber, and many other. Moreover, Quercetanus in the twentieth Chapter of his Dispensatory, commends a Medicine made of Peacock's dung, whose Preparation and manner of use, may be seen in the Author. If the Disease do obstinately resist the propounded Remedies, you must fall to a Diet of the Decoction of Guajacum. A 〈◊〉 in the fore part of the Head, is much commended by Zacutus Lusitanus in his first Book of Admirable Practice, Obs. 38. in these words: A certain man was so troubled with a dark Vertigo, that his Brain did almost continually seem to run round: and when he had tried many Medicines, and there was fear of an Apoplexy to follow; with no other means (besides general and particular Evacuations, and Fontanels or Issues in divers parts, and a Seton in the nape of the Neck) could he be cured, but with a Cautery in the fore part of the ●ead; by which only (beyond the expectation of Physicians) I have cured many of the Falling-sickness, letting them run a long time. CHAP. X. Of Tremor, or Trembling. TRemor is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek; it is a voluntary Motion depraved, by which the Member is sometimes elevated, sometimes depressed, through the mutual contention between the faculty, and the part affected. It is called a depraved motion from Galen, 2. de sympt. cause. chap. 1. and he says the same in his Book of the Difference of Symptoms, chap. 3. but he seems to contradict himself, when in his Book of Trembling, chap. 4. he reckons Trembling among the Motions which are diminished. But that contradiction may be reconciled, by saying, that Motion may be considered two ways, Either in respect of itself, or in respect of the faculty: If it be considered in respect of itself, it is depraved, because it is not in that manner it ought to be; if it be considered in respect of the faculty, it is a deminished motion, because it comes from a faculty so weak that it cannot produce motion strong enough. But one may instance, That the action is always diminished when comes from a weak faculty, but never depraved. I answer, That it is true if all the actions depend upon the faculty; but Trembling comes partly from the Faculty, partly from the heaviness of the part; therefore it is a depraved Motion. The moving faculty desireth to lift up the Member, and to keep it in that Position; but the weight of the Member presseth it downwards, whence comes a trembling Motion. The Mediate Cause of Trembling, is weakness of the Motive Faculty, or rather of its nearest Instrument, that is, the Animal Spirit, which is not able to exercise a voluntary Motion perfectly. The Spirits are made weak, either by a fault in themselves, or by a defect in the Nerves, which are the Conduit Pipes by which they are carried, and do act. The fault is in the Spirits, either when they are but few at the first; or when they are afterwards dissipated. They are few at the first, either by reason of the cold distemper of the Brain, as in old men, or through the want of vital Spirits, which are the matter of which the animal are made. The Spirits are dissipated from many external Causes, as immoderate Evacuations, much use of Venery and unseasonable, great pain, and constant fasting, sorrow, and long violent Diseases. The Spirits are hurt by defect in the Nerves, and are weakened either when the Nerves are too cold, or are infected with a malignant quality, or obstructed or compressed. They grow too cold, either from a cold Air, from use of cold meats, or much drinking of Water, swimming often in cold water, and the like. They are infected by the use of Opium, Henbane, Poppy, and the vapour of Quicksilver, as it is seen in Goldsmiths, and them which have the French Pox, and have been cured with the fume of Cinnaber. So in malignant Fever's tremble come also (which are rather to be accounted Convulsive Motions) and also they come from the provocation or irritation of the Nervous parts. They are stopped not wholly, as in a Palsy, but much less, but by the same cause, namely a watery humour gently sprinkled upon the Nerves, which is produced of gluttony, drunkenness, and other Causes. Lastly, Trembling may come from compression of the Nerves, when excrementitious humours abounding in the whole Body do compress the Nerves, and hinder the free passage of the Animal Spirits. Hercules Saxonia, besides the causes mentioned borrowed from Galen, acknowledgeth another Tremor coming of wind; and Cardanus another from pain in nervous parts: But they are deceived, because the Motion produced from those Causes, are to be referred to Palpitation, or Convulsive Motion. There is no need of signs in this disease, because trembling appears of itself: But the Causes that produce it, are to be known by their proper signs; as also we must search for those external Causes which went before. As for the Prognostic. Trembling of itself is not dangerous, but if it be in old people it continueth with them till they die. But it may be deadly by accident, in as much as it usually goes before a Palsy, or an Apoplexy. You must Cure Trembling as you cure the Palsy, and therefore we shall not make vain repetitions of Medicines. CHAP. XI. Of Phrenitis, or Frenzy. A Frenzy is an Inflammation of the Brain, and its Membranes with a continual dotage, and a a sharp constant Fever. By the word Inflammation, we understand a true Tumour, which is commonly called a contracted Inflammation, coming of Blood out of the Vessels falling upon the substance of the part; for the Blood being hot and Choleric, and in the Membranes or substance of the Brain, causeth a true Erysipelas, or an Erysipelas Phlegmonodes, or Phlegmon Erysipelatodes. By Delirium, or Doting, we understand the erring of Reason, for we suppose that fault cannot be in the Imagination alone, without a fault be in the Reason, in a Frenzy; whatsoever others think, we are led by the Authority of Galen, who in his Book of the Difference of Symptoms, chap. 3. gives an Example of one Theophilus a Physician, who thought Fiddlers sat continually in a corner of his house playing, and believed that he saw them sometimes standing, sometimes sitting, and cried continually that they should be cast out of doors. And Galen saith, that in him the Imagination was hurt without the Reason. First therefore we may say that Theophilus had not a Phenzy; for Galen doth not say that he had, but speaking of a Delirium (which Theophilus had) therefore it was rather Melancholy, because they sometimes err in one object, and discourse well concerning other: so saith Galen of Theophilus, that he had wisdom in other things, both to discourse, and to know his friends. But we say further of Theophilus, that not only his Imagination, but also his Reason was hurt, because he really thought the Fiddlers were there, and desired they should be put forth: For when the Imagination alone is hurt, the Reason being not hurt, acknowledgeth the error of Imagination, as in a Vertigo, in which the Patient thinks all things run round, but Reason knoweth that it is not so indeed, but that Imagination doth err. Nor is the Opinion of Eustachius Rudius to be received in this case, who saith, That it never comes to pass that the Imagination should be hurt, the Reason being sound, because Reason worketh upon Phantasms received from the Imagination, and therefore if foolish Phantasms are offered to the Reason, he thinks it necessary that the Understanding beholding those foolish fancies, should also be foolish: And hence Eustachius gathers, that the Imagination is not depraved, but there is a mere and simple deceit of the sight. We say that the understanding doth run from one thing to another, and is busied about those Species which are retained in the Memory; and though the Fancy presents absurdities to the Mind, yet the Species before received, are still retained in the Memory, and are presented to the Reason, it can know and correct that mistake of the Fancy; namely, if it judge that those absurd fancies which are brought to it by a depraved Imagination do neither agree with time, place, or other circumstances which still remain in the Memory, and are known to be true. So in a Vertigo, Reason being in order judgeth that it is impossible that Roofs, Walls, and Pavements, should turn round, and therefore they are falsely represented to the Imagination. So the Philosopher that was bit with a mad dog, and his Imagination began to decay, going into a Bath, perceived the false Image of a Dog therein; but Reason being sound reproved the error of his Imagination, and made him speak thus; What hath a Dog to do in a Bath? and presently he cast himself into the Bath, by which means he was delivered from the danger of a Disease called Hydrophobia, or fear of Water. There are two kinds of Frenzy; namely, a true Frenzy, which is laid down in the Definition above mentioned: Another which is called Paraphrenitis, or Bastard Frenzy. A true Frenzy is sometimes in the Disposition, which is most usual, sometimes in the Habit, which is called Hectical Frenzy, in which, the Choleric Humours are strongly fixed in the Brain, and possess many parts thereof, sticking thereto like a tincture or die. A Paraphrenitis, or bastard Frenzy is, when a hot distemper is communicated to the Brain, either from the whole Body (as in burning Fevers) or from some part inflamed, as the Stomach, Liver, Lungs, and especially the Diaphragma or Midriff, which by inflammation doth produce a Disease very like a Frenzy; namely, a continual Dotage called Delirium; which cometh to pass by the great consent which is between the Brain and the Diaphragma through the Nerves that come thither, and by the perpetual motion of the Diaphragma or Midriff, by reason whereof continual vapours are sent to the Brain. The Cause of a true Frenzy is Choleric blood, to which there is joined also Excrementitious Choler, and this produceth a greater or less Frenzy according to its divers degrees; namely in heat and adustion. So a Pale Choler produceth the mildest Frenzy, and an Adust or Choler stirs up a bestial Frenzy. But when the Brain is inflamed, and the Membranes thereof; the Choleric blood is out of its Vessels, and shed abroad into the substance of those parts: which is done Two ways, either when the Brain is principally affected; or when it is affected by Sympathy. The Brain is primarily affected when it doth immediately grow hot from an external Cause, as from the Sunbeams, drinking of Wine, Wrath, and the like; so that the blood which is contained in the veins of the Brain is moved and carried out of its Vessels: and this may come from a wound, or stroke, or contusion of the head: And a Frenzy so coming may be called a primary, or principal Frenzy. But a secondary Frenzy is that which follows burning and malignant Fevers, when a part of that humour which causeth the Disease, is carried to the head. It followeth many times in these Fevers, That Nature being disturbed by the malignity of the Cause which maketh the Disease, sends some portion thereof to some flesh between the skin and the bone; whence we see Pluresies, shortness of Breathe, Squinseys', Hipatitides, or Inflammations from the Vena porta, and other parts, to follow these Fevers: So if these humours are sent to the Brain they make a true Frenzy, and then the Fever goes before the Delirium, or doting: But in primary Frenzies a Delirium appears with the Fever from the beginning. The Signs which declare a Frenzy to come are these, watch, troublesome sleep, much talk, an urine that is first thick, and after thin, and perspicuous; heat of the head: for these declare that hot matter is carried to the head: the eyes are altered because (the brain being hurt) they want the animal spirit. There is a pain about the hinder part of the head, because the jugular veins are carried to that part and send forth the Choleric blood. These are the signs of a Frenzy present: a continual doting, because the Brain is always affected: troublesome watch coming from the hot distemper of the Brain; seldom and great violent breathing, because men in Frenzies forget to breath: for when by forgetfulness, or great trouble of the mind by many fancies which are presented to a doting imagination, and withdraw the animal spirits: Respiration, or breathing is very seldom, it is made up with the greatness of the blast. Moreover, in a Frenzy there is no thirst, or very little; albert there are strong causes of thirst present, because the mind is sick, and the animal spirits (by reason the Brain is hurt) do not send their beams to the mouth of the stomach whereunto thirst belongeth. The Pulse is weak because the heart suffers with the brain: hard; because the Membrana is inflamed: quick and often; by reason of the great urging; and something moist; because the brain is affected. Moreover, there is a continual Fever because the inflammation of the brain must of necessity cause a Fever. The tongue is rough, black, and yellow, by reason of the Choleric vapours which dry up its moisture. An Hectical, or Habitual Frenzy is known from Hippocrat. 1. Prorrhet. text. 33. by small doting, and little perceived; when the sick do not speak, but lie still and seem to sleep. But a Frenzy, or Phrenitis is distinguished from a Paraphrenitis in this; The Disease which produceth that, is sooner known than a Delirium or Doting; and by the increase or diminution of that the Delirium is increased or diminished; and sometimes it intermits and is not constant. But a Paraphrenitis springing from the Inflammation of the Midriff, in which there is a constant doting, is distinguished by other signs. Namely, because in a true Frenzy there is great and seldom breathing: but in the other, little and often. Little; because the Diaphragma, or Midriff being inflamed, cannot easily be extended and dilated. Often; for necessity, that the smallness might be made good by the frequency. Moreover, in a true Frenzy the voice is high, and the Patient cries out loud; in the other the voice is low, because the instrument of Breathing is hindered. And lastly, In the inflammation of the Midriff, the Hypocondria are drawn up (according to Hypocrates in Coacis) and the reason is, because the Midriff is covered beneath with a Membrana coming from the Peritoneum; and therefore when it is inflamed, it contracts the Peritoneum, and with it the Hypochondria. Lastly, The Signs of the Causes may be known from the predominancy of the Humour in the whole Body, and from the manner of the Delirium: For a pale Choler makes a more gentle Frenzy; a yellow Choler make a more violent; an adust Choler makes the most violent: But Choleric blood causeth the most mild of al. The Prognostic of this Disease is for the most part deadly; for few escape in regard a noble part of the body is affected with a great Disease. The greatest hope of recovery is when there is Dotage with laughter, and a decrease of Symptoms, continuance of strength; as also when after the height of the Disease there happeneth some beneficial evacuation, as sweat, blood, or looseness. But these show the Disease to be deadly. The Tongue quavering, and Hand trembling, gnashing of Teeth, Convulsion, a great Chillness or Cold in the beginning of the Disease; as also when the Patient picketh the Wool or Straws about his bed. You may farther Collect Death to be at hand by a drop of black blood flowing from the Nostrils, by white stools, white and thin urine: For all these signify a great oppression of the Brain, or a flowing of Choler from the whole body to the part affected. For the Cure of this Disease, the blood that flows to the Head must be let forth, and reveled, derived, repelled, and intercepted; and that which was there before must be evacuated and discussed. The distemper of that part must be corrected; the strength of it, and of the whole body is to be preserved. All these things may be done with the following Medicines. In the beginning of the Disease, at any time of the day you must let blood out of the Head vein, because the Disease is very violent, giving a Clyster before: or if blood do much abound, out of the Liver vein: or first, out of the middle vein; and a little after out of the Head vein. If the Disease come from stoppage of the Terms or Hemorrhoids upon the vein called Saphena in the foot. In the next place you must open the Chephalick or Head vein, that you may draw forth what is received into the brain, or what is nigh unto it. For the most part once bleeding will not be sufficient in this Disease, but twice or thrice, or oftener in the beginning or increase of the Disease; you may adventure upon it, according to the condition or plenty of the Humour; the age, temper, and strength of the patiented. If a Frenzy taketh one that hath a constant Fever, (as it is often in the increase of Fevers, or in the state of them, when nature is out of order and disturbed by the malignity of that matter which causeth the Disease, sendeth Choleric humours to the head) you must again let blood, though you have done it before in respect of the Fever; but you must do it sparingly, because the strength is abated by the Fever and former bleeding. Therefore at that time open the Head vein, or if strength will not bear that, open the Saphena in one foot, or both; which is approved in such Diseases: neither is it less beneficial to open the Hemorrhoid veins by Leeches. But in all Bleedings which are made in time of a Delirium, you must observe this that the Orifice be not large, for than it will quickly heal, and you must bind it up carefully lest the Patient being unruly cause it to bleed again; as also 'tis very good for the sudden Cure of it, to lay a plaster of Aloes, white of an Eglantine, and the hair of a Hare. After Bleeding provoke sleep. For if after bleeding there comes watchfulness, the Humours wi● be again inflamed, and the patiented grow worse. Sleep is caused by repelling Medicines laid to the forehead which are cooling and narcotick or causing sleep, which we shall mention hereafter. When you cannot conveniently let blood, apply Cupping Glass' with deep Scarrifications; first, to the lower; than, to the upper parts: and also to the Thighs, and other parts, without Scarification. Use Frictions in the same parts; and use Ligatures to the Legs for rewlsion. Apply Vesicatories to the Shoulders and Arms. Give every day a Clyster, made of cold and moist things: For by these the Acrimony of the Humours is qualified, and they are put downwards. And they are thus made, Take of Marsh-mallow Roots one ounce: the Leaves of Mallows, Violets, Lettuce, Pellitory, Beets, of each one handful: the flowers of Water-lillies, and tops of Dill, of each one pugil: Prunes six: boil them in Barley water; to one pint of the straining ad of Cassia newly drawn, and Diaprunes simple, of each six drams: red Sugar one ounce: make a Clyster. Use no Oils in these kind of Clysters, because they will then inflame. You must not Purge in a primary Frenzy, such a one as comes not from another Disease, but it is good sometimes to Purge when the Frenzy comes upon a continual Fever. For if there be an evil digestion or ill juice in the Body, and the Frenzy begin: then the matter is wandering, and is taken for that which is called Turgent, or abounding: And therefore by the Counsel of Hypocrates, Aphor. 22. Sect. 1. is to be presently evacuated. But the Purge must be made of cold things, with gentle, as Senna, Rhubarb, Cassia, Tamarinds, Catholicon, and Syrup of Roses. Presently after blood letting you must use repelling Medicines, which hinder the assent of humours and cool the head, as Vinegar of Roses made of Oil of Roses and Vinegar, in time past; but now we use distilled Waters and Juices of Herbs with it, and we repel and cool more or less, as there is a greater or less flux of humours, and inflammation, which we must diligently observe. Therefore we will lay down many forms that in particular cases we may choose those which are most fit. Take of Oil of Roses three ounces; Vinegar of Roses one ounce; Rose and Plantain Water, of each two ounces: lay them on the forehead shaved▪ and with four-folded . Or, Take of Rose water four ounces; Oil of Roses two ounces; Vinegar of Roses half an ounce; two whites of Eggs; mix them together. Or, Take of Oil of Violets and Water-lillies, of each half an ounce; Rose, Lettuce, and Houslee● Water, of each two ounces; Vinegar half an ounce. Or, Take of the Juice of Lettuce, Purslain, Nightshade, Penny-grass, or Venus-navil, of each two ounces; Oil of Roses three ounces; Vinegar of Roses one ounce. Or, Take of Oil Olive in which Roses are infused, one ounce and an half; new Poplar Ointment (for the old inflameth) one ounce; Vinegar of Roses half an ounce; one white of an Eglantine: Beat them together, and apply them with Flax. The Milk of a Woman which hath brought forth a Girl, with the Juice of Lettuce, and Oil of Roses, is very excellent. Concerning these cooling Medicines, you must observe that they be administered warily, and with judgement, because the Brain is of its own Nature cold, and a principal Member, therefore it is to be feared left the Patient by too much use thereof should fall into a contrary Disease, as a Coma, or the like, especially if he be weak or old; and although they are used sometimes more, sometimes less, yet the extent of the time of their usage ought not to be above three days. Moreover, Those Medicines do stick to the face and eyes, therefore you must lay about them a cloth, or a little wool: in the fore part of the head you must apply them to the middle of the forehead; in the sides of the head, above the ears; in the hinder part, about the nape of the neck and towards the crown of the head: and these are in Winter, to be applied hot; in Summer, cold, as Galen saith, 2. the comp. med. cap. 2. But it is best in old and weak people never to apply them actually cold. If the Inflammation cometh to the Skin, as it sometimes doth; then we must avoid repelling Medicines, especially those that are strong, lest the matter driven to the Brain should augment the Disease. You must apply wet in Rose-water and Vinegar to the neck, to hinder the humours from flying into the head. Caustics applied to the Legs do very well for revulsion or drawing down of the humour to the inferior parts. While these things are doing, you must use all those things which do cool the whole Body, especially the principal parts both internally and externally. Inwardly you must use Juleps, Emulsions, and Electuaries. Take of the distilled Waters of Lettuce, Purslain, Roses, and wild Poppies, of each three ounces: Syrup of Violets, and Pomegranates, of each one ounce and an half: Sal Prunellae three drams: Make a Julep for three Doses to be taken twice or thrice in a day. Or, Take of Lettuce, Purslain, and Plantain, of each two handfuls: Water Lilies, and Violet flowers, of each a pugil: Boyl them in Barley Water to one pint; and being strained, dissolve in it Syrup of Violets three ounces; Sal Prunellae three drams: Make a Julep for three doses or draughts. It is very good to put to your Juleps, besides the Sal prunellae, the spirit of Sulphur, or Vitriol, for those do much allay the heat of Choler. Take of the four great cold Seeds, six drams: white Poppy seeds two drams: Barley Water, half a pint: Lettuce and Water-lilly Water, of each two ounces; Rose water, one ounce: Make an Emulsion according to art, to two Doses, putting thereto Syrup of Violets two ounces. Take of Conserve of Violets and Roses, of each one ounce: Conserve of Water-lillies and candied Lettuce stalks, of each half an ounce: the powder of Diamargariton frigid. half a dram: With the Syrup of Violets make an Electuary. You may also make an Electuary of white Poppy Seed, beaten in a stone Mortar, and mixed with Sugar; this may be called Diacodium album: this temperates sharp and hot humours, and brings rest; it is made of one ounce of Poppy seeds beaten with so much Rose water; after put two ounces of Sugar to it: Or make it of equal parts of each. Outwardly you must apply cold Epithems to the Heart and Liver. Take of Rose water three ounces: borage, Bugloss, and Sorrel Water, of each two ounces: white Wine Vinegar, half an ounce: the powder of three one dram and an half: of Ivory half a dram: Wood of Aloes one scruple: Saffron eight grains: Camphire six grains: Make an Epitheme for the Heart. Take of Lettuce and Rose Water, of each three ounces: Endive and Purslain Water, of each two ounces: Vinegar of Roses one ounce: white and red , and burnt Ivory, of each one scruple: Camphire and Spicknard, of each six grains: the powder of Diarrhodon one dram: Make an Epitheme for the Liver. Let the Liver and the Loins be anointed with this Ointment. Take of the Unguent of Roses one ounce and an half: the cerate of Sanders one ounce: the Juice of Lettuce and Oil of Roses, of each half an ounce: Make a Lineament. Let the Breast be anointed with supling Oils, as Oil of Violets, and the like. Apply wet in Water and Vinegar to the Stones or Cod, or which is better, let them be wet with Rose water and Vinegar. It is good to wash the feet with an actually hot decoction, made of cold things; for it will soften those parts by its hot moisture, and make the humours descend, and its potential coldness will be communicated to all the Body, and to the Brain especially by the Nerves, whereby sleep will be provoked. It is made thus: Take of Violets, Mallows, Willow Leaves, Vine Leaves, Water-lillies, of each two handfuls▪ the flowers of Roses, and Water-lillies, of each one handful: Poppy heads, ten: Make a Decoction for the use aforesaid. Fair Water may suffice to wash the Feet, and if the feet of the sick man be put therein when it is a little warmed, for three or four hours, it frees him from his Delirium, and makes him sleep. The same effect is wrought by Housleek beaten into a Cataplasm, and laid to the sols of the feet: and also by Pompions or Guords beaten and so applied. Sweet Scents often applied to the Nose, cool the Brain: they are prepared after this manner following: Take of Violet flowers, and Water-lillies, of each one pugil; of Roses two pugils: yellow one scruple: Tie them in a clout, and dip it into Rose water, and let the Patient smell to it often. Or, Take of yellow , Roses, and Water-lillies, of each one dram: Camphire half a scruple▪ put them with Rose water into a narrow mouthed Vessel: Let them boil over the fire, and after let the Patient receive the vapour at his Nose. But because watch do chief trouble in this Disease, you must use all your skill from the beginning of the Disease to provoke sleep. For which, the repelling Medicines before mentioned are very good; especially if you anoint the head with Oil of Violets cold, before you apply Rose Vinegar, which is good against watch and Convulsions which come in this disease. But the Medicines following, will do it more powerfully. Take of the heads of white Poppies with their seeds, in number six: the flowers of Water-lillies two pugils: beat them together, and with Rose and Lettuce water make them like a pultiss, which apply to the forehead between two . Note that in Medicines to provoke sleep, you must use but little Vinegar, because it causeth watching. Take of Lettuce flowers one handful and an half: Roses half a handful: white poppy seeds half an ounce: boil them in water till they grow soft; stamp them in Barley Meal, and woman's Milk, of each ha●f an ounce, and a little Oil of Violets: Make a Frontal thereof. Take of Oil of Violets, water-lillies, and new Ointment of Poplar, of each three drams: Opium and Oil of Nutmegs, of each three grains: Mix them into a Lineament to anoint the Forehead and Temples. Great Housleek bruised with Woman's Milk, and laid to the Forehead, appeaseth a Frenzy, and provokes sleep. But as soon as the Patient gins to sleep, you must take it away, lest he fall into a Coma, or sleeping Disease. Guords of Pompions do the same thing with less danger. Penotus doth extol this Epitheme: Take of Musk twelve grains; Camphire twenty grains; red Rose water in which Sanders hath been infused, twenty ounces; mix them: Shave the head, and wet double therein, and apply them warm to all the Sutures of the head. When they are dry wet them again, and continue the application twenty four hours, and so doing you shall provoke sleep, strengthen the brain, and wonderfully recover the Patient, except the very substance of the brain be corrupted. Inwardly you may give one ounce of Syrup of Poppies sometimes in his Juleps and Emulsions. Or you may give four or five grains of Laudanum, which also given in a Clyster, doth provoke sufficiently to sleep, and with more safety. The Physician must be wary in the use of Narcoticks, or Medicines that provoke sleep; for they must not be given if the Patient be very weak, lest the Spirits and Natural heat, be thereby extinguished. Having sufficiently used Evacuations, Revulsions, Derivations▪ and Interceptions: we must come to the bringing forth of the matter. And first we must open the forehead vein if it appear, and may be taken, not tying a Ligature about the Neck as usually they do, for so the blood will be forced upwards. But you may with most profit open the veins in the nostrils, and if the Disease be any ways curable, it will be cured thus: You must bleed plentifully, and betimes, in the beginning of the Disease, after you have made general Evacuations. And they are opened with Bristles put up into the Nose, and pricking often therewith. Or you may draw blood from behind the Ears, from the Nostrils, Forehead, Hemorrhoids, with Hors-letches. Apply to the Head, things that resolve, with things that repel, in that proportion, that first you use a little of the resolvers, and as the disease declineth, increase the quantity, so that at length you use only resolvers to discuss the relics of the Disease. For this end we use Oil of Chamomel, and of Dill mixed with Oil of Roses. But among Resolving Medicines, the chiefest are Creatures newly killed and applied to the head, or pieces of them; as young Pigeons, Chickens, Puppies cut along the Back, and Sheep's Lights; for they fortify the part with their Natural heat, discuss the humour, and qualify the sharpness thereof. Which things, if you have tried one or two days, and have found no benefit, Mercatus teacheth to apply a Cupping glass to the crown of the head, that the humours may breathe through the Sutures into the Skin: and if it appear●red, and be swelled under the Cupping glass to scarify. This Counsel he saith (if followed) will do good when all things besides fail; especially if you bathe presently after with sweet Water in which you have boiled some discussing Medicines: But he adviseth that this be not used in Frenzies that come from other Fevers, but only in that which beginneth of its self. This Remedy is confirmed by Zacutus Lucitanus, who says that he cured a most desperate Frenzy by applying a Cupping Glass to the fore part of the Head with Scarification. Some are so bold as to apply Vesicatories, or Medicines to raise Blisters to the fore part of the Head, which they say hath sometimes had success: But this requires extraordinary premeditation before it be used. For his Drink, let the Patiented use Barley Water, or Water made of Sorrel Roots, with Syrup of Pomegranates, Barberries, or Lemons; or let him drink this following Infusion. Take of Spring Water two pints; the Leaves of Sorrel, and wild Poppies, of each half a handful; the Flowers of borage, Water-lillies, and Violets, of each half a pugil; the spirit of Vitriol one dram: red Sanders rasped two scruples: Let them be infused for some hours cold; then strain▪ them with a Cap paper, and ad as much Sugar as is sufficient to make it pleasant. There is in this Disease for the most part a stoppage of Urine, because the Patient neglecteth to make it; from whence those parts that contain it are distended, and bring so great an Inflammation, that it alone is able to bring death to the Patient. Therefore you must often call upon the Patient to make water, and you must foment the place where the Bladder lieth with warm Water, and drive the Urine forth by the compression of the hand. But if the Symptoms do not yield to these light Medicines, you must proceed to stronger. Take of the Leaves of Pellitory of the wall two handfuls; Parsley with its roots, one handful▪ Boyl them, and after they are strained add three ounces of the Oil of Scorpions, and foment the hairy place of the Privities therewith. Let the remainder of this Decoction after the straining, be fried in a pan with the Oil of Scorpions, and applied to the same part after the Fomentation. If you desire a stronger Decoction, ad the Seeds of Smallage, Parsley, Gromwel, Seselis, or large and broad Cummin, of each two drams. You may also profitably apply this following Ointment after the Fomentation: Take of the Fat of a Rabbit, and of Oil of Scorpions, of each two ounces: Smallage Seeds, Parsley seeds, Asarabacca, and Cummin seeds finely▪ powdered, of each half a dram: Make an Ointment. Chap. XII. Of the Imposthume, and Spacelus, or Mortification of the Brain. THe Imposthume and Mortification of the Brain is described by few Authors, although it was observed by Hypocrates in his 3. Book of Diseases, and happeneth sometimes in Practice, and deluding those Physicians who are not well grounded, making them conceive it to be another Disease. Now a Spacelus, or Mortification of the Brain, is a suppuration, or corruption, or matter of the substance of the Brain, which is called a Gangrene, Syderation, or blasting of the Brain. The Immediate cause whereof, is an Inflammation of the substance of the Brain, which is distinguished from a Frenzy, in this: In a Frenzy the Membranes are chief inflamed, and they do communicate an inflammation to the external part adjoining; but in this Disease, the inward parts of the Brain are inflamed, and the whole substance thereof is putrified; for so great an inflammation in a most tender part and moist, will quickly produce a Spacelus, or Mortification. The Cause of this Inflammation is Blood overheated, or over choleric, running into the Body and internal parts of the Brain. The Primary Causes, are, all such things as produce hot and much Blood in the whole Body which is sent to the Brain; as violent Exercise, the heat of the Sun, heat of the head by Fire, Wrath, and the like: But great Wounds do more usually produce this Disease, as also Contusions. But a Spacelus or Imposthume coming from a Wound or Contusion, is different from the former in this: An Imposthume made by a Fall or Contusion, doth n● possess so many parts of the Brain, but for the most part adhaereth to one. Hence the Symptoms are higher, especially in the beginning, and the Di●e●●e continueth longer. The Signs of an Imposthume or Spacelus, which cometh without a Wound, or Contusion, are these: In the beginning there is a great Headache, which is communicated by the hinder part of the head to the neck and all the back; after which comes a general decay of all the Senses both internal and external, as in an Apoplexy, from which it is distinguished by the Signs hereafter mentioned▪ The Patient is tossed to and fro, and cannot remain in the same place; he layeth hold with his hands upon his head, and desires to tear and scratch his face, plucking his hair: but as the Disease increaseth, his Body groweth faint, and cannot use such violence. A most sharp and strong Fever always accompanieth this Disease, which comes from the great Inflammation of the brain. Lastly, In this Disease, the Patient never takes meat or drink, neither can you take any course to give them any thing, and therefore their strength soon faileth. An Imposthume by a Wound or Contusion, is known by these signs following: After the Wound or Contusion is received, there is a kind of numbness and sadness in the Body, the Animal Spirits beginning to be weakened by the matter which is got out of its Vessel. When the Disease increaseth, there ariseth a kind of Fever, when the matter gins to putrify, thence comes headache and drowsiness: after, when putrefaction is increased, all the symptoms grow stronger, the Fever sharper; the Patiented rising from sleep suddenly roareth out, and then presently lieth down again; he often brings his hand to his head: Hence it is, that many before they die do send forth filthy green matter out of their mouth and nose. As to the Prognostic part thus: This Disease is most dangerous, and commonly deadly, even in three day's space, as Hypocrates showeth in his 51. Aphorism, Sect. 7. saying, That they who have a mortified and putrified brain, die in three days; but if they live longer, they recover. Galen in his Comments teacheth that we are not to understand here by a Spacelus, a complete corruption of the Brain because that is uncurable, but such as is at hand by reason of the great Inflammation. In those which recover, who are very few, there is no remembrance of things past: they can neither remember their Disease, nor any thing concerning it. We must make great haste for the Cure of this Disease, for if we do not apply Remedies in the beginning, there is no time for Cure. Therefore in the first beginning of this Disease we must let blood in great plenty, and very often twice, or thrice, or four times in the same day, as strength will permit: for all the hope of the Cure lieth in this only Remedy; for when a great quantity of blood possesseth the substance of the Brain, which is large, soft, and moist, we cannot make so great a revulsion from thence, except we draw almost all the blood in the veins: and here that common saying of Celsus is to be observed; Many things are done well in time of sudden danger, which at other times may be omitted. You must also give sharp Clysters every day, that the humours which tend upwards may be brought down. At the same time apply those Medicines of Rose Vinegar prescribed in the Chapter of Frenzy. For the greater revulsion and derivation, apply Cupping-glasses to the Shoulders and Back, with deep scarification; use Frictions and Ligatures to the extreme parts: first open the Ankle Veins, than the Forehead, and the Arteries in the Temples; apply Horsleeches behind the Ears, and to the Hemorrhoids; Vesicatories to the Neck and Arms, and other Medicines which we prescribed in the cure of the Frenzy. At last, if the Disease decline, you must apply to the head things that gently resolve; among which, the best is, the hot Lungs of a Sheep newly slain. CHAP. XIII. Of Mania, or Madness. MAnia is Delirium without a Fever, with raging and fury. It is distinguished from a Frenzy, in that there is in a Frenzy an acute Fever, coming from the inflammation of the Brain and its Membranes. But a Mania hath no Fever in respect of its Being; but a Fever may be joined with a Mania, coming from some other cause, but not from that which produceth a Mania. And therefore in a Frenzy▪ a Fever is symptomatical; but in a Mania it is essential, and original, coming from some other cause▪ And ●● is Galen to be understood, Book 3. de loc. affect. chap. 7. where he says, The 〈…〉 which is made of Choler burnt, begets beastial madness, sometimes without, sometimes 〈◊〉 a F●aver. It is distinguished from Melancholy by the symptoms which declare the disease; for Mania is with fury and boldness, but Melancholy is with fear and sorrow. The immediate causes of a Mania according to Galen, is a cold and dry distemper, coming o● black Choler, which is urged with many difficulties. For if there were such a distemper in the Brain that it would disturb the Mind, it should produ●●▪ a Fever, when a less heat than will produce a Delirium, can produce a Fever, as appears in th●● that are inflamed by the Sun. To this Doubt, divers Authors answer diversely: the Answer of the most solid is, That the 〈◊〉 which produceth a Fever must be smoky, that the vapours sent to the heart may cause it▪ and this vaporing heat ought to be in a moist matter, such as is in putrid Fevers: but in a madness the Humours are adust and burnt, so that no Vapours can ar●●e from them. In one word they ●ay, That the heat in a Madness or Mania, is as ●eat in a live coal, but heat in a Fever is as heat in the flame 〈◊〉 ●nd this answer is urged with a strong instance; namely, in a Hectic Fever, there is more consumption of moisture than in a Mania: yet the Fever continueth to the absolute consumption of all moisture, even Radical also, and the death of the Patient. Pla●erus being persuaded by this and other Reasons, supposeth that besides the hot and dry distemper, there is a malignant and venomous quality, which is the chief cause of a Delirium. A great probability for this Opinion is, That a raging from the Mother, comes from Seed corrupted and poisoned in that part. Because Hydrophobia or fear of water, which is a kind or Mania coming from the biting of a mad dog, is caused in any constitution, without the mixture of Melancholy: And the disease which comes from the bite of a Tarantula, is called a kind of Madness: And lastly, certain poisons do cause madness, as is reported of the Brain of a Weesil, and Nightshade: Therefore it is probable that some certain poison bred in the Body may be the chief cause of madness; since malignant Fevers which are very mild, and so sometimes that the pulse and Urine is like to those that are in health, use to produce Deliriums more than burning Fevers without malignity. And Experience teacheth us that Madness happens often, not only in Melancholy men, but also in all Natures and Ages, especially if it be haereditary, or come from Parents: and it is often cured by hot Medicines which have special virtue against it. But we must con●ess that this disease is oftenest in Melancholy people, because that humour is more fit to receive such poison. And Galen seems to acknowledge that malignity to come upon Melancholy in his Comment upon Aphor. 56. Sect. 6. where he saith, That the cause of a Mania is a Melancholy humour, not always, but when it is burnt above measure, or when it is putrified, and hath received a malignant sharpness. There remains yet one dimculty, That mad men can endure the coldest weather naked without hurt, and to be hot externally, which shows an extraordinary heat. But we answer, That this is not proper to all mad folks, for some cannot endure cold, but go as warm as they can. And the other are not disturbed with the external air by reason of Custom, because from custom there is no passion; so we see tender women in Winter go with naked Breasts, which are hot to the touch, albeit according to Hypocrates cold is a great enemy to the Breast. The matter producing this Disease, is contained in the veins and arteries, either of the whole body, or those nearest to the Brain, or in the vessels of the Brain, and in respect of the difference of the place containing, greater or lighter symptoms do arise. Sometimes the matter causing this disease is in the Vessels of the Matrix, as Blood, and Seed corrupted: hence cometh the raging called Furor Vterinus. If the matter offending be in all the Veins, or those near the Brain, there is a continual madness: but if it be shut up only in one part, the disease hath intermission, and comes by fits. The signs by which it is known, sometimes shows the disease to be present, sometimes that it is growing. For the knowledge of Madness to come, first consider the Natural disposition of the Patient, which is choleric, or melancholy. So in Hypocrates, 2. epid. 5. He who hath a Vein beating in his Arm, is like to be mad, and is subject to wrath; but he that hath it moving by degrees, is slow and stupid. Here Hypocrates calleth Arteries by the name of Veins. For he doth not mean a simple, but a violent Pulsation, unto which he opposeth that which is by degrees▪ So that the meaning of his saying is this; They who have naturally a high strong Pulse, great and swift, are inclinable to anger and fury; but they who have a slow pulse, are dull and blockish. Secondly, You must regard the Sex, for Men are more often mad than Women: Which is to be understood of the Original Disease of Madness; for Wo●en are often mad by consent from the Matrix. Thirdly, The Age is to be considered; for Madness comes oftener to young men than to boys and old men. Fourthly, Mark the time of the year; It comes often in Spring, oftener in Summer, most often at the fall of the Leaf, according to Hypocrates and Galen, Aphor. 20, 21, and 22. Sect. 3. In the Spring, the humours bred at other times, and kept all Winter quiet, are moved and stirred, and produce proportionable diseases: In the Summer, much choler, not only yellow, but black is increased in them that are inclined to it, which causeth madness at that time; or else increasing till Autumn, the disease comes then. These Signs are more remote, and show only in general a disposition to this disease; but these following show it to be at hand. Constant pain in the head, watch, short and little sleep, troublesome dreams, cares, and thoughtfulness, frights from small causes, a rash and often fury from none, or the smallest occasion, eyes not enduring light, noise in the ears, an unaccustomed desire of Venery, Nocturnal pollutions often, laughter unaccustomed and without Reason, much talk not formerly used, and sometimes much silence. These show that a Mania is begun. But that the Mania is present you may know by the signs mentioned in the Definition; namely, a Delirium without a Fever, with fury and boldness; divers are the kinds of Dotage or Delirium in divers sick men, and at divers times they come according as the cause is more or less vehement; for some have a rash madness, and seize upon every man they meet, tear their own , sometimes lay violent hands to destroy themselves. Others eaten milder and tamer, and hurt no body, but speak distractedly and ridiculously, sometimes they sing, sometimes they laugh, and have divers whimsies, and symptoms much like those in Melancholy men and fools. And from the variety of those symptoms you may gather the variety of the cause: For immoderate laughter, mirth, and singing, signify that the matter offending is dashed with much blood: but wrath, restlessness, howling, striking, pale and yellow colour in the face, show that choler is in fault: but a furious madness that lays hold on all it meets, and sometimes stayeth them, comes from choler burnt, which is called black choler; but if this black choler comes not of yellow choler, but melancholy adust, the Patient looks furiously, sometimes is long silent, and then breaks forth into earnest discourse; they are unruly and untoward, and sometimes cry and lament grievously. The Prognostic of this Disease is, A Mania is a strong Disease, and continueth not only months, but years, even to death, especially if it be haereditary. All Diseases of black choler are hard to be cured, and this especially, because the Patient will not be ruled, and take their Medicines prescribed. A Mania which comes with laughter, and those light symptoms is easier cured than that which comes with sadness and fury. That the Disease will shortly be cured, appears by Natural Evacuations, by sweat, stool, bleeding at no●e, or hemorrhoids or varixes, or crooked swollen veins appears: whence Hypocrates, Aphor. 21. Sect. 6. if varices or hemorrhoids come to mad men, the disease is cured. Bloodyflux, Dropsy, Tertian Ague, or Quartan happening to a mad man, takes away his disease, for there is a remove of the humours unto the lower parts from the Head, in which they produce a new Disease. For the Cure of this Disease, the matter offending is to be evacuated, reveled, and repelled, the hot Distemper is to be corrected, the Brain and other principal parts are to be strengthened, which may be done by the means following. First, Let blood, out of the vein of the Arm which appears most; but give a Clyster before: the day after bleed again in th● other Arm; and do thus often. For Platerus affirms that innumerable mad folks have been cured by Chirurgeons, and others who have studied the Cure, and have let them blood twenty, or twenty six times; not only in the Arms, but Feet, Forehead, Nostrils, Hemorrhoides, if the veins appear there; and also in the Hand, or Salvatella: This is to be done by degrees, intermitting Clysters, and purging Medicines here prescribed, Cupping Glasses to the Shoulders and Back with scarification, are to be applied after the other veins are opened: as also Horsleeches to the Temples, and behind the Ears. And you must intermix Preparations and Purges proper for the matter offending when you let blood so often; and they must be continued long: for which use are all those which we have mentioned for preparing and purging of Choler, to which we may add these following, as being more excellent and choice. Take of La●is Lazuli, one dram and an half: Diagridium half a dram: the best Turbith one dram: Senna half an ounce: Epithymum, and Cream of Tartar, of each two drams: Cinnamon, and Citron peeles, of each one scruple: Saffron half a scruple: make a powder: the Dose to be given at once, is one dram, or four scruples, with any proper liquor or broth. Take of black Hellebore one ounce: infuse it for three day's space in four ounces of rain water: boil them with a gentle fire, to three parts: ad to the straining of the best clarified Honey two ounces: and take one spoonful in fat broth▪ Or, Take of the Extract of black Hellebore half a scruple▪ Sirup of Violets one ounce: mix them for one Dose. All Medicines made of Hellebore; as the Wine, Syrup, and Oxmel of it are very good against this Disease. Hence it is reported that Melampus the Son of Amythaon the Physician, Cured the Daughters of Praetus King of Greece with Hellebored wine, when by Madness they supposed themselves to be Cows. Antimony in this Disease is not only Commended by Chemists, but also by all Galenists: both in regard it doth discharge Melancholy from the whole Body; and also because the Patients will be easily persuaded to take it. The Dose is divers according to the diversity of the preparation of it. Baths of hot Water are to be often used, and after every Purge. The Order of Purging Medicines for this Disease is as followeth: First give altering Apozems that Purgeth for three or four days together after you have let blood in both Arms. After give twice in a week gentler Potions, or Powders, or a Magistral syrup: but give strong Purges, only twice in a month; letting blood constantly before as is before mentioned. In the time of Intermission, use Baths, preparing Juleps, or altering Broths; as also strengthening Opiates. Besides the vulgar Juleps, this following made of Juices is very profitable. Take of the juice of Borage, Bugloss, and Pairmains, of each three ounces: Fumitory, and Succory water, of each four ounces: white Sugar six drams: boil, clarify, and aromatize them with yellow Saunders: and take six ounces thereof morning and evening. You may make Opiates as followeth. Take of Conserve of Roses, Violets, and Bugloss, of each one ounce: Conserve of Tamarisk-flowers, Clove-gilli-flowers, Cand●ed Lettice-stalks, and Citron-peels cand●ed, of each half an ounce: one Emblick Myrobalon candied, Confection of Alkermes and Hyacynths, of each three drams: the Powder of the Electuary called Diamargariton Frigidum, and Laetificans Galeni, of each one dram: Coral and Pearl prepared, of each half a dram: with the syrup of sweet-smelling Apples, make an Opiate, of which let him take the quantity of a Chestnut, drinking after it a little o● his Julep, or of some other proper liquor. Tablets also may be made in this manner: Take of Confectio Alkerm●● two drams: Species de Gemmis, and Diamargariton Frigidum of each half a dram: Sugar dissolved in the juice of Apples, four ounces: make Tablets of the weight of two drams, and give one for a Dose. Sometimes we may try Specifical Medicines, and Annulets, or things to be hanged about the Neck; of which sort Sennertus hath many: but we will mention only one which is in a Noble Family of Montpelior, is accounted as an Hereditary Secret: which is this, Take of Balm-flowers one handful▪ chop them small, and infuse them in four ounces of the spirit of Wine: then add of prepared Pearl half a dram: mix them, and give two spoonfuls at à time▪ while you use these things, you must with all possible art procure sleep by Medicines both internal and external; such as you have for the Cure of the Frenzy. And besides external sleeping Medicines, you must apply such Remedies outwardly to the head, which may temper and allay the vehement heat and fury thereof. And these must not only be cooling, but also more moistening and (in the beginning of the Disease) repelling. Therefore in the beginning, Oil of Roses, Violets, Dill, and Chamomil are very good: After you must leave out the Oil of Roses: but when you will Cool more, you must add the Oil of the Cold Seeds and Poppyes. And lastly, that they may be brought into the form of a Lineament, you may add Butter, or the Mucilage of Linseed, or Fenugreek. An Epithem thus made, is very good. Take of the water of Water-lilies, one pint: Sal. Prunella one ounce: Camphire one scruple▪ mix them, and apply double dipped therein, to the forepart of the Head. And Epithem of Sal. Saturni, or Salt of Lead with Rose-water, is very profitable. As also that which is formerly mentioned, made of Rose-water, red Saunders being infused therein, with Musk and Camphire. The Chemists prefer the Balsam of Lead, and anoint the Head therewith, as with a Lineament. But in the height of the Disease, it is very necessary to apply some Creature newly killed, or some part of it; and especially a sheep's Lungs; which must be warmed again in hot water after it is grown cold. Some use stronger Discussients in the declination of the Disease, and also in the vigour of it after sufficient evacuation; this following Fomentation is of wonderful Virtue. Take of the Head Herbs with their flowers, as many as you think fit, boil them in Spring water: then take of Bay-berries, and the Roots of black Hellebore, of each as much as will suffice: beat them grossly, and sew them into a long Bag, and then let it boil in the Decoction before mentioned. Afterwards for Nine days together, Take Two Pints of the Decoction, and Foment the Head being shaved, with double Cloat●s for the space of an hour: after apply the Bag to the Coronal Suture, bin●ing it about with linen . Let the Patient lie down, and rest if he can: then will he Purge by all the Emunctuaries of the Brain, and also somewhat by stool; so will the filth sticking to his Skull and Brain be wonderfully dissolved, which few other Medicines can perform. Lastly, Apply a Cautery to the Coronal Suture, which is much approved by Gordonius, who confirms the benefit of it by the Hist of a certain Madman; who had a wound in his Head, with a Fracture of the Scull; and was ●●●y well as long as it was Open, but still when it was Healed, grew mad again. Although the Brain be principally affected in this Disease, yet other parts are to be altered, especially the Heart and Liver, with Epithems and Liniments prescribed in the Cure of the Frenzy. CHAP. XIV. Of Melancholy: Melancholy is a Doting or Delirium without a Fever with fear and sadness. It is distinguished from a Frenzy by want of Fever; and from Madness, by Fear and Sadness, because that comes with Fury and Boldness. We say this Disease hath no Fever: namely, of its own nature of itself: but a Fever may Accidentally be joined with it: For nothing hindereth, but a continual or intermitting Fever may happen to one in this Disease; but this Fever will not be essentially in it, as in a Frenzy, where a Fever is essential to the Disease. But we may doubt how Fear and Sadness may be said to be of the essence of Melancholy: when we perceive that in many Melancholic people there is much laughter and appearance of joy. For some laugh, some sing, some think themselves to be very rich Kings and Monarches. We Answer, That there are divers degrees of Melancholy, and divers mixtures of Melanchollick humours with others; from whence come varieties of Passions, so that they who have much blood or phlegm mixed with Melancholy, may have joy and Cheerfulness: but that Disease is not at that time a true Melancholy, but is more like foolishness. Also great variety of Doting ariseth from the various disposition of the Melanchollick humour: Hence it is that some think themselves to be Kings, Princes, Prophets: Others, that they are made of Glass, or Potters-Clay; or that they are barely Corns ready to be devoured by the Hens▪ Some think they are melting Wax, and dare not approach the Fire: Others, That they are Dogs, Cats, Wolves, Cuckoos, Nightingales, or Cocks, whose voices they imitate. Others fancy themselves dead, and will neither eat nor drink. Others dare not piss lest they should drown the World by a second Deluge. Some think they have lost their heads, or some other Member, or that they carry the world upon their finger's end, or that they have Sparrows in their heads, or Serpents, Frogs, Mice, and other Creatures in their Bellies. The immediate Cause of Melancholy (that I may use the words of Galen) is a dark spirit or vapour very black; for when the Animal Spirits ought in their own Nature to be pure, thin, and transparent for the cheerful performing of the actions of the Brain, and to cause cheerfulness, if they change their constitution, and become dark and obscure, they produce sorrow and fear. Galen in his 2. the sympt. cause. chap. 6. by an Example borrowed from external darkness, doth explain the matter: Of those things (saith he) which are without the Body, we see nothing that doth more terrify us than darkness; therefore when darkness doth encompass the rational part of man, it is necessary that that man should exceedingly fear who doth always carry about with him, another cause of fear, besides that which is external. The cause of this e●il disposition of the Spirits, is a Melanchollick humour, which being possessed with thickness, darkness, and blackness, doth infect the Spirits, and makes them cloudy and dark. And this Melanchollick humour is cold and dry, and therefore proper for fixing and condensing of the Spirits, which fixing and condensing or thickening of the Spirits must needs cause sorrow and heaviness. For if the humour be thin and hot, as is black choler (from which comes madness) it doth rather produce fury and boldness than fear and sorrow. Therefore the immediate cause of Melancholy is thickness and darkness of the Spirits Animal; but the necessary condition, and without which it cannot be, is a cold and dry distemper. But if any shall instance of an Hypochondriack Melancholy from Galens third Book de locis affect is, chap. 7. that it is an inflammation in the Hypochondria, and therefore the hot distemper doth prevail. We answer, That that Inflammation or burning of the Hypochondria, comes from the heat of blood long retained in the spleen and Meseraick Veins by reason of obstructions, from whence many vapours are sent up into the Brain, which though they be hot, yet are overcome by the coldness of the Brain, and are easily brought to a cold and dry temper which is proper to Melancholy. But if the heat of those vapours be such, that they spoil the temper of the Brain, and make it hot and dry, then comes Madness and not Melancholy. So that in Madness or Mania, and Melancholy, there is this difference; That in the first, namely, Mania, there is a hot and dry distemper; In the other, called Melancholy, a cold and dry distemper. The former mentioned darkness of the Spirits confirmed by Galen, is rejected of Averro, in this respect, Because darkness brought upon the Animal Spirits, and the black colour of a Melanchollick humour cannot infect the internal Senses; according to that vulgar Axiom, There is nothing in the Understanding which was not first in the Sense; therefore since that black colour, or internal darkness was not first represented to the eyes, it cannot be perceived by the internal Senses. We answer, That the blackness of a Melanchollick humour, or the darkness of the spirits doth not affect the internal Senses under the notion of colour; but as they are somewhat besides Nature in the brain hindering its actions. For the Animal Spirits for the perfect performance of the Actions of the brain, aught to be pure thin, and clear: But if (on the other side) they be impure, thick, and dark, they hinder the actions of the brain by infecting the species which are sent thither, even as a coloured glass doth represent the species of the object to the eye with its own Tincture. A cold and dry distemper, which is propounded for a necessary condition to this disease of Melancholy, may be opposed by this Argument taken from Avicen in Fen. 1. Lib. 3. Tract. 4. Chap. 18. he saith, That Stammerers are for the most part Melanchollick. But these Stutterers are very moist in temper according to Galen, Comment. Aphor. 32. Sect. 6. where Hypocrates saith, That Stammerers are most subject to looseness: And Galen thereupon saith, That Stammerers have the moistest temper, as appears in children who are most subject to looseness. We answer, That Avicens Text is not to be understood of those which are true Stammerers, which cannot pronounce the letter R. of which Hypocrates and Galen spoke in the Aphorism aforesaid, who are of a moister temper: But of those which are called Trauly and Stutterers, which repeat the same syllable very often before they can pronounce a whole word: Which comes from their headlong fancy, when they strive to speak very quickly, for then the tongue foldeth its self, and is constrained to stop and stay in the production of Words. And these Stutterers are of a melanchollick temper. Lastly, It may be doubted, how darkness of the Spirits should be an immediate cause of a melancholy Delirium, when every hurt action depends immediately upon some disease; but this tenebrosity or darkness can be referred to no kind of Disease. We answer, That tenebrosity or darkness, is a Disease in number, by reason that the coming thereof doth increase the number of those things which are necessary in the Brain for the performance of animal Functions. And the instance which may be brought against this Argument, namely, That a disease is an affect of a true part, is answered in the Treatise of Vertigo. The Proper signs of Melancholy, are propounded in the definition, namely, Fear, and Sorrow, without any manifest Cause, which are found in every kind of melancholy. But the several sorts of melanchilly are known by their proper signs. So these following signs do show that melancholy doth only▪ reside in the head, namely, an evil habit of the Brain, or hot Diseases going before, by which the blood contained in its Veins, is torrefied and burned, and at last brought into a melanchollick humour. Short and interrupted sleep, troublesome dreams, giddiness, noise in the Ears, and no symptoms from other parts, and especially from the belly. That this Disease cometh from the whole Body, appears by a melancholy habit of the whole body; either Natural, known by a black colour, roughness, and leanness; or acquisite, coming by cares, labours, watch, course diet, and the like. That it comes from the Hypochondria, these signs declare; Heartburning with no thirst, often spitting, sour belchings, and windy, eruptions upwards and downwards, rumbling of the guts, pain and heaviness of the midriff, perplexity, nauseousness, sometimes insatiable appetite, heart-beating, sometimes a swelling in the Hypochondria: And other signs which shall be shown more at large in the Discourse of Hypochondriack Melancholy. That this Disease comes from the womb, may be known by those which are set down in their order for the declaring of Hysterical Diseases. The Prognostic of this Disease is thus: The Disease is dangerous, if Chronical, of long continuance, and very fixed: For a melanchollick humour, especially that which comes by adustion, and inclineth to black choler, contemns the force of Medicines, if weak, and opposeth the strongest: whence a melanchollick humour is said to be the scourge and disgrace of Physicians. But a new sprung melancholy coming of immediate Causes, is easily cured: For Galen reports in his third Pook, de loc. affect. chap. 7. That he hath often cured a melancholy in the beginning with only Baths of sweet Waters. The Hemorrhoids, or Piles coming upon melancholy men, sometimes bring cure, if the humours be cast down thither critically by Nature: For sometimes they come symptomatically, and multiply the matter of the Disease in many parts. Sometimes it is cured by flux of the Hemorrhoids, by Scabs, Itch, or other diseases breaking forth of the Skin. As to the Cure of it, from whencesoever the Disease took its original, we must observe always two things: First, That the whole Body be freed from a melanchollick humour, and the filth of other humours; for it seldom happens that one part alone is troubled with it. Secondly, That the main Cure be directed to the Hypochondria, because that in the spleen and liver there is the first generation of Melancholy, and the gathering of it is in the parts thereabout; therefore the Cure of Hypochondriack Melancholy set down by us, will serve for the Cure of other diseases of Melancholy: for you can scarce cure the Hypochondria from the abundance of any humour, and the generation of any new, but by consequence the whole body must be cured of the same. Therefore for all diseases of Melancholy those Remedies will suffice which are propounded in the Cure of Hypochondriack Melancholy. CHAP. XV. Of a Catarrh, or Defluxion. A Catarrh is a preternatural Defluxion of an Excrementitious humour, from the head into the inferior parts. It is therefore a Symptom of the third kind, namely, a fault in the Excrements. The substance of the Brain being large, needs much nourishment; of whence comes necessarily abundance of Excrements, especially by reason of the cold and moist distemper of the part: which excrements if they have only their moderate and natural quantity are received into the fore Ventricles of the Brain, and are sent by the Choana, as by a funnel to the moist Glandels, and so are spit forth every day from the ; but if they grow more plentiful, and yet consist in their Natural condition, they are dispersed about the Brain and the meanings, and so are sent forth, not only by the , but also by the nostrils. But when the Brain is affected with distemper and weakness, or is constrained to receive too much and disproportionable nourishment, which it cannot sufficiently concoct, there is a great increase of excrements. Add further (as Hypocrates saith) that the Brain like Cupping-glasses applied to the Body, never cease to attract humours and vapours from the inferior parts; hence the excrements are increased, which by their quantity and quality provoking the expulsive, and overcoming the retentive faculty, run immoderately by unusual and improper ways which they find out, to the great disturbance of the Body. Since then a fluxion is the motion of matter from one part to another, we must consider in that as in all motions, five things. The Terminus, or place from whence the place to which it moves; the Mover; the Moved; and the ways by which it is moved. The place from whence, is the Brain; the place to which, is some part beneath the 〈◊〉, the selover, is the expulsive faculty stirred up, or the retentive weakened; the thing 〈◊〉 is an excrementitious humour▪ the way by which is the , Nostrils, Eyes, Ears, and in e●●ble passages, as also the Veins, Arteries, and Nerves. In the place from which, or the part which sendeth forth, we may observe two kinds of Causes: One is that which begetteth much moisture in the Body; the other is that which make the humours flow: That is called the generating, this the expelling Cause. The generating Causes 〈◊〉 the hindering of Concoction, which comes either from the fault in the nourishment, or in the faculty. The Concoction of the Brain is hindered chief from distemper, either cold or hot. A cold distemper causeth that the Nourishment brought to the brain, is ill concocted and turned into phlegm; as also that the vapours brought from the inferior parts, are not sufficiently discussed, but are turned and condensed into Water. But a hot distemper doth attract more plentiful nourishment and vapours, so that Nature cannot sufficiently discuss them. The Concoction of the brain is hindered through the Nourishment, either when there is too much, or when it hath evil qualities; so cold, gross, and slimy meats and drinks immoderately taken, cannot be perfectly concocted, and make the Brain crude and moist. So sharp and windy nourishment send many vapours to the head. To these you may add external Causes, which use to fill the head with superfluous humidity▪ as Southernly Air, long sleep, especially at noon, an idle life, and the like. Although the Brain be called the chief sending part, yet it is not always the chief cause of defluxion; but for the most part, the matter is sent from other parts to the Brain: for after evil humours are collected, either in the Veins, or any peculiar part, as the Liver, Spleen, Mesentery, Womb, not only many Vapours are sent from them to the head, but also the humours themselves are carried to the head, and descend again to the inferior parts▪ and the fault lieth most in the inferior parts in the breeding of a defluxion, whose distemper is divers, and the Obstruction also divers. For a hot distemper of the Bowels, makes abundance of vapours, from which comes defluxions, as in a Still or Alembick: But a cold distemper by weak concoction begets crude humours, which upon the least occasion ●ly to the brain. But the Obstructions of the parts of the lower belly, hinder the voiding of Excrements, whence it comes, that they being increased by degrees, when they cannot find their free and ordinary course fly up to the brain. And to this doth also concur the weakness of th● brain, fit to receive these Excrements, for (as we said) the stronger parts to disburden themselves upon the weaker, and it often happens that the brain by reason of its soft and lose substance is weakest, and can less resist than solid and compact substances. The impulsive causes are, too much heat of the brain, or coolness, or some concoction of humours: Too much heat doth extenuate and diffuse the humours contained in the brain, and opens the pores by which they use to flow: such is the heat of the head with the Sun or fire, or too much covering, smelling of hot Spices, and other passions. Coldness doth compress the brain, and strains forth the humours therein contained, as a Sponge is squeezed in the hand: Such change is often in Winter, and especially in sudden alteration of Air; as when a Southern wind hot and moist, is turned into a North wind cold and dry; or when one going out of a hot place, comes speedily into a cold. To these Causes you may add coldness of the feet, which by sympathy is communicated to the Brain. Many there are who deny the aforesaid compression of the brain by cold, because cold doth incrassat and condense the humours, and makes them less apt to flow; neither doth the example of a Sponge prove any thing, which will not empty its self in the Air. But this Opinion delivered by Hypocrates in lib. de loc. in homine, seems to be true; Fluxions (saith he) come of cold, when the flesh and veins of the head, are extended: for those when the head is cold and contracted, bound together, and excluding, do strain forth moisture. And also the flesh doth assist them, and the hairs are on end, as being every where strongly pressed, and therefore whatsoever is strained from thence, falls where it is occasioned. From whence is manifest, That a Coarctation and compression of the Parts may be made by cold, and from thence a humour may be expressed. Neither doth it hinder that densation or thickening of humours which is made by cold, as was said; for it may be so when the whole body is equally cold. But when the external parts are offended by sudden cold, they are presently straitened, and strain the humour contained. Of less force is that Argument against the Sponge, that it is not expressed by the cold Air; for there is another Reason to be given of living parts, whose heat and spirits fly from the sense of cold, and cause the parts wherein they are to be contracted; which cannot be in a Sponge full of Water. Yet we must confess, that this is not the only way by which a Defluxion comes through cold; for cold of the feet will produce a Catarrh by communicating a cold distemper to the brain by the chiefest Nerves that come through the marrow of the back bone; and this coolness goes into the innermost parts of the brain, not the external, as cold air, which affects the head immediately: therefore we may rather think in this case, that the retentive faculty of the brain is weakened by cold of the head, so that it cannot contain the superfluous humours which are many, but lets them flow forth. There is also another way very usual, by which a Catarrh of a cold cause cometh, namely, The stoppage of the external pores, especially in the time wherein the body requireth most sweat: Hence it comes that men very much inflamed, running suddenly into the cold air, are troubled with Catarrhs. So Catarrhs comes to be most frequent in Autumn, because the Body being made thin, and the ports opened in the Summer, casting forth many excrements by insensible transpiration, if they be presentsently stopped by contraction of the body with cold, do cause humours and vapours to fly into the head, and centre of the brain, So about the beginning of Autumn there are not only Catarrhs, but also abundance of watery humours are sent forth by most men in their urine, and by stool, which cause fluxes of the Belly at that time. But if any ask why defluxions do not last all Winter when by reason of cold the pores are always stopped? We answer, That Nature doth in Winter discharge herself by other ways rather than by sweat, namely, by stool, urine, and spittle. How great that Evacuation is which is usually by insensible transpiration or sweat, is pleasantly taught by Sanctorius in his Book de Statica Medicina, where he saith, That it is larger than all the sensible Evacuations put together: so that if the meat and drink of one day be eight pound in weight, the insensible transpiration will be five pound: he is very curious in this matter. What light he hath left to the finding out of Causes, and Curing Diseases, I leave to be judged by the Learned. In the part receiving, you must consider the imbecility, or other disposition to receive and attract defluxion. In regard of weakness, it is an usual saying among Physicians, That the stronger parts do always lay their superfluous burden upon the weaker; as in Commonwealths, the Great Ones lay the chiefest burden upon the poor Commons. Now the weakness of the parts is either Natural, or Adventitious. A Natural weakness comes from the softness and looseness of the parts from the Glandles and Lungs, do easily entertain defluxions: But an Adventitious weakness, is from a distemper, or from solution of continuity. A cold distemper by weakening the Native heat causeth the part to have less power to resist the humour flowing unto it. And also a Solution of continuity or wound, makes the part more fit to receive defluxions by its weakness; hence arose the use of Cauteries or Issues, because the part being thereby weakened, the humours do flow from other parts unto it. And so the Lungs being ulcerated receive the humours from the head, and from all other parts. Among other dispositions for the attracting of a defluxion, heat is chief to be reckoned; for we may observe, that parts inflamed do plentifully attract humours. So in a Consumption, many humours are drawn from the head to the lungs, not only by reason of the ulcer, but also by reason of the inflammation. Whence Hypocrates speaking of a Phthisis or Consumption in his first Book of Diseases, saith thus: The Lungs being inflamed draw humours from the whole Body, and especially from the Head; and the Head being made hot from the Body, spits forth that thick matter. There are two ways by which the humours are carried from the head into the inferior parts, either internal or external: The internal way is when the humour flows from the parts under the Skull, chief from the Ventricles of the Brain, and makes divers diseases and symptoms according to the diversity of the parts receiving, of which some have peculiar names, according to those vulgar Verses in Schola Salerni: That Rhewm is called Catarrhus which doth fall Upon the Breast; upon the Jaws we call It Branchus; Coryza through the Nose doth fall. When the Humour flows upon the Breast, the Disease keeps the general name of a Catarrh, or Defluxion; when it falls upon the Jaws, and Aspera Arteria, or rough Arteries, it is called Branchus, Raucedo, or Hoarseness; when it flows into the Nostrils, it causeth not only a Coryza or Murrh, but Ozaena and Polypus. But in other parts it produceth various effects; if it fall upon the Nerves it produceth a Torpor or Numbness, a Palsy, Convulsion, Trembling: if in the Ears, Deafness, Swelling; if in the Eyes, Ophalmy, or Inflammation, Tears, Blindness; if upon the Uuula or , Swelling, Looseness or Laxity, or Ulcer; if in the Throat, the Squinzy; if on the Lungs, the pleurisy, Inflammation or Imposthumation, Cough, shortness of Breath, spitting of Blood, Consumption; if into the Stomach, Vomiting, want of Appetite; if into the Bowels, it causeth Diarrhaea, and Dysentery: therefore it is rightly conceived that the greatest part of Diseases that trouble man's Body, have their original from the Head. Moreover, Sometimes the humour flows from the Brain with the blood into the veins, whence comes the Disease called Febris Catarrhalis, when Nature is strongly moved to expel the superfluous humour, and the Spirits being thereby much disturbed, are inflamed, and cause a Quotidian Fever: hence it is that a defluxion is reckoned among the causes of a Quotidian Fever. And always before the coming of the Joynt-gout or Inflammation called Erysipelas, such a Fever doth proceed. The external ways by which the humour flows from the head, are those which are without the skull under the skin; and Fernelius supposed that the humours which chief carried between the flesh and the skin, although by the continuity of the Muscles, Membranes, and Nerves, as also the Veins and Arteries, the humours use to flow into the Eyes, Teeth, Jaws, Neck, Shoulders, Joints, and other external parts. Some Authors make difference of Catarrhs, which are these: Some are called Ferini, or wild; some Suffocating; some Epidemical, or common. A wild violent Catarrh is that which by its sharpness ulcerateth the Lungs, and brings a Consumption, and it comes of a sharp and salted humour rising from a hot Liver, and sent into the brain, and from thence into the Lungs. A Suffocating Catarrh, is when the humour flows violently into the hollow of the Lungs, and is still renewed to the danger of strangling. Lastly, An Epidemical Catarrh hath a malign quality, and is common among the people, and comes from the corruption of the Air. The Knowledge of this Disease, is from three signs: of the Subject, of the Disease, and of the Cause. The Subject, or Body apt to fall into a Catarrh, is known by the slender Fabric of it, easily pierced with either hot or cold air; as also by the too compact Fabric of it, which hindereth a free transpiration: as also a weak and cold brain, which cannot discuss the vapours which are sent unto it, or sufficiently concoct its own nourishment: also a hot brain that attracts too many vapours: also the contrary actions of the Stomach and Liver, when one is hot and the other cold. The Signs which show the Disease, either declare it to be coming, or present. The aforesaid Causes show it to be coming; but especially, heaviness in the head, dulness and numbness of the Senses, long sleep, much snorting, a snotty nose, and more spitting than usual, costiveness of Body, and abundance of wind. The signs of a Catarrh present are manifest, for either the humour flowing from the brain, is plainly seen, or the swell and pains which it produceth in divers parts. The signs of the Causes are also evident; for if a Catarrh come of a cold humour, there will be sense of cold, paleness of face, sweet spittle, sour belchings, slimy matter, or watery, and a general phlegmatic habit of Body. But that the humour distilling is hot, appears by redness of the face, thirst, saltness and sharpness in the mouth, inflammation, pain, and ulcers in the parts affected, and a choleric habit of the whole Body. An external Defluxion is known from an internal, in regard the pain is more external in the former, especially under the skin of the crown of the head, where sometimes you may perceive a soft tumour; often a painful combing back of the hair: and many times the humour is felt to fall down upon the outward parts with great pain, heat or cold. The Prognostic of this Disease is elegantly laid down by Cornelius Celsus, in these words: If the humour flow from the head into the nose, it is small; if into the jaws, it is worse; but if upon the Lungs it is worst of all. But Hypocrates saith, That a Catarrh is very hard to be concocted in those that are very old. Where there is a great plenty of humours, either from repletion, or from evil Concoction: there is a dangerous Catarrh, for it is to be feared lest the humour flow suddenly, and cause Suffocation, or some other grievous accident. The Cure of this Disease is twofold; The one is of the Cold, the other of the Hot Catarrh. The whole Cure of a cold Catarrh consists in the preparing and evacuating of the humour off ending, and in the revelling of it if it flow to the breast, or other part, and the stopping of its motion; and after let the distemper of the brain be amended. First then, If the matter be much, and flow very violently, and we fear lest it flow also from other parts, especially if the Liver be hot (for it is often seen, that men subject to Catarrhs, have a hot Liver, and a cold brain) we must breathe a Vein; but if the matter be but little, and move gently, and the party be aged, and the temper of the Liver not hot, so that there is no suspicion for humours to be sent to the brain from any other parts, you may omit Phlebotomy. The matter offending is first to be diminished with a Potion or Pills, or other Purging Medicine, mentioned in the chapter of the cold distemper of the Brain. Afterwards the remainder of the humour is to be prepared with an Apozeme, there also mentioned; or if you fear not to disturb the humour too much, you may give a purging Apozeme, and at last make a complete Evacuation with stronger Pills, or other Purges. If the Catarrh be very strong, you may give that which will powerfully root out the Matter. Coloquintida is very excellent for to purge the Brain strongly; but it worketh very violently, and is offensive with its bitterness: both which faults are corrected by steeping it in Urine; for so it lays aside its bitterness, and becomes almost without taste, and also is so gentle that it may be given to the quantity of a dram safely, and it is a most gallant Remedy for all cold Diseases in the head. It sometimes happens that Excrementitious Humours sent from the parts beneath into the brain, produce a Catarrh: and they find a preternatural course that way, by reason the natural course by which those humours use to be evacuated is stopped; and then the Catarrh is best cured by opening those ways with gentle, mild, and constant purging, that the humours flowing upwards, are so sent downwards, and by degrees brought to their proper motion. And these gentle Purges may be made of Decoctions or Broths long continued; but in the mean while you must not neglect strengthening Medicines. For Revulsion, apply Cupping-glasses and Vesicatories, or things to cause blisters, to the neck and shoulders, and make issues in the hinder part of the head and arms. Zacutus Lusitanus in lib. 2. Praxis admirandae, observat. 160. commends Issues behind the Ears for the best remedy against all distillations from the head: And we have seen good success by them, especially in defluxion upon the Eyes. You may use Errhines, Neesing, Gargarisms, and Masticatories; but with this Caution, That you use Errhines and Neesing only when the Catarrh falls upon the Jaws, Lungs, and Stomach; but when it falls into the Eyes or Nose, use Masticatories and Gargarisms. The forms of all these Medicines were set down in the Chapter aforegoing. But observe in the use of them, that when the matter is somewhat thin, you use not strong discussients and dissolvers, for by these you shall cause the humours to flow more violently upon the Breast, Lungs, or other parts; but you must mix some thickening things that may constrain the humour, as red Roses, Mastich, Coriander, Nutmeg, and other things which we shall declare more at large in the hot Catarrh. You may make an Errhine for this purpose as followeth: Take of▪ Marjoram Water four ounces: the Juice of Bettony one ounce: Nigella or Gith seeds powdered, half a dram: Nutmeg one scruple. For rich people you may add two grains of Musk and Ambergris. Or, Take of Lignum vitae one ounce: Spring Water one pint: Infuse it all night upon warm embers; then boil it to the consumption of half, adding in the conclusion, sweet Marjoram, and red Rose leaves, of each two pugils. So when the matter is but thin, you may make a Masticatory, either of Mastic alone, or after this manner: Take of Nutmeg one dram: Mastich, and Gum Arabic, of each half a dram: Powder them, with Rose water make Troches to chew. The best Sneezing is made of black Hellebore, and Sugar, equal parts. The Extract of Tobacco made in Aqua vitae, and held under the tongue in the bigness of a Pease, brings forth abundance of Water; but if you take too much, or swallow it down, it will cause violent vomiting. We have showed that Cauteries to the Arms, hinder part of the Head, and behind the Ears, are very good, as also to the nape of the Neck, and Shoulders, which are now adays in great request. But there is a new place found out by some, namely, in the Neck, near the Jugular veins, between the Muscles: And by this means two men have been cured of old Catarrhs which caused hoarseness. Finally, After convenient Evacuations, things that strengthen the Brain and dry it, are to be used both internally and externally, as Opiates, Powders, Bags, Fumes,, described in the Cure of the cold distemper of the Head. But you must remember to put unto them some Conserve of Roses, Nutmeg, or white Frankincense, when you cure a Catarrh. The Decoction of Mastich Wood used as a Sudorific, dries the Brain, and stops Defluxions. For which, the following things are good. Take of Coriander seed prepared half an ounce; Nutmeg and Frankincense, of each three drams; Liquoris and Mastich, of each two drams; Cubebs one dram; Conserve of red Roses one ounce; white Sugar dissolved in Rose water ten ounces: Make a Confection in little rolls, weighing three drams. Let him take one morning and evening. These following Troches are much commended by Solenander, Cons. 10. Sect. 4. which he borrowed which he borrowed from both the Ancient Greeks and Arabians. Take of the best Frankincense and Juice of Liquoris, of each one dram: Opium, Saffron, and Myrrh, of each one scruple: With Syrup of Poppies make Troches, or Pills to be taken now and then, two scruples, or half a dram at a time. These Tablets following are very good: Take of Diambra, and Diamoschi dulcis, of each one dram: white Amber one scruple: Oil of Annis seeds, three drops: Sugar dissolved in Lavender Water, four ounces: Make Tablets of two drams in weight; take one morning and evening. The Balsam for the Head prescribed in the Chapter for the cold distemper, after the Opiate is excellent taken inwardly, and into the nostrils. Lac Sulphuris, and the flower of Brimstone are commended by Chemists for the Cure of a Catarrh: and the Galenists use it much in Tablets. In a new Catarrh, Water of Nuts, with Hydromel, given three nights together doth much hinder it. Shave the fore part of the head, and apply a Cataplasm, of two ounces of Leaven, and two drams of Amber: But if the Patient will not permit his head to be shaved, let it be cut, and lay a bag of Chamepits or Groundpine, mixed with Amber. Besides the afore mentioned Fumes, one made of Tacamahaca is excellent; for it dries a Catarrh, and hinders his Motion; neither is the scent too strong, but the Patient may shut it into his chamber without offence. It is profitable to dry the Head with bags of Bran, Gromwel, and Salt, Leaves of Sage, Bettony, French Lavender, Annis seeds, Fennel seeds, and the like. Lastly, If the Disease be stubborn, all those Medicines which are mentioned in the cold distemper of the head, are to be used. A hot Catarrh is Cured by Medicines which discharge the matter offending, and which do thicken it, and revel it; as also by correcting the distemper of the parts, sending and receiving it. For this end, first let blood, if nothing hinder, by which the humour flowing is reveled, and the sharpness abated. Then carry away part of the humour by a gentle Purge, which may no ways stir violently the humours, as followeth: Take of the best Rhubarb, four scruples: Citrine Myrobalans rubbed with the Oil of sweet Almonds, half a dram: yellow half a scruple: Infuse them in Lettuce and Purslain Water, and strain it, adding of Manna and Syrup of Roses Solutive, of each one ounce: Make a Potion. Or instead of the Waters afore mentioned, you may make a Decoction of cold Herbs, and Tamarinds; to which you may put your Purgatives. Then you must alter and thicken the humour with convenient Juleps. Take of Lettuce, Purslain, and Plantain, of each one handful: the four great cold Seeds, white Poppy seeds, of each two drams: Violets, Water-lillies, and red Poppies, of each one pugil; boil them to a pint: Dissolve in the straining, the Syrup of Violets and dried Roses, of each one ounce and an half. Make a Julep for three draughts, to be taken twice in a day. Or instead of this Decoction, use the distilled Waters of those Herbs, or Emulsions of the four great cold Seeds. After use a little stronger Purge, putting to the former, Senna, or Catholicon, or Diaprunes, or the like. A light sweet Medicine, thickening and sweetening the humour, is made of the Yolks of two new laid Eggs, dissolved in five or six ounces of spring Water with one ounce of Sugar; heat them well, and stir them upon the fire, and take it as hot as you can morning and evening for three days together. And at last you must labour for a stronger restraning of the flux, and thickening of the humour with this Syrup. Take of Syrup of Violets and dried Roses, of each one ounce: Syrup of Poppies half an ounce: Give an ounce at a time in a spoon at Bed time. The following Opiate is good for the same purpose. Take of old Conserve of Roses six drams: the species of Diatragaganth frigid. two drams: Bolearmenick washed in Rose water, two scruples: With the Syrup of dried Roses make an Opiate. Take the quantity of a small nut at night▪ This Barley Cream is very profitable. Take of cleansed Barley as much as is sufficient, steep it six hours, and then boil it well, and strain it; then take three ounces of blanched sweet Almonds; Pompion seeds husked, one ounce and an half; Melone seeds one ounce; white Poppy and Lettuce, of each half an ounce: Beat them together, and with Barley Water take out the Milk, which with two pound of the Pulp of Barley boil a little and mix it with Sugar: Let him drink ten ounces at a time, some mornings in his bed, and sleep after it, and sometimes in the evening. Hold the Troches in the mouth. Take of Gum Traganth, and Arabic, of each two drams: Bolearmenick, and Terra Sigillata washed in Rose water, of each one dram: white Poppy seeds, and juice of Liquoris, of each half a dram: Sugar Penids one ounce: With the Mucilage of Quince seeds, extracted with Rose water, make little Cakes to be held in the mouth day and night. The Spirit of Sulphur and Vitriol, three or four drops given morning and evening in convenient Liquor, hath great force against all Catarrhs, especially against those which come from Inflammation of the Bowels: It may be given in drink in a smaller quantity, for it goes with the drink through all the veins, and hinders the motion of the humours. The Crystal Mineral is for the same use given with Juleps and other Medicines. When these do not avail, we must be constrained to use Narcoticks or Stupefactives: Among which Laudanum is the best, given to four or five grains at bed time; or one ounce or half an ounce of Syrup of Poppies: These do wonders being used in the beginning of the Disease. New Treacle given at night from a scruple to half a dram, hath the same force. Benedictus Faventius useth the following Pills in a Salt Catarrh with good success. Take of the Juice of Liquoris two drams: washed Aloes one dram: Filulae de Cynoglosso, half a dram: With Syrup of Violets make a Mass, of which take a scruple at bed time. The Troches of Solenander before mentioned, are excellent. Diacodium album prescribed in the Cure of the Frenzy is good for this. In the mean while the matter flowing must be reveled by Clysters, Cupping Glasses, Frictions, and binding of the external parts, and chief by Vesicatories in the Neck, and finally with Issues in the hinder part of the Head and Arms, if the Catarrh be old. But for the strengthening of the Head, and stopping of the fluxion, and consuming the remainder; Powders, Bags, and Emplasters, are good. Take of white Amber, Sandarach, Mastich, Benjamin, Nutmeg, of each one ounce: Frankincense, Grains of Kermes, and red Roses, of each half an ounce: all the , Myrtles, and Pomegranate flowers, of each two drams; make a Powder. Use it to the Head at night, and 〈◊〉 it off in the morning. Take of the Gum of Juniper two scruples: red Roses two pugils: Myrtles one dram: Mace and Nutmeg, of each one scruple: Frankincense, and Peony seeds, and Poppy heads, of each two scruples: Cyprus nuts half a scruple: Powder them, and take them up with red wool, and with a red cloth make a lining for a Cap to wear constantly. Take of Mastic and Frankincense, of each half a dram: Sandrach, red Coral, red Roses, Myrtles, Pomegranate flowers and Peels, of each one dram: Labdanum two drams: Wax and Oil of Roses, as much as is sufficient. Make an Emplaster for the Coronal Suture. But because this Catarrh for the most part comes from a hot distemper of the Liver, therefore you must use Medicines to that. Finally, This is most remarkable, which is also mentioned in the Cure of a cold Catarrh; That Excrements use to cause Catarrhs by flowing to the Head when their usual natural passages are stopped: And then a Catarrh is best cured by opening those passages with a gentle and constant purging in Broths, or the like. CHAP. XVI. Of the Headache. THe word Cephalalgia is used generally for every pain of the Head: but more especially it signifieth a new Headache: But the word Cephalaea signifieth an old Headache; and Hemicranea signifieth that pain which only is in one side of the Head. There are other differences of headaches: they are divided into Internal, and External; Pains by consent, and by propriety: and of these, one is called a pricking pain; another a stretching, or extending pain; another a heavy; another a beating or shooting pain. The internal pain of the head is in the meanings or Membranes, that is very deep, and reacheth to the roots of the Eyes: But an external pain is in the Pericranium or Membrane without the Skull, and will not endure the roots of the hairs to be combed back, and is made greater by the least compression of the Head. This is the Doctrine of Galen, which he teacheth 3. the loc. off. cap. 1. and lib. 2. de comp. med. secundum loc. cap. 3. saying very solidly, That the internal Headache is distinguished from the external by this peculiar sign, That in the internal the pain comes to the roots of the eyes, not in an external, and he gives this Reason, Because the coats of the Eyes come from the meanings of the Brain, whence it comes that the grief is conveyed to the Eyes. But Fernelius contradicts this Doctrine, lib. 5. Pathalogiae cap. 1. and affirmeth, that external pains do reach to the roots of the Eyes, because the Pericranium or Skin of the Skull wherein those pains are, doth reach to the cavity of the Eyes: to whom Rondoletius answers, lib. 1. m. med. cap. 5. that the Cavity of the Eye doth not suffer with the Pericranium, although it reach to it, by reason that the pain of the Pericranium comes for the most part of external cold; for a cold part will easily suffer from the like quality. But that cold cannot reach to the hollow of the Eye, because it is preserved by the heat, blood, and spirits of the Eyes; but if at any time a headache cometh of external heat, or the like, the Skin of the head is only affected, not the Pericranium which lieth deep. But this Doctrine of Rondeletius doth not altogether take away all difficulty; for although all things which he allegeth should be granted, yet if a pain arise from a tumour gathered upon the Pericranium, or of some other cause that dissolveth continuity, and divideth, there is no reason why the grief should not reach to the hollow of the Eye. We can say this in defence of Galen, that this sign was given by him for two Reasons: First, Because the Membrane which reacheth to the hollow of the Eye from the Pericranium, is not so sensible, and therefore cannot suffer but obtusely: but the coats of the Eyes which come from the meanings are very sensible, and therefore have great pain: Moreover, that Membrane which cometh from the Pericranium doth not touch the Eye so inwardly and deeply towards the optic Nerves, as the coats which come from the meanings, whence it is that the external pain cannot extend itself to the roots of the Eyes as Galen saith. A pain by propriety is constant and permanent, nor doth it follow the disease of other parts: But a pain by consent or sympathy, depends upon the infirmity of another part, so that as that increaseth or diminisheth, the Headache increaseth or diminisheth. Now this pain by sympathy, is either by consent from the whole Body, as in Fevers; or from some peculiar part as the Stomach, Liver, Spleen, or Mother. But we may know what part is affected when a pain is communicated to the head by its proper signs. A pricking pain comes from a sharp choleric humour or vapour which toucheth the Membranes of the Brain. A heavy pain comes from much thick, and cold matter, namely, phlegm or melancholy compressing the sensible parts. An extending pain comes from wind or mild humours which work themselves into the Membranes and distend them. A beating or pulsative pain, comes of thin choleric blood or spirits abounding, by which the Arteries being stretched and swollen, do beat more vehehemently, and shake the Membranes, and so striking the adjoining parts, cause in them a sense of Pulsation, as Galen teacheth more at large, 2. de loc. off. c. 3. From what is said, the chief causes of a Headache are sufficiently declared, which in general are referred to the solution of continuity, as to the immediate cause: For whatsoever doth bring a manifest or hidden solution of continuity, is like to bring a headache. The signs of the kinds of Headache, and of the causes that produce them, may be learned from what is said, and therefore we come to the Prognostics. An external headache is always less dangerous and easier cured than an internal. A Headache in a sharp Fever with thin and white urine is dangerous, for it signifies the choleric matter is sent into the Brain, whence there is fear of a Frenzy. A strong pain of the Head suddenly seizing without evacuation following, or mitigation of the disease, is deadly: for it signifies the destruction of the animal faculty, which no more feeleth that object which caused the grief. In a great Headache it is evil to have the outward parts cold; for by the vehemency of the pain there is a strong attraction of heat to the part affected, which will cause inflammation. They that recover of a disease in the inferior parts, and have after a vehement Headache, if a manifest evacuation went not before, will have an imposthume in their Brain, for it signifies a translation of the matter which caused the disease into the Brain. They who vomit green in a headache, and are deaf being awake, are suddenly very mad, 1. Porrh. for it signifieth a collection of choler into the Brain, which maketh the Stomach consent therewith and suffer. Headache and noise in the Ears without a Fever, or a giddiness, or deafness, or numbness of the hands, signifieth an Apoplexy or Epilepsy to be at hand, Hipp. in Coacis: For those symptoms come from abundance of thick phlegm in the Brain. To women with child sleepy and heavy headaches are evil, 1. Porrh. for they signify the flux of humours to the head, which when they are many in women with child by reason they have not their courses, do threaten danger. A Headache which was not from the beginning of the Disease, but risen from the disturbance of the body, shows that there will be a crisis by bleeding at the nose, or by vomit. Since then the pain of the head cometh either of a cold or hot cause, we must direct the Cure for the taking away of both. For the Cure of a cold Headache the flegmy matter is first to be evacuated being prepared, as is showed in the chapter afore going. Then we must correct the cold distemper of the Brain, and the relics of the humour are to be discussed with Bags, mentioned in the former Chapter, or in the Chapter of the cold distemper of the Brain: With which being warmed, let the head, being shaved, be rubbed for an hour and an half every morning till the cause of the pain be spent and exhausted. After the head is well rubbed, sprinkle upon it this following Powder, having upon it Cotton or Wool. Take of Nutmegs, Cloves, Pepper, Pellitory, of each half an ounce: the Leaves of Sage, Bay-berries, of each two drams: Mustard seed, and Water-cress seeds bruised, of each six drams: Make a powder of these, sprinkle it upon the Head as aforesaid; and comb it in the morning before the use of the little Bags, that the powder laid on the day before may be taken off. Errhin●s are also profitable, Neesing, and Apophlegmatisms or things to chew, which were described formerly. A Magistral Syrup also made as followeth is very profitable. Take of Guajacum wood, and Roots of China sliced, of each one ounce and an half: Infuse them twelve hours in four pints of spring Water: Boyl them till half be consumed, adding in the end, the Leaves of Vervain one handful; the flowers of French Lavender and Margerum, of each a small handful: dissolve in it being strained half a pound of white Sugar. Boyl it up to a Syrup; but before it be perfectly boiled cast in two ounces of Senna tied in a clout; the best Agrick two ounces; Rhubarb three ounces: let him take two or three ounces, once a week. These Pills also following are very good which in times past were of great esteem in Italy in the days of Eustachius Rudius chief Professor in the University of Milan, who was reported to be the Inventor of them, and accounted them a great Secret; and therefore gave them to one Apothecary only to be made by him, lest others should know the Receipt which indeed he borrowed out of Wickerus, who propoundeth it from Andernacus: and it is thus: Take of Coloquintida six drams: Agarick trochiscated, Diagridium, black Hellebore, and Turbith, of each half an ounce: Aloes one ounce: Diarrhodon Abbatis half an ounce: Let the purging things be bruised and beaten together, and put in a glass with the spirit of Wine, so much as is sufficient, and let them be digested for eight days in a warm place, and then add the powder of Diarrhodon, and infuse them four days longer, then strain them and press them, and let the Liquor so pressed forth be distilled in Balneo, so long till the extract in the bottom of the Alembick grow so thick that it may make Pills, the dose whereof is one scruple. But the following Pills are ascribed to Fernelius, of which he affirmed he found by experience such excellency, that he never met with a Cephalalgia, or Hemicrania, that is, half Headache, but he cured it. Take of the best Aloes half an ounce: the Powder of the Electuary of Pearls, the three , and red Roses, of each three grains: With Syrup of Wormwood, and Violets, make a Mass. Give a dram thereof twice in a week one hour or two before Supper. And finally, in a stubborn pain that is old, all those Medicines are convenient, which were before mentioned in the Cure of the cold distemper of the Brain; among which, Epispastics, or blisterdrawing Plasters are not the meanest. Which also not prevailing some are so bold as to apply Vigo's Emplaster with Mercury, which they say hath cured old headaches sometimes, by causing them to spit much. Baths of Brimstone and Bitumen are very efficacious in this case, used both to the Head, and the whole Body. Also in an old Headache, sweeting Decoctions are very good, and famous Authors declare that many have been cured thereby, Which not prevailing, Mercatus is bold to fly to the use of Stibium, and commends it highly in his first Book of the Cure of internal Diseases, and the eighth Chapter. But in an old grief, it is better to strengthen the head often, than to use too many Evacuations: Therefore Powders and Caps, and other topic or external Medicines are very necessary before mentioned in the Cure of the cold Distemper of the Brain. But Powders are more commendible, because the virtue of a Cap is not so much communicated to the Brain, and the pain may be increased by the filth which is contracted by the long wearing of them. Moreover, An Ointment may be applied of the Oil of Almonds, in which wild Bettony, Bay leaves, Mastic, Lavender, Mints, Marjoram, Thyme, Penyroyal, Nutmeg, Cloves, and Cinnamon, or some of these have been boiled, adding in the time of the boiling a little red Wine. Or this following Chemical Oil. Take of Turpentine one pound: Mastich, Nutmeg, Cinnamon, of each one dram: Cloves, Zedoary, Galangal, Laudanum, of each one ounce and an half: the juice of Ebulus or Dwarf-Elder, and of the wild Cowcumber, of each one dram: the Oil of Chamomel and Lilies, of each half a pint: red Wine one pint and an half: wild Marjoram green one handful: Powder those that are to be powdered, and put them into a Glass Retort, and extract an Oil; with which anoint the head after it is shaved. Oil of Amber is very good, and it will be sufficient only to anoint the Head therewith. While you use the afore mentioned Remedies, you may also use from the beginning of the Cure specifical Medicines, such as this Epitheme. Take of the powder of Zedoary one dram: the Water of Bettony, Vervain, and Elder, of each one ounce: Mix them and apply them hot to the part grieved with Scarlet cloth. Among the proper Medicines for the Headache, from what cause soever it ariseth, Vervain is the chief; whose Water distilled, you may both apply externally, and give of it internally to the quantity of ounces, with three drops of the spirit of Salt. Green Vervain alone only hung about the Neck, hath cured two Pat●●●●s when many other Medicines failed, as Forestus reports. Zacutus Lucitanus it 〈◊〉. 1. Praxis Med. mirab. observat. 7. 8. 9 & 10. propounds four Remedies, confirmed by Experience; namely, An Issue in the back of the hand, Horsleeches to the Temples, opening of the Vein in the Forehead and the corner of the Eye, which you may read in the place cited. These things are to be noted concerning those Observations: First, That the ●●sue between the Thumb and fore Finger is approved by other Experiments, and hath cured great Headaches. Secondly, In the Cure by Horsleeches, Zacutus is not content to apply two or three as ordinarily is done, but ten or twelve round about the Temples; whence comes a great attraction of Blood, which may draw forth the whole matter of the Disease. Thirdly, In the Curing by opening the Veins in the Forehead, we must observe, That that Vein was twice opened, whence it appears that the first was not sufficient; when ordinarily our Practitioners do seldom open it the second time, if the first hath been to little benefit. The hot Cause of a Primary and Essential Headache, is Blood or Choler. And the like Remedies are proper for both, though they must be made stronger or weaker according to the strength of the Disease. First then (after a Clyster is administered) begin with Blood-letting, drawing forth more when the grief proceeds of blood, than when it proceeds of choler. Then give a Medicine to purge Choler, not only when Choler is the Principal Cause, but when blood aboundeth whose thinner part is easily turned into Choler. If the matter offending is not sufficiently taken away by one purge, you must purge again at a due distance. After apply Repelling Medicines to the Head, and Vinegar of Roses, such as were propounded in the Cure of the Frenzy, making choice of the mildest. And after it will be very profitable to apply Creatures newly killed, or parts of them, to discuss the relics of the Disease, and to assuage the pain. In an Headache which goeth with a continual Fever, a Sheep's Lungs applied hot do much assuage the pain. Also a Cataplasm of bruised Guords, and Housleek to the feet. The opening of the Saphena after sufficient bleeding in the Arm, cures often times a Headache with a Fever very suddenly. You must use Cupping-glasses with, and without Scarification and Frictions of the extreme Parts. And in the whole time of the Disease, if the Belly be not lose, you must every day give an Emollient and cooling Clyster, and which do gently purge. After general Evacuations and Revulsions, you may rightly, and with profit derive the matter by opening the Head Vein, or with Horsleeches to the Forehead, or with Vesicatories to the Neck. In the mean while let the whole mass of Humours be qualified with Juleps, Emulsions, and Broths, as was mentioned in the Cure of the Frenzy. Lastly, If the pain be very violent you must apply Narcoticks both externally and internally, as they are set down in the said Cure of the Frenzy. Here also may avail the opening of the Forehead Veins, and Leeches to the Temples, commended from Zacutus Lusitanus. Paraeus lib. 16. cap. 4. reports that a desperate half Headache was cured by opening the Arteries in the Temples, and says there is no danger in doing it. The Artery is opened as a Vein, and six ounces of blood forcibly leaping forth are to be taken: After apply a convenient Ligature, and open it not in four days. Botallus also says, That it doth miraculously cure old headaches; and we also have cured desperate ones the same way, and never found any danger in the opening of the Artery. You must apply a Plaster to the Orifice, of Frankincense, Mastic, Bole armenick, and Hare's Hair, with the white of an Eglantine, and then make your Ligature as you use to do in Wounds of the Head. In all pains of the Head, of what cause soever, if other means fail, and the greatness of the pain, make thee run to extremities; a Vesicatory applied over all the Head, after it is shaved, will cure it. A Cautery upon the Coronal Suture sometimes hath perfectly cured a violent Headache. But it is more powerful if it be applied to the Temples, of which see Poterius, observat. centur. 3. cap. 8. and our Observations thereon. The End of the first Book. THE SECOND BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Eyes. The PREFACE. THE Diseases of the Eyes are so divers, that it is very hard to lay them down clearly and plainly, and to distinguish one from the other: which that we may endeavour as much as may be, and clear up our Treatise for Practice, we will so divide them, the Diseases by which the sight is immediately hurt, may first be expounded, and afterwards the rest which happen to the Parts of which the Eyes are Compounded, or which are near unto them, without any, or very little hurt to the sight. The sight is hurt when it is diminished, abolished, or depraved. Sight abolished is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek: in Latin Caecitas. But sight dimished hath divers Names according to the degree and manner of the diminution: of which the chief are Amblyopia, Myopia, Nyctalopia, and Acies Vespertina. Caecitas blindness, comes either from an absotute Obstruction of the Optic Nerves (and then it is called Amaurosis) or from a total Suffusion, or from some great fault in the Tunicles and Humours. Amblyopia, in Latin Obscuritas, Hebetudo, or Caligo, dark or dim sight, when the Object is not clearly seen at what distance soever placed; comes from the same Causes, but more light and imperfect, as an imperfect Obstruction of the Optic Nerves, a light suffusion, want of spirits or grossness of the same, and the like. Myopia, in Latin Lusciositas, or Pur-blindness in which the Objects are not perceived, except they be very nigh, and close to the Eyes, but not at all a far off, or very little; and imperfectly: so that they perceive not their known Friends passing by: And according to the Opinion of Galen, and all Modern Physicians, from the thinness and smallness of the visor spirits which stand not in need of a medium, much enlightened to make a perfect sight, but is thereby dissipated. On the contrary, they which have gross and thick spirits, see things best at a distance, because that gross spirits needs more enlightening which is brought by the larger illumination of the medium: But this Doctrine is demonstrated to be false, and to spring from ignorance in Optics whose Principles declare, that these diversities of sight proceed from the diversity of the situation of the Crystalline humour. For when the species of the Objects are received into the Crystalline humour by a Pyramid or sharp Point thereof called Conus; if the Crystalline humour be too much inward towards the pupil of the Eye, the remote Objects are better seen, because it is necessary that the Objects should be at a farther distance, that the Conus, or point of the Pyramid may come to the Crystalline bumor, and there be terminated: But if the Objects come nearer the Eye, the Conus goeth by the Crystalline, and they are seen more obscurely: Again, If the Crystalline lie too low and too far from the Tunicle called Uuea, the Objects must be nearer to the Eyes, that the Conus or point of the Pyramid may come to it: whence it appears that Myopia comes no other ways then from the Crystal me lying too low; and so this Disease becometh connatural, and not to be cured. But the affect of Myopia is contrary in which the Object is better seen at a distance; and this happens for the most part in Old Men, in whom some of the portion of the watery Hamor is spent, so that the Crystalline goes to the Pupil of the Eye: Farther, By long holding down of the Head either with Reading, Writing, or otherwise, the Crystalline Humour comes by degrees forward: This is demonstrated by the use of Spectacles; because that they who have Myopia, or are Purblind, see best with hollow or concave spectacles, by which the rays or beams of the visible species are dispersed, whereby it comes to pass, that the Conus of the Pyramid is more long, and so that thing which by reason of the great distance could not be seen, is now plainly perceived; because the Conus of the Pyramid is extended as far as the Crystalline, which before ended in the Pupilla, or in the watery Humour, or in the white Humour: On the contrary, Old Men are helped with Convex Spectacles, by which the beams are united, and the Conus of the Pyramid is made shorter, and so things are better perceived whose Conus before passed by the Crystalline, which was too near to the Pupilla. Nyctalopia, or Nocturna Caecitas, is when men see well enough at day time; at Sunset worse; and at Night not at all: and it comes from the over thickness of the spirits, or Humours, or Tunicles; or the straightness of the Pupilla. For in these Cases a greater light is necessary for true sight, which being wanting, at Sunsetting, or at Night by a Candle, they see little, or not at all. Vespertina Acies, is when men see worse by day, and better by night; and this sometimes is called Nyctalopia, as we see in Hypocrates, 2. Prorrhet. but the Modern Greeks have from long Custom used the word Nyctalopia only for Night blindness: it comes from the thinness of the spirits which are spread abroad by too much light: or from the enlarging of the Pupilla, by which too much light goes into the Eye, and hurts the sight, for a little light at night doth more illustrate and shine to them, than to those who have the Pupilla enlarged. After what manner the sight is hurt by diminishing, abolishing, and depraving, we shall lay down more plain when we explain the Diseases of all parts of the Eyes by themselves. For when all the parts of the Eye do conduce to the action of it, namely Sight, when any part is distempered, the sight must also suffer. The Eye is compounded of Tunicles, Humours, and the Optic Nerve, for the action of which parts, the Animal Spirit doth concur as a principal and universal Agent. And therefore that we may run through the Diseases of those parts, we will begin from the distemper of the constitution of the optic Nerve; next we will proceed to the Disease of the Humours and Tunicles. But the faults of the Spirits either depend upon the distemper of the Brain, and then other Senses are also hurt; or from the distemper of the Eye itself, which being cured the spirits receive their ancient and due constitution, so that we need not make a particular tractate of them. But in curing Diseases of the Eyes, when sight is hurt, we must always mingle those things which comfort the visive spirits with other Medicines. CHAP. I. Of Gutta Serena, or Amaurosis, WHen the sight is gone, and no fault appears in the Eyes, it is called Gutta serena, or Amaurosis. And it comes to pass, when the Animal Spirits cannot pass from the Brain to the Eyes; for when the Animal Spirits come into the Eyes from the Brain by the Optic Nerves, we must find out the stoppage of their influx in the Optic Nerves. The Optic Nerves are many ways affected, but chief by obstruction or stoppage, astriction or binding, and by solution of continuity. Obstruction is the most common and most ordinary cause of Gutta serena, which comes of a watery humour flowing down from the Brain upon the Nerves, even as other Nerves are obstructed in a Palsy by the same humour; so that the Diseases may be said to be alike by reason of that Obstruction. But it is most certain that this Disease is also begot by adstriction and compression of the Optic Nerves; which compression may come both or a moist humour gathered about the optic Nerves, and pressing upon them: as also of blood, filth, or matter: Whence sometimes certain tumours rising in those parts, produce the like Disease. For Experience teacheth, That sometimes blindness in one Eye, sometimes in both, comes upon inflammation of the Brain, and from Frenzy in malignant Fevers. And Platerus reports lib. 1. Observation, That he saw a blindness which came from a round tumour growing in the Brain, and compressing the optic Nerves, which appeared by opening of the Head after the Patient was deceased. Finally, Wounds in the Head, in which the Optic Nerves are divided, without controversy do cause that the Animal Spirits can no more come to the Eyes. This Disease is known, in that the Eyes seem to be in their natural condition, and there is no fault apparent in them, only the Pupilla seems blacker and larger. But in distinguishing the differences of Causes, there is great difficulty; for although the Disease coming of blood or matter is known by inflammation, aposthume, or wound going before, yet no certain sign can be given by which we can distinguish a compression made with phlegm from an obstruction: but we may in some part conjecture, for in the obstruction only of the optic Nerve, the Eye is only affected; but if a compression be made of the same Nerve by phlegm gathered about the roots of the Eyes and Mamillar Passages, that matter possesseth other parts of the Brain, and then all or some of the other Senses are hurt; but if it seize only upon the Optic Nerves, there is more plenty of humour sent forth at the Nostrils, and the Patient perceives a heaviness in the fore part of the Head, especially about the Eyebrows. As to the Prognostic part; If this Disease be absolute, that is, if there be a total loss of sight, especially if it come from obstruction of the optic Nerves, it is for the most part incurable; as we see in Palsies also, that they are scarce or never cured which come from the obstruction of the Nerves, especially if the Patient be old. But if the obstruction be imperfect, which only causeth a diminution of sight, but not blindness, there is more hope of recovery, although it cannot be brought about without much pains, and long use of Medicines. But if this Disease come of humours gathered in the fore part of the head, which compress the Nerves, it may be more easily cured. So saith Fabricius Hildanus, observ. 19 cent. 5. That a certain man after a strong vomit lost his sight, and that he cured him with giving him the same Medicine again; for as the humours being too much stirred by a violent vomit, and cast upon the Optic Nerves, compressing them, did hinder the passage of the Spirits to the Eyes: so the same humours being carried away by the same Medicine, the disease became cured. Almost the like story is mentioned by Sennertus of a certain Student, who taking too strong a Purge became suddenly blind. He also affirmeth, That certain women after they had conceived with child, became blind through the straightness of the optic Nerves, and that this Disease went away after four or five months, or in the time of their Delivery. We also have seen some which fell suddenly into extreme diminution of sight, who within fifteen days, were cured by universal Evacuations, and some revulsions, and by the easiness of the Cure we supposed that the humour was not fastened within the substance of the nerve, but only gathered together in the Brain about the original of those Nerves. For the Cure of this Disease, The matter fastened upon the Nerves, or cleaving thereto, and maketh the obstruction or adstriction, is to be evacuated; which cannot be done, except first the whole body be cleansed, as Galen saith 4. m. The Eye is not to be cured before the whole Head, nor the Head before the whole Body. And that Remedies may be set down in a convenient Method, we will first set down a Course of Diet, which must be attenuating and moderately drying. And first, The Air must incline to hot and dry, and a thick, cold, cloudy, and moist Air, must be altogether avoided. Let him cat meats of good and laudable Juice, avoiding them which beget gross Juice, as Pork, and all Swine's flesh, Geese, Fish, Pulse, Cheese, and the like; as those which are windy, and fill the head, as Milk-meats, and hot Spices, viz. Pepper and Ginger, etc. Let his Bread be made with Fennel Water, or with the Seeds thereof; being careful that the Wheat of which it is made, be not mixed with Darnel, which all the Ancients believed to be very naught for the Sight: hence in the Comedy, he that derideth another for defect in his sight; I think (saith he) thou hast said upon Darnel. In the sauce to his Meat, and in his Broths, let him use things extenuating, as Hyssop, Fennel, Margerum, Bettony, Sage, Eye-bright, and especially Nutmeg, which strengtheneth the Brain, and clears the Sight. He must eat Turnips often, which are thought to quicken the Sight: So do Sparrows, Pigeons, often eaten. Cold Herbs must be forborn, and especially Lettuce, which hurts the Eyes. Let him take but a small quantity of Meat at a time, and let the sick man never fill himself immoderately: Let his Supper be less than his Dinner: and to abstain from a Supper twice or thrice in a week is very good. At his Meat, instead of Salt let him use this Powder following: Take of common Salt two ounces: Eyebright dried two drams: Nutmeg one dram: Cinnamon two scruples: Mix them into a Powder. After every Meal, let him take one spoonful of the Powder following: Take of Coriander seed prepared half an ounce: Annis seeds, and Fennel seeds, of each two drams: Cinnamon and Nutmeg, of each one dram: Eyebright dried three drams: Sugar of Roses, a double weight to all the rest. Make a Powder. Wine in this Disease is not good, because it is too full of vapours, and fills the Head, and is apt to cause defluxions: therefore a Deoction of Sarsaparilla, sweetened with Liquoris, and aromatized with Coriander, will be very profitable. But because the Disease is of a long continuance, and all cannot abstain so long from Wine; if we must permit Wine, let that be chosen that is weakest, and less vaporing; and it would be more beneficial if Eye-bright dried were first steeped therein: and that he may make Eyebright Wine for a long time, in the Vintage let him put Eyebright into a vessel filled with new Wine, and let the Patiented use that for his ordinary Drink. Let his sleep be less and shorter than usual, and let him he upon his back with his face upwards as much as may be: Let him avoid sleeping at noon, because it is very hurtful. Let his Exercise be moderate, and instead of exercise let him use frictions or rubbing of the inferior parts. Let his Belly be always kept lose, and let him avoid disturbance of mind. The course of Diet being thus ordered, you must begin your Cure from Universal Evacuation And first you must purge with the following Medicine: Take of clean Senna half an ounce: Fennel seeds one dram: the Leaves of Bettony, Eyebright and Vervain, of each half a handful: Liquoris three drams: Boyl them to three ounces. Dissolve in the straining three drams of Diaphaenicon; Syrup of Roses one ounce. Make a Potion and give it in the morning with orderly Government. After this first Purge, let the Physician consider seriously with himself, whether he may bleed or not. For it is disallowed in this case by almost all Practitioners, because it is a Chronical Disease of long continuance, coming of a cold distemper and of a flegmy humour. Hence they fear least by blood-letting, the Brain should be made more cold, and so beget more phlegm, and lest the conjunct cause of the Disease should be more incressated or thickened, and so become more difficult to be discussed and dissipated. But although their Opinion may take place as to old men, and such as are of a Phlegmatic Constitution, yet it is not to be admitted to them that are young, or of a hot Constitution, especially if there be manifest signs that blood doth predominate; for then there is no doubt but seasonable blood-letting may much profit. Nay, where the aforesaid signs of blood do appear, it is profitable in the judgement of Paulus and Aetius after the Vein in the Arm is opened, to open the particular Veins of the Head, and those which are nearest the Eyes, namely, the Frontal and Temple Veins, and those which are in the corners of the Eyes near the root of the Nose. But you may better apply Horsleeches to the Forehead, as also behind the Ears. Some Practitioners do relate, that some by a wound in the Forehead have been cured of blindness. In which it is most probable that the cause of their blindness was the compression of the optic Nerves by the Veins and Arteries adjoining, and swelling with too much blood, which the Wounds aforesaid emptied forth. Whence Spigelius (as Plempius reports in his Book of the Eyes) was wont in Gutta serena with good success to open the middle Vein in the Forehead, and let it bleed while it stop of itself. But if the suppression of the terms went before this Disease, you must draw blood from the lower veins, or apply Leeches to the Hemorrhoids: if the Patient had formerly a flux thereof, which then is stopped, or if he have a very hot Liver, or be of a melancholy temper. Afterwards the whole body is to be more exactly purged by this following Apozeme. Take of Fennel Roots, and Sarsaparilla, and Flowers-de-luce-root, and Elicampane roots, of each one ounce: the Leaves of Bettony, Margerum, Balm, Eyebright, Fennel, Vervain and Celendine the great, of each one handful: Liquoris sliced, and Raisins of the Sun stoned, of each one ounce: Annis-seed, and Fennel-seed of each three drams: cleansed Senna two ounces: Gummy Turbith and Agericks newly made into Troches, of each two drams: Ginger and Cloves of each one scruple: flowers of Stoechas, Rosemary, and Lavender, of each one small handful: Boyl them in five quarters; that is a pint and a quarter of water; dissolve in the straigning four ounces of white sugar: make an Apozeme, clarify it and perfume it with two drams of the best cinnamon, for four morning's draughts: After the Apozeme is done, let him take these Pills. Take of the mass of Pill, Lucis major, and Cochia the less, of each half a dram: malax them with Bettony water, make six guilded Pills thereof, which let him take early in the morning. After this general Evacuation the antecedent 'Cause is to be reveled; and the conjunct Cause is to be derived and discussed. For this Frictions of the extreme parts, especially beneath, are to be used every morning. Cupping-Glasses must be applied to the shoulders and back without sacrification; especially to the hinder part of the Head with scarification; for they do so powerfully draw the humours from the foreparts and the principle of the Nerves, that some presently after the application thereof have recovered their sight: At the same time apply a Vesicatory to the hinder part of the neck, and let the blisters that are raised be kept long open, with Beet or Colewort Leaves often applied. When the Vesicatory is dried up, apply a Caustick to the hinder part of the head or neck between the second or third Vertebra; or (as it is now most usual) apply two Caustics to the Neck behind upon the fourth and fifth Vertebra; so that the back bone may lie untouched between them, and both may be Cured with one Plaster. Instead of Cauteries a Seton applied to the same part is most efficacious; but the tenderness of our Country men hath almost abolished the use thereof. If the aforesaid Cauteries avail not, you may lay a potential Cautery to the Coronal Suture, which sometimes hath done the work when other Remedies have failed. When these things are doing, presently after universal Evacuation by siege, you must order a sweeting Diet of the Decoction of Guajacum Sassaphras, and the Roots of Sarsa, according to the method prescribed by us in the Cure of the Cold distemper of the Brain. Observing this; That towards the end of the Sudorific Decoction, you and those things which peculiarly respect the Eyes; as Vervain, Fennel, Eyebright, and Celondine the greater. And for the better drying of the Brain; let the Bags prescribed in the Chapter above mentioned be applied to the Temples if you fear not an inflammation. Also after the Sudorific Diet it is very convenient to use Sulphurous and Bituminous Baths and washings of the head; because they are very proper for the correcting of a Cold and Moist Distemper, for the consuming of Phlegm, and strengthening the brain. Besides the universal Evacuation of the body and Head, particular may be ordered; as Medicines that cause spitting; called Apophlegmatisin; by which the Rhewm is brought out of the Brain by the palate; which may be made either in the ●orm of a Gargarism or Masticatory; according to the forms prescribed in the Cure of the cold distemper of the brain. Errhins and Sternutatories or Neesing are condemned by almost all Practitioners in this Disease; because they draw humours to the eyes: but yet if some of the milder and gentler sort be used (after an exact purging of the whose body and head) for some few days they may be profitable in regard they may by degrees draw forth and derive the humour which causeth the Disease, and is fastened in the Optic Nerves; nor can they fetch any thing from the profound part of the brain to the foreparts: Otherwise in every derivation which is an evacuation by the part affected, or that which is near unto it; we should always fear lest there should be an attraction to the part affected, which is easily hindered by universal Evacuations which ought to precede; and those Errhins may be made of the juice of Beets and Marjoram with white Wine in which Manna hath been dissolved. But a stronger and yet safe Errhine may be made of the powder of Tobacco corrected with Cephalicks, and Oxydorcicks; or Medicines that help the sight; for by that the Rhewm is drawn forth rather by the Palate than the Nostrils; and the brain is so fortified, that it will not so easily receive the defluxion of humours from other parts. The Composition whereof is as followeth. Take of dried Tobacco one ounce: the leaves of Sage, Margerum, Bettony, Eyebright, the Flowers of Clove-gilli-flowers, and Red Roses, of each one dram: make a powder to be snuffed into the Nostrils for some few days. Neither is it sufficient once to cleanse the Body of Excrementitious Humours with universal Purging; but you must keep it in that condition all the time of the Cure; therefore with Purges intermixed, the Excrements which daily increase must be brought forth; which may be done with usual Pills made after this manner; Take of the best Aloes half an ounce: clean Senna, Turbith, Hermodacts, and Agarick newly trochiscated, of each two drams: Diagridium, one dram: Mace, Cloves, and Eastern-Saffron, of each seven grains: sprinkle them with the juices of Marjoram and the greater Celondine: then dry them again in the shade. And with the Oxymel of Squills make a mass of Pills of which let him take half a dram or two scruples twice or thrice in a month. While these things are used, you must continually labour to strengthen the brain and the eyes: and the Patient must take diversity of Medicines, lest by taking the same a long time, it prove Nauseous unto him; and lest Nature be too much enured to a Medicine, and so it lose its Operation. Old Physicians say, Treacle is reputed to be of excellent virtue to this purpose, which may be taken by a dram every night with Fennel, Eyebright, or Celondine water twice or thrice in a week. Nutmeg eaten every morning fasting, is much commended if it be long chewed that the vapour may be carried to the Eyes; if you fear that the swallowing down thereof should offend by reason of the heat: it may be spit forth after it is chewed. Candid Myrabolans taken in the morning are thought to clear the sight exceedingly. The usual Opiate is thus made: Take of Conserve of Bettony, and Rosemary flowers, of each two ounces: Candied Myrobalans two: old Treacle two drams: the Leaves of Eyebright powdered, three drams: Fennelseed two drams: Nutmeg, Cinnamon, and Cloves, of each one scruple: With the Syrup of the Juice of Fennel, Rue, and Celondine made up with Honey, make an Opiate. Let him take thereof the bigness of a Chestnut, drinking after it a little Wine mixed with Fennel Water. Nor must you omit external Medicines which strengthen, warm, and dry the Head; of which sort is the Cephalick Powder for the Hair, a Cap and Fumigation, mentioned by us in the Cure of the cold distemper of the Brain. Finally, You may apply Topical Medicines to the Eyes to strengthen them: these are usual in Authors; but they are of little force which cannot reach to the optic Nerves; but if any desire to try some of them, they may find enough of them in my Treatise of the Cure of a Suffusion. In a desperate case when all other Medicines have been used in vain, a Vesicatory applied over the whole Head (being shaved) in form of a Cap, hath many times been very successful: if it be twice or thrice used after the drying up of the former Blisters, it is more advantageous. CHAP. II. Of the Disease of the Vitrous, or Glassy Humour. THe Vitrous Humour is next under the Crystalline, and therefore it is made by Nature transparent, that the Species carried to the optic Nerve may be pure and clean. If therefore the cleverness of that humour be hindered by the mixture of another, and so made dusky: according to the degree of that duskiness or foulness, the sight is either diminished or abolished. Moreover, This humour may be out of order in respect of its situation; namely, when any part of it by a blow or contusion shall be brought before the Crystalline; for then the sight will be darkened, in regard the vitrous Humour is more thick than the watery, and therefore the species of the objects cannot be carried pure and clear unto the Crystalline. The first affect, namely the Mixion of a Humour with it, cannot be perceived by any signs, but only it is judged probable by reason, for the vitrous Humour cannot be seen, or its condition known; and therefore Practitioners are constrained to confound it, and to make it one with Gutta serena, because no fault appears in the Eye, and this they do without offence to the Patient, in regard any humours that are mixed with the vitrous, are to be discussed with the same Remedies that a Gutta serena is cured. But you may know that this vitrous humour is disordered in respect of its Situation, when it appeareth white under the Pupilla, yet it is not easily distinguished from Suffusion, except the antecedent and first cause be diligently observed. For a Suffusion is caused by a simple defluxion of an humour; but this transposition or displacing of the vitrous humour useth to come of a Wound or Contusion. This last Disease is incurable, for the vitrous humour being displaced can by no art be reduced to its former condition. But this by Nature hath sometimes been done, and therefore the whole business is to be committed unto her. CHAP. III. Of the Diseases in the Crystalline Humour. THe Crystalline Humour is the chief instrument of Sight, and therefore aught to be kept more pure and perspicuous than the rest, that that Sense may more freely be exercised. And if it be soiled in the least measure, the sense of Seeing is much hindered. The chief Disease whereby the purity thereof is infected, is called Glaucoma (or the changing of the Crystalline Humour into a fiery redness) and this happens when the Crystalline Humour is made thick by dryness, as in old people, from some drying and condensing cause it is often seen. This Disease is known, by a plain appearance of a thick white about the Pupilla, and when all objects are apprehended by the Patient as through a cloud or smoke. But it is hard to distinguish this Disease from a Suffusion which representeth such a whiteness about the Pupilla: hence it▪ is that many Authors do not distinguish between a Glaucoma and a Suffusion. But they which diligently observe may distinguish them thus: In a Suffusion there is a white in the very Pupilla, and very near the Membrane called Cornea; but in a Glaucoma it lieth deeper. This Disease is incurable; especially in old folk in whom the dryness of the part cannot be amended; but if it be not manifest that the fault is in the Crystalline, and there is a suspicion of a suffusion; you may use the remedies prescribed for it. Moreover, the Crystalline may be out of place, namely when the broader part of it which is flat like a Fetch or Lentil is not directly against the hole of the Pupilla, but either is too high or too low, and then objects appear double when one Eye only suffereth; because the p●●… 〈◊〉 ●●eight line is lost which ought to be one and the same in both Eyes, that whatsoever 〈◊〉 is 〈◊〉 both Eyes may appear but one and the same. And if they be not in that order, things 〈…〉; which you may prove by depressing or lifting up one of your Eyes with your ●●●nger: for then the parallel is lost, and things appear double: But this Depravation of sight by whi●h objects appear double, comes not only of the Cause now mentioned, but also from vapours, or water which hurt the Crystalline; by which the visive Spirits are divided, whence it comes to pass that the species of the same thing is received into two places, which Drunkards usually perceive when they see double. Secondly, The situation of the Crystalline is altered, when it declineth backward or cometh forward, if it comes forward to the Pupilla, than things near at hand are not so rightly perceived as those which are more remote, as in old men often. But if it decline backward towards the Optic Nerve, things near are truly seen, but not afar off, and then is the Disease called 〈…〉 which was mentioned in the Preface; where we shown, That these Diseases are only Cured by Spectacles. Thirdly, The Crystalline is out of its place when it tendeth either to the right or left side, which is called Strabismus, or Squinting; when the Pupilla is not directly but obliqne upon the Object, and appeareth not in the middle of the Eye, but in one side: so that there appeareth more white in one part of the Eye, than in the other. This Disease comes not only from the displacing of the Crystalline, but also from the Evil Disposition of the Muscles which move the Eyes: which is either natural, or else proceeds from a Palsy or Convulsion of the said Muscles. Of what Cause soever it comes, if it be connatural, it is incurable: but, if it come from Palsy or Convulsion of the aforesaid Muscles, you may find out a way of Cure, in my Treatise of head Diseases. Finally, Other Depravations of sight may come from the inversion of the Crystalline be it greater or less; as when straight things appear crooked, or when the Objects seem to be ●oulded: which happened to a certain Physician (as Sennertus reports) who going up a Ladder to take a Book from a shelf, and turning his Eyes violently upwards, saw all things afterwards turned upwards as though men walked upon their Heads, which ca●e by the attraction and displacing of the Crystalline. For a quarter of a year after when again he turned up his Eyes violently, his natural sight returned, and all things appeared in right order. Hence it appears that by a violent motion of the Eye that the Crystalline may be displaced, and again by the same motion be set right. I suppose that the displacing of the Crystalline was thus, It was so inverted that the forepart of it (which is more depressed than the other) was not right against the Pupilla; but rather its side which being more round and convex might represent the species of the Objects inverted, as we may observe in round Glasses, which discover the Object inverted; and this is true from the principles of the Optic art: for in a Medium that is Convex and thick, the species are so broken, and as it were cross-cut, That they which come from the upper part of the Object, do represent the lower part; and so contrarily, but if the inversion of the Crystalline be less, so as both the depressed part of the Crystalline and also the Convex part thereof, be right against▪ the Pupilla, the Objects may seem crooked. Although that Depravation of sight whereby Objects seem crooked, may come by other means: namely when any part of the Crystalline is mixed with the watery humour then by reason of inequality of the Crystalline in regard of thickness, the refractions are divers, which are the Cause of Depravation of sight whereby things appear crooked. This may be demonstrated by a clear Example: A staff put half into the water, appears crooked for this Cause, namely, The species of that part in the water, when it is carried out of the water into the air, from a thicker to a thinner Medium, is broken by the perpendicular; but that part which is in the air is not broken, because it doth not pass through divers Mediums as that which is in the water: Hence it comes that the stick seems crooked. After the same manner the species of the object which is carried into the thicker part of the Crystalline is more broken, than that which is carried to the thinner, which is in its natural state, and not mixed underneath with the watery humour; and so by reason of the divers refractions the objects appear crooked. But since Medicines are to no purpose, we shall prescribe none for these Diseases. CHAP. IU. Of the Diseases of the Watery Humour, and especially of a Suffusion. THe Watery Humour is out of its Natural Condition, when it is distempered in quantity or quality. When the Distemper is in quantity; it is enlarged or diminished, and makes the Pupilla be dilated or contracted, which Diseases shall be mentioned in their places. When the distemper is in quality, it becomes thicker, and that comes from another Humour mixed with it, and that is called Suffusion, which we here speak of. For although Galen 1. de Symp. cause. cap. 2. showeth that a Suffusion may come from the condensation of the watery humour without the access of an excrementitious Humour: yet because it happens seldom, and is known rather by imagination than art, and is altogether incurable: omitting that, we shall speak of that Suffusion only which cometh from the afflux of another excrement or humour. This is called in Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, in Latin Suffusio, by the Arabians, Water, vulgarly a Cataract. Some Authors would distinguish these names, and make them signify divers sorts of this Disease: They call it in the beginning (when the sight is only a little darkened) a Suffusion; but when it is grown older, and something gathered into the Pupil appears like water, than they call it only Aqua, Water: but when the matter is grown thick in the Pupilla, and the sight almost gone, than they call it a Cataract. A Suffusion comes from a serous Watery Humour spread in the space between the Cornea and the Crystalline: and since a Watery Humour is contained in that space, it may well be reckoned among the Diseases of the Watery Humour. This is the Cause of a true Suffusion: There is another Bastard Suffusion which comes from vapours sent from the Stomach and other parts into the Eyes. Galen 4. de loc. off. cap. 2. taught that vapours may be sent from the Head to the Eyes, and make a bastard Suffusion; but although Authors speak of two sorts of Suffusions, yet they are for the most part united, and a spurious or false pleurisy is complicated or joined with a true one; because vapours sent from the lower parts to the Brain, are easily carried to those parts of the Head which are weakened with any Disease, and this appears in that all troubled with Suffusions are less troubled, and see better in the morning than at noon or night, because after dinner or supper many vapours are sent up from the Stomach to the Eyes which disturb the sight. And Experience teacheth, That men so diseased have their sight more dull and dark presently after meat, than a few hours after. Moreover, all that have a Suffusion relate that they see in the Air little bodies, as Gnats, Flies, Hairs, Cobwebs, and the like; which could not be but by the gross vapours which are sent to the Eye, and there move: for although Authors suppose that these representations depend upon some thick Humours contained in the Eye, which make a Suffusion: yet this is not credible, Because than it should always move in the Eye, to represent those little Bodies which fly in the air, which is contrary to reason. But rather without question, the vapours are in perpetual motion, and so can represent those flying fancies. A Watery Humour is the chief and most ordinary cause of a Suffusion, yet other Humours at least in a small quantity may be mixed therewith: and if Choler be mixed, than it is citrine or yellowish; if Melancholy, than it is a black Suffusion. And those Humours use to slow to the Eyes when they are weak, either Naturally, or by Accident. From a Natural debility comes a thrusting forth of the Eyes, for they who have such Eyes, are very subject to a Suffusion; for such Eyes use to be great, and therefore the virtue spread abroad is less in them: as also by reason of their largeness they do more easily receive humours and vapours. External causes make an accidental or adventitious debility, as a stroke, contusion, baths, a Southern and rainy habitation or season, heat of the Sun, smoke, continual reading, especially by candle light, and the like: All which may also cause a flux of humours to the Eyes. Now the Humours flow from the Brain to the Eyes by the Veins, by the Tunicle called Uvea, and by the Optic Nerve. The Veins by which they flow are divers: either those which come from the Pericranium to the Conjunctiva, thence to the Cornea and Wea: or those which come from the Meninges, from which some branches come to the Membranes of the Eye, from which Membranes, especially from the Wea, the excrementitious humours may easily fall into the watery humour being so near. Finally, Humours may easily be carried by the Optic from the Brain; by the Tunica Retiformis and Aranea, to the Crystalline; and then the matter of the Suffusion sticks upon the superficies of the Crystalline. Although a Suffusion for the most part comes by a defluxion, yet sometimes it may come by congestion or gathering, when that nourishment of the Eye is not well changed, and the expulsive Faculty is so weak that it cannot expel sufficiently the remaining excrements, so that they are by degrees gathered together about the Pupilla, and so make a Suffusion, in which case other humours are ordinarily disturbed, and difficult diseases are produced. The Differences of a Suffusion are taken from the thickness and quantity of the humour causing it, and from the place in which the humour resideth. In regard of thickness more or less, the sight is more or less offended, for if the humour be thin and serous, of which the Suffusion is made, which is cured by pricking, as Galen taught 14. Meth. cap. ult. The sight is little worse, and it is called a Suffusion only begun, if it be somewhat thicker the sight is darker; if very thick blindness followeth. In respect of the quantity and the place, Either the humour possesseth the whole Eye, and the sight is equally hindered which way soever it be directed; or it possesseth one part of the Pupil more than another, and so the objects are not seen wholly at one direct view, nor can many objects be seen at one time: but if the humour be very little, and possess the middle of the Pupilla, the objects appear with holes through them. But if the matter be divided into divers parts, possessing divers parts of the Pupilla, the forms of Gnats shall seem to be before the eyes: All these differences are exactly distinguished by Galen, 1. de symp. causis, c. 2. Moreover, In respect of the place or Situation of the matter, other differences may be made, as sometimes the matter is in the very hole or cavity of the Wea about the Cornea; sometimes about the Wea, and between that and the watery humour; sometimes it is mixed with the Watery Humour; and finally, sometimes it is between the Crystalline and Watery Humour.▪ Some Differences may be taken from the figure or shape of the matter, which Galen relates 1. the sympt. causis cap. 2. and 4. de loc. affect. cap. 2. for as the figure of the humour adjacent to the Pupilla is various, so divers objects are present thereunto, as Gnats, Hairs, Cobwebs, Circles about Candles, and other things. The knowledge of this Disease, is first in distinguishing a true from a bastard Suffusion, and then in the discovery of the differences of true and right Suffusions. A true Suffusion doth for the most part affect only one Eye; but if both be affected, they are not at one time, or alike affected, as in a spurious Suffusion. Secondly, In a true Suffusion, some dark matter appeareth in the Pupilla, which doth not in a Spurious or Bastard Suffusion. But this is not always a true sign; for if the Suffusion cometh of a thin and serous humour, because it is no thicker than the Watery humour, there appeareth no change in the Eye, by which Physicians are sometimes deceived, not knowing that kind of Suffusion, take it▪ for Gutta serena, perceiving no change in the Pupilla: but this kind is easily distinguished from Gutta serena. First, in Gutta serena the sight is quite gone, or much diminished, no hurt appearing in the Eye: On the contrary, In a Suffusion which we cannot see, there is only a small decay of sight, because the serous humour from whence it proceeds, is thin, and transparent, so that it may be pierced by the species of objects like Glass. Secondly, They differ in this, For the most part in a Suffusion, the Sight is not equally hindered in all parts of the Pupilla; but the objects sometimes are seen better when they are direct before the Eye, sometimes when they are opposite to the corner of the Eye, because the humour is thicker or thinner in one part of the Pupilla than the other. Thirdly, In a true Suffusion the Symptoms are continual, and have no intermission: in a bastard Suffusion, they are sometimes increased and remitted, as the vapours are more or less which are sent unto the Brain. So they are fewer when the Stomach is empty, than when it is full, especially presently after meat, for then a greater company of vapours do ascend, which sent to the Eyes, represent to the sight, Flies, Gnats, Cobwebs, and such like small bodies, not always, but at some times only. Which little bodies represented in the Air, depend upon the Vapours as aforesaid: but in regard the Eyes are weakened by a true Suffusion there is almost a continual sending up of vapours unto them, and therefore there is a continual appearance of these little bodies flying in the Air. Moreover, there is a constant darkness of sight in a true Suffusion, being always after the same manner, as if all the objects were seen through a cloud or thick glass, which is the proper sign of this Disease: but in a bastard Suffusion, there is sometimes a greater, sometimes a less, and sometimes almost no dimness at all of the Sight, even as the vapours are many, or few, or none that are sent to the Eyes. Lastly, A true Suffusion grows in a short time, and is confirmed for the most part in six Months, and sometimes it increaseth in a few days: and Fernelius saith, 5. Pathol. cap. 5. that a Suffusion was perfect in one day, which we also have often seen: but a bastard Suffusion continueth many years without increase. The Differences among true Suffusions are these: In a Suffusion beginning certain small Bodies, as Hairs, Gnats, Flies, pieces of Wool and Cobwebs, fly before the Eyes. But when it is far gone, the Air appears cloudy, and the objects are seen thicker, as through a glass; the colour of the Pupilla is changed, and it appears either troubled or cloudy, or like filthy Glass, or of a sky colour when a suffusion is perfect, the sight totally perisheth: the Pupilla is either white, or of some other colour is mixed with white. Some signs are taken from the Colour: for when it is like a Pearl in colour, it signifies that the phlegm is still fluid and transparent: when it is white as Chalk, than it signifies a thick and compacted matter: when yellow, than phlegm and choler are mixed: when black, it shows Melancholy. The Place in which the Suffusion grows, is thus known; For if the matter be placed between the Uuea and Cornea, the Pupil appeareth more dark, because the matter is nearer to the beholder▪ Moreover the Pupilla is dilated by the Humour contained therein; and when the Disease is confirmed, white or red veins, or swell are perceived to be about the Iris, or circle of the Eye; or certain white spots appear about the Pupilla. If the Matter be contained between the Crystalline and the Uuea, contrary symptoms will appear▪ as also the Pupilla will be contracted if the matter lie deep, and enlarged if the matter lie higher. The Prognostic of this Disease, is to be diversely made, according to divers seasons: For when a Suffusion is only begun, when the Patient can perceive an object as through a cloud, it is curable as Galen saith, 14. Meth. Cap. ult. and Celsus lib. 6. cap. 6. which Opinion wants a restriction: Namely, if the Patient be young, but in old it is incurable: and if the eyes be not naturally of a weak constitution. We also have seen some that have been cured in fifteen day's space, of a Suffusion newly began; who have been above fifty years of age, only by universal Purging, sweeting Diet, and a Vesicatory, without any other application of Topics. This Cure is better wrought in a warm air and in summer time, because the Pores are then open, the matter of the Disease ●● more movable and obedient; so that oftentimes it dischargeth itself by siege; which, is very much to the Cure of this Disease: as Hypocrates showeth, Aph. 16. Sect. 6. in these words, It is a good sign, when men with sore Eyes, have a lose 〈◊〉 If a Suffusion come from an acute Fever, a Peripneumonia, a Frenzy, or from a violent pain of the Head, it is hard to be Cured. A Cataract or Suffusion confirmed when the matter is grown thick, cannot be discussed with Medicines, but must be couched with a Needle. This Operation is not safe; and often hath ill success: For either the Tunicle Uuea is torn, or by the pain and inflammation, a new flux of Humours is brought to the Eye, which hath been long before weak: and many other inconveniences by which the sight is for ever lost. But since this Operation hath been sometime successful, it may be tried by those who have no other hopes of Cure; For it is better, as Celsus saith, to try a Doubtful Medicine, or Remedy, than None at all. In a confirmed Cataract, if when the other Eye is shut the Pupilla appeareth larger in the Eye affected, there is hope of Cure by Couching; but if it be no larger, it is uncurable; as Galen teacheth, 1. desymp. cause. cap. 2. because the optic Nerve is obstructed, and the spirits cannot come to the Pupilla, though it be open. But if the Patient perceive no light when the Pupilla is enlarged by the shutting of the other Eye, he cannot be recovered by the Needle, because the visive spirit is troubled and obscure, and therefore unfit for sight. A black Cataract, free from all brightness, can neither be Cured by Physic, nor Chirurgery; because the Visive Spirits are destroyed; but a clear Cataract that hath some splendour, is Curable. These also are uncurable for the most part, a green, dark, very yellow, and hard Cataract; and that which moveth and is coloured like quicksilver. A Cataract which representeth objects full of holes, is not to be tampered with: For since the matter is in the Centre of the Pupilla, it is to be feared, lest when the Needle is thrust in, the whole Pupilla be filled with the matter, and so the fight be utterly lost. The Operation of the Needle, is more successful, in a full Eye; and that which keeps its natural greatness: But if the Eye be small and decayed, it is less successful. In Old men, this Operation is not to be tried; nor in Children, in them the Disease is incurable; in these the Humour is too soft being not ripe; there is most hope of success in young persons. If this Operation be, when some part of the Suffusion floweth down (if the eye be compressed) and appeareth more large, and after returneth to its former station and figure, it is not successful; because the Cataract is not yet ripe, but thin and crude: But if by a compressing with the finger there is no change of the shape and figure of it; it is then ripe, and may be couched with a Needle. But we must take notice, That the ripeness or thickness of the Cataract ought to be moderate and not too much compacted, that it may be easily couched: for it ought to be like a thin skin which may be rolled about the Needle and so couched down; for if it be too thick and solid, it cannot be couched, which you may perceive when it is like Chalk or Hail. Contrarily that which is fit for couching useth to be Sky-colored, and Sea-green, of the colour of Iron or Led not black. The Cure of a Cataract must be directed not only to the Conjunct, but to the Antecedent cause. And therefore you must purge the whole Body, and especially the Brain very exactly. After you must discuss that humour which obstructeth the Pupilla, and some way soften it. Which intentions, when they are almost the same which were propounded in the Cure of Gutta serena, we may use the same Remedies for Diet, evacuation or purging of the whole Body, for revulsion of the humour offending, and for the strengthening of the Head and the Eyes, so we shall not in vain repeat them. Having therefore first used all that Method which was laid down for the Cure of Gutta serena, we will declare unto you those Medicines, which belong properly to the taking away of the matter about the Pupilla. And though Topical Medicines are counted little worth according to Galens Opinion, 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, who saith that they promise more than they can perform: yet their Lawful use is not to be rejected: and Experience hath taught, by very good Authors confirmed, that Cataracts in their beginning, after universal Medicines used, have been cured with Topics, that is, Medicines applied to the Eye. First therefore begin with mild dissolvers, and such as dry not overmuch lest the matter grow hard, and be made unfit to be dissolved: then use mollifiers with your dissolvers, that induration may be hindered, and it may more easily be dissolved. For this purpose the following Fornentation may be first used. Take of the Leaves of Rue, Fennel, Eyebright, the greater Celondine▪ of each one handful: Foenugreek seeds one ounce: Chamomel and Melilot flowers, of each one pugil: Boyl them in three parts of spring Water, and one part of white Wine added towards the end of the Decoction. Foment the Eyes with a soft sponge dipped in the strained Liquor, morning and evening. Of the same Decoction you may make a Fumigation, covering the head that it may be received into the Eyes. In the beginning of the Disease, while the defluxion is new, and that revelling Medicines are used, it is good to wash the Eyes with only red Wine, which by its astriction hinders the defluxion, and by its spirits discusseth and dissolveth it. In the progress of the Disease, a Fomentation of white Wine, in which Crocus Metallorum hath been infused, is most profitable. It is no less profitable to let a child eat sweet Fennel Seeds in a morning, and afterwards breath into the Eyes. As also to let him lick them, or to let a Dog lick them. Also Bread hot from the Oven, in which is sweet Fennel seed cut in the middle, may be so placed to the Eyes that they may behold it when they are wet with the vapour. These Medicines are to be used in the morning. At night you may apply this Cataplasm: Take of Fenugreek seed beaten one ounce: Aloes half an ounce: Saffron one dram: Make them into fine powder, put it into white Wine wherein Crocus Metallorum hath been infused, and make a Cataplasm to be applied to the Eyes at night. Many commend Pigeon's blood, put hot into the Eyes, for with the Natural heat of that Creature the part will be much strengthened, and the excrementitious matter dissolved: but because the heat will quickly departed from the blood, it is better to take a young callow Pigeon, and slit it in the back, and apply it to the Eye. With these Medicines you may discuss the matter if it be possible. Topical Medicines called Collyria, which are dropped into the Eyes, are of little force, and those are they which Galen said did promise more than they perform; for all their virtue is spent in the Cornea; neither can they reach to the internal parts, except they be made very sharp, by which, pain would be caused, and a greater defluxion: hence many that have used them immoderately, have from a light infirmity become stark blind. But because many of those Collyriaes' are found in Authors which have good report by them, lest we should seem defective, we will show some of the choicest, that they who please may try them. Take of the best Honey two pints: Fennel Roots, and the Roots of long and round Birthwort, of each one pound: the leaves of Rue, Eyebright, Celondine the greater, and the tops of Fennel, of each six handfuls: Centaury the less three handfuls: Roses four pugils: the Urine of a Boy two pints. Mix them all in a glass Vessel and distil them in Balneo Mariae. Drop this Water often into the Eyes. Or you may make Bread with the Bran in it, with the Powder of Rue, Celondine, Eyebright, Bettony, and Fennel with a little Honey, which as soon as it is drawn and cut in pieces, must be put between two Pewter or Silver Dishes; from whence will come a Water, which Zechius affirmeth, dropped into the Eyes, doth wonders. Also this following is highly commended. Take of white Violet Leaves, one handful: Radish seed, one dram: Amoniacum, half a dram: mix them, and powder them; then steep them twenty four hours in one pint of Fennel water: then let them boil a little space: ad to the straining one ounce of the clarified juice of Fennel: the Balsam of Peru, two drams: make a Collyrium: which Zechius saith, Dropped into the Eyes morning and evening, after the Body is sufficiently Purged, doth so cleanse the Eyes, that it takes away a Cataract wonderfully, without Couching. Hollerius Describes a Water, that he saith, Cured one that was Nine years blind: Which is this. Take of the juice of Smallage, Vervain, Germander, Burnet, Avens, Sage, Celondine, Rue, Knotgrass, Chickweed, the powder of Cloves, of each one ounce: gross Pepper, Nutmeg, Lignum Aloes, of each three drams: steep them all in the Urinal of a Boy, and the sixth part of Sack: Let them boil a little, then strain them, and press them, put it in a Glass close stopped; drop every night some of it into each Eye. The juice of Brooklime only, being often dropped into the eyes, hath sometimes Cured a young Suffusion, when a Cautery also hath been applied to the Coronal Suture. The Juice of Celondine and Calcitrap mixed together, are as good. Quercetan, in his Dispensatory doth much commend▪ Water in which Crocus Metallorum hath been infused, which is thus made. Take of the Water of the greater Celondine, six ounces: Crocus Metallorum, one dram: infuse them, and drop three or four drops of this Water warmed into the Eyes for three or four times a day for a long continuance. Fonseca saith, That he knew one Cured by this Water, who was very dim sighted many months: This is the excellency of it, which few other Medicines have; It cleanseth very powerfully without any sharpness. The same Fonseca says the Water following is admirable. Take many Swallows, beat them with their feathers in a Mortar: put to every pound of them four ounces of bread crumbs: of white wine, four pints: infuse them six days, and distil them in Balneo till they are dry: then set that Water in a Glass in the Sun for twenty days, and drop it into the eyes morning and evening. There is a Water made of Rosemary flowers, which discusseth Films in the Eyes after this manner. Take of Rosemary-flowers as many as are sufficient to fill a Glass which must be well stopped, and set it in the Wall against the South Sun, thence will an Oil come, which with a feather anoint the Eyes with. Some Authors commend the Galls of Beasts because they cleanse and discuss strongly, but they cause pain with their sharpness, and therefore are seldom used. Forrestus, Obs. 35. Lib. 1●. commends a certain Fish in his Country, out of whose Liver there comes a moisture, by which he saith Cataracts are presently, as by a miracle, Cured. See in the place cited the use of it. William Lozellus saith, That he hath Cured many stark blind, after universal Medicines have been used, with this Water. Take of the Liver of a sound Goat, two pound: Calamus Aromaticus, and Honey, of each half an ounce: the juice of Rue, three drams: the Waters of Celondine, Vervain, Fennet, Eyebright, of each three ounces: Long Pepper, Nutmeg, and Cloves, of each two drams: Saffron, one scruple: Rosemary-flowers bruised, half an handful: Sarcocol, and Aloes, of each three drams: the Gall of Ravenous Birds, Capons, or Partridges, one ounce: let those that are to be sliced be sliced, and that are to be bruised be bruised; then mixed altogether, with two ounces of white Sugar and six drams of Honey of Roses, cast them into an Alembick of Glass, and distil them in Balneo Mariae with a gentle fire, keep this Water in a Glass close stopped, for precious; which you may drop twice or thrice in a day into the eye affected. Zacutus Lusitanus commends the Water following, in these words, For an old Disease in the Eyes, called Ophtalmia, or any other which cometh of overmuch moisture, and gross humours and mists; as in thickness, whiteness, the Haw, and Suffusion; this Water is the best in his Experience; if after sufficient Purging, you drop six drops cold every night three hours after meat into the Eyes, then about two hours after you shall have Water flow out of them in abundance. Take of Aloes, three drams: Rue, Fennel, and Pettony, of each two handfuls: Vervain and Tormentil, of each one handful: Sarcocol, three drams: the froth of Nitre, two drams and a half: Sugar Candy, three ounces: syrup of Roses, four ounces: the Urinal of a young Boy, half a pint: Lizzards dung, three drams: Horehound, three handfuls: Eyebright, one handful and a half: Ginger, Spicknard, long Pepper, Cloves, and Tutty, of each two drams; Balsam, three drams: Honey of Roses, two ounces: Verdegreese, one dram: Licium, two scruples▪ Radish leaves, one handful: powder those which are to be powdered, mix them, and infuse them in the best white wine, in a Still, putting to a fourth part of the best Honey, for ten days, and stir them daily, then Distil them, and keep the Water. The same Zacutus commends the Ointment following, in these words: For the drying up of moisture flowing from the Head into the Eyes, and for Purging them by the Corners very strongly; this Magistral Ointment is excellent; being applied after universal Evacuations from the Head and the whole Body; let the upper Eyebrows be anointed lightly therewith morning and evening twice in a day three hours after meat: one hour after there will slow plentiful Water from the corners of the Eye, especially from the great corner. Take of the Oil of Roses, three ounces: Rose-water, nine ounces: Camphire, one dram: Tutty, one scruple: Honey, two ounces: the Gall of a Goat, half an ounce: Lupin meal, half a dram: Aloes, Succotrine, one dram: Sugar candy, half a dram: the juice of Horebound, Fennel, and Rue, of each half an ounce: Myrrh, one scruple: Ammoniacum, half a dram: Sarcocol one dram and a half: Powder them that may, mix them, and boil them a little with a gentle fire▪ and the grease of a Goat or Sheep, and a little wax: make an Ointment according to art. Finally, when all Medicines fail, when the Disease is almost desperate, it were good to try an experience with the Ointment of Quicksilver; which Fonseca saith was his invention, yet seldom used; for in his 19 Consultat. lib. 1. he thus saith: I have thought sometimes that the Unction used for the Cure of the French Pox, hath power to take away Cataracts in their beginning and increase; by the same reason that it takes away the Humours remaining in the Eyes from the French Pox; for by it the Head may be so Purged, that a Cataract may be Cured; and I have determined to make trial of it. Fonseca had much commended his Judgement if he had seen Skenkius his Observation, 309. Lib. 1. which is taken out of the 5. Book of Alexander Trajanus Petronus, of the French Pox, Cap. 1. One (saith he) before he had the French Pox was blind of one Eye with a Cataract or thick Suffusion; by the Unction with Quicksilver was freed wonderfully from his Pox and Cataract both at once: Neither is it without reason that Cataracts may be dissolved with that Unction, when we see by Experience that very hard Tumours of thick and gross Phlegm are powerfully dissolved by the Unction of Quicksilver. When a Cataract can be dissolved with no other Medicines, the last Remedy is the Chirurgical Operation, which with a Needle put into the Eye, after the matter of the Cataract being thick, and turned to a little skin, thrusteth it to the lower part of the Eye, so that the sight is restored as if a window were opened. This Operation is successful sometimes; but often not: But when the case is so that no hope remains of other ways, it is better according to the Opinion of Celsus, formerly Commended, to try an uncertain Medicine than none: But it useth not to be tried by reason of its uncertainty by ordinary Surgeons; but of Quacksalvers, who go to and fro practising, and therefore the time and manner of the Operation is to be left only to them. But because those things ought not to be hid from a Physician, you may find them exactly treated on in divers Practical Authors, when the Cataract is Cured. Whether it be with dissolving Medicines or manual Operation you must use a course of Physic long after, because there is a great fear of a Relapse. For the Eyes having been much weakened by a long Disease, are very ready to receive any Defluxion again from the brain. Therefore you must follow the usual Purging; you must have Issues continually for diversion; and use often strengtheners of the Eyes, such as are prescribed in Gutta serena: to which you may add a washing of the Eyes, which must be done every day thus: In the morning first chew sweet Fennel seeds some space of time, then fill the mouth with Wine, and after it is warm in the mouth, wash the Eyes therewith till they begin to smart, which will cease when you leave washing. Moreover Spectacles are very good to preserve sight which do make the Objects neither bigger nor less than they naturally are. And it is profitable to refresh the sight with green or sky coloured Spectales. And Lastly, You must avoid all things which hurt the sight, and use those things which help it, as is declared in the Diet for the Cure of Gutta serena. CHAP. V Of the Enlarging, or Dilatation of the Pupilla. THe Tunicle called Wea, out of Galen, 1. de sympt. cause. cap. 2. is obnoxious to divers diseases, and especially to Ruption, Distortion, Dilatation, and Constriction. A Ruption may come both of an external Cause, as stroke or contusion; and of an inward, when much humour distendeth and breaketh the Tunicle: But this being incurable concerneth not us. A Distortion of the Wea cannot be but in the first constitution of it, because it adhaereth to the Cornea. Therefore Galen in the place quoted doth only reckon it among the different symptoms of the Wea: and doth not stand to explain it, because it is of no concernment in the practice of Physic. We therefore omitting the first two differences, will only insist upon the explaining of the Dilatation, and constriction of the Pupilla. The Dilatation of the Pupilla, which is a hole in the Uvea Tunicle, by which the Species of Objects pass into the Eye, is called in Greek Mydryasis; this hurts the sight because too much light goeth into the Eye; hence it is that they which have this disease, see better in a darkish place than in a light. Which appears by Natural and ordinary change in the Pupilla in bright and obscure places; for when the Sight is exercised in a clear light place, the Pupilla is contracted that the light may go less into the Eye, and not hurt it with too much, by dissipating and dispersing the Spirits; and hence it is that they which go out of a very light place into a dark, see almost nothing at their first entry: because the Pupilla being formerly contracted, doth not in an obscure place receive light enough to make a perfect Sight. After, when they have continued a while in an obscure place, the Pupilla is by degrees dilated, to receive more light, for the clearing of Sight, and then those things which at first entrance were not seen, are clearly perceived. On the contrary, they which go out of a dark, into a very light place, cannot at first endure the light, and their Eyes are much dazzled, because the Pupilla being much dilated before in the dark place for to get light enough into the Eye, when it comes suddenly thus enlarged into a great light, too much light gets into the Eye, and so makes it dazzle and disturbs the Sight. Whence it appears, that light necessary to sight ought to pass into the Eye in a moderate quantity, and for the receiving thereof, it is necessary that the Pupilla be moderately large. Now the Preternatural Dilation of the Pupilla is either in the first original, which is not to be tampered with; or comes of Preternatural causes which are internal or external. The nearest and immediate of the internal causes, is the stretching of the Wea, which comes either of dryness or repletion. Dryness doth stretch the Wea, and makes the form of the Pupilla larger, as when leather pierced through, when it is dried hath the hole larger: And this dry distemper comes from long watching, Fevers, and other drying causes. The repletion of the Wea when it distendeth it on every side, makes the Pupilla larger, and this is produced either of vapours, and wind sent into the Eye, or of humours flowing thither, or from the extraordinary increase of the watery humour of the Eye, or lastly from the swelling of the Tunicle Uvea itself. To these Causes we may add, the Convulsion of the Uvea, which appeareth chief in Epileptical fits; for then all the Nervous and Membranous parts are distended, and so is also the Uvea; and this appears chiefly most manifest in Epileptic Children, in whom the dilation of the Pupilla is so great, that it is over all the Circle called Iris, and therefore the sight is abolished. The internal Causes are, a stroke, or a fall, or a retention of the Spirits, as in Women in Childbirth, and Trumpeters. A stroke or fall make a defluxion to the Eyes, hence comes extending of the Pupilla: retention of Spirits makes wind and humours, from whence comes distension. The knowledge of this Disease is not difficult, because it may be seen with your Eyes, especially if the Physician knew before it became infirm how large naturally the Pupilla was; as also if there be a hindrance of the sight by reason of the over largeness of it. Moreover, The natural largeness of the Pupilla is known by this, If when you shut one Eye, the Pupilla of the other is larger, which will not be in a Preternatural dilatation, because then the Uvea cannot be further extended. Lastly, If this dil●aation of the Pupilla be only in one Eye, it is Preternatural, and signifieth one Eye only is affected. As to the Prognostic, The Dilatation of the Pupilla from the original so, is incurable; but that which cometh after is hardly cured, especially that which comes of dryness, but that which comes of other ●inuance, is curable; because young diseases of the Eyes, according to Galens Doctrine may be cured, out old may not but with very much difficulty be cured. The Cure is to be varied according to the variety of the Cause; and if it come from dryness, which can scarce come from an internal cause, but also the whole Body must be so afflicted; therefore we must refresh the whole body with moist Remedies, and nourishments, and such as are restaurative, such we use in Hectic Fevers: but more peculiarly the Body is to be moistened with a bath of warm water, and new milk, which also must be often put into the Eyes, especially women Milk. If it comes from a humour which filleth the Eye, because it floweth from the Head you must purge the Head and the whole Body also, and then you must discuss the humour that is fixed in the Eye. Which when they may be sufficiently performed by the Remedies propounded for the cure of a Cataract or Suffusion, we shall not in vain repeat them here, but send you to the aforesaid Trearite for them, where you shall find all things necessary for the discussing and dissipating humours contained in the Eyes. Yet you may after use some astringents which may make the Pupilla which is too much enlarged more narrow: for this end you may make use of this following Collyrium, o● Water for the Eyes. Take of red Roses dried two scruples: Saffron, Spicknard, the Bark of the Frankincense Tree, of each half a scruple: Tutty prepared, lvory, and Acacia, of each one scruple: Bring them into a Powder, and put them in a thin linen cloth, and tie it; then hang it in three ounces of Rose Water, and wash the Eyes often with the Water, dropping into them, squeezing the cloth as often as you use the Water. If it comes from wind (after universal Evacuations) those Medicines are to be used which discuss wind in the whole Body, and especially in the Eyes, and so they may be fomented with the Decoction of Fennel, Rue, Dill, red Roses, Myrtles, made in Rose Water with the fourth part of white Wine. Finally, If it come with a stroke, you must alter the manner of Cure, according to the greatness of the Contusion; and if there be an Inflammation, you must cure it as an Opfithalmy: But if there be no Inflammation, you shall at the first apply a Cataplasm of Bean flower, Plantain Leaves, and red Roses made up with Rose Water. After that, you shall often drop therein the blood of a Pigeon, which is a most excellent Remedy in all Wounds and Contusions of the Eyes. CHAP. VI Of the straitness, or Contraction of the Pupilla. THe Pupilla being too strait, hindereth the sight, as the being of it too large, as was showed in the former Chapter, because a moderate largeness of the Pupilla is necessary for receiving perfectly the visible Species. So when the Eye is in its Natural condition, and is in a light place, the Pupilla is contracted lest it should take in too much light, if suddenly it be in a dark room, the things therein contained are little or scarcely seen at the first entrance, by reason of the aforesaid contraction. Afterwards when the Pupil is dilated, all things are seen rightly, therefore in a place moderately light, the breadth of the Pupilla ought to be moderate, that it may receive moderate light, not too much, nor too little, for making a perfect sight. But if the Pupilla be too narrow, it receiveth not light enough, therefore they who are so affected, the sight is diminished, yet they see well in a very light place, because at that time light sufficient will pass through a narrow hole, if no other Disease of the Eyes be joined with it. Now the narrowness of the Pupilla, cometh either from the original, or first constitution, and then it little hindereth; for if they who are so affected see less in a dark or dusky place than they who have a Pupilla of its moderate natural breath, yet in a clear light place they see better. Hence Galen said in 1. the symp. cause. cap. 2. that they who are born with small Pupillas see best. Or the straightness of the Pupilla comes from preternatural causes, namely, overmuch moisture, dryness, or defect of the Watery Humour, and want of Spirits. The Pupil is contracted by humidity, when the Uvea is relaxed, and so makes the hole less or narrower: For although the dilatation of the Pupilla come of the same humidity, yet contrary effects come not of the same cause, because if the cause may be called the same, it ought to have the same relation to its effects, but humidity is not in the same manner when it makes a Dilatation, for it makes ●hat by filling and distending the Membrane, but it makes the angustia or narrowness by relaxing it: 〈◊〉 relaxeth when it is united to its substance. Concerning dryness there is the same difficulty, since it is mentioned among the causes of dilating ●he Pupilla. But this is the difference: When the Uvea is dried, and the humours of the Eye remain in their due quantity, than it makes a dilatation of the Pupilla, because it looseth not the extension which it formerly had, as was said in the precedent Chapter, concerning Skins extended when dried, make their holes larger; but if the Tunicle Uvea when it is dried, wrinkled, falls together, and lose its former extension, from the defect or diminishing of the humours of the eye, then is the hole of the Pupilla made straighter. And so the constriction of the Pupilla by dryness will be almost the same with that which happeneth from a defect of the watery humour in the eye; although it may come without dryness, when by the pouring forth of the watery humour the Uvea falls down. Lastly, she narrowness of the Pupilla comes from the defect of Spirits, or from the fewness of them, when by reason of the obstruction of the optic Nerve or some other cause, the visive spirit cannot come to the eyes, which when it is filled with spirit keeps its Tunicles extended; but when it wanteth spirits they grow lax and fall together: Hence the constriction of the Pupilla usually cometh. This appeareth in very Old men, in whom the Pupilla is made narrow by reason of the want of spirits. This Disease is known easily being open to the sense, for if one eye alone suffer, by comparing it with the other you may perceive the straightness of the Pupilla; but if both suffer, by looking upon the eyes of another man who is sound sighted, you find it out. As to the Prognostic, a straightness in the Pupilla which cometh from the loss of the watery humour in the eye, is incurable, because when that is once lost it cannot be recruited; especially in old folk: in young people sometimes the watery humour of the eye hath been let forth by a wound, and hath been repaired again: A Constriction of the Pupilla from dryness, can scarce, and very hardly be cured: But that which comes from moisture, in the beginning, and being young, may be easily Cured: but an old one very hardly. The Cure of this Disease differeth not from the former, for they come both from the same Causes, namely, Dryness, or Moisture; which distempers, although they produce contrary effects, after the manner before Explained; yet are they to be Cured by the same Remedies. CHAP. VII. Of Albugo, or the white Spot called Pin and Web, and of other Colours of the Cornea changed. THe Natural Constitution of the Cornea Tunicle is destroyed when it looseth its brightness and transparentness; or when it's infected with another colour. It looseth brightness when it is grown thicker; now the Cornea doth grow thick by dryness, as in old men, which is incurable; or by gross humours fastened upon it, which happeneth often in an Ophthalmy; when either by too much use of Resolving Medicines the thinner parts of the humour are dissolved, and the thick remain: Or when by an extraordinary use of cold Medicines the humours are thickened: and the Cornea doth not only become thicker in that part unto which the humour is fastened, but it also contracteth a white Colour, which is called Leucoma, or Albugo; sometimes this also comes from a scar after an Ulcer, whereby the Cornea is made thicker in that part, and looseth its transparentness. The Differences are divers, as they are more or lessthick; one doth possess only the superficies of the Cornea: another lies more deep, and pierceth the whole Cornea: another is greater, and possesseth the whole Pupilla, or the greatest part thereof: another is less, and comprehendeth but a little space of the Pupilla, and then it is properly called Macula, or Pin and Web. The Cornea is altered in Colour when it is bloodshot, which Disease is called Sugillatio, and then all Objects appear red: Or when Choler is got into it, as in those who have the yellow Jaundice; and then the Objects use to appear yellow according to Galens Doctrine, which is to be understood of a great effusion of Choler upon the Cornea, for if it be only lightly died therewith, which often happeneth (for the Tunicle Adnata receiveth more Choler than the Cornea) than the Objects will not seem yellow, but as they naturally are. These Diseases need their peculiar Diagnosis for the knowledge of them; because they are apparent to the Senses, but especially Albugo, which is thicker and more white; and more hindereth the ●●ght: So also that which is more superficial is more white; but that which is deeper declineth unto black because it is nearer to the Uvea, which being its self black, communicates its Colour unto that. The Causes which produce these, are easily known by what hath been said; namely, if an Ophthalmy, or Wound, or Ulcer went before. As to the Prognostic: An Albugo which comes of Phlegm, or a thick humour remaining after an Ophthalmy, it is easily Cured, especially if it be not inveterate: but that which cometh after a Wound or Ulcer, and is a scar, is very hardly cured; because in a part which hath exquisite sense, sharp Medicines, such as are proper to wear away a Cicatrize or Scar, cannot be endured. The Cure of an Albugo congealed or gathered in the Cornea from Phlegm, is done by Emolients attenuating and discussing Medicines, but by always using universal Medicines first, wh●ch may take away the antecedent Cause, and hinder a new defluxion from the eyes, which would be caused by Medicines to the place; especially if they be sharp, or hot, except the matter be first removed. Therefore first make universal Evacuations, than revulsions, than Derivations, as it is set down in the Cure of Gutta serena, and Cataract. Afterwards apply a Fomentation to soften the hard matter (with soft sponges) made of the Decoction of Foenugreek, Melilot, Celondine, and Fennel. Or, Let the Vapour of it be taken into the eyes; and to this purpose you may make this that followeth. Take of Marsh-mallow Roots one ounce: the Leaves of Mallows, Eyebright, Celondine the great, of each one handful: Linseed and Foenugreek of each three drams: Melilot flowers one pugil: make a Decoction of these in springwater, and let the steem or vapour of it be taken into the Eyes, morning and evening. Afterwards use Discussives, such as are prescribed in the Cure of a Cataract or Suffusion; for they also will do well here. And so Collyria Eye waters which do attenuate and resolve the Humour fastened in the eye, may be taken from thence, and especially those which are made of Honey and things that quicken the sight. For the Water of Honey distilled used alone, is very good to take away all blemishes in the Eye if you continue the use of it any time. Sugar Candy is good for the same, Dissolved in the Water of Eyebright, Celondine, or Fennel. As also it would be very good to let a Child that hath chewed Fennel-Seed to lick the Eye often. Amatus Lusitanus reports that he Cured thick clouds in the Eye of a Girl of twelve years of age after he had given the Decoction of Sarsa twenty days, with this Medicine. Take of Honey from the Hive two pints: the tops of Fennel, the flowers of Elder and Eyebright, of each two pugils: Sugar Candy four ounces: distil them in Balneo Mariae; and let the water be dropped into the Eyes. The Seed of Clary put into the Eye at bed time, purgeth the Eye from Filth, and foe cleanseth it, that it conduceth to the Cure of Albugo. The juice of Fennel doth potently discuss an Albugo if newly made, and mixed with a drop of the Balsam of Peru. The same doth an Oil made of Rags mixed with the spittle of Child, and laid on with a Feather: It is made by burning of a Linen Rag, and quenching it between two dishes; when it is cold you shall find the Oil in drops upon the dish. But Albugo coming of a Scar, is cured with Remedies that are good to mollify, attenuate, and dissolve Scars; but since such are always sharp, you must be more careful in applying, first universal Medicines, and revulsives, lest a flux of humours be brought to the part. Having therefore used them as aforesaid, first it is good to apply emollient Fomentations or Fumigations above prescribed. Then use abstergent & discussing Remedies: First those that are gentle, such as are above mentioned, especially the compound Water of Honey: After you may come to stronger, such as are the Galls of Fishes, of the Uranoscopus, or one-eyed Fish; of the Pastinaca, or fish like the Ray; or of the Pike; as also of other Creatures, as of a Partridge, Cock, Goose, Ox, and others. After the same manner may be used the juice of great Celondine, of the lesser Centaury, of Brooklime, and the like, which must be mixed with Honey both because Honey hath a cleansing and discussing quality, as also because Liquors that are put into the Eye, flow to the corners, and stay not in the Pupilla in which their operation is required; but being thickened with Honey, they cleave well to the Eye: But if their sharpness cannot be endured, the said Juices or Galls may be thickened, with that Mucilage or slime of Gum Traganth, of Fleabane, or of Quinces, being drawn with the Water of Fennel, Eye-bright, or other proper to the Eyes. The form of a Collyrium made of Juices, is thus: Take of the Juice of Fennel, Celondine, and Brooklime, of each three drams: the juice of the lesser Centaury, ha●f an ounce: white Honey one ounce: ' Mix them like a Lineament. If with the Albugo there be redness of the Eyes, the Collyrium made of Salt, white Wine, and Wheat prescribed in the Ophthalmia, is very good. Or this, Take of Aloes and Agarick, of each one scruple: Powder them, and tie them in a clout; which steep in the Water of Eyebright or Fennel, and wipe the Eyes therewith morning and evening. Aloes doth cleanse, strengthen, and stop the defluxion; Agarick doth powerfully cleanse. Sugillatio or bloodshot, or that red colour in the Eye which cometh of blood sent thither, if it be young, is easily cured with Pigeon's blood dropped in: but in the want thereof you may use women's Milk with a little Frankincense and Saffron. Or you may apply the Yolk of an Egg with Wine; which is commended of Galen, 4. de comp. Med. sec. loc. cap. 8. But if the disease be stubborn, you must foment the Eye with the Decoction of Foenugreek, Marsh-mallows, Fennel, Rue, Celondine; or let the fume of the same be received into it. And finally, all Medicines prescribed in the Cure of a Cataract may be very proper for the cure of this. But more especially, when the disease is old, and the redness turneth black, Galen commends dried Hyssop tied in a rag, and put into hot water, and applied to the Eye: and Experience teacheth that this Medicine is of such force that the blood is drawn away by it sticking to the clout. And lastly, The yellow colour of the Jaundice, which most appears in the Eyes, when the Jaundice is cured is easily discussed: if you would hasten the Cure, take the fume of Vinegar into the Eyes. CHAP. VIII. Of Ophthalmia, or Inflammation of the Eyes. THe Tunicle called Adnata is so joined to the Cornea, that many diseases are in both; as the Inflammation of the Eyes, though it is proper to the Adnata, yet it is often extended to the Cornea, and produceth divers Diseases in it, namely, Ulcers, Hypopyon, when matter is underneath, Albugo or Pin and Web, and others. So also Pustals, and other Tumours, Wounds, and Ulcers are common to both Tunicles. Therefore because all the Diseases of these Tunicles cannot be spoken of severally, we will only speak of the Diseases of the Adnata before we speak more of the Cornea. Beginning with an Ophthalmy; We say that it is, as the word in Greek showeth, only an Inflammation of the Eye, and by all Authors it is used for the inflammation of the Adnata, or Conjunctiva. It is called by the Latins Lippitudo or blood-shotness since Cornelius Celsus. This Inflammation, as it is greater or less, hath a threefold difference. The first is called in Greek Taraxis, in Latin Conturbatio, which according to Paulus cometh from an external cause, namely, the Sun, smoke, dust, oil, and the like: but it may also come of an internal, namely, by fault of the stomach after drinking of Wine, or other Distempers; and this is a light Inflammation called Phlogosis, with a small pain and redness, yet it sometimes turneth into a true Ophthalmy, and is the original of it. But a true Ophthalmy comes always from an internal cause, and it is a true inflammation with which tumour, redness, and pain, it is called by Celsus, Lippitudo or blood-shotness, because there cleaveth a thick excrement, which the Latins call Lippa. The third is called Chemosis in Greek; in Latin Chemosis also, and it is when an inflammation groweth so high that it is very great with vehement pain, and both the Kickshaws are inverted so, that the Eyes can scarce be covered therewith; and the white of the Eye stands higher, and the red doth cover most part of the Iris or Circle. In Children, and such as have great Eyes, this hath often happened, and it comes from a great repletion, and from flegmy humours. There is another Difference of the Ophthalmy taken out of Hypocrates, Aph. 14. Sect. 3. by which it is divided unto a moist and a dry Ophthalmy: The moist Ophthalmy is that which is already described, and hath a weeping. But the dry Ophthalmy called by Hypocrates, Xerophthalmia, which cometh in dry weather, is made of Choler, or burnt or adust Melancholy, and is such as wanteth humidity in part, and therefore there is no weeping. There are other subdivisions from the adjuncts; for if there be an itching joined with it, it is called Psorophthalmia; but if it come with hardness of the Eyelids, it is called Sclerophthalmia. There is also another Difference of Ophthalmies, taken out of Galen, 2. de diff. febrium, cap. 11. where he saith That some are Periodical, or such as cometh by fits, to those which have a very hot and moist head, and weak Eyes, fit to receive a defluxion. These after many years have a consumption of their Eyes, and lose their sight; hence it is called Tabida Ophthalmia, or a consuming Ophthalmy, or an Ophthalmy which ends in a consumption of the Eye. There is also another difference taken from the immediate cause, which is defluxion or congestion, that is, gathering of humours. It comes for the most part by defluxion; but by congestion only, when there is either a distemper or weakness of the Conjunctiva, by which there is no equality, or Omoiosis in the part, but many excrements are gathered together, from whence through the weakness of the part cometh an inflammation. The Conjunct cause of an Odhthalmy is Choleric, or Waterish, or Melanchollick Blood flowing into the Eyes, or gathered into them. The Causes of defluxion are manifold, both external and internal ordinarily known. But the causes of Congestion or Cumulation are all such as distemper or weaken the Eyes; so that an Ophthalmy which at the first came only by defluxion, in time by weakening of the part may spoil its concoction, and so it may be said to be an Ophthalmy partly from defluxion, and partly from Congestion, which is often seen in old Ophthalmies. But when an Ophthalmy comes only by way of defluxion, it is certain that it comes for the most part from the head, and almost all Authors acknowledge this. Notwithstanding Experience teacheth that many violent Ophthalmies come from the Liver, and the humours that come from thence to the Eyes; insomuch that Cauteries applied to the hinder part of the head, e●crease the Disease, which otherwise are good Remedies when the defluxion is from the head, for they draw up the humours: and we have often seen that old Ophthalmies which were accounted incurable, have suddenly gone away of their own accord, by stopping of an issue which hath long been kept open, namely, when the motion of the humours from the inferior to the superior parts hath ceased, which before was caused by the Cautery or Issue in the Neck, by Nature sending part of the humours to the weakened Eyes, not far distant from the Issue. That defluxion which cometh from the head, either is carried by internal Veins, which are under the Skull, into the Eyes; or by the external Vessels, which is most frequent, namely, by the Veins, and Arteries which come from the Pericranium by the Forehead and Temples, to the Conjunctiva. An Ophthalmy is easily known, because the blood diffused upon the Conjunctiva may be easily seen, and if redness appear without a tumour coming of an external, it is called Taraxis, or Conturbation. But if besides the redness there be swelling and heat with weeping, it is a true Ophthalmy, and at length if it so increase that it cover the black of the Eye, and the Eyelids be inverted, then is it called Chemosis. Hence we fetch the signs of the Causes: for if it comes from repletion, and of blood alone, not only the Tunicle Adnata, but also the whole face will be red; as also there will be a swelling of the Veins, drowsiness of the Senses and whole Body, and a manifest swelling. If it come from Choleric Blood, there will be sharpness of tears, and not only the corners of the Eyes, but also the very cheeks will be corroded, there will be a pricking and intolerable pain, a little swelling with redness inclined to yellow; and the patiented hath formerly used immoderate exercise been inflamed by the Sun, subject to anger, and eating of sharp things, his complexion is Choleric, or he is young, and the disease cometh in hot weather. If it come from phlegm, there will be a heavy pain, little heat, not much redness, little shooting, no sharp tears, but many, and slimy and glutinatious. If it come of Melancholy, the Tumour will be small, the redness will be dusky, few tears, little clamminess, but very thick, a Melanchollick constitution, and the like signs of Melancholy. If the defluxion come from the inner parts of the Head, there will be a pain in the Head internally coming to the Roots of the Eyes. But if the defluxion come into the Eyes by the exterior Vessels, the pain of the Head will be more external, the Veins of the Forehead will be distended, and also there will be perceived a great beating in the Temples. The Prognostic is either in respect of an Ophthalmy coming, or already begun. An imminent Lippitudo is known by an itching and pricking in the Eyes, with heat also, and the disposition of the Eyes to receive defluxions, doth give advantage to the prognostic of it; wherefore they who have great Eyes are more subject to this disease: Moreover, the season doth much conduce to the breeding of it, as Hypocrates teacheth, Aph. 11. Sect. 3. If the Winter be dry and full of North winds, and the Spring rainy, and with South winds, in Summer you shall have sore Eyes very common, especially in women, and men of moist constitutions. A flux of the Belly coming upon an Ophthalmy is good, according to Hypocrates, Aph. 17. Sect. ●6. because the superfluity of humours is discharged, and carried downwards. An old pain in the Eyes is very dangerous, for it signifies the cause to be violent, and it is to be feared lest Imposthume, Suppuration, or Ulcer do follow. An Ophthalmy beginning in one Eye useth ordinarily to pass to the other. For the Cure of an Ophthalmy, the external causes must be first removed, as also the antecedent causes are to be evacuated, reveled, and repelled; the conjunct cause is to be derived and discussed, and the part affected strengthened. For the performing of which Indications there are these usual means to be applied. First, Let his Diet be cooling and moistening, of Meats that breed good nourishment, boiled rather than roasted; of suppings rather than solid things; because the Eyes are moved in chewing: let him avoid sharp things, Salt and Pepper. As also things that Fume, and will fill the Head with vapours: As also such as quickly turn into Choler, as Milk, Sugar, Honey, and all sweet things; Wine especially is not good; but instead thereof use Barley water, with Liquoris and cooling things. Sleep is very profitable, because then the Eyes rest from motion which is apt to stir up pain and defluxion; besides pain is assuaged by sleep, and the matter causing the Disease is concocted: Let the Patiented sleep with his Head high, and more inclined to that side which is least affected. Let him avoid almotion of his Body, for rest is so profitable that Celsus commands that the first day of Cure they speak not, lest by that motion matter be carried to the head. The Belly must be kept Solluble, for Hypocrates saith it is good for him that hath sore eyes to fall into a looseness. Let him avoid Passions, especially Anger. Let the Air be temperate and pure, without Smoke, Dust, and Winds, and somewhat dark; of the light by moving the Spirits causeth defluxion: Let him have a black, green, or sky coloured cloth before his eyes; and keep not only his sore but his sound eye shut or covered; for while the sound eye is moved towards the Objects the sore is moved also, whence the pain increaseth; and this is the reason why men have greater pain when one eye is affected, than when both. The Diet being thus ordered, let us lay down the Cure of the Disease; and since it comes for the most part of external Causes: first let them be removed lest they nourish it: next make a Collyrium, or Eye-water, or Rose and Plantain Water, with the white of an egg, and Woman's milk, and let that be instilled into the Eye often in a day; as also let a linen clout be dipped therein and applied. At the same time let him sleep as much as he can; for sleep is very profitable to concoct and discuss the matter causing the Disease. If it yield not to these, you must use the Remedies proper for a true Ophthalmy, in this Order. First open a Vein (having given a Clyster) on the contrary Arm, and do it often, till you have made sufficient Evacuation and Revulsion: For Avicen teacheth, That in a true Ophthalmy you may let blood till they faint. But Galen, lib. de curate. per sangu. miss. cap. 17. tells a story of a Steward which was freed of a great Ophthalmy by blood letting: first three pound; and four hours after one pound: And in his 16. cap. of the same Book he affirmeth, That Ophthalmies are often cured in an hours space only by Phlebotomy: which could not be but by losing of a great quantity, as they did in those times in that case. Phlebotomy must be regulated and moderated according to the temper, age, sex, strength, and kind of the Disease; for in a Plethoric body, and when it comes from blood, you must take a greater quantity: but in a Choleric body, or Melancholy, or Phlegmatic, and other Circumstances which prohibit blood-letting, you must take less. If the whole body be full of blood, first open the Liver or Median vein, after the Head vein; but if you intent to lose but little blood, begin with the Head vein. But in them who have a stoppage of any ordinary accustomed Evacuation by the Terms or Hemorrhoids, you must open the veins beneath, or apply Leeches to the Hemorrhoid veins. After you have bled enough, you must labour to make Revulsion by applying of Cupping glasses to the shoulders and the back, both dry and with scarification. Frictions also are good for the same; and Ligatures in the lower parts. To the aforesaid Revulsions you must add means to derive, which are by the opening of the veins of the Forehead and Temples; to which some add the opening of the veins in the corners of the Eyes: others apply Horsleeches to the Temples, others behind the Ears; all which derivations are very profitable after sufficient Evacuation. Galen 13. Meth. Cap. 22. Commended the opening of an Artery in the Temples, when the Disease comes of very hot blood: And though this way of Practice is not used in our times, yet it is very excellent and profitable, without any danger; for in those lesser Arteries the blood is staunched by good Ligature and bondage only; nor is the Plaster mentioned by Galen in the same place necessary, which is made of Bole, Frankincense, Mastic, and the Hair of an Hare, with the white of an Egg: yet for the better security, they who are afraid of the opening of an Artery, may make use of it; you may see what we have said concerning the opening of Arteries in the Cure of the Headache. Vesicatories' also are very profitable in this Disease, both applied to the Neck and behind the Ears. When you have bled sufficiently you must purge, that the Choleric Humours, especially such as make the blood hot, may be evacuated: And Hypocrates saith it is very requisite, Aphor. 17. Sect. 6. For it is good for him that hath an Ophthalmy to fall into a flux. And Galen, 13. Meth. Cap. 11. saith, That he hath seen some who began to have sore Eyes to be cured in one day only by a Purge. But it must be made of gentle ingredients, and such as do allay the heat of the blood, taking heed of all Medicines that have Scammony in them, and they be made thus. Take of Tamarinds half an ounce: clean Senna three drams: Annisseeds half a dram: Endive, Succory, and Fumatory, of each half a handful: boil them to four ounces; and when it is strained infuse in the liquor of the best Rhubarb and yellow Myrobalans rubbed with the Oil of sweet Almonds, of each one dram: yellow Saunders half a scruple: after strain it again, and dissolve of Manna and syrup of Roses of each one ounce. Make a Potion. Or in Form of Bolus, thus. Take of Cassia newly drawn six drams: Diacatholicon three drams: Powder of Rhubarb one dram: make a Bolus with Sugar. So many times we prescribe Pills in an Ophthalmy which comes of Phlegm, namely, Lucis majoris, of Agarick, and the like: which though they are very good in the state of the Disease, yet it is better to abstain from in the beginning, lest the Humours moved with too violent a Medicine should fall more upon the part. Nor is one Purge sufficient, but you must repel it a distance, if the Disease be old; first giving good preparatives by Apozemes or Juleps proper for the Humour offending: therefore in the beginning allay the heat of the Humours with cooling Juleps, and such as thicken; or with Emulsions made of the greater Cold Seeds, Lettuce and white Poppy seeds, in some cooling Decoction, with a little Rose water. After universal Revulsions and Evacuations come to Topical Medicines with that part, which from the beginning must be repelling; yet the soundest Practitioners do warn us not to use repelling Medicines to the Eyes at first, because for the most part they stop the Humour and retain it in the Eye, and so increase the grief and inflammation: For Galen Comment. Aphor. 31. Sect. 6. reproves a certain Oculist which used these kind of Medicines in the beginning of the inflammation; for they may be suspected in the beginning not to stay violent defluxions, but rather to keep them from coming forth: Hence it cometh to pass that when the humours are sharp the Cornea is sometimes ulcerated, but when they are many it is streaked and sometimes broken: But Avicenna, fen. 3. lib. 3. tract. 1. cap. 9 saith, That it is fit, that if possible, we abstain from Collyriums' the first three days. And a little after, he saith, That we ought not in the beginning to apply strong Astringents and thickners: because they thicken the Tunicles or coats, and hinder resolution and increase pain. Yet we need be so exact in the time and number of days, because the Disease is in some older, and in some younger: But we may with profit apply Astringents at the beginning to the Forehead and Temples; for by those, the veins by the humours flow to the Eyes are stopped, and they driven back. The Form of this is as followeth. Take of Bolearmonick, sanguis Draconis, Frankincense, Mastic, of each one dram: red Roses, Balasts, or Pomegranate flowers, & the powder of Lentils, of each two scruples: mix them with the white of an Egg and Vinegar of Roses, and make a Cataplasm for the Forehead, and Temples. Moreover, A Cataplasm made of the Juice of Nettles and Wheat flower, applied to the Forehead and Temples, is excellent to stay a defluxion by reason the Juice of Nettles hath a special Virtue for the stopping of all sorts of Bleedings, as it doth the bleeding at the Nose or Mouth. But if the pain be very great, which useth to increase the defluxion upon the Eyes, you must apply anodynes or Medicines assuaging pains upon them. Among which new milk, especially if it be that which a sound woman giveth is best, if it be often milked fresh into the Eyes from the breast▪ and not be used stolen, for than it will grow sour and be offensive to them: instead thereof you may use fresh Cheese made of Sheep's milk, which you must often change, lest it turn like Butter, and so inflame the Eye. The white of an Egg well beaten till it turn to water, is commended of Galen, for it assuageth pain, and gently stays the Flux. Also an Apple roasted in the Embers doth much assuage the pain of the Eyes. The Mucilages, or slime of the seeds of Fleabane, Quinces, Foenugreek, drawn with Rose-water, do take away pain; but they must be renewed every day or they will grow sour. Of these things you may make divers kinds of Medicines. As for Example. Take of the pap of a sweet Apple roasted in the embers, an ounce: the Mucilage of the seeds of Fleabane and Quinces drawn with Rose Water, of each six drams: the white of a new laid Eglantine beaten into water, and woman's Milk, of each one dram: Make a Cataplasm and apply it to the Eyes. Or, Take of the pap of a roasted Apple one ounce: Crumbs of white Bread half an ounce: one Egg mixed with Breast milk: Make of these a Cataplasm. Thin slices of Goat's Flesh, Veal, or Mutton, often applied to the Eyes, do very much assuage pain. A Cataplasm may be made more easily with crumbs of white Bread, and Woman's Milk mixed with Rose Water. If the pain be intolerable, you must fly to Narcotick or stupifying Medicines, which you must use sparingly, and with good advice, because they do thicken the visive Spirits, and make the Humours and Tunicles gross, by which the Sight will become dim. Among Narcoticks for the Eyes, the white Troches of Rhasis are principal; made with Opium thus: Take of Rose water two ounces: the Water of an Eglantine well beaten one ounce: the white Troches of Rhasis with Opium, one dram: Make a Collyrium, or Water for the Eyes. When the pain is aslwaged, you must come to repelling Medicines, which must be gentle and mixed with anodynes continually: for this end make this Collyrium following: Take of Plantain and Rose water, of each one ounce and an half: the Water of the white of an Egg beaten, one ounce: the white Troches of Rhasis with Opium, one dram: Make a Collyrium, and drop it often into the Eyes. If the pain be very great, you may put to it Woman's Milk, and the Mucilages aforesaid. This following Medicine doth powerfully resist inflammation, and stay the flux. Take of the white of an Eglantine, beat it in a pewter dish with a piece of Alum very well, till it come to the consistence of an Ointment, which you must spread upon a linen cloth, and apply it warm to the Eyes: After two or three hours take it away, left by its long continuance having an extraordinary astringent quality from the Alum, it retain the humours in the Eyes. Also the Water of Alum distilled in an Alembick, laid to the Eye with a linen clout, doth allay the inflammation thereof. The Salt of Lead dissolved in Rose Water, or Wine Vinegar, or mixed with Pomatum, doth powerfully cool the inflammation. In the increase of the Disease you must mix digestives with Repelling Medicines, and therefore you must put the Water of Eyebright, Fennel, Celondine, and the Mucilage of Linseeds, Althaeae, o● Marsh-mallows, and Foenugreek, Gal. 13. Meth. commends especially the Decoction of Fenugreek, because it digesteth, concocteth, and moderately repelleth: but you must sift the Fenugreek to take out the dust, and after wash it often in warm Water, before you boil it, or make the Mucilage of it. You may thus make a Collyrium. Take of the Mucilage of the seed of Foenugreek, and Quinces drawn with Rose, and Eyebright Water, of each one ounce and an half: the white Troches of Rhasis with Opium, one dram: Tutty prepared half a dram: Make a Collyrium. When the Disease is at the height, you may put Sarcocol to it, which is of a more digestive quality; but since it is apt to hurt the Eyes by its over dryness and sharpness, it must first be steeped some few days in Milk, often changed, and you must prepare but a little at one time, for if it be long kept it will grow sour, and hurt the Eyes. You may use it thus: Take of the flowers of Chamomel, Melilot, and red Roses, of each one pugil: the seeds of Foenugreek cleansed one dram: boil them in Plantain Water. Dissolve in four ounces of the straining, Sarcocol one dram: Tutty prepared, and of the white Troches of Rhasis without Opium, of each half a dram: Make a Collyrium. Authors do commend some Waters to be very powerful. Quercetan commends the infusion of Crocus Metallorum made in Eyebright and Fennel Water, which is strong enough, and is no ways too sharrp for the Eyes as others are. Crollius and the rest of the Chemics, do highly commend the Salt of Lead dissolved in Rose Water, to which they put a few grains of Sul Armonic. The manner is thus: Take of the Salt of Lead twelve grains: Sal Armonic three grains: Rose Water three ounces: Mix them, and drop some into the Eye morning and evening. There is also a Water made of calcined or burnt Lead, or Litharge, or Menium infused in Vinegar, which laid to the Eye with a linen clout presently cureth their inflammation. The Water of white Vitriol is most common, being dissolved in Rose or Plantain Water; this mitigateth inflammations, discusseth, and hindereth defluxions. Thus they are proportioned: Take of white Vitriol one scruple: Rose or Plantain Water four ounces: Dissolve the Vitriol in it at the fire: Strain the Water and drop it into the Eyes. If it be too sharp, you may qualify it as you please with more Rose or Plantain Water. This following Medicine is not so sharp, and more dissolving. Take of Flower-de-luce Roots, and red Roses, of each one scruple: Rose and Plantain Water, of each three ounces: Boyl them to the third part with a gentle fire. Ad to the straining white Vitriol poundered eight grains: Make a Collyrium. Many Ointments also are used for the Eyes, of which, these three following are the best, and sometimes do wonders. The first is in Renodaeus his Dispensatory, called Vnguentum Ophthalmium, made thus: Take of Bolearmenick washed in Rose Water, one ounce: Lapis Calaminaris washed in Eyebright Water, and Tutty prepared, of each two drams: Pearl finely powdered half a dram: Camphire half a scruple: Opium five grains: Butter as much as will be sufficient to make an Ointment according to art, for to be applied to the corners of the Eyes, and the Eyelids. The second is John Cratoes, which is set down in his Physical Counsels gathered by Laurence Scholzius, Cons. 6. thus: Take Butter made in May, if you can get it, or other that is fresh and well worked, or the marrow of an Ox or Deers Shank, and mix therewith as much of the fine powder of Lapis Calaminar is as it will receive, make an Ointment. The third is from Paenotus in denario, thus made: Take of Tutty prepared one ounce and an half: Camphire one dram: Verdegreece twelve grains Beat the Tutty with the Camphire together in a Mortar, the Verdegreece by its self, all very sine: Then take of fresh Butter one ounce: Rose water, one dram: boil them gently together, and then take them from the fire, and first put in your Camphire with your Tutty, than your Verdegreece by degrees; stir them very well, and reserve them in a glass. Make an Ointment and strain it through a Sarsenet; anoint the inside of the Eyelids, especially about the corners, and the Patient will soon recover. This is a most approved Medicine against Inflammations both with matter and dry, against itching of the Eyelids, and weeping. There is another very good, though sharp, and therefore must be only applied to the Eyelids; it is thus made: (And when all have failed, this hath cured the most desperate Ophthalmy) namely, Of May Butter, and Juice of Tobacco boiled to an Ointment, which must be applied, the Eyelids being closed, and in a darkroom; as soon as the Patient opens his Eyes, it will begin to by't, and will certainly cure. In the height of the disease, you must apply more resolving than repelling Medicines, therefore they which were prescribed in the increase of it are good in the height or state of it, if you increase the quantity of the resolver's, and diminish the Repellers. But especially these two following Ointments may be used not only in the state and height, but in the declination, to the perfect cure of the Disease. First Fomentations to discuss the matter, are good in the height of the Disease, made thus: Take of the flowers of Chamomel, Melilot, and Roses, of each one pugil: Foenugreek seeds prepared as before shown, two drams: Make a Decoction, with which foment the Eyes with four-double clouts. This is good in the end, of the increase, and the beginning of the state of the Disease; and in Winter you must use it hot, in Summer only warm. In the end of the state and declination, you must make a more resolving Fomentation, which is done by adding to the former Ingredients, the Leaves of Eyebright, Margerum, Bettony, and a little white Wine. The best and rarest Secret from the Cure of an Ophthalmy, is made of the Oil which cometh from Linen burnt between two close dishes; one drop of which mixed with the spittle of a Child must be dropped into the Eye with a Feather. In the declination, not only the Remedies afore mentioned, but also Waters more resolving are to be used, as thus: Take of Frankincense and Aloes, of each half a dram: Sarcocol washed with Breast-milk, one dram and an half: Saffron half a scruple: the Mucilage of Foenugreek half an ounce: Fennel and Eyebright Water, of each one ounce and an half. Make a Collyrium. But if you will, dry more, and also digest. Take of Sarcocol one dram and an half: Tutty prepared one dram: Aloes one scruple: Myrrh half a scruple: the Mucilage of Foenugreek half an ounce: Vervain and Celondine Water, of each one ounce. Make a Collyrium. In a defluxion which comes of phlegm, you may use strong resolver's, not only in the declination, but also in the state and increase of the Disease very confidently. Moreover, In the declination Authors do set down two special Remedies, namely, The use of Wine, and Baths: which first were delivered by Hypocrates, Aph. 31. Sect. 6. in these words; Drinking of Wine, or Baths, or a Fomentation, or Blood-letting, or a Potion, do take away pains in the Eyes. Galen in his Commentary thereon, distinguisheth the Case and the Time in which these Remedies are good, which we have explained as to Blood-letting, Fomentations, and Purging: But Galen in the place cited, cap. 22. lib. 13. m. teacheth that Baths are then good, when an Ophthalmy 〈…〉 of sharp humours, and when the body is sufficiently cleansed by purging and bleeding: because they qualify the sharpness of humours, and stays their motion and defluxion; the chiefest part 〈◊〉 them being sent forth by insensible transpiration, and that which remaineth of the Choleric hu●mor is easilier overcome by nature. Galen also commends a Bath in a Phlegmatic Ophthalmy, always using before Evacuations necessary, because the thick humours fastened in the Eyes are extenuated by Baths, and so are easily discussed. So Galen in the same place saith, That the drinking of pure Wine is good for those who have thick blood in the veins of their eyes, and have not gross or phlegmatic bodies; because Wine doth dissolve, diffuse, and discuss the thick blood, and also openeth obstructions. For the taking away of the remainder of Redness and Inflammation, make this Fomentation following. Take of the Leaves of Eyebright and Pennyroyal of each one handful: the Flowers of Chamomel, Melilot, and red Roses; and of Oaten chaff, of each one pugil: Foenugreek-seed three drams: Fennel-seed one dram: make a Decoction, adding in the end a little white Wine, foment the Eye with this, dipping therein linen , or with bags being half filled with the aforesaid ingredients. Fennel water alone mixed with astringent wine is a good Fomentation to discuss the relics, and to strengthen the eyes. An Egg boiled hard, and the shell taken off, and cut in the middle, laid hot to the eye, takes away the remainder of redness. So doth a Fomentation made only of the Decoction of Hyssop. An old Ophthalmy requires another and longer way of Cure, and is sometimes very troublesome to a Physician; because he can hardly hinder a delicate and noble part from receiving a defluxion by which it hath been long weakened. Moreover, This Disease is not only nourished by defluxion, but by congestion whereby there is destemper brought into the part, which also is hard to cure. But for the Cure of it you must first observe whether the Disease come not from a hot Distemper of the Liver, as often it doth: and then you must first administer such things as amend that. And chief after convenient Purging and Bleeding, Baths are good, Whey, and Mineral waters of Vitriol, as also Horsleeches applied to the Hemorrhoids. But if the matter of the Disease come only from the distemper of the Brain through which watery Humours flow to the eyes being mixed with some blood: than you must fall to purging the head with ordinary Pills, twice, thrice, or four times in a month, after you have given universal Medicines, as Apozemes or the like; which you may make according to our description in the cure of cold Diseases of the Head. If the aforesaid Purges with other Medicines now prescribed do not prevail, you must use Mercurial Purges as the most excellent, by way of intermission. Moreover a Cautery applied to the hinder part of the head is very profitable, to divert the humour flowing. Instead whereof you may apply a Seton to the Neck behind, with better success, to them who can endure it. A Vesicatory applied to the forepart of the Head, as Forestus reports, Obs. 11. lib. 11. did a wonderful cure upon an Old Woman with sore eyes. But Rondoletius says, That a Cautery applied to the Coronal Suture, is better than to any other part. Masticatories are profitable for the deriving of the Defluxion, but not Errhins because they are applied so near the part affected that they may draw humours to it. But if the Brain doth seem to want drying, you must have recourse to your sweeting diet drink of China, Saria, and the like. To these you may add Topics, which resolve and strengthen the eyes; such as are Fomentations and Unguents before mentioned for the state and declination of the Disease, which also are excellent for old Ophthalmies: nor must you forget the washing of the eyes as above mentioned with Fennel-water and red Wine, to take away the remainder of the redness, and to strengthen the eyes every morning. For which purpose also, Take of the best Aloes, and of Tutty prepared, of each six drams: white Sugar one ounce: Rose-water, and mild white wine, of each six ounces: set them in the Sun forty days in a glass well stopped: put some drops of this water not strained, into the Eyes. Or, Take of white Wine three pints: Rose-water half a pint: Tutty prepared three drams: powdered Cloves one dram: Camphire half a dram: mix them in a glass close stopped, and shake them for two hours, and set in the Sun one whole month; remembering every day a little before Sunsetting to take it out of the air, and never bring it forth till the Sun is risen: two or three drops of this water strained by filtration, must be put into the Eye before he go to sleep, or in the morning one or two hours before he rise. This takes away the oldest redness; it dries up weeping, and Fistulaes'; it consumes all superfluous moistures upon the outward membranes and quickens the sight. This also following is excellent. Take of Wheat two handful: powdered Salt one handful: put them in a Copper Vessel, and put white Wine to them two fingers breadth above them; cover the Vessel, and let them stand in the shade six or seven days till the liquor turneth green, stirring them often with a wooden Spatula, after pour off the liquor by inclination without the dregs, and if need be, filter it. One drop into the Eye, taketh away redness, and defluxion, and all spots or blemishes thereon, and quickeneth the sight. Solenander, commends highly the Decoction of Quince Leaves, which are to be gathered without breaking in the beginning of the spring, and kept diligently that they neither be dusty, nor musty; nor otherwise defiled: and when you use them, boil one handful of them in pure water, and let the Eyes be often washed therewith: It is a wonder (saith he) to see how it doth preserve, cleanse, and stop Rheums in the Eyes. Sometimes in a● inveterate Ophthalmy much filth like matter is gathered in the eyes, which can scarcely be cured with Collyriums, or other remedies: but in this case fine Cotton dried at the fire and laid like a small pillow upon the eye and rolled down, is very good; for the next morning you may take much filth away with it. And with this Remedy used many nights together many eyes have been cured which could not otherwise; and this kind of Medicine prevails chief among Children that have sore eyes. For a Conclusion of this Chapter, it will not be amiss to set down the experimental Medicines of Sacutus Lusitanus who cured an old Ophthalmy which would not otherwise be removed in a whole year with a Mercurial Unguent, although there was no sign of the French Pox: being persuaded by Mercurialis, who in his Book of the French Pox saith, When you see any Disease that will not be Cured by ordinary means, imagine it to be the French Pox. He asked the Patient if ever he had the French Disease, or ever lay with a foul bodied Woman? He denied all but only confessed that he lay with one Man once in the bed, whom he suspected to be Frenchified: Upon this conjecture, the Physician prescribed a sudorific diet of Sar●a for twenty days, but to no end. And though the Disease was chief in the upper parts, so that it was to be feared, lest if he fluxed him at the mouth with Mercury that the humours should fall more into the eyes, but in regard it was old, and the force of the defluxion was attained, he prescribed the Unguent of Mercury after his body was well Purged, and by it in seven day's space after plentiful Salivation or Spitting, his pains ceased, that inflammation was gone, the itching abated which was before in his eyelids, with much acrimony: And so leaving him only an issue in his Arm to breathe the Brain; and prescribing a good diet, which he kept; the Patient returned to his former health. The same Zacutus Lusitanus in his Praxis ad Hist. commends that Water and Ointment which we mentioned in the Cure of Suffusion, for an old Ophthalmy. Chap. 9 Of Hypopyo, or Matter under the CORNEA. WHen the Inflammations of the Eyes are great, and swelling; sometimes they cannot be resolved, but they will be suppurated; which is much to be feared, and to be prevented by all means: For from thence Ulcers will come; and sometimes Matter is gathered under the Cornea, which Disease is called Vpopuon; and this comes often from a stroke or contusion, & blood-shotness: sometimes it covereth all the Pupilla, and hinders the sight: sometimes it compasseth the circle of the Iris, and is like the pairing of a nail, and thence it is called Onux, or Vnguis. This Disease is known not only by the whiteness which is like Matter, but also from the Inflammation and Bloodshot that went before; for when the Eye is moved, there appears a motion of the Pus or Matter urder the Cornea. There is a redness in the Eye, and Pulsation; or at least went before it. For the Cure, first using universal Medicines, if there remain any relics of Inflammation, you must take them away by the Remedies prescribed in the Ophthalmy: than you must apply gently Discutients mixed with Emollients, lest when the thin part is resolved, the matter become thicker, and less fit to be dissolved. Therefore make your Fomentations of the Decoction of the flowers of Chamomel, Melilot, the seeds of Fleabane and Fenugreek, to be used with Linen, or Bags. You may add the Leaves of Eye-bright, Celandine, and Fennel seed: or use this following Collyrium. Take of the Water of Vervain, Rue, Celandine, Roses, and Fennel, of each half an ounce: the best Aloes and Tuity prepared, of each half a dram: Sugar-candy one dram. Powder and mix them; with a little Breast-milk make a Collyrium, of which drop some into the Eyes twice or thrice in the day. This following is excellent: Take of Saffron, Aloes, and Myrrh, of each one dram: Wine three drams: Honey six drams: Dissolve the Saffron in the Wine; then mix them with the Aloes and Marrh, than put them to the Honey, and anoint the Eyes. Lastly, Those Medicines which were prescribed in the declination of an Ophthalmy, in the spots or Maculae of the Eyes, and in Suffusion, or Cataract are good here. If the Matter cannot be discussed with Resolving Medicines, you must seek others. Gal. in 14 Meth. reports, That there was one Justus an Oculist in his time, that cured many of this Disease by shaking their heads; for setting them strait upon a seat, and taking hold on both sides of their head, he shaked them till he perceived the matter to descend. But if the matter which hindereth the sight cannot be thus cured neither, Galen in the place cited flies to Manual Operation, or Chirurgery; whom Aetius and others do follow, which is done by pricking of the Eye, which is used also in a Cataract. Which operation, as it is little used in our times, so it requireth the hand of a most skilful Chirurgeon; and it is much to be feared, lest when the Cornea is opened, the Watery Humour come forth with the matter. Chap. 10. Of Phlyctaenae, or Blisters in the Eyes. IN the Cornea and the Adnata Tunica, as in other parts of the Body, there breed sometimes little blisters full with water, like bubbles, or bladders, which come from the heat of the Humour Phlyctainai in Greek, and called in Arabic Bothor: and they are little tumours like Gromwel seeds, coming from a sharp watery humour. They are easily known. They in the Adnata are red: in the Cornea, blackish, if they be outward; but white if they be in the inner part of it. As to the Prognostic P●lyctaenae which grow in the Adnata, are less dangerous than they in the Cornea. The more superficial these Pustles are, the le●s dangerous they are; the more inward, the more danger; for it is to be feared lest the whole thickness of the Cornea be eroded, and so either the watery humour will flow forth, or else the Uvea will start out. The Cure consisteth wholly in the resolving of the matter conjoined, and the averting of the antecedent cause. And we must take heed lest we bring these Pustles to suppuration, lest they turn into Ulcers. Therefore those Universal Evacuations, Revulsions, and Derivations, which were declared in the Cure of the Ophthalmy, must here be used. Afterwards, we must apply Topics, or Medicines to the part, which at the first must gently repel, and discuss; such as were laid down for them in the treaty of the increase of Ophthalmy, which are most proper when there is an Inflammation also, as it often falleth out. Afterwards you may u●e more drying and dissolving Medicines, such as are described for the state and declination of Ophthalmy; and especially the Ointments there set down, which are very proper to discuis and dry up Pustles. Chap. 11. Of the Ulcers in the Cornea and Adnata. AFter an Ophthalmy, there followeth often Ulcers in the Tunicles called Cornea and Adnata, when it comes to suppuration. They follow also the Phlyctaenae or Pustles, which bred in the Cornea, but not till they break. They also use to come from sharp corroding humours flowing into the Eyes. There are divers sorts of these Ulcers mentioned in Authors, taken from their divers circumstances, as they are superncial or profound, broad or narrow, and according as they differ in shape and figure, and the like. So a hollow, narrow, and hard Ulcer is called Bothrion, or Fossula like a little trench: A broad and not so deep an Ulcer, is called Coil oma: That which cometh in the Circle Iris, is called Argemon, or Vlcus Coronale: Finally, that which is deep and hard, is called Epicayma, and Egcayma. The knowledge of Ulcers is easy, for they may be seen: If the Ulcer be in the Cornea, there will be a small white blemish in the black of the Eye; if in the Adnata, there will be a small white blemish in the white of the Eye, because the Veins of the Tunicle Adnata are full of blood. The Ulcer of the Eyes are dangerous, and hard to be cured; but more in the Cornea than in the Adnata. An Ulcer in the Pupilla is more dangerous, because after it is cured, it will leave a Scar, which will hinder the perspicuity of the Cornea, and so the sight will be hurt; and if the whole Tunicle be corroded, the Watery Humour will flow out, and the Uvea start forth. The Cure of this Disease, as of other Ulcers, is, By cleansing and drying means; but they must be very gentle by reason of the tenderness of the part, and exquisitness of the sense. But you must first use such things as revel and hinder the flux or humours from the Eyes; as in Ophthalmy either old or new, were declared. And if there be an Inflammation with it, you mix must things that are proper for that. With which also you may use things that assuage pain, if there be any. These things do moderately dry and cleanse: Sugar, Honey, Saffron, Myrrh, Frankincense, Aloes, Sarcocol, Tutty, and Ceruse; of which you may make these following Medicines: Take of Barley and Foenugreek Water boiled, four ounces: the best Honey half an ounce: or of the Syrup of dried Roses, one ounce: Make a Collyrium to wash the Eyes often. Take of Vervain and Plantain Water, of each two ounces: Sugar candy half an ounce. Mix them for a Collyrium. Take of the Water of Honey distilled in Balneo, and of Rose water, of each equal parts. Or, Take a hard Egg peeled, cut it in two pieces, and taking out the Yolk fill the hollow with the powder of Sugar candy; tie it fast, and hang it in a Wine Cellar, and you shall have a Water drop from it, which is excellent to cleanse the Eyes without pain. But if you will have it stronger mix the Powder of Mirch with your Sugar candy. Montanus highly commends this Powder following: Take Twenty Whites of new laid Eggs, put them in a pewter dish in the Sun till they are dry: then powder them finely with as much Sugar; and this powder put into the Eyes, doth much good without causing pain. In the Progress of this Disease, if you will cleanse and dry more, put to the former Medicines the white Troches of Rhasis, Frankincense, Aloes, Myrrh, Sarcocol, or the like, but in a small quantity lest it be too sharp, and also mix them with Milk, white of an Eglantine, some Mucilages, and other anodynes, or things that mitigate and assuage pain. Tutty is the best, for it causeth no pain, and drieth and healeth; therefore Collyriums, or Unguents are good that are made thereof. And chief the Ointment prescribed in the cure of Ophthalmy, which hath in it a great quantity of Tutty. This following is very cleansing, drying, and healing. Take of Sarcocol steeped in Rose Water, Ceruse and washed Aloes, Myrrh, and Tutty prepared, of each half a dram: Sugar candy one dram: With the Mucilage of Gum Traganth drawn with Rose Water, make a Collyrium, with which anoint the Eyelids. Chap. 12. Of a Cancer in the Cornea. AS a Cancer may come in other parts, so sometimes it breeds in the Eyes. And though the knowledge and Cure of a Cancer is in the Treatise of external Diseases, yet we will speak briefly here of those things which properly belong to a Cancer in the Eye. A Cancer is either occult, or hidden, or ulcerated. The occult is reckoned among Tumours, and it is called a Cancerous Tumour, or Cancer of the Eye: But the ulcerated is called a Cancerous Ulcer in the Eye. But in both there is an unequal hardness, a blue Lead colour, a strong pricking pain, especially about the Head and Temples: the Veins adjoining are blue, and very full. Sometimes adust and sharp blood floweth from the part affected, when the Cancer is ulcerated. And this pain is increased by any warm Medicines. This Disease is incurable, as well in the Eye as in any other part, when it is fixed; except it be taken away by manual operation. Authors propound two ways of Cure, namely a True, and a Palliative. A true Cure (as was said) cannot be wrought but by Chirurgery when the Cancer is fixed: but when it is new in the beginning, it may be cured by often evacuation of the Choleric humour, first having let blood; as Galen teacheth 2. ad Glauconem, cap. 10. where he boasteth that he hath often cured this disease, adjoining a convenient Diet with the aforesaid Physic. A Palliative Cure, which tends only to the mitigation of Symptoms, is done not only by the aforesaid Evacuations ' but also by convenient Topics. First than you must appoint a convenient Diet, such as is good against Cholle●; and it must be cooling and moistening. Then draw Blood on the same side, and apply Horsleeches behind the Ears, and also to the Hemorrhoids if they do appear, applying Cupping Glasses to the Shoulders, and use other kinds of Revulsions. You must also prepare and Purge Melancholy by Potions, Apozemes, opening Broths, by Magistral Syrups, and the like: But above all for the purging of Melancholy black Hellebor well prepared is the best; and by giving the Extract thereof twice or thrice, we have sometimes cured a Cancer in the beginning. These Remedies do exceedingly diminish the Humours that flow to the Eyes, and take away pains and other Symptoms: for which purpose also Topics are good, such as are prescribed in Ophthalmy, for assuaging of pain: especially the Collyria made of Mucilages, the white Troches of Rhasis, and prepared Tutty, with the water of Roses, Nightshade, and Plantain. This following Water is a good Collyrium to wash the Eye with. Take of the Roots of Pilewort, and herb Robert, of each two handfuls: Ribwort, Nightshade, borage, Bugloss, Purslain, Eyebright, and Bettony, of each one handful: green Frogs, and whites of Eggs, of each twelve in number: the seeds of Foenugreek and Quinces, of each one ounce: let the Roots and Seeds be bruised, and the Leaves Cut: then pour upon them of Eyebright and Rosewater of each one pint: mix them and Distil them in a pewter Still. The flesh of Chickens is very powerful to alswage pain: and some say that the Disease itself hath been Cured by it alone. So Maritius Cordaeus, Comment. 7. in lib. 1. Hipp. of women's Diseases, relates a history of a noble Woman, who had the right side of her face a long time infected with a Cancer ulcerated, and having tried all means she could from Italian, French, Germane, and Spanish Physicians, was at length Cured with this vulgar Medicine by a Barber: He took Chickens and cut them in thin broad pieces, which he often applied to the Cancer: Others apply the flesh of young Pigeons so cut, while it is warm. Finally, The true Cure of a fixed Cancer is only by taking it out by the roots, and is by a taking out of the Eye; which Fabricius Hildanus saith may be done very safely; and he showeth the manner and Circumstances thereof at large, Observe. 1. Cent. 1. so that we shall not here Repea● them. Chap. 13. Of the Rupture of the Cornea. Sometimes the Cornea Tunicle is so divided, that the watery Humour, and sometimes the Wea also cometh forth; and this is called the Rupture of the Cornea. The Cause of this is an Ulcer, or Wound in the Membrane, or a great afflux of Humours, by which the said Membrane is so distended, that it cracks in the middle, and the Humours contained are let ou●: As Paraeus reports it happened to a certain Woman in Paris, lib. 16. cap. 13. This Disease is for the most part incurable, and takes away sight, because the Humours of the eye cast forth cannot be repaired: but if the Wound be small, so that only a portion of the watery Humour is only lost, it may be Cured; for the watery humour may sometimes be renewed: as Galen taught 4. the tymp. cause. cap. 2. You must use Astringent and Glutinating Medicines; having first Bled and Purged if necessary, as the white of an Egg, with the white Troches of Rhasis dropped into the Eye. Let the part be Fomented with a Decoction of red Roses of Solomon's Seal, Bramble buds, shepheards-purse, and Plantain boiled in red Wine if there be no inflammation; but if there be, in spring water. Take of Quinces half a pound: red Roses three pugils: Acacia two drams: Saffron one scruple: boil these in red Wine, and make a Cataplasm to be applied to the part. For the perfect Consolidation and Cure, use this Collyrium. Take of washed Aloes, Tutty prepared, and Sarcocol steeped in breast Milk, of each half a scruple: Saffron five grains: with the Mucilage of Gum Traganth, make a Collyrium. Chap. 14. Of the Coming forth of the Uvea. UPon the Rupture of the Cornea, often comes the shooting forth of the Wea, which is called in Greek, Propto sis Ragoidous: there are four kinds mentioned by Authors, especially by Paulus; of which the first is called Mu●cephalon, because it is like the head of a Fly: and this is when a small portion of the Wea comes forth. The second is called Staphuloma, and this is when a great part of the Wea comes forth so that it is like the stone of a Raison. The third is called Melos, when there is so great eruption of the Wea, that it seems like an Apple. The fourth is called Elos, or Clavus, when the Wea being come forth groweth hard. The Cure of this Disease is Difficult, and the more when the Wea comes most forth: but when it is small, as in Muocephalon it is Curable by moderate astringents, such as we prescribed in the Rupture of the Cornea. The Ancients as Paulus Aetius, and Celsus, do labour to Cure them when old and not movable by Medicines, with Chirurgery; but this is now out of fashion, by reason of its great difficulty and doubtful success: but if any will try it, he shall find the way exactly set down in Jerom. Fabricius, ab Aquapendente, cap. destaphylomate. Chap. 15. Of Aegylops, and Fistula Lacrymalis. HItherto we have spoken of the Diseases of the Eyes which happen in the humours and upon the Tunicles; it remaineth that we speak of the Diseases of the Corners of the Eyes and Eyelids. And first of the Tumour in the great Corner of the Eye, by the Root of the Nose, called Aegylops, and Anchylops if not broken. This little Tumour, is either with, or without Inflammation. When it is inflamed, it is like a small Phlegmon: or Bile, red about, with a shooting pain. And it comes of thin and choleric blood that flows into the part by the veins of the Temples, Forehead, and Face, and so impostumateth; which being open produceth an Ulcer, which speedily turns hollow, and then it is called Fistula Lachrymalis. And if this continueth one year, there is a Caries or foulness of the Bone, as Hypocrates saith, 45. Sect. 6. In Ulcers of a year old, the Bone is foul: And this Caries is known by the Cavity, which is known by the finger: and by the stinking Matter flowing from it. Sometimes it comes without Inflammation, and then it is bred of a thick slimy Humour, like Pulse or Honey: As the Tumours called Atheromata, Stea●omata, Meliceris, which are without pain. The Cure of an Aegylops is very hard, both in regard Medicines are ill to be applied to it, by reason the sight is so nigh; and because an Impostume will quickly Ulcerate in such a tender part (as aforesaid) But it is most difficult when the Impostume breaks out at the Nose, and the Matter flows through the Nostrils; because thereby the Bones will be putrified. Sometimes Aegylops turns to a Cancer, which comes with a pricking pain; extension of the veins, hardness and blewness of the skin, and then it is better to let it alone, because Medicines will enlarge it, and increase pain. A Lachrymal Fistula that is newly begun, and which hath an external orifice to be seen, is curable by Medicines; but that which is deep and old, and hath fouled the Bone, is scarcely Cured without burning. The divers times of these Diseases require divers Medicines. And First in the beginning of an Aegylops you must revel the defluxion from the part by bleeding and purging; and use repelling Medicines to the Forehead, by which sometimes the Progress is stopped before it come to suppuration. For this end, use the following Ceratum. Take of Pomegranate-peels, Acacia, Pomegranate flowers, Galls, Cypress-nuts, Roch-Alum, Bolearmenick, of each one dram: white Wax four ounces: Turpentine three drams: Make a Cerate. After the use of Repercussives, you must apply resolver's to the part affected, as this Decoction. Take of pure Honey and Aloes, of each two ounces: Myrrh one ounce: Saffron one dram and an half: Water two pints: Boyl them gently to the consumption of half: dip a piece of soft Sponge therein, squeeze it a little, and apply it hot to the part, bind it on; and do thus often. Amatus Lucitanus, Curatione 68 Cent. 5. prescribes a Cerat against Aegylops, which he highly commends, which is this: Take of the Powder of Cockle shells, two drams: Myrrh, washed Aloes, and Frankincense, of each half an ounce: Sarcocol, Dragon's blood, and Ceruse, of each three drams: Opopanax dissolved in Wine, Vinegar and Bloodstone, of each one dram and an half: Saffron two scruples▪ Wax and Rozin, of each three ounces: Mix them according to art at the fire, and make a Cerate to be applied to the corner of the Eye. If the Tumour will not be resolved with the former Medicines, but will come to suppuration, you must help it forward with a Plaster of Simple Diachylon; or if there be pain or inflammation, you may apply a Cataplasm of Crumbs of Bread. If it will not break▪ open it with a Lancet, and delay not lest the matter contained do corrode the parts, and make an incurable Fistula. Many open it with a hot Iron, but the cold is best. After the imposthume is opened, you must cleanse the Ulcer, and heal it as others. But if it fistulate, cure it thus: First make a general Evacuation by bleeding and purging. You must divert the defluxion from the Head by Cupping-glasses, Vesicatories, and Caustics applied to their proper places; and then use the decoction of China, or Sarsaparilla, for many days. And at the same time dry the Brain with Fumes and Head Powders, as in a Catarrh. Instead of a Cautery you may apply a Seton to the Neck; for Fabricius Hildanus reports Obs. 41. Cent. 1. that it hath done it alone without other means. If the distemper of the Liver be the Cause of the defluxion (as it often is) you must have a special care to administer Medicines proper for that. When you use Topics, open the orifice of the Ulcer, and dilate it by degrees, with a Tent made of an Elder pith, a sponge made fit, or a Gentian Root. When it is large enough, apply this following Medicine, commended by Forestus, Obs. 17. Lib. 11. Take of Honey two ounces: Verdegreece one dram: Water of Rue four ounces: Powder the Verdegreece very fine, and boil it with the rest at a gentle fire till the third part be consumed, and make a warm injection of the strained Liquor with a Syringe: if this be too sharp, wash the Ulcer every day with the Water of Rue, and after apply a little Unguentum Apostolorum. Continue this course for three weeks, laying on some convenient Plaster, and defending the Eye with Rose Water. When the Ulcer is sufficiently purged, use this following Collyrium to incarnate and cicatrize: Take of Frankincense, Aloes, Dragon's blood, Pomegranate flowers, Alum, and Antimony, of each one dram: Verdegreece five grains: Powder them fine, and with Rue Water make a Collyrium to be dropped in with a stalk of Rue, thrice in a day, and put in a tent wet therewith, laying upon it a Diapalma Plaster: Lessen your Tent by degrees, and at length take it quite out, only washing the part with the aforesaid Collyrium, and laying on Diapalma. Forestus in the place cited saith, that new fistulas have been cured thus by a famous Chirurgeon of his time. If it appear that the bone be foul, it must only be cured by an actual Cautery; the manner of which is exactly described in Paraeus, Fallopius, and Aquapendente in their Works: But Fabricus Hildanus Obs. 22. Cent. 5. boasteth that he cured a Fistula lachrymalis with foulness at the Bone, that was four years old, and counted desperate, in a child of thirteen years of age, with Medicines alone, dilating of it with prepared Sponges, and after sprinkling Euphorbium into it, and that very much and often; and after applying only an Emplaster of Gum Elemi. Having used these things diligently for the space of divers weeks, he perceived a scale of the Bone, which he drew forth; and then with half a drop of Tolutan Balsam upon a little Lint, once in a day conveyed into the Ulcer, he perfectly consolidated the Fistula in a short time. Chap. 16. Of Rhyas and Encanthis. ANother Disease often followeth the Fistula Lachrymalis called Rhyas; and this is the consuming or diminishing of the small flesh in the great corner of the Eye, from whence it is enlarged: This comes also of other Causes, as sharp humours falling upon the part, or from cleansing Medicines formerly misapplyed. Encanthis is contrary to Rhyas, which is the immoderate increase and swelling of the Caruncle, or little flesh in the great corner of the Eye; and this comes from much blood flowing to the part, and the not orderly curing and drying up of the Ulcer. The Cure of Rhyas is by Incarnatives, such as follow: Take of red Roses, one pugil: Cypress Nuts, and Myrtles, of each two drams: Aloes one dram and an half: old Wine one pint: Boyl them till the fourth part be consumed: wash the part often with this Decoction. Or, Take of Aloes and Frankincense, of each one dram: Dragons blood half a dram: red Roses and seeds of Sumach, of each one scruple: Rose Water one pint: boil them to the consumption of the fourth part. Make a Collyrium. Encanthis is cured by taking away of the superfluous flesh growing in the corner of the Eye; this is done with eating Medicines, beginning with the mildest first, therefore first use burnt Alum; after proceed to Apostolorum Aegyptiacum, or burnt Vitriol. But if these will not do, cut it out, or burn it with an Iron. But before you do these things you must prepare the Body with convenient Evacuations lest you cause a new defluxion: but in the cutting, burning, or consuming of this Caruncle with Medicines, you must take heed that you take it not wholly away, but only that which is superfluous, otherwise it will turn to Rhyas. Chap: 17: Of Epiphora. THe word Epiphora signifieth any Defluxion into any part. But through custom it is used especially for the defluxion of a thin Rhewm from the Eyes; hence it is called involuntary weeping, which flows daily from the corners of the Eyes. For the producing of which Humour flowing preternaturally there is an evil disposition in the part from whence it cometh, and in the part receiving it: the part that sends this humour is the Brain, which when it is too hot, or too cold gathereth a watery Humour, and so sends it to the inferior parts, which are fit to receive it: The part receiving is the Glandle or Kernel by the great corner of the Eye, and the Caruncle upon the corner; the thinness, or thickness, or other weakness of which parts causeth that they easily entertain the humours that flow thither. Therefore an Epiphora happeneth often in an Egylops, a Lachrymal Fistula, a Rhyas, and Encanthis, because the superfluous humours use to be easily received into the parts affected. This humour is carried from the Brain into the corners of the Eyes, sometimes by the internal Veins, sometimes by the external, as we shall show you hereafter by their proper signs. But the Humour which maketh an Epiphora, is sometimes cold, and brings no other inconvenience, but only defluxion, sometimes it is salt and sharp, and causeth pain, heat, and redness, and exulceration of the Kickshaws. There need no signs to be given of Tears, they are visible. It will appear by what hath been said whether they are cold or hot, and sharp. But we must distinguish whether they come by the internal or external Vessels. When by the internal, there is pain in the inside of the head, and sometimes violent sneezing. But if they come by the external without the Skull. The Vessels of the Forehead and Temples are stretched, and the head seems to be bound about and astringent means, outwardly applied do help. As to the Prognostic; New Epiphoras coming from outward causes are easily cured, especially in youth: but old, and in old men very hardly. They which proceed from other diseases, as Aegylops, Fistula Lachrymalis and the like, have their Cure with the diseases whence they came. The Cure of this Disease consists in taking away the defluxion, and strengthening the part receiving. You must take away the defluxion with Evacuation of the humour offending, revulsion, derivation, and strengthening the part from whence it cometh. The Peccant humour which is a Water superfluous in the Brain, must be evacuated with bleeding and purging. Blood-letting is not good in a cold distemper of the Brain, except there be manifest signs of plethory or fullness; but in a hot distemper, when the humours are very sharp, it is very good, and you may use it twice or thrice if need be. You may purge by Potions, Apozemes, Pills, and the like, which you may proportion to the condition of the Patient. Make a revulsion of the humours flowing by Cupping-glasses often applied to the shoulders, by Vesicatories to rai●e blisters behind in the Neck, or with Cauteries to the hinder part of the Head, and Issues in the Arms. In a stubborn Epiphora, a Vesicatory applied to the forepart of the Head doth wonders; as Forestus showeth, Obs. 11. lib. 11. concerning an Old Woman who had sore Eyes, weeping and mattery, with great pain and itching, and could by no means be Cured, that with applying a Plaster of Cantharideses with Honey and Leaven to her head being shaved, he perfectly Cured her. Rondeletius saith, That a Cautery applied to the Commissura, doth more good than when it is used to any other part. For Derivation, use Leeches behind the Ears; and Masticatories every morning. But least the Humours once evacuated should breed again, the Brain must be strengthened and dried; and if it be too cold, you may use all our Remedies prescribed in the Cure of the cold Distemper of the Brain. But if it be too hot, those things which we prescribed in the Cure of a hot Catarrh; especially such as respect the Brain most, are here to be used. While the former Medicines are used, you must apply Topics to the part receiving; and first if the Humour comes through the external veins, apply Astringents to the Forehead and Temples: and if the Defluxion come from a sharp hot Humour, use the following Cataplasm. Take Bolearmenick, Dragon's Blood, Pomegranate Flowers, and Myrtles, of each one dram and an half: Accacia and Hipocistis of each one dram: Frankincense and Mastic of each two scruples: Red Roses one pugil: Powder them and mix them with the white of an Egg and a little Vinegar, make a Cataplasm, which spread upon a Cloth and apply to the Forehead and Temples, and renew it as fast as it groweth dry. If it come of a Cold Humour, apply this following Cerat. Take of Frankincense and Mastic of each one dram and an half: Gum Anime, Tacamahacca, and Bloodstone, of each one dram: Gum of Juniper two scruples: Turpentine and Wax as much as will serve turn: make a Cerat. But you must apply Astringent and Drying Medicines to the part affected: which are thus made. Take of Tutty prepared one dram: Sarcocol half a dram: Frankincense and Mastic of each a scruple: Spicknard six grains: make Troches, which being mixed with the white of an Egg, or the juice of Quinces may be applied to the corner of the Eye. Or, Take Tutty prepared in a fine Rag, and tie it with a string, and put it in sharp Wine, and with this often wash the Eyes. Or, Take Tutty prepared, Egg shells powdered, the best Aloes, of each one dram: tie them in a Rag and make a little Ball which steep in Fennel-water, and squeeze the Ball often into the Eyes. Only Aloes powdered and made into a Ball (as above) and put into Rose-water, is very good. Or, Take Aloes, Cypress Nuts, Frankincense, Mastic, Myrrh, of each two drams: Tutty prepared, and Sarcocol, of each one dram and an half: Sanguis Dragonis, Barberries, Sumach, red Roses, of each one scruple: Powder them finely, and with Fennel-water make a Collyrium. In a Hot Defluxion this is excellent. Take of white Troches of Rhasis without Opium, Sarcocol, Lycium or Box-thorn, Acacia, Olibanum, of each one dram: the stones of Myrobalans calcined, of white and red Coral, of each half a dram: Pearlhalf a scruple: as much of the juice of Pomegranates boiled to half, as will make a Collyrium. If Redness be joined with it, this following is profitable. Take of the seeds of Sumach bruised one scruple: hot Plantain Water one ounce: macerate them a while, then press them strongly, and put of Rose, Eyebright, and the Waters of the white of an Egg well beaten, of each half an ounce: Sugar Candy finely powdered and strained with a little water, one scruple: Make a Collyrium. Lastly, Those Medicines which were prescribed for an Old Ophthalmy, are good in this Disease. CHAP. XVIII. Of Pterygium, or Haw in the Eyes, called Unguis. THis is a Hard and Nervous little Membrane, which coming out of the great Corner of the Eye, first covereth the white, and after by continuance, the black; and covering the Pupilla, hindereth the light. Sometimes it is thin and white; sometimes it is fleshly with many red veins, and it is called a Pannicle, and Sebel, by Avicen; although some distinguish a Pannicle from a Haw, or Vngula; because Vngula is a Nervous Tunicle without repletion of veins, and is only in the Adnata: But Sebel, or Pannicle, Covereth the whole Eye, and is very Red, and full of Veins. This Disease comes from Ulceration of the flesh in the Corner of the Eye; or, of the Adnata, whence there comes a roughness or inequality in the part, which while the Nourishing Faculty labours to make equal, it fills with blood, and begets a preternatural increase, or covereth it with a Skin. And because many Excrements do use to flow to an Eye disordered, therefore the Haw is not bred of pure Blood, but of many Excrements also, whence arise many sorts of Haws: Because, Some are Hard, others Soft, some White, some Red, some Yellow, some Brown, others are easily separated from the Adnata and Cornea, others stick fast; some are simple and without Malignity, others are Cancerous and filthy. The Diagnosis, or Knowledge of this Disease, is known by what is said; also the Causes, namely, The Humours of which it is made, may be known by their Colour; for a Red Haw comes of pure Blood: a Yellow, of Choler: a White, of Phlegm: a Dark and Black one, of Melancholy. As to the Prognostic, This Disease is scarcely to be Cured, and that in a long time; because sharp Medicines which are proper for to eat it away, cannot be used but by degrees, by reason of the exquisite sense of the Eyes. If the Eye Affected grow smaller, it is an evil sign; for it argueth the Debility of the part. A new Haw and small, may be Cured with Medicines; but an overgrown, old, and one covering the black of the Eye, cannot, but by Chirurgery. A Haw which is thick, turned out, stretched forth, hard and black, cannot be Cured; for it is of a Cancerous nature. The Cure is to be by the Antecedent and Conjunct Cause. In respect of the Antecedent, first good Diet is to be enjoined, such as is mentioned in other Diseases of the Eyes from Fluxes. Also the Evacuations and Revulsions may here be used, namely, Purgations, Bleeding, Cupping, Vesicatories, and the like. And when the Body is sufficiently Purged, we must come to Topics, which may Consume the Haw. Beginning first with Mild, such as were they which we spoke of in Curing of the Spots in the Eye, called Phlyctaenae: which not prevailing, we must use stronger, which are frequent in Authors. Forestus commends this following. Take of the juice of Fennel four ounces: the juice of Celandine three ounces: the juice of Rue two ounces: the juice of Mallows two ounces and an half: Aloes one dram: Vitriol two scruples: Verdugreese one scruple: Ginger and Cinnamon, of each half a scruple: the Gall of an Eel half an ounce: the Gall of an Ox, or Hog two drams: Sugar Candy two scruples: Let the juices boil with the rest, and then clarify it and make a Collyrium. This also is by him Commended. Take of Bloodstone two drams: white Vitriol and Verdegreece calcined, of each three drams: Myrrh and Saffron, of each one dram: Long Pepper half a dram: Sugar Candy half an ounce: Powder them very fine, and mix with one dram of this Powder two drams of Radish-water, and apply twice or thrice in a day, as the Patient can endure it. Before you use these Remedies, you must Foment the part with an Emollient Decoction, which you must do also afterwards to assuage the pain. Among the Mildest, this following is best. Take of Cuttle Bone, one scruple: Sugar Candy, one dram: Vitriol, half a scruple: Tutty Prepared, half a Dram: Mix them, and make a fine Powder, to lay upon the Haw. If it cannot be taken off with these Topics, you must fall to Chirurgery, and taking up the Vngula with a Hook at the bottom or root; draw a double Thread through it with a Needle, then laying it down close on both sides beneath, cut it off with your Cissours; as is more at large showed by Celsus, Paulus, Aetius, Jerom ab Aquapendente, in their Chirurgery, and by others. Having made Incision, lay on a little Lint dipped in Rose-water and the white of an Egg, to assuage pain, and hinder Inflammation. And Lastly, you may Heal it up with drying Medicines, as Collyriums of Tutty, Frankincense, Aloes, the white Troches of Rhasis, and the like. The End of the Second Book. THE THIRD BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Ears. The PREFACE. THe Ears as Galen showeth in 1. the symp. cause. cap. 2. have divers Diseases similary, organic, and common; which because they are not to be known, but by their Symptoms, I determine to reduce them into a Series of Symptoms. The symptoms in the Ears either are such as come from the Action hurt, or the fault of the Excrements. The Action is hurt either in the Ear alone, or in all instruments of Sense. The Action proper to the Ear, namely, Hearing, is hurt by being abolished or diminished and depraved. It is abolished by Deafness, diminished by thickness of Hearing, depraved by a noise in the Ears. The Action common to all the Instruments of Sense, is Feeling, by which they are subject to pain. The fault in the Excrement is seen by all those things which come preternatur ally out of the Ear. So this whole Book hath four Chapters. The first is of Deafness and thick Hearing. The second of noise in the Ears. The third of pain in the Ears. The fourth of those things which preternaturally come forth of the Ears. Chap. 1. Of Deafness, and thick or dull Hearing. WE comprehend Deafness and thick Hearing in one Chapter, because they come of the same Causes, differing only in Degrees, so that when they are great they take the Hearing quite away; when less, they diminish it: And both these are called vulgarly Deafness; for they who cannot hear any but such as speak very loud, are called deaf folk. But Surditas properly, or Deafness, is called in Greek Cophosis, when the Hearing is totally gone; so that the Patient either heareth no noise, or if he do, he cannot distinguish it. These are often dumb if they are born so; not only because men learn to speak by Hearing; but by reason of the great consent that is between the Instruments of Hearing and Speaking by the Nerve of the fifth Conjugation, whose chief Branches are brought to the Ears, but some of them reach to the Tongue and Throat; whence ●● is, that when the inner Ear is pulled, there is a cough raised; and the reason is plain, for they who are born deaf, if they had their Instruments of Speech corrupted, would by a Natural instinct send forth some Articulate voice; as other Creatures, although they are kept from their birth, from other Creatures of the same kind, so that they never hear them, yet they produce their connatural voice; but men born deaf never sent forth an articulate voice, but only a confused sound, which argueth a manifest hurt of those parts which serve for Speech. Now the hurt of those parts is chief from humidity, which affecting that Nerve which goeth to the Ears, Tongue, and Throat, must needs hinder both Speech, and Hearing. Thick Hearing is called in Greek Baruecoia; and they who are so hear difficultly, and understand not what men say, except they speak very loud: Others cannot hear so well, and not except the speakers whoop and hollow in their Ears. Both these Diseases come from the distemper of the Brain or Ears. A cold distemper of the Brain, or repletion, or weakness, or some other hurt in that part, especially in which is the rise and progress of the Hearing Nerve, may cause Deafness or thick Hearing. The Diseases of the Ears are either in the inside or the outside thereof. In the exterior Cavity, a perfect or an imperfect stoppace from a Tumour, Imposthume, or Blood, Matter, Phlegm, and other things coming either from within or without, may cause a defect in the hearing. But you must observe, that the stoppage of the external passage cannot make a perfect and absolute Deafness, but only thick hearing, because sounds may be carried by the mouth also, to the Ears. For there is an open way from the internal Cavity of the Ear to the , by which sounds do easily pass, and insinuate themselves into the Ears; and this passage is made for the purging of the Ears. And many Experiments do show that a sound may pass through the open mouth to the Ears. We may observe that they who are very thick of hearing, will open their mouths that they may better hear those that speak unto them. And if you stop both Ears close, and strike a Music Instrument with a stick held in your Teeth, you will hear the sound better. And when you travel in the night, you will better hear any man coming afar off, if you put one end of your Sword or Staff between your Teeth, and fasten the other end upon the ground. The Humours which are gathered into the internal Cavity of the Ear, and especially such as flow from the Head do cause deafness or thick hearing in the inner part of the Ear, and these are for the most part flegmy, and sometimes choleric; as appears Aph. 28. Sect. 4. where Hypocrates saith, that choleric Evacuations are good for deaf men; sometimes bloody are good, for it is manifest, that the deafness accompanied with the Crisis, comes from the flux of blood to the Ears. Now the Humours are sometimes sent from the whole Body to the Ears, as in continual Fevers and especially those that are malignant. The ill composition of the Instruments of Hearing produceth the same effect; as when the Tympany or Drum groweth too lose by a violent noise or over moistness; and for this reason deaf people are more thick of hearing in Southernly weather, because the Membrane is relaxed by the moistness of the Air; or when the Tympany is over stretched or dried after a violent disease, long watching, or fasting; or when it is broken by violent motions, or eaten by a corroding humour: Sometimes blood cometh forth after a great hurt, and matter without hindrance to the Hearing, because the passage is between the bone and the Membrane. Or when any parts of the Ear, either originally; or by some outward cause, as stroke, fall, or the like, are put out of their Natural order. Moreover, a cold distemper useth to produce this disease, coming either from the cold Air, or very cold Water poured in, or over much use of stupefactive Medicines called Narcoticks. 'Tis very hard to distinguish all these causes by their proper Signs, but by Art, and conjecture thus: If Deafness come from the distemper of the Brain, either other Senses suffer, or there appeared some peculiar Dileases in the Head, as headache, drowsiness, Apoplexy, Lethargy, and the like. The stoppage of the External Cavity of the Ears is discernible by the Eyes, if you look upon them in the Sun, for than it will appear whether it be a tumour, or thick matter, or any other heterogeneal substance of another Nature which filleth the Cavity. As also the Patient will tell you if any thing fell into his Ears. But if the internal Cavity be filled with a humour, we may conceive it to be phlegm, if the Patient were formerly subject unto defluxions of that sort. But that this comes from Choler, is known by some Choleric Fever that went before, or now possesseth him, or by some violent pain. But when it comes from blood, there is a heavy pain, and abundance of blood in the whole Body, and this happeneth often in critical disturbances. The looseness and moistness of the Tympane is known by the causes preceding, which were moist, and distempered some other part: for it can scarce be, that moist causes should only affect that part, and no other. You may also know the distension and dryness of the Tympane by the dryness of the whole Body, and by the drying causes aforegoing. And for the breaking or corroding of the Tympane, you may know that if there were formerly any vehement Causes that could break or gnaw the same. You must make your Prognostic thus: Deafness by Birth, and of long continuance, if it be absolute and total, is incurable; and that which is not absolute if it be old, is never or hardly cured. A Deafnels from Choler or Blood which happeneth only in sharp continuing Fevers, useth to be cured with these Fevers. Thick Hearing, if it be not speedily cured, endeth in perfect Deafness; witness Galen, 3. de comp. med. sec. loc. cap. 3. The Membrane of the Tympane being broken, or a scar left thereon, makes an incurable Deafness. A Deafness increasing and decreasing by degrees, is curable, for it signisieth that it comes from a movable humour, which sometimes is more, sometime less in quantity. A Deafness coming from distemper of the Brain, is more easily cured than that which comes from a proper disease of the Ear. As to the Cure: That Deafness which depends upon any Disease of the Brain, requireth no other Cure, than that which belongs to such diseases, which you may find in their several Chapters. That which comes from a Tumour, if it be hard and old, admitteth no Cure; but if it be hot, you may find the Cure for it in the Chapter of pain in the Ears. But if it come from matter gathered in the Ear, you may find the Cure in the last Chapter of this Treatise, where we shall speak of those things which preternaturally come forth of the Ear. If this Disease comes of Dryness, it must be cured by the way of Rhasis, that is by moistening things, long sleep, and washing of the Head with warm water; as also putting of moist things into the Ear, as Oil of sweet Almonds, and the like. If Deafness or thick Hearing come from any thing that is fallen into the Ear, that must be taken away with washing, shaking, or extraction: or if any Vermin are g●t into the Cavity of the Ear, they must either be taken forth, or killed there: they are washed forth by making the part moist and slippery, and enlarging it, with either Milk, the Oil of sweet Almonds, or some mollifying or relaxing Decoction: they are shaken forth by sneezing, for so by the force of the air the parts being moved, that which lieth in the passage of the Ear is excluded, and the sooner if the way be first made slippery and enlarged with Medicines (as we said) It is good also to hang down that side of the head, and to hop upon the log on that side; by which way the Boys after swimming get the Water out of their Ears. If these will not do, you must endeavour to draw it forth with an Ear-picker, taking heed, lest when you put it in, you thrust that which you would draw forth, further in; therefore let the spoon of the Ear-picker be very thin that it may easier pass by the thing in the Ear. Or you may lay hold of it, and take it out with a pair of Forcepts made on purpose, rough on both sides within. And if this avail not, when the body is hard, as a nut or stone, it must be laid hold on with an Instrument and broken, and then the Ear must be washed as aforesaid. If the Ear-picker will not enter, arm your probe with a little Cotton all over, and then dip it in Turpentine, or in some other clammy substance, and put it in the Ear that it may stick to that which is there, and stoppeth the Ear. The same may be done with a Wax Candle touched with Birdlime; and if any of the Birdlime stick in the Ear, you may afterwards take it out with the Ear-picker. There are some which put a hollow quill into the Ear, and draw out things with sucking. The worms in the Ears are enticed forth by laying to such things as they love, as Milk with Sugar laid to the Ear in a sponge, or easily put in; or a Fig turned inside out; or the pap of a sweet Apple, or Bacon, and turning the Ear to the Sun at that time; and especially if Horsleeches get in, they are drawn forth by an Injection of blood. Fleas are drawn forth with Dog's hair; but if they be living they must be killed, and then they willess hinder the hearing, and will be drawn forth more easily: And they are killed with fasting spittle, or your own Urine dropped into the Ear. Bitter things do sooner kill those Vermin, as the juice of Wormwood, Centaury, or the Decoction of Aloes, or Beasts Gall. Also sharp things, as Vinegar, juice of Onions, and the like. And because the usual cause of Deafness is a cold distemper and a defluxion of moisture to that part, you must labour most to oppose that. But because this defluxion comes originally from the Brain, therefore we must begin the Cure there, as in the cure of the cold distemper of the Brain; which a Prudent Physician will moderate according to the degrees and violence of the distemper. The brief way of Cure is, first an attenuating Diet, moderately warm and drying, such as is prescribed in Gutta serena: and then avoiding of Southernly winds, by stopping the Ears; and vaporing nourishment, as Garlic and Onions; as also of things that beget thick and flegmy Humours, First, Let a general Evacuation be made by Pills Cephalick Purging Apozemes; then by Phlebotomy if need be; to which add if the Disease be stubborn, a sweeting Diet; and then use particular Remedies that revel the defluxion, as Cauteries, Vesicatories, Neesing, Masticarories, Gargarisms: but Masticatories, or Chewing; are peculiarly necessary in this Disease, by reason of the passage which comes from the internal Ear to the , and throws out the excrements of the Ears. And finally, When the Disease grows old, you must use ordinary Pills, Magistral Syrups, Cephalick Opiates, Powders and Caps to strengthen the head, and the like. All which are laid down in the Treatise of the Cold Distemper of the Brain. In time of Diet, if the Disease be stubborn, Bags are good applied to the Head after the sweeting Potion is administered, as in the said Treatise is prescribed, not only to the fore part of the Head, but to the Ears also. Brimstone and Bituminous Baths are very proper in this Disease, with washing of the Head, for by them sweat is provoked, and the matter of defluxion is drawn out. But by washing of the Head, the Brain is strengthened and dried, and the humours fixed in the Ears are discussed. The way of using them is described by Penotus, and much commended, in these words: There is nothing in the Cure of Deasness more prevalent after the use of an hundred Medicines, than that the Patient after his Body is first well purged, and then his Head. Wash his Head well in Brimstone Baths, thus: Let him wear a great cap reaching to his Eyelids, and beneath his Ears, made of Sponges sewed together; let him sit under the cock or spout in the Bath, and let it run upon his Head; which Water the sponges will suckup, and so keep the head in a continual heat; and so opening all the Sutures of the Head, and Commissures, it will take away all the vapours: or it will breathe away the matter compacted in the Nerves, and the passages for Hearing, or so change it, that it will quickly be gone: It is good for him to sit so twice in a day for two hours, and presently after to sweat in his bed, and use a slender Diet of Juices and Broth, and to beware of Wine except it be very weak. Then you must use Topics, to discuss the matter fastened in the Ear; which may be thus applied: Take of the Leaves of Organ, Wormwood, Penyroyal, wild Marjoram, Sage, Mints, Centaury the less, Mallows, and Marsh-mallows, of each one handful: the flowers of Chamomel, Melilot, Stoechas, and Rosemary, of each one pugil: Cinnamon and Cloves, of each half an ounce: Boyl these in equal parts of white Wine and Water: Foment the Ear wuh the straming hot in a sponge morning and evening. Of the same Decoction you may make a Fumigation into the Ear by a Funnel which must needs be excellent because the vapour arising from the hot Decoction must needs reach into the innermost parts of the Ears. Instead of a Fomentation you may apply a hot loaf made with Caraway seeds, and cut in the middle. Or take ordinary Bread from the Oven, and break off the lower crust, and dip it in Spirit of Wine, and let the Patient endure it at his Ears as hot as may be, that the vapour may be received in. Bread made of Bran is better with Caraway seeds, Bay-berries, Juniper berries, and Nutmegs mixed before it be baked: then after it is a little baked, break it and apply it hot to the Ears. If you desire a stonger Decoction for Fomentation and Fume, you may add one or two drams of the Pulp of Coloquintida, and the root of white Hellebore. You may make this Decoction in white Wine alone, or with Vinegar, that it may pierce more, and discuss. The Fume of Cloves may be taken with much profit to the Patient by a Funnel into the passage of the Ear when the Head is covered with a warm cloth. After Fomentations and Fumes, you must put some liquor into the Ears, and then stop them with Muskified Cotton. Take of the Oil of bitter Almonds, and Rue, of each one ounce: Mixthem and put them hot into the Ears. Or, Take of the Oil of white Lilies, and Castor, of each one ounce: the Oil of Dill, half an ounce: white Hellebore half a dram: Aqua vitae one ounce. Boyl them in Balneo Mariae till the Aqua vitae be consumed; strain them for the use aforesaid. Or, Take of Cypress Roots, Bay-berries, Annis and Cummin seed powdered, of each one dram: Powder of Castor half a dram: Oil of Rue as much as will be sufficient: Mix them and put them into a great hellow Onion; roast it, and strain out the Liquor to be dropped into the Ears. Chemical Oils work most powerfully; as Oly of Rosemary, Marjoram, Sage, Fennel, Spike, Cloves, which are too strong to be used alone, therefore you must mix a very small quantity of any of them with the Medicines mentioned; thus: Take of the Oils aforesaid two ounces: Oil of Spike, Fennel, Cloves, or the like, half a dram, o● a dram: Mix them. There are also some Waters, which if dropped into the Ears do much good. Some Authors commend the Water of an Ash, which is made by putting one end of a green Ash into the fire, and taking the water out of the other end: this is best when deafness cometh of a hot cause, and you fear to use hot Medicines. But if not, than you may mix as much Aqua vitae therewith. Mathiolus mixeth this Water with Juices, and commends it highly, in these words: We know that the Water which ●●mes out of Ash, when it is burnt, mixed with the Juice of Showbread, Squils', and Rue, in equal ●●rts warmed together, to be excellent against Deafness, if it be dropped into the sound Ear when the Patient goeth to bed, and lieth upon that Ear which is Deaf: but when both Ears are deaf, then into that which is least affected. The Spirit of Wine wherein white Hellebore hath been infused, being dropped into the deaf Ear, is very efficacious. Others commend the clarified juice of Ivy mixed with strong white Wine. The Galls of Beasts, as of Hairs, Goats, Partridges, are much commended if they be used fresh, with an equal portion of Honey, and warmed in the shell of an Onion. The fat dripping of an Eel is much used; Put a great Eel upon a Spit, and take the dripping upon Bay Leaves, and drop it warm into the Ears. Zechius commends Antinous Eggs, in these words: Aunts Eggs mixed with the Juice of an Onion, and dropped into the Ear, do cure the oldest Deafness. The Blood of a young Wolf, dropped hot into the Ears doth the same. Lastly, If the Disease be so stubborn that it will not yield to the Medicines prescribed, it will not be amiss to use the last Remedy which is prescribed by Fonseca, consult. 58. tom. 2. namely, an Unction with Quicksilver, because when Deafness cometh of the French Pox, it is so cured, and it may be when it comes otherwise; and the reason is, because Quicksilver doth dissolve and discuss ●ard tumours, when they are gathered upon any part, and therefore when phlegm is gathered in the Ears, which no other means can dissolve, Quicksilver may dissolve it. But this Remedy must not be tried but in a desperate condition; for it is doubtful what the event will be, and the Unction with Quicksilver doth much weaken the Brain, and cause defluxions. So that some who have been cured of the Pox by Quicksilver, have after fallen deaf by defluxions; although sometimes (as I said) deafness coming of the French Pox is cured thereby, and Quicksilver rightly used after due Purgation doth ●o hurt to the Brain. This you must always observe in the use of Topics, That you never put cold things, but warm, into ●he Ears, and you must not dress them till the old Medicine be taken out. And after dressing you must ●top the Ear with Cotton Muskified, for that only conduceth much to the Cure: as Forestus saith, Obs. 15. lib. 12. in these words: A woman of Delf after a long disease fell deaf, which after sufficient ●urging abstained from Physic: at length she was persuaded by an old woman to put a grain or too of Musk into her Ears with a little Cotton, and so doing she was wonderfully cured. I have ●ured many the same way whose Ears have run. Chap. 2. Of Noise in the Ears. THe sense of Hearing is hindered by noise in the Ears; for as the Eyes must be void of all colours that they may truly perceive the colours of all Objects, and when they have a preternatural colour, as in the Jaundice, the sight is depraved; so the Ears must have no sound in themselves, that they ●ay more distinctly receive all other sounds; and if there be any noise in them, the Hearing is depraved. This is called in Greek Paracousis, in Latin Obauditio, vulgarly a noise in the Ears. This comes from a preternatural motion of the Air which is naturally contained in the Ears; for ●s Aristotle saith, Though the natural Air in the Ear do move, yet the noise is not heard except you ●top the Ears with the hollow of your hand, or the like, for then the hearing is more inward when ●he outward air is kept out. This is seen by Experience, when one stoppeth his Ears, and holds the ●andle of an Instrument in his teeth, the sound will be four times greater than when his Ears are open, ●or it passeth through the moutth, there is a Natural Motion of air in the Ear by the Spiritus Acou●●ico, continually working. But if it be too violently moved, then there is a preternatural noise in ●he Ear which hindereth the hearing. The Causes are many of this preternatural Motion, but chief a vapour or wind sent from other ●arts into the Ear, or bred there; either coming from the whole body, or from some peculiar part. In Fevers it comes from the whole body; whence Hypocrates saith in Coacis; A noise in the ●ead coming in an acute Disease is deadly, for it cometh of wind sent by the Arteries from the whole ●ody into the Ears; it useth to come chief in the beginning of a fit, and before bleeding. Wind is also sent to the Ear from a peculiar part, namely, the Stomach, Liver, Spleen, Midriff, Womb, and ●he like, whence it comes to pass, that in great Vomitings, in Hypochondriack Melancholy, and ●●ts of the Mother, there is for the most part a noise in the Ears. Often there is a wind sent from the ●ead coming of a cold phlegm, through want of heat to the Ears by the Veins and Arteries, and the ●erves of the fifth Conjugation, by which passages also vapours come from the inferior parts. Wind is bred in the Ear also, of phlegm contained therein; whence it comes to pass that thick Hearing is always accompanied with a noise in the head. For by the humour there is a stoppage, from whence comes deafness, and from the wind that proceeds from that humour, comes the none. There are other causes of this noise, as a great stroke upon the head, a great sound, Ulcers in the Ears, a hot distemper, weakness, and exquisite sense. A stroke, by moving the Spirits in the Head too violently, causeth a noise. A great sound doth violently move the natural Air. And Ulcers by the heat of the matter boiling and working, make a noise; and by the Spirits gathered thither, and moving the Natural Air. A hot distemper fills the inward Arteries of the Ear with much Spirit, whence a great beating noise proceedeth. Sometimes too much Spirit is sent by those Arteries into the Ears, and the Natural Air is thereby moved, from whence cometh a noise. And from this cause may come a continual none for some months or years. Weakness of hearing useth to make a noise in the Ears, as in sick people, because every sense debilitated is hurt by every violent or moderate object: so they who have weak sight, are offended by a small light. And lastly, When the sense is most exquisite, as Galen, lib. 3. de comp. med. sec. lo●. cap. 1. there will be a noise in the Ears, because even moderate objects are too vehement for it. Now this exquisite sense must be preternatural, for the exquisitness of ●ence cannot of its self produce a depraved action, but rather the more exquisire it is the le●s will it Err. This preternatural exquisitness of sense, comes from a hot distemper, ulcer, or the like: as parts inflamed do deprav●dly, that is painfully, feel moderate touchings. Or if the exquisitness of sense be Natural, you must suppose that the cau●e of the noise is Preternatural; for the vapour which is so little that it cannot be felt of dull sense, and so the action not be hurt, will be felt of him that hath exquisite ●ense, and will cause a noise; so that in one it is Preternatural, in another Natural. There are divers sorts of sounds in the Ears, which proceed either from the quantity of the vapours as they are more or few, thinner or thicker, swift or slow in motion; for if the vapour be much, thick, and of quick motion, it will make a noise like swift running water, or like a drum, or like ●ome such Musical Instrument, or a rushing wind, or the like; but if it be little, thick, and move quick, the noise is like the falling of a ●ree or House. If it be much, thin, and swift in motion, it causeth a hissing, or is like falling of a gentle Water. If it be little, thin, and quick in motion, it causeth a tickling. If it be much, thick, and of slow motion, it makes a murmuring noise. If the matter be little, thick, and slow in motion, it makes a kind of whispering noise. If it be much, thin, and of slow motion, it causeth a hissing. And lastly, Because the degrees of thickness and thinness, of greatness and smallness, of swiftness and slowness, are infinite, therefore there are innumerable sorts of sounds in the Ears. There is no certain knowledge of the causes aforesaid, as Galen teacheth 3. the comp. med. sec. loc. c. 1. but we may make conjecture from the precedent Causes and Circumstances. We conjecture that the noise comes from wind, because sometimes it ceaseth, and returneth again; as also when the Patient hath formerly used to eat windy meat. It cometh by consent from other parts, when there is some peculiar disease in them. It appears to come from the Brain when pain and heaviness of the Head went before, and when other senses also are hurt. That the fault is in the Ears, appears by a continual noise without any intermission. We know that that Disease comes from a cold matter; if the Patient be better for the use of hot things, and if in time of health great noise be not much disturbance. The difference of sounds above mentioned, do show whether the disease comes of thick or thin, many or few vapours, it will easily appear by what hath been said. When it comes from the weakness of the faculty of hearing; as from some Diseases aforegoing, of which the Pati●nt is scarce recovered. We conjecture that it comes from a hot distemper, and from an exquisite sense coming thereupon, when the Patient perceiveth a heat in his head about his Ears; when some hot Causes went before, and Medicines that discuss wind do increase the disease: as also when the Patient in time of his health could not endure any great noise by reason of the exquisitness of sense. As to the Prognostic: A new begun noise in the head is easily cured, but an old, hardly, and the more if it come from the French Pox. That which proceeds of a hot cause, is more easily cured than that which comes of a cold. An old noise coming of phlegm contained in the Ear, turneth to deafness; for when the matter is increased, the passage of Hearing is stopped. The Cure of this Disease is divers in respect of the diversity of Causes. And first the Cure of Noise in the Head coming from consent with other parts, depends upon the Cure of the Diseases of those parts, and must be taken from their proper Chapters. But that which comes principally from the Ear Distempered, must have its proper Cure: And if it come of a cold Distemper, and thick Vapour, it will be ●ured as in the Treatise or thickness of Hearing; for they are complicated and joined together; For Noise in the Ears is the forerunner of thick Hearing, and Deafness. Therefore all Remedies both Universal and Particular, may be used here which we prescribed in the former Chapter of Deafness and thick Hearing. If the Noise come from an Ulcer in the Ear, it requireth no other Cure, than that which is proper for the Ulcer. And that shall be laid down in the following Chapter. If it cometh from weakness of Sense as in them who are lately Recovered of some great Disease, it will vanish of its self as the Body gathereth strength: yet you may drop some proper temperate Oils sometimes into the Ears to mitigate, as Oil of Chamomel, Dill, Sweet Almonds, and the like. And Finally, If it come from a hot distemper and exquisite Sense, you must prescribe a Cooling and Moistening Diet; as also drop Cool things into the Ears, beginning with mild first, and after proceeding to stronger. And first, U●e the Decoction of Barley, Violets, Lettuce, Water-lilies, to which you may put a little Balm or Chamomel to make it pierce: which not prevailing, you must use the juice of Lettuce, Purslain, Henbane: Galen alloweth the Juice of Poppy and Opium its ●elf, but these must be used sparingly and with much Caution, lest by weaking the natural heat of the part, the Hearing grow more dull. Chap. 3. Of Pain in the Ears. PAin of the Ears called Otalgia in Greek, is a violent Disease, both in respect of the part affected, namely, the inward Membrane which goeth about the Cavity of the Ear; as 〈◊〉 by reason of the nearness of the Brain which often suffereth at the same time. But since all pain comes from the solution of Continuity, all those things do cause pain in the Ears, which do dissolve the Continuity of those sensible parts which compass the Cavity of the Ear: the chief whereof are Distempers both without, and with, Matter, Wounds, Ulcers, or things fallen, or put into the Ears Externally. A Cold Distemper doth sometimes cause pain in the Ears, and it comes from cold Winds, cold Laths, and other very cold Causes. A Hot Distemper without Matter, seldom or never produceth a pain in the Ears, as a cold doth: For Cold is an Enemy to these Nervous and Membranous parts, but Heat is a Friend to them. Nor can it cause any pain but that which is excessive, and will cause a defluxion of Humours to the parts, and then it is not without Matter. For this Cause neither Galen, nor any of the ancient Greeks made mention of a Hot Distemper, although Avicen of all the Arabians have mentioned it. Now the Cold Matter which causeth pain in the Ears is either phlegm or water which comes from the Brain into them, or else wind coming from the Brain or the inferior parts. But the Hot Matter, is either Choler that falls from the Veins and Arteries into those parts, or Blood, from whence cometh Inflammation. The afore aid 'Cause produceth an occult Solution of Continuity from whence cometh Pain. But manifest Solutions of Continuity, as Wounds and Ulcers, are more evident Causes of pain. Wounds come from external Punctures, Cuts, and Contusions. But Ulcers come either after Inflammation and breaking of an Impostume, or from sharp Humours that corrode the parts, Finally, Things that get into the Ear outwardly, if they be hard, sharp, or any ways piercing or biting, will cause pain. You may know all these Causes thus, If the Distemper be without Matter, there will be no heaviness, distension, or tumour: And you may know that the Distemper is Cold, when cold Causes have preceded, as travel in Winter, when the pain increaseth in cold weather, or with cold Medicines and decreaseth with hot: but you may know a hot distemper by hot causes preceding, as being long in the Sun, or heat, and when hot Medicines hurt, and cold do profit. If the Pain come from phlegm, there will be a heaviness in the Ear, and the Head; as also a Rhewin will fall upon some other part, besides cold Causes did pr●cede, as cold and Northerly weather, cold meats; or it is winter and the Patient is old, and the like. If it come from Wind there will be a great pain without weight or heaviness, not constant, but intermitting and with noise. That it comes from Water, the Patient will have other Diseases from the same, as sharp and thin defluctions upon the Teeth, Eyes, Ears, Breast, and other parts; and Evacuation of serous Matter by Vomit▪ Stool, Urine, or Sweat. If it come from a Choleric Humour the pain will be sharp and pricking, and there will be sensible heat; it will be mitigated with cold things, and Choler will sometimes come forth of the heat▪ the Body is of a Choleric temper, the Party young, the Wether hot, and Diet also with the like, by which the Patient is often distempered. An Inflammation is known by a great beating pain, with great heat and redness about the Cheeks and Temples, to which there is joined a continual violent Fever; sometimes Doting, Swooning, Convulsion, and coldness of the extreme parts. A Wound is known by the blood which will come forth of the Ear, but an Ulcer by the filth, or matter; but because sometimes there is a defluxion of filth from the Brain by the Ears, we must distinguish, for it if comes from the Brain; there w●nt before it a Headache and other signs of an Impostume in the Brain: And first the matter is sent forth in great abundance and after by degrees while it is all spent. From an Imposthume in the Ear may come plenty of Matter, but then there went signs before of an Inflammation there, and afterward followed an Ulcer, wh●ch you may know whether it came from an Imposthume or a Defluxion of sharp Humours by the●e signs following; There is a constant Flux of a little filth or matter by degrees; there is felt a pain burning and shooting in the Ear, especially if it be picked. Moreover, We may conjecture of the Difference of the Ulcers, For if it be in the Bone, it is known by the thin Matter yellowish, and by the long continuance o● the Disease: If it be deep, you shall know it by much Matter: If it be clean, by the laudable Matter▪ If it be foul, by the thickness and plenty▪ If it be virulent, by the thinness: If putrid, by the stink of it: If it be corroding, by blood following. If fistulous, from the oldness of the Ulcer, the virulency of the Matter, the callosity and hardness of the flesh. Finally, If there be any thing fallen into the Ear, either it may be seen, or related by the Patient. The Prognostic of pain in the Ears is divers, according to the diversity of the Causes. That which comes from a bare distemper is easily cured. That which comes from a cold ●●egmy ferous, or windy matter, is not very dangerous, but u●eth to continue ●ong▪ But that which cometh from hot humours, and especially such as cause inflammation, is very dangerous, for the Brain being nigh must needs consent, and be also affected; from whence Deliriums, and Convulsons use to proceed. In this Disease young men are in most danger: for they being of a hot temper, and their blood ●ot, the inflammation is greater; and this dissolveth the natural heat of the Brain, and killeth the Patient: Hence it is that they die for the most part within seven days. But old men who are colder, have ●ess inflammation, and so are in less danger. Ulcers in the Ears are hard to be cured, because the Brain being nigh, doth send its excrements to those parts: But those which follow an Imposthume▪ are easier cured, especially if the matter be laudable. But where the matter is virulent, stinking, or the like, it is difficult, especially if the Ulcer be cavous, and the bone foul. The Cure, as the Diagnostic and Prognostic, is to be varied according to the Cause. For if it comes from a bare cold distemper, hot Medicines applied to the Ears are sufficient, such as are in the cure of Deafness, especially Fomentations and Fumes, as also the warm Oils there described. But when a hot distemper comes without matter, it may be cured with Topics, which are cooling, which we will show afterwards, and especially with the white of an Egg beaten with Breast milk, and put into the Ear. If it come from a cold distemper with matter, as phlegm, water, or wind, you must use the Medicines prescribed in the cure of Deafness. First, Purge the whole Body, then correct the distemper of the Brain, and apply warm Topics that discuss unto the Ears. If it come from a hot distemper with Choler, which is of long continuance, or comes by fits. First revel the humour that floweth to the part by Phlebotomy, by which the hot distemper of the whole Body with the Liver, in which Choler is made, is amended. Then purge the Humour with proper Medicines. You may amend the hot distemper of the▪ Liver with Juleps or cooling Broths, with Whey of Goat's milk, with sharp Vitriolat, Mineral Waters, with hot Baths, and the like. And lastly, All things are proper for it which are prescribed in the Cure of the Head from a hot cause▪ But you may use cooling Topics and anodynes that take away pain, which we shall show afterwards concerning the Inflammation. Inflammation of the Ear is cured first by blood-letting, according to the quantity of the humour, for revulsion of it from the Ears, first having given an emollient and cooling Clyster: This must be done in great quantity, at divers times, for the greatness and violence of the Disease requires it. You must open the Head Vein on that side the Ear is that is pained. If you think it comes from stoppage of Terms or Hemorrhoids, open the lower Veins, first having let blood in the Arm. When the cause is not from thence, it will do good for revulsion to apply Leeches. Also you make good Revulsions by Frictions and Ligatures of the Arms and Thighs, by cupping the Shoulders and Back with Scarification, or without. Sometimes for Derivation it is good to apply Cupping glasses behind the Ears, with Scarification; as Zacutus Lucitanus teacheth, Obser. 64. lib. 1. Praxis Admirandae, in these words. The Divine old man in his second Book, Epid. Sect. 6. towards the end, saith thus: For pain in the Ear, clap on a Cupping glass. This worthy saying gave much help to a poor man which was in pain; and when all things failed, and he grew weak with watching, and mad with a continual Fever, being ready to departed; having opened a Vein, and applied Cupping glasses to the Shoulders and Neck, and taken revelling Clysters, and purging, and the like; as also anodynes into his Ear without any profit, he was cured only with a Cupping glass with Scarification applied by the Glandles of the Ears, which drew much blood, and took away the inflammation. The same Zacutus Lucitanus in Praxi ad Histories, commends four Horsleeches applied behind the Ears, which he saith gave much ease to a young man which had a violent inflammation in his Ears. The cutting of the Arteries in the Temples of the Forehead, doth produce rare effects for the appeasing of the greatest pain in the Ears, by taking away the hot and windy blood which produced that grievous symptom. The way of doing it, is set down by us, in the Cure of the hot Headache. A Purge against Choler is good, for so the Choler mixed with Blood, which by it is made so fluid, is drawn down, and sent forth. Afterwards the whole mass of humours is to be tempered with cooling Juleps, made of the Decoction of Lettuce, Purslain, Plantain, Sorrel, and the like, with Syrup of Lemons, Pomegranates, or wild Poppies. In the mean while, these Medicines are given; you must always apply Topics, which must always be Anodine, by reason of the vehemency of the pain, the mitigation whereof must be your chief intent; and this will be more rationally done, if in the beginning and the increase of the Disease, you mix things that do gently repel; but in the state and declination, things that resolve, such as these following: Take of new Breast-milk two ounces: the white of an Egg beaten to Water half an ounce: drop these mixed together, warm into the Ear. Or Milk alone squirted into the Ear from the Breast; this doth much assuage. Take Plantain and Nightshade, of each one handful: the flowers of Chamomel and Melilot, of each one pugil: Make a Decoction, and let the Patient receive the fume thereof into his Ear by a Funnel. Take of the Oil of Water-lillies and Roses, of each one ounce: Mix them, and drop thereof into the Ear; after the fume. * Called ● Cheslip, or Kitchinbob, with many feet▪ which being touched gathereth itself round like a ball. Sows infused in the aforesaid Oils and strained, are the best anodynes; for these Creatures have especial force to appease pain, and therefore are used in the toothache, hemorrhoids, and the like; or take them asive, and boil them with Water in the Oils till the Water be consumed. If the burning be very violently, you may mix cooling Juices with the aforesaid Oils, thus: Take of the Oil of Water-lillies, and Roses, of each one ounce: the Juice of Nightshade and Plantain, of each half an ounce: Mix them, and drop thereof into the Ear. Rose Vinegar is used of some Practitioners made of two parts of Oil of Roses, and one part of Vinegar, which ought to be suspected, as all strong repelling Medicines; for there will be danger, lest the humour flowing thither should return to the Brain; and it is a general Precept always to be observed. That you never lay repelling Medicines to inflammations which are near unto noble parts: but you may mix gentle Repellers with anodynes and Relaxers; for ●o they will moderately repress the Defluxion, nor will they drive it far back: Such are the afore mentioned, to which you may add this following: Take of the Oil of Roses, and Water-lillies, of each one ounce and an half: Rose and Plantain Water, of each half an ounce: Breast-milk one ounce: the Mucilage of the Seeds of Fleabane and Quinces drawn with Rose water, of each six drams: mix them. Put some drops thereof warm into the Ears, and bind clouts dipped in the same Liquor about the Ears. In vehement pain we are constrained to fly to Narcoticks, or Stupifactives; but you must use them seldom, and with much care, because they offend the Brain. Galen saith, 3. de comp. med. sec. loc. I knew one, who only with the use of Opium, took away both speech and sense from his Patient, that he could be cured neither with Opobalsam, nor any other hot Medicine injected. Therefore if necessity constrain, thus they are to be prescribed: Take of Oil of Poppy-seeds one ounce and an half: Camphire and Opium of each two grains: mix them, and drop them into the Ear. Take of the Oil of sweet Almonds two ounces: the Juice of Mallows half an ounce: Myrrh half a dram: Saffron half a scruple: Opium three or four grains: mix them for the use aforementioned. In applying of Topics, the Rule of Galen is diligently to be observed, which is in lib. 3. comp. medic. sec. loc. cap. 1. that an inflamed Ear be not touched, but let the Medicines be injected by an instrument for to see into the Ear, or a Probe armed with lint and dipped in the Medicines. Then that you ask the Patient if he feel it warm, and if he can endure it hotter? and let it be used so hot as he can suffer: You must put the Probe so armed gently into the Hole of the ear that the Medicine may soak from it into the ear, you must do thus till the passage of the ear be ●illed with the Medicine, than you must dip lint in the same Medicine, and lay it to the Hole of the ear, and round about. In the state of the Disease you must mix gently resolving Oils with anodynes, thus. Take of Oil of Chamomel, sweet Almonds and Violets, of each one ounce: the Oil of Lilies half an ounce: Mix them. But these Fomentations and Fumigations which are made of the following Decoction, do resolve more powerfully. Take of Marsh-Mallow-Roots one ounce: Mallows, Nightshade, St. Johns-Wort, of each one handful: Linseed half an ounce: the seeds of Mallows, Ma●sh ●allows, and white Poppies, of each two drams: the Flowers of Chamomel, Dill, and Roses, of each one pugil: make a Decoction in Water and Milk for a Fomentation and Fumigation: ●ate● taken out of Ashen sticks, being dropped into the Ears easeth pain and dissolveth the cause of it. You must put green Ashen sticks in to the fire, and take the Water that comes from both ends. If the Tumour cannot be dissolved but it seems to tend to suppuration, which you may perceive by the increase of pain, by greater Pulsation, and a stronger Fe●ver. You must help the motion of Nature, and apply this following Cataplasm. Take the faeces of the former Decoction made for a Fomentation and Fumigation: and put to them of D●cks and Hens-grease, Marrow o● Vea●, and the Mucilage of Fleabane and Foenugreek-seeds, of each one ounce: the Oil of Chamomel and Violets, of each ●n● ounce: Fresh Bu●ter one ounce and an half: Saffron half a dram▪ Make a Ca●a●lasm. A Cataplasm o● Crumbs of Bread is also very good; for it assuageth pa●ns and furthers suppuration gently without inflammation: and therefore it is very proper in all Phlegmous or ho● Tumours: you must make it thus. Take of the Crumbs of white Bread one pound▪ boil it in Goat's Milk to a Pultis, then add of the two Yolks of Eggs, the Oil of Roses two ounces: Saffron one scruple: Make a Cataplasm. The Cataplasm made of an Onion, is much commended of Victorius Faventinus. Made thus. Take one Onion: Fresh Butter two ounces: Oil of Chamomel and Roses, of each one ounce: Saffron one scruple: Make a Cataplasm, apply it warm. The Suppuration being made, the Imposthume breaketh, and the Matter comes forth either by the Membrane of the Ear made thin, or else corroded, and then the Patient must lie upon the Ear that is pained, that the quittour may come forth; and you must drop such things into it as may cleanse. Take of the Decoction of Barley four ounces: Honey of Roses one ounce: drop this warm into the Ears at several times. If an Ulcer come from sharpness of Matter, you must have a peculiar way of Cure; such as is used to an Ulcer caused from a Defluxion of Humours. And first, because according to the opinion of Galen, 4. de comp. Med. sec. loc. we may not apply Topics to any part, except the whole Body be first often purged: we must use ordinary Evacuations by Bleeding and Purging according to the nature and temper of the Patient; and these must be repeated through the whole time of Cure, as often as need requireth. Then we must apply Drying and Cleansing Topics or Medicines to the place affected, beginning with the mildest first. The Examples of which are these. Take of the best Honey and old white Wine of each three ounces: boil them, and skim them: drop of this into the Ear, and stop it with Cotton dipped in the same. After that it may be stronger; mix the juice of Horehound, Smallage, Wormwood, and the lesser Centaury, or of Showbread with Honey: boil them gently, and drop thereof into the Ear. Or, Take of the Juice of Beets one ounce: Horehound half an ounce: the best Honey six drams: ●oyl these a little, then add of the Syrup of Wormwood two drams: Mix them. You may make a stronger Medicine thus. Take of the Juice of Showbread one ounce: Myrrh one dram: Saffron half a scruple: Frankincense one scruple: Verdegreece half a scruple: old Wine one ounce and an half: boil them gently till the Wine be consumed: drop of this twice or thrice in a day into the Ear. Observe, Before you drop any liquor into the Ear, you wash the ear in warm Hydromel, or water and Honey, and wipe it well with lint upon a Probe armed. When the Ulcer is sufficiently Cleansed, you must come to Cicatrizing. Thus. Take of Round Birthwort, Pomegranate peels, and Galls, of each half an ounce: boil them in equal parts of Wine and Smiths-forge-water, to half a pint, when it is strained, ad to it of the juice of Plantain and Poligonum, of each one ounce: Honey of Roses two drams: mix them, and drop of this into the Ear. Or, Take of Frankincense and Myrrh of each one dram: Gum of Juniper half a dram: Sarcocol, and Labdanum, of each one scruple: Make a Powder of them and mix it with Turpentine into Balls, which you must lay upon the Coals so that the Patient may take the Fume into his Ear by a funnel. Or, You may mix that Powder with some of the aforesaid Juices, and drop thereof into the Ear. Or, You may mix burnt Alum with white Wine, for this hath a very great Drying quality. If the Ulcer be stubborn and old, it is nourished by a Defluxion, which you must labour to remove by usual Purges, Diets of Lignum vitae and Sarsa, by Errhins, Masticatories, Cauteries, and other Remedies that will divert. Then must you use stronger Medicines to dry the Ulcer; such as we prescribed of juice, of Showbread, Myrrh, and Verdegreece. Or this following Medicine of Valescus, with which he saith that he Cured a Priest that had an Ulcer in his Ear from the eighth year of his age. Take of Honey ten drams: Vinegar eight drams: boil them: take off the scum, and put to one dram of Verdegreece: Mix them. These must be dropped morning and evening into the Ear, after it is washed with this Decoction. Take of Wormwood, Marsh Mallows and Agrimony, of each one handful: boil them in equal parts of water and white Wine put to it towards the conclusion, to half a pint: Dissolve in the strained Liquor Oximel simple one ounce and an half: Alum powdered one dram: wash the ear with this warmed, and after dry it with an armed Probe. If the pain come from sharp Medicines, drop in the Oil of sweet or bitter Almonds with Myrrh▪ Aloes, and Saffron: and if it be violent, mix a little Opium, or drop in the Oil made of yolks of Eggs in a leaden Mortar. If the Ulcer be very foul, you must use Aegyp●iacum, Dissolved in the aforesaid Juices. Lastly, Galen, Aerius, and Others, both Greeks and Arabians do much Commend the Rust of Iron for the drying of Ulcers in the Ear. Galen, 3. de comp. med. sec. loc. useth Scales of Iron ground or boiled with the sharpest Vinegar. Hollerius in his Comment upon that Chapter doth prefer the Arrabian Preparation, for they first grind the Iron with Vinegar, than they dry it; thus they do seven times, than they make it very fine, and boil it long with the best Vinegar, while it is as thick as Honey, and then they dry it, and use it with Honey or other liquors. If the Pain of the Ear come from any thing fallen into it, as a little stone, Cherry-stone, or the like; which will be very grievous, and sometimes cause Convulsions, Inflammations, and Death; as Matthaeus de Gradi saith of a Boy of ten years had a Cherry-stone in his ear, and through the ignorance of the Chirurgeon, he endured great pain, and after died. You must draw out these things thus. First, You may try with an Ear-picker which you must carefully attempt, lest your instrument force it further, which often hapeneth. Therefore if that which is fallen into the ear do fill the hole. it is better to abstain from the use of the Ear-picker, and try these Remedies. Paulus u●eth to dip his armed Ear-picker in Rozin, Turpentine, Gum, or the like; and to put it into the Ear, turning of it till you get it out by degrees. If thus you cannot, put hot Oil continually into the Ear to relax the part, and make the thing contained slippery, so it will easier come forth. Use Neesing with the mouth and nostrils shut, for so it will be forced out of the Ears. These are to be followed till the party be freed; for if it continue long in the Ear, it will be inflamed, and then the thing will be more difficult and dangerous to be drawn forth. Arculanus upon Rhasis, affirmeth that the Head of a Lizard applied to the Ear, will draw out any thing, and confirmeth it by his own Experience, in these words: In my Experiences for drawing things out of the Ear, this is one; Tie a live Lizard, or one lately dead, with his head to the Ear, for the space of three hours, and when you take it away, you shall find the thing sticking to the head of th● Lizard: and this is good for the extraction of any thing wheresoever it is fastened. Lastly, If the former Medicines do not prevail, you must come to the use of a Chyrurgical Instrument, which is at large elegantly declared by Fabricius Hildanus, Cent. 1. Observ. 4, 5, 6. and by Aquapendent, in his Chyrurgical Operations, in his Chapter of the Chirurgery for the Ears. Sometimes Fle●s get into the Ears, and moving themselves in the Cavity, bring much disturbance. For the taking out of them, make a little ball of dog's hair, and put it into the Ear, so▪ will the Flea by reason of its affection to dogs come into it. Or make a tent, and put it often into the Ear, with a little Turpentine. Oftentimes through swimming, or washing of the Head, water getteth into the Ears, which is very troublesome: this is shaken forth by hopping on the contrary foot, and holding the Ear down. If this will not do, you must ●uck it out with a reed, or a pair of bellows. If you arm the pipe with tow to make it stick clo●e, and keep the air out of the Ear, it will be better. Galen and Aetius continue in pouring in of Oil, suppling the Ear, and then wiping it with wool; and after using Oil for divers times. And lastly, Put soft and dry Sponge into the Ear often, till it come out dry. CHAP. IU. Of those things which come forth of the Cavities of the Ears preternaturally. MAny Preternatural things come out of the Ears, which we will set down particularly with their Remedies. First, After an imposthume is broken which came after an Inflammation, or from an Ulcer coming from sharp Humours, filth, or matter, useth to come forth; whose Cure is laid down in the former Chapter. Sometimes blood comes out of the Ears; as in wounds of the head, or blows by which the Veins of the Ears are broken or rend. If this flux be small, it is not to be stopped, because then being retained, it would cause Inflammation; but if it be great, or of long continuance, it must be stopped by bleeding in the Arm, and Cupping glasses applied to the Shoulders with Scarification. Then you must drop cooling and binding things in, as juice of Plantain, Polygonum, or the Decoction of Madder, red Roses, Mastich, Acacia, Hypocistis, Pomegranate flowers, Sumach, and the like, made in Wine and Vinegar, or Smith's Forge-water. Sometimes Water comes out of the Brain into the Ears, as in children, which must not be stopped, for if it be suddenly stopped, it causeth the Falling-sickness, or some grievous Disease of the Brain; for Nature casts forth Excrements by that way, though not proper; and the great moistness in children's heads is not only purged by the ordinary ways ordained by Nature, as the Nostrils and , but also by the Ears, Eyes, and the who● Head, from whence it becomes sore. But when this Evacuation is symptomatical, and the humour gins to ulcerate the Ears, and hurt the hearing, we will lay down a convenient Method for the ●ure. And ●irst, The abounding ●umors in the Head are to be purged with gentle Medicines often repeated, and to be derived by Ve●cator●es to the Neck, and by a Caustick. Then you must cleanse the Ears, and dry them with this Medicine: Take of the Juice of Agrimony, and Wormwood, of each four ounces: white Wine, and Honey of Roses, of each one▪ ounce: Boyl them a little, and drop into the Ear after it is wiped; then stop it with Cotton dipped in the same. Take o● white Wine four ounces: the Juice of Agrimony, Wormwood, and Centaury the less, of each one ounce: Boyl them, and drop into the Ear. In elder people, if water floweth out ●f the Ears long, you must purge the whole Body and the Brain with a Cephalick Apozeme that is purging; than you must consume the superfluous Humidity with a Sudorific Diet; derive it with Vesicatories, Cauteries, and Cupping glasses; and use other Remedies which are set down in the Cure of the Cold Distemper of the Brain. Lastly, There are Worms sometimes in the Ears coming out of filthy Ulcers, which are cured with the Ulcer; but because the Ulcer cannot be speedily cured, you must therefore endeavour the Cure of the Worms. Take this one Medicine as an Example: Take of the Oil of bitter Almonds: the Juice of Smallage, and the less Centaury, of each two ounces: Vinegar two drams. Boyl them a little; then add of Myrrh, and Aloes, of each one scruple. Mix them, and drop into the Ear. If you will make it stronger, put half a scruple of Coloquintida thereunto. The End of the Third Book. THE FOURTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Nostrils. The PREFACE. THe Nostrils use to have many Affects which are referred either to the Series, or Method of Diseases, or of Symptoms. These are Diseases, An Ulcer, Ozaena, Sarcoma, and Polypus. These are Symptoms, The loss of Smelling, Stinking in the Nose, the Coryza or Pose, Sneezing, Bleeding. Therefore this Fourth Book shall be referred to Seven Heads: The First Chapter is concerning the Ulcer of the Nostrils, and Ozaena. The Second of Sarcoma and Polypus. The Third of the loss of Smelling. The Fourth of the Stink of the Nose. The Fifth of Coryza. The Sixth of Neezing. The Seventh of Bleeding at the Nose. Chap. 1. Of the Ulcer of the Nostrils, and Ozaena. THe Ulcer of the Nostrils is either New and Simple, or Old and Stinking; This last is called Ozaena. The New Ulcer which is Simple, either comes of External Cause, as a Wound, or Contusion: Or, from an Internal Cause, as the sharpness of Humours, flowing to the part; & especially salted Phlegm coming from the Brain. Ozaena cometh from a simple Ulcer neglected, or from the Malignity and Acrimony of the Cause by which it becometh putrid and filthy. The Diagnosis of both is this; a Simple Ulcer Causeth little or no pain, but only sends forth blood often, especially when it is meddled or tampered withal; otherwise is is covered with a dry black Scab which sometimes is cast forth. But Ozaena Causeth great pain, the Scab is fouler; as also Stinking Matter cometh from it. The Patient is not only annoyed therewith, but noisome unto others: and the Greeks call it Ozaena from the stink. Often this Ulcer creepeth, or either eateth the Gristle of the Nose, or the parts between, or the tender Bones thereof, and putrifie●h them, and sometimes destroyeth the , especially if it turn to a Cancer, or if it come from the French Pox as it often doth, or from an Elephantiasis. As for the Prognostic, Ulcers that are New, and come from a gentle Humour that hath little Malignity are easily Cured: but Old Ulcers that are sordid and putrid are hardly Cured, and if they turn into a Cancer, never. If they come of the French Pox, or Elephantiasis, they cannot be Cured except those Diseases be first Cured. For the Cure: First you must appoint a good Diet, which may assuage the sharpness of the Humours, and hinder the breeding of them; than you must Evacuate the whole Body by Bleeding, convenient Purging, and by Cupping Glasses with Scarification: And if the Defluxion of Humours into the Nostrils be very stubborn, it must be derived by Vesicatories and Caustics applied to the hinder parts, and then you must give things to strengthen the head. After Universal Remedies you must come to Topics. And first take notice if the Ulcers be Crusty and Hard. and before you proceed, take away that with a little warm water and fresh Butter, or Goo●e grea●e, or Hen's grease, Oil of sweet Almonds, or the like. The Scabs being mollified, must not presently be taken off by force, lest the Ulcer be exasperated with a Defluxion; but you must expect till they fall off of their own accord by blowing the nostrils; or at last you may take them gently off with a little Oil of sweet Almonds upon the tip of your ●inger. After the Scab is off you must use astringent and drying Remedies. In a Simple Ulcer it is sufficient to wash it with Barley water, and Honey of Roses, and then to anoint it with Ointment of Tutty, or with the white Ointment of Rhasis, or the Oil of yolks of Eggs which will be of more source if it be made in a Leaden Mortar. But for the Cure of Ozana, you must prepare the●e following Medicines. Take of Barley one pugil: Agrimony, Plantain, Wormwood, and the lesser Centaury, of each one handful: Red Roses half a pugil: boil them in Forge-water: in the straining dissolve of Honey of Roses four ounces: Make an Errhine to be of●en snuffed into the Nostrils. After it is somewhat clean, you must use this following Decoction. Take of the Flowers and Rinds of Pomegranates of each two ounces: Plantain, Horstaile, Fleabane, and Rapture-wort, of each one handful: the Roots of Bistort, or Snakeweed, one 〈◊〉: Crude Alum, one ounce and an half: Make a Decoction. Alum Water is also good; as also those Remedies which shall after be prescribed for the Cure of P●lypus, in the following Chapter. Aegyptiacum▪ Dissolved in Barley Water is good for the same. After this make Ointments which may Ast●ing or Bind, Cleanse, and Dry exceedingly, as of Pom●holygos, with Alum Chalcitis, and the Pomegranate Peels. Or, This following. Take of Oil Olive, half an ounce: Pomegranate Peels, and Flowers, of each three drams: 〈◊〉. Alum, La●●anum, of each two drams. Chalcitis, Aloes, Frankincense, of each one dram: Oil of Roses and Myrtles, of each two ounces: Red Wax as much as is sufficient: Make an Ointment, which apply to the Vcer; or dissolve it in Wine, Plantain, Rose or Myrtle-water, which f●en snuff ●nto the Nose, the mouth being filled with Water. If these things prevail not, wash the Ulcer with sublimate Water, twice, thrice, or four times in a day, for it drieth very much, and cleanseth without any pain or biting: You must make it thus. Take of Plantain water four ounces: Crude, Sublimate Powdered, twelve grains: boil them in a Glass to the Consumption of half, you may increase or diminish the quantity of the Sublimate as you desire to have it stronger or weaker. When the Ulcer is well Cleansed, you must proceed to the Drying of it up: for which purpose the Po●der of Red Roses blown into it, is very good. Rondeletius witnesseth that there is nothing more efficacious for the drying of Ulcers after sufficient cleansing than a Fumigation, becauset it entereth deep into the parts, and drieth, and he saith it must be made of powerful dryers, as of Orpiment, and Cinnaber, to which you must add some sweet things, from whence there will arise a fume or smoak to dry the Ulcer; as Myrrh, Frankincense, Mastic, benjamin, and the like, which may be brought into this form: Take of the best Labdanum, Hypocistis, Mastich, and Myrrh, of each three drams: red Storax, and Styrax calamita, Frankincense bark, Sandarach, & Orpine, of each two drams. Make them up with Turpentine into Troches, with which let the Patient be fumed morning and evening in his Chamber. It is excellent also to burn Candles of red Wax; for the smoke of them will powerfully dry the Ulcers in the Nose, especially if the Patient be kept in a close room. And Rondeletius saith, That we may perceive that the smoke of a Candle doth affect us by receiving it: for if at any time we sit long in a little Study by Candle light, our spittle and snot will appear afterwards black: And by this means he saith he cured an Ulcer, which neither Italian nor French Surgeons could Cure. Chap. 2. Of Sarcoma, and Polypus. SOmetimes there is not only an Ulcer, but an excrescency of flesh in the Nose, which maketh preternatural Humours called Polypus and Sarcoma. Sarcoma is flesh growing in the Nostrils without any certain shape, but like the proud flesh of an Ulcer. But Polypus is an Excrescency of flesh growing with small roots, and spreading and hanging down to the lower part of the Nose, like the fish called Polypus, from whence it hath the name. Rhasis calleth it the Hemorrhoids of the Nose, because like those of the Fundament. This flesh is soft, sometimes white, sometimes red and blue, and if it grow big, it hangeth out of the Nose: but if it grow in the highest part of the Nose, it sometimes hangeth down to the , and stops the common passages, and may easily be seen behind the Uvu●a. In Southernly weather, and at the full Moon, it is much swelled. But in a Northernly dry time, and at new Moon, it is le●s. It differs from Sarcoma in this: Sarcoma groweth chief in the lowest part of the Nose, where it is ●●●shy; but Pol▪ pus grows in the highest part by the Root of the Nose. The Cause of both, is a gross slimy humour coming from the Brain mixed with blood; sometimes with melancholy, and then you may fear a Cancer. Sarcoma o●ten cometh from the superfluous nourishment of the Nose turned into proud flesh, and therefore is more easily cured. The knowledge of these Diseases is eadie by what hath been ●aid, they being apparent to the Eyes. The Prognostic is thus made: A Sarcoma is easily cured for the most part; but Polypus hardly. But that which is soft, white, or red, or white and red, is more easily cured; but that which is hard and livid or blew, is difficultly cured, and is like to be a Cancer. Also that Polipus whic● groweth low, or in the middle of the nostril, is more curable than that which is rooted high, because Remedies will not so well reach it. Both are cured with the same Medicines, which are to be ●o ordered that the superfluous flesh may be taken away; but first you must remove the antecedent Cause, that is, the slimy humour which cometh from the Head, which you must do by a drying and attenuating Diet, general purging, by Revulsion, derivation and drying of the head; all which may be done by those Remedies which are prescribed in the cure o● the cold distemper of the Brain, being discreetly used; and although many Authors commend the Decoction of Guajacum with a drying diet, you must take heed lest by so doing you mix the phlegm with not humours, and ●o it turn into a Cancer. After this, you must take off the superfluous flesh with Caustics, or with Cissers made purposely, and t●en cicatrize. But in the beginning of this disease, it may be cured with only strong dryers and astringents; and constantly you must apply such kind of Medicines first, before you come to stronger. First of all, try the Medicine made of the three sorts of Pomegranates prescribed by Galen, lib. 3. de comp. med. sec. loc. cap. 3. thus: Take three Pomegranates, one sour, another sweet, and the other of the middle sort: let them be ripe, bruise them in a mortar; then take the Juice, and boil it to a Limment; dip a tent therein, and often put it into the Nose. This drieth and astringeth without sharpness, and consumeth the Excrement. This following Water doth it more powerfully: Take of unripe Grapes three pound: Pomegranate peels and flowers, and Sumach, of each two pound: macerate them in Vinegar, and distil them: then put to it Alum one pound: Vitriol three ounces: then distil them all together again, and touch the part affected often with that Water. If these things will not do, you must u●e stronger, by putting Sandarach and Orpiment to the aforesaid Water. Or you may mix the Spirit of Vitriol, or the Water for separating Gold, commonly called the second Water, with Plantain Water, and touch the Polypus often therewith. Or with the Mercury Water prescribed in the Cure of the Ulcer in the Nose. Or you may put in a tent dipped in the juice of Cuckoo-pintle roots, and if it be too sharp, mix it with Plantain Water. Mercury Precipitate, which is red, is accounted the best Medicine to consume proud flesh without pain, if it be often washed. This Powder is to be mixed with Honey of Roses, and applied with a ●ent. There are also Plasters of the same virtue to consume a Polypus, without pain, as this: Take the Emplaster de Mucilaginibus half an ounce: the powder of Savin two drams: Incorporate them, and put thereof into the Nostrils. Or, Take of Verdegreece, Orpiment, Vitriol, and Alum, of each one ounce and an half: Antimony six drams: Steep them in Vinegar, then beat them fine, then dry them: thus beaten and steeped eight times, let them be steeped in Plantain Water, and then dried. Then take of Oil of Roses four ounces: Litharge two ounces: Boyl them, and about the conclusion ad two drams of the said powder: Make a stiff Plaster thereof, of which make tents. In the use of Caustics, first you must observe that before they be applied, you defend the Nostrils with the cooling Ointment of Galen, or with Nutritum, or Populeon, or white of an Eglantine beaten with Oil of Roses, and the like. Secondly, lest the Caustics should hurt the Nostrils, they must be applied through a silver pipe, so that it may compass the Polipus, and the Medicines may be conveyed to it without touching the Nostrils. Thirdly, You must observe that these Medicines are to be used in the decrease of the Moon, for the tumour than is less, and therefore Medicines may easily be conveyed to the root. Lastly, If Polypus cannot be taken off with Medicines, you must come to Chirurgery, or Manual operation; which is described in Paulus Aegineta, Cornelius Celsus, Jerom, Fabricius de Aquapendente, and other Modern Writers. Chap. 3. Of the loss of Smelling. THe Sense of Smelling is hindered and hurt three ways, as other Actions are, that is, by diminishing, abolishing, and depraving. The Causes are the same that diminish, and abolish the Smelling, only they differ in degrees, namely, distemper, obstruction, and astriction. A cold and moist distemper joined with phlegm, as it can easily make any sense dull, so doth it especially hinder the Smelling, or abolish it; hence it is that the Smelling is often hurt when there is a Catarrh, or a Coryza, for cold doth either diminish or abolish the sense, because it doth dull and we●ken the Natural heat, which is the producer of every action. Obstruction comes also from phlegm which fills the sensible Passages, as the Nostrils; and also the insensible; as the pores of the Brain, and the processus of the Temples, called Mamillares, so that the scents and smells cannot come to the parts: it may also come of a Sarcoma, Polypus, or other cause filling and stopping the Nostrils. Astriction sometimes may come from phlegm gathered in the fore part of the Brain, and compressing the Processus Mamillares, as we said of the diminishing of sight, from the astriction of the Optic Nerves. This astriction may also come from the Natural shape of the Nostrils, when they are so strait that there is no free passage for the Scents. The Cause of Smelling depraved, is a stink always coming to the Nostrils, either from an Ulcer there, or from stinking phlegm in the Nostrils, and Os Et●moides: for those things which putrify either in the very sense of Smelling, or near it in the Meninge, are not smelled by the Patient, but by them that stand by; for it is fit that whatsoever toucheth the sense of Smelling, should be brought from other parts. Moreover, a foul stinking vapour arising from other parts, as the Stomach, Jaws, and Brain be carried to the Processus Mamillares, and so infect them, that all the scents that are brought thither shall smell thereof; as when the Tongue is foul with Choler, all things which you taste seem bitter. The Causes are easily known. A cold and moist distemper of the Brain, and slimy phlegm coming from the Brain, show an abundance of phlegm. An obstruction if it come from phlegm shall be known by the same signs. If it come from Sarcoma or Polypus, you may learn the knowledge thereof from their Chapters. Now the place in which the matter causing obstruction is contained, is known thus: If it be in the passage of the Nostrils, the voice is hindered, because the Nostrils conduce to Speech: but the voice is perfect if the matter be in the Processus Mamillares, or the fore part of the Brain. You may know by the default of the parts, from whence comes the scent which hurts the instrument of Smelling. As to the Prognostic: When the Smelling is newly hurt, and coming of a simple Coryza or defluxion, is easily cured; but when it is of long continuance, and from a settled distemper, hardly: that which comes from the ill shape of the Nostrils, is incurable. You must order the Cure diversely according to the diversity of the Causes: If it come from a cold Distemper, you must use those Medicines which were prescribed for a Cold Catarrh. For the taking away of the Obstruction or stopping of the Nostrils and Processus Mamillares by phlegm fastened there; You must use Medicines that Purge those parts, as Errhins, Neezing, and Gargarisms; which were propounded by us in the Cure of the Cold Distemper of the Brain. If the Nostrils be stopped by a Sarcoma or Polypus; you must fetch the Cure from the Precedent▪ Chapter. Chap. 4. Of the Stink of the Nostrils. THe Stink of the Nostrils, and of the Breath, do much differ; for that comes only from the Nostrils, and this from divers parts, as from the Stomach, Lungs, Gums, Jaws, or being Ulcerated, which you may know by sense, or by their proper signs. But the stink in the Nostrils comes of stinking Vapours either bred in the Nostrils, as in Ozaena, Sarcoma or Polypus: or sent thither from putrid Humours contained in the forepart of the Brain; or about the Processus Mamillares, or Os Cribrosum. Now the Humours do putrify in the said parts when they are too long retained in them, especially if the Brain be hot and moist; and they are retained either by the stoppage or astriction of the parts, and in flat Noses. The Diseases of the Nostrils which produce this stink, are known by their proper signs above mentioned; but if you find none, you must conjecture that the stink comes from a putrid Humour in the Brain, Processus Mamillares, or Os Cribrosum. The Prognostic of the stink in the Nose coming of an Ulcer, Polypus, or Sarcoma, depends upon their Frognostick: but that which comes from corrupt Humours contained in the forepart of the Brain, if it be New, is easily Cured; if Old, uncurable: especially if it come from a depression and flatness of the Nose. The Cure is performed by removing the Causes, and appeasing the Symptoms. The Cure of an Ulcer, Sarcoma, and Polypus is above mentioned: but you must take away the putrid Humour in the Brain, Processus Mamillares, or Os Ethmoides, by emptying and Cleansing means. And first, You must use Universal Evacuations for Cleansing the whole body and the brain from flegmy Excrements, by Pills, Apozems, and the like; to which you may add, if there be great plenty of Humours, a Sweeting Diet: afterwards administer Errhins that cleanse and bring forth the Matter conjoined. And first of all, Let him morning and evening snuff up white Wine from the palm of his hand in which the Lesser Centaury and Calamints have been boiled. Then let the juice of Beets extracted with the Water of Margerum be used in like manner. Or, Take of Cyprus Roots and Calamus Aromaticus, of each half an ounce: Red Roses one pugil: Myrrh two drams: boil them in white Wine for an Errhine. That you may draw down the phlegm more violently, make this. Take of Flowers-de-luce-root half a dram: white Hellebore and long Pepper of each half a scruple: Annis-seeds and dried Marjoram powdered of each one scruple: Euphorbium one grain: Oil of Spike Chiry, and Violets, of each as much as is sufficient: make a soft Ointment, in which dip the top of your little finger, and ano●● the Nostrils within; or put it with a Tent or Pledget as big as a Pease into the Nostrils▪ Lastly, To oppose the stink, you must snuff up sweet things, as Galla Moschata dissolved in sweet Wine, Angelica-water, or the like. Chap. 5. Of Coryza, or Pose. COryza, called in Latin, Gravedo, is a Catarrh falling from the Brain into the Nose; which Defluxion is of a crude Humour contained in the fore Ventricles of the Brain, and comes for the most or an External Cause, as from the heat of the Sun, drinking of much Wine, hot Baths, and the like, which do melt and dissolve the thick phlegm gathered in the Brain: It comes also of External Causes which Cool the Brain, for than it is squeezed like a sponge, and so it sends down the Humour into the inferior parts: as also by overcooling the Brain there is an increase of phlegm, for through want of heat the Excrements are not concocted; therefore are they sent forth through the open passages by the Expulsive Faculty. This Disease appears of its self, for the Humour is sent in abundance out of the Nose. Among all kinds of Catarrhs that which is through the Nose is most safe and gentle, easily Cured if it be New, and come of an External Cause; but that which is Old, and comes from a stubborn Distemper of the Brain, is difficult. As also, when it proceeds of a hot Distemper of the Liver, which sometimes causeth sharp and hot Catarrhs; by which the Nose is often Ulcerated and ill affected otherways. The Cure of this Disease is by Curing the Catarrh; for it requires the same Evacuations, Revulsions, and Derivations; except that here you must not use Errhins, lest they should draw the Humours to the part affected; but Gargarisms and Masticatories after Universals are very good. And besides these, Authors do commend those things which properly belong to the stopping of a Cataarh; as the vapour of boiled Marjoram; or of Margerum water taken into the Nose. The fume of Vinegar sprinkled upon a red hot Iron is good for the same; and the better if red Roses have formerly been infused therein: If the Defluxion be very Cold, dry Fumigations of Nigella, Frankincense, and the like, thrown upon Embers are very good; for by these the cold Distemper of the Brain is amended, and the superfluous moisture consumed. Chap. 6. Of Sternutation, or Neezing. ALthough Neezing come often to sound men, and useth to be so light an Affect that it deserveth not the name of a Symptom; yet sometimes it is troublesome, that it requireth a Physician: As we may read in Forestus, Obs. 127. Lib. 10. in his History of a certain Maid which had so grievous a fit of Neezing from a sharp salt Catarrh, that she had the advice of many Physicians. This is confirmed by the Old Custom of saying God bless you to him that Neezeth; which some say came from hence, In the time of Gregory the Great there was an ordinary Disease of Neezing by which the Patients died; albeit some say that Custom is more ancient. Sternutation is a swift motion of the Brain, with which the breath is forced out of the Nose for the throwing forth of things that offend: By the Brain we understand not only the substance thereof, but the whole Body with its Membranes; especially the fore-membranes, which are especially contracted in this Disease, which we may gather from hence, because when we hold up the head we Neez more easily; for then the matter provoking which for the most part is windy and tends naturally upwards, is more easily carried to that part. But the motion which happens in Neezing belongs to the natural Expulsive Faculty of the Brain and its Membranes, according to Galen, 2. de symp. cause. cap. 1. where distinguishing Neezing from Trembling and Palpitation, saith, That Palpitation comes only from a Disease: Trembling from Nature and a Disease: but Neezing from Nature only. But Galen at the first sight seems to contradict himself; who in Cap. 4. of the same Book, saith, That a Cough and Neezing are Symptoms of the Voluntary Faculty; but it is no contradiction: and Galen clears himself wisely; saying, That in Neezing the Animal Faculty doth concur only secondarily; because in Neezing breath is sent from the Head and from the Lungs; yet the Head gives the original of the motion to the ●reast; for when it hasteneth to send forth those things that offend in the Nose, it useth both ways at once to send forth breath: One way which it maketh by itself, Another way which it maketh by the Nerves, descending like long arms into the breast; whence Galen, Com. Aph. 51. Sect. 7. teacheth, That Neezing comes with antecedent inspiration or taking in of breath when Nature gathers it together to make Sternutation, than the air which goes forth of the breast, joined with that which is drawn by the Nose into the Brain, doth expel with Noise and violence whatsoever offendeth the Membranes of the Nostrils which have most Exquisite Sense. From this place of Galen, we may gather, That the irritation which causeth Sternutation is made chief in the Nose; which is confirmed, Aph. 51. lib. 7. where he saith, They only Neez of those thus Affected which have a sharp moisture flowing from the head, as when you put sharp things into the Nose: For as a Cough is a certain natural motion to purge the Arteries which are in the Lungs; so doth Neezing the passages of the Nose. But it may be objected, That many standing bareheaded, or otherwise in the cold Air, do presently Neez, that one would think the Brain was provoked immediately at that time. We Answer, That cold Air is the Cause of Sternutation not while it doth immediately act upon the brain: but because through compression of the brain and its Membranes, it causeth a sharp Matter to descend to the Nostrils; although therefore in this Symptom the Membranes of the brain may be provoked: yet Neezing is not produced before a sharpness or tickling come to the Membranes of the Nose which are tightly sensible. The Causes of Neezing are known by what hath been said, namely, What things soever can provoke the internal coat of the Nostrils, such as are sharp humours or vapours, either coming from the Brain, or sent from the inferior parts; hence men neez in fevers, saith Avicen, because sharp vapours are sent from the whole body into the head; or it is caused when sharp things are externally put into the Nose, as sharp Medicines called Ptarmica Neesing. These are the external Causes which provoke neezing immediately. There are many other mediate Causes which make internal Causes, or move them, as all alterations of the Air, as above said of cold Air. Galen in his Book de instrum▪ odoratus, cap. 6. saith, That neezing is provoked by beholding the Sun, because the Spirits of the Brain, like to a vapour, are discussed by the Sun. The knowledge of this Disease is manifest. The outward Causes appear by the relation of the Patient; but the internal from the signs of the parts affected, by which the matter provoking is sent to the Nostrils, and fore part of the Brain. As to the Prognostic; This Disease is of itself without danger. But in the beginning of a Catarrh or Coryza it is very hurtful, because it keeps the humour from concoction by its motion. Sometimes in Fevers it is so strong that it takes away all strength, and causeth bleeding at the Nose; sometimes it is no ways hurtful, and in sound men it expelleth the superfluities of the Brain: In sick men it is held a good sign. It promiseth help in Fevers, especially in malignant Fevers when all things are desperate. If neezing happen to a woman in fits of the Mother, or that hath hard travel, it is good, Aph. 35. Sect. 5. Neezing provoked with Medicines is good against Apoplexies, and other great Diseases of the Brain. And if being provoked they do not neez, it is a sign of death, for it signifieth that Nature leaves to act. In Diseases of the Lungs, especially in a Pleurisy, and Peripneumonia, or inflammation of the Lungs, neezing is evil, Hipp. 2. Progn. because from the shaking of the Brain in neezing, the parts of the Breast are violently pulled and torn; from whence the inflammation is increased, and there is no other evacuation of the matter causing the disease; but for the expelling of phlegm contained in the Gristles of the Lungs, which could not be cast out by a Cough: Galen showeth that neezing is good, Gal. 2. de symp. cause. cap. 5, & 6. The Cure when it is necessary, or when neezing bringeth inconveniencies, is made first by removing of the External Causes, if it come from them. If it come of an internal Cause, you must remove that also, by Evacuations, Revelers, Derivers, and Discussers. If a hot distemper of the Brain or any other part send sharp vapours to the Nostrils and inward meanings. Then you must open a Vein, and then purge, then revel the vapours with Frictions, and Ligatures, with Cupping Glasses to the Shoulders; also use other Revelling, Deriving, and Discussing Medicines, comb the Head, pull the Ears, rub the Eyes, blow the Nose, and hold the Breath. Lastly, To take away sharpness, and hinder the Nostrils from being provoked, it is good to take the vapour of hot water into the Nose; or to anoint the Nostrils with Oil of Roses, sweet Almonds, Violets, or with fresh Butter; or to snuff up warm Milk into the Nose; by which only Remedy Forestus presently cured the Maid mentioned formerly. Chap. 7. Of Bleeding at the Nose, called Haemorrhagia. THe word Haemorrhagia, vulgarly signifieth any flux of blood coming from any part. But peculiarly, when it is named simply of Hypocrates, it signifieth only that flux which cometh from the Nose, as the first and most evident kind, as Galen observed, Com. 1. in 1. Epid. An Haemorrhagia of the Nose, is a Symptom in the excrements of those things which are wholly against Nature. For Blood coming through the Nose, either comes from the Veins and Arteries in the Brain, or from the Vessels coming from the to the Nostrils, which eaten like the Hemorrhoid Veins in the Womb and Fundament. But since every Symptom depends upon a Disease as its immediate Cause, the cause of this will be either an Organical, or a Common Disease. The Organical is twofold: The opening of the Vessels, which is called in Greek Anastomosis; and the thinning, or rarefaction of them, called Diapedeses. The Common Disease is twofold: The breaking of the Vessels, called Rexis; and the Erosion called Diabrosis. The Causes immediately producing those Diseases, are either exceeding in quantity or quality of Blood. Blood offending in quantity can either break the Veins, or open the Orifices of them. In quality, if it be too hot, or too thin, it will flow out by Anastomosis, because heat doth dilate the Orifice, and thinness maketh it flow more easily. Also the same qualities make a Diapedeses: for heat maketh the coats of the Vessels thin, and the thinness of the blood makes it easy to pass through the pores of those coats. Lastly, The sharpness of the Blood gnaweth the Tunicles of the Veins, and ulcerateth them, from whence cometh a Diabrosis. The external Causes also do concur to produce this Disease, either mediately, or immediately. Immediately, as falls, strokes, wounds, and the like, which break and divide the Veins. They work mediately which do increase, warm, and make thin the blood, as plentiful Diet, Drunkenness, Idleness, too much Exercise, great Noise, Heat, long staying in the Sun, and the like. The Differences of Hemorrhagia are these: Some are Critical, some Symptomatical. Critical Hemorrhagia's are in acute Fevers, by the force of Nature endeavour to expel the cause of the Disease this way, as especially in those Diseases which are joined with the Inflammation of some Entral, especially of the Liver, or the Spleen, which are many times discharged by these ways; sometimes it comes without a Fever, when Nature dischargeth herself of the superfluous blood, whence we see many in their youth have an Hemorrhagy by fits, and others bl●ed other ways. A Symptomatical Haemorrhagy happeneth chief in Chronical Diseases, in which filthy blood is produced by reason of the debility of the Liver, or some other great Distemper, which either flows through those Veins by the weakness of the retentive faculty, or is sent forth by the expulsive, as an unprofitable burden, because impure blood is not fit to nourish the Body. Haemorrhagia is known of its self. But its Causes are thus distinguished: That which cometh by Anastomosis, hath this common with that which comes by Rexin, or rapture, in that in both the blood floweth plentifully; but in this they are distinguished, If a blow or a fall went before, we should suppose it to be Rexin: But when Ruption cometh from Plethora, or much Blood; as also apertion of the Veins; thus they may be distinguished: When the Vessel is broken, the Blood sloweth constantly; when it is opened, at a distance, and by fits only; because the Orifices of the Vessels use to be knit and closed when there is less plenty of the Humour which dilateth flowing thereto; but broken Vessels stand always open, and therefore blood continually sloweth till the solution of continuity be united. Moreover the opening of a Vein, is distinguished from the breaking, by the substance of the blood: For if it be thin, it comes from a Vessel opened; if thick, it comes from a broken. Hence it is that Hemorrhagy comes in young men for the most part by the opening of the Vessels, because their blood is thin; but in old men from Ruption, because theirs is thick. If it comes from Erosion of the Veins, there will be signs of Cacochymia, or ill juice in the body of an Ulcer, and matter sometimes comes forth: or at least a salt Catarrh hath gone before. If it comes by Diapedeses, or Rarefaction, the blood is thin and little. The Causes autecedent and external, are easily distinguished: For if it come from plenty of blood, there is a red face and large veins: as also the Diet hath been large and hot, or there hath been some external cause which hath melted and made thin the blood, and these especially befall them who have very hot Livers. If it come from evil Juice, it is known by its proper signs, which declare whether Choler or Melancholy doth abound: Moreover, the Blood will appear corrupt either from the Nose, or taken from the Arm. If it come from the weakness of the retentive faculty, the face will be pale, and the whole body weak; as also some Disease hath gone before, by which the Liver was first weakened, and then very little blo●● comes forth, and by degrees. If the blood comes immediately from the Veins of the Nostrils, it is easily stopped with astringent Medicines applied thereto, and there will be no pain in the Head. Contrary wise, if it come from the Brain, there is some pain in some part of the Head, the flux is hardly stopped, and things put up into the Nose do no good. Sometimes blood comes from other parts, as the Liver, Spleen, Womb, whose signs are the pains and extensions in those parts. If the blood flows from an Artery, it comes with force, it is hot, pure, fresh, and clear; but when it comes from a Vein, it is dark, red, thick, sometimes foul, and comes forth with small force. The Prognostic of Hemorrhagy coming, especially if it be Critical, is taken from the hurt actions, when the Excrements and qualities are changed: as watch, and dreams of red things, a great pain of the Head and Neck, heaviness in the Temples, and great beating of those Arteries, ringing and noise in the Ears, dulness of the Eyes, with redness thereof, and of the whole face, hating of light, involuntary tears, itching of the Nose, a drop of Blood upon the day that declares the Crisis, difficulty of breathing, an extension of the Hypochondria without pain. The Reason of which signs is: When the Blood gins to be carried to the Head, it begets in the Head Phantasms of red things, both waking and sleeping: as it happened to a young Roman which Galen mentioneth, lib. de praesag. ad Posthumum, cap. 13. he had an acute Disease, and thought he saw a red Serpent about the Chamber Seiling, at which being frighted, he leapt out of his bed: Hence Galen foretold a Haemorrhagy at hand, and hindered the letting of blood which other Physicians had prescribed. The pain of the Head and Neck comes from the translation of the blood into the superior parts, which by distending and pulling the Membranes causeth pain. The Arteries in the Temples beat by reason of their compression which is caused by the fullness of the Veins. The noise in the Ears comes from vapours flying in abundance into the head. The sight is dim because many thick vapours sent up do stop the passages. Hence it is that when passage is denied to the Animal Spirits, the sight is dim. The things flying before the Eyes called Marmaryges', are nothing but thin bodies divided and of divers colours contained between the Cornea and the Crystalline, coming from vapours ascending: which though they be inward, yet through deception of the sight they seem to be outward; because the Eye being used to see External things, supposeth whatsoever is within, to be without. The Redness of the Face and Eyes comes from blood in those parts increased: there is a detestation of light, because the Eyes being distended with plenty of humours, will be more distended with light, because it disperseth the Spirits: Hence the Eye is dilated, which causeth pain, which that the Patient may avoid, he avoideth the light. The involuntary Tears come from the repletion of the Eyes, and the parts adjacent, which being too much Distended to press the Glandles that contain the moisture of which tears are made. The Itching of the Nostrils comes from vapours ascending upwards. Drops of blood upon the day of demonstration, namely, the fourth or eleventh, showeth that there will be an Haemorrhagy upon the day of judgement; namely, the seventh or the fourteenth, because in those day's Nature gins to transfer the Humours to those parts. The breathing is difficult, because while the blood flieth upward it compresseth the Diaphragma. Lastly, There is a stretching of the Hypochondria, because the blood gins to move in its fountain, and in the roots of the veins: but this distension is not constant, and is without pain, as the difficulty of breathing is: for if they should last long and increase they would be signs of the Liver inflamed. The Prognostic of a present Bleeding at Nose is thus. If Blood flow moderately out of the Nose in the day of judgement it is sign of Health; although Galen doth confirm this; yet Fernelius denyeth it, saying, lib. 2. de sanguinis m●ss. cap. 1. That no discharge of blood, although critical, is sign of health; for though it ease madness, watch, headache, and other Symptoms, yet it scarce ever cureth the Disease, because the purer portion of blood is sent forth and the pure remaineth; and this is thus proved, because the blood coming from the nose is of a laudable colour and substance, when blood at the same time taken out of a vein in the arm or else where, shall appear to be corrupt. This Doctrine of Fernelius is very real, but not altogether to be received: It is true, That in acute Diseases, especially malignant Fevers, a Haemorrhag doth not always Cure the Disease: as Sweat is not always a sign of Health in those Diseases▪ because these Evacuations being forced by Nature before the time, come for the most part from the malice of the matter of the Disease: Yet sometimes acute Diseases are cured by Haemorrhagia, as Galen taught in his Third Book de cris. cap. ult. and elsewhere. And the reason why blood out of the Nostrils is always pure, is because it comes by drops, and therefore would be so quickly cold that the impure parts could not be separated; and the purer parts mixed with the rest would make the whole mass red. But blood taken out of the arm, because it comes flowing freely, keeps the colour long in the vessel from which the impure parts are separated, so that the thick and drosly part goes to the bottom, but the choler and phlegm which is more altered and impure, swims at the top, and so the blood seems impure and sordid. On the other side, if blood should drop from the vein it would appear pure, because it presently goes together before the Haeterogeneal parts can be divided by the heat; nay if blood flow freely and be caught in a large vessel, it will appear pure because it is quickly cold. Haemorrhagyes that are very great are the worst, for they tend to a Convulsion: For sometimes it comes to pass that Nature being burdened with much blood, and stirred up to throw it forth, cannot observe a Mean, and makes an over Crisis, which Physicians must stop. An Haemorrhagy in the beginning of the Disease is evil, because it is Symptomatical, and comes from the malignity of the matter of the Disease, Nature being stirred up to send it forth before her time. An Haemorrhagy which is on the same side with the part affected is good, but otherwise it is evil so in the inflammation of the Liver when blown forth out of the right Nostril it is good, but out of the left, bad. Contrarily, When the Spleen is inflamed, if blood come forth of the left Nostril it is good but out of the right bad: because all good Evacuation ought to be ●ata ixin. A few drops coming from the Nose are evil: for it signifies the weakness of nature, and the malignity of the disease. For all Excretions are condemned by Hypocrates, in acute diseases if they be begun only and not finished, because there is greater security in those Fevers in which nature putteth forth nothing, than in which she puts forth little to no profit. For than it is to be supposed that she tends to Concoction; but if a drop appear, it is a sign that nature was stirred up before her time. But a drop coming upon the day of Indication, and signs of Concoction also appearing, it signifies that there will be an Haemorrhagy upon that Critical day. Hemorrhages continuing long, foreshews the weakness of the Liver, and the coldness also, and an evil habit with a dropsy to be at hand. To him who have bled at the nose in Quartane Fevers it is evil, Hypocrates, Aph. 87. Sect. 7. For as Avicen sayeth bleeding in Melancholy and Phlegmatic people is hurtful, because i● cooleth too much. To them who in Fevers have lost much blood at the Nose, or any part, when they amend their belly will be lose, Hip. aph. 27. sect. 4. For as Galen saith in Com. when the natural heat is debilitated by bleeding, neither can their meat be well concocted, nor turned into blood, nor distributed into the body: and therefore it is fit they should be lose bellied, until Nature recover her strength. In the Cure of Haemorrhagia, first observe whether it be Critical or Symptomatical: For a Critical is not to be stopped, but you must suffer it to flow in a great quantity: For Avicen saith, That blood hath come from the Nose to the quantity of four pints by a Crisis without any decay of strength. And this seems to be taken out of Galen, who in his Book de Progn ad Posthum. cap. 13. suffered a young Roman to bleed four pints and an half before he would stop it. Which as it may fall out well in very Plethoric people, so in others it may endanger life; and it is certain that a Critical Haemorrhagy, although it is the work of Nature, yet sometimes is beyond measure; for Nature being burdened with blood, and stirred up to expel it, sometimes cannot keep within measure, but maketh too great an Evacuation; whence we ought to fear a great dejection of strength, and death, and then it is to be stopped, as often as any notable infirmity followeth. So also that blood which customarily floweth without a Fever is not to be stopped, but to be left to Nature's ordering, except it be immoderate; for many by such bleeding have been freed from great Diseases, into which after, upon suppression thereof they have fallen. But a Symptomatical Hemorrhagy is to be stopped, which may be done by revulsion of the Blood from the Nose, and by repelling it to the parts adjacent, by stopping of the Veins which are open, by staying the disorderly motion of the blood, and by evacuating the sharp and thin humours mixed with the Blood, which are the chief Cause of Haemorrhagy, by correcting them, and hindering their increase, and by strengthening the retentive faculty of the Liver and Veins: All which may be done with the Remedies following. And first Blood-letting is the chief thing for Revulsion, which must be done quickly before the Patient grow we●k, and that out of the Vein on the same side the Nostril is, out of which it cometh: on the right ●ide, if from the right Nostril; on the left, if from the left: And Galen, lib. de sang. miss. cap. 11. confirmeth the efficacy of this Remedy, affirming that he hath presently stopped violent bleedings at the Nose only thereby. But it must be taken in a large quantity if the Patient be strong, and from a large orifice: Although most of the Ancient and Modern Physicians think otherwise, and say that blood must be let out at a final orifice by little & little often, by which means they say the Revulsion will be better. But that you may make the blood move the contrary way, you must have a stronger motion for hindrance of a weaker; therefore by how much the larger the orifice, and the more violent the motion is of the blood from the Vein opened, by so much the sooner will the blood at the Nose be stopped: But if by once letting blood, and applying other Remedies, the Haemorrhagy be not stopped, you must repeat Blood-letting according to the strength of the Patient. You may also open the Vein in the Foot, that a Revulsion may be made at a great distance, which also availeth much, as Avicen, Paul. and Trallian say. After Blood-letting, as also before, rub and bind the extreme parts, and clap great Cup-glasses to the Hypochondria; to the right side, if the right No stril; to the left, if the left do bleed: For Galen stopped an Hemorrhagy in a young Roman, by a Cupping-glass to the Hypochondrion without blood-letting, as he saith lib. de prog. ad Posthum. cap. 13. Notwithstanding, the applying of Cupping-glasses to the Hypochondria, is not altogether safe, for the blood then being hot may be drawn in too great a measure into the Liver, or the Spleen, and inflame them. Of which there is an example in Fabricius Hildanus, Obs. 47. Cent. 2. of a Gourtier who bleeding violently at the Nose; to whom, with other Remedies, there were great Cupping-glasses applied to his Liver: The blood stopped, but there followed a great inflammation of the Liver. Therefore you must be wary in applying Cupping-glasses to the Hypochondria, and never use them but when all other Remedies fail, and after divers Phlebotomies: For after the plenty of blood is taken out of the Veins, there is less danger of attracting too much Blood to the Liver to inflame it, but which way soever they are applied, they draw blood and spirits to those parts whereby their heat is increased, which seems to be contrary to the opinion of Hypocrates. Aph. 13. Sect. 5. where he saith, That in those parts from whence Blood cometh, or is about to come, you must use cold things. The Interpreters say, that cold things are to be applied to those parts from whence the motion of the Blood beginneth, as the Liver and Spleen. Forestus commendeth Cupping-glasses to the Feet, by Experience, Obs. 14. Lib. 13. in these words: When a Gentleman exceedingly bled at the Nose, and no Remedies would help him, having lost at least twelve pound of blood from both Nostrils; I was sent for▪ and after he had bleda whole day, I commanded two Cupping-glasses without scarification to be applied, one to his Liver, the other to the Spleen, and the blood seemed to stay a little; but after my departure, when his wife perceived him to bleed again out of both Nostrils, and that his cupping had done no good, she commanded that the cupping should be set upon his feet, and the blood wonderfully stopped beyond expectation: But after the Cupping-glasses had been a while fixed, the Patient fell into a swound; and therefore they took them off, and threw water in his face, by which he recovered; and then being refreshed with the scent of Wine, he came to himself, and was restored to his former health, from his bleeding, as it were by Miracle or Enchantment, beyond all expectation. Moreover, Cupping-glasses applied to the Shoulders both dry and with scarrisication, do draw back the blood ●rom the Nose. But they be not always safe, for they may attract blood from the inferior parts, and so give occasion to a further bleeding. Some Practitioners do apply Cupping-glasses to the Biceps Muscles of the Arms, by which they make revulsion. Crato in his Counsels, reckoneth the bending of the little finger on the same side among the revulsives: for by the great pain that will be caused thereby, there will be a drawing back of the blood. But the Blood and Spirits are drawn inwardly more strongly by swooning, whereby we saw a Bishop in the year, 1629 cured of a violent Hemorrhagy; for being in a malignant Fever with the inflammation of the right Cidney, which after in the twenty seventh day of his sickness, turned to an Imposthume, he was taken with so violent a bleeding, that in four hours he lost two pounds, and still bleeding and strength decaying, we bethought how we should stop it; and after the use of many remedies to no purpose, the Patient desired to ease his belly, and could not be compelled to do it in his bed: we foretold him, that if he arose, he being very weak would faint away, but that would be good to stay his bleeding: and so it came to pass, for after he risen he swooned; from which with a little Wine he was recovered, throwing also Water in his face; after that he had a large stool was brought to his bed, and bled with less violence; then giving a dram and an half of Lapis Prunellae in cold Water, presently the blood franched when the same and other Medicines could not formerly do it. Although fainting be not vulgarly accounted a Remedy against bleeding at the Nose, yet Hipp. lib. 3. Epid. Sect. 7. saith thus: These things stop the bleeding of the Veins, swooning, the alteration of the posture or figure of the Body, m●erception, a tent, apposition, and deligation or binding. Galen in 5. m. cap. 5. teacheth the same, in these words: Moreover Blood is staunched 〈◊〉 by fainting, and by revulsion, and derivation to the parts adjoining, and by cooling of the whole Body, and especially the part afflicted: But you must observe that fainting doth only profit when the blood floweth from the Veins which are terminated in the superficie of the body, which Hypocrates also hints at, when he prescribeth tents, bandage, and the like. For when blood cometh from the internal parts, as in an Hemoptoe, or spitting of blood, immoderate flux of the terms, or internal wounds, then fainting will increase the bleeding, the heat being thereby drawn into those parts from whence the blood cometh. Zacutus Lucitanus, Lib. 1. Praxis admirandae, Obs. 66. reports that he cured a desperate Hemorrhagy, which would yield to no other Medicines, by an actual Cautery to the sols of both feet; which Remedy he saith had like success in a great bleeding at the mouth coming from the opening of the Vein called Ranuncula under the Tongue by corrosion from a sharp Gatarrh; and when the Blood had flown two dates to the quantity of twenty pounds, and many astringents and Empla●ers had been used, as also Revulsies and thickening Medicines, with Narcoticks or Stupefactives, by a Cautery in the sole of the foot it was staunched. If still he bleed after all the aforesaid Revulsions have been tried, you must come to repelling Medicines, such as are vulgarly called Anacollemata, things to be applied to the Forehead and Temples, which are thus made: Take of Bolearmenick, Terra Sigillata, Sanguis Draconis, Frankincense, Mastic, and Aloes, of each one dram: Bran and the hair of an Hare cut small, of each half a dram: one white of an Egg, the Juice of Plantain, and Nightshade, of each as much as is sufficient to make a Cataplasm for the Forehead, and the Temples. In extremity you may quickly make a Cataplasm of Bolearmenick only, mixed with the white of an Egg and Vinegar for the same parts. The most excellent is made of Time and Vinegar, and applied to the Temples and the Forehead as thick as two fingers: and if the first application do it not, let it be repeated, and it will certainly cure. Amatus Lusitanus commends a cap made with the aforesaid Powders, mixed with Vinegar and Water, laid upon the Head being shaved; which you may try in great extremity. Also you may make a Fomentation of very cold Water, or Water and Vinegar to the Temples and Forehead, changing your as they grow hot. Or you may make a Fomentation of the Juice of Plantain, Knotgrass, Horstail, Shepheards-purse, and the like, with a little Vinegar to make it pierce. Where mark, That the Head is not to be washed with cold Water, nor repelling Medicines to be laid to the Forehead, before you have made sufficient Revulsions; otherwise the blood being struck in with cooling will fill the Veins above, as Galen showeth, 5. m. cap. 6. and so the flux will be increased, by the heat increased through Antiperistasis, by which the motion and force of the blood is increased; or if the blood be stopped, there will follow a Convulsion, Apoplexy, short and difficult breathing, called Dyspnoea, or the like. Vinegar alone will stop blood if the Forehead be fomented therewith in a Sponge. Or if you dip a Sponge in Vinegar, and put it into the Nose. To throw cold Water in the Face, doth not only drive back the blood, but also draweth inward by fear, if done on a sudden, and unawares. As a syncope or swooning, as we said before, stauncheth blood by the retraction of it inward; by the same reason doth fear also. A great quantity, namely, two or three glasses must be cast into the face divers times in a short time. Ordinarily they use to hinder the ascent of the Blood with fomenting of the Neck with a cloth dipped in cold Vinegar and bound about the Neck, changed often before it turn warm. Vinegar and Water held in the mouth, doth drive the blood down, and keeps the blood from falling into the Throat. Also Vinegar put into the Ear next to the Nostril bleeding, is good to close the Vein. A Bean, or piece of money bound to the root of the Nose, between the Kickshaws, stoppeth the flux. Also you must observe if the Veins or Arteries in the Forehead or Temples do swell, for than you must bind them down with Money, or a dry Bean slit in length, and this is a special Remedy. And for the better Compression, you must lay a Pledget dipped in the white of an Eglantine beaten with Time, upon the Bean or Money. The sum of Vinegar sprinkled upon a hot Iron, taken into the Nostrils, will close the opened Veins. As also Vinegar and Water often snuffed up. Besides those things which repel, we must use things that close and glutinate the Veins. For which end, many Remedies may be put into the Nose. Galen, lib. de paratu facilibus, cap. 13. used Frankincense and Aloes powdered, with white of an Egg, and the hairs of an Hare, upon lint. Or you may make a Tent thus: Take of Frankincense, Aloes, Dragon's blood, Bran, Cobwebs, and the hair of an Hare cut small, of each half a dram, made up in a Tent with juice of Plantain. The same Powders may be blown into the Nose. For which purpose also great Practitioners do commend the powder of Eglantine shells burnt, and burnt Paper. But you must remember besides the use of these powders, at the same time to fill the mouth with cold Water lest the Medicine get into the mouth. The Cotton of an Ink-horn squeezed a little, and made into a tent, doth powerfully stop. As also laid and bound to the Forehead. If it yet continue, you must come to Escharoticks, which by burning the mouths of the Veins produce a Scab, and so stay the blood. But these must be used warily, for when the Eschar falls off, they will bleed again. Vitriol is the best, which besides its Escharotick quality, is good to staunch blood. If you will make it gentle, you must mix other Medicines thus: Take of Galls half a pound: Alum a quarter of a pound: Calcine them, and blow the powder into the Nose. Or, Take of Bolearmenick, Dragon's blood, Frankincense, Aloes, Time, Vitriol, Sarcocol, and Mastic, of each one dram: Make afine Powder. White Vitriol is more gentle than Vitriol, and is not very Escharotick: yet it stays bleeding very powerfully by astringing the Orifice of the Veins, if it be put into the Nose with a Tent. You may make Remedies to stop blood, by restraining its motion by cooling, thickening, and coagulating, thus: Take of Sal Prunellae one dram: Troches of Amber half a dram: Bloodstone and red Coral prepared, of each one scruple: the Syrup of dried Roses one ounce: Plantain Water three ounces. Make a Julep to be taken twice or thrice in a day. Take of Conserve of Roses and Quinces, of each one ounce: the Troches of Spodium, or burm Ivory, and Terra Sigillata, of each one dram: Coral prepared, and burnt Hartshorn, of each one scruple. Make an Opiate, of which let him take the quantity of a Chestnut twice or thrice in a day. Vinegar and Water called Oxycrate, drunk plentifully stays an Hemorrhagy. Outwardly to cool the blood, and to hinder its motion, you must apply cold Water, or Water and Vinegar to divers parts, pouring it upon the Arms, and putting the feet therein, and applying to the Cod, as also to the back, because the Vena Càva runs that way, and so the blood will be cooled when it is exceeding hot, when the aforesaid Medicines cannot remedy, some wet the whole Body with Vinegar and Water, or put him into cold Water, which is not without danger, when the Patient is weak. It is excellent to temper the heat of the blood, to lay Epithems to the Liver and Spleen made of warm Vinegar and Water. Finally, In the most desperate Case, when no Medicines will prevail, you must use Narcoticks, or Stupefactives, which presently stop all fluxes and evacuations and motion of Humours; and among the rest three or four grains of Laudanum is the best. But take heed that you give it not to the Patient being very weak, for it is to be feared that the native heat being very little, will be thereby quite exstinguished. One ounce of the Syrup of Poppies given in an astringent Julep at night will do the same. At length you must come to proper Remedies which by an occult secret quality stop bleeding. The most usual and best are these: The Juice of Nettles is extolled for strengthening any blood, of what part soever, and therefore it is both given inwardly to four ounces once or twice, as also snuffed into the Nose, and applied to the Forehead and Temples made like a Cataplasm with Bran, or the whole Nettle beaten. Some say that the Root held in the mouth will do the same. Hog's Dung is one of the best Specifical Medicines, if it be applied hot to the Forehead and Temples, or smelled unto, or put dry into the Nose, of which this is a form. Take of Hog's Dung dried three drams: the powder of Roses to take away the scent of it, half a dram. Mix them with juice of Plantain, and dip a Tent therein to be thrust into the Nose. Ass' Dung used thus is also commended. And Rodericus a Castro lib. 1. de morbis mulierum, cap. 5. saith that a Physician of seventy years old given to violent bleeding, carried always Ass' Dung not quite dry in a box about him, than which he confessed he never knew a better Medicine; especially if when it was dry he mixed it with the Juice of a Nettle, or if wet he put it alone into his Nose. Zacutus Lusitanus, lib. ult. praxis Histor. cap. 2. saith that he cured one of seventeen years of age that was weak and lean, after he had lost seventeen ounces of blood and used many Medicines, only with this, He gave him the Dung of an Ass very finely powdered in all his Drink and Broth, he made Tablets of the same with sugar, and gave them with steeled water, by which means only the Patient recovered in seven day's space. The blood itself which comes out of the Nose, is not only vulgarly commended, but by the learned to stop an haemorrhagy by a specifical quality; they fry it in a pan and give it the Patient to eat, he not knowing of it. As also they Calcine it in a Potsheard, and mix it with the mentioned Astringents. Others commend the Powder of Snails burnt with their shells: and others put the Powder of Frogs Calcined into the Nose. Pereda speaks of an old Woman of Mount pelior, that she was Cured of a Flux at the Nose of three day's continuance, by only Mints put into the Nose. Among other Remedies this is excellent and usual, The fine Powder of Spicknard taken the quantity of a dram in Broth, Plantane-water, or other liquor, not only by a specifical force, but also by strengthening the Liver it stops bleeding. Finkius witnesseth that a dried Toad powdered and put in a fine red Sarcnet under the Armholes, or held in the hands till it grow warm, will staunch blood presently: And that the blood will be immediately congealed as if it apprehended some terrible thing. Others hang a Toad in the Air while all the flesh is consumed, and keep the bare thigh bone which they put into the Nose, and then it stops bleeding presently. While you use the aforesaid Remedies, you must think of the taking away of the Cause, which usually is a thin watery Humour or Choler which abounds in the blood, and makes it move disorderly, and provoketh Nature to throw it forth: whence it comes to pass that when it is purged away and the blood cleansed that then Nature embraceth blood most familiarly as its chief Friend and the treasure of Life, and will not labour to cast it forth. Therefore you must purge twice or thrice if need be with binding and cooling Medicines, thus made, Take of Tamarinds half an ounce: Plantain Leavs one handful: boil them to four ounces, being strained infuse of the best Rhubarb one dram: yellow Myrabolans' half a dram: Spicknard seven grains: strain it and dissolve therein one ounce of Syrup of Roses, and add one scruple of the Powder of Rhubarb. Make a Potion. In an old Disease that Returneth often, such a Purge repeated once every Week, is excellent. And after every Evacuation, Astringent Juleps, or Opiates, that are above mentioned; you may make Juleps thus. Take of the Roots of Snakeweed, and the greater Comfrey, of each one ounce: Plantain, Knotgrass, Rupture-wort, & Fumitory, of each one handful: of the four great Cold seeds, of each one dram: boil them to a pint, and dissolve in the strained Liquor of white Sugar, three ounces: Make a Julep for three morning's draughts. Instead of Juleps or Opiates, or after they have been used a while, you may give a Syrup made of the Juice of Nettles, and an equal proportion of Sugar, two spoonfuls at a time every morning. Nor is it sufficient to take away the present Cause of the Hemorrhagy, namely, To Evacuate the Peccant Humour, but you must see that it return not again. The Bowels are to be strengthened, and their Distempers amended; especially the Liver in which those Humours use to breed. And the Juleps formerly prescribed will do this, as also the Tincture of Roses to Cool the Liver and strengthen it, is very good. Outwardly you may apply Epithems made thus, Take of the Water of Roses, Plantain, Purslain, Sorrel, and Succory, of each four ounces: the seeds of Purslain, Sorrel, and Succory, of each one dram: the Troches of Camphire, and yellow Saunders, of each two drams: Vinegar, two ounces: Make an Epithem. To these you may add all the Remedies which are prescribed for the Cure of a Hot Liver. Sometimes the Hot Distemper of the Spleen and Reins is the Cause of this Disease; and than you must apply Cooling Medicines to those parts also. To these must join a good order of Diet, which from the beginning of the Cure must be diligently observed. And therefore, first the Air where the Patient is, must be Cool: and if it be Summer time let it be altered, by sprinkling the floor with Vinegar and Rose-water, and strowing of the Leavs of the Vine, Willow, or Water-lilies, or the like. Let his Meat be thickening of little nourishment, as Calves-feets, Sheep and Goats-feets, and the like: Rice, new fat Cheese, hard Eggs, and the like. Let him eat Fruits that are somewhat sharp, binding, and bitter; as Pears, Quinces, Medlars, Services, and Sauces of the Juice of Pomegranates, Lemons, Oranges, Sorrel; some commend the use of Lentils or Pease boiled in Vinegar, because they have virtue to thicken, astring, and allay the Acrimony of the blood. Let the Patient abstain, especially in the beginning of the Disease while his strength is good, from Wine, Flesh, and Rear Eggs, which breed much and thin Blood: you must give him Moist Meats and Suppings in the time of his bleeding: As cooling Broths made of Barley, Oates, and Rice, with Water, for chewing doth provoke bleeding, if he be weak you may give him Flesh-broth and Panadoes, in which there is Starch dissolved, which is made without Chalk or Gum Arabic. Let his Drink be steeled Water, and let all his Meat be boiled in the same, which will be of more force if Nettle Roots be first boiled therein. Command him to rest, so that he neither Walk, nor Cough, nor Speak loud or at all, for the motion of the Tongue and Jaws provoke bleeding. Let his Head be covered, and let him not see the blood, for thereby the imagination being moved, he will bleed faster. Let him sleep, for long Watch make the blood more sharp, Choleric, and thin: but sleep doth contemperate the Humours, and restrain the motions thereof. Lastly, Let him avoid the Passions of the mind, which cause the blood to ascend, as Anger, Laughing, and Joy. The End of the Fourth Book. THE FIFTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Tongue. The PREFACE. THE Tongue is the Instrument both of Speech and Tasting: But both these Actions are hindered by divers tumours which grow thereabout: And especially every Action is diminished, abolished, or depraved by its peculiar Cause. That all these may be severally described, this fifth Book hath four Chapters: Of which, The first is of Inflammation, and other Tumours of the Tongue. The Second is of the Ranula under the Tongue; which though it belong to the kinds of Tumours, yet it is handled by itself, because it requires a different Cure from all the rest. The Third is of the Taste hurt. The Fourth of the Palsy of the Tongue, and other binderances of its Motions. Chap. 1. Of the Inflammation of the Tongue, and other Tumours of the same. AS all the Parts of the Body, and especially the fleshy parts, use to be inflamed; 〈◊〉 also the Tongue by blood flowing unto it; which blood as it is either pure, choleric, phlegmatic, or Melanchollick, produceth either a true Phlegmon, or a Phlegmon erisipelous, oedematous, or schirrous, which sometimes comes to suppuration: of which there is an Example in Forestus, Obs. 24. Lib. 14. of a Brewer which had a great Inflammation of his Tongue that broke, which came to suppuration. Also the Tongue often suffers a soft and lose Tumour, which is purely oedematous, by the falling of Rhewm from the Head; of which Galen propounds an Example, Lib. 14. m. cap. 8. in a certain man whose Tongue was so swollen, that he could not contain it in his mouth. Sometimes the Tongue grows very great, which cannot be accounted any kind of tumour; as Galen teacheth, lib. de diff. morb. cap. 9 that he saw a Tongue which grew exceeding great without, any sense of pain, neither would it pit or yield to the finger, but it was a bare increase of quantity in the Tongue, and the substance was no way hurt, which came by too much nourishment brought and converted into the substance of it. And Claudinus, Consult. 9 gives an Example of this in a maid of twelve years old, whose Tongue grew to a great bigness, and the Tumour could neither be called an Oedema, nor a Schyrrus, because it was without pain; neither would it yield to the hand pressing of it, nor take an impression or pit, nor was it without Natural sense. The Original of it was a forceable breach of the bridle of the Tongue, by the pain whereof blood was attracted to the part; which being sent thither continually caused this largeness. But in this case Glaudinus observeth that it is bigger at night, and less in the morning, and always livid, or bluish: The reason whereof he saith is, because in the Concoction and assimulation of the Blood, (which is flegmy otherwise, such as is bred in children by reason of their moist Nature and intemperance) many vapours are raised, especially at night, when the heat is drawn in and contracted, by which the Tumour is enlarged: but in the day they are discussed by the motion and heat of the Tongue, by which means it becomes less. The reason of the blewness is the Air, to which it always is open; for by the coldness of the Air, the blood which cometh to the superficies of the Tongue, before it comes to be like in the substance, doth increase somewhat, and so turns livid. For Galen saith that blood waxeth black with cold, 3. the symp. cause. cap. 2. which yet is not so in other parts, because there is no superfluity sent to them, but as much as is sufficient for nourishment. The knowledge of these Tumours is not difficult, because the preternatural greatness of them is visible. But the differences of these Tumours are these: If there be an Inflammation, than there is pain heat, and redness also in the Tongue, wherewith also the face is somewhat infected: But if the Tumour come originally from phlegm, the Tongue is white, and there is much spittle whose taste is sweet or without taste. If there be only a bare increase in the Tongue, there are no signs of other Tumours and Vitrous humours. As to the Prognostic: Tumours in the Tongue for the most part do not endanger the life unless they grow so big that they cause suffocation, or come from a malignant melanchollick humour; from whence they may prove Cancers, which is known by their hardness, blewness, and pricking pain. You must begin the Cure of the Inflammation of the Tongue with Revulsive and Repelling Remedies; and therefore first, after you have given a laxative Clyster, open a Vein, and take away as much blood as the Patient's strength will permit. Then apply Cupping-glasses with scarification to the Shoulders. After that use cooling and repelling Gargarisms, and among the rest the Juice of Lettuce, is commended of Galen to wash the Tongue with often, Meth. 14. Cap. 8. Or you may make one more compounded of the Decoction of Plantain, Nightshade, Pease husked, and Pomegranate peels, adding some Syrup of dried Roses, or Diamoron, that is, Syrup of Mulberries. After bleeding, appoint a Purge made of things to purge Choler and Phlegm, because phlegm from the Head doth peculiarly concur to the production of these Tumours. After the flux is stopped, you must labour to derive the humour fixed to the part by Evacuations, Revulsions, and Repercussives; and to this end open the Vein under the Tongue, which if you cannot reach by reason of the largeness of the Tongue, you must apply a Cupping-glass with Scarification under the Chin. If it tend to suppuration, it must be furthered with a fig slit in the midst, often applied, or with a Gargarism of the Decoction of Barley, Mallows, Violets, Figs, Raisins, Quince seeds, and Foenugreek seeds, with a little Syrup of Violets and Jujubes. Suppuration being made, if the Imposthume will not open of itself, make incision: then cleanse it with the decoction of Barley, Agrimony, and Plantain, with Honey of Roses. But a soft and lax humour coming of phlegm, is cured first by a Revulsion with Phlebotomy, if the Patient abound in Blood: then give him a strong Purge, such as Pilulae Cochiae minores, made of Aloes, Scammony, and Coloquintida, which were happily used by Galen to one of sixty years, 14. Meth. above mentioned. But if he cannot swallow Pills, make him a Medicine of Senna, Agarick, Diaphoenicon, and the like. After these Evacuations you must first apply cooling and repelling Medicines, as we shown in inflammation. And Galen in the place quoted, cured a Patient of sixty years, only by washing with the Juice of Lettuce after Purging. Moreover, You may with good success wash the mouth with Juice of Lemons, Pomegranates, Sorrel, and Plantain, because they do not only repel with their coldness, but also with their sharpness draw forth the moisture that is fastened in the Tongue. Also the Tongue may be embrochated with Oxymel simple, unto which you may add a little Ginger, Sal. gem. or Sal. armoniac. You may also wash the Mouth with the Decoction of Origan, and Pellitory, with Hydromel, or Honey and Water. Zacutus Lucitanus, lib. 1. in his History of the chief Physicians, Obs. 47. in a desperate case, when the Tongue grew to a wonderful bigness, so that he feared suffocation, after emptying and revelling Medicines used in vain, applied four Horsleeches to the Tongue, and in a short time, after plentiful bleeding, it became thin and small, and the Patient escaped. The same Zacutus, Obs. 48. of the same Book, says that he cured a child of ten years old, who had a Tongue swollen by a defluxion, so big that it could not be contained in his mouth (after Revultions by bleeding, Cupping-glasses with scarification, and sharp Clysters) because the Tumour was soft and loose, only by profound scarification of the Tongue, and after he commanded that it should be washed with salt Water, from whence there came such abundance of humours that the child presently recovered. Which Observation he took from Joachim Camerarius, who saith in his Book of Observations, that one who was almost suffocated with a swollen Tongue, cured himself by cutting it a cross with a sharp Penknife, after he had lost much blood. Finally, A fleshy Tumour of the Tongue, or the over-growing of the Tongue, coming of the superfluous flesh, although it seem to be uncurable; yet it is showed by Claudinus by Chirurgery to be done, in the place cited; namely, If whatsoever be superfluous be taken away with an incision Knife, first giving fit preparations, all which are described by him in the same Place. Chap. 2. Of the Tumour called Ranula under the Tongue. ALthough in the former Chapter divers Tumours of the Tongue are laid down by us, yet there remaineth one called Ba●rachos in Greek, in Latin Ranula; for since it differs from the rest in Nature, and requires a different way of Cure, we thought it best to describe it in its proper Chapter. Ranula is a Tumour under the Tongue in that part by which it is bound to the Ligament; and for the most part it is so large that it is above the lower Teeth; a cloven being in the middle dividing the right side of it from the left, it representeth the hinder parts of a Frog, from whence it is called Ranula, a little Frog. Others say it is called so, because they who have it, have an impediment in their Speech, and croak like Frogs, when they speak. It is like the Tumour Oedima, or Meliceris, from which when it is opened, there comes as it were the white of an Egg, or matter like Honey. And because the said matter is contained in a bag, therefore it is accounted a Meliceris. In these bags sometimes is found a stone as many observe, which Schenkius also observeth, Obs. 388. Lib. 10. The knowledge of this Disease is not difficult, for when the Tongue is lifted up, there is seen a certain lose and soft carnosity, and on both sides of the Ligament there is a certain round swelling like a Pease, Bean, or Che●nut. This Disease is commonly without danger: But in Children sometimes it threatneth suffocation by Reason of the nearness of the Larynx to the rough Artery. In men if they have pain and a Fever there is danger, for it may turn to Squinancy. Also that Ranula is dangerous which is black or dusky and hard, and inclining to the Nature of a Cancer, and this must not be touched. For the Cure of this Disease, first you must take away the antecedent cause by blood-letting, and with purging agreeable to the age and nature of the Patient. And if the Disease be old you must use Cauteries and sweeting Drinks. Then you must endeavour to dissolve the Tumour with Topics, thus: Take of Pomegranate peels, dried Hyssop, and common Salt, of each two drams: Make a Powder thereof to hold under the Tongue, and use it often. Forestus speaks of a Girl of twelve years of age, that was cured in two day's space with this only Medicine; whose Author is Nicolaus Florentinus, who instead of common Salt, useth Sal. armoniac to men, because it pierceth more, and dissolveth better. And Forestus used the said Powder to a Student made with common Salt: as also a Decoction made of equal parts of Galls, Alum, and Pomegranate flowers: And lastly, he commanded the part to be rubbed with parched Salt, and Sal. gem. and the Patient was cured without manual Operation, which is seldom seen, because those Tumours are of the Nature of Imposthumes, and are contained in a little bag, so that when the matter hath been discussed, they have been filled again. If this Tumour cannot be cured with discussing Remedies, you must open it, which must be often done, for it will not often be discussed. You must not make a small Orifice when you open it, because the matter contained in the Bag, will be again gathered and the bag filled (unto which the part being lose and soft, is very much disposed▪) but you must make a very long Incision through the height of the Tumour in both sides that the whole matter may be discharged at once: than you must wash the Ulcer, first with gentle things, as the Decoction of Mallows: and then with Clensers, as white Wine and Honey of Roses, or Diamoron, and after with Oxymel till it be clean and free from the Bag: And finally, to heal it up, wash the mouth with red Wine in which Alum is dissolved. Forestus Cured the like in a Woman by an Incision made on both sides, and after by washing with Wine and Water mixed with a little Salt. If the Disease be old, and the Ulcer will not be cured by the aforesaid Remedy, let it be touched with Oil of Sulphur twice every day, mixed with Rose-water, one drop of Oil to six of Water; for so the Distemper will be corrected, and the part dried, which must be often washed for confirmation, with Red Wine with Alum dissolved in it. If after the use of these the Disease return, you must come to an actual Cautery, the manner whereof is taught by Paraeus, lib. 7. cap. 5. Chap. 3. Of the Taste being Hurt. THE Taste as other Senses, and all actions of the Body, is hurt Three ways, by being Diminished, Abolished, Depraved; it is lessened when it scarce perceiveth remiss savours and strong savours but a little: It is Abolished when it no ways perceiveth those savours whether they be great or little: It is Depraved when the object seems to be of another taste. The Causes of Diminishing and Abolishing the taste are the same, only they differ in degrees; for if they be light and weak, they Diminish; if great, they Abolish the taste. And these Causes are either a Defect of the Animal Spirit in the part, or a Distemper of the Third pair of Nerves which come to the Tongue; or the Tongue itself is Preternaturally affected. The Spirits fail, either by reason of their scarcity, as in dying men; or of the obstruction of the Nerves of the Third Conjugation by which they are carried: or by reason of a Tumour bred in that part of the Head from whence those Nerves do arise. The Tongue is either covered with a moist slimy matter, or hath Tumours, Pustuls, or Ulcers, and by these the proper action of taste may be diminished or abolished. The Taste is Depraved when the Tongue is infected with an evil Humour, as in Fevers, when the Tongue is infected with Choler, all things tasted are thought better: otherwise if it be with salt phlegm or melancholy all things appear to be salt or sour, for the outward objects being brought to the Tongue do move the vicious juice of it, which at that time striking upon the tongue most leaveth its savour thereon, and so those things which are tasted, seem to be of the same taste. It happeneth also sometimes that the Tongue perceiveth the savours of the juices contained in its self, although no external Object be applied, as Galen teacheth, 1. the sympt. cause. cap. 4. And it is confirmed by daily Experience in men in Fevers, whose tongue is covered with Choler; which if it be very bitter, they find a continual bitterness on the Tongue though they take nothing into their mouths. The Diversity of the Causes aforesaid is known by the variety of the tastes and disposition of the Tongue; for a sweet taste and redness of the Tongue signifieth blood: bitterness and yellowness Choler: whiteness with sweetness Phlegm: blackness and sharpness Melancholy: a Nauseous taste showeth that evil Humours are contained in the stomach: Pustuls, Tumours, and Ulcers are manifest to the Eyes. And Lastly, If the taste be hurt, and there appear no change in the Tongue, you must suppose that the Cause lieth in the Brain or Nerves. The Cure is various according to the diversity of Causes; and therefore if the Disease lie in the Brain or Nerves, you must apply Remedies thereto, especially such as use to be prescribed for the Cure of the Palzey: but when the taste is depraved by ill Humours, commonly that Symptom depends upon other Diseases, especially upon Fevers, which being Cured the Symptoms also are removed. If the Taste be offended by Tumours, the Cure thereof depends upon the Cure of the Tumours above mentioned. Finally, If it come from Pustles or Ulcers of the Tongue, you must Cure them by blood letting and Purging of sharp Humours; to which you may add Cooling, Drying, and Binding Topics in form of a Gargarism: And if foul Ulcers be found, let them be cleansed with Honey of Roses, with a little Oil of Sulphur or Vitriol, in such a quantity as may gently touch upon the Tongue. Or, if you will Dry more violently, Let the part Affected be often touched with the aforesaid Oils, pure and not mixed; for so the Aphthe or Thrush and all Ulcers of the Mouth and Tongue are quickly Cured. Chap. 4. Of the Palzey of the Tongue, and the Hurt Motion thereof. THE Chief Action of the Tongue, is Speech: and this is Abolished, Diminished, and Depraved by divers Causes, which are referred to Similary, Organick, or Common Diseases. As for the Similary; A moist Distemper with Matter maketh the Tongue more soft and lose, so that it cannot freely exercise its motions. Dryness doth too much foul the Tongue, as in Fevers. But Organical, or Diseases of the Instrument, are when the Tongue is enlarged, as we said before concerning Tumours, which hinder the free motion of it: also when the figure or shape of it is deformed▪ as when the Tongue is naturally too short, or by being partly cut off, or if it be tied too straight; as also when the seventh pair of Nerves which come from the Brain to the Muscles which move the Tongue are stopped. Lastly, Common Diseases are Solutions of Continuity or Wounds in the part. Too much moisture maketh Balbuties, a kind of Stammering, which keepeth men from provouncing of the Letter R. And this is either natural as in Children by reason of their much moisture, who are Cured by age when the superfluous moisture is consumed. But in some there is a moist distemper all their Life, and they are always stammerers; of which Hypocrates speaketh Aph. 32. Sect. 6. thus, Stammerers are most subject to long Fluxes of the Belly. Galen in his Comments saith, That they who naturally stammer, have either a moist Brain, or Tongue, or both. From the moist Brain much moisture may fall into the belly, whence the Flux is caused. And when the tongue is naturally too moist, it is probable also that the belly will be lose and weak through moistness: because the Stomach and the Tongue have both the same Tunicle: Now the proper passion of a moist belly is a looseness. But Avicen seems to be against this Doctrine, saying, Fen. 1. lib. 3. tract. 4. cap. 18. That Stammerers are given much to Melancholy, and Melancholy cometh from a dry Brain: but this Contradiction is Reconciled, thus, Avicen meaneth by Stammerers, not such as are properly so called and cannot pronounce R, but such as Stutter, and repeat the same Syllable often before they speak a word; and this cometh from a hot and dry Distemper of the Brain; in which the thoughts are so quick that they outrun the tongue, and hasten its motion, whence comes that disturbance. But the Stammering aforesaid coming from the Birth, is incurable. In some an accidentary Stammering cometh by a Catarrh; and great Defluxion of Rhewm upon the Jaws and Tongue, which is cured by Evacuation, Revulsion, and Derivation of the Humours; as also by Strengthening and Drying the Brain: but because the Remedies are the same with those for the Palzey of the Tongue of which we shall now speak, they may be taken from thence. Two pair of Nerves go to the Tongue: the Third pair to Exercise the act of Tasting and Sense: And the Seventh pair for Speech and diversity of Motion; by the Obstruction and Relaxation of the taste, cometh the Palzey of the Tongue, which is a Privation or Diminishing of the motion of the Part; and this useth to follow an Apoplexey when the hinder part of the brain is too moist, and then other parts of the body, and for the most part half the body hath the Palzey; sometimes it is only in the Tongue when the Nerves and moving Muscles are too moist: also by cutting of those Nerves there cometh a Palzey of which there is an example in Avicen, Fen. 6. lib. 3. tract. 1. cap. 12. in these words, A certain man was▪ Cupped and Scarified, and the small hair like Nerve, was cut with Scarification, which is in the substance of the Pannicle joined with the Tongue; wherefore the Tongue was relaxed. We may suppose that these Cupping Glasses were applied to the Neck and hinder part of the head; for since the Nerves that move the Tongue, come from the beginning of the Spinal Marrow which is in the Neck: It is most certain that the Scarification was made so deep that some branch of them was divided. But although the matter producing this Disease be Phlegm, yet sometimes it is thicker and colder; sometimes thinner and hotter as the Humours which predominate in the Body; the knowledge whereof is from▪ Avicen, Fen. 6. lib. 3. tract. 1. cap. 6. in these words, And sometimes the redness of the Tongue and hotness show that the matter is blood; and sometimes much watery spittle showeth that the matter is thin, and when there is little benefit by Resolving Medicines, and much by binding and astringent. This Disease, if it come from the Brain, and follow an Apoplexy, so that other parts also are affected is seldom cured, especially if the Patient be in years; but if it be single, and in the part only it is to be cured, and the easier if the Patient be young. The Cure of the Pal●ey in the Tongue, is by taking away the antecedent Cause, that is the humour abounding in the Brain, and by discussing and dissolving the conjunct cause, namely, the humour which is fastened upon the Nerves that move the Tongue. The antecedent cause will be taken away by the Medicines prescribed in the Cure of the cold distemper of the Brain. And first you must purge with Pills, or a Potion there mentioned. After if blood abound, and be either the Principal, or the assistant Cause of the Disease, take so much as age and strength will permit, then administer a Cephalick Apozeme, and if the Disease seem stubborn give a sweeting diet; all which are formerly prescribed in the place mentioned. After general Evacuations, come we to the Derivation of the matter, causing the Disease by Cupping and Vesicatories applied behind; as also by Cauteries. Avicen applied a Cupping-glass under the Chin, which is now also allowed. Open the Vein under the Tongue, and it will profit, if before you have made general Evacuation to derive the Humour from the Muscles of the Tongue. For the discussing and drawing forth of this Humour, let the Gargarism following be often used. Take of Flowerdeluce roots half an ounce: Origan, Sage, French Lavender, Rosemary, of each half a handful: Cubebs three drams: Liquoris one ounce: Boyl them in equal parts of white Wine and Water to a pint: Dissolve in the straining, Oxymel of Squils' two ounces. Make a Gargarism; to which if it work not strong enough, you may add two or three drams of the Decoction of Pellitory of Spain, or of Mustard seed. You may also add Castorium if it offend not the Patient with the scent. To this end you may often rub the Tongue with Oxymel of Squils' alone, or mixed with Mustard Seed. A bag of Sage is much commended for to rub the Tongue with often, to which you may add Mustard seed also. Also these following Pills ought to be held often upon the Tongue. Take of the Juice of Bettony and Liquoris, of each one dram and an half: Castor and Assafatida, of each half a dram: Nutmeg and Spicknard, of each one scruple: Incorporate them with Honey, and make them into the form of Lupins. Here also Gargarisms, Masticatories, and Errhines, which are prescribed in the Cure of the cold distemper of the Brain may be used. Also for the strengthening of the Brain, and dispersing the relics of the humours therein contained, Fumigations, and Powders for the Hair, with Caps mentioned in the same Chapter are here to be used. Lastly, You must prescribe the usual Medicines against increase of phlegm, namely Syrupus Magistralis, or ordinary Pills, with a strengthening Opiate, as is there declared. The End of the Fifth Book. THE SIXTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Teeth, Gums, Jaws, , and Windpipe, or Larynx. The PREFACE. THE Parts contained in the Mouth and Jaws suffers divers Diseases, the Chief whereof we only desire to lay down, and to omit those that are ordinarily Cured by Surgeons: Therefore this Book shall contain Seven Chapters: First, Of the Toothache: Secondly, Of the Blackness and Consuming of the Teeth: Thirdly, Of the Eating away and Exulceration of the Gums: Fourthly, Of the Flux of Blood from the Gums: Fifthly, Of the Ulcers of the Mouth and Jaws: Sixthly, Of the Relaxation or Falling down of the : And, Seventhly, Of Angina, or Quinzy. Chap. 1. Of the Toothache. GAlen in his Fifth Book of the Composition of Medicines, cap. 8. & 16. of the Use of Parts, cap. 2. saith, That the Teeth are not only sensible in respect of their Nerves at the Root, and Membrane which inwardly covers their Cavity, but also in their proper substance; and saith, That the Teeth and other parts of the Mouth do taste, as also doth the tongue. And in his Book of Bones, cap. 5. he saith, Of Bones only the teeth are partakers of the tender Nerves of the Brain; and for that cause they alone do manifestly feel. Therefore pain reacheth not only to the Nerves and inward Membrane, but also to the substance of the teeth. The Toothache comes from a Flux of Humours, either Cold and Flegmy, or Hot and Watery, Salt and Sharp: hence comes the Distension or Convulsion of the parts: & these Humours either flow to the Membranes of the Jaws, and of the holes wherein the Teeth are, or to the Nerve which is inserted in the root of the Teeth, or to the substance of the Teeth. Although some think that the Teeth cannot receive into their own substance afflux of humours and distension, because they are most hard and thick; yet this is taught by Avicen, Fen. 1. Lib. 1. Doct. 1. Cap. 5. and Fen. 7. Lib. 4. Tract. 1. Cap. 4. And sometimes, saith he, there is matter which doth imposthumate the Tooth itself. Which Opinion he confirmeth and treateth of chief, Fen. 1. Lib. 3. Tract. 3. Cap. 1. in these words: It is not as some Physicians think, that the Brain itself will not imposthumate, reasoning thus; That which is soft, as the brain, and hard, as a bone, is not extended, and that will not imposthumate which cannot be extended. But this is erroneous, because that which is soft, if it be viscous or claminy, may be extended, and bones are imposthumated, as Galen teacheth, & we will show in our Chapter of the Teeth. Moreover, we say that whatsoever is nourished is extended and increased with the nourishment, and it is likewise possible that it may be extended and augmented with its superfluity, and that is an imposthume. This Avicen teacheth from the Doctrine of Galen, who Lib. 5. de comp. med. sec. loc. cap. 8. saith, Because the Teeth cannot grow without nourishment, they are only obnoxious to these two Diseases following, namely, of want, and superfluity of nourishment: by want of nourishment they grow dryer and thinner, and by superfluity of it, there will be an inflammation about the fleshy parts. Thus Galen. But it is probable that pain is more usual (if it be vehement) in those parts which have most exquisite sense, namely, the Nerve and the Membrane in the hole of the Tooth next to the root, which doth not only suffer distension and vellication, but also sometimes inflammation of the humours flowing down; for it blood be mixed with other humours, than the pain hath two causes, namely, Distension, and Compression, which comes from the hardness of the Tooth, which the Membrane being inflamed cannot endure: and this Inflammation of the Membrane is for the most part accompanied with the inflammation of the Gums; which also is reckoned by Galen and Avicen among the causes of the Toothache. Now the Humours commonly flow from the Head upon the Teeth and parts adjoining, sometimes from the inferior parts; for when any bad humours, especially watery, bred in any part, are abounding in the Veins, Nature desiring to cast off her burden, sends them to the weakest parts And if the seethe by reason of the distemper, foulness, or erosion are such, the flux will chief come thither. Charles Piso propounds an Experiment of this (who also thinks the Toothache con comes chief from a serous humour) lib. de morb. ab illuv. ser. obs. 7. where he reports that himself being troubled with the Toothache for many days, halr an hour after he had taken a purging Medicine, vomited up above a pint of clear water with such success, that ten years after he was never troubled with it. By which Experience he always prescribed Medicines that purge water to them who were so troubled, and with good success. Moreover, he striveth to prove that it comes from this cause, by this sign, Because they who have the Toothache, do continually spit. Besides the Causes mentioned, there are also Worms in rotten Teeth, and they breed of any matter which is contained and putrified in the Cavities, whether it be excrementitious, or come of putrifying meats, especially flesh and sweet meats, which by reason of their clamminess stick to the Cavities of the Teeth. Others think that the Toothache comes sometimes from wind contained between the Cavity and the Nerve, which doth violently stretch the inward Membrane, whence comes such intolerable pain. The principal external causes of Toothache, are all those things which cause defluxions; the chief are, Cold Air, South winds, staying in the Sun, or night Air, Surfeit, and all faults in Diet. Ad to these, things that debilitate the part, and make it more fit to receive a defluxion, as rotteness and hollowness in the Teeth, which sometimes make violent pains. The diversity of Causes is k own by divers igns. For pain when it comes from hot humours is stronger, the constitution hotter, the age younger, if Summer, there is heat sensibly in the part, and inflammation of the Gums often times; it is better for the use of cold, and worse for hot things. But if it come from a cold humour, the signs contrary to these will appear. If worms are the cause of pain, it will be intermitting, coming and going often, and sometimes the motion of the worm will be felt. When it comes from Wind, it is known by the excess of pain, and sensible stretching, and it ends in short time, and is easily cured with discussing Medicines. The Prognostic is divers, according to the variety of the Causes; for that pain which comes from a hot, thin, watery, sharp and salted humour, is more violent, but sooner at an end, by reason of the sudden change of the humour; but that which comes from a cold and flegmy humour, is less, and lasteth longer. A Tumour rising in the Gums or Jaws, takes away the pain of the Teeth, for the flux is carried to the external parts, so that it no longer lieth in the internal Cavity of the Tooth. The Cure must be directed for the taking away the Cause, and mitigating the pain; for although anodynes profit but little except the defluxion be stayed, yet sometimes we are constrained not only to use them, but also Narcoticks or Stupefactives before we take away the Cause; therefore the humour flowing to the Teeth is to be reveled, evacuated, and repelled, and that which is there, is to be derived and discussed. First therefore, if the pain comes of hot humours, open a vein in the Arm on the same side, by which the humour flowing will be reveled. But if it come of cold, bleeding is not so good; but in regard of the defluxion it may be used, because it is the chief reveller. But than you must take less blood, except there be a Plethory, in which regard although it be from fiegm, you may bleed freely according to Galen, who said that a large evacuation of blood agreeable to the Plethory, is the best remedy for all pains, which we have found true by experience, not only in the pain of the teeth, but in other parts. Let him purge the day following, with that which is proper for the humour; in the form of a Potion, if a hot, with Pills, if a cold humour be the cause of pain. After this, if the pain continue, apply Cupping-glasses to the Shoulders with scarrisication, or one great one between the shoulders without scarrisication. A Vesicatory applied to the neck, or behind the Ears doth violently draw back the humours. Also to hinder the defluxion, apply astringents to the Temples, as Emplaster of Gum Elemi, or Mastic only, upon a piece of Silk, and heat with a brass pestle, the Shop Emplaster of Mastic, or that against Ruptures called ad berniam. Or this following is good. Take of Frankincense, Hypocistis, Labdanum, of each one dram and an half: Pitch and Mastic, of each one dram: Opium half a scruple: Oil of Mastic as much as is sufficient: Make a Mass of Emplaster. The Root of Comfry fresh and bruised, applied to the Temples doth intercept the defluxion very well. There is also a good Plaster made of powder of Alum, and Galls mixed with Pitch. Riverius the chief Physician to Henry the Great, had this Plaster as a Secret: Take of Cyprus nuts, red Roses, Mustard seed torrefied or parched, Mastic and Terra Sigillata, of each one dram and an half. Let them be steeped in Vinegar of Roses twenty four hours; then dry them: Opium dissolved in Aqua vitae three drams: Pitch and Colophonia, of each one dram: yellow Wax melted in the expressed Oils, Henbane and white Poppy as much as is sufficient: Make an Emplaster; apply it to the Arteries, and the part affected with pain. And because the small Veins by which nourishment is carried to the Teeth do run by the Ears, you put Medicines into them for the Cure of the Toothache; as Oil of bitter Almonds to the Ear on the same side, or the fume of Vinegar, in which Penyroyal and Origan have been boiled. Others put Vinegar into the Ear, by which the defluxion is mightily stayed, especially if the flux be hot. But in a cold defluxion, the Juice of Garlic mixed with Treacle and dropped warm into the Ear, doth wonderfully assuage the pain of the Teeth. A Clove also of Garlic peeled and put into the Ear, is good. Also astringents in the beginning of the defluxion, may be applied to the part pained, cold, if the matter be hot, but if it be cold, you must put hot things with your repellers: But in every cause, if the pain be great, you must mix anodynes with Repellers. As, Take of the Roots of Snakeweed, Five-leaved-grass, and Tormentil, of each one ounce: the Leaves of Vervain, Plantain, and Maudlin, of each one bandful: Cypress Nuts, Galis, and Acorn Cups, of each two drams: red , and Crystal, of each one dram and an half: red Roses and Pomegranate Flowers, of each one pugil: boil them in red Wine and Vinegar, and wash the part grieved often therewith warm. This may be used in the beginning of a hot defluxion, but in a cold ad Cypress Roots, Box Bark, Ivy Leaves, and the like. A plainer Medicine is made of Plantain and Rose Water, with as much Vinegar like an Oxycrate. Or boil Galls in Vinegar, and wash the Teeth therewith. Or, Take of the Roots of cinquefoil half an ounce: Willow Leaves half a handful: Galls two drams: boil them in red Wine, and wash the mouth. This stays the defluxion, and takes away pain. Then you must use these Remedies, which assuage pain, and take away the cause, of which there is in authors, and vulgarly a multitude: we will give you the best; of which you must make your choice with this judgement, That those which do not only dissolve and discuss, but also astringe and stop the flux, be used in the beginning and the increase of the pain, but things that only discuss in the state and declination. Take of the Juice of Housleek and Nightshade of each two ounces: Cow or Sheep's milk eight ounces: Oil of unripe Roses one ounce and an half: Opium and Saffron of each three grains: mix them and apply it warm with a cloth to the Jaw of the same side often. Take the Pap of sweet Apples two ounces: Bran steeped in Vinegar three ounces: Oil of Roses one ounce: Saffron half a scruple: Opium two grains: mix them for a Cataplasm to the part pained. Or, Take of Barley and Bean meal of each three ounces: Oil of Roses and sweet Almonds of each half an ounce: the juice of Housleek one ounce and an half: Milk as much as is sufficient; make a Cataplasm to be applied often warm to the part. Or, Take two whites of Eggs, beat them with Rose Water, and dip stuphs therein sprinkled with two drams of Pepper Powdered: Apply them to the pained side over the whole Cheek. But here observe, That you apply not Astringents to the Jaws if they be swollen, for it is to be seared, That the Humour will so be Repelled to the Throat, and the Patient Choked: An Example of which Valesius de Taranta giveth, of a Physician troubled with the Toothache and Inflammation of the Jaws, who applied only Oil of Roses with Vinegar, which brought him to a Squinzy and he died. Other Waters may be made to wash the mouth: Thus. Take of the best white Wine four ounces: white Henbane Roots two drams: let them boil to the Consumption of the third part: strain them, and add one ounce of Vinegar: Varnish one dram: let them boil a heat, and let the Mouth be washed often therewith. The plain Decoction of Vervain is Commended of many for the same. Also a Decoction of Guaiacum made with Wine, or Water, and a little salt. Or, Take of Arsmart, and the barks of the Roots of Henbane, of each equal parts, boil them in Rose Vinegar, and wash the mouth. And if the pain cometh from a Hot Cause, only boil a Henbane Root in Vinegar. If the Arsmart be too sharp, take a less quantity: Nay, you may leave it quite out in a Defluxion coming of a Hot Cause, and put Persicaria Macutata instead of it, which is Astringent and Cooling, and his juice may be given safely at the Mouth in all Defluxions that are sharp and Choleric: Also you may use the Leaves of Henbane instead of the Root. Some use the Leaves of Henbane and Persicaria Maculata as a secret Magnetic Charm, they boil them in Vinegar, they burn the Leaves being boiled with a gentle fire, and wash their Teeth with the Vinegar, and they say that as soon as the Leaves are burnt the pain will be gone: But I rather think it is Cured by the Vinegar with which the Teeth are washed. In the aforesaid Decoctions if the Vinegar be so sharp that the Patient can scarcely endure it, you may mix▪ half Wine; and in a Cold Cause make them of Wine only. Amatus Lusitanus, Commends Exceedingly Sandarach boiled in Vinegar and Wine, Thus. Take of Sandarak one ounce: Wine and Vinegar of each half a Pint: boil them and let the strained liquor be held a long time in the mouth. The Decoction of the Roots of the great Nettle, with a little Nutmeg and Saffron made in equal parts of Wine and Vinegar, and held warm in the Mouth, doth wonderfully draw the Humours forth. But at the first, the pain will seem to increase; but afterward, it will be mitigated, and cease. The Root of the sharp Dock gathered in the Spring before it groweth forth and dried, applied to the Tooth pained, doth appease the pain by a specifical propriety: which is confirmed by the experiment of Forestus, in Obs. 6. lib. 4. where he saith, That he applied this Root green, and cut in small pieces to the Tooth of a Maid with good success; and that he Cured many other therewith after he had given them universal Medicines. If the body be well purged, and the head be not very full of phlegm, Masticatories to draw the Humours from the part affected will do very well: which are made either of Pelitory of Spain a long time h●ld in the mouth and chewed, or as followeth. Take of Mastic, Pelitory of Spain, and Staphisagre▪ of each one dram: the seeds of Henbane half a dram: Powder them, and mix them together, and make little balls thereof in a thin linen Rag, which let him long chew, to make him spit. Commonly the Oil of Cloves is used in a little lint to stop the Tooth if it be hollow, or otherwise, for so the humour adhering to the part is drawn forth and the part strengthened. Oil of Camphire is very profitable for the same purpose. Or Dissolve eight grains of Camphire in one dram of the Oil of Cloves; and use it as above. But above all the rest the Oil of Box is extolled, which being but once dropped into the Tooth presently stays the pain. This Oil is made of Box cut in small pieces, and then Distilled by descent, in two Vessels, the one put into the earth, the other above, upon which you must make a strong fire, and so the Oil will fall into the lower vessel. Besides the aforesaid Oils, the Chemists commend the Oil of the Hazel Nut used in the same manner. If the pain be so great that it will not away with the aforesaid Medicines, you must come to Narcoticks, which are set down by Practitioners under divers forms; although their effect is as uncertain as others: but they do surely stupefy the Pain: Among the rest Laudanum is chief, which doth not only appease the pain, but also stop the Flux; and it may be given safely after universal Remedies to the quantity of three or four grains, if it be well prepared. Many Topics made of Narcoticks are carried about; These Two following are the best. Take of Opium, Myrrh, and Labdanum, of each one dram: Powder them, and with white Wine boil them into a Lineament, which put with lint into the Tooth. The Other is the Emplaster of Riverius, Chief Physician to Henry the Great above mentioned. If Worms be in the Teeth you must kill them with bitter things: And this following is good for that. Take of Aloes one dram: Camphire half a scruple: Aqua Vitae half a dram: mix them and apply thereof with lint to the Tooth. It is to be observed, That the Teeth do seldom ache except they be hollow to the Nerve; therefore to take away the sense of pain burn the Nerve with an actual Cautery, or with Aqua Fortis, or Oil of Vitriol, which often done to a very hollow Tooth, it will be broken in pieces, and so drawn forrh. If the Pain still continueth, and the Tooth be very hollow, you must draw it out, and then the pain will presently cease and never return. But you must take heed that you draw not the Tooth when the Defluxion falls violently, or when the Head acheth, or the Gums swell, or when there is great pain. And the Chirurgeon is to be Admonished, That he pull it not out violently at one pull lest the brain be too much shaken, and the Jaw bone broken; from whence comes a great Flux of blood, a Fever, and sometimes death. After it is Drawn, close the part with your fingers, then let the mouth be washed with warm Oxycrate; and let him take heed of Cold Air, lest a new Defluxion fall upon the other Teeth. But if the blood flow so fast that it will scarce be staunched (which sometimes happeneth by the breach of the Vein and Artery, without the breach of the Jaw: And Varaiola reports of one that had his Tooth pulled out without iron or force but with the fingers, and yet bled a pint at one time, and as much the next day from the Artery under the Gum) This Flux of blood is stopped by laying a hard piece of lint like a ball, and holding it down for one hour or two with the fingers: If that will not prevail, apply burnt Vitriol, and lay a Rag upon it dipped in Vinegar, and compress it with your finger till you make an eschar. The last Remedy is an actual Cautery by which the blood will presently be stopped. If any fearful people refuse burning and require other means, you must try those which Authors prescribe; As Paste made of the milk of Spurge, and the powder of Frankincense mixed with a little Starch, the Root of Crowfoot, the Bark of the Mulberry Root, the powder of Earthworms, Pellitory of Spain steeped in Vinegar, and the Root of Wild Cowcumber so steeped, and the like. But the Leaf of Elleboraster rubbed upon the Tooth is best; but you must not touch the other lest they also fall out. A Country man troubled with the Toothache, was persuaded by another to rub his Tooth with Elleboraster; he unwittingly rubbed all the Teeth on that side, and presently almost all his Teeth fell out: Therefore if any will try this Medicine, I advise them to defend the other Teeth with soft Wax. Although when there is a Tumour in the Jaws, the pain for the most part ceaseth; because the matter is carried outwards: Yet for the quick Dissolving of it, use this Lineament. Take of Fresh Butter, and Hen's Grease, of each one ounce: the Powder of Flower-de-luce-Root, one dram: Sa●●ron half a scruple: Oil of Chamomel and sweet Almonds, of each half an ounce: make a Lineament. A Cataplasm made of Figgs, Bread and Vinegar, is better. A Nettle bruised, and laid to the Jaw, doth quickly assuage the pain▪ This is the Cure of the Toothache for the present. But if it return often, as is usual, you must use prevention, which is to hinder the breeding of those humours that flow thither; and let the Teeth be strengthened that they may be less capable to receive them. Therefore if it proceed from a hot cause, you must use such Medicines as were prescribed in the Cure of a hot distemper of the Liver and a hot Catarrh. If from a cold Cause you must take that course which is prescribed in the Cure of the cold distemper of the Brain; but you must strengthen the Teeth with the Medicines in the Chapter following. Chap. 2. Of the blackness and rottenness of the Teeth. MAny times the Teeth do contract a black, livid, or yellow colour, from the evil Humours, cleaving unto them, which by long continuance do also corrode them, and make them rotten: and these Diseases come from filthy vapours that fly upwards, and are engendered of evil nourishment, or from the distemper of the stomach, which corrupteth good nourishment. Quicksilver doth black the Teeth, whether it be used to the whole Body, as in the Pox, or only to the Face. Hence it is that women which use Mercury to make them fair, have black and ill coloured Teeth. For the Cure you must first remove the antecedent Cause, and if it comes from evil humours in the stomach, they must be discharged, and the distemper of the parts which produce them must be corrected, and a good diet prescribed, and those things forbidden which do corrupt the teeth, especially sweet things. Infinite Medicines are prescribed by Authors for making teeth white, which may be experienced. We are contented with one, which presently makes them white, cleanseth them, and keeps them from rotting, namely, the spirit of Sulphur, or Vitriol, in which you must dip a little stick, and rub the teeth with the end thereof, and then wipe them with a clout. In a great foulness you may use the Oils by themselves, otherwise you must mix them with Honey of Roses, or fair Water, lest by the often use of them the Gums should be corroded. Montanus, consil. 113. reports that he learned that at Rome, of a Woman called Greek Mary: to whom when he came when he was young, and she twenty years old, and after when she was fifty, he found her almost in the same condition, and she confessed that her Beauty and strength was preserved by the Spirit of Vitriol, and that her Teeth which were very bad in her youth, were by that, made very fair and firm, and also her Gums; and also that she perceived herself by the use thereof to seem more youthful, and she used every day one drop or two to rub gently her Teeth and Gums. The Ashes of Tobacco is very good also to cleanse and make white the Teeth. For prevention, and to preserve the Teeth, first cleanse them with a Tooth-picker made of Mastich Wood, or the like; then wash the mouth with Wine, and rub the Teeth with this Powder: Take of the Roots of Snakeweed, Alum, and white Coral, of each one ounce: Make a Powder to rub the Teeth. Or wash them with this Water. Take of the fine Powder of Alum two drams: whole Cinnamon half a dram: Spring and Rose Water, of each four ounces: boil them in a Glass upon hot Embers to the consuming of the third part. Wash the Teeth therewith every morning with a cloth dipped therein. Chap. 3. Of the Erosion or eating away, and of the Exulceration of the Gums. THe Gums are eaten away and exulcerated by sharp corroding humours which come unto them. The parts from whence they come are, the Brain, Stomach, Spleen, and others. Men that have Diseases in the Spleen, are most subject to Ulcers in the Gums, as in the Scurvy; sometimes the erosion of the Gums comes from worms, or the corrupt humours which cause worms, so that it is a plain sign of worms when it continueth long. So saith Fabricius Hildanus, Obs. 59 Centur. 1. the Son of a Citizen of Dusseldorp was long troubled with erosion of the Gums, and died, after the use of many internal Medicines and Topics: when he was opened we found abundance of worms, which had eaten through his Guts, and many in his Stomach. The Cure is first to be directed to the antecedent cause, and the vicious humours are to be evacuated by blood-letting and purging; the sharp and hot humours are to be tempered with Apozemes, Juleps, and Physical Broths, and the like. The flux of the same is to be diverted by Cupping-glasses, and Cauteries fitly applied. And lastly, the faults of the parts affected are to be corrected. Afterwards you must use Topics, which are to be altered according to the greatness of the disease, so that to a simple Erosion, you must apply only those which astringe and dry, as this Water following: Take of unripe Galls, Acorn Cups, and Flowers of Pomegranates, of each one ounce: red Roses one pugil: Alum three drams: boil them in two parts of Forge-water, and one part of old red Wine, and wash the Gums often therewith. If the Erosion be not taken away with that, use this Opiate: Take of Dragon's blood three drams: Lignum Aloes, red Roses, Spodium; and burnt Hartshorn, and Cypress nuts, of each one dram: Myrrh and Tobacco Ashes, of each three scruples: Alum one dram. Make them into Powder, and mix them with Honey and a few drops of Spirit of Vitriol, or Sulphur. Make an Opiate, which must be spread upon linen cloth and laid to the Gums at night. The Spirit of Vitriol and Sulphur, as they cleanse and whiten the Teeth, so they take away the rottenness of the Gums, either alone, or mixed with Honey of Roses, or Water, as in the former Chapter. If the Ulcer be deep and foul, anoint with this: Take of choice Myrrh and Sugar-candy, of each equal parts: powder them, and fill the white of an hard Egg cut in the midst therewith; then tie it with a third, and hang it in a Wine-Celler with a glass under it, and there will come forth a Liquor or Balsam, with which anoint often. But if by the use of the aforesaid, the disease be not cured, if the Tooth near the Ulcer be rotten, you must pull it out, and then it will be presently cured, otherwise never. Chap. 4. Of bleeding at the Gums. Sometimes abundance of blood flows from the Gums, either Critically, or Symptomatically, although the former be very seldom, yet it is sometimes; so we may see by Experience, and by reading. So saith Dodonaeus, Obs. 14. A certain Quarrier having the small Pox, had a flux of blood from his Gums, and being stopped, it made the Urine bloody, which being stopped it returned again to the Gums, and there continued till he recovered of the small Pox. Amatus Lucitanus, Curate. 5. Centur. 5. says that some have had benefit by bleeding at the Gums, and have been worse when it was stopped. Also Zacutus Lucitanus, obs. 86. lib. 1. Praxis admire. speaks of a Goldsmith who when he fell into a Fever by labouring at the Furnace, being of a strong constitution, lost much blood by opening a Vein and amended, so that the seventh day (having had an itching of his Gums, and a pain in the lower Lip) the blood gushed from the Veins of his lower Gums for three days in such a quantity that he lost above five pints more, and the more he bled, the more his Fever abated, and when it was gone the blood stopped. The Gums bleed Symptomatically when the blood is sharp, and the Liver or Spleen distempered: So that in the Scurvy this flux is ordinary. Sometimes after a Tooth is drawn, there is so great a flux of blood by reason the Artery is torn, which is the root of the Tooth, that sometimes men have died thereof. The Cure of a Symptomatical flux, is by bleeding and purging, and other Remedies for the bowels. As also by Topics astringing, made into Gargarisms, Powders, Liniments, or Opiates. If it come from a Tooth drawn, you must first let blood and Cup to make revulsion, and apply astringents to the part, as a Cataplasm, of Bolearmenick, Terra Sigillata, Sanguis Draconis, and the like astringents made up with the white of an Egg. Also Time alone with the white of an Egg is good. But if they do not suffice, you must lay the Patient's finger upon the part, and let him hold it there till the blood congeal above the orifice of the Artery. If it cannot be stopped with slight things use stronger. Valeriola, obs. 3. lib. 5. reports that an old woman who had a Tooth taken forth with the singers only, had a violent bleeding upon it, from the Artery under the Gum; which he stopped with Vitriol when other things failed; which is excellent both for astringency and burning. Zacutus Lucitanus, obs. 84. lib. 1. Prax. Med. admire. relates a History of one who having a grievous Tooth that ached, drew it violently forth▪ and after had a great flux of blood from the Artery torn, which when it could not be stopped by Blood-letting, Cupping, and Astringents, nor by laying on the finger, nor by Vitriol, at last by his advice the place was filled with Gum Arabic, which stopped it in three hours' space, for it hath power to stop, cool, glutinate, and dry. The same Zacutus Obs. 85. of the same Book, reports of a certain strong Soldier, who after great pain drew a Tooth violently, and bled much from the Artery under the Tooth, for two days: the best Physicians use all Astringents to the part, with Revulsives, and burn the Artery with a hot iron, but all in vain, for he bled still even unto death: Zacutus being called, applied the Plaster of Galen, made of Frankincense, Aloes, the hairs of an Hare powdered, and mixed with the white of an Egg, by which in a few hours the blood stopped and the Patient recovered. Galen boasteth that he invented this precious Medicine, lib. 5. m. cap. 7. and stopped the Artery in the Elbow: And cap. 4. of the same Book, and in his Book of Curing by Blood-letting, Chapter the last, he confirmeth the Excellency thereof by many stories. Chap. 5. Of the Vcers' of the Mouth, and Jaws. THe small and superficial Ulcers of the Mouth are usually Aphthae or Trush, although in Galen and Hypocrates, it is sometimes used for Ulcers in other parts; but they which are deeper are absolutely called the Ulcers of the Mouth and Jaws: Such as are in the French Pox. These Ulcers breed of sharp Humours or Vapours coming from divers parts into the Jaws; so in malignant Fevers they often happen, or to those that have hot Livers, or foul Bodies: So the Children have the Trush, as Hipp. aph. 24. sect. 3. either from the sharpness of the Milk which Ulcerates those tender parts in its passage, as Galen teacheth in his Comment upon the same Aphorism, or from the corruption of the milk in the Stomach by which sharp vapours are sent to the mouth, as Galen affirms, 9 de compos. med. sec. loc. cap. ultimo. Now these Ulcers are divers, as some are slighter, some more dangerous; some are in Children, some in Men; some are joined with Inflammation, some are without; these divers degrees are according to the variety of the Humours of which they come: For they proceed either of Blood, Choler, Phlegm, or Melancholy, or Choler Adust, which hath not only a burning, but often a malignant quality, and begets evil conditioned Ulcers. These Differences are known by their proper signs, for if the Ulcers be Redish they come of Blood: if Yellow, of Choler: if White, of Phlegm: if Livid or Blue, from Melancholy, if they stink they are foul. As for the Prognostic. Aphthaes, or Truth is easily Cured, but deep Ulcers and putrid, called in Greek Nomai, are hardly Cured: And in Children they are more dangerous by reason of their tender flesh which they sooner devour: As also because strong Medicines cannot be applied unto them; hence sometimes Children die of them, when they are Malignant and putrid. Also in respect or the Cause, those Ulcers which come of Phlegm, are least dangerous: those that come of Blood or Choler, more: and those that come of Melancholy, most of al. Black and Crusty Ulcers are deadly, especially in Children. The Jaws Ulcerated in a Fever are hard to be Cured, as Hipp. teacheth, 3. Prog. Because as Galen explaineth they show the malignity of the matter. The Cure is first by good Diet, which Cooleth and Drieth, and hindereth the Generation of the antecedent Cause: Therefore when Children have it from their Suck, let the Nurse be changed, or eat good Diet, as also let her blend and be purged, if need be: especially let her eat Cool Astringent things, as Quinces, Pears, Meddlers, Services, Lettuce, and Purslain, prescribe the same to men, and let them avoid sharp things, salt, and pepper. Then you must look to the antecedent Cause, with Universal Evacuations according to the age; And first Phlebotomy doth powerfully revel the Humours, and tempereth their sharpness, by Cooling the whole body. After this ●up and scarify, put Horsleeches behind the Ears and under the Chin, and apply a Vesicatory to the Neck behind. The next day after you have let blood, you must prescribe a Purge, agreeable to the Humour offending, and the age of the Patient. From the beginning of the Cure use Topics, called by Galen Stomatica, or Medicines for the Mouth: and at first they must be mild, as Gargarisms, Mouth-waters made of Plantain, Honeysuckle, and Roses; Water with Syrup of dried Roses and of Mulberries: or Decoctions of Plantain, Bramble Leaves, Knotgrass, Pomegranate Flowers, Red Saunders, and the like; with Syrup afore mentioned. And if there be Inflammation, you may do well if you add the Juice of Nightshade, Housleek, and Purslain, with as much Sal Pruneilae as will not make it too sharp: Or a little crude Alum. If there be no Inflammation, the Chief & only Remedy is Spirit of Vitriol, or Sulphur, which may be used alone to Men, upon a little lint at the end of a stick, gently touching the part, by which it will be presently Cured if it be a simple Aphtha: But to Children you must mix the Spirit aforesaid with Honey of Roses, so that it may be but a little sharp, and with a little Lint at the end of a Probe often apply it, and they will be quickly Cured. If the Ulcers are very painful and inflamed, they must Gargoyle with Milk often, or with an Emulsion of the Cold Seeds, or the Mucilage of Fleabane-seeds and Quince-seeds extracted with the waters of Roses, Plantain, and Nightshade. If the pain will not be removed with these Revulsions and Topics, but the Humours are still drawn thither by it, which causeth want of sleep, and Consumption of the body, which endanger the life; the last Remedy is Narcotick, which will assuage the pain and stop the Flux, you must give it according to the strength and age of the Patient. I once saved a Child's life (by God's assistance) of Four Years old with one grain of Laudanum, when his Jaws and Tongue were deeply Ulcerated with such an Inflammation, that he could neither take Broth, nor Topics, the Humours flowing so fast from his mouth, that he lay night and day complaining without any rest. If the Ulcer be sordid, First wash it with the Decoction of Barley, and Honey of Roses; and in Children, with Milk chaly beated, or in which Steel hath been often quenched, mixed with Conserve of Roses; then use stronger Medicines, and principally Honey of Roses above mentioned made a little sharp with some drops of Spirit of Vitriol: If these will not do, you may add to the Waters and Decoction above mentioned burnt Alum, the Collyrium of Lanfrank and Aegyptiacum, in a quantity agreeable to the Disease. Lastly, If it come from the French Pox, it will not be Cured till the Pox be Cured. Chap. 6. Of the Relaxation of the Wula, or Falling Down of the palate. THe Relaxation of the Uuula comes from a Rhewm falling from the Brain upon it, with which there is sometimes blood mixed, and then there is an Inflammation also, and this often falls upon the Tonsils or Spongious Kernels; the Inflammation whereof shall not here be treated of, because it is Cured by the same means, with the Inflammation of the Tongue, and of the Ulcers of the Mouth. A Waterish Humour falling upon the Uuula or Collumella, doth so moisten, soften, and relax it, that it will be extended to the upper part of the oesophagus or Weazand, and cause a Nauseousness, and the Patient will seem to have something in his Throat which he cannot swallow down, by which you may know it without looking into the mouth. The Cure is first by the Antecedent Cause, that is, by Evacuating the Humours flowing from the Head, by Revelling and Deriving them with such Medicines as were prescribed in the Cure of a Catarrh. The Chief Topics are Astringents and Repellers, such as were prescribed in the Cure of the Ulcers of the Gums and Jaws, and shall be prescribed in the Chapter following of the Cure of the Angina, to which afterwards you must add some resolver's and Dryers: And though the Gargarisms in those Chapters mentioned, are here good, yet when there is no Inflammation the use of Powders is better; for with them the Wula relaxed is more powerfully dried and Astringed. And therefore, First apply Pomegranate peels powdered, and after mix it with a little Pepper: Or, Take of Red Roses and Pomegranate flowers and Peels of each half a dram: the Roots of Snakweed and Tormentil, Galls and Flowers-de-luce-root, of each one dram: Alum, two scruples: make a Powder. Ordinary Surgeons apply the Powder of Long Pepper, but it is dangerous, for it is to be feared, lest the Humours should be drawn violently from the Brain, to the part. The Manner of applying this Powder is to depress the Tongue with a Speculum Oris, and then blow up some powder in your Uuula spoon: do this often till the Humour be spent: The instrument invented by Fabricius Hildanus, Obs. 21. Cent. 2. is the best for this. And if the Uuula relaxed cannot be brought to its former condition by these means, but continueth extended and painful; your last Remedy is to cut off a piece thereof: in which Operation you must take some Cautions. The first is from Hypocrates, 3. Progn. Text. 21. where he saith, That Wula's are Cut and Scarified, and burnt when they are red and swollen, but not without danger; for an Inflammation followeth, and a Flux of Blood; but you must endeavour to extenuate these accidents by other means at that time: But when the Wula hangs down, and the lower part of it is greater than the higher, and round, than it is safe to operate: but it is better first to administer a Clyster, if time will permit. Galen in his Commentary upon these words of Hypocrates, saith that an Uuula inflamed, is not to be cut off, or scarified; but after the inflammation is gone, so that the superior part is lessened. Another Caution is taken out of Paulus Aegineta, lib. 6. cap. 31. you must not touch the Uuula with an iron to cut it when it is livid or blackish, that is, when it hath malignity in it, and inclineth to be a Cancer. But out of the same Author we have a lawfulness of the operation, when they are long and white, or as Hypocrates saith, small at the top. We have an Example of the good success of this operation in Amatus Lucitanus, Obs. 65. Cent. 3. upon a Student who had his Uuula hung down like a thong, long, and without blood in it; which when Medicines could not cure, he cut off, and after touching the part with a little Spirit of Vitriol, he cured the Patient. The third Caution is, That you cut not off too much; for then the Voice and Breathing will be hurt according to Galen, 11. de usu part. cap. 11. and consumption and death itself will ensue as often is seen in the French Pox. Chap. 7. Of Angina, or Quinsy, or Squinzie. THe word Angina taken generally signifies every Disease of the Jaws and Throat, by which breathing and swallowing are hindered, when there is no defect in the Lungs and Breast. And this is twofold, a Legitimate and proper Squinzy; and a Bastard, or or improper. A Legitimate Squinzy comes from an Inflammation by which the Muscles of the Jaws and Throat being swelled, do stop and contract the ways of breathing and swallowing. This Inflammation doth either possess the Throat or the Jaws, called Pharynx. Both these parts have both internal and external Muscles. And though for the most part the Pharynx and Larynx, Jaws and Throat, do suffer in an Angina by reason of their nearness, yet one is more affected than the other: Hence many differences of Symptoms do arise, in respect whereof Galen in 4. de loc. off. cap. 5. makes four sorts of Angina's, which the Grecians before his time named too curiously. One is called Sunagchen; another Cunagchen; the third Parasunagchen; and the fourth Paracunagchen. If the Inflammation be in the inward and proper Muscles of the Larynx, it is called Cunagche; if it be in the inward Muscles of the Pharynx, Sunagche; if in the outward Muscles of the Larynx, Paracunagche; and if in the outward Muscles of the Jaws or Pharynx, it is called Parasunagche. Not only the Muscles of the Jaws and Throat are for the most part inflamed, as aforesaid, but also the parts adjacent, and the outward part of the Neck, as shall be said in the Diagnostic and Prognostic of this Disease. In all these kinds of Angina's, when there is great danger by the difficulty of swallowing, than those things which are given use to fly out at the Nose, especially if they be liquid things, which are more hard to be swallowed at that time; because they spread themselves abroad, and therefore cannot so easily be comprehended of the Muscles to be sent into the Oesophagus, which Muscles cannot sufficiently contract themselves by reason of the inflammation; but solid nourishment being more corpulent, need only the superficial action of the Muscles, and are swallowed down by a small contraction of them. But it sometimes falls out that solid things are harder, and liquid things easier to be swallowed, which dependeth upon the diversity of the parts affected: For the Muscles of the Larynx are ordained for to swallow meat, as well as for the voice; and when the meat is thrown into the Oesophagus, the Larynx is lifted up with the Tongue: But for to swallow drink we use the Tongue most, which while it is drawn inwards it brings the drink from the Lips to the Jaws. If therefore the Muscles that move the Tongue are more affected, it is harder to swallow drink. But if the Muscles of the Larynx are more hurt, it is harder to swallow meat. Here by the way we must mark, that Hypocrates sometimes by the word Angina, doth understand only the inflammation of the Larynx, and so it is taken more strictly; of which there is an Example 6. Epid. Sect. 8. Text. 1. where he saith thus: Some had inflammations of their Jaws, some had Angina's; where by the name Angina he understands the inflammation of the Muscles of the Larynx, and distinguisheth it from the inflammation of the Jaws. A Bastard Angina is without a Fever, and is twofold. The first and most ordinary comes of Rhewin falling upon the Jaws and parts near unto the Larynx. The other comes from the Luxation of the Vertebrae of the Neck, by which the passage of the Gullet and Throat, is pressed and made narrow. The Cause of a true Angina, as of other inflammations, is either pure blood, or mixed with Choler, Phlegm, or Melancholy, which falls upon the parts aforesaid out of the Branches of the Jugular Veins, and this is either attracted by the heat or pain of those parts, or sent from other parts, because these parts are weak, lose, and fit to receivea defluxion, especially if the whole Body abound with humours, or the Head, or the parts near the Jaws. For when evil blood aboundeth in the whole Body, and is carried unto the Head, if the Brain be strong it will not receive it, but sends it down by the same Veins into the lower parts; hence come divers inflammations as Parotides, or tumours under the Ears, Ophthalmies, Angina's, and the like. Young men are more subject to the Angina, than old, because they have much Choleric blood, and because they are full bodied, and have much blood, especially in the Head. Some Authors say that men are more subject to Angina's than women; which it seems Hypocrates observed, 6. Epid. Sect. 7. where describing an Epidemical Constitution, in which Angina's, Coughs, and Peripneumonia's, or Inflammations of the Lungs, were frequent, he affirmeth that few women were sick, and he gives no other reason, but because they went less abroad than men, and therefore were not so subject to injuries from the Air. Which Reason doth not agree with the universal Proposition, That women are less subject to Angina's than men; but this may be a true Reason, because women have colder Blood, a less Larynx or Windpipe, and narrower Veins of the Throat. For which Reason those parts do not so easily receive defluxions. The precedent Diseases may be reduced to their internal Causes, as continual, putrid, burning, and especially Epidemical Fevers, such as were mentioned by Forestus, Obs. 2. Lib. 6. which happened in the year 1517. at which time all that were infected had an inflammation of the Jaws, and died within sixteen or twenty hours, except they were let blood within six hours. But in this Angina the Fever is not Symptomatical, but Essential, and the Angina is symptom to it, because part of the matter causing the Disease is sent to this place; for in Epidemical Fevers, Angina's, Pleuresies, Inflammation of the Lungs, Disenteries, and the like do happen, from some secret force and influence of the Stars, by which sometimes one part of the Body, and sometimes another is more affected. Whatsoever can cause a flux of humours to these parts may be reckoned among the external Causes of this Disease: As Southernly winds, according to Hypocrates, Aph. 16. Sect. 3. in time of much rain, many diseases happen, as long Fevers, Fluxes of the Belly, Putrefactions, Falling-sicknesses, Apoplexies, and Angina's. Also for the producing of this last, the inequality of weather doth much, when the parts are made lose by heat; and by cold suddenly coming thereupon, the humours are sent thither. A sudden cooling after heat, and drinking of cold water doth the same, or if the Head be kept too hot or too cold. The first Cause of a Bastard Angina, is propounded by Hypocrates, 4. de vict. rat. in morb. acut. text. 39 where he saith, an Angina comes when in Winter and Spring time much slimy phlegm falls from the Head to the Jugular Veins, which obstructeth the passages of the Spirits with its cold glewiness. There is another Cause of a Bastard Angina given by Hypocrates, 2. Epidem. Sect. 2. namely, a Tumour rising in the Vertebrae of the Neck, and especially in that which is called Dens, or the shape of a Tooth by Hypocrates, by which the Vertebrae are drawn inward, and therefore a Cavity appears in the external part. Now this Tumour either comes from phlegm, removing by its increase the Vertebra from its seat, or from blood falling upon the Muscles, from whence comes an inflammation by which the Muscles being contracted draw the Vertebra's inward, and then it is a true Angina coming from the inflammation of the said Muscles. There may also be a Luxation of the Vertebrae by a phlegmatic humour losing their Nerves, and making them slippery between the Joints. And lastly, it may come from an external Cause, as a fall, or stroke, as in other parts. An Angina is generally known, first by its proper signs, namely, difficulty of breathing and swallowing, when there is no fault in the Breast and Lungs, and when pain is felt about the Jaws and Throat: and in a true Angina, redness, heat, and a fever are signs. The Differences may be distinguished by their proper signs. In Synanche there is less difficulty of breathing, but great difficulty in swallowing, so that moist things can scarce be swallowed, but come out at the Nostrils. In Parasynanche there is less difficulty of breathing, nay, very little, because the inflammation of the external Muscles of the Jaws doth little hinder respiration, there is pain and redness outwardly in the Neck, when the outward parts are inflamed. In Cynanche there is great hindrance of Respiration, so as the Patient seems to be strangled, and sometimes is strangled for a short time, and cannot breathe but with the Neck upright, and the Mouth open. The Jaws are much pained, yet there is no redness or Tumour inwardly in the Jaws, nor outwardly in the Neck; the Tongue is livid, black, and retorted, or bend by reason of the great fullness of the Veins about it. There useth also to be an acute Fever, you may find an acute description of this kind of Angina in Hipp. 3. de Morbis. And this is remarkable, which is observed of few, the inward Muscles of the Larynx are not here only affected but the Lungs themselves, from whence is difficulty of breathing and Suffocation, which Dodonaeus observeth very well, Obs. Med. Cap. 18. where he relates a history of a Butcher who at noon felt a pain about his Jaws and Throat, and some difficulty in swallowing, and died strangled the same night; his body being opened the substance of his Lungs were found turned into matter. He gave other Examples, Anno 1565. in which year many had the Angina, with pain about the Larynx, which ceasing, they fell into Peripneumonia, and they being opened after death, had either their Lungs full of Water or imposthumated; but nothing was perceived about the Larynx or its Muscles, which might show an inflammation: And in these Causes he supposeth that the Larynx did not suffer principally, but by consent; and it is probable that the Aspera Artery, or rough Artery and its branches may be filled and extended with the Humour flowing from the head, and then if the Humour be sent to other vessels, the Aspera Artery and Larynx are freed from pain, and the Lungs are infected, and so an Angina may turn into a Peripneumonia: We may gather that the Lungs may be affected in an Angina from Hypocrates, 4. acut. text. 30. & 31. where he lays down Two kinds of Angina's from the diversity of the Humours; one, in which a Flux of Rhewm in Winter and Spring is carried to the Jugular veins; another, in which Choler abounds, which is in Summer and Autumn: of the last he speaks thus, When a hot and salted Defluxion comes from the head, being sharp it gnaws and ulcerates, fills with Spirits, brings an Orthopnaea or difficulty of breathing with the Neck stretched forth, and much drought. Besides, there is no Tumour; the Tendons of the Neck behind are stretched like a Cramp, the voice is hindered, the breath is little, and often stopped, such have the Artery ulcerated, and the Lungs inflamed, so that they cannot breathe: Thus Hypocrates he saith also that a hot and sharp Defluxion will bring an Orthopnaea, because it biteth, ulcerateth, and filleth with Spirits, which are carried to the place hurt; hence comes the filling of the Lungs from whence Orthopnaea comes: When there is no room for receiving of the external Air, how much so ever the Lungs be enlarged. Hypocrates affirms this, 3. de morbis, where in the Cure of a Squincy he saith, the vein under the Breast or Pap is to be opened, for in this part there is a hot Spirit from the Lungs, and a little after he saith, You must make haste to cause Spitting, and that the Lungs may grow less, as if the Lungs were swollen by the hot Spirit contained therein. But it is most remarkable that when the Spirits are carried in great plenty to any part, there is also blood carried therewith, which if it flow in such a quantity that it cannot be well governed by nature, it useth to make inflammations and imposthumes; from whence it is no wonder if in such an Angina the lungs become purulent or full of water. In a Paracynanche the breath is less difficult than in a Cynanche; but more difficult than in Synanche, there is some redness and tumour about the Jaws. A Bastard Angina is known by the Phlegm, by want of Fever, by the plenty of humours flowing to the mouth. But a bastard Angina coming of a Luxation is known by the hurt motion of the Head and Neck, and by the Preternatural Cavity which appears in the Neck by reason of the Vertebra inwardly depressed. The knowledge of the Causes is taken from the universal and particular signs of the humours predominating in the whole Body. When an Angina comes of blood, there is heat and redness in the Face, and a great distension in the part affected. When it comes of Choler, the pain and heat is greater, with thirst, bitterness in the mouth, and sharpness. And if it comes from phlegmatic blood, the pain and redness is less, and the Fever little. From the part affected some knowledge of the humour offending may be had. For Choleric blood for the most part maketh an inflammation in the Muscles of the Larynx; but flegmy blood goes rather to the Jaws; for when the Veins of the Larynx are small, only thin blood goes thither; but the Jaws being lose and spongy, do more easily receive the phlegmatic humours. Finally, From the time of the year you may know the peccant humour: For Choleric Angina's do come chief in the Summer and Autumn, because in the Summer Choler breedeth, and in Autumn it is ●eteined. But phlegm breeds in Winter and the Spring, because the humours gathered in Winter are then melted and sent from the Head into the inferior parts. As to the Prognostic. A true Angina is a most acute Disease, and very dangerous by reason of the hindrance of respiration, and for strangulation, which sometimes happens by the stoppage of the passages, by which respiration is made. Therefore by how much the greater the Constriction, so much the more danger, and so the first kind of Angina is most dangerous, because the inflammation of the internal Muscles of the Larynx doth more stop the passage. Whence Hypocrates, Aph. 34. Sect. 4. saith thus: If a Suffocation comes presently upon a Fever, and no Tumour in the Jaws, it is mortal. Which Opinion he confirmeth in coac. & progn. saying that these kinds of Angina's do strangle in the same day, and in the second, third, and fourth. The second sort of Angina, though it be very dangerous, yet is it not altogether deadly as the first, because the inflammation of the external Muscles of the Larynx doth not make so great and so sudden a constriction. Of this Hypocrates spoke 3. Prog. Text. 17. thus: Whatsoever Angina's do resemble others in pain, and make a Tumour and redness in the Jaws, are very deadly, and are of longer continuance than others if they be very red. The third kind is less dangerous, because the Breath is less hindered than the Swallowing, from the inflammation of the internal muscles of the Jaws: But the Swallow hurt is not so dangerous. Of this Hypocrates speaks in the Book above cited, Text. 18. in these words: If the Jaws and Neck are red, these Angina's continue longer; but they are chief preserved who have red necks and breasts, and the holy fire without, not within. The fourth kind is least and safest, because the inflammation is furthest from the Throat. Hence Hypocrates, Aph. 37. Sect. 6. saith, If a Tumour appear in the neck in him that hath an Angina, it is good, for the Disease comes forth. He confirms the same in 3. Progn. Text. 20. thus; But it is most safe to have a Tumour or redness come forth. Hypocrates seems to comprehend all these Differences in one Sentence, 6. Epid. Sect. 7. where speaking of the signs of an Epidemical Angina, he saith: In the sum of all, To them that could only not swallow, the disease was mild, and easy to be endured; but it was desperate to them who had withal a difficulty of breathing. If the matter causing the Angina be carried to the Lungs, either the Patients die, or else turn Fools, or Empyick, that is, imposthumated between the Breast and Lungs; as Hypocrates, Aph. 10 Sect. 5. and 3. Progn. In an Angina that is strong, if the Patiented foam at the mouth, it is deadly, Aph. 43. Sect. 2. for it shows a great straitness about the Heart, and violent heat, from which the proper moisture of the Lungs is squeezed forth, and carried to the mouth in a kind of froth. They who have an Angina, if they spit not concocted matter, but a little, viscid, slimy, and thick, are desperate; Hipp. in coac. The Tumours of the Jaws in an Angina suddenly vanishing without reason are deadly, Hipp. in coacis. Without cause or reason, that is, without a precedent Evacuation by Art or Crisis; for it signifies the returning of the matter inward, from whence a more dangerous Disease may be in the internal parts; or as it sometimes falls out, the matter returning to the same part makes a sudden suffocation. The Cure of the Angina is made by the same Indications which are observed in the Cure of all Inflammations, so the humour flowing to the part is to be reveled and repelled, that which is there is to be derived and dissolved: But if it cannot be dissolved, it is to be digested and suppurated; all which may be done as followeth: First, appoint a slender, cooling, and moistening Diet, of Barley, Cream, Chicken Broth, or Capon Broth, with cool Herbs, and the like. If the Patient cannot swallow by reason of the narrowness of the Oesophagus, so that from thence you fear loss of strength and death. You may free him from that danger by putting down a Catheter into the Oesophagus, to which you may fit a Syringe by which you may send Broth into the Stomach. The Practical Physicians use nourishing Clysters, by which some nourishment may be carried to the Liver from the Meseraick Veins. Let his drink be Barley Water, and other things used in acute Fevers. Let the Air be temperate, and without extremity, for the cold will stop the pores, and the hot will increase the defluxion and inflammation. The Patient must lie with his head high, and his neck upright, that he may better breathe: he must avoid much sleep, as in internal inflammations; for as Hypocrates saith, Blood runs inward in time of sleep, and so the confluxion of humours to the part affected will be increased. But since Angina is a most acute Disease, and sometimes kills a man in one day, you must use great Remedies with much diligence. Therefore in what hour soever the Physician comes, let him presently let blood, on the same side that is affected, out of the Head Vein, or if that appear not, out of the Median, to a pound, or a pound and an half, or two pound, as much as his strength will permit, for in this there is most hope; but you must not take all that blood away at once, lest the Patient faint, by which he would be in danger; but by degrees, and intermission, at every third or fourth hour. This kind of blood-letting is so necessary in this disease, that it may be hindered by no contrary indication. So in the flowing of the Terms, or at any other time you must take away blood in a great quantity. Of which we have a precedent in Zacutus Lucitanus▪ 2. Prax. admire. cap. 135. of a Woman which was in her seventh month great with Child, and was taken with a Squinzy: but being seven times let blood in one day was cured. If the Disease be not violent, you may first give a Clyster; but if otherwise, afterwards. While Phlebotomy is iterated, make other revulsions in the same day with Cupping-glasses, both dry, and with scarification upon the shoulders and loins, make frictions and painful Ligatures upon the extreme parts. Having bled enough, fall to purging the next day, not expecting the concoction of humours, because the disease admits of no parley; therefore give one proper to the humour, nay, if the disease do constrain you, let blood, and give a purge, both in the same day; as Trallianus did by his confession, Lib. 4. Cap. 1. in these words: I truly remember that I, when occasion required, opened a Vein in the morning under the Tongue, and at night gave a purge of the extract of Scammony in Broth, and could scarce hinder strangulation for all that, and another the next day; after I had opened both the Arms, purged him again. Now your purge must be of gentle things, if the disease come of Choler, lest the humours should be moved too violently, and so come to the part affected. Also if the Inflammation come only of blood, it is better to abstain altogether from purging. But if phlegm run with it, make stronger Purges, and give Agarick, and Diaphoenicon with Senna; nay, in a strong phlegmatic Angina you may rise to those Medicines which cause violent vomiting, and among the rest, the Aqua Benedicta of Dr. Rowland is the best, which given to the quantity of two ounces, doth wonders, and for the most part cureth the disease in the space of two hours. Moreover, it hath no evil taste, and so may easily be sipped up, which you cannot do in other Medicines, which by reason of their evil taste cannot be taken but at one draught by the Patient; therefore they can seldom be purged till the passages are a little opened. But that is supplied by often Clysters, and therefore they who cannot take Aqua Benedicta Rulandi, by reason of its heat, or their weakness (because they must be strong who take it) nor any other Medicine, must use often Clysters that are very sharp to draw down the Humours. For the same Revulsion, it is good to apply Cupping-glasses to the Neck and Shoulders with scarification, Frictions, and Ligatures, to the lower parts, and to wash their Feet with hot Water. But a Vesicatory to the Neck behind, doth more strongly revel the humours flowing from the head, which you must do presently after blood-letting. After Revulsions are sufficiently and diligently made, you must derive the Humour from the part, and first open the Veins called Ranulae under the Tongue, it is commended by Hypocrates, Galen, and the Modern Physicians, by which the blood which doth immediately cause the inflammation, is drawn forth. The Ancients in a desperate Angina, open the Jugulars, which though some late Writers have approved, yet it is out of fashion, being thought dangerous by reason of the bleeding, which can scarcely be stopped by reason of the largeness of the Veins. But Experience hath taught that this operation is not so dangerous if it be well administered. First then, bend the Patient's Head on one side as much as you can till his chin almost touch his shoulder; then open the Vein without a Ligature, with a small Orifice, according to its longitude, for so it will more easily cicatrize; and having taken a sufficient quantity of blood, bring the Head to its natural position, and so sometimes the blood will stop of its self. But you must presently apply Galens Emplaster described 5. Meth. Cap. 4. made of Hare's hair, Aloes, Frankincense, and the white of an Egg, so the flux of Blood is surely stopped. Trallianus reports in Lib. 4. Cap. 1. that he cured many of the Squinzy with opening of the Jugular Veins; and Zacutus Lucitanus, obser. 89. lib. 1. Praxis admire. tells of a Spaniard which was cured of a most violent Angina. A Cupping-glass with Scarification under the Chin, is good for derivation, by which Zacutus Lucitanus, obs. 88 lib. 1. Prax. adm. saith he cured a woman of a Cunagche, or dog Squinzy. Scarrifications under the Jaws, and upon the Neck are good, if deep, by which means Benivenius faith in lib. de abdit. morb. cause. cap. 38. Nicholas Rota was cured of a desperate Angina; whose story Sennertus hath fully related, Pract. Med. lib. 2. part 1. cap. 24. While the aforesaid Medicines are used, the inflammation of the Throat and Jaws is to be allayed with Topics, and they are to be varied according to the time, as in other inflammations, so in the first Repelling Medicines, are good made into Gargarisms that they may presently touch the part inflamed. Take of Plantain, Nightshade, and Woodbine Water, of each three ounces: Syrup of Mulberries three ounces: Sal prunellae, one dram and an half. Make a Gargarism. Or of a Decoction thus: Take of Plantain, Sorrel, and the tops of Brambles, of each one handful: the Grains of Sumach half an ounce: one Pomegranate beaten with grains and peel: red Roses one pugil: make a Decoction to a pint: Dissolve in the straining Syrup of Mulberries, and the composition made of Nuts, of each one ounce and an half; Sal prunella two drams: Make a Gargarism. Concerning Gargarisms you must observe, that they are to be suspected, because the parts inflamed are moved thereby, which should be at rest; but you may remedy that if you hold the Gargarism in the Mouth, turning backwards, and not move it. Without Gargling you may use the Spirit of Salt, Sulphur, or Vitriol, which mixed with Water, to qualify their sharpness, are to be taken by little and little; for by passing through the part affected, they qualify its heat, and being sent from the Stomach to the Liver and Veins, it alleys the heat of the blood; which remedy is also good in the Inflammation of the Jaws and Tonsils. While you use repelling Gargarisms, you must apply outwardly to the neck, loosening and resolving Liniments, that the matter may be brought forth; thus made. Take of Oil of Chamomel, Lilies, and sweet Almonds, of each one ounce: Hens grease and fresh Butter, of each one ounce and an half: Saffron one scruple: Make a Lineament to be applied with greasy wool. This Lineament will assuage pain, which if violent, it may be qualified also with a Gargarism made of Milk, or an Emulsion made of the four cold great seeds, or of Mucilages of Fleabane and Quinces, drawn with Rose water, adding Syrup of Violets, or Cassia dissolved in Whey, or in a Decoction of Marsh-mallow Roots. After the beginning of the Disease when it increaseth, or is at a stand, you must mix Digesters and dissolver's with Repellers, which must be done the second day, because the Disease is most acute. Take of the Leaves of Hyssop and Plantain, of each one handful: Liquoris, Raisins stoned, of each one ounce: fat Figs twelve: red Roses and Barley, of each one pugil: make a Decoction of a pint. Dissolve in the straining Honey of Roses, and Syrup of Violets, of each one ounce. Make a Gargarism. Observe, That as long as the Inflammation continueth, you must mix some things that repel with dissolver's and Astringents, lest the part which by Nature is soft, should be more relaxed, and made more fit to receive a defluxion. But outwardly you must apply dissolver's most, with a Swallows nest, which by the Opinion of all Writers hath a specifical property against this Disease. Take of the powder of a Swallows nest, and of Album Graecum, of each one dram: the powder of Flower-de-luce Roots and Chamomel, of each half a dram: Hens grease and Oil of Lilies, of each one ounce, yellow Wax a little: Make a Lineament. Or it may be made into a Cataplasm thus: Take one Swallows nest, Mallows, Violets, of each one handful: Althaea Roots, Lily Roots, of each half an ounce: fat Figs three or four: Chamomel and Melilot Flowers, of each one pugil: boil them and beat them; then put to them, Barley meal, Linseeds, and Foenugreek, of each three drams: Saffron, one scruple: fresh Butter one ounce: Oil of Chamomel and sweet Almonds, of each as much as will make a Cataplasm to be applied to the fore part of the Neck. In the mean while, you may use Eclegmas, or things to be licked, now and then, that the matter which breathes forth of the part, or falls upon it from the head, may be cleansed. Take of the powder of the Electuary of Diatragacanth frigid, two drams: Simple Diaireos one dram: Sugar-candy, and Penides, of each half an ounce: Diamoron one ounce: Syrup of Jujubes, as much as is sufficient. Make a Lohoch. If the Tnmor will not be discussed, but tendeth to suppuration, which useth to be upon the fourth or fifth day, you shall assist it with the Cataplasm aforesaid, and other Emollients and Suppuratives, and he must hold those Medicines at the same time in his mouth, which was prescribed formerly for assuaging of pain. Or, Take of sliced Liquoris and Raisins stoned, of each one ounce: fat Figs six: Althaea and Quince seeds, of each two drams: the flowers of Chamomel, one pugil: boil them in Hydromel. Dissolve in the straining, boiled Wine two ounces. Make a Gargarism. It is also good to hold Cassia new drawn, in the mouth, that by degrees it may dissolve into the Throat, for it assuageth pain, dissolveth and maturateth. If the Tumour come to suppuration, which may be known by the decrease of symptoms, and will not break, let the sick man, or some about him, put their fingers into his mouth, and endeavour to break the imposthume, which if it cannot be done, let his mouth be wide opened with a Speculunt oris, and then open the imposthume with a crooked incision knife called a Bistort. Then let the Patient hold down his Head lest the matter fall upon his Lungs: after, wash the Ulcer with Barley Water and Honey of Roses, Water and Honey called Hydromel, or Wine and Honey called Oinomel; after this, dry it up with Alum Water. Others put a Wax Candle anointed with Oil of sweet Almonds into the Oesophagus to break the Aposthume; which if they cannot do, they use a sharp wooden knife, or at last an incision knife. Others touch it with Oil of Vitriol, which presently breaks it, Arcalanus opens it with a Lancet fixed at the end of a stick lest it should touch other parts. Faventinus commends the same, in these words; Take a little round stick, & in the end of it, fix a little sharp Iron as long as half a finger; then open the mouth, and put a stick between the Teeth, then let him open the imposthume with the former Instrument: when it is open, let him bend forward with his mouth open, that the matter may come forth. Schenkius out of Dovynetus, used to break an imposthume with the Decoction of Agarick, and confirmeth it by the following History taken out of Dovynetus, Apolog. lib. 3. cap. 1. A Noble Woman called Gabriella Goufier, Lady of Saulton, being taken with a Squinzie in Autumn, which is most dangerous, I remembered that I read in Aetius, lib. 15. cap. 6. that Agarick doth destroy bidden imposthumes, or draw them forth; presently I took Agarick, and cut it and steeped it in the decoction of Althaea with the fourth part of white Wine, and Figs, and a little Ginger, with a little Syrup of Marsh-mallows, and gave it to the Lady to drink, commanding that she swallow it not down suddenly, but hold it in the mouth a little, if she would be cured: she obeyeth, and while I was talking with her, behold abundance of white stinking matter came forth of her mouth, in so much that her daughter that held the Basin fainted, the other people ran away, others came and took away the matter, others perfume the room; which done, I came to the Patient, and found her delivered from the impediment in her voice, difficulty of breathing, and her fever, and out of all danger. If the matter seem to tend to the external parts, you must open it outwardly; which Lanfrank saith he did with good success, Chir. maj. doct. 2. tract. 3. cap. 5. in these words: Because the Chirurgeon is much confirmed by good experience, I will tell you what befell me in the City of Milan, with a Lady of fifty five years old, which had a phlegmatic Squinzie in the whole Throat, inwardly and outwardly, but outwardly it appeared most swollen, and she could neither speak nor swallow: being sent for, I felt her pulse, and found her exceeding weak; touching the part affected I found the matter very deep, and that she was more likely to be choked, than that it should break either internally or externally: then I got ready my Razor, and touching the place with my singers I found ripe matter between the Chin and the Epiglot, and there I made a deep incision, by which I drew forth a great part of the corrupt matter, but willingly left a great deal behind, for a reason known; then her breath grew better, and pulse stronger; then giving her Broth, a great deal of it came forth of the wound: then I invented a silver pipe which should pass the wound being put into the mouth, and by which she should receive her nourishment. I used Mundificatives, and Maturatives to the whole Throat and Neck, till I drew out of the wound a great piece of viscous matter, and stinking, like a Gut as long as my finger, which was condensed by heat; which taken away, the place did no longer stink, and the Patient began to cheer up: but I continued to mundify, and after with Incarnatives and Cicatrizers, I healed up the wound, and the Patient was cured. Here may be related the History of Beniven before mentioned, of one in a Squinzy, who was left of other Physicians, and was cured by him with deep scarification under the Jaws, and in the Neck, from whence much matter flowed. If the Aposthume break inwardly in the Mouth, let it be cleansed with Barley Water, and Hydromel (as is said.) But sometimes the Ulcer is foul, and then you must use stronger, thus made: Take of Scabious and Agrimony, of each one handful: Cypressnuts one dram: Flowerdeluce Roots, and round Birthwort, of each half an ounce: Myrrh half a dram: red Roses two pugils: boil them in Hydromel to a pint; strain it, and wash the part ulcerated therewith. This Decoction is very good to cleanse Ulcer; but if it be not sufficient, use the Collyrium of Lanfrank, which is wonderful. After it is well cleansed, you must endeavour consolidation with Bole-Anmenick mixed with Honey of Roses for an Eclegma, with Frankincense and Myrrh. It comes to pass sometimes that the Inflammation decreasing, the Tumour will neither be dissolved, nor suppurated, but grow harder; in which case you must Emollient and Suppurating Cataplasms, made thus: Take of Althaea, and Briony Roots, and of the wild cucumber, of each one ounce: Mallows, Pellitory, Origan, and the lesser Centaury, of each one handful: fat Figs, six or seven: Linseed and Foenugreek, of each one ounce: Boyl them, beat them, and strain them, and then add of the powder of a Sallows Nest burnt, and of Album Graecum, of each three drams: Brimstone one dram: fresh Butter, and Duck's Grease, of each one ounce: Oil of Dill two ounces. Make a Cataplasin. For a Conclusion, we will speak something of Laryngotomia, or cutting of the Throat, which Ancient Physicians mentioned, and the Modern approve and confirm by experience: As when in a desperate Squinzy when the Patient is almost choked, an incision is made in the rough Artery, by which there is a passage for Air into the Lungs, and for vapours coming out of them. This Avicen alloweth, Fen. 9 lib. 3. cap. 11. Paulus, lib. 6. cap. 33. Rhasis, 3. continuentis. Alsaharavius, Avenzoar, Albucasis, and Halyabbas in their proper Chapters. Galen sets down the same out of Asclepiades, in his Introduction, chap. 13. Of the Modern Brassavolus, comment. in lib. 4. Of Hipp. concerning Diet in acute Diseases, Sect. 35. saith, that he made this operation with his own hands, and good success. But this is seldom used by Surgeons for fear of disgrace through the death of the Patient; for men are more apt to make the operation the cause of death than the disease, although the Physician have been very careful, and foretold them the danger. Moreover, In a desperate Angina the Lungs are often affected, and full of humours, whence comes suffocation; and then the incision of the rough Artery will not profit. Which danger Jerom Fabricius ab Aquapendente observing, being a good Chirurgeon, saith that he never undertook this Operation, nor any other in his time. But he confesseth it may be used, so that the Lungs and rough Artery be not full of filth: and he showeth the manner of it in its proper Chapter most exactly, from whence any one may take it. The End of the Sixth Book THE SEVENTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Breast. The PREFACE. BY this name Thorax, or Breast, we mean those parts only which serve for breathing; for although the Heart be contained in the Thorax, yet the Diseases thereof shall be set down in a Book by themselves. But in this we will only speak of those which hinder breathing, and hurt the part of Respiration; as Astbma, pleurisy, Peripneumonia, or Inflammation of the Lungs, Empyema, and Phtysis; and we have ordained proper Chapters for each of them. Chap. 1. Of Asthma, or Difficulty of Breathing. THe Breath is hindered by divers Causes, either by sympathy, or propriety of part. The hindrance of breathing by propriety called Idiopathica, comes from the Lungs distempered, and therefore every Disease of the Lungs hurts their action, which Diseases are either in the substance of the Lungs, or in the Vessels thereof. In the substance of the Lungs come inflammations, pimples, imposthumes, ulcers, and sometimes a drying, and atrophy of the part; sometimes a serous watery humour is sucked into the spongy substance of the Lungs, and hinders their free dilatation; sometimes, though seldom, there is a schirrus, a stone, or hard swelling in them. In the Vessels of the Lungs, there are often obstructions, which hindering the free passage of the Air, cause difficulty of breathing. Breathing is hindered by sympathy or consent from other parts, which are not only near, but remote, so the Membrane that goeth about the ribs being inflamed, or the Diaphragma, or Mediastinum, the breath is hindered. So by custom there is a great and often breathing when the heart is inflamed, as in Fevers; and on the contrary, when the Heart is cold, as in dying men, it is diminished and ceaseth; the same happeneth in swooning or syncope, when the action of the Heart, and consequently Respiration ceaseth. So in the Empyema, or Dropsy of the Breast, when matter or water is collected in the Cavity of the Thorax, the Dilatation of the Lights, and Respiration is also hindered. So the Muscles of Breathing being hurt, hinder Respiration, as in wounds and tumours of them, especially in an Apoplexy, when the influence of the Animal Spirits is kept from them. Moreover, The Inflammation of the Muscles of the Larynx makes difficulty of breathing in a Squinzy. So also the Diseases of the Hypochondria do hinder Respiration by consent, as tumours of the Liver, Spleen, Sweetbread or Pancreas, do by their weight draw down the Diaphragma to which they are joined, and so hinder the motion of it. Also vapours and wind sent from those parts compress the Diaphragma, and hinder its action, from whence comes a flatulent Asthma. The same happeneth by the abundance of wind or water contained in the belly of an Hydropical man, and compressing the Diaphragma. Lastly, Vapours coming from the Mother hinder Respiration, from whence this disease is called, Suffocatio Hysterica. Among the aforesaid hindrances of Respiration, the Asthma is handled by itself, because the other depend upon other Diseases; they shall be mentioned in their places. Although Asthma used generally, comprehendeth in a large signification, all kinds of difficulty of breathing; yet it signifies more specially that shortness of breathing which comes from the stuffing of the Lungs, and the obstruction of the Bronchion, or Gristles of the Windpipe; which of its self essentially is without a Fever, although sometimes it be joined therewith. And again, it is subdivided into three other kinds; as first, Dyspnoea; the second called also Asthma; the third Orthopnoea. Dyspnoea is a difficulty of breathing, in which the breath is drawn oftener and thicker, from the stuffing of the Lungs. This is less than Asthma, or Orthopnoea, because the matter obstructing is less, and it rather stops the substance of the Lungs, than Gristles or Bronchia: hence it is that there is no snorting at all, which comes from the commotion of the humours contained in the Bronchia, with the Air continually passing through. Asthma is a great and often breathing, in which the Diaphragma, the Intercostal Muscles between the Ribs, and of the Abdomen, are violently moved, joined with snorting and wheesing. For in a true Asthma properly so called, the Btonchia of the Lungs are filled with phlegm, which (as is said) being moved by the Air, make that noise. Orthopnoea is a great difficulty of breathing, in which the Patient cannot breathe but sitting, and with the neck extended upright; and the aforesaid Muscles are not only moved vehemently, but also those of the Breast and Shoulders. The names Dyspnoea and Orthopnoea, as we said of Asthma, are used commonly for all difficulties of breathing, which happen in Pleuresies, or Inflammation of the Lungs, or the like. The same may be said of Apnaea, which doth not only signify a depravation of breathing as the former, but also a diminishing or abolishing thereof; and this happeneth in syncope, Hysterical Passions, and strong Apoplexies. The humour which causeth an Asthma, is for the most part phlegm, which falls from the Head into the Lungs, and obstructs the Bronchia or Windpipe. Sometimes it comes from crude and serous humours brought by Arteria Venosa into the Lungs, and if these flow to the Bronchia, they produce a true Asthma with snorting; but if to the substance of the Lungs, or smooth Arteries, they cause a bastard Asthma without snorting. This kind of Asthma, which is unknown to vulgar Physicians (who will acknowledge no other cause but a defluxion from the Head) is confirmed, not only by not snorting, but from the thick and turbulent Urine of the Patient at that time, especially in the sit, because some part of those thick and crude humours in the Veins is sent to the Reins and Bladder. And some Asthmatical men are subject to stoppage of Urine, and when they are so, they are free from it. But when the fit of the Asthma comes, the difficulty of Urine ceaseth, because the matter of the disease contained in the Veins goes from one place to another: We have also seen some subject to a flux in the Belly, who while they were so, were free from the Asthma; but when that stopped, the Asthma returned. Moreover, this kind of Asthma which is without snorting, is so directly opposite to bleeding, that when a Vein is opened in the fit, as soon as it bleedeth, the Patient gins presently to breath better, and in the end, or after a little space, they are cured of their fit. And finally, these kind of Asthmatical men, are for the most part of an ill habit of body, and have an oedematous humour in their feet, which showeth that the cause of the Asthma at that time came from the Liver, and is contained in the Veins, so that sometimes a Dropsy followeth in many. Hence Aretaeus reckoneth a wind in the Midriff, and belchings, without reason among the signs of an Asthma at hand, which certainly do come from a crude matter moved in the Midriff. That flatulent matter doth of its self sometimes produce another kind of Asthma, which is called Asthma flatulentum, or Hypochondriacum; when many thick vapours rising from the Hypochondria, do compress the Diaphragma, and hinder its motion, whence comes great difficulty of breathing, without snorting. The Knowledge of this Disease, and its kinds, may be by what hath been said. In a Dispnoea, the breath is thick, without noise or anhelation, and with less trouble. In an Asthma the Breast is more heavy, the Breath thicker and quicker, with anhelation, snorting, and wheesing. But in Orthopnoea, the Patient cannot breathe but with his neck upright, and if they lie down, they are ready to be choked. The Signs of the Causes are these: If Asthma come from gross humours gathered in the Lungs, the difficulty of breathing comes by degrees, by little and little, and is continual. But if Humours come at a distance from other parts into the Lungs, the difficulty of breathing is not continual For albeit Asthma which comes from matter contained in the Lungs, useth to be increased by external causes, as Anger, Southernly winds, and the like; yet in Asthma which comes from matter flowing from another part, the increase is more manifest. If this matter come from the brain, there is a manifest Catarrh; but if no signs of a Cararrh appear, you must conjecture that the matter comes by the Veins to the Lungs, and the swelling of the feet, and evil habit of body called Cachexia, is a sign that the Liver is affected. If a thick humour be contained in the Bronchia of the Lungs, the Respiration is with noise and cough; as also by spitting the disease ceaseth, or is diminished. If the Humour be in the Veins, or substance of the Lungs, there is no noise, and there is seldom any spitting by Cough. As to the Prognostic. An Asthma is a Chronical disease, and very hard to be cured, and often ends in a Cachexia or Dropsy. Young men are sometimes cured, and not without great labour, but old men never. Infants except they be speedily cured, die by a Catarrh, which followeth: They who grow crooked upon an Asthma or Cough, die before they come to ripeness of age, because the gibbosity hindereth the convenient growth of the breast, nevertheless get their due increase and bigness, but having not room enough to dilate themselves; from whence the heat of the Heart being not sufficiently fanned, the patiented dieth. A pleurisy, or Peripneumonia commg upon an Asthma, is deadly, because the Lungs being weakened by a long disease, cannot resist so great a disease coming thereupon, and expel the matter. The Cure of the Asthma is twofold. namely, in the Paroxysm, and out or it. In the fit, presently you must open a Vein, a Clyster being given, if the blood do seem any way to abound: for when the Veins are empty of blood, the Respiration is more free. But if the disease be elder, and blood hath been often drawn, it is better to abstain from bleeding, because by diminishing the natural heat, it will increase phlegm. It is good to open the Veins in the Ankles in this disease, coming by consent from other parts. After bleeding, or if it be omitted as not thought fit, you must purge phlegm, with the things prescribed in the Cure of the cold distemper of the brain, putting to them always things proper for the breast as much as may be. Vomits, althongh disallowed by some in this disease, yet are they most convenient, as frequent experience hath taught, and sometimes the sit is taken away with a vomit only. Among these the chief is Aqua Nicotiana, or Tobacco Water. given in the quantity of an ounce; and it may be made into a Syrup with Sugar: In want whereof you may use the Salt of Vitriol, Aqua benedicta Rulandi. Now the reason is excellent why Vomits do so much good in this disease. For while the thin humour falling from the head insinuateth itself into the Aspera Arteria, and the Bronchia of the Lungs; and the thick falls into the Stomach, and is there so fixed that it can scarcely be taken away. And while the weak heat of the Stomach doth stir the matter, thick vapours are produced, which puffing up the Stomach, compress the Diaphragma, and cause difficulty of breathing. Hence it comes that when the Stomach is emptied, the fit ceaseth, or is much less. Moreover, An Asthma sometimes (nay often, according to Sennertus) cometh of crude humours about the Liver, and in the Veins, which are carried by the Vena Arteriosa into the Lungs, and compress the Bronchia, from whence cometh an Asthma. For the evacuating and revelling of these humours from the Lungs, a Vomit is very good. As also for this cause, the Remedies purging humours downward are very excellent. The Juice of our Flowerdeluce, doth gently move and purge downward, taken to the quantity of half an ounce, with one ounce of Hippocras, which Placerus in his Observations saith he hath used with good success. You may give two ounces of the juice of Flowerdeluce, if the former did work sufficiently. Also you may use sharp Clysters often for revulsion. But they must be given in small quantities, lest by filling the Bowels the Diaphragma be compressed. You must also use Frictions to the inferior parts, and apply many Cupping-glasses thereon, as also to the Neck. Afterwards you must extenuate and dissolve the thick humours, and discuss the vapours that come from them. For which purpose you may give a spoonful of Cinnamon Water, either by its self, or with Syrup of Violets: as, Take of Cinnamon Water two ounces: Syrup of Violets one ounce; or instead of that, mix with the Water one ounce of Oxymel to discuss the humours better. It is also profitable to give three, four, or five drops of Chemical Oil of Sage, Rosemary, or Annis feeds with a little Wine; or sprinkle therewith the Tablets of Diatragacanth frigid, and so let the Patient eat them. Others commend one scruple of Saffron given in a spoonful of Wine. Also Aqua Clareta thus made is very good. Take of Aqua vita four ounces: Water of Colts-foot and Scabious, of each two ounces: Cinnamon six drams: strain them through an Hippocras Bag. Let him take two or three ounces. Tobacco taken in a pipe hinders the sit; so doth the Leaf chewed: and also the smoke of Cloves in a pipe. In the mean time you must use expectorating Medicines, which bring forth the thicker matter upwards. As, Take of the Syrup of Horehound, Liquoris, and Coltsfoot, of each two ounces: Oxymel simple one ounce. Mix them, and let him lick it by little and little. Take of washed Turpentine one ounce: Ammoniacum two scruples: Flower of Brimstone one scruple: mix them into soft pills, of which let him take one every second hour with half an ounce of the Syrup of Hyssop. Take of the Oil of sweet Almonds new drawn without fire six ounces: Sugar Candy▪ two ounces: Mix them for a Lambitive. Or Take of candied Elicampane three drams: Sugar-candy half an ounce: Syrup of Hyssop and Horehound, of each one ounce: ammoniacum dissolved in Aqua vitae half a dram. Mix them for a Lohoch. Or, Take of Conserve of Violets and Elicampane, of each six drams: the powder of the Electuary Diatragacanth frigid, Diaireos Solomonis, of each one dram: Syrup of Violets and Maidenhair, of each as much as will make a Lohoch. Take of Althaea Roots one pound: Elicampane four ounces: Quinces, or Marmalet thereof, sixteen ounces: boil them in Water till they are dry: Beat them and strain them, adding two pints of Honey: boil them again gently. Take them from the fire, and ad of Cinnamon one dram: flower of Brimstone half an ounce: Liquor is perfumed with Musk and Rose water two drams. Make a soft Electuary; of which let him hold now and then as much as a Hazel nut in his mouth: 'tis also very good to take half an ounce thereof morning and evening, when the fit is off. Also you must anoint the Breast with Mollifying and discussing Ointments and Liniments, thus made: Take of the of Oil of Chamomel, Flowerdeluce, and sweet Almonds, of each half an ounce: fresh Hen's grease, one dram: the Powder of Marsh-mallow roots and Flowerdeluce, of each one dram: the meal of Linseed and Foenugreek, of each two drams: Gum Ammoniacum dissolved in Wine one dram and an half: Wax, as much as is sufficient. Make a Lineament. Or, Take of the Mucilage of the seeds of Quinces, Line, and Foenugreek drawn with Scabious and Coltsfoot Water, of each six drams: the Powder of Flower deluce root and Hyssop, of each half an ounce: Saffron one scruple: Oil of Lilies and sweet Almonds, of each two ounces: Wax as much as will make a Lineament. If the fit be long, clap a Vesicatory to the hinder part of the head. Out of the fit you must stop the Defluxion, and also cut, cleanse, and expectorate that which hath fallen into the Lungs. For staying the defluxion, all those Remedies are good which were mentioned in the cure of the cold Catarrh. But you must take a Caution concerning some of them. First, In Apozems, Syrups, or the like, you must not make them two hot and dry, which by consuming of the thin parts, may make the remainder thicker, and so the Disease will be worse, But you must rather mix moisteners, as Raisins, Figs, Liquoris, Jujubes. Secondly, Instead of Head Medicines, you must use things fit for the Breast, above mentioned. Thirdly, For the Derivation of the Humours that abounds in the Head, use Errhines, Sternutatories, Gargarisrus, are Apophlegmatisms: Which last are not so proper, by reason of the nearness of the part by which the humour runs to the Lungs. But Errhines and Sternutatories may be used safely. Fourthly, To strengthen the Head, and dry it, Fumigations are there commended; which are not so proper in this, especially if taken in at the mouth and nostrils, because they make the breath shorter, and bring the fit. But with them you may air the Patient's Caps, without, from the Chamber. For to cleanse and expectorate the thick Humours that stick to the Bronchia of the Lungs, the Medicines already mentioned, or these following, may be used. Take of Elicampane root, and Polypody of the Oak, of each half an ounce: the Leaves of Origan, Calamints, Hyssop, Savory, Maidenbair, Scabious, and Coltsfoot, of each one handful: the seeds of Marsh-mallows, and Cotton, and Carthamus, of each three drams: Liquoris and Raisins stoned, of each six drams: Jujubes, Sebestens, and fat Figs, of each five, make a Decoction to a pint and a quarter of Hydromel; dissolve in the straining a pound and a quarter of white Sugar; make a Syrup well boiled, for a Lambitive. You may make a better and cheaper Syrup thus. Take of Elicampane Roots three drams: Spanish Tobacco one dram: infuse them a whole night in six ounces of Aqua Vitae: in the morning strain them, and ad of the best Sugar four ounces; stir it well upon the fire, and ad of the syrup of Erysimum or Coltsfoot two ounces: Oil of Sulphur as much as will make it sharp: make a Lohoch. These following are proper for to unstuffe and clear the Lungs. Take of Ammoniacum, and Bdellium, dissolved in Vinegar of Squills, of each half an ounce: Flower of Brimstone three drams: the leaves of Coltsfoot and dried Savory, powdered, Diaireos' simple, of each half a dram; with syrup of Hyssop and Oximel of Squills make a mass of Pills; of a dram whereof make six Pills, and let him take three of them two hours before supper twice in a week▪ Or, Take of Aloes Succatrine, half an ounce: Myrrh and Ammoniacum, of each half a dram: Saffron half a scruple: Flower of Brimstone half a dram: with the syrup of Coltsfoot make a mass of Pills, of which let him take a dram two hours afore dinner for some days. Let the Water which is taken out of a hollow Briony Root, be distilled in Balneo Mariae to eight ounces, whereof mix half an ounce of Spirit of Vitriol or Sulphur, let him take every day a spoonful fasting. Take of Tobacco Leaves, Hyssop, white Horehound, and Maidenhair, of each two handfuls▪ the Roots of Flower-de-luce and Liquoris of each half an ounce: boil them to a pint and an half, dissolve in the straining of white Sugar one pound▪ of the best Honey half a pound: make a syrup: well boiled, clarified, and perfumed, with a little Saffron and Cinnamon, let him take a spoonful or two every morning. The Oximel and Syrup of Tobacco invented by Quercetan, prescribed in his Dispensatory, is of the same virtue. The Tincture of dry Tobacco is drawn with Aqua Vitae, a little thereof mixed with Honey, and that held in the Mouth as big as a Pease or Bean, swallowing it by degrees, this draws Phlegm in abundance from the Stomach and Lungs. Hog's Lice, called Millepedes, or Aselli, in number twelve, put into a linen Cloth, are to be steep● in white Wine▪ and then strained and so given to be drunk, and do in a short time cleanse the Lungs. Oleum Sacchari doth powerfully dissolve thick glutinous Humours in the Lungs, and causeth expectoration: But the Compound Oil following is best. Take of the Roots of Flower-de-luce, and Elicampane powdered, of each half an ounce: the Pulp of Dates and Raisins, of each three drams: Citron and Orange peels, of each one dram and an half: Benjamin two drams: Saffron one dram: infuse them two days in the spirit of Wine well rectified: then take of the liquor by inclination, dissolve as much Sugar Candy powdered as you can therein, then fire the spirit of Wine stirring them continually till▪ it comes to a liquor as thick Oil, then mix as much Oil of Sulphur as will sharpen i●▪ A Decoction of Red Coleworts taken many days with a little Sugar, doth help the Asthma. But the Juice of Red Coleworts with Sugar of Roses, or Syrup of Coltsfoot, taken in form of a Julep for many days is better. The Spirit of Sulphur doth dissolve slimy Phlegm, and open the Bronchia if four or five drops are taken in Broth, or convenient Syrup. Turpentine is much Commended for this use▪ given often to two or three drams with the Oil of sweet Almonds or Conserve of Violets, or you may make it into the form of an Opiate thus. Take of Turpentine well washed in Clotsfoot Water one pound: fat Figgs half a pound: Penides four ounces: Oil of sweet Almonds one ounce: mix them into an Opiate. Saffron in Sauce is good for the Breast; also a Junke● made of Mustard seed and Honey doth expectorate. Oxymel also with Agarick taken two spoonfuls in a morning, doth purge the Lungs. The flower of Brimstone made into Pills with fresh Butter, given three days together to one scruple, doth much help the Asthma. Lac Sulphuris doth the same better in ●ight grains, which is the greatest dose. Also these Tablets following are excellent. Take of the pulp of Marsh-mallow roots, and of the greater Comphry, of each two ounces: flower of Brimstone two drams: the flower of Benjamin half a dram: Sugar dissolved in white Lily Water eight ounces: make Tablets, which let the Patient hold often in his mouth. The Decoction of an old Cock is commended, and it is thus made: Take of the Roots of Elicampane, and Flower deluce, of each half an ounce: Hyssop and Horehound dried, of each six drams: Carthamus seeds one ounce: Annis and Dill seed, of each two drams: Liquoris and Raisins stoned▪ of each three drams: the powder of Fox Lungs prepared two drams. Beat them, and fill the belly of an old Cock therewith; then boil him in fifteen pints of Water till his flesh comes from his bones. After it is well strained, set it in a cold place that the thickest may settle, and the thin may be taken off; of which let the Patient take six ounces with one ounce of Oxymel simple. If you will make it purging, you may add two or three drams of Senna for every dose, or half an ounce of Manna. Or if you will have it stronger, you may sometimes put in some Electuary that purgeth phlegm. Platerus prefers the following Preparation of a Cock before the rest: Take an old Cock, kill him, pull him, and draw him; stuff him with these things following: Fox Lungs fresh, or prepared and dried, one ounce: Raisins stoned, and Figs, of each two ounces: Elicampane one dram: Hyssop, Savory, Horehound, Thyme, Calaminth, Penyroyal dried, of each one dram: Fennel and Annis seed, of each one dram: Carthamus seeds bruised and Polypody, of each half an ounce: white Tartar one dram: Salt half an ounce: two yolks of Eggs: fresh Butter half an ounce: Cut them and bruise them, and sew them into the Cock, boil him till his flesh comes from his bones in a large vessel with so much Water as you may need to add no more: then strain it, and put to ten pints, one pound of pure Honey that it may not quickly corrupt. Let him take a Porringer full every morning; in which let him dissolve Manna and new drawn Cassia, of each half an ounce, continuing it for a month and longer; which will be the better, if presently after he take a dram of Turpentine with Penides in form of a Bolus, or otherwise. Ludovicus Septalius in his Practical Observations condemneth these Cock-broths as unprofitable, or hurtful: His Reasons are, Because they do not answer Experience, and have been used in vain by him and other Physicians of Milan. For by long boiling, the nitrous parts (by which those Broths are thought most to profit) do settle, and are lost in the straining: but the slimy, glutinous, thick, and fatty, from the skin, feet, wings, musculous and nervous parts do remain. Hence the matter is made thicker, and less fit to be expectorated. But Septalius his Experience, must not be preferred before so many famous Physician's Experience, both old and modern. For if it did not profit some which he and others have cured, many other things might hinder, as namely, the evil disposition of the Patient, and contumacy of the disease, or other things not well ordered which concerned the Cure, or the Medicine itself not well made. And whereas he saith, that the nitrous parts do fall to the bottom by long boiling, and are lost in the straining, it is ridiculous; for only the Earthy parts do settle, but the nitrous part once taken into the liquor, is never separated. Hence it is that the longer you boil Broth the Salter it is. But this Salt doth cut, extenuate, and open, it is so far from incrassating being salt. Neither hath the flesh, or other parts of a Cock, such a glutinous substance as he imagineth, as you may find in Neat's feet▪ or Calves feet, but rather an attenuating quality, because it is full of nitrous substance. And if purging and altering Medicines be made according to the Precepts of Pharmacy and Art, they do leave all their strength in the Decoction, because daily Experience teacheth us that such Broth of an old Cock doth purge. And if we may oppose our Experience to that of Septalius, we can truly say, that we have found admirable effects of these Broths in violent Asthmaes and colics. But this we use to alter in these Broths; We give many draughts in a day lest it should be spoiled by keeping. But this is the Example of what we prescribe in this disease: Take of the Roots of Elicampane and Flowerdeluce, of each one dram and an half: Hyssop and Coltsfoot, of each one handful: Liquoris and Raisins stoned three drams: fat Figs four: Senna three drams: Polipody of the Oak and Carthamus seeds bruised, of each half an ounce: Annis seeds one dram and an half: Boyl them with the third or fourth part of an old Cock: make a Broth for twelve or fifteen days. By this Purging Wine following, Platerus cured a Woman of a Dyspnoea, inclining to a Dropsy: Take of Flowers-de-luce-root one ounce: Elicampane, and Squills prepared, of each half an ounce: Horehound one handful: Elder Bark and Danewort, of each one dram: Senna one ounce and an half: Agarick two drams: Ginger one dram: shake them well together, and ad of Wine four pints, boil them a little: she drank hereof six days together when she went to Bed, the Dyspnaea ceased, the Tumour vanished, and she was finely Cured. But we must observe that we repeat Purging often in this Disease, under divers forms, lest nature should be used too much to one Medicine: So Cleansing, Cutting, and Expectorating Medicines, and the rest are to be alterated for the same reason. Chap. 2. Of Pleuritis, or a Pleurisy. APleurisie is either True; or Spurious, called a Bastard Pleurisy. A True Pleurisy is the Inflammation of the Membrane that goeth about the Ribs of the internal intercostal Muscles. But a Bastard Pleurisy is the Inflammation of the external intercostal Muscles. There are also other pains of the Side and other parts of the Breast which are improperly called a Bastard Pleurisy. When the Mediastinum is inflamed, the Lungs cleave to the ribs, or when serous humours flow from the Head to the Membranes of the Breast, or when Wind doth tear the Muscles or Membranes of the Breast, or vapours rising from the Stomach, as in the Worms. We have said that in a true Pleurisy not only the Membrane Pleura, but also the internal Muscles are inflamed, because it is impossible but the Inflammation of the Membrane should be communicated to the contiguous Muscles. Besides, Others do affirm that the Lungs are inflamed in every Pleurisy, and confirm their Opinion by Authority, Reason, and Experience: The Authority is that of Hypocrates, lib. de loc. in homine, where he saith, That a Peripneumonia is when both parts of the Lungs are inflamed; but if only one part be inflamed, it is a Pleurisy. Also Reason may seem to confirm this, for the signs of a Pleurisy are also the signs of Peripneumonia; namely, a Cough, continual Fever, difficulty of Breathing, and spitting of Blood. Also the Prognostic and Cure is the same in both. They say moreover, That they have found by experience in the opening of those who have died of Pleurisies that their Lungs appeared always to be inflamed. It is to be granted that in many the Lungs are affected as well as the Pleura, for the Defluxion may easily fall upon both; because the Lungs are fastened to the upper part of the Pleura: but we must avouch that often the Pleura alone is only affected, and not the Lungs: or at least they are so lightly affected, that the Disease cannot be said to be an affect of that part. The Authority of Hypocrates in this, is cast off by some as false, and contrary to many of his own Assertions, in which he acknowledgeth the Pleura only as the part affected; especially in his 1. lib. de morbis. where he often saith, That Choler and Phlegm do stick to the side, and cause vehement pain. But Mortiamis doth reconcile this; saying, That Hypocrates speaks in that place of a Peripneumonia which comes of a Defluxion from the Head, a portion whereof falls upon the Pleura, and he calls it by the name of a Pleurisy, that he may distinguish that which inflameth one part of the Lungs, from that which inflameth both: For the same nature of a Disease being in both the Pleurisy and Peripneumonia, makes the likeness of Symptoms in both, being both from inflammation, and nearly adjoined. And though many who have died of Pleurisies, have been found to have their Lungs affected, it is not to be concluded that it is so in all; for the most vehement Pleurisies which use to cause-Death, do many times turn into a Peripneumonia. But many do witness, and we have found by experience, That in many bodies dead of Pleurisies, the Pleura only hath been found putrified. It may be questioned, Why the Pleura, rather than other Membranes, should be inflamed? But the Answer is from Hypocrates, 1. de morb. text. 124. according to the Division of Salius, where he saith, That the side is a very weak part, because it is naked from flesh in respect of other parts, and hath nothing to rest upon; therefore when the humours are moved and inflamed, their Defluxion is easily sent thither. The matter Causing a Pleurisy is for the most part Choleric Blood which doth easily penetrate a thick Membrane; As Avicen speaking of a Pleurisy, saith, Except the Humour be thin and Choleric it cannot pierce into the Membrane. Other Humours may also Cause this Disease so they have a serous Choleric Humour mixed with them for a Vehicle: I say other Humours not Excrementitious but Natural, which are contained in the form of blood, and are called either blood itself, or blood that is waterish, or melancholy. But you must note, that thin Humours make a true Pleurisy, and thick, a Bastard Pleurisy. Now this blood is carried by the Vessels which nourish the Breast, especially the Vena Axillaris, and Azygos; and if it offend either in quantity, quality, or motion, it is cast upon the Membrane and Muscles adjoining. The Difference of Pleurisies is taken from the part affected, and the Causes. In respect of the place of the pain, it is divided by Hipp. 2. acutor. into an ascending Pleurisy, namely, when the pain reacheth more to the Throat; and a descending Pleurisy, when it goeth down to the Hypochondria. Sometimes it is extended more towards the back, of which Hipp. 3. de morbis makes mention; and sometimes it comes more forward. In respect of the Cause and the Humour offending, it is called either Sanguineous, coming of blood, Choleric, Phlegmatic, or Melanchollick. There is also another excellent Difference made by Hypocrates, 1. acut. where a Pleurisy is divided into a dry and a moist Pleurisy. A dry one is that in which there is little or not spitting, not only in the beginning, but continuance of the Disease; of which there are divers Causes, as the Crudity of the matter, the thickness and sliminess thereof, the weakness of the faculty, the obstruction of the Bronchia, or the vehemency of pain. But a moist Pleurisy is that in which there is abundance of spittle, from the beginning of the disease. The Diagnosis or knowledge of this Disease, is by the signs, as saith Galen, 5. de loc. off. cap. 8. and elsewhere; who reckoneth Five. 1 A pricking pain of the side. 2 A continual sharp Fever. 3 Difficulty of breathing. 4 A hard pulse like a saw. 5 An often troublesome Cough. A pricking pain is chief in the Membranes, and comes from a Choleric matter, and this pain possessing the ●●de, stretcheth itself into the parts adjacent, one while to the Throat, another while to the Hypochondria, by the continuity of the Membrane, which covers the whole Cavity of the Breast. By this sign a Pleuritis is distinguished from a Peripneumonia, in which there is no pain, or very little of the side, except it be joined with a Pleurisy. A continual sharp Fever hath its original from a Fl●gmon or Sanguineous tumour in some part near the Breast, and therefore is symptomatical: although sometimes an essential Fever be joined with a Pleurisy; and gives it sometimes a being, for it often happeneth in the beginning of continual Fevers, that the blood boiling in the veins is expelled by Nature unto some part which is most fit to receive it; as the sides, and there it breeds an inflammation. The sign of this is, That the Fever first seizeth upon the Patient, and the second or third day after the pain is in the side. But when the Fever is symptomatical, than the pain in the side comes first, but the Fever a little after. Difficulty of breathing doth necessarily follow in this disease, because the parts inflamed cannot sufficiently distend themselves to draw in a great quantity of Air, which is requisite for the cooling of an inflamed heart. The Pulse is hard because the Membrane is affected, and stretched forth, which also distendeth the Arteries, and they therefore make that difference of pulse, called Serratilis, like a saw; for when you lay many fingers upon the Arteries of the Pulse, one part seems to be more lifted up than the other, so that it seems to represent a saw. A troublesome Cough follows a Pleurisy, because Nature doth continually strive to expel that which is troublesome from the part affected: as also some of the matter sweateth from thence into the Lungs, which moveth the expulsive faculty, whence the Cough cometh. There is also a spitting of blood as another sign, which is neither in all Pleurisies, nor at all times of the Disease; therefore it is not reckoned as a proper sign. They who say that the Lungs are always affected in a Pleurisy, do affirm that the blood is spit from the Lungs, and they deny that it can pass from the Membrane about the Ribs to the Lungs, because it is very thick; and also the Membrane about the Lungs is of the same Nature, and cannot therefore be pierced by that blood which is without the Vessels. But Galen doth clearly confute these, 5. de loc. off. cap. 3. where he first, shows that the matter contained in the Cavity of the Breast may be taken into the Lungs, and be sent upwards, by two clear Examples. The one is those who have received a wound in the Breast that pierceth into its Cavity; for if an injection of Honey and Wine be made into the wound, and it be presently closed at the orifice, in a little time the injection will be coughed up and spit forth, and the Patient will have the taste of it in his mouth. Another Example is taken from a Fracture of a bone, when the skin is not broken; which while the Callus is growing, and the broken bones begin to glutinate, that blood which flowed to the part affected is carried forth to the skin, and goeth through it, so that it moisteneth and fouleth all the rulers and ligatures about the part. Galen also shows the manner how blood, matter, or the like, being contained in the Cavity of the Breast may be taken through the lungs, namely, by the extreme outward orifices of the Bronchia or branches of the rough Artery, which are spread through the Lungs, and end in the superficies of them. Although the orifices of the Vein Arterial, and Artery Venal are also carried to the superficies of the Lungs, yet the orifices of the Bronchia are more large and open than they. For by how much greater the Body or Trunk of the rough Artery is, than the Trunk of the Venal Artery, or arterial Vein, by so much the greater are its branches than theirs; and its orifice than theirs; because all these Vessels are equally divided and distributed into the whole body of the Lungs. Moreover, the substance of the rough Artery, and its Bronchia or branches, are Cartilaginous or grisly, from whence it is that they cannot clo●e together so much as other Vessels; and their orifices are more constantly open, by which they can better receive the matter from the Cavity of the Breast. But Galen teacheth that the matter contained in the Breast is taken through at the time of breathing, when the Thorax is straightened; for then the Thorax doth press those things that are in the Cavity of it, and drive them into the Lungs, so that some part of them at least is carried into the orifice of the Bronchia. Neither is the softness of the Lungs, which yield to a compression, and therefore cannot be forced to receive the matter, any hindrance. For this softness is the cause why all the matter is not received; yet it is no obstacle but some part thereof may be received in, although the greatest remain in the Cavity by reaon of the softness aforesaid. Let us add to this Doctrine of Galen, the wonderful providence of Nature, which hath found out ways, not only manifest, but also unknown, and sometimes incomprehensible, by which she useth to expel things hurtful; as we said of the matter in Fractures, which is purged forth by the insensible pores of the Muscles, and of the Skin. A bastard pleurisy is distinguished from a true, in that the pain is increased when the Patient lieth on the contrary side, in a true Pleurisy; for then the part inflamed is pulled, and more distended by its own weight▪ but in the other, the Muscles external being inflamed, are compressed when the Patient lieth on the same side, and therefore he hath then greater pain. The times of this Disease, are known by these signs following: In the beginning of it, all the symptoms are weaker, the pain and fever small, there is a dry Cough, and very little and crude spittle: In the increase of the Disease, the fever and pain increase, and there is more spittle. In the state or height the symptoms are more vehement, want of rest, dotage, pain of the Head; and if the disease will be cured, there is much concocted spittle easily raised. In the declination, the spittle is perfectly concocted, a free spitting, and decay of all symptoms. The signs of the Causes, are generally taken from the temper of the Patient, the time of the year, the Country, the Diet, and the like. But especially the●e things show that a Pleurisy comes of pure blood, red and bloody spittle, a stretching and pricking pain, the fullness of the Veins, especially about the Forehead and Temples, redness of the whole face, a full Pulse, thick and red urine, sometimes with a blue crown. These signs show that it comes from Choleric blood, yellow spittle, a burning fever, great thirst, a hard and quick pulse, a more acute pricking pain, greater watch and restlessness, bitterness of the mouth, a thin and very yellow urine. These signs show that it comes from Phlegmatic blood, a white, viscous, or frothy spittle, sweet and slow in coming forth, a remiss fever, little thirst, much spittle, a le●s, but heavy pain, more sleep, a little pulse, and not so hard, pace and thick urine. These signs show that it comes of Melanchollick blood, black spittle, tough and slow in coming forth, a less pain and fever, a red urine and dark, a dry Cough, a black and rough tongue, a belly bound. The Prognostic is taken first from the remission or vehemency of the Symptoms. For if pain, difficulty of breathing, and a fever be not great, they signify that the disease is gentle; but if the pain be great, and the Cough, and there is nothing ra●●ed up, and if the fever be violent with great difficulty of breathing, you must took upon it as a desperate Pleurisy. A small pulse, quick, and hard, foreshow death in a Pleurisy. And Galen saith that none of this have been cured; Gal. 4. de praesag▪ ex pulls. cap. 5. An exquisite Pleurisy in which nothing is raised by Cough, or when with the spitting after it began, is restrained, having still the pain and weight in the side, is most dangerous. For it signifieth a very crude disease, which will either shortly kill, or be long in cure. If the spitting begin with the first, or within three days, it signifieth the disease will be short; but if it begin late it will be long. Hipp. Aph. 1. Sect. 5. Yellow Choler mixed with phlegm or a little blood, appearing in the beginning of the disease with much spittle, is a sign of recovery. Very bloody spittle is dangerous; for it signifieth a ruption, either of a Vein, or of the flesh; from whence we expect suppuration: For it is thought that little blood doth breath through. White, glutinating, and round spittle, is evil, for the clamminess comes from the fiery heat which burne●h the matter. Green and rustic spittle, is evil, but black worst of all: For it signifies the greatest adustion or extinction of the Natural heat. A plentiful spitting which doth not abate the pain and other symptoms, is evil: For it signifieth great plenty of matter. A Pleurisy in old men, women with child, and in them that are Asthmatical, or have twice or thrice had the same disease, is dangerous. Whosoever hath the disease in the side called Pleurisy, and are not cleansed of it in fourteen days, have an Empyema, or collection of matter; Aph. 8. Sect. 5. Others do extend it to the twentieth day. A Diarrhoea, or looseness coming upon a Pleurisy or Peripneumonia, is evil; Aph, 16. Sect. 6. which we must understand of a Pleurisy, in which there is so great an inflammation that the Liver and Stomach consent therewith, or when the strength is so gone by the disease that the retentive faculty is almost spent. But if the Pleurisy be not so great, and be in a body full of evil humours, the flux of the belly useth then to be healthful, especially if any signs of concoction went before. A Choleric and plentiful vomiting in the beginning of a Pleurisy signifieth health to come: For Nature being eased by that evacuation of Choler, doth more easily overcome the disease. If a Peripneumonia comes from a Pleurisy, 'tis evil; Aph. 11. Sect. 7. For it is the translation of the matter to a more noble part. If the pain in the Pleurisy, and the Choleric spitting, go away without reason, the Patient falls mad. Hipp. 3. Prorrhet. For the Choler is carried into the Head, and then the urine looks thin and white. A Pleurisy which followeth an old disease, or is in a body of evil habit, is dangerous. Thick bodies used to exercise, do soon die of Pleurisies and Peripneumonia's, as Hipp. in Coac. And Experience teacheth us that almost all the Diggers taken with Pleurisies, do die thereof: Because such strong bodies fall not sick, but upon some great cause, and by reason of their thickness they cannot easily sweat, so that the disease cannot breathe forth. They who in a Pleurisy have much noise in their Breast from the spittle, and their countenance dejected, with yellowness in their Eyes, and mists; in these death is to be expected, Hipp. in Coac. They who in Pleurisies have Choleric tongues at the first, are judged in seven days; but they who have not much Choler upon their tongue till the third or fourth day, are judged about the ninth day. For the Cure of a pleurisy, first the humour causing it is to be reveled, derived, and discussed, and if it cannot wholly be discussed, it must be digested, maturated, and expectorated; as also the Fever which is commonly essential to a Pleurisy, and not always symptomatical, is to be cured by proper Medicines. All which may be done by the following Remedies. And first you must (after a Clyster, if the disease be not very violent) open the Basilica on the same ●●de; but if it be violent, give the Clyster afterwards. You must bleed every day till the pain or fever grow less; nay, sometimes twice in a day, if the pleurisy be very violent. Hypocrates in his 2. lib. deratione victus in acutis, Text. 10. gave an excellent rule to posterity most profitable in practice, That blood be let till the colour of it change: For if at the first or second time, ●t appear crude, flegmy, or watery, it is to be continued every day, sometimes twice a day till it appear red or yellowish. But if it appear red in the beginning, you must bleed so often till it become livid or black, for that will signify, that the last blood came from the part affected, or the neighbour Veins, which is altered by the part inflamed, and of crude is made red, or of red, black or blue by adustion. Although the observation of that Rule bring commonly good success, yet sometimes you must not expect that change of colour, but desist from bleeding; namely, when the strength is little, or the Patient is of a thin habit of body easily dissolved, or the weather very hot. And although blood-letting is excellent in the beginning of the Disease, yet if it be omitted, or done insufficiently, you may open a Vein after the seventh, ninth, or eleventh day, according to the Example of Hypocrates, who in 3. Epidem. opened a vein for Anaxion in the eighth day, either because he was not sent for sooner, or because that it was a most crude Pleurisy, which will scarce concoct till the eleventh day. But when he expectorateth freely, than you must abstain from Phlebotomy, which will stop his spitting, and bring him in danger of his life. But blood-letting is so necessary in the beginning of this Disease, that it must never be omitted, neither in old nor young, nor women with child, in childbed, or having their terms; unto all which Experience hath taught us that Phlebotomy is good in this Disease. Yet you must observe some Rules in bleeding of women in Childbed, or having their Terms, which you may find hereafter in the Fifteenth Book, and the last Chapter, concerning the Cure of acute Diseases in women that lie inn. From the beginning of the disease twice or thrice in a day, you must give cooling Juleps, which restrain the heat and boiling of the humour, and stop the defluxion; thus made: Take of Poppy Water four ounces: Syrup of Violets, or Poppies, one ounce: Sal prunella one dram. Make a Julep. After the first Phlebotomy let the side be anointed with this Lineament, covering the part with greasy wool sewed into a linen cloth. Take of Oil of Lilies, Chamomel, and sweet Almonds, of each one ounce: fresh Butter, and Hen's grease, of each one ounce and an half. Make a Lineament. Many put Wax to these Liniments, which is not good, because it stoppeth the pores; but the mucilaginous bodies do not, because they cool and astringe. In a malignant pestilential Pleurisy, you may add to your Liniments, Oil of Scorpions of Mathiolus, or a little Treacle. After the second bleeding, you must apply this Fomentation, made thus: Take of Althaea roots, and Lilies, of each two ounces: the Leaves of Mallows, Violets, and Pellitory, of each one handful: Line and Fenugreek seeds, of each one dram: the flowers of Chamomel, Melilot, Elder, and Violets, of each one pugil: Boyl them together, with which foment the side that is pained in a Hog's bladder. After Fomentation apply the Lineament aforesaid, to which in the progress of the Disease, you may add more dissolving Oils; as of Dill and Flowerdeluce; as also the powder of Flowerdeluce and Saffron. And to the Fomentation ad discussing Herbs, as Origan, Calaminth, Hyssop, and the discussing seeds. Many other Topics are very profitable against Pleurisies, which Authors relate; as these: First, anoint the part with Ointment of Marsh-mallows, then lay on the powder of Cummin seed, or a Colewort Leaf heat at the fire, and anointed with the same. Faventinus mixeth the Ointment of Althaea with Oil of sweet Almonds, and after he hath anointed, sprinkles on the powder of Cummin seeds, and layeth on a Colewort Leaf; and this he commends highly. Also the Cataplasm following is very profitable. Take the Residency or Ingredients of the Decoction above mentioned for a Fomentation; beat them in a stone Morter, adding of the Oil of sweet Almonds, Lilies, and Chamomel, of each two ounces: Hens grease one ounce: Barley and Bean flower, of each as much as is sufficient to make a Cataplasm. Also a live Hen slit through the back, and sprinkled with the powder of Flowerdeluce roots, being applied doth very well. The Paunch of a Sheep laid hot to the part is a very good Anodine: but the Lungs are better. The Chemical Oil of Wax being mixed with the Liniments, assuageth pain, and powerfully discusseth the matter. Hot Bread from the Oven, dipped in fresh Butter, and applied, doth very much dissolve the matter fixed to the side. After he hath taken twice or thrice of the Julep aforesaid, you may use Pectoral Juleps thus made: Take of Barley one pugil: Liquoris and Raisins stoned, of each one ounce: Jujubes twenty: the four great cold Seeds, of each three drams: Bugloss and Violet flowers, of each one pugil: boil them to a pint and a quarter. Dissolve in the straining, Syrup of Violets and Jujubes, of each two ounces. Make a Julep for four doses to be taken morning and evening. Or if the Fever be very sharp, and much watching, you may make the Emulsions following: Take of Almonds blanched, and steeped in cold Water, one ounce: the four great cold seeds, of each half an ounce: Lettuce and white Poppy seeds, of each two drams: beat them in a marb●● mortar, pouring on by degrees, the Decoction of Barley and Liquoris one pint and an half: strain it and dissolve in it Syrup of Violets three ounces. Make an Emulsion for three doses to be taken morning and evening. Some Practitioners in want of sleep give Narcoticks; as Syrup of Poppies, Philonium Romanum, and Laudanum, which are dangerous in this disease: for they stop spitting, and astringe and strengthen the Breast. From whente often times comes sudden death. But this must be understood of the whole dose of Narcoticks: for given in a very small quantity they do good in vehement pain, a thin defluxion which causeth a Cough, and in want of sleep. In which cases I have often given one grain of Laudanum with good success, and sometimes often. But the use of this is most proper in the beginning of the disease; for then the humour flowing to the part may be restrained, and the increase of the Disease hindered. When the Cough is violent, and Nature gins to evacuate by spirting, let the Patient hold often in his mouth Sugar of Roses, Sugar candy or Penides, or the Tablets of Diatragacanth frigid, Syrup of Violets and Jujubes. Or this Eclegma following: Take of Sugar candy, and Penides, of each one ounce: the powder of Diatragacanth frigid two drams: Syrup of Violets and Jujubes, of each as much as will make a Lohoch; which let him take often with a Liquoris stick, or make it of Butter, Honey, and Sugar, of each equal parts: the Oil of Linseed, or of sweet Almonds, being fresh drawn without fire, mixed with Sugar, doth much help the Cough and pain in the Pleurisy, especially if it be drunk in Broth, or any other Decoction. If the spittle be thick, you must mix some attenuating and cutting Medicines, as Syrup of Coksfoot, Liquoris, Oxymel simple, powder of Diaireos, and the like. You must take these lying with the face upwards, for so they better go to the Lungs. As the Disease increaseth, you may use this restoring Medicine to strengthen. Take of Conserve of Violets one ounce: Conserve of borage flowers, and Bugloss roots, of each half an ounce: Confection of Alkermes two drams: powder of Diamargariton frigid, and Diatragacanth frigid, of each one dram: Sugar of Roses as much as all the rest. Make a Composition covered with Gold to be taken often with a spoon. Purging is improper in a true Pleurisy, except it be in the declination; and than you may appoint this: Take of Senna half an ounce: Annis seeds one dram: Bugloss and Maidenhair, of each half a handful: Liquoris and Raisins stoned, of each three drams: the flowers of Bugloss and Violets, of each one Pugil. Boyl them to two ounces: in the straining, dissolve of Rhubarb infused in Scabious Water with a little yellow , four scruples: the best Manna, and Syrup of Roses, of each one ounce. Make of these a Potion. In the whole time of the disease, let him take Barley Water for his ordinary drink, made with Liquoris, Poppies, and Maidenhair; and let not his drink be actually cold, for it would hurt the Breast. Wine in this Disease is Poison, and also all sharp things which provoke Coughing, and by their astringency hinder spitting. In the declination of the Disease, after purging, and when the Fever is less, if the pain continue, you may apply to the part, Cupping-glasses with Scarification two days together. They may also be applied before the declination, after often bleeding: And if the pain still increase, and return, you may again let blood, and after Cup with Scarification. Zacutus Lusitanus having taken off the Cupping-glasses, applied six Horsleeches with good success, as he witnessed, observ. 104. lib. 1. Praxis admirandae. For the same purpose to discuss the relics of the matter, having first tried Fomentations and Liniments, you may apply with benefit, the Emplaster of Brimstone, and Bay-berries. Besides vulgar Medicines, there are some proper and specifical, namely the shave of a Boars Tusk, the ashes of the Pizzle of a Bull or Deer, the flowers of red Poppies, or Coral prepared. Quercetan in his Dispensatory commends an Apple made hollow, and one dram of Frankincense put therein and roasted, which the Patient must eat, and drink three ounces of Carduus Water after, then cover himself warm, and sweat. He will have this Medicine used after the third day, and affirmeth that many have been restored therewith. The flowers of Box-tree do so much purge the Blood, that if a dram of them in powder be given with Poppy Water, and a Vein opened an hour after, the blood will continue pure. Hors-dung dissolved in Carduus Water, and strained, doth powerfully disperse the pain, and the humour in the Pleurisy. White Hen-dung given in a dram of the same Water, doth as much. These Dungs have much Volotile Salt, which is very piercing and discussing. You may make a Potion of them both thus: Take of Hemp seed one ounce: bruise them, then put to them, of the white Dung of a Hen, and of Horse Dung, of each half an ounce: dissolve them in five ounces of Carduus Water; strain them, and drink it. The Blood of a wild Goat given to ten drops with the aforesaid Water, doth powerfully discuss the Pleurisy: In the want thereof, you may give the blood of a tame Goat. But because the strength of him is little, you may give thereof to the quantity of one dram. You must prepare it thus: Hang up the Goat by the Horns, and bend his hinder Legs backward to his Horns, then cut out his Stones, and take the Blood in a broad Vessel; dry it in the Sun in Summer, or at other times upon an Oven. It is far different from the Goat's Blood in the Shops. The Soot of a Chimney given to a dram is very good, but much rather the spirit of Soot, described by Hartman in his Practice of Physic. In an Epidemical Pleurisy, Sudoroficks are to be given, such as are prescribed in malignant Fevers, which also ought to be made as proper for this Disease as may be. A Diarrhoea coming upon a Pleurisy is dangerous: therefore you must give Syrup of Myrtles, which doth stay the Diarrhoea, and also expectorate: and this is to be mixed with other Syrups. Let me Belly and Reins be anointed with astringents, as useth to be done in all Diarrhoea's. Give Clysters made of Barley Water, which, as Galen saith, doth cool and astringe if it be boiled with red Roses, and also Yolks of Eggs be dissolved in it. Chap. 3. Of Peripneumonia, or Inflammation of the Lungs. PEripneumonia hath the same essence with a Pleurisy, and is distinguished only by the part affected, because that is the inflammation of the Lungs, and this of the Membrane that compasseth the Ribs. They differ somewhat in the matter, for a Pleurisy comes often of Choler, but a Peripneumonia of Phlegm; although all humours (as we said of a Pleurisy) may produce this disease, I mean humours which are like blood, and make up the mass of it. For as thick humours do hardly penetrate the thick Membrane called Pleura, but thin and Choleric easily; so on the other side, thick phlegmatic humours do easily go to the soft and thin substance of the Lungs, and stick close thereto; but thin and Choleric humours do easily pass by. But this hindereth not, but the Choleric blood may sometimes cause the Inflammation of the Lungs, as Hypocrates 1. de morbis, describeth the Erysipelas, or Choleric tumour of the Lungs, which comes from Choleric blood thrown into the Lungs from the right Ventricle of the Heart by the Arterial Vein. But an oedematous Inflammation comes from phlegmatic blood falling upon the Lungs by way of defluxion from the Head. But only excrementitious phlegm, falling as a Catarrh from the Brain, can make a Peripneumonia, because it putrefieth in the Lungs, and attracteth blood, by the mixture whereof there is an Inflammation, and this often happeneth in old folk. Mesue saith that this Peripneumonia comes rather of Choler, because the Lungs are nourished with Choleric blood which cometh in great plenty to them by the Arterial Vein. To whom we answer, that fresh, thin, and steaming blood made in the right Ventricle of the Heart is carried into the Lungs, which by reason of its purity, is easily governed by Nature, and is sent by the Venal Artery to the left Ventricle of the Heart, and it seldom is altered from its Natural condition, which useth to make a Peripneumonia. But contrarily, a defluxion from the Head cutting through the large passages into the Bronchia of the Lungs, if it there putrify, will draw blood unto it, and make a Peripneumonia. This Peripneumonia is sometimes alone without another disease, sometimes it followeth other diseases, as Squinzy or Pleurisy. Galen in Com. 11. Sect. 7. Aphor. teacheth that a Peripneumonia doth follow a Pleurisy two ways: Either when a Pleurisy is turned into a Peripneumonia, or when an inflammation of the Lungs followeth a Pleurisy. This transmutation is when the former disease ceaseth, and the other comes; but it comes upon it when it is white, the former remaineth. Therefore the immediate internal cause of a Peripneumonia is blood, often phlegmatic, seldom choleric, and most seldom melanchollick, Which either comes from the whole body being plethoric, or cachochymical, that is, full, or of evil habit; or from some part which is replete or distempered. The External Causes of Peripneumonia and Pleurisy are the same; namely whatsoever defluxion can come to those parts: the chief whereof are: First great exercise and violent motion of the Body, especially after long rest, and high feeding. For then the humours abounding from high diet, and kept in by long rest, by exercise are dispersed, attenuated, and heated, and are after sent to the weaker parts, most fit to receive them, among which the Breast and Lungs are chief, because by strong exercise, there is caused great and often breathing, and so they become wearied, and the substance of the Lungs being soft and lose can easily receive the humours coming to them. Secondly, Among the external Causes the cold and Northernly Air is reckoned, when it comes suddenly after a Southern and warm; for the pores are opened by warm Air, and the humours are more fluid, which by the cold Air coming after, are compressed, and the humours sent to the weak parts. Lastly, From Hipp. lib. of Air, Places, and Waters, the drinking of standing Pools and Lakes, begets the Peripneumonia; for saith the Divine old man, we observe diseases of the Lungs to be most in Marshy Countries. Also the Signs of a Peripnumonia do agree with the signs of a Pleurisy. Two are the same, as a sharp Fever, and a Cough; which sometimes is dry, sometimes moist, or with more Phlegmatic spittle coloured with Choler or Blood; and in the progress of time, the spittle becomes Mattery when the matter of the Disease grows ripe, and concocted by heat, which sometimes comes to pass when the substance of the Lungs is not hurt; for if they ulcerate, a Consumption will sollow. So we may observe, That in sore Eyes that are Mattery, the humours are converted into Matter when the substance of the Eye is neither suppurated, nor ulcerated. The other signs differ in respect of the part affected; the difficulty of Breathing is greater than in a Pleurisy by reason of the narrowness of the part inflamed, so that the Patient seems to be choked and cannot breathe but with the head upright: For the part cannot be compressed by reason of the extension and repletion, nor be more dilated, although it be much dilated, yet it takes in but little Air, therefore the respiration is quick and often, with snorting: This is augmented by a Fever by which the breath is hotter, and the desire of cold air is greater. The Pulse is great, faint, and soft by reason of Phlegm and the looseness of the Lungs: yet there is some hardness by the Choler and blood: it is unequal from the compression of the Artery near the Heart, and in thick Humours most: Sometimes it is intermitting, watery, vermicular, when the Lungs are rotten by too much moisture. There is a heavy pain that reacheth from the Breast to the Back, sometimes it is between the Shoulders, and sometimes under one only Shoulder, and from thence communicated to the Throat and Pap: Especially in a Cough, sometimes they feel no pain till they begin to Cough: sometimes there is also a pricking pain in the side when it is joined with a Pleurisy as it often happeneth: Although the Membrane that covers the Lungs be of the same nature with the Pleura, as Galen taught 4. de loc. affect. cap. 5. Yet there is not so great pain in a Peripneumonia as in a Pleurisy, for two Differences which are laid down by Galen in the place . The First is, Because the Nerves that go to the Membrane of the Lungs, are few and very little; but they which go to the Pleura, are many and great. Th' Other is, Because the Breast consists of Bones and Flesh, which will not be stretched, from whence the pain is greater. But the Lungs are soft and yielding, and therefore their pain is less. There is Redness in the Cheeks, by reason of the hot vapours which fly into the head and carrying with them the thinner blood. And this Colour is most in the Cheeks, because their skin is thinnest. There are besides these signs, Heaviness, Weakness, and a Tossing, with great sense of Heat in the whole Body. The Tongue is Yellow, and then it groweth Red; a great thirst, swelling of the Eyes, and of the veins of the Temples. There is a Delirium, or Doting, when it comes from Choler; and a Coma, when it comes from Phlegm. If the Disease comes of Choleric blood, the spittle will be yellow, the heat and thirst greater, more difficulty of breathing with less Heaviness; the air breathed forth is more hot: the Fever is very violent, the Pulse swift, the Delirium great, the Water thin, yellow and clear, the age, time of the year, the Country, and Diet before, do all attest for Choler. If Phlegm (which is most ordinary) produce the Disease, the spittle will be white, viscous, and frothy; the Fever, burning of the Breast, thirst, and dryness of the tongue, will be less: the weight of the Brea●● greater; the Pulse slower, and softer; the Age, old; Habit of body, time of the Year, and the Country, are cold and moist. If the Disease come from pure Blood, the Spittle will be Red; the Urinal Red and Thick; the Face more Red; the Veins of the Temples more swollen; with heaviness and distension of the whole body; and other things that declare abundance of blood. Lastly, If Melancholy blood be the Cause, the Spittle will be black or bluish; the Tongue black, from the beginning dry and rough; there will be also heaviness and great sighing between breathing; and all the signs of Melancholy predominating in the whole body. The Prognostic of this Disease is thus to be made. A Peripneumonia is more dangerous than a Pleurisy; and for the most part deadly by reason of the necessity of respiration, and the nearness of the Heart. Celsus saith, That this kind of Disease hath more Danger than Pain; and for the most part Killeth. But strength of Body, less vehemency of Symptoms, yellow Spittle, not mixed with much Blood, raised in the beginning; a great flux of blood at the Nose in the Critical day; or a flux of the Belly which is Choleric and frothy; or a flux of the Hemorrhoids or Terms, do show some hope of recovery. Imposthumes about the Ears, or inferior parts, being well suppurated and kept open, do foretell recovery, as Hipp. in proga. If a Peripneumonia be turned into a Pleurisy, it is good, and though it seldom happen, as Galen teacheth, Comment. Aphor. 11. Sect. 7. because there is a going from a Disease more dangerous, to one less dangerous. And this transmutation is known by a pricking pain of the side coming thereupon, and by abating the shortness of breath. But the vehemency of the Disease and symptoms do declare a dangerous and deadly Peripneumonia, as want of spittle, continual watching, a Delirium or Coma, coldness of the extreme parts, snorting with great difficulty of breathing, blewness and crookedness of the nails. Moreover, A Peripneumoma coming upon a Pleurisy is most dangerous, as Hypocrates teacheth, Aph. 11. Sect. 7. because the translation of a humour from an ignoble part, to a more noble, is evil; and the strength being spent by the disease foregoing, can endure the force of a new, and wor●e. When the urine is thick in the beginning of the Disease, and after before the fourth day it becomes thin, death is at hand. Hipp. in Coacis. The Cure of the Peripneumonia is very like that of the Pleurisy, and there must be first bleeding as much as the strength will permit, once or twice in a day till the disease abate: for since the Lungs are then full of blood, and draw much from the heart, which is inflamed, you need not fear to let blood thrice, four, five, or six times. But if a Peripneumonia follow a Squinzy, or Pleurisy, you may let blood more warily because the strength is abated by the former Disease. You must let blood from the Basilica Vein of both arms, if the whole Lungs be equally affected, or from either, on that side the pain is, or on which the Patient sets more weight, or from which he supposeth he raiseth most spittle. You must bleed women in this disease, first in the Ankle Vein, and after within six hours in the Arm; except it be so desperate that you are constrained at the first to bleed in the Arm. In which case, all the time you bleed, and a little before, you must apply Cupping-glasses to the Thighs. But after, if the strength will not permit further phlebotomy, you must apply Cupping-glasses to the Shoulders and ●ack, both dry, and with Scarification, as much as the Patient can suffer. Also Emollient and loosening Clysters are good revulsives; but you must not use too strong purging Medicines therein, lest you bring a flux of the Belly, which is most dangerous in this Disease. If a crude phlegmatic humour coming from the head cause this disease, or nourish it, a Vesicatory laid to the hinder part of the Head, doth very much good. In the mean while use the Juleps and Emulsons prescribed in the Cure of a Pleurisy. Anoint the breast with Oil of Violets, sweet Almonds, or with fresh Butter, or the like, or with this Lineament: Take of Oil of Violets, and Water Lilies, of each one ounce and an half; fresh Butter and Mucilage of Fleabane seeds, of each one ounce: Oil of Roses half an ounce: the Troches of Camphire one dram. Make a Lineament. Or, Take of Oil of Violets three ounces: the Oil of Pompey seeds, and Breast-milk, of each one ounce: fresh Butter one ounce and an half: Mix them and make a Lineament. You may provoke spitting with Syrup of Violets and Ju●ubes, and the rest, prescribed in the Cure of a Pleurine. As the Lohoches and Compositions there mentioned, given with this Caution, In a thin matter give things that thicken, and in a thick matter give things that attenuate. Let his ordinary drink be Barley Water, with Liquoris, as in a Pleurisy. Purging is not good in this Disease, except in the declining of it, and you must make choice of such things then, as were prescribed in the Cure of a Pleurisy. Chap. 4. Of Empyema, or matter in the hollow of the Thorax. ALthough the word Empyema signify all Suppuration, yet Custom hath prevailed so that it is taken only for a Collection of matter in the Cavity of the Thorax. Now there is a Cause of the gathering of matter between the Lungs and the Thorax. The first is an Inflammation suppurated, which happens in a Pleurisy or Peripneumonia; and when the Imposthume is broken, the matter falls into the Cavity of the breast. The same may be in a Squinzy, as Hypocrates teacheth, Aph. 10. Sect. 5. in these words: Whosoever is freed from an Angina, they have a Disease in the Lungs, and die within seven days; but if they live longer, it comes to suppuration. The second is blood falling into the Thorax, where by continuance it must needs come to Suppuration. So Hypocrates, Aph. 20. Sect. 6. If blood be sent into the Belly besides Nature, necessarily it is suppurated. But this suppuration is not always true, and properly so called, a● Hypocrates teacheth, but rather to be called a corruption, of which there is matter like quittor produced. This Blood may come from a Vein wounded. The third Cause is phlegm falling from the Head & other parts into the Breast, and there putrifying. So Hypocrates, Aph. 38. Sect. 7. The distillations into the upper Belly are suppurated in twenty dales. Galen in his Commentaries, by the upper Belly understands the Breast. But the phlegm there putrifying doth not beget a true Pus, or matter, but something like it; as we observe in phlegmatic Tumours, as Atheroma, Steatoma, Meliceris, which are kinds of Imposthumes. The Diagnostic signs are of two sorts: Some declare the disease to be in the beginning; others that its old, and confirmed. Hypocrates layeth down Three signs of this Suppuration, beginning 2. Progn. The first is when the Fever groweth stronger, because the Pleurisy, or Peripneumonia is not purged, for while the matter is turning into Pu● the fever is increased, Hipp. Aph. 47. Sect. 1. The Second is a quaking, which comes when the sharpness of the matter doth twitch the Membranous parts. The Third is weight, and sense of heaviness in the part; for the humour being contained in the Gavity doth weigh heavier than when it is diffused. Galen addeth in 4. de loc. asf. cap. 9 fluctuation or routing: For (saith he) if any one is forced to turn in his bed, and perceive something to slow down at that time, it is no doubt but that there is much matter contained there. And you may often hear the fluctuation, unless the thickness or plenty of the matter, which fills the whole Cavity of the Thorax, do hinder the sluctuation. To these you may add dissiculty of Breathing. For although after the Imposthume is broken, the pain of the side ceaseth, and the Diaphragma and Muscles of the Thorax move more freely; yet because the Lungs are oppressed with matter round about them, so that they cannot move freely, and some part of the matter is sucked into the substance of the Lungs, from whence it is that the Lungs are so heavy, and the Bronchia is obstructed, thence is short breathing. For the purulent spittle comes from the filth sent into the Lungs and Bronchia, which shows an Empyema; but this is not always a spitting of matter by reason of its thickness, which keeps it from coming to the Bronchia. But a long linger Fever, partly putrid, partly Hectical, milder in the day, and sharper at night, much sweat, especially at night, a constant troublesome Cough, signify that the Disease is old and confirmed; as also when the Cheeks grow red, and the Eyes hollow, the Nails crooked, the Legs swell, and Pustuls break forth of the Breast by reason that the sharpest part of the matter breaks out of the Skin; these signify the Disease confirmed. You may know which side is affected from Hypocrates, 2. Progn. text. 21: If (saith he) an Empyema be only in one part, you must turn the Patient, and learn whether he be pamed, or hotter in one side than the other, and to ask him if he perceives any burden to hang on the side that is upward, and if it be so, in which side soever the weight is, the suppuration is on the other; as if heat and weight be in both sides, the Pus is contained in the whole Cavity of the Breast. Also Avicen adds a Conjecture which he took from Hipp. 3. de morb. Apply (saith he) a linen cloth wet to both sides, and that will be dry soon which lieth upon the part where the matter is contained. We may lay down another sign from our own Experience, which was not observed by Authers, namely, In the side affected there will he an Oedematory Tumour, from a Potion of the thinnest matter breathing through the Museles of the Thorax. And when, in suspicion thereof there appears such a Tumour, and blowing up of the skin on either side, you may certainly pronounce that the Empyema is there, and you may safely open the side. The chief Prognostic Signs are given by Hypocrates, 2. Progn. Text. 63. in these words: In Suppurations they chiefly escape, whom the fever left the same day they broke; and they who presently desire meat; and are freed from thirst, and have smell, and laudable excrements: and if the Pus be white and even, and of the same colour, and when it is voided without pain or great Coughing. But they die whom the fever leaveth not, or to whom seeming to leave them it returns again, and who are thirsty and have no appetite, have a lose Belly, the Pus green, and livid, or srothy. They die who have all these signs: But they who have but some of them, some die, and some lie long sick. To these we will adjoin these following Prognostics. They who have an Empyema, and by reason of the abundance of matter, lift up their whole Breast when they Breath, are quickly choked. Galen, 4. de Loc. Aff. Cap. 7. If an Empyema is not spit forth in forty days, it turns into a Consumption, which brings death. Hipp. Aph. 15. Sect. 5. A Suppuration on both sides of the Thorax, is more dangerous than in one; also that on the l●f● side is more dangerous than on the right: by reason of the left Ventricle of the heart, which is more greivously affected with the matter gathered on that side. Whosoever are Burnt or Cut for a Suppuration, if the Matter cometh forth pure and white, they escape: but if it be bloody, foul, and stinking, they die. Aphor. 44. Sect. 7. If the Matter flow plentifully by Stool and Urine, and the Patient continue strong, it is a sign o● Recovery, although this Evacuation is very seldom: yet is it spoken of by Galen, Aetius, and Paulus: As also the way declared by Galen through which it passeth, 3. de loc. affect. cap. 4. and come. in aphor. 30. sect. 3. In the first place he speaks thus, This question doth not a little disturb th● followers of Erasistratus, who think that there is nothing but spirits in the Arteries. But we find no difficulty in it, because we know that the smooth Artery in the Lungs, so much Pus as it received from an Imposthume broken, can carry the same into the left Ventricle of the heart, which after goe● to the Reins by the great Artery. In the last place, he saith, That the matter▪ contained in the Lung● doth first come to the Ventricles of the Heart, and then to the great Artery; or by the hollow Vei● to the outside of the Liver, from thence to the inside, and so to the Guts. From which you may easily see the way by which an Empyema may be purged by stool and urine. If the Patient grow better, and be almost cleansed, and then again raiseth stinking Spittle, he dieth of that which remaineth and returneth. Hipp. in Coac. For the Cure of this Disease: First, if you cannot hinder the Suppuration of the matter in the Thorax, you must further it by convenient Cataplasms. As, Take of Marsh-mallow Roots three ounces: fat Figs ten: Raisins stoned one ounce: Chamomel and Melilot flowers, of each one pugil. Boyl them all well, then beat them and strain them▪ then add the flower of Line, Foenugreek seed, and Wheat, of each one ounce: Oil of Lilies, sweet Almonds, and fresh Butter, and Turpentine, of each one ounce. Make a Cataplasm. Also to help Concoction, and maturation within, you may give this following Apozeme: Take of Marsh-mallow Roots, and of the greater Comphry, of each one ounce: Agrimony, Coltsfoot, Scabious, and Maidenhair, of each one handful: the four great cold seeds, of each one ounce▪ Annis seeds one dram: Liquoris and Raisins of the Sun stoned, of each one ounce: the three Cordial Flowers, and Chamomel, of each one pugil: Make a Decoction to one pint and an half; dissolve in the straining, Syrup of Colts-foot, Liquoris, and Sugar-candy, of each two ounces. Ma●● an Apozeme perfumed with the Powder of Flower deluce Root one dram; for five morning's draughts. This following Eclegma is good for the same purpose: Take of the pulp of fat Figs one ounce: fresh Butter two ounces: Oil of sweet Almonds newly drawn without fire, one ounce: Sugar candy two ounces: Starch two drams. Make a Lohoch. Venice Turpentine washed with Barley Water given to the quantity of three drams with the powder of Liquoris, doth much profit for Maturation, Discussion, and Cleansing. But if the Empyema will not be spit up (as sometimes it will not) you must come to opening of it, which you must do between the fourth and fifth Ribs, beginning to count from below, with many Cautions, which are elegantly set down by many Chirurgeons, especially by Hierom● Fabricius ab Aquapendente, in his Book of Manual Operations. But it is more profitable to open the Imposthume which comes from a Pleurisy before it break, and the Pus flow into the Cavity of the Breast, which is known by the Tumour which is against the place of Suppuration, and by other signs of an Empyema. And then you must not open it below, and between the fourth and fifth Rib, because if you make an orifice far from the imposthume, there will no matter come forth; but you must open it in the middle of the Tumour, first applying a Caustick. But if no Tumour appear, it is hard to open it before the Imposthume be broken. But if any will t●y, he must find out the place in which the Patient finds weight, pain, and heat. And it must be made between two Ribs upon the higher part of the Rib, because there is a Vein and Artery near the Inferior; which you must observe in the opening of every Empyema. While the matter is taken forth by degrees, let the Patient take a Wound Drink twice a day, which will purge the blood, cleanse the Ulcer, and hinder putrefaction: As Take of Sanicle, Bugle, Scabious, Bettony, St. John's wort, Carduus, Mousear, Burnet, Perewinkle, Agrimony, Plantain, of each one handful: the seeds of St. John's wort, and Carduus benedictus, of each half a dram: Cordial Flowers one pugil: Boyl them in Hydromel to a pint and an half. Take six ounces every time. With this same Decoction Injections may be made into the Cavity of the Breast. For his Drink, let him take Hydromel, or Barley Water, or Spring Water with Sugar. If after the Breast is opened the matter do not flow freely, you must draw it forth with the following Plaster, which doth powerfully draw from all Imposthumes. Take of Rozin of the Pinetree that is fresh, clear, and sweet, half a pound: Oil of Bays and turpentine, of each one ounce: Gum Elemi two ounces. First let the Rozin and the Gum be ●elted and mixed; then add the Turpentine and the Oils, and let them boil a little; then strain ●●em. Make a Plaster thereof for the part: change it once a day in Winter, and twice in Sum●er; cut it in two or three places that the matter may pass through. Chap. 5. Of the Dropsy in the Breast. THe Dropsy in the Breast is like to Empyema which comes from a serous humour contained in the Cavity of the Breast. The common Practitioners do not describe this Disease, although Hypocrates doth it excellently, 2. Lib. of Diseases called dropsies in the Lungs, thus: There is a Fever, and a Cough, quick breathing, the feet swell, the Nails are contracted, and they suffer as ●●ey do in an Empyema, but not so violently, and longer; and if you power any thing in, or apply a fomentation or fumigation the matter doth not follow; and by this you may know that it is not ●atter, but water that is within: and if you try a long time to discover it by your Ear laid to his ●●de, it boils inward like Vinegar; after that it goes into the belly, and then he seems to be recovered; But in progress of time, the belly is inflamed, and that endureth the same, or more: some swell in the ●elly, cod, and face. Thus Hypocrates. This Disease seldom happeneth, it is more often than it is discovered, for it is not ordinarily known. Many relations of it are given by Schenkius, by which it appears that he never see it till ●heir bodies who died of it were opened by him. Therefore we will describe it exactly that a Phy-●●tian may not be deceived. This serous humour, either may be bred in the Lungs, by the proper fault of them, as when it doth ●ot concoct its own nourishment, but turneth it into Water, which by degrees is sent to the Cavity ●f the Breast, or by bladders breaking upon the Lungs, which are mentioned by Hypocrates in his ●ook of Internal Diseases, and also by others. Or it is sent into the Breast from other parts, as from ●he Hypochondria especially, when the Liver or the Spleen are distempered with a Schirrus or other ●isease by which much water is produced. This watery humour, is either sent by the Veins to the ●ungs which are weak, or else from the Cavity of the Abdomen it is carried to the Breast by Insensible Transpiration. Now Experience teacheth that this serous humour may be sent from one Belly to ●nother, because the dropsy of the Breast turns into a dropsy of the Belly, and a dropsy of the bel●y into the Breast, from whence they are suddenly choked. The Diagnosis of this Disease (as hath been said) is very hard, for almost all the signs are the ●ame with the signs of other Diseases of the Breast. But a noise of Water in the breast, is only peculiar to this Disease, and to Empyema, which may be heard within if the body be moved to and fro, ●r be taken upon a strong man's shoulders and shaken. But all the Signs which we mentioned from Hypocrates taken together, may make a certain Diagnosis. To which you may add this one, as being most evident to show the Disease, and by which ●he Dropsy in the breast is only distinguished from other difficulties of breathing: namely, When ●t every first beginning to sleep this difficulty of breathing cometh and hindereth it, and by night increaseth, and towards morning by degrees abateth. To these you may add sometimes, a pain of one Arm or Shoulder, which comes either from the humour falling from the Head into the Breast, part whereof falls into the Arm, being near, or from the water contained in the breast, and sent to the Arms by the Axillary Veins of the Armholes; or from ●he Refrigeration of the Intercostal Muscles, from which the Nerves are derived to the Arms, or from ●ome other sympathy by way of vicinity: For Hypocrates in Coacis observed this Sympathy of the ●reast and arms, If those parts or lobes of the Lungs which hang towards the right and left side of ●he Chest, be vehemently inflamed, so that they sway or rest upon one side of the Chest or Ribs, the ●atery matter breaks out on the same side of the Body where the Lungs lean or rest. This is a great Disease, and hard to be cured, for they who have it have their Natural heat very ●eak, and their natural strength also, from some great disease in the bowels: from whence it comes that when the humour collected in the breast is evacuated by Medicines which is very difficult) there ●omes more in the place of it; from whence the disease is not only nourished, but increased; so that ●t length by abundance of water they fall into the Dropsy called Ascites; yet in the beginning be●ore the bowels are much hurt, it sometimes may be cured. For the Cure of this disease, you must observe two Indications; namely, That the matter contained in the breast be evacuated, and that the breeding thereof again be hindered. It is a hard thing to empty the water contained in the breast, because the ways are not open by which it should be brought forth. Therefore Hypocrates doth advise to open the side, which because ●e never see practised, and never read in any Author that it was done with good success, we cannot absolutely approve; and we may speak of it as we have of the Opening or Tapping for the Dropsy, in its proper Chapter. Therefore it is better to attempt this Evacuation with Medicines that expel Water, for which purpose all those Medicines prescribed by us in the Cure of the Dropsy, are good. Where we must observe diligently, That if when the Disease is confirmed, and much serous humour is gathered in the Breast, you give a violent Purge, those humours will be much moved, from whence there will come a great Suffocation which will kill the Patient: therefore be wary, and give your Medicine in a less Dose, though oftener, and mix them with strong Openers that purge Urinal, that both the passages may be unstopped, and the Matter carried to the Uritories. Among Water Purges the Minerals are best, as Mercurius Dulcis, and Mercurius Vitae so corrected that it may work only downward. Also Diuretics alone, or Medicines to provoke Urinal often used are good, because they turn away the matter coming to the breast, to the bladder, and by way of Consequence they bring it also from the breast. Also Sudorificks are profitable, to the carrying away of this serous matter; and we saw a man of sixty years old, who by the use of a Sweeting drink made of Guaiacum and Sarsa taken fifteen days together, and by provoking sweat with the vapour of the Spirit of Wine, was Cured. Cauteries applied to make Issues in the Thighs and Legs, are also good to take Water from the breast. You may hinder the breeding of this Water, by amending the faults of those parts which send this Matter. So if the Lungs be in fault you must apply proper Medicines unto them: if the Liver or Spleen be troubled with Distemper, Obstruction, Schirrus, or the like, you must cure them by Medicines taken out of their several Chapters. But those things which do strengthen the Vital and the Natural parts will always agree, such as are prescribed in the Cure of Weakness, Dropsy and Flux of the Liver. Chap. 6. Of Haemoptysis, or Spitting of Blood. ALthough usually the word Haemoptysis doth signify all manner of Spitting of blood from what part soever it doth proceed whether from the Breast, Lungs, Rough Artery, or from the Jaws, Gums, , Uuula, Brain, Stomach, Liver, and Spleen. Yet Galen, lib. 1. decris. cap. 5. saith, That Haemoptysis properly is taken for that spitting of blood which comes from the Vital parts, as the Breast, Lungs, and rough Artery. It is a Symptom in the excretion of those things which are wholly besides Nature. But since every Symptom depends upon a Disease as its next and immediate Cause: the Cause of this will be either an Organical, or a Common Disease: The Organical is Twofold; the opening of the Vessels called in Greek Anastoriosis; and Rarifaction called Diapedeses. Also the Common Disease is Twofold, namely the breaking of the same Vessels called Rexis, and the Corrosion of them called Diabrosis. The Internal Cause immediately producing the Diseases is a great quantity of blood. Blood exceeding in quantity will either break the Veins or open their Orifices, and so make either a Rexis, or Anastomosis. The same blood offending in quality, as when it is too hot or too thin, it will come forth by way of Anastomosis; but because heat will open the Orifices, and the thinness causeth it to flow more easily: Also the same qualities make a Diapedeses or Rarifaction: for heat doth make thin the Tunicles of the Vessels, and the thinness of the blood causeth it to flow more easily through the pores of those Tunicles. Lastly, The sharpness of the blood doth gnaw the Tunicles of the Veins and exulcerate them, & so cause a Diabrosis, or Erosion; this also is caused by sharp or salted humours which distil from the head, or coming from other parts to the Lungs. Moreover, The External Causes do concur for the production of this Disease either mediately or immediately: It is produced immediately by a stroke, fall, wound, or the like; but they produce it mediately which increase blood, heat and attenuate; as high and hot feeding, stoppage of Terms or Haemorrhoids, too much exercise, great clamour, heat, long staying in the sun, and many others. Moreover, External Cold may cause the Ruption of the Vessels, by making their Tunicles harder and not so easily to be extended; but with this must be joined strong Motion, or abundance of Humours. The Diagnosis of this Disease is difficult in respect of the part from whence it comes: yet Galen declareth it in few words; 4. de loc. affect. cap. 6. namely, blood coming from the Gullet and Stomach is put forth by vomit; when it comes from the Vital parts, by Cough: from the Jaws and Weazand, by Hawking: from the Mouth by simple spitting, which wants a more clear explication when blood comes from the head to the inner parts of the Weazand and the Jaws, it comes forth by Coughing, and so it doth when it comes from the breast; and therefore it is not distinguished by this sign. Moreover, When blood coming from the Lungs or Breast is brought out by Coughing: There are other necessary signs from which the parts affected may be distinguished. First therefore when blood comes from the head, although it sometimes cause Coughing; yet the greatest part thereof is put forth by Hawking, and there is a tickling in the as in a Catarrh: as also when you look into the it appeareth to be foul, and bloody; and it is more confirmed to be from the Head if at that time the Nose bleed. When the blood comes from the Lungs, it is distinguished from that which comes from the Breast by Galen in the place mentioned; for that which comes from the Lungs is frothy, in greater plenty, and without pain: but from the Breast, it is black, little, and with pain. But it may be objected, That blood coming from the breast is carried by the Lungs, and by consequence is frothy, because it is mixed with the air taken in, as that which comes immediately from the Lungs. And Avicen saith, That blood from the breast is frothy: I Answer, That it is one thing to spit some froth mixed with the blood; and another thing to spit nothing but froth, which only comes from the substance of the Lungs. Therefore you may observe▪ Three degrees of froth: for it is either wholly frothy from the flesh of the Lungs, which it resembleth, for the Lungs are but a congealed froth; or it comes from the Vessels of the Lungs and is very frothy: or it is mixed with froth and comes from the breast. But the most certain sign that it comes from the Lungs is taken from the pain, which is fixed and continueth where the solution of continuity is. And you must observe, That blood is sometimes sent from the Liver, Spleen, Matrix, and other parts into the Lungs and spit forth: so that the Breast is not primarily, but secondarily affected; which thing is hardly to be discovered. But we may conjecture of it, namely if any of the aforesaid parts be troubled with pain, inflammation, or any other distemper, and there neither is, nor hath been, any other fault in the breast. You may find out the signs of the Causes from what hath been said: For if blood be brought by the Anastomosis of the Veins, there went before some Cause that opened the mouth of the Vessels, than blood is thrown forth in a pretty quantity and without pain. But if it come forth by Diapedeses or Rarefaction, then is it waterish, little, and without pain. When it breaks forth by Rixis, or Eruption, it is very much; if a Repletion went before, or any External Cause that might break the Vessels. Lastly, If it comes by Diabrosis, or Corrosion of the Vein, there went before salt and sharp diffillations from the head: The blood is salt, and sharp, and ill coloured; and some Causes of sharp humours were formerly: in the beginning there is but little blood, but after when the Corrosion is greater, than is much blood spit forth, and at last there is a spitting of Matter. Hypocrates, Aphor. 25. Sect. 4. doth lay down the Prognostic of this Disease, as what kind of blood soever is spit out of the mouth from any part below, it is evil: for every opening of a vessel which letteth blood come forth so, is dangerous; especially in the Lungs; concerning which his Aphorism chief speaks. But sometimes such spitting of blood may be without hurt; namely, When Nature by a critical Motion doth purge the superfluous blood by those ways. And it is observed, That Women which have had their Terms stopped have without harm at certain times spit blood from their Lungs by the Anastomosis of the veins. In respect of the Causes. Diapedeses or Rarifaction is less dangerous than Anastomosis or Apertion and Eruption is most dangerous; for unless it be healed within three or four days there cometh an inflammation, which being suppurated produceth an Ulcer, from whence cometh a Consumption: Whence Hypocrates saith, Aphor. 15, & 16. Sect. 7. That from spitting of blood there followeth spitting of Matter, and from spitting of Matter a Phthisis or Consumption. But Diabrosis or Corrosion is most dangerous; and Galen saith, That it is incurable by reason the Ulcer that followeth it is incurable. The Cure of Haemoptoe or spitting blood, is wrought by Revulsion of blood from the Lungs by correcting the evil quality thereof, and closing the vein that is opened, by astringing and conglutinating means. First therefore let blood from the Arm on the same side on which you find heaviness or pricking, in a small quantity often, and at a distance for the better Revulsion. After that, open the vein in the Foot, and so you will make a Revulsion to a further distance, and this will be more profitable if the disease come from obstruction of the Terms. If the Patient be subject to the Hemorrhoids, you must open them with Horsleeches. Also apply Cupping-glasses with Scarification to the shoulders and back, or without Scarrificaon to the Groins and under the Ribs. Rub and bind the extreme parts, and in all the time of the Cure, at some distance apply often those Cupping-glasses to the Hypochondria, or under the Ribs. And let him take the following Julep thrice every day. Take of Plantain and Poppy Water, of each two ounces: Syrup of dried Roses one ounce: Lapis Prunellae one dram: Mix them for a Julep. Lastly, You must often purge the serous and Choleric humours which make the blood more thin and fluid with Medicines that have an astringent Virtue: As, Take of Rhubarb one dram: yellow Myrobolans' half a dram: Tamarinds half an ounce: Infuse them in Plantain Water; strain it and dissolve in it Powder of Rhubarb half a dram: Syrup of dried Roses one ounce. Make a Potion. Then give Medicines that close the Orifices of the Vessels by an astringent quality, but such as will not retain the blood in the Breast by too much astriction; therefore mix sometimes with them such as dissolve and expectorate the congealed blood which is out of the Vessels. Of all which these following are the best: Take of Bolearmenick, Terra Sigillata, both sorts of Coral, Bloodstone, of each half a dram: Sugar of Roses half an ounce. With one white of an Egg well beaten with Rose Water, make a Lohoch. Or you may make one more speedily, and more pleasant thus: Take of the Water of the white of an Egg well beaten two drams: Sugar of Roses one ounce: white Starch three drams. Mix them for a Lohoch. Or, Take of Conserve of Roses, and the greater Comfry, of each one ounce: Bolearmenick and Terra Sigillata, of each one dram: With the Syrup of dried Roses make an Opiate to be often held in the mouth, and swallowed by degrees. Take of Conserve of dried Roses, Troches of Amber, and of sealed Earth, of each half a dram: prepared Pearls one scruple: Sugar of Roses as much as of all the rest. Mix them and let him take a spoonful thereof one hour before meat. Take of the Juice of Purslain twelve ounces: Sugar eight ounces: Boyl them to a Syrup, of which let him often lick. This is the best for spitting of blood. And if you want Purslain, you may take Plantain. The Syrup of Comfry according to Fernelius, prescribed by Bauderon, is good for the same. Take of Yarrow with the white Flower: and yellow Flower, of each two handfuls: Green Roots of Tormentil, with the Leaves if they may be had, otherwise of the dry, one ounce: the greater Burnet one handful: Conserve of red Roses half a pound: spring Water sixteen pints: put them in a glassed pot covered and luted, that the vapours may not come forth: then boil them in Balneo Mariae sixteen hours; keep the straining in a glass, and take six ounces thereof every morning, noon, and night. Take of the Troches of Amber one dram: Plantain and Rose Water, of each one ounce and an half: Syrup of Myrtles and dried Roses, of each half an ounce. Mix them for a Julep. Take of Spirit of Vitriol half a scruple: Plantain Water four ounces. Mix them for a Potion. This presently stops blood coming either by Cough or Vomiting. Two spoonfuls of Syrup of Coral taken every day, is good against all manner of bleeding. But the Tincture of Coral drawn with Juice of Lemons, is more powerful. Quercetan in his Dispensatory, prescribeth this following Water against spitting of blood, which is very excellent. Take of the Roots of Snakeweed, Comfry, and Tormentil, of each one ounce: Knotgrass, Yarrow, Veronica, Winter-Green, Sanicle, Shepheards-purse with the Roots, of each one handful: Bramble tops, and Mastich wood, of each half a handful: Sumach and Myrtle berries, the seeds of Plantain, Barberries, and white Poppies, of each six drams: the flowers of Water Lilies, Guords, Quinces, and red Roses, of each two pugils. Bruise them and mix them; then steep them four days at the fire in the Juices of Plantain, Purslain, Sorrel, and Agrimony, of each two pints: then strain them well, and put to them Acacia and Hypocistis, or Conserve of sloes, of each two ounces: sealed Earth, Bolearmenick, of each half an ounce: the Electuary of Diatragacanth frigid, two drams: then macerate them again four days, and distil them. Take two or three spoonfuls of this Water alone, or with some proper Syrup. The Chemical Oil of Amber doth pierce, astringe, and dry powerfully, if you give two drops thereof in Plantain Water: As Cesalpinus teacheth in his Speculum Artis Medicae. Mercurialis in his consultations doth highly comm●nd the seeds of white Poppies, or white Hexane to be taken en every morning in the quantity of a dram, with Sugar of Roses and Syrup of Purslane: So you may also use the white Diacodium or Syrup of Poppies prescribed in the Cure of the Frenzy. Amatus Lucitanus doth highly commend the Juice of Nettles, in these words: They which have vomited blood, after they have been given over by Physicians, have been cured only by the juice of Nettles drunk five or six days fasting, in the quantity of four ounces, and by Nettle Broth. Sanguis Draconis doth wonderfully conglutinate all inward Veins, if you give half a dram thereof with Plantain Water, or other proper Liquor, or Medicine. The usual Pills to hold under the Tongue, may be made thus: Take of the Mucilage of Gum Arabic and Tragacanth, drawn with Plantain Water, of each two drams: Mummy and Mastic, of each one dram: Sugar of Roses as much as will make Pills, of which let him hold one continually in his mouth. And take this following Powder in his Broths. Take of red Coral and prepared Pearl, of each half a dram: Gum Arabic and Tragacanth, of each two drams. Make a Powder. Or boil white Poppy seeds and Sumach tied in a clout, in his Broth. Narcoticks are good in this case, and you must use them thus: Take of Syrup of Poppies, Jujubes, and dried Roses, of each one ounce: Mix them, and take a spoonful every night. Or, Take of Syrup of Poppies and Purslain, of each three drams: Terra Sigillata half a dram: Purslain and Plantain Water, of each one ounce and an half. Make a Potion to be taken at night. Or, Take of Syrup of Myrtles and Poppies, of each one ounce: Bolearmenick half a dram: mix them to be taken at night. Sometimes you may give Treacle of four months old, as Galen teacheth, 5. Method. cap. 13. or Philonium Romanum, or Laudanum. Platerus reports that he cured one, only with the Troches of Winter Cherries, with Opium dissolved in Goat's milk, taken some days; and also that he cured a Woman with one ounce and an half of Manna given in Broth, and with blood, and the use of the Tablets following, morning and evening for many days. Take of the Seeds of white Henbane powdered finely two scruples: red Coral half a dram: Gum Arabic one scruple: new Violets ten: the Juice of Barberries two drams: Sugar dissolved in Rose and Plantain Water, two ounces. Make Tablets. Trallianus, lib. 7. cap. 1. doth highly commend the Bloodstone, by which he saith that he cured many, giving it to four scruples, with the Juice of Pomegranate, or Knotgrass; but to them who bled not much, he gave it with warm water. But he saith you must sift it well, give it often, that it may better be distributed, and in Wine. Antony Valerius exercit. ad cap. 27. lib. 1. Hollerij de morb. internis, reports, that he cured, when all means failed, by this Powder, which he had from Julius Scaliger. Take of Spodium, red Roses, Bolearmenick, Terra Sigillata, and Bloodstone, of each half an ounce: red Coral, Amber, and Pearls not perforated, of each two drams and an half: Gum Arabic and Tragacanth of each two drams: the seeds of Purslain, Mallows, Ribwort, red Roses, Hartshorn, and white Starch burnt, of each three drams. Make thereof a fine powder, and give three drams thereof with rain water. This Powder Scaliger borrowed of Serapio, who mentioned it in his Book of Spitting of blood; and which Valesus also commends. And you may make Tablets thereof with Sugar dissolved in ●ose or Plantain Water. The Electuary of Haelideus is like it, and easier made; which was wont to be famous in Germany, ●●d so commended of Gesner, Erastus, and Crato, thus: Take of the seeds of white Poppy and Henbane, of each ten drams: Terra Sigillata, and red Coral, of each five drams: old Sugar of Roses, as much as will make an Electuary. Give hereof ●e dram morning and evening, after universal Medicines have been given. But because that spitting is stopped by the use of Astringents, and thence comes difficulty of beathing, you must at times use things that mollify the Breast, and also stop bleeding, such as they ●hich are compounded of Gum Arabic, Tragacanth, Starch, and Syrup of dried Roses, Quinces, Mir●●s, and Jujubes the Juice of Plantain and Purslain, while you use Astringents, if the Belly be ●●und give a Clyster or Purge, that leaves some Astringency. In the whole time of the Cure, if you suspect that there is any congealed blood in the breast, you must dissolve it with Oxycrate thus made, according to Galen, 5. Meth. that it may be pleasant and not provoke Coughing with the Vinegar; for so it dissolveth the blood and gently bindeth: Let him take six ounces warm twice or thrice in one day: and if it provoke Coughing sweeten it with Sugar: but you must use this when the bleeding gins to cease; for this also Amber and Mummy mixed with glutinatours and astringents is good. Also for the allaying the Heat of the Liver, use often a Cooling Epithem to the right side. Take of Rose, Plantain, and Succory Water, of each four ounces: Vinegar of Roses two ounces: the Powder of the Electuary of the three Saunders one drani and an half: Camphire one scruple: make an Epitheme to be applied warm to the Liver. After the use of the Epitheme anoint the same part with Ointment of Roses, or the Cerat of Saunders, with a little Rose-Vinegar. Anoint also the Reins of the Back with Oil of Roses and Water-lilies washed with Vinegar; adding a little Camphire to allay the heat of the blood in the hollow Vein: But you must beware of things that are too Astringent, lest they drive the blood from the hollow Vein into the Lungs. It is also very good to wash the stones with Oxycrate to stop the Flux and allay the heat: for there is a great consent between these parts. A Bath would also be good to allay the heat of the Bowels; but because they relax and so open the Veins, you must avoid it. Let him drink Syrup of Myrtles, Purslain, and dried Roses; or Sugar of Roses with Barleywater, or with the Water wherein Bloodstone or sealed Earth hath been infused. Or mix Conserve of Roses with the Water, or with Water wherein Coriander hath been infused, made sharp with the Spirit of Vitriol: or with the Tincture of Roses. A weak Decoction of Yarrow drunk ordinarily is good against all bleeding. If a sharp Defluxion from the Head upon the Lungs, be the Cause of this Disease, besides what hath been said, you may use those Remedies which are prescribed in the Cure of a Hot Catarrh. After the Blood is stopped, to keep it from returning you must first abstain from all things that stir the Humours, as violent exercise, great heat, anger, roaring, rich Wines, the meats mentioned which are either salt or spiced. Conserve of dried Roses must be held in the mouth, especially at bed time. Take of Conserve of Roses and of Comfry Roots, of each one ounce: the Troches of Amber, and sealed Earth, of each half a dram: red Coral and prepared Pearls of each one scruple: Sugar of Roses as much as all the rest: make a mixture, of which let him take a spoonful sometimes one hour before meat. Let him be purged four times in a year, or oftener if occasion be, with the Potion of Rhubarb and Myrobalans above mentioned; to which, instead of Syrup ad one ounce of Manna. You may with good success give a scruple of torrefied Rhubarb every morning one hour before meat, especially if the blood be very serous, as it is commonly in Haemorrhages. Also Rhubarb not torrefied given in the same quantity; for so the blood after the serous watery Humour is carried away will grow thicker: Or, You may give a dram of Rhubarb once every Week. There is also a Magistral Syrup to cleanse the blood from thin serous Humours. As, Take of the Leaves of Bugloss, Fumitory, Hops, Succory, Endive, Agrimony, Plantain, Maidenhair, of each one handful: the Tops of Asparagus, Vervain, and Eyebright, of each half an handful: the Seeds of Gourds and Melons, of each half an ounce: Endive and Dodde● seed of each two drams: Liquoris scraped, and Raisins, of each one ounce: sweet Prunes twelve: Senna four ounces: Polypody of the Oak two ounces: Agarick tied in a thin Clout, six drams: Mace one dram: the Three Cordial Flowers & red Pease or Pulse of each one pugil: boil these to a pint & an half: dissolve in the straining of the juice of sweet Apples three ounces: sine Sugar o●● pound and a quarter: make a Syrup boiled well, & scented with yellow Saunders: Then infuse in it one ounce of Rhubarb beaten and tied in a Clout, let him take an ounce and an half, or two ounces, with Broth twice in a month. Make an Issue in the right or lest Leg, as the Liver or Spleen are affected. Lastly, Let him use for a whole Month Asses-Milk steeled, for prevention of this Disease. For his Drink, take Water boiled a little with Coriander seeds, or the Decoction of Barley and Liquoris. Chap. 7. Of Phthisis, or Consumption. ALthough the word Phthisis signify every Consumption, yet it is most properly taken for that extenuation of body which cometh after an Ulcer in the Lungs. For this Extenuation of body comes from a putrid lingering Fever, which turneth to an Hectic; and this Fever comes from the Ulcer in the Lungs, from which by reason of their nearness to the Heart putrid Vapours are continually sent thither and cause the Fever, which after is dispersed from the Heart into the whole body; so all the parts being too cold and dry, and receiving the intemperate putrifying heat, do not well concoct their nourishment, but are ill nourished, from whence you may plainly perceive a Consumption of the substance of the whole body: for that Fever by reason of its continuance from the perseverance of the Cause turneth Hectic: and it's often joined with a putrid Fever, which is known by the Urine, and by the Distempers extraordinary at sometimes, insomuch that in some Consumptions you may observe sits of an intermitting Fever. A sharp and Corroding Humour, either coming from other Parts, or breeding in the Lungs, is the immediate Cause of an Ulcer in the Lungs. First sharp and salt Rhewm falls from the brain, which being violent easily ulcerateth the Lungs: Sometimes Phlegm that is not sharp nor salt will do the same: namely, if it lie long in them and putrify, and from the putrefaction ariseth an Acrimony, which Corroding Ulcerateth: yet this putrid phlegm in the Lungs doth not always ulcerate, as we may observe in a Catarrh when putrid Matter is spit forth, and the Lungs are sound. But there are two Conditions for the Causing of an Ulcer: one in respect of the matter flowing; another in respect of the Lungs: In respect of the Matter it is required that it should be so disposed, that when it is putrified it begets a sharpness which may cause an Ulcer: In respect of the Lungs, they must be extraordinary tender, and disposed to corruption, which in a word is called a Vicious Constitution of the Lungs, coming from the Parents usually, of which we will speak hereafter. Now the Humours that Exulcerate and putrify the Lungs, come from the parts adjoining, as the Pleura, Mediastinum, Diaphragma, rough Artery, and especially from an inflammation in them, w●●●h comes to Suppuration and turns into an Empyema: of which Hypocrates speaks, Aphor. 15. S● c. 5. They who fall from a Pleurisy into an Empyema, if the Empyema break in forty days and come away, are Cured; but if not, they fall into a Consumption. The Humour is in the Lungs when from some vessel broken, corroded, or opened by a wound, the blood flowing doth putrify; or when an Ulcer is left there from the small pox. Sometimes from the evil Constitution of the Lungs, evil Humours proceed; which corrupt their substance and cause a Consumption: and this comes commonly from the Parents, from whence a Con●mption is reckoned among the Haereditary diseases, of which it is the chief, so that we may observe how many whole Families are taken away with this disease. This evil Constitution of the Lungs is not in the first qualities, but hath some malignant and venomous quality, by which it becomes infectious: Although we deny not but a soft and lose substance of the Lungs, and therefore more fit for Corruption, doth much conduce to the breeding of this Disease. This evil Constitution of the Lungs causeth that some fall into Consumptions without a Distillation, Inflammation, or any other evident Cause, but only from the fault of the part that corrupteth its own nourishment. Sometimes it comes from a Pustulae bred in the Lungs and broken, which by Hypocrates, 1. de morbis, is made twofold: One by him is called, A Crude Pustule, because it never comes to Suppuration, but growing by degrees stops the passage of the breath, and at length kills the Patient. The other is that which cometh to Suppuration, and is called the Imposthume of the Lungs, and these come two ways, either by Defluxion, or Congestion; and the Matter gathered is either in a Bag or without it in the very substance of the part. The thickness of the Bag often causeth that such an Imposthume is carried many years in the Lungs undiscovered, and without any hurt to the body: From whence Hypocrates saith, Aph. 41. Sect. 6. They who have an Imposthume in the body, and feel it not, it is by reason of the thickness of the Matter, or of the place wherein it is that they feel it not: For this Cause many who seemed to be in perfect health have suddenly died by an Imposthume broken within: of which there are Examples in Ferne●ius, lib. 5. de morbis, de part. ●orb. & sympt. c. 10. among which he mentioneth two Physicians who sore-●aw the danger without signs. If the matter which comes from the Imposthume broken, flow into the Ventricle of the Heart, the sick presently die: but if it come to the Bronchia, or passages in the Lungs, it may be spit up; if the body be strong, and the matter little in quantity; but commonly there is an ulcer remaining in the Lungs which causeth a Consumption. Moreover, There are external Causes, as contagion, which is the chiefest; for this Disease is so infectious, that we may observe Women to be infected by their Husbands, and Men by their Wives, and all their Children to die of the same; not only from the infection of their Parent's seed, but from the company of him that was first affected. And this Contagion is more easily communicated to them that are of kin, wherefore it is not safe for a Brother or Sister to enter into the Chamber for the Miasmaza, or vapours infective, which come from their Lungs, and infect the whole Air of the Chamber, and being drawn in by others (especially if they are any way disposed to the same Disease) beget the same disease in their Lungs. There are other external Causes, especially very hot or cold Air; the hot Air doth melt down the sharp humours which are contained in the Brain, and sends them to the Lungs. The too cold Air by astringing, compressing, and Squeezing doth cause the like defluxion: But the Air in Autumn is most dangerous, because by its inequality in heat and cold, it causeth sharp and salted distillations; whence Hypocrates saith, Aph. 10. Sect, 3. Autumn is the worst time for People in Consumptions. Secondly, Sharp and salted meats and drinks do cause a Consumption, which fill the Head with salt and sharp vapours. And lastly, all those internal and external Causes which use to produce spitting of blood, which useth to end in a Consumption, may be said to be Causes thereof. Among the Antecedent Causes, evil humours throughout the whole body, are accounted the chief, which being moved by external causes, are sent to the brain, and from thence to the Lungs. Among which you may reckon the suppression of the Terms, Hemorrhoids, or other usual evacuations, which doth cause Catarrhs and defluxions. The aforesaid Causes do produce this Disease, especially among those whom Hypocrates calleth Phthirodeis, and Pterugodeis, that is, such as have a strait and distressed breast, a long neck, and shoulder bones sticking forth, who must of necessity fall into this disease, if they have tender Lungs, or any hereditary inclination thereunto. Also they are inclined to a Consumption, who have a weak Head, which is easily filled winh superfluous Humours, which are sent to the Organs or Instruments of the Spirits. There are no true and proper Differences of Consumptions, but such as come from the variety of their Causes. Yet Hypocrates doth lay down many kinds which are worth the observing, which must be reduced, not to a true Consumption, but to one in general, which is without ulcer of the Lungs. And first lib. 6. epid. sect. 8. text. 47. he showeth of a Consumption which came from a running of the Reins, in this History: A Satire called Grypalopex, being twenty five years old, had Nocturnal Pollutions, and daily loss of Seed; who when he came to be thirty years of age, fell into a Consumption, and died. For by the continual loss of Seed the nourishment of the body is taken away, by which the solid patts are consumed and dried. There is another kind in Hipp. 2. de morb. called the Consumption of the back, which comes from too much Lechery, which destroyeth the whole habit of the Body, and takes away the nourishment from the solid parts: this happens to new married folks, who are unsatiable, and is the chiefest of the Consumptions of the back; for Hypocrates lays down four kinds thereof: The first is that mentioned, which comes from Lechery. The second is laid down lib. 2. de intern. affect. text. 13. which comes from too much blood, and nourishment going to the Spinal Marrow, by which the Natural heat, and all other faculties are stifled and destroyed. Now Hipp. 5. epid. showeth that the body may consume by too much blood, in a story concerning one, who, when nothing would nourish him, but he still grew leaner, was perfectly cured, when all other Medicines failed, by bleeding in both Hands as long as the Veins would discharge. The third kind is in the place mentioned, namely, when the marrow of the back is dried, by which the whole body drieth and consumeth. Hypocrates mentioneth two Causes of this dryness: one is the obstruction of the veins which go to the back with nourishment; another is the flowing of Choler from the head upon the back, which Hypocrates showeth in his Book de locis in homine. The fourth is described in the same Book, and it comes from a distillation upon the marrow of the back, in these words: Moreover, when a defluxion falls upon the Back, this kind of consumption cometh with pain in the Loins, and seeming emptiness to the Patient in the internal parts of the head. In the same Book, numb. 18. he saith thus: When there is a defluxion upon the Marrow, there is a secret undiscernible Consumption. He calls it secret, because when the body decays, you cannot so easily find out the cause: he calls it undiscernible, because you cannot perceive the inconveniences of the defluxion at the first. But it ceaseth to be secret and undiscernible, if the defluxion be not only upon the marrow of the back, but also upon the Os Sacrum, and Hippolito: for then the distillation is apparent, and there is pain and loss of motion, with dejection of mind. These are more clear in Hypocrates, in his Tenth Book de glandulis, in these words: There is another Disease which comes from a defluxion from the Head by the Veins upon the Marrow of the Back, and from thence to the Os Sacrum, and Hippolito, which is a Consumption also which destroyeth, for then the Shoulders and both the feet are weak, and after the legs, and they always die of it, though they have been formerly cured. This kind of Consumption is to be observed, because it often happeneth, especially to such who have weak Nerves, which will easily receive the desluxion. To this kind you may refer that which comes of want and hunger; which Galen mentioneth, libde Marasmo, when the Body decays for want of nourishment. Now Nourishment is wanting to the solid parts, not only for want or meat, which the Stomach concocteth, and sends to the Liver to make blood for the whole Body: but also when the Chylus which is sufficiently concocted in the stomach cannot pass through the Meseraick Veins, by reason of their obstruction; as it happeneth to them who have a Struma, whose Mesentery for the most part is full of Glandles; by which the milky Veins called Venae Lacteae, are compressed, from whence the whole Body grows lean, and they die of a Consumption. But the solid parts are deprived of their necessary nourishment when salt blood that is not sit for nourishment is gathered into the Veins, which, as Galen shows, are incurable, 5. Meth. except by Epicrasis, or change of habit. And finally, Galen, lib. de Marasmo, decimo m. and in other places, speaks of a Consumption from a manifest or hidden Inflammation, from the syncope of the Heart or Stomach, and the like, which may be seen in their proper places. The Diagnostic signs by which you may know a true Consumption, do some of them, declare a Consumption beginning, or begun, or confirmed, which are very well set down by Hipp. 1. de morbis. The signs of a Consumption at hand, are in Hipp. Book, mentioned, Text 9 in these words: There is also a Suppuration when phlegm flows from the Head upon the Lungs; and first for the most part it flows privately, and causeth a little Cough, and the spittle to be bitter, and a little heat. In this saying there are contained four signs of an eminent Consumption. The first sign is, A defluxion from the beginning closely conveyed to the Lungs, because then the matter is little, and because the thinner part of the humour, which floweth about the rough Artery, and doth not vex the Lungs, which otherwise would be more disturbed in the beginning, before they are weakened; thence it is called a secret defluxion, because there is little hurt at the first done thereby. The second sign is, When the Humour flowing makes but a small Cough, being at the first but little and thin. The third sign is, When the spittle is more bitter than usually it was, because the humour that must ulcerate the Lungs must be sweet, sharp, or salt; which qualities being altered by a preternatural heat, do turn bitter: for it is known that sweet and salt things overmuch boiled, do grow bitter. But in regard that preternatural heat is not very great at the first, the spittle is but a little bitter. The fourth sign, is a little heat, as being feverish; for when the matter is not much moved, but receiveth putrefaction from the heat of the place, wherein it hath been long contained, the Fever cannot be very violent, for the putrid matter can many ways be refrigerated; therefore it is no wonder if the Fever be small in the beginning. To these signs of Hypocrates we may add an evil formation of the Breast and Youth, which meeting with the aforesaid signs, must needs declare a consumption to be at hand. The evil fashion of the Breast is when it is narrow, and the Shoulderblades stick up like wings, when the fore part of the Breast is narrow, and the hinder part broad, for then the Breast is both small and evil proportioned. The straightness of the Breast shows want of Natural heat, and the evil proportion shows its weakness. For if the Natural heat were much and vigorous, the breast would have thereby been extended. But such and so great is this disposition, that Hypocrates calls it a Natural Consumption, coming from a principle in Nature. Wherefore they who are thus made must of necessity fall into a Consumption, except some other disease take them off. Which by the way is observable, for if they have any acute disease, who are thus inclined, they seldom escape, because the Natural heat is weak and little, and therefore will easily be overcome by a strong disease. Therefore the most wary Physicians in such kind of Natures and habits, do use to prognostic rather death and danger, than health or recovery, when they fall into any disease. In them who are inclinable to this Disease, Youth is most dangerous, according to Hypocrates, Aph. 9 Sect. 5. especially from Eighteen to Thirty Five years, in which time there is much blood for to break the vessels; as also it is then thin and sharp, more proper to open and corrode the Vessels: In Children, the Catarrh is made slow with much Moisture: in Old Men, it is allayed with Cold: but in the Middle Age, for the Reason's aforesaid, it doth often exulcerate. Moreover, in Youth many distempers come by Diet, by which many ill humours are produced and the blood infected● as also by reason of violent exercise, as running, wrestling, leaping, fencing, going in the sun, a vein may be broken in the Lungs which may produce a Consumption. The signs of a Consumption begun, are set down by Hypocrates in his Book of Diseases before mentioned, Text 10. in these words, In progress of time the Lungs are exasperated and ulcerated within by the Catarrh putrifying there, whereby the breast seems ponderous, and there is a pain before and behind; and there is more sharp heat in the body: and the Lungs by reason of their heat draw moisture from the whole body and especially from the head, which also is made hot from that body, and spetteth forth thick matter. In these Words there are Six Signs contained of a Consumption begun. The First sign is, That the Lungs are exasparated in progress of time: that is, The Cough is more violent; for the Disease increasing the Distillation is stronger, and the Lungs are pierced therewith, and provoked to Cough forth that which hurteth them: which Cough doth not only come from the matter flowing down, but from that which flowed formerly: for being not Coughed up it groweth foul by long continuance▪ by which means the Lungs are more forced to expulsion. The Second sign is, The weight of the Breast which comes from the matter gathered into the Lungs: For albeit the Lungs of themselves do feel little or nothing, yet because they are tied to the Breast by Membranes, they perceive a weight, when they are burdened. A Third sign is, A sharp pain before, and behind: for the matter contained in the Lungs doth with its evil quality offend them, as well as with its quantity and putrefaction, by which the Membranes are pricked, which cause great pain: for the pain in the Membranes is always pricking. Now this pain is perceived before and behind; because these Membranes are joined before to the Sternon, and behind to the Back: and the cause of this pain is from a great Cough, called by Hypocrates, A Malignant, or Cruel Cough. The Fourth sign is When sharp Heat falls into the body, and there followeth a violent Fever: for when through progress of time the matter putrefieth more, it is probable that the Fever will be greater; for although the matter from the beginning do only putrify in the Lungs, yet by reason of the Suppuration made in the Breast with an Ulcer, the filth is communicated to the humours contained in the Veins; from which come divers sorts or putrid Fevers, and these differ from that Fever which comes only from the Ulcer in the Lungs, through the filthy vapours which are carried from them into the Heart, which turns to an Hectic; and therefore in a Consumption there is a Hectic Fever often joined with a Putrid. The Fifth sign is, When a great quantity of Phlegm falls from the Head to the Lungs: which Hypocrates confirms, when he shows the Cause of that great Defluxion; namely, The Lungs by their Heat drawing Phlegm from the whole body: Hence it is that the humours contained in the whole body are the matter of a continual and great Flux which doth so trouble men in Consumptions. The Lungs by the filth which they have contracted, grow hot; by which heat Phlegm is drawn from the Brain, which the Brain fetcheth from the whole Body: And this is one of the principal Causes of the extenuation or the whole body: for all the humours, good and bad, are carried to those parts, and so the whole body decayeth. The Sixth sign is, Spitting of thick rotten Phlegm: for when the Matter putrefieth and there is an Ulcer, quittor or filth must needs come from thence, and therefore the Spittle is Mattery: but it is between thick and thin: for after that it hath by long continuance in the Lungs grown thick, it is made thinner by the addition of that which breaks from the Ulcer, and so it becomes moderate, which Hypocrates calls Subcrassum, or Thickish. To these mentioned Signs of Hypocrates you may add this as most certain, namely, The Extenuating the body with a linger and constant Fever: For besides the putrid Fevers above mentioned which come and go by fits, and grow from the humours which putrify in the Veins: there is also always present a linger daily Fever coming from the vapours sent from the Ulcer to the Heart which corrupteth the nourishment of the whole body, and makes it dry and hot, from whence the body must needs grow extenuated. To there you may add Sweatings at Night, with which men in Consumptions are often troubled as soon as they begin to sleep: for by sleep the Heat is drawn in which increaseth the Inflammation of the Lungs; and the heat inwardly increased, causeth abundance of vapours, which are thickened in the skin, and turned into sweat. Moreover, There is a continual rigour which comes from the sharpness of the matter which pricketh the Membranes. And Lastly, You may add sweetness of spittle, which useth to come when it gins to Suppurate, which is the original of Saltness. Hypocrates shows also the signs of a Consumption confirmed, in his 11. Text of the Book above mentioned in these words, The longer this Disease lasteth, the more absolute matter will be spit, and the Fevers be the sharper, the Cough more frequent and strong. the body will more consume, and yet the body is disturbed downward from Phlegm, and this comes from the Brain▪ when any man comes to this he must perish. In these Words we may observe that there are Five Signs of a Consumption confirmed. The First is, The Spittle being more Mattery, or rather Matter itself. The Second is, A strong Fever, and sharp, more putrifying; and the Ulcer more foul. The Third is, An often and violent Cough more than formerly; often because of the great provocation and little evacuation, therefore nature laboureth to do that at divers times which the cannot do at once: and it is a stronger Cough, not only because the greater sharpness of the Water doth more violently stir up the expulsive faculty; but also because of the wearing away of the solid parts, the breast is made more hollow, hence comes a hoars and sounding Cough, as from a hollow place. The Fourth sign is, Pining and want of Appetite, which makes them leaner; now the want of Appetite comes from the distillation which doth not only fall upon the spirital members, but also upon the natural▪ especially the Stomach, whose mouth is thence weakened to the loss of Appetite; as also from the putrid vapours sent thither either from the Fever or the Ulcer. The Last sign is, A lose belly which comes from Phlegm falling from the head, by which in time the stomach and guts are weakened, and the retentive faculty destroyed: and this kills the Patient as we shall show more at large in the Prognostics. To these signs of Hypocrates, we may add some other: The First is, A great Extenuation of the whole body, so that all the Musculous flesh is consumed, and the bones appear only covered with skin: and hence it is that the nails are crooked, because the Flesh which was in the tops of the Fingers to hold up the nails, is consumed. To this you may add Difficulty of breathing, both because the Faculty is weak, as also because the Bronchia of the Lungs are stopped with putrid matter; as also because the part is for the most part putrified and consumed, and therefore cannot take in sufficient air to cool the heart; so that what the Lungs cannot do by one breathing, it must do by often. And Lastly, We may add, That in a confirmed Consumption that is desperate, the Hair falls off, the Cheeks wax blue, except it be after meat, and then the vapours sent up make the red Lice breed in abundance, and the Feet swell. Neither need we so many signs, for if any ordinary man, saith Areteus, shall see a man pale, weak, and coughing, and very lean, he will conclude him to be in a Consumption. Yet we must observe diligently, That sometimes a violent Catarrh falling upon the Lungs will resemble a Consumption so, that filth like Matter, shall be spit forth, and thence may a Fever come through putrefaction and extenuation of body: but they who are so are easily cured by diligence in means, therefore let us distinguish this rightly from a Consumption, which is chief done by discerning between putrid Phlegm and Matter. Thus; Matter is of a dun Colour, and less White than Phlegm; sometimes of divers Colours, and being put into hot Water it sinketh and dissolveth: but Phlegm swims at the top and sticks together by reaof its s●●ininess, and will not dissolve. But if some of the Spittle dissolve and the rest not, it is made of Phlegm and Matter, which often happeneth. As for the Prognostic, it is very hard to Cure a new Ulcer in the Lungs; but it is impossible to Cure an Old, because it is opened by the continual motion of the Lungs and by Coughing, so that it will not be united: as also the force of the Medicine is gone before it can come at it, and the lost substance of the Lungs cannot be repaired. Moreover, An Ulcer, Spittle, Fever, and Leanness, require contrary Remedies, for those things which dry the Ulcer, do hinder Spittle, increase the Fever, and Leanness: and Moist things which are good against the Fever and Leanness, do make the Ulcer more foul. Sometimes the Ulcer seems Cured, and there is a scab upon it, but with the least motion it falls off, and the Disease returns. A Consumption which comes from a small Ulcer of short continuance, although it be difficult, yet is not uncurable if proper Medicines be timely used: And they who have gathered Observations mention many so Cured; now there is most hope when the Patient is strong, the spittle white, even of one colour, and easily raised; if the humour falling from the head pass through the Nose, and if thereupon the Fever abate, if the Appetite be good, & there be no thirst, & if the belly bound & in good order, if the Patient have a good habit of body, young, and have his breast large and hairy. They whose spittle stinketh, or have lose bellies, or cannot spit, are near death, as Hypocrates teacheth, 1. Prog. & Aph. 11. & 12. Sect. 5. And, Aph. 16. Sect. 7. A Consumption coming upon an acute Disease doth kill speedily, but if it come from other Causes it is Chronical, and lasteth many years: And Avicen saith, That he knew a Woman that lived twenty three years in a Consumption. And Matthew de Gradi saith, That another Woman which was always about the fire, lived in a Consumption twenty eight years. The Cure of this Disease, as is said, is for the most part impossible, if the Disease be Old; but if it be New it may sometimes, and easier when it is but coming upon them who are disposed thereto by an hereditary disposition, but are not yet fallen into it. Therefore we shall first lay down a Prophylactick or preservative, and then show how to cure the disease. Therefore for the amending of the evil disposition in a Consumption, use a cooling diet, and moist, and all such things as correct the blood, and make it mild, and correct its saltness and sharpness: as the Waters of sweet Baths, the use of Milk and the like. As also China Roots boiled in small Beer; but the Decoction of the Sanders is the best, which is not only good in a Consumption at hand, or begun, but also in salt and thin distillations, and in old bleeding from thence. The Decoction of Guajacum doth wonders upon the same account with the former, either given in distilled Waters, with a little white or red Wine, as the disease will bear it. Now the Decoction of Guajacum, and of Sanders, are made both alike, both for the first and second drink, and given the same way. To these you may add change of Air, which is good both to prevent and cure, And lastly, those Remedies are good which we will lay down for the cure of the disease confirmed, to be used first. Now the whole Cure consisteth in the clesing and glutinating of the ulcer, by taking away the Causes that produce and nourish it, by opposing the Hectic Feavet, and restraining of the Consumption. First therefore, because an ill habit of body may increase the Ulcer of the Lungs, you must use gentle purges, at divers distances, as long as the body is not very low. And these must be made of Manna, Rhubarb, Cassia, or Syrup of Roses, thus: Take of Barley half a pugil: Liquoris scraped, and Raisins stoned, of each three drams: Jujubes four: the flowers of Bugloss, and Violets, of each half a pugil: boil them to three ounces: In the straining dissolve Rhubarb infused in Scabious Water with yellow four scruples: Manna one ounce: Syrup of Roses half an ounce. Make a Potion. Or give two ounces of Manna with Chicken or ordinary Broth. Or make a Bolus of Cassia one ounce, and one scruple of the powder of Liquoris. In the beginning you may give stronger purges for to draw down the salt and sharp Catarrh which is the chief Cause of the Ulcer, such as are prescribed in a hot Catarrh. Also before the body be too lean, at the first you may let blood to allay the Fever, and the acrimony of the humour. But in the beginning of the Cure you must stay and divert the Catarrh from the Breast, otherwise all other things will be in vain. And all those things which were prescribed for the Cure of a hot Catarrh are good in this case. Besides a Seton to the Neck, is very good. And Fabricius Hildanus reports that he cured many by this way. At length you must come to the Cure of the Ulcer; for which, give things that cleanse, knit, and expectorate. Many there are of this nature. But these following are the best. Milk doth hit all intentions for Cure: It cleanseth with its serous parts, it conglutinateth with its coagulating part, and nourisheth and refresheth with its unctuous part. But there are divers kinds of Milk, and Woman's Milk is the best, because it is more agreeable to our Natures, especially if it be sucked from the breast. Platerus affirms that he knew many cured by the use thereof; and that one of them did not only recover, but grew so strong, that lest his Nurse should want milk for him, he got her with child again. But because many will not endure that sort, Ass' Milk is commended, which because it is very full of Whey, doth easily pierce into the Veins, and excellently cleanse the Ulcer: the next to this is Goats Milk. Let the Ass be fed with Plantain, Vine Leaves, Brambles, Polyganon, Grass, Barley, and Rye. Let him drink it new milked, warm, therefore let the Ass be brought near the Chamber, and be milked into a warm Vessel. First let him take it in a small quantity three or four ounces, that his Stomach may be used to it, increasing the quantity by degrees to eight or ten ounces, or a pint, and lest it should grow sour or curdle in the Stomach: and that it may agree better with the Lungs, put Sugar of Roses to it, one ounce thereof to eight of milk: let him not sleep after his Milk immediately, but walk gently about the Chamber: let him not eat before the Milk be concocted, and he find a stomach, and that it be more effectual. You must not give it in a strong Fever, or when there is a pain in the Head, or swelling in the Hypochondria, or a Choleric flux, according to Hypocrates, Aphor. 64. Sect. 5. Commonly it is taken only once in a day; but it is better twice; and best if the Patient live only upon it. For besides that it doth work more powerfully in a great quantity, there is a great profit by not mixing it with Broth and other meats, for they will easily putrify. If therefore the Disease be very desperate, give Milk after purging every six hours with Manus Christi of Pearl and Coral. And least strength should fail, let him intermix a restoring distilled Water. Sugar of Roses is very profitable, as also the Conserve; by use whereof, Avicen reports that he cured a Woman of a desperate Consumption, so that she was not only sound, but very fat afterwards. Mesue also witnesseth that many have been recovered by the same, and he directeth that the Conserve of Roses be new, not above a year old, taken in a great quantity, and often, with Medicines, Meat, and drink, and also by itself at any hour. But first give Clensers, because it will otherwise astringe and retain the excrementitious matter in the Lungs. But when breath gins to fail, and the Patient cannot raise phlegm, let him take expectorating things; as Syrup of Hyssop and Coltsfoot, and other Lohoches. And if heat arise from drying too much, give Syrup of Violets, Jujubes, the Mucilage of Fleabane and Quinces, and the like. Montanus, Valeriola, and Forestus, say that they have seen some cured by taking Sugar of Roses in great quantities. An Apothecary whom I knew in a Consumption, made a great quantity of Sugar of Roses for himself, and eat it constantly, by which he was cured. An Infusion of Yarrow, Tormentil, Burnet, and Conserve of Roses made in Balneo Mariae, is very good, as it is described in the Chapter of spitting of blood, if it be used twenty days together. The Decoction of Bugle in Mutton Broth, doth excellent against a Consumption and inward ulcers, it doth a little gently loosen the belly against the Nature of all the Consolidae. Trallianus, lib. 7. cap. 1. boasts that he cured many with Bloodstone. The preparation and use whereof we have showed in the Cure of spitting blood. The Syrup of the Juice of Ground Ivy is commended by Quercetan, thus made: Take of the Juice of Ground Ivy two pound and an half: let it be digested in Balneo Mariae. To this Juice well refined, put Sugar of Roses one pound; Penides four ounces: Boyl them to Syrup, to be taken now and then a spoonful. He also addeth the flower of Brimstone to it to make it into a Lohoch, of which he gives four times in a day; and he boasteth that he hath therewith cured many. The Syrup of the flowers of St. John's wort, made by Infusion in Balneo Mariae, is very good in this Disease, as also for all inward ulcers. The Syrup of Comfry is excellent; for it cleanseth, healeth, and strengtheneth by astringing; as also Comphry Roots boiled in Broth It is affirmed that many have been cured by this Hydromel. Take of China Roots sliced, six ounces: Coltsfoot Roots three ounces: Burdock and Avens Roots, of each three ounces: Elicampane Roots two ounces: Lungwort Leaves, and Scabious Leaves and Roots, both the Veronicaes, Vlmaria, and Herb Twopences, of each two handfuls: all the Capillar Herbs, of each one handful: the tops of Bugle, Bettony, Cowslip flowers, and red Veronica, of each four pugils: Ground Ivy Leaves and Roots three handfuls: Jujubes, Dates, Sebestens, and Raisins stoned, of each one ounce and an half: Spanish Liquoris one ounce and an half. Let them all, being well sliced, boil in thirty two pints of spring Water till half be consumed, with a little gentle fire: ad to the Liquor being strained, of the best Honey four pound: Boyl it again, and skim it; then strain it through an Hippocras Bag, putting thereto half an ounce of Cinnamon, six drams of Coriander seeds: Annis and sweet Fennel seeds, of each three drams: put the Liquor in a large Vessel, and let it work in the Sun; for so it will be done in forty days; otherwise it will be longer: but you must keep the Vessel always full and open, that it may froth over: therefore you must make more Hydromel than the Vessel will contain; and if the disease require it you may use it fresh before it worketh till you make another in the Vessel; and you may make this quantity twice or thrice at once, because it must be taken divers months together. Let him take a good draught hereof twice or thrice in a day. This following Syrup is made more easily, and hath great Virtue: Take of the Juice of Ground Ivy, Veronica, and Carduus Benedictus refined, of each eight ounces; in which, boil gently Maidenhair, Politrice, Scabious, and Lettuce, of each half a handful: Dissolve in the strained Liquor one pound and an half of white Sugar. Make a Syrup well boiled, adding in the end three drams of the Extract of Juniper; Juice of Liquoris and the Extract of Carduus, of each four scruples. Let the Patient take one spoonful an hour before dinner, and another before supper, and another at bedtime. Cardanus saith, that he cured many Consumptions with this course following: namely, by giving no other nourishment than Barley Broth made without Flesh, and Water with Sugar, and every morning four ounces of the Decoction of the Tails and Legs of Crayfish made in Barley Water with two drams of Sugar. Arcaeus, Ingrassias, Fracastorius, and Erastus, say with admiration, That they have cured many Consumptions by the use only of Guajacum for a long time continued; yet this in respect of the antecedent cause, which is a hot and sharp humour, seems to be an enemy. Avenzoar reports that his Grandfather cured a Consumption, with well leavened Bread, and Salad Oil, and also that he did the same. This Powder following is highly commended by Valescus de Taranta, and it is reported to be invented by Haly Abbas, and he saith, that he cured one with it. And Forestus saith that he cured his Brother with the same. Take of white Poppy-seeds ten drams: Gum Arabic, Starch, and Gum Tragacanth, of each three drams: Purslain-seed, and Mallows-seeds, of each five drams: Pompey, Melons, Cucumbers, Gourds, and Quince seeds, of each six drams: Spodium, and Juice of Liquoris, of each three drams: Penides the weight of all the rest: make a Powder: give every morning two drams thereof with the Syrup of Poppies or Jujubes: Let him also take it in Barley, Cream, are Almond Milk, and with other meats. Cappivaccius, and Claudinus do approve of Oil of Vitriol to dry the Ulcer, giving two or three drops with Rose-water or Juice of Plantain, with a little sugar. Crollius also commends the Elixir Proprietatis which is made of the Spirit of Sulphur; with the Spirit of Wine, Myrrh, Aloes, and Saffron. The Chemists do highly commend the Medicines made of Brimstone, as the Flower, Milk, and Balsom thereof, as you may read in their Books: You may use them thus very well. Take of the Flower of Brimstone, and Powder of Frankincense, of each one scruple: put them into a hollow Apple, then roast it, and let the Patient eat it with sugar every morning for eight or ten days together. Or, Take of Conserve of old Roses, Diamargariton frigid, and Diapenidion, of each one ounce: Flower of Brimstone three drams: make it up with clarified Honey, of which let him take the quantity of an Hazelnut twice or thrice in a day. Or, Take of Flor. Sulphuris three drams: Sugar dissolved in Rose-water three ounces: make Lozenges▪ which let him hold in his mouth often. Or, Take of Lac. Sulphuris half a dram: Magistery of Pearl, and Coral, of each half a scruple: the Emulsion of Melon-seeds made with Coltsfoot or Veronica-water, two ounces: the Julep of Roses six drams: Cinnamon-water, and Manus Christi, with Pearl, of each two drams: Mix them, and let him take two or three spoonful every morning. Some Chemists commend Antimonium, Diaphoreticum well Calcined with thrice as much Saltpetre, so that all the vomiting quality be gone, which must be given every day in Lozenges made with Sugar of Roses, or mixed with Conserve of Roses, or with the Medicines above mentioned. The Balsam of Peru is good to heal Ulcers in the Lungs, if you give one drop made into a Pill with Sugar, every day. The Powder of Burnet, one dram given every day in Broth, is esteemed excellent. Ruffi Pills are commended by some taken one scruple every day, but made as followeth they do wonders. Take of the Mass of Ruffi-pills▪ one ounce: Antimonium▪ Diaphoreticum▪ and Gum of Guajacum▪ of each half an ounce: Make a Mass with the Balsam of Peru: of this let him take one scruple every day for one Month. The Syrup of Coral, and Jelly of Quinces are good for the same. Rodericus out of Fonseca commends the Decoction of yellow Saunders for a good Medicine against Defluxions upon the Lungs; which he prepareth thus: Take of Succory and Sorrel Water, of each four pints: yellow Saunders sliced three ounces: infuse them one day, then boil them in Balneo Mariae in a close Vessel three hours: take three ounces of this every morning in Beer for forty days together. Also all the Medicines which we mentioned for the Cure of Spitting blood, are here very good. Fumigations may be well used to dry the Ulcer of the Lungs very well, and they must be often taken in at the Mouth and Nose: You may make them thus: Take of the Gum of Ivy one dram and an half: Frankincense one dram: Myrrh half a dram: Amber one scruple: Benoimin and Storax, of each half a dram: Hypocistis two scruples: Coriander seeds, red Roses, and red Saunders, of each one scruple: Powder them, and mix them with the Mucilage of Gum Tragacanth: make Troches and cast them upon Coals. Or, Make plain Fumes of Frankincense, Myrrh, Mastic, and Benjamin, always in the Chamber that he may take in the dry and sweet scent of them. You may make a stronger Fumigation, but it is not to be used but in strong bodies. Thus, Take of Gum Anime, or Gum of Guajacum, two drams: Tobacco half an ounce: dry Coltsfoot one ounce: Hyssop, white Horehound, Rosemary, and Orpiment, of each three drams: make a Powder; put a little thereof into a Tobacco-pipe, take of it twice a day fasting, and half an hour after a dra●ght of this Decoction. Take of China and Sarsa of each half an ounce: Scabious, Coltsfoot, and ground Ivy, Vlmaria, Maidenhair, and Avens Leaves and Roots, of each one handful: whole Barley one pugil: Liquoris scraped, and Currens, of each one ounce: boil them to two pints, and put to it being strained four ounces of sugar of Roses: Let him take half a pint twice in a day as aforesaid. For the Rich People you may use a moist Fumigation made of the Decoction of Herbs, which is a good way to carry the strength of them directly to the Lungs: You may use all such Herbs as are proper for the Lungs and to Cure Ulcers. Take this following for an Example: Take of green Coltsfoot eight handfuls: Hyssop two handfuls: bruise them and put them in a Pot with a little water, lute it close, than set it into the Oven when the Bread is half baked, and then take it out with the Bread, and put a Funnel into a hole made at the top, and so take in the smoke through the mouth at the Lungs, and put it out at the Nose, and it wonderfully provokes spitting. You must also Morning and Evening use a Cooling Lineament to the Breast. As, Take of Gum Tragacanth and Arabic of each one dram: infuse them in Rose water a day and a night: put then thereto of Oil of Violets one ounce and an half: Fresh Butter half an ounce: Sal. Prunellae two drams: Camphire one scruple: Breast-milk as much as will serve: Mix them in a Mortar to an Ointment. To Repair a Consumption, or to Prevent or Hinder it besides Restoring Diets, which are principally made of Barley, Almonds, Pine-nuts, Rice, Nuts, and the like, which Authors declare; Milk commended at first is very good, and a Bath of hot Water of Barley and Almonds bruised: but this is not good in a Catarrh, nor while there is a putrid Fever, nor when the Lungs are full of Excrements. Let his Drink be Water and Sugar, Barley Water, and Liquoris: an Infusion of Liquoris, a thin Hydromel, or a weak Decoction of China. The End of the Seventh Book. THE EIGHTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Heart. The PREFACE. THE Heart hath many Diseases, Similary, Organick, and Common: But because few will submit to the Physician, in regard of the nobleness of the part, which will endure long pain, but a man is suddenly gone, and there is no time for Physic; we who intent to bring all our Labours into practice, will lay down only three Diseases of the Heart, which are usual, and require many Medicines; and we shall bring them into three Chapters. The first shall be of Swooning. The second of Palpitation of the Heart. And the third of Weakness. Chap. 1. Of Syncope, or Swooning. Syncope is defined by Galen, 12. m. c. 5. to be a sudden failing of all the Strength: For although the Heart only suffer, and the Vital Spirits are only intercepted; yet when it fails, the rest must suffer, because they have a continual and necessary influence from it. It is called a sudden failing of all the Strength, that it may be distinguished from other Diseases, in which the strength goes by degrees, till death come: nor is the Doctrine of Avicen against it, Fen. 1. Lib. 3. Tract. 2. Cap. 2. where he propounds the sign of a Syncope that comes by degrees; for although the Causes that dissolve the Spirits, do sometimes work by degrees, yet when they grow great they make a sudden Syncope: and therefore Avicen rather propoundeth the signs that go before a Syncope, than those that accompany it. Moreover, This Definition may seem to agree with an Apoplexy, in which there is a sudden failing of all the strength; but in an Apoplexy there is strength in the Heart, and the Pulse is generally great and full. And also there is great hindrance of breath, with snorting; but in a Syncope the breath is no ways stopped. The question is, Why? When the action of the heart ceaseth, doth the action of the Brain also cease, since the Animal Spirit is made of the Vital by way of Concoction, and must therefore stay some time in the Brain, although the Vital do not constantly come to it? We answer, That the Brain as all other parts, for the perfecting of its actions doth always stand in need of adventitious heat, which is brought to it by the Vital Spirits, and therefore when the Vital Spirits come not, neither doth heat come for the Brain to perform its functions. There are other Diseases very like to Syncope, differing only in degrees from it, namely, Eclusis, Leipothumia, and Asphuxia: Eclusis, is a light fainting: Leipothumia, or Leipopsuchia, or Apopsuchia, is a very strong and great fainting: Syncope is the greatest, which if it go so far that the pulse in the whole Body ceaseth to beat, it is called Asphyxia, which is next unto death. The word Synchope, was not used by Hypocrates, and the Ancient Greeks; but they called this Disease Leipothymia, Lipopsychia, and Asphyxia. But it was invented a little before Galens time, and used for the greatest; so Galen, 1. ad. Glauc. cap. 14. saith, Leipothymia is an imperfect Syncope, and goes before it. By what hath been said, it appears, that the part affected is the Heart, where the Vital Spirits are all made; by whose influence the Natural heat and Spirits in every part are made to act: therefore when that ceaseth by stoppage of the Influx of the Vital Spirits, it is necessary that the strength of all parts should fail, and their actions cease. The immediate Cause of this Disease, is the defect of the Vital Spirits, not wholly, for then sudden death would come; but so great, that Nature is constrained (lest the strength of the Heart should totally fail) to fetch the Spirits from the other parts to the Heart, by which means the parts lose their functions. Now this defect of Spirits comes four ways: Either because they are Naturally few; or because they are dissipated, and spent; or because they are preternaturally altered and corrupted; or lastly, because they are suffocated and destroyed: They are few by fault of the faculty making, or matter from which they are made. The Faculty is hurt, either by a disease proper to the Heart, or by consent from another part. The proper Diseases of the Heart which are the chief, are great distempers, which overthrow the Natural temper, or destroy the substance of the parts, or of the Natural heat; as swooning Fevers, sharp, and malignant, Syntacticae, or Colliquantes, or fainting, pestilential, hectical, or Marasmodes, which consume; to this come organical diseases, as too much constriction and dilatation, and constant solutions, which come to the Ventricles of the Heart. The Faculty may be hurt by consent from other parts, which have great sympathy with the Heart, as the Brain and Liver, and sometimes from the mouth of the Stomach, by reason of its nearness and exquisite sense; from whence a Syncope is divided into a Heart and Stomach Syncope. The Cardiaca or Heart Syncope, is when the Heart is principally affected; but the Stomachia, or Stomach Syncope, is that which comes by consent from the Stomach. Sometimes it comes from the Mother, by filthy vapours sent from thence to the Heart, from whence comes the Suffocation of the Matrix, Apnoea, or want of breath, and Hysterical Syncopes, as those vapours do assault the Lungs, Diaphragma, or the Heart. The fault is in the Matter, when the Air or Blood is defective, or corrupted; from whence the Vital Spirits are generated. There is defect of Air when the Respiration and Transpiration is hindered; but the defect of Blood, is when Nutrition is hindered; there is a corruption of both, when their qualities are changed: So when the Air is infected in time of Pestilence, it begets Leipothymia and Syncope, as also stinking vapours, and sweet also do the same with some Women; and the blood is corrupted from evil meats. Too great Evacuations, whether sensible or insensible, do disperse the Spirits. The sensible are chief of Blood, from the Mouth, Nose, Womb, Belly, Hemorrhoids, Phlebotomy, and great Wounds▪ and next of other Humours, which though they are Excrementitious, yet because of their great Evacuation the Spirits are much dispersed, and cause a Syncope. These Humours are discharged by Vomit, Stool, Urine, Sweat, the opening of a great Imposthume, especially if it be inward, as an Empyema; or outward, as in a Dropsy when the Navel is tapped. The insensible Evacuations are by the Rarifaction of the Skin, and by the acrimony and thinness of the Humours, immoderate heat, hot Baths or Houses, great Labours. Also long watch, and fasting, Lechery, great anger, and joy, long and violent sickness do dissipate the Spirits; as also great pain of the Heart, Stomach, Guts, Reins, Ears, Teeth, and of all Nervous parts. An evil disposition of the Bowels doth alter and corrupt the Spirits, and whatsoever doth procure a malignant quality which is adverse to the Heart, as Air, Stinks, venomous and pestilential, taken in by the Breath, or bred in the Body from putrefaction of Humours; as also poison taken in, or applied outward, or sent to the Heart by biting of venomous Creatures. Lastly, The vehement returning of blood and Spirits to the Heart, and an abundance of evil vapours gathered about the Heart and the parts adjacent, and too much cold and thick blood gathered about the Heart and its Veins, Arteries, and parts adjacent, do suffocate and destroy the Spirits. We lately saw a Noble Lady, a Virgin, which from her Infancy was subject to this Disease, that with every light passion of the mind she was taken therewith, taken with a violent Syncope which ushered death in by a sudden return of blood and Spirits to her heart; for when she should have been married to a fine young man which loved her dear, and her Parents, Friends, and Kindred were solemnly met about it, they gave her a Pen to write her hand to the Contract; but she having not fully written her name fell down dead upon the ground: Hence we easily conjecture, that there was a great and sudden retraction of the Blood and Spirits to the Heart by a vehement passion of the mind, which choked the Natural heat, and the Spirits therein, of which she died suddenly. Petrus Salius Diversus saw, as he reporteth, Lib. de off part. cap. 4. a Girl of fourteen years old fall into a Syncope from abundance of cold and thick blood garhered about her heart and the great vessels: for having for a whole day a heaviness of head with giddiness and disturbance. she died the next day after suddenly: After being opened, the blood appeared so congealed in the great Artay and Vena Cava or hollow Vein, that taking it by the end you might draw it out like a Sword from a Scabbard. Wherefore we judged, That the sudden death came from the interception and stopping of the Veins by congealed blood. This happeneth seldom, for you shall seldom see blood in dead bodies so congealed: for the veins have such a property to retain blood, that even after death they keep it thin, though without them it growth always thick. But Salius gives the Reason of this Congealation by comparing it with blood without the Vessels, which as soon as it is cold, is congealed; and the sooner from the coldness, thickness and slyminess of the Melanchollick or Phlegmatic humour therein contained. Something like to this may besal blood constrained in the veins which abounding with vicious juice thick and cold, doth ●o fill the greater Veins, that it stops the spirits, and so extinguisheth them: and then the blood grows cold and thick, from those humours which otherwise would have been thin. The spagirics refer this to a congealing Spirit, made of a peculiar and extraordinary mixture of Humours, which since it seldom happeneth, the Disease is very rare: And truly a simple Refrigeration cannot cause that concretion, for then in dead bodies, especially in winter, the blood would always be thick in the Veins, but we find it always thin; but we may suppose that this Congealing Spirit is like that which causeth a Catalepsis, or Congealation which makes the parts inflexible. The Chemists do acknowledge such kind of Congealing Spirits to be in many Creatures, Vegetables, and Minerals; such as are reported to be raised out of the Earth, in some Histories of Men and Beasts who have been Congealed by filthy vapours coming from Earthquakes, or Dens; so, that their bodies became presently stiff: And Cardanus saith, That such spirits are in Thunderbolts, in his History of the Eight Mowers, who Supping under an Oak were struck stiff, and remained as at first, the one seeming to Eat, the other to reach the Pot, and the other to Drink. The Signs to this Disease by either are from the Subject which is more capable to receive it, or from the Fit either coming or present, or from the Causes that produce it. The Subjects which are most fit to receive a Syncope are men who by some Natural Debility or Weakness from some Disease, become faint-hearted. Women rather than Men, especially in their Terms, or with Child: As also they who have fine Constitutions, subject to the Jaundice, Spleen, or Melancholy. These things signify that a Syncope is coming to them who are subject to it; Anxiety and sudden disturbance of mind, heaviness in the head, giddiness, an apprehension of divers colours, green, and yellow, a sudden and often change of the colour in the face, and of the beating of the Pulse. When Leipothymy is present the same signs are, but greater; and there is often a cold sweat, as also the sick complain of their faintness. But these signs show a Syncope, A sudden failing of all strength, a slow pulse, low and at length stopping, a pale and bluish face, coldness of all the body, especially externally; a cold sweat especially in the temples, neck, and breast, from whence the Disease is named. The signs of the Causes are commonly manifest, for Fever's malignant, acute, syncopal or fainting, cause a proper Syncope or Swoonding, are easily known: As also those external Causes which make a sudden Syncope, may be plainly seen, As Anger extraordinary and Joy, a sudden Fright, stinking smells, great bleeding, and other large evacuations, long watch, and fasting, much lechery, and grievous pain. These things do signify that the Humours and the Body are thin, a sharp nose, hollow eyes, temples fallen; and the gnawing of the mouth of the stomach, trouble of mind, pricking, heat and great pain, do show abundance of Choler. When there is abundance of crude Humours you may know by the enlarging of the body, swelling about the breast, a pale colour, black and blue, a small, obscure, and unequal pulse. A swoonding by way of Sympathy from other parts, is known by the sign of those parts affected; so that if it come from the stomach, that hath been distempered with loathing vomiting, gnawing, the mouth hath been bitter, and dry, and the like. The same Judgement is to be taken in other parts: but if you see no sign of any other part affected, you may conclude that it comes principally from the heart. Moreover, A Syncope is distinguished from other Diseases by its proper signs. From an Epilepsy, because that hath a Convulsion, but a Syncope not: From an Apoplexy, because in that the breath is stopped, and there is often snorting, and the pulse is not much abated, except when Death is at hand; but in a Syncope the Pulse is almost gone, and the breath is free. It is distinguished from the Mother, for in that the breathing parts are most affected, so that the Patient is almost strangled, but the Pulse is not much altered, nor the colour of the face, but keeps its natural complexion, and sometimes is higher coloured; but in a Syncope the breath is not stopped, but the pulse is almost gone, and the face is pale: But sometimes a Syncope is joined with the Suffocation of the Mother, and then the Pulse is not perceived. The Prognostic of this Disease is first taken from Hypocrates, Aph. 41. Sect. 2. They who often and violently faint without a manifest Cause, do die suddenly. For as it is said, a great Syncope doth quite take away the strength from the heart. A Syncope from which a man is not recovered by Rose Water thrown in his face, and Wine given to drink with sneezing-pouder put into the Nose is deadly. When one is raised from a Syncope, health is not to be promised; for if his Pulse return not, but his colour be wan, and he still be cold, he will quickly Relapse, in which is danger. That Syncope which comes from immoderate Evacuations, fear, sorrow, or some evident Cause, is of less danger than that which comes from an internal Cause. As for the Cure, because it comes from divers Causes, it must be various. But of what Cause soever it come, in the time of the Fit these are good, Lying upon the back, throwing of cold Water in the face, provoking to neez, putting of strong Wine, Cinnamon, or imperial Water, Aqua vitae, Coelestis, and the like into the mouth, holding of hot bread to the Nose, loud calling and shaking, stopping of the Nostrils; wring of the Fingers, pulling of the Hair, rubbing, binding, and cupping. But in respect of the Causes which are divers, you must vary the Cure thus: If it come from want of meat, he will be Cured with strong Wine, and a Toast, or Sop: Also with nourishing broths, and Restoring distilled Waters among other things, a dish of Eggs with sugar, Wine and Cinnamon described in the following Chapter. If it come from thinness of the Humours by which the spirits do easily fly away, give him sweet things and meats of good juice, and thickening; let the pores of the skin be stopped with Oil of Roses, and let the Patient stay in a cold place. If it come from the Mother, you must give Medicines for that. If it come from some evil quality, give Cordials and Antidotes, such as are prescribed in malignant Fevers. If from poison, give things to expel it: First a Vomit, and then Treacle; and than if he feel burning or gnawing in the Guts, let him take Milk of Butter, or fat Broth, or cooling Cordial Potions. If it come of immoderate Evacuation, let the Patient be refreshed with Scents, Meat, Drink, sleep, and rest. If from too great loss of Blood, lay him upon his bed, with his Head backwards, dash his face with cold Water, give him a little Wine with cold Water. If it come of too much Purging, give him new Treacle, or old if you cannot get new, with two grains of Opium dissolved in Wine, or three grains of Laudanum which is better. And let the Belly be anointed all over with this following Oil: Take of Oil of Myrtles, and Quinces, of each one ounce and an half: Oil of Wormwood one ounce: With a little Rose Vinegar mix them and anoint often. Give a Clyster of steeled Milk with three Yolks of Eggs, and two drams of Philonium Romanum. Use Frictions of the Arms and upper parts, give him a Sop in Wine, or Wine alone. And lastly, Every Evacuation whether it be of Blood from the Nose, or Womb, or other parts, or of Humours by Vomit, or Stool, must be stopped with their proper Medicines prescribed in their several Chapters. That Syncope which comes from too much Sweat, is cured by Medicines that restrain Sweat; as with Cold, or Rose Water alone, or with a little Vinegar sprinkled upon the Face and Hands. Also let the Air be cooled with the same Water, and with Fanning. Apply cold Epithems to the Heart made of Rose, Sorrel, and Borrage Water, with Powder of Diamargariton frigid, with a little Wine to make it pierce. You must also give often cooling Juleps made of Syrup of Sorrel, Violets, and Apples, or Lemons, with cooling Waters, and Lapis Prunellae. Let the Pores be closed with anointing the Skin with Oil of Roses, Myrtles, and Mastich. Let him abstain from Wine. Let him not be rubbed, b●t let him move often gently, being lightly covered. Let his bed be perfumed with this Powder following: Take of the flowers of Water-lillies, red Roses, of each three ounces: the best Labdanum half an ounce: Storax two drams: Myrtles, and grains of Sumach, of each two ounces. Make a Powder. If it come from suffocation of the Spirits, you must call them forth by Frictions▪ Ligatures, Cupping-glasses, and the like. And if this Suffocation came of Repletion, you must bleed plentifully, but by degrees. If it comes from terror and fear, you must also bleed, lest it cause an Obstruction or Inflammation. Chap. 2. Of the Palpitation, or Breathing of the Heart. AS in a Synoope the motion of the Heart is diminished, so in this Disease it is depraved. It i● wrongly styled by some a trembling of the Heart, when trembling is a passion of the Animal and voluntary motion, and is not proper to any parts but such as have voluntary motion. Galen in his Book of Trembling, Palpitation, and Convulsion, saith, That Palpitation comes only from the Disease that is from the Cause which lifteth up, and depresseth the part, without any help of the Faculty; but Trembling comes partly from the Faculty, partly from the Disease. Hence it is that many using the word Palpitation indifferently to any part, think it is in the Heart, as in the Skin and Muscles, in which it comes from wind driven violently thither: for if the Heart be moved as a Bladder by water or wind, they suppose that to be a Palpitation. But the reason is different; for the Skin and Muscles cannot naturally dilate and contract themselves, but by Diseases. But the Heart hath a Natural Faculty to contract and dilate itself, therefore a Palpitation cannot be without its motion. And they do in vain muster up Galens Reasons, so thought by them, to prove that the Palpitation of the Heart comes not by Nature, but by a Disease, or cause of a Disease. For Galen in all those places speaks of no other Palpitation than that which is in the Skin and other external parts, and not of the palpitation of the Heart, which is of another Nature; and Galen 2. de sympt. cause. cap. 2. saith that the Palpitation of the Heart and Arteries, is different from that of the other parts. Therefore the Palpitation of the Heart is an immoderate and preternatural shaking of the part, with a great Diastole or Dilatation, and a vehement Systole or contraction which sometimes is so great that as Fernelius observes, it hath often broken the Ribs adjoining, & sometimes displaced them which are over the Paps; and sometimes it hath so dilated an Artery forth into an Aneurism as big as one's fist, in which you might both see and feel the pulsation. This immoderate shaking of the Heart comes from the Pulsative Faculty provoked. But here may be objected, That in Fevers all these things are found, for this is an immoderate Systole and Diastole, by the provocation of the Faculty through some troublesome matter, or by increase of heat in the Heart. To this we answer, That the motion of the Heart in Fevers is distinguished from Palpitation, only by its degrees, and the depraved motion of the Heart when it is vehement, is called Palpitation; but if it be not vehement, it is called a quick, great, and swift Pulse, and is referred to the difference● of Pulses. Now the Efficient Causes of this Palpitation may be referred to Three Heads: Either it is somewhat which troubleth and pricketh; or necessity of Refrigeration; or defect of Spirits: which two latter may be referred to the increase of Custom. The Molesting Cause is most usual, so that many Authors knew no other, the other are rare, and that is either a vapour or wind which troubleth the Heart either in quantity or quality, or both. The quality is either manifest or occult▪ A vapour troublesome in a manifest quality, is either in the Heart and its parts adjoining; or it is sent from other parts; and this suddenly getting to the inmost parts of the Heart, doth stir up the Expulsive Faculty, which being Naturally very strong, ariseth powerfully with all its force to expel the enemy. In the Heart, and thereabout, especially in the Pericardium, are gathered sometimes cold and thick Humours, which send up vapours to the Ventricles of the Heart, which cause Palpitation. But from more remote parts, vapours and wind are sent to the Ventricles of the Heart; as from the Stomach, Spleen, Mother, and the other parts of the lower Belly. Many times a Vapour that troubles the Heart by an occult quality, ariseth in malignant Fevers, Plague, and after Poison, and sometimes from Worms putrified, and the terms stopped from corrupt seed, or other putrid matter which do much stir up the Expulsive Faculty thereof. Divers Humours do molest the Heart, either with their quantity or quality; so too much Blood oppressing the Veins, Arteries, and Ventricles of the Heart, so that they cannot move freely, makes a Palpitation by hindering motion, which that the Faculty may oppose it moveth more violently. So Water in the Pericardium, being in great quantity, doth compress the substance of the Heart and its Ventricle, so that they cannot freely dilate themselves. The same do Humours flowing in abundance to the Heart, as it happens sometimes in Wounds, Fear, and Terror. Humours offending in quality, hurt the Heart, if they be venomous, putrid, corrupt, sharp, or too hot, especially burnt Choler coming to the Heart, and provoking its Expulsion. Also Tumours, though seldom, cause this Disease; as Inflammation of the Heart, Imposthumes, or Swelling in the Arteries of the Lungs near the Heart; which Galen saith befell Antipater the Physician, 4. de▪ loc. off. by which, after an unequal Pulse, he fell into a Palpitation and an Asthma, and so died: so Dodonaeus reports that he found a Callus in the great Artery next to the Heart, which caused a Palpitation for many years. Also Tumours in the Pericardium, whether they be without humours and scirrhus, or with humours in them, as the Hydatides or watery Pustles, and little stones, bones, and pieces of flesh are sometimes growing in the Heart, which cause Palpitation. So Platerus reports, that in one who had a long Palpitation, and died thereof, there was found a bone in his Heart. But Schenkius reports, that in a Priest who was from his youth to the age of forty two troubled with a Palpitation, there was found in the bottom of his Heart an Excrescens of flesh which weighed eight drams, and resembled another Heart. The Second Cause of Palpitation is necessity of refrigeration, which is, when there is a preternatural heart in the Heart, by which the Spirits are inflamed within, and therefore the motion of the Heart and Arteries is increased, that what is spent, may be restored, and the heat cooled; and this comes sometimes from an internal cause, which is rare, but oftener of an external, as anger, vehement exercise, and the like. As Platerus observed in a young man, who being hot and angry at Tennis, fell into a Palpitation of the Heart, and so died. The third Cause, is the defect of Spirits which comes by hunger, watching, anger, Joy, fear, shame, and great Disease's, and other causes which do suddenly dissipate the Spirits, which defect the Heart labouring to repair, that it may beget more quick and plentiful▪ and send them into the whole Body sooner, it doth enlarge its motion, and make it quicker. You must observe for conclusion that it is more ordinary to see a Palpitation which comes by consent from other parts, than from the Heart itself: For it hath a consent with all parts by the Veins and Arteries, by which, Vapours, Wind, and Humours are sent. Which all shall be showed in the Diagnosis following: The Diagnosis or knowledge of this Disease, is directed either to the Disease, or the Causes which produce it. The Disease is subject to sense; it may be felt with the hands, sometimes seen and heard; for the Artery may be seen to leap especially in the Jugular. And Forestus saith it may be heard, by an Example of a young man, that they who passed by might hear it by laying their Ear to the Window. Also the Causes are distinguished by their Signs: A hot distemper is known by the greatness of the Pulse and swiftness, by a Fever and heat of the Breast, by great and often breathing, and desire of cold things. If the Palpitation come of wind, it quickly comes and goes, and is presently raised by little motion, and the Breath is difficult, with trembling sometimes at the knees, mists in the Eyes, noise in the Ears, and sometimes pain of some part, which quickly is gon●; but you must gather the Nature and quality of the Vapour by the signs of the Humour which aboundeth in any part, because vapours do always arise from Humours. If the Palpitation come from Humours in the Heart, the Disease doth not come so suddenly, and continueth longer, and you may know what kind of humour it is by the signs of the Humour which abounds throughout the whole Body. And especially if it be from Blood, from which it most often proceedeth; and this is known by a divers and unequal Pulse, sometimes great, sometimes small, slow, and swift, to which the Breathing answereth in proportion; the Patient's heart seemeth to be bound and oppressed, as appears by the exceeding heat, distension of the Veins, redness of Face, the time being Spring, the Age, Region, and Diet causing Blood to abound▪ That which comes by consent from other parts, is known by the proper signs of the parts affected, so we know that it is from the stomach, when there is want of Appetite, loathing, vomiting of base Humours, and gnawing at the Stomach. A troublesome breathing about the Pancreas or Spleen, or any other disease of the Spleen, showeth that the matter lurketh there, from whence the vapours fly to the Heart; so suppression of the Terms, and Hysterical fits, declare that it comes from the Womb. The Water abounding in the Pericardium is harder to be known, but we may conjecture, if the Pulse be weak and faint, and the Patient bemoaneth himself, that his heart as it were is sometimes in Water, and is suffocated, and if it be constant, and he incline to an Atrophy or Hectic. If malignant humours cause it, there will be great change in the Pulse, a loss of strength, sometimes fainting, and other signs of malignity. If it come from a Tumour there is remarkable variety in the Pulse, and the motion of the Heart is different from the natural, very unequal and inordinate, and if the humour be hot, there will be great inflammation in the Body, great thirst, difficulty of breathing and fainting will follow with death: but if the Tumour be hard, and in the Pericardium, the disease is constant, and the Patiented decays by degrees without any manifest cause: if flesh, or any more solid thing grow to the heart, there will be a continual Palpitation from the beginning of the Disease to the end of Life. Lastly, You may know when it comes by want of Spirits, by the precedent causes, which destroyed the Spirits, and by the quick and small pulse, and when it comes from the least labour or motion. Sometimes the like befalls them that are well from walking or other motion, with a change of Pulse, and a resembling Palpitation. The Prognostic is to be taken thus: It is dangerous from the hindrance of the motion of the Heart, by which Life is preserved, and it brings Syncopes and death: For it is a true Observation of Galen, Com. Aph. 41. Sect. 2. and 5. de loc. off. cap. 2. All that in youth, or in declining age are troubled with the Palpitation of the Heart very much, die before they are old; for the often Palpitation is a sign that the Vital faculty was very weak. A Palpitation by Propriety is worse than by consent, and sometimes deadly. And that which is of an internal, is worse than that which comes of an external Cause, unless it be from poison, or some great wound. If it come from a Tumour, or solution of Unity, it is incurable. The Cure is various, according to the variety of the Causes: and first that which comes from a peculiar distemper of the Heart and Pericardium, is incurable; therefore we must look only at the Cure of that which is by consent, which depends upon the divers diseases of the parts, whose Cure must be sought in their proper Chapters. But besides those Remedies which take away the Cause, you must use those which assuage the Symptoms by refreshing the Heart, and strengthening it, and which discuss the vapours which arise from melancholy, or crude & waterish Humours; as Cordial Juleps, Opiates, Epithems, & Perfumes, which are prescribed in weakness, and these that follow. Take of Conserve of Balm, Rosemary-flowers, Borrageflowers, and Clove-gilly-flowers, of each one ounce: Confection of Acorns and old Treacle, of each one dram: the Powder of Diamber, and Diamoschi dulcis, of each one scruple: with the Syrup of Citron Barks make an Opiate, which let him take often. Take of Bugloss, Rose, and Orenge-flower Water, of each two ounces: the syrup of Clove-gilly-flowers, one ounce and an half: Cinnamon Water half an ounce: the spirit of Roses two drams: Confection of Acorns one dram: mix them and give two spoonfuls now and then. This following Liquor which immitateth the Juice of Hearts described in the following Chapter, is good. Take of Hogs or Sheep's Hearts three: Cinnamon and Cloves of each one dram: Lettuce and Sorrel seeds, of each one dram and an half: white Wine two ounces: borage, Scabious, and Rose Water, of each one ounce and an half: Confection of Alkermes, one dram: boil them all between Two Dishes, and let him take two spoonfuls of the Liquor morning and evening. Take of Red Roses and Rosemary-flowers of each two drams: Lavender flowers one dram: Angelica seeds, Citron peels, Cloves, Cinnamon, and Mace, of each half a dram: Saffron one scruple: Musk and Ambergris of each six grains: Make a Bag with red Silk and sprinkle it with Rose water and white Wine, and apply it warm to the Heart. Take of Ointment of Roses half an ounce: Oil of Cinnamon and Cloves of each six drops: Musk and Ambergris of each four grains: Mix it for a Lineament for the heart. Purging Clysters and Carminative to expel Wind are often to be given. But in the Fit it is best to open a vein; And Galen witnesseth 5. de loc. off. cap. 2. That he never did it without profit. Some apply Cupping Glasses without Scarification to the Breast, which they say are excellent to discuss Wind there contained. Others to the Hypochondria, when the matter of the Disease is there. But Zacutus Lusitanus applied a Cupping Glass with Scarification to the heart with wonderful success, as you may read in prax. admire. obs. 133. lib. 1. Others commend true Rhapontick given to two scruples in Wine, or Wine wherein the same hath been steeped. Chap. 3. Of WEAKNESS. ALthough Weakness of Strength doth generally comprehend the hindrance of all Actions, Animal, Vital, and Natural; yet more particularly it comprehends the Vital which are known by a Weak Pulse: yet this Weakness useth to be found in all great Diseases, in which Nature doth yield or resist the Cause. Therefore as in Palpitation the Action of the Heart that is Pulsation is depraved, so in Weakness it is diminished. Which is the same with a Syncope, but it differs in this, In a Syncope it is so little that it is hardly perceived; but in Weakness the Pulse is manifest and not so little. In this also the Animal Faculty is always offended: Hence comes weak motion without hurt of the Brain, Nerves, or Muscles, but from the defect of Vital Spirits which are not so sufficiently sent to the Head that they may be made Animal. The immediate Cause of Weakness is Defect of the natural heat and spirits from which the life and strength of the parts do depend. And this Defect is in every part from the Defect of Vital Spirits, and heat flowing from the heart. Now the Vital Spirits are Defective, either because they are not bred many; or because they are dissipated after they are Bred, or Corrupted, or Suffocated, as we said in a Syncope, where there is this difference, That in a Syncope the Causes of Defect of Spirits, do suddenly produce their effect; but in Weakness they operate by degrees. And therefore in Syncopes and Leipothymia all the Vital Spirits almost, do suddenly fail, but in this there are fewer than ought to be communicated to every part. Moreover, When the Natural heat wants not only adventitious heat, but also radical moisture to feed upon: if this moisture be wanting and diminished, the natural heat must be less, and the strength abated. Now the Causes which hinder the spirits from being Generated, or maketh them disperse themselves, or Corrupt, or Suffocate them, are propounded in the Treatise of a Syncope. The Diagnosis of this Disease needs no Explication because it is manifest, and the Patients do complain of their Weakness. But the signs of the Causes were Propounded in the Syncope. The Prognostic depends upon the various disposition of Causes, for as they are greater or less, there is more or less danger. The Cure of this Disease is to be directed to two things, To the taking away of the Cause, and the Restauration of the Heart and vital spirits. The Causes are, almost all great Diseases, in which either Nature yields to, or resisteth with difficulty, therefore the taking away of the Cause belongs to the Cure of almost all Diseases: which you must take from their proper Chapters. But the strengthening of the Heart, and restoring of the vital spirits are to be here declared; sometimes to be preferred before the Cure of the Cause, when death seems to be at hand: but we must always take heed least when we increase the strength we increase the Cause of the Disease: and therefore in a hot Disease you must use more temperate Cordials, but in a Cold Disease those that are more hot. First then mix Cordials in his nourishment, as Confectio Alkermes, or Confectio de Hyacyntho in Broths, or with pleasant Wine or Cinnamon Water, if there be great weakness. Boyl also between two Dishes a piece of a Leg of Mutton, after the skin and fat is taken off, and after that let the Patient drink the Broth, being strained, at one daught. Or, Take the Flesh of a Capon after the skin and fat is taken away, cut it in pieces, and put it in a glassed Pot well Luted, and set it in Balneo Martae to boil for five hours, then let the Patient take two or three spoonfuls of the Liquor in all his Broths. Or you may make a distilled Water thus: Take a Capon or an Hen, after the skin is taken off, and the fat, cut it in pieces; then power upon it Water of Bugloss, borage, Sorrel, Roses, and Orange Flowers, of each half a pound: the Powder of three , Aromaticum Rosatum, and Cinnamen, of each half an ounce: yellow one ounce: Lemmons sliced, three. Distil them according to art, which must be given every hour by the spoonful. The Juice of Legs of Mutton only is of much use. Half roast a Leg of Mutton, and slash it upon the Spit; take the Juice and boil it a little in the dish, and give it either alone, or with Broth, or with Yolks of Eggs. Valeriola doth much commend the Juice taken out of Sheep's Hearts. And Zacutus Lucitanus confirms it by his Experience, saying, That he with this only Medicine a mouth continued, cured a rich man, who often swooned through weakness of the Vital Faculty, and resolution of the Blood and Spirits, when many other Medicines had been used in vain. The Juice is thus taken forth: Slit the Heart of a Sheep or Goat in the middle, then wash it well, and last wash it with Rose Water; then cut it in slices and put it in a glassed Vassel with a few Cloves, and no other Liquor. And after the Pot is well luted, put it into the Oven after it is drawn, till the Juice come forth. Give this to the Patient to drink. The Italians use Caudles of Yolks of Eggs, Wine, Sugar, and Cinnamon, which is very restorative. Zacutus Lucitanus makes a fine dish of twenty Yolks of Eggs; as you may see in the 107. Observation, Lib. 2. of his Admirable Practice. You may make Cordial Juleps thus: Take of the Water of Bugloss, Roses, and Orange flowers, of each one ounce: Syrup of Apples and Lemons, of each half an ounce: Confectio Alkermes one dram: Cinnamon Water two drams. Make a Julep. Or make this following mixture: Take of white Sugar two ounces: moisten it well with the best Cinnamon Water; then put to it as much Spirit of Vitriol as is sufficient to make it sharp; then add of the Essence of Cinnamon four drops; the Essence of Mace, Nutmegs, and Annis seeds, of each three drops; the Essence of Cloves two drops. Mix them, and take it either by itself, or in Broth. You may also make a restoring Opiate thus: Take of Conserve of Roses, Bugloss, borage, and Clove gillyflowers, of each one ounce: Citron Barks, and Nutmegs candied, of each three drams: one candied Myrobalan; Confectio Alkermes half an ounce: the Spirit of Roses, and Essence of Citrons, of each half a dram: the Essence of Cinnamon six drops: With the Syrup of Apples make an Opiate; take it often. This Water following is excellent: Take of the Jelly of Hartshorn drawn with white Wine, four pints: the Blood of a Lamb and a Calf cleansed with the hands from all fibres, of each two pints: Muschadel, Canary, and Malago Wine, of each three pints: of Calves Hearts cut in pieces four: Crumbs of new white Bread dipped in Milk two pound and an half; the Juice of Balm one pint and an half: Rose and Orange Flower Water, of each one pint: great Citrons sliced three: Cinnamon four ounces: Mace one ounce: Put them in a large glass Still, and still them in Balneo Mariae. You may make a most excellent and precious Cordial Water after this manner: Take of Ambergreese two drams: Musk two scruples: Lignum Aloes one dram and an half: the white part of Benjamin three drams: after they are bruised and mixed, put them into Spirit of Wine, and setting them upon a gentle fire draw out the Tincture fully; and then filter off the Liquor, and draw off half the spirit with an Alembick upon the ashes with a very gentle fire; keep the Liquor close stopped in a Glass, with a Cork waxed over, and a bladder; of which you may give two, three, or four drops in Broth, or in Juleps, or in this following Syrup. Take of Cinnamon Water four ounces: the best Rose and Orange flower Water, of each six ounces: Mix them, and dissolve therein as much Sugar candy as you can, and make it into a Syrup without fire; with a spoonful whereof, mix four Drops of the aforesaid Cordial Liquor. Of the Ingredients remaining from the former Liquor, with as much of Damask Roses, and four times as much Benjamin, you may make Cakes to perfume the Chamber. Apply both Liquid and Solid Epithems to the Heart, and young Pigeons slit and sprinkled with Cordial Powders. Apply to the Stomach, bags of Spices dipped in Wine. Let the Stones and privy Members be fomented with Confection of Alkermes dissolved in Wine. Let the Arteries of the Temples, Hands and Feet be touched with Confectio Alkermes, adding a little Cinnamon Water. Apply this following to the Nose: Take of the Leaves of Balm, Bazil, and Marjoram, of each two drams: Citron peels, yellow Sanders, and Cloves, of each one dram: Saffron half a scruple: Ambergreese six grains: Musk four grains: tie them in a clout and dip them in Rose and Cinnamon Water, and smell thereto often. Or make a Balsam to anoint the Nostrils with the Chemical Oils aforesaid of Nutmeg, Cinnamon, and Cloves, with a little Wax. The End of the Eighth Book. THE NINTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Stomach. The PREFACE. AS there are divers Actions of the Stomach, so there are divers Hindrances of those Actions which Cause variety of Diseases: For this part being ordained to Concoct meat, and make the Chyle; for the performance thereof first it is constrained to desire Meat and Drink by the Appetite which may be diminished, abolished, or depraved. When it is abolished, it is called Anorexia, & Apositia: When 'tis diminished, it is called Inappetentia, and Loathing: But when it is depraved, it is called Doggshungs, or Pica, or Malacia: Too great desire of Drink is called Sitis Morbosa: These Diseases mentioned do concern the attractive Faculty, they which concern Concoction, as it is diminished, abolished, or depraved, are comprehended under the name only of Concoction hindered; if the Retentive and Expulsive Faculty be hurt, it consists in Vomiting and Hickocks: There are divers kinds of Vomitings according to the divers Condition and nature of the Matter Vomited forth. And because the Stomach is of exquisite sense of Feeling by reason of the famous Nerve it hath from the sixth Conjugation, it is therefore as other sensible Parts, subject to pains; and it hath sometimes Tumours, (as other parts) and Inflammations, Imposthumes, and Ulcers. That therefore we may in this Book explain all the Ordinary Diseases of the Stomach, we will Comprehend it in Eleven Chapters. The First, Of Inappetentia, or Loathing or meat. The Second, Of Fame's Canina, or Dog's Appetite. The Third, Of Pica and Malacia, or Green-sickness. The Fourth, Of Sitis Morbosa, or diseased Thirst. The Fifth, Of Concoction hindered or hurt. The Sixth, Of Hickocks. The Seventh, Of Vomiting. The Eighth, Of Vomiting Blood. The Ninth, Of the Disease called Chollera. The Tenth, Of Pain in the Stomach. The Eleventh, Of its Inflammation, Imposthume, and Vcer. Chap. 1. Of Want of Appetite, or Loathing of Meat. INappetentia, and Loathing, is either from the abolished or diminished Action of the stomach: When it is Abolished it is called Anorexia, & Apositia: but when it is Diminished it is called Dusorexia, but by Custom Anorexia, & Apositia are used for both. The Causes of this Disease are divers, which that we may bring into Order, let us consider the Natural Causes of Hunger or Appetite: These are called by Galen, lib. 1. de symp. cause. cap. 7. Symptoms: and are Five, The First whereof is emptiness of the parts. The Second is the Natural Appetite of those parts so emptied. The Third is the Sucking and Attraction of the Mesaraick Veins in the Stomach and Guts. The Fourth is the sense of their sucking in the Stomach. The Fifth is the Animal Appetite which cometh from the Nerve in the mouth of the stomach which comes from the Brain, and is endued with great sense and feeling. As also the Melanchollick Humour which comes from the Spleen to the mouth of the stomach, which with its sharpness gnaws the inmost Tunicle of the stomach, and is like sauce to stir up Appetite; which that it may be natural, it is necessary that all those Causes be in Order; for if there be any fault in either, then there is a hurt or hindrance of Appetite. Therefore the First Cause which is Emptiness of Parts, if it be wanting there is no Attraction made by them from other parts and the stomach, and so there is no Appetite: now this Emptiness is wanting either when the parts are filled with plenty of crude juices, by reason of gluttony or drunkenness; or for want of exercise, or usual evacuations, or when there is so much fat that it is sufficient to nourish the parts: Also the great stoppage of the pores of the skin, doth hinder the emptiness or the parts: or great weakness of the natural heat, so that it can disperse none or but little of the substance of the Parts: or the calling of that heat to the concoction of the matter of a Disease whereby the nourishment of Parts is neglected, as in Fevers. The Second Cause is Natural Appetite, and the Attraction of nourishment to the stomach; and this is depraved when the Parts though empty, will not draw by the veins, by reason they have lost their strength, but languish and forget their duty: As happeneth in acute, malignant, pestilential, syntectick, and hectic Fevers: And in immoderate evacuations, as in Flux of the Liver, Womb, Haemorrhoids, Bleeding at the Nose, Great Sweat, much Lechery, long Fasting, and the like. The Third Cause is, The Attraction of the stomach by the Mesaraick Veins, which useth to be depraved by stoppage of those veins, by which means the empty Parts cannot attract their Chylus, nor make the mouth of the stomach sensible: so we may perceive in Children troubled with Struma, to consume by a long Flux of Chyle, by reason all the Mesentery is full of Glandles which stop its Veins, and hinder the passage of the Chyle to the Liver, by which means it is sent half concocted forth by siege, and the Parts are deprived of their necessary nourishment. The Fourth and Fifth Causes, which are Sense of Sucking, and Animal Appetite, do require a good disposition in the Stomach, brain, and nerves: Therefore whatsoever can al●er their dispositions may also destroy Appetite; so every great distemper of the belly, especially if it be hot and dry doth hinder Appetite. Great heat by dispersing the moist substance of the stomach, doth take away Appetite; as also great Cold not only positive as when the bowels are so cold that they are stupefied by Air, Water, Frost, Snow, and the like; but also privative, when the native heat is spent, which Galen calls Na●cosis or Stupefaction, as by long bleeding, fevers, and the like, by which the strength of the stomach and other Parts is consumed. Evil also and corrupt Humours; whether hot or cold, do cause want of Appetite: The hot are choleric, adust, putrid, or virulent, whether they are bred in the stomach for want of Concoction, or brought from other infirm Parts. The Cold Humours are, Flegmy and Slimy, gathered in the stomach by evil Concoction, or coming from the whole body, as in them who by often Vomitings bring the corruption of other Parts into the stomach. Or from the Brain by Catarrhs in which the stomalch useth to be troubled with Phlegm: The suppression of the Terms and Haemorrhoids also, by choking and smothering the natural heat do also diminish the Appetite. Moreover, The distemper of the Brain and Nerves Cause that the Sucking is not flet in the stomach in them who have lost or depraved the Animal Faculty; therefore they are ●ick in mind, as in an Apoplexy, Lethargy, Frenzy, Madness, and the like; as also in a Palsy by reason of the Obstruction of the Nerve of the sixth Conjugation which comes to the Stomach, or by reason of the stupefaction thereof, by the use of cold and narcotick things. The knowledge of this Disease is manifest, for the Patient will complain of his want of appetite, and loathing of Meat. But the signs of the Causes are partly manifest, and partly to be discovered by art. And first, they which cause the want of emptiness, are known by former high feeding, repletion, want of exercise, or evacuation, long sleep, and other Causes of crude Juices; as also if the body be full, and the Veins swollen. Also the thickness of the Skin signifieth the same, for that hinders the dispersing of the nourishment, as also some great disease in some particular part, by which there is 〈◊〉 dispersing of the Natural heat in the whole Body, so that it is so weak that it cannot concoct the nourishment brought to the parts, and supply its wants. The signs of the second Cause are manifest, namely acute, malignant, pestilential, and syntectick● Fevers, strong evacuations, and other Causes, by which there is a great decay of Natural heat in the parts, so that they cannot attract necessary nourishment. The signs of the third Cause are obstructions, whose signs are known in the diseases of the Liver, Spleen, and Mesentery. The signs of the fourth and fifth Cause, need a more curious search, and first heat in the Praecordia, especially in the Stomach, thirst, dryness, and bitterness of the Tongue and Jaws, and a Fever, do signify a hot distemper of the stomach, and abundance of Choler. And if this hot humour do flow from other parts, the disease of that part will show it, as inflammation of the Liver, or other part. But if no other part seem to suffer, you must conjecture that the fault is in the Stomach, or that evil meats have been received. To these are joined Cardialgia, Heart-scalding, Nausea or loathing, Vomiting, and Purging, the Nature of which humours are known by what is sent forth. A cold distemper and much phlegm is known by cooling Causes afore going, or such as disperse the Natural heat, and extinguish it; as also from the sense of weight in the Stomach, from sharp belching, or from a slimy thick humour sent out of the mouth, or by stool. The same is signified by a long Catarrh, and a disease in some part which may send phlegm or melancholy to the Stomach, as of the Spleen, Womb, or the like. Also the distempers of the Brain and Nerves are to be known by their proper signs. As to the Prognostic: As a good Appetite is good in all Diseases; as Hipp. Aph. 33. Sect. 2. says, To be right in mind, and to be willing to take that which is brought, is good: so want of Appetite useth to be an evil sign. For it sgnifieth a great digression from the Natural state; and it comes, as Galen teacheth, Com. in 3. Epid. either from evil Humours in the Mouth of the Stomach, o● from the loss of the Faculty, whose duty it was to be sensible of the want of nourishment, and consequently to desire it. So Hipp. in 1 Epid. saith concerning men in Consumptions that died in the time of an Epidemical disease, they always abhorred meat and drink. And so Galen, Comment▪ in 3. Epid. saith that he hath seen many in a Plague time which could take no sustenance, and died: But some who were stronger, and took courage, and did eat, recovered. So in Hipp. 3. Epid. Sect. 1. Aegr. 2. Hermocrates, who died the twenty seventh day, abhorred meat all the time, and in the last days could not taste. And Sect. 2. of the same Book, Aegr. 6. Euryanactis her daughter, abhorred meat all the while, and drank nothing worth speaking of, died about twelve days after. But we must observe, that loathing of meat is sad if it come from the destruction of the Natural heat: but it is not so dangerous if it come from abundance of evil humours, and Cacochymia; as you may see in Hipp. 7. Epid. by the Son of Cleomenis, who without a Fever abhorred meat for two months, through abundance of crude and viscid phlegm, which he at last vomited up. So in the beginning of Diseases, and especially of Fevers, want of Appetite is not so dangerous, because then Nature being busy about the concocting of filthy humours, is called from her usual desire of meat. But after, when the Fever is appeased, and the humours that caused the Disease being spent, she returns to her old custom. In Children, want of Appetite is worse than in others, because their substance is moist, and easily dissipated, and requires more use of nourishment to restore them. In men recovered of a Disease, loathing threateneth a relapse, by reason the relics of the Disease cause it. In a continual Disease, loathing and sincere dejections are evil. Hipp. Aph. 6. Sect. 7. loathing is an evil sign in long diseases: but they who are like to escape, have the contrary; that is, a good appetite. But sincere dejections coming, do cause a worse Prognostic; because Hypocrates understands by sincere dejections, such as have no humidity mixed with them, when the humour alone without any Water, is cast forth, whether Choler or Melancholy; for these stools do show that all the Natural humidity is burnt up by the heat of the Fever. In long Diseases of the Guts, loathing of meat is evil, and with a Fever worse; Hipp. Aph. 3▪ Sect. 6. when there are deep and putrid Ulcers in a dysentery, the Stomach suffering with the Guts ●oth not well concoct, which offence arising higher, affects the mouth of the Stomach with loathing. There are some in Dysenteries, who abhor meat from the beginning of the Disease, by reason of the will humours which come from the Liver; for the superfluous part of them comes to the mouth of the Stomach, which is not always dangerous. But in long Diseases when it is so, there is either a putrefaction about the Ulcer, or a great Inflammation, both which are desperate. The Cure of this Disease, if it come from the distemper of other parts, must be by the Cure of it. But if it come only from a fault in the Stomach, it is to be reduced to a hot or cold distemper joined with matter. A hot distemper is to be cured first by purging of Choler gently and often. And this may be made of Rhubarb, Myrobalans, Tamarinds, Syrup of Roses, or of Succory with Rhubarb; Or if the Pati●nt be subject to vomiting, you must give him a gentle one. The same Humour is to be altered with Juleps or cooling Broths, in which you must not omit the Spirit of Vitriol or Sulphur; because all sharp things do not only allay Choler, but provoke an appetite. Hence it is that we use Salads in Summer, to provoke appetite. Or you may alter and purge this Humour at once with a convenient Apozeme, to which, for the Stomach, ad half a handful of Sea Wormwood, and half an ounce of Citron Myrobalans. After Purging, Marmalade of Quinces is good to strengthen the Stomach; or the Syrup mixed with Syrup of Wormwood, the Lozenges of Diamargariton frigid, or Triasantalon, or Diarrhodon ●bbatis, if there be a suspicion of Obstruction. Or this Opiate: Take of Candied Lettuce, and Guords, of each one ounce: Conserve of Sorrel, Roses, Succory, and Bugloss, of each half an ounce: red , Coral, and Pearl prepared, of each half a dram: ●he Troches of Spodium and Sorrel seeds, of each one scruple. With Syrup of Lemons make an Opiate, of which let him take the quantity of a small Nut morning and evening, drinking after a little Wine and Water. Anoint the Stomach outwardly with this Ointment. Take of Oil of Roses, Myrtles, and Quinces washed with Vinegar of Roses, of each two ounces: all the , red Coral, Coriander seed prepared, and red Roses, of each one dram: grana Ker●nes and Spodium, of each half a dram: white Wax as much as is sufficient. Make a Lineament, with which anoint the Stomach with your warm hand only twice or thrice in a day, putting in a little Rose Vinegar at the same time. Or lay on a Rose Cake sprinkled with Rose Vinegar, or steeped therein, which you must remove before it groweth hot. Lastly, In the continuance of the Disease a Bath is good twice or thrice used, by which many are brought to their former appetites. Vinegar, and all sharp things are good with their meat. A loathing cometh from a cold distemper, when flegmy melanchollick humours are gathered into the Stomach, and hinder its office; or being drawn from all other parts of the Body, as in them who using to vomit, draw the impurity of other parts to the Stomach, or from the Brain, Spleen, and Mother, and other parts. In the Cure hereof, you must first look at the distemper of the parts from whence they come, which must be amended with Remedies laid down in their proper Chapters. Then you must apply Medicines to the Stomach by Evacuation of the Humour offending, and strengthening the parts. Evacuation may be made by vomit or stool. By Vomit, If the Patient be Nauseous, and easy to vomit, with Medicines for that purpose. But if the Humours be thick, and fastened upon the Tunicles of the Stomach, and the Patient is not used to vomit, they must be purged, especially with Pills, because they stay longest in the Stomach; as Galen showeth cap. 7. lib. 4. de sanit. tuenda. Who exceedingly commends Pills of Hiera; which may be given to two scruples or a dram in the morning two hours before meat: and you may make them fresh, thus: Take of the best Aloes washed with the Juice of Wormwood one ounce: Agarick trochiscated two drams: the powder of Rhubarb sprinkled with white Wine one dram: Nutmeg and Spicknard of each half a dram: Salt of Tartar, Mastich, and Cinnamon, of each one scruple: With Syrup of Wormwood make a Mass of Pills; of a dram whereof make six Pills guilded. Let him take them in the morning if you will purge much; or give half a dram two hours before dinner twice or thrice in a week, They may be quickened with Diagridium, if you will have them stronger. If you fear the Liver is too hot, you may mix cool things; as red Roses, Sanders, Diamargariton: and make up the Mass with Compound Syrup of Succory. Strong Pills are not good, because they will draw humours from other Parts to the stomach. If he cannot swallow Pills, you must give him Hiera to drink with a convenient Liquor. Or, If a Potion shall be unpleasant, make an infusion of Senna, Myrobalans, Rhubarb and Agarick in Wormwood Wine, or the stomach Decoction, dissolving in it a little of the Electuary of Citrons solutive, if you will make a stronger. If this Disease comes from slow, slimy Phlegm, before Purging you must dissolve it with Honey of Roses, and Oxymel, with syrup of Hyssop and the like, with a cutting and cleansing Decoction. Or, This following Apozeme will do both. Take of the Roots of common Acorus▪ Cypress, and Calamus Aromaticus, of each one ounce: dried Citron peels, and Sarsa, of each six drams: Wormwood, Mints, Marjoram, Germander, and Chamaepitis, or Ground-pine, of each one handful: Citron and Annis-seeds, of each two drams: Senna, two ounces: Carthamus-seeds bruised, one ounce: Agarick trochiscated, three drams: Dodder of Thyme, or Epithimum Flowers, Sage, Rosemary, and Lavender, of each one pugil: boil them to a pint and an half: in which dissolve of the Syrup of Wormwood and candied Citron-peels, of each two ounces: make a clear Apozeme, and scent it with a little Cinnamon, and powder of Aromaticum Rosatum for four morning's draughts: in the first and last whereof you may dissolve for the better Purging three drams of the Solutive Electuary of Citrons, with one scruple of the powder of Rhubarb. The use of Turpentine is good, because it cleanseth all the Bowels; especially if you make it into Pills with Rhubarb. It is not good to let blood in this Disease, except the Liver be very hot. After sufficient Purging, you must come to Strengthening; both Internally, and Externally: Thus, Take of Syrup of Wormwood, one ounce: Let him Drink it Fasting many mornings: or Wormwood-wine. Take Conserve of Mints, Citron peels candied, and candied Mutmegs, of each half an ounce: one candied Myrobalane: of Confectio Alkermes, three drams: the inward skins of Hensmaws powdered, two drams: Cinnamon and Aromaticum Rosatum, of each one dram: with syrup of Mints make an Opiate: or candy them with sugar of Roses; use it in the morning, drinking after it a little Wine. Salt of Wormwood is good to be put to the aforesaid Medicines, Or, Oil of Mints Chemical. Or, Salt of Wormwood with Orange peels, or either of them to half a dram in Wine, or Broth. This following Syrup is most excellent: Take of the syrup of Quinces, and Citron Barks candied, of each two ounces: Cinnamon water, one ounce: Oil of Sulphur twelve drops: mix them to be taken now and then a spoonful. Claret Water is usual, and it is made thus: Take of Cinnamon grossly powdered two ounces: steep them in one pint of Aqua Vitae in a glass; in another glass put six ounces of sugar with half a pint of Rose water: let these Glasses stand two or three days; every day shaking them often; then mix them both together and strain them by filtration; keep the Liquor in a Glass close stopped, and let the Patient take a spoonful or two Fasting. In Paris the Syrup of Wormwood made by Pena is highly esteemed; made thus, Take half a pound of candied Citron barks sliced: boil them in equal parts of the Waters of Succory and Agrimony, make a strong expression and put to it the juice of Quinces, and Wormwood water, of each half a pint; in which infuse for four days four ounces of Schoenanth in a close vessel well glassed and set upon the Embers; dissolve in the straining as much sugar as is needful; then boil them to a syrup, in which when it is hot dissolve one dram of ash-coloured Amber: keep it in a close Glass. Cinnamon Water alone is excellent good in a Cold Stomach, or with other Medicines, as Syrup of Wormwood, Mints, or Coral; to which you may also put Ambergris. The Syrup of Cinnamon made with Aqua Vitae, according to Quercitanus Dispensatory is no less powerful. And Cinnamon Water distilled with Juice of Quinces. And also the Spirit of Mastic made thus, Take three ounces of Mastic, one ounce of Galangal, half a pint of spirit of Wine, digest them and distil them. The Elixir Proprietatis, described by Crollius, is good, if you give twelve or fifteen drops in Wine they wonderfully strengthen the Stomach. You may make Tablets for the same purpose thus: Take of the pulp of Rinds of fresh Oranges, and Aromaticum Rosatum, of each two drams: white Sugar dissolved in Orange flower water four ounces. Make Lozenges. Tablets of Aromaticum Rosatum, Opiata Solomonis, and old Treacle are good for the same. A Decoction of Guajacum or Sassaphras taken many days together with a little sweeting, or without in weak people, is very good in this Disease, being o● long continuance. Also Sulphurous and Nitrous Baths, as our Bellilucanae being taken in great quantity many days, do powerfully cleanse the Stomach and Guts from all slimy filth. Take of Agrimony, Centaury the less, and common Wormwood, of each half an handful: boil them to half a pint, and add one ounce of sugar, drink it, either in a cold or hot Cause. Hartman exceedingly commends the use of Zeadoary in these words, The often use of Zedoary doth so strengthen the stomach, as nothing more, therefore we may commend it having tried it often, and never miss; you must eat it often. Costaeus Commends hot Wine thus, Hot Wine drunk ordinarily doth am●nd the imbecility of the stomach: It is usually observed that they who have been continually vexed with Wind and Pain from an evil Concoction when they have begun to drink warm drink, have been cured, and lived after a long time more comfortably. You must give him Wine in Water, wherein Coriander hath been boiled, for his ordinary Drink. But observe, That if a hot distemper of the Liver meet with that of a cold stomach, as often it doth, you must give hot Medicines warily, and rather those that are temperate. Zechius Commends this Bolus following, in these words, That the stomach may be warmed gently and not dried, you can use no Medicine inwardly more powerful. Take of washed Turpentine two drams: Powder of Mastic half a dram: Aromaticum rosatum ha●f a scruple: make a Bolus to be taken two hours before meat. This digestive Powder is usual to help Concoction, Take of Coriander seeds prepared half an ounce: sweet Fennel seed and Annis seed of each two drams: Cinnamon and Cloves of each half a dram: Sugar twice as much as the rest: make a Powder, of which let him take one spoonful after every meal. The Ballom of Peru is good if you give a few drops in Wine one hour before meat. Or in form of a Pill, one or two drops in sugar for many days. There are some ordinary Medicines for this, Hippocras Wine, a Decoction of Annis, Coriander and Cinnamon mixed with sugar for ordinary drink. The Duke's Powder, commonly so called, made of two parts of Sugar and one of Cinnamon, to sprinkle upon all meats. A Salt to be eaten with meat, made of Coriander, Annis seeds, long Pepper, Galangal, and Nutmegg, mixed with an equal proportion of Common salt. Some Grains of Pepper whole or beaten, taken fasting. Acorns stuck with Cloves and Cinnamon, and candied with Sugar, Citron, and Orange peels candied together, Annis seeds, Fennel, Coriander and Cinnamon infrosted with Sugar, all these men may use as they please. Citron Peels are more pleasant than the rest, but because it will grow so dry that it will hardly be chewed; we are often constrained to make it up in a Mortar with Rose Water, in the form of an Opiate. Candied Myrobalans and Nutmegs may be used for the same, and be made up as the former, though they are not so apt to grow hard. The Essences of Annis, Cinnamon, Citron peels, Nutmegs, and Olives, are excellent to strengthen the stomach, and they must be used as above in the Diseases of the Heart. Of Meats, They which are Salt do most provoke Appetite, and Sharp things in a small quantity; and mixed with other things lest they cool the Stomach. Outwardly apply Liniments, Fomentations, and Emplasters, thus made: Take of Cypress Roots, Galangal, Flower-de-luce, and dried Citron peels, of each two ounces: Mints, Hyssop, Sage, Rosemary, and Marjoram, of each one handful: Annis seeds, Bay-berries, Nutmegs, Cloves, and Cinnamon, of each three drams: the flowers of Stoechas, Schoenanth, and Rosemary, of each one pugil; slice those that must be sliced; and bruise those that must ●e bruised, according to art, and put them into two Bags with holes pricked through, and steep them in strong Wine, and lay them warm to the stomach one after another. Take of the Oil of Wormwood, Mints, and Spike, of each half an ounce: Oil of Nutmegs, two drams: Wood of Aloes, Mace, and Cinnamon, of each one scruple; with a little Wax make a Lineament, which will be better if you add six drops of Oil of Cloves, and of Musk and Ambergris, of each eight grains. Also there is a Lineament of Oil of Nutmegs, Balsom of Peru, or of Oil of Wormwood, Mastic, and Balsam of Peru. Take of the Emplaster of Mastic one ounce: Aromaticum Rosatum one dram: Oil of Nutmegs as much as is fit to make a Plaster like a Buckler for the Stomach. Crato doth wonderfully commend this following Plaster: Take of Labdanum two ounces: Wax four ounces: Oil of Nutmegs three drams. Make an Emplaster. Galen adviseth 7. m. not to keep these Plasters long upon the part, for at length they will dissolve the heat. Many Practitioners do not only apply these Remedies before to the Cartilege called Xiphoides, like a sword; but also behind upon the thirteenth Vertebra, because the proper orifice of the Stomach inclineth backward; but the thickness of the Vertebra is such, and of the Muscles under them, that the strength of the Medicine cannot pierce through to the Stomach. Take of Galangal, and Calamus Aromaticus, of each three drams: Mastich, and Cloves, of each two drams: one Nutmeg: dried Citron peels half an ounce: Annis seeds one dram and an half. Make a bag of these being bruised and put into red silk pricked through, and into musked Cotton, to be worn always upon the Stomach. The Skin of a Vulture dressed and worn upon the Stomach, is commended for the same: in want of which a Hairs Skin, or a piece of Scarlet may be used. Chap. 2. Of Dog's Appetite, called Fames canina. HAving in the former Chapter spoken of Appetite diminished and abolished, now we shall speak of it depraved. And this is done two ways: When it either offendeth in quantity or quality. It offends in quantity when nourishment is required in a greater quantity than Nature would; and this is called Boulimia, or Dog's Appetite: It offends in quality when things are required which are evil, or are not food, and this is called Pica or Kitta. Of the first we shall speak in this Chapter, of the last in the Chapter following. The word Boulimia comes apo tou bou kai limou, because the Particle Bou put to other words, increase the signification, as if it were compared to the greatness of an Ox. It is also called Phagedaina, which word is given to Ulcers which eat the flesh and enlarge, and therefore called Vlcera Phagedaina, that is, spreading Ulcers. Now it is called Fames Canina, or Dog's Appetite, because they who have it are hungry as Dogs. But you may observe that these two words, Boulimia, and Fame's Canina, are sometimes confounded, and used for the same thing: and sometimes distinguished, so that it is called Fames Canina, when after much feeding they vomit like Dogs. But some purge rather than vomit, when Nature throweth down that which it cannot concoct. In Boulimia, vomit doth not follow, but sometimes Lipothymia. There are some who feed unsatiably, and yet vomit not, nor purge, but concoct all, and if they have not presently more, are sick. As Sennertus reports of a Scholar, who was black coloured, who eat not only in the day, but night, and digested it without vomiting; he could not be satisfied with delicate meats, but required gross, and therefore would eat no Baker's Bread, but such as the Country people made, and would eat as many raw Parsnips in a Summer morning as could be bought for six pence, without damage. Hence it appears that this disease is a Symptom of an action depraved, in respect of quantity, which action being increased, is called Doglike, or an Appetite beyond Natural Measure. The part affected is chief the mouth of the Stomach. The cause containing, is sense of sucking, and vehement pulling, which stirs up the Appetite. Galen 2. de symp. cause. cap. 7. reduceth the immediate causes of this Disease to two Heads, in these words: Evil Appetites exceeding in quantity, which are called by some Caninae, are then, when either some evil sharp Juice biteth the Stomach, or when the whole Body immoderately concocting, wants nourishment; for evil Juice which is cold, biteth like the Natural sucking, and produceth appetite by the resemblance of Nature. The immediate cause of a preternatural Appetite, according to Galen, is first a vicious humour, and cold, sticking to the Stomach: Secondly, want of Food by over much concoction. Evil Humours sticking to the Stomach, cause immoderate Appetite, because they by their too much coldness, sharpness, and sowrness, do constringe, wrinkle, and pull the mouth of the Stomach, and so make a sense of feeling like a natural sucking, and beget a false Appetite. This Humour is either sour phlegm staying long in the Stomach, or many times Melancholy sent from the Spleen into the Stomach, which in a natural state, and a moderate quantity and quality begets a moderate and natural Appetite; but if it be preternatural and exceed, it makes the Appetite too great. The want of Food, by reason whereof the Veins do continually suck from the Stomach, either it comes from too great Evacuation by bleeding, purging, vomiting, sweeting, and the like, or from too great a Consumption of the alimentary substance, by reason of the immoderate heat of the parts, or the thinness of the humours, and body, and looseness of the pores, watch, baths, immoderate exercise, much venery; all which do dissolve the substance, making humidity; and by these emptiness being caused, and want of food, the meat is carried from the Stomach sooner than it ought. Also this Fame's Canina, or Dog's Appetite, may come from Worms which devour the Chylus; as Trallianus reports, lib. 7. cap. 4. of a Woman in this Disease, which voided a worm twelve cubits long by the use of Hiera, and was cured. The Hermetical Physicians do lay down another cause of this wonderful Appetite, namely, a certain dissolving Spirit begot in the Body, which by an inhaerent property doth so readily consume whatsoever meat is taken, so that it doth not allow Nature a lawful and necessary bound of nourishment. This they call a hungry devouring, salt, sharp, vitriol Spirit. For say they, as from divers Salts, Vitriol, Niter, common Salt, and Salt Armoniac, with the like, Aqua fortis is made by Chemistry, which will dissolve the hardest Stones, Metals, into Liquor in a short time; so that Gold which will not be dissolved in a month by a strong fire, in a quarter of an hour will be dissolved in Aqua regia, and be turned into a Liquor of the same colour. This Doctrine is diligently to be examined; for as the digestion of the Stomach in its Natural condition hath something to be admired by the curious Searchers into Nature; so the same being made preternatural hath something to be wondered at. This is wonderful in the Natural digestion of the Belly, that the hardest meats are digested therein, and in three or four hours' space are turned into a Chylous Liquor, so thin that it may be strained through the narrowest branches of the Venae lacteae; and that Dogs do turn the hardest bones into the same Liquor, is not to be attributed to a stronger concocting heat, because meat in a pot, although the fire be never so hot, cannot in twenty four hours, or many days be converted into the same. The Galenists hold that this comes from the faculty of the Stomach, which faculty works not without an Instrument, because if there is an Idiosyncrasia, or a certain proportion of the first qualities, as is commonly reported, its chief action must be from heat; for cold, moisture, or dryness, do nothing to that great dissolving of food, and heat, as it is said, hath not that power. Therefore the Idiosyncrasia is somewhat more unknown, and not to be expressed. Let us therefore search after it in the Macrocosm or grater World, of which there is a great Analogy or resemblance in the little World. And therefore the more witty Hermit's say that there is a certain Spirit or acide Liquor sent from the Spleen into the Stomach, which dissolveth the solid nourishment, and shortly converteth it into Chylous Liquor, and that is the principal Instrument of digestion. And some conjecture that this may be made, because Birds who digest the hardest nourishment have a Spleen round about their Maw; for the flesh which is found about their Stomaches is like the substance of a Spleen; from whence there is a more noble use of the Spleen than what is allowed by the Ancients, who said that it was only for the purging of the grosser sort of Blood; because according to this opinion it serveth for concoction of meat. Therefore if the Spirit or sharp Liquor which comes from the Spleen when it is in its Natural condition, makes a natural and moderate digestion; the same spirit being altered from its natural condition and defiled, or made sharper or more dissolving, it will sooner dissolve solid nourishment; and when they are so dissolved and thrown from the Stomach, it will make a new immoderate Appetite. We do not conclude that this new Doctrine is certain and undoubted, but we only show it that solid wits may examine it. And we will talk of it again when we speak of the causes of the hindrance of Concoction. The signs by which this disease is known are manifest; for it will appear to them that eat, and to the standers by, that the Appetite is depraved which causeth such devouring of meat, which afterwards is thrown up by vomit, and then it is Fame's Canina, and if Vomits follow not, then there is fainting, with coldness of the extreme parts, and this is called Boulimia. The signs of the Causes may be found by the Antecedents, Concomitants, and Consequents. These are the signs of a cold distemper, and of sharp humours in the Stomach, belching, and sharp vomiting, crude dejections, or stools, want of thirst, and external Causes of refrigeration afore going. If it come from defect of Nourishment, the Patient is lean, and there are causes present or foregoing of the dissolving of the Humidity; and lastly, the signs of Worms shall be spoken of in their proper Chapter. The Prognostic of this Disease, is thus: If it come only from External Causes it is not dangerous if they be presently taken away: And if it come of Worms there is little danger, for when they are taken away the Disease is cured. But it is very dangerous if it follow great Evacuations and melt of the body; especially if after meat when the belly is yet full there come a fainting; for when that which should most help, becomes unprofitable, it signifies a great distemper of the Stomach. So a Dog Appetite continuing with Vomiting and great Purging is dangerous, for it useth to end in an evil habit, dropsy, lethargy, consumption and the like. As for the Cure, because Fame's Canina for the most part takes its Original from Melanchollick and Phlegmatic Humours fastened in the Mouth of the Stomach; therefore Medicines must principally be directed to them; such as do empty and change the Humours and also strengthen the part affected. You must Evacuate by Vomit or Stool with Medicines Prescribed in the Cure of Want of Appetite from a Cold Cause; for although these Diseases are contrary, yet come they from the same Humours, different in the degrees of Coldness, and second Qualities, and such as diversely affect the Stomach. Also the Remedies there Prescribed to heat the Stomach and strengthen it both internally and externally are excellent, because they not only correct the Cold Distemper, but dry and cause thirst; and thirst coming, hunger is diminished. Moreover, Wine plentifully taken assuageth hunger, according to Hypocrates, Aph. 21. Sect. 2 And especially the Spirit of Wine, or Aqua Vitae. They do properly stay Hunger which do much moisten the Stomach, relax it, and assuage the sharpness of humours. As all Fat things and Oils, as Villanovanus reports, That one thus diseased did eat a hot Loaf dipped in Oil; and a Woman drank the melted Suet of an Ox with as much warm Oil at Twice, and both did so Disdain Meat, That they eat nothing in Five Days, and were Cured. Narcotick Medicines by Dulling the too exquisite sense of the Stomach, do lessen this Disease; and new Treacle is most usual for it because besides its stupifying quality it doth correct the malignity of the Humours which is some cause thereof. But because these are to be used but seldom and not without urgent necessity, sometimes you may use old Treacle, for the reason aforesaid, as also to strengthen. Five or Six Grains of Ambergris taken in a rear Eglantine doth not only strengthen the Stomach, but by a special quality cureth this Disease. Chap. 3. Of Pica and Malacia. PIca and Malacia, are a depraved Appetite; by which, evil, unprofitable, and hurtful things are desired. It is called Kitta or Pica from the bird called a Pie, either in regard of the variety of colours, or because it eateth lumps of Earth, for Women in this Disease use to eat Earth and Chalk, and the like: It is called Malacia by Pliny, for these Women through Weakness of mind, and tenderness, want that right and natural Appetite. This Disease comes of evil corrupt Humours, which are gathered into the Stomach by reason of its hurt Concoction, or else sent from other parts. Phlegmatic and Melanchollick People are most disposed for the production of these Humours, especially Women, to whom this Disease seems proper and peculiar; although sometimes Boys and Men, though seldom have the same: Eating of evil Diet doth cause this, want of any natural Evacuation, especially of the Terms, Sadness, Distemper of the Liver and Spleen, Obstructions and Weakness, divers diseases of the Womb, and the like. These Vicious Humours according to the divers degrees of distempers and other dispositions have a divers nature, from whence come divers appetites of evil things: For since some Humours are crude and inconcocted, others burned, and adust; some require sour things, sharp, bitter, and very cold, so that they are delighted with the continual use of unripe Fruits, Vinegar, Juice of Lemons, Pomegranates, and Oranges, cold Water, Snow, Ice, and the like. Others desire Earthy, Dry, and Burnt things, as Gloves, Cinnamon, Nutmegs, and other Spices, Salt-Ashes, Chalk, and the like. This Disease is Common to Women in the Chlorosis, or Green-sickness; to Women great with Child; and such as have their Terms stopped; which staying in the Body corrupt, and ascending do infect the Stomach, from whence its Actions are depraved, and chief the Appetite is taken from its natural Condition. Boys are sometimes troubled herewith, and especially if they are born of a Woman that hath the Chlorosis: Nor are men altogether free from it, although it happen seldom; and they are especially troubled therewith who are Melanchollick, have Obstructions, or want their usual Flux of the Haemorrhoids. It is Disputed much among Authors, Whether a Depraved Appetite require those Things which are like to the Preternatural▪ State or Distemper of the Stomach, or those that are Contrary? Galen raised the first Dispute, cap. 3. artis parvae, where he teacheth, That the Stomach being distempered, doth desire Contraries, and in its natural state and temper it desireth things like to its self. Which Doctrine Avicen following, Fen. 13. lib. 3. tract. 2. cap. 10. speaks thus, When there is an evil Humour gathered in the stomach, different in quality from its own nature, than it doth require things contrary to it; therefore some desire Clay, Coals, Earth, Loam, Chalk and the like, by reason of the quality that is in them, to dry up and cut that which is contrary to the quality of the Humours: But they who are in health desire judicially rather things like, than contraries; for since fancy is much employed in stirring up of Appetite, and is much stirred up from the disposition of the body, it is probable that the humour predominating should move the fancy to desire things like unto it; For as choleric men both in time of health and sickness, do dream of Fire and Anger: and Phlegmatic men of Snow, Ice, and Waters: the Apprehension of which things proceeds from the Humours predominating in the body: So when the seat of Appetite the mouth of the Stomach is affected by foul humours there long continuing, they do imprint their similitudes in the Fancy which stirs up the Appetite to desire things like it though never so contrary to reason, which is now overcome by the force of imagination. Moreover, If things contrary to the disease or its cause were desired by the continual use thereof, the disease would be cured; daily experience confirmeth this. By which we are taught, That Virgins in the Green-sickness, and Women with Child, do for the most part desire those things which are agreeable to their present Distemper and evil Habit, so that they who have Salt and Adust Humours long for Coals, Salt, Spices, and the like: but they who have Melancholy or Salt Phlegm predominating, desire Vinegar, green Fruits, and the like. As for the Authority of Galen, some wholly reject it; saying, That if it were true, That Diseased Dispositions should desire their Contraries, all sick men, of evil Habit, would desire Meat of good nourishment; which is not true, for we often see that sick men desire evil meats, and refuse good: and we see that bodies inflamed, whether they are in a preternatural state, as in Fevers; or in▪ a natural, as by violent exercise, require cooling. Some desire to Reconcile this Opinion of Galens, saying, That in this Pica the distemper upon the Stomach is habitual and connatural, and therefore doth cause an Appetite like to a natural, which is for things like it; which may be thus explained, When we say that every natural temper doth require the like, and every preternatural the contrary; the last is to be understood of distempers which come without overflowing moisture; for they which are with much moisture when it is sucked up by the tunicles of the Stomach, do rather desire things like the moisture with which they are wet, because the Humour which now pierceth all the Tunicles although it be noxious, yet it is not troublesome: On the contrary, when the humour only possesseth part only of the Stomach, or is only in the bottom, the Stomach desires the contrary to that which is offensive unto it; but if it possess the whole Stomach, and be soaked into its Tunicles, than the natural Faculty is destroyed and so changed, that it doth not desire any thing but what is like to the Humour so soaked in, and so it may be rightly said that the humours was become as it were connatural. Platerus and Sennertus do easily free themselves from these difficulties, by flying to an occult quality, and they take occasion from hence, if the Patients so affected should require things like to the cause of the disease, then by the plentiful use of them the disease would be exceedingly increased, but we see that they will devour Chalk, Day, Coals, and the like trash, and receive not the least hurt thereby, by which men that are sound would be almost killed. Moreover, They say that Women with Child will often void salt and sour humours, and yet not require salt or sour things, but the contrary. And lastly they affirm constantly that there is no agreement of Coals, Chalk, raw Flesh, and the like with the Humours. And therefore they say that they must not rest in manifest qualities, and that the Cause of this Symptom and wonderful Appetite cannot be taken from them, but they must fly to some occult quality not to be explained. Yet Sennertus confesseth that it is probable that this Appetite depraved, should proceed rather from a like than a contrary quality: but what that quality is cannot be explained, because the things which are desired have no agreement with the humours either sweet, salt, or sour in manifest qualities. We may Reconcile all these thus: The desire of Trash is stirred up by humours of the like nature and temper, but these humours besides their native temper have a certain peculiar fault from corruption, which since it cannot be well explained, it may be called an Occult Quality. The Knowledge of this Disease is easy, for the Patient can relate it; it is manifest that the part affected is the mouth of the Stomach, for that is the Seat of Appetite. The Cause also may be found out by conjecture from the supposed desire of things like. For if they desire Coals, Salt, and the like, we may gather that the disease depends upon Salt and humours, which will more clearly appear, if any of those Humours be cast forth by vomit or stool, if there be sharp belchings, or salt, a taste bitter, sour, or salt. As to the Prognostic; This Disease is Chronical, of continuance, but not very dangerous, if the Body by Nature or Art may be brought to its old condition, which is not very difficult. For in time the Humour offending may be sent forth by vomiting naturally, or by Medicines: and the Terms or Haemorrhoids stopped, which caused this disease first, may in time be discharged; which if neglected, and Nature sinks under the burden, great diseases follow: For when the first Concoction is hurt, it is necessary that the second and third be corrupted, from whence come great Obstructions, evil habits, and dropsies. Or if the Humour be carried in greater plenty to the Stomach, and partake of greater Malignity, sometimes it produceth violent Cardialgiaes', or Heart diseases; from whence fainting, swooning, and sometimes death doth follow. If Women in this disease begin to abstain from trash, and to eat good meat with less disdain, it is a most certain sign of health at hand. Women with Child use to be freed of this disease about the fourth month, because then the Child is grown greater, and so consumeth more of the humours, and the mother hath sent it forth by often vomitings; but if it last longer, 'tis dangerous; for it signifies that the evil disposition of the Stomach hath taken deep root, which will hardly be plucked up. It is better for people in this disease to desire sharp and sour things; it is worse if they desire things contrary to Nature, as Avicen teacheth, fen. 13. lib. 2. tract. 2. cap. 20. for it signifies a greater distance from the Natural state, which is harder to be cured. The Cure of this disease is divers, according to the variety of the Bodies affected. In Women with Child, few Medicines are to be used, by reason of the unfitness of the subject, and danger of Misearriage, but you may give them gentle things, and such as were prescribed in the Cure of want of Appetite to cleanse and strengthen the Stomach. Nor must you omit blood-letting, which done sparingly and often, is of great consequence. But in Virgins of the Clorosis, or green sickness, this disease is cured with the same Remedies, which shall be prescribed for the Cure of Clorosis in its proper place. But the Pica which is in men, is very seldom, because it comes from obstructions of the Liver and Spleen, you may use those things which shall be prescribed for the Cure of them. Chap. 4. Of the Thirsty Disease, called Sitis Morbosa. THe Appetite of Drink, or Thirst, may be three ways hurt, as that of Meat, by diminishing, abolishing, and depraving; it is diminished many times by a sweet insipid humour, which moisteneth the Tunicle of the Stomach, or from too much moisture in the whole Body, from whence it is that the parts do not draw the drink from the Stomach. It is abolished by acute Diseases through interception of the sense, when the mind is sick, or because the Natural Faculty is decayed by the extinction of the Natural heat; from whence Hipp. saith, It is evil not to thirst, when a cause of thirst is taken: and since thirst diminished doth depend upon the same cause, from which want of Appetite is produced, and thirst abolished, is only in acute Diseases, we shall not speak here of them particularly. But we will only speak of thirst depraved, as being most usual: and this is to be divided two ways, and Hunger. The one requiring divers kinds of Drinks; the other great quantities, and often. That which desireth filthy drink is to be referred to Pica, as when they desire Vinegar, Lemmons, and salt Water. It remains that we speak of thirst increased, which is an usual Symptom when the Appetite offends in the quantity of Liquor, and much drink is desired. The immediate Cause is a want of moist nourishment, and dryness of the Stomach, and of other parts which make the Stomach sensible of their wants. This dryness and want of moisture, useth to come from all such things which can consume the dewy moisture of the Stomach and the whole Body, and dry it up, and they are hot and dry. The dry do principally suck up the Humour, and the hot things secondarily. Also this disease is either by Propriety, or by Sympathy. It is by Propriety when the innate moisture of the Stomach is altered and drawn forth by an unequal distemper, dry or hot, or both; sometimes by a simple distemper, but often by that distemper which is joined with matter; as a salt, sharp, or filthy humour fixed in the mouth of the Stomach, or contained in its Cavity. But that which is by Sympathy, comes by consent from the whole Body, or some part whose Veins having lost their moisture, do suck from the Stomach; as it is in Fevers, Inflammations of the Liver, Lungs, and other parts, as also in hot and dry distempers, especially of the Reins, as you may see in a Diabetes, or invoiuntary pissing, which is called by the name of Dipsacus, by reason of the great thirst which accompanieth it. The outward Causes are all such as extraordinarily heat or dry, as very hot and dry Air, long continuance in the Sun, or at the fire, use of Salt meats, sharp, and spiced, much use of old rich Wine, great watch, too much evacuation, especially by purging. The Hermetical Physicians say, that immoderate preternatural thirst comes from some thirsty spirits which are bred of Sulphureous excrements, which will not be satisfied with simple cooling and moistening, but with other Spirits like unto themselves; as we see in Fevers that a strong thirst is little allayed with much Water, which with sharp Spirits of Vitriol, Sulphur, Salt, and the like, will be satisfied with a less quantity of Water. The knowledge is easy, for the Patients will complain. But the Causes are known by their proper signs; as a hot and dry distemper cleaving to the Stomach and other parts; as also sharp, salt, and bitter humours, some whereof are sometimes cast forth, or they have their tastes in their mouths, if the humours are in the Stomach; but if thirst come by consent from other parts, the signs of those Diseases will be manifest. As to the Prognostic: That thirst which comes from Primary Causes is safest, for that is quenched presently with drink. But that which comes from internal Causes, is more or less dangerous, according to their differences. That thirst which comes with Fevers, and other easy cures, endeth with them. But if it come from great and dangerous Diseases, it is very dangerous; as in a Dropsy in which thirst is not slacked, but rather increased with drink. The Cure of this Disease is often in Fevers, and Inflammations of some parts; which is described sufficiently in our Method of the Cure of Fevers, Sect. 2. Cap. 2. But if Thirst be contracted by immoderate Evacuations causing a dry distemper of the Stomach, and other Causes, the Cure is by suppressing those Evacuations, and by restoring the empty parts with moist Medicines. Therefore first, having ordered a restoring Diet, as in a Hectic Fever, Consumption, and Marasmus. Two Remedies prescribed by Galen are the best, 7. m. namely, Milk and Baths. Although Hypocrates, Aph. 64. Sect. 5. forbids milk to thirsty people, that is to be understood of those who thirst from abundance of Choler, and putrid Humours, in whom Milk is easily putrified; not of those who thirst from dryness and Consumption. We shown the use of Milk in the Cure of a Consumption. Let the Bath be made of the Decoction of Althaea Roots, and Lily Roots, with Mallows, and Violet Leaves, and of a Decoction of the Heads, Feet, and Guts of Sheep, or melt fresh Butter, or Oil in warm Water, to be changed often. Going out of the Bath, let the Loins, Back, and Stomach be anointed with Oil of Violets, the Marrow of a Veal Bone, and the like, with which let as much Breast, or Goat's Milk be mingled, as they will receive. Let the Patient in the mean while use restoring Syrups and Lozenges, and other Remedies which shall be laid down in the Cure of an Hectic Fever. This following Opiate is excellent: Take of Eryngus Roots candied, and Conserve of Bugloss, of each two ounces: Conserve of Violets and Borrage flowers, of each one ounce: Confectio Alkermes half an ounce: Diapenedion newly prepared without the Species, two drams: with Syrup of sweet Apples make an Opiate, of which let him take the quantity of a Chestnut at the time of thirst, drinking after it a little borage Water. Chap. 5. Of the Hurt Concoction of the Stomach. THe Concoction of the Stomach called Chylosis, as of all other parts, is hurt three ways, either by diminishing, abolishing, or depraving. This Concoction diminished is called Bradupepsia; the abolished Apepsia; the depraved is called Dyspepsia; all which differences are comprehended in this one word Crudity. Now this Crudity is twofold: either nidorous, stinking, and acidous, or sharp. The nidorous Crudity is when the nourishment is turned into a stinking, matter, as when the stink of Eggs, or rotten fish, or fried Oil, is smelled by belching, which happens often in hot Choleric Bodies. But a sharp sour Crudity is when meat turns sour, and the belchings are sour, and this comes from a cold distemper. To these you may add a third difference of Crudities, when by reason of weak heat the matter is imperfectly concocted, and is turned into phlegm without sowrness. The Causes that hinder Concoction in the Stomach may be brought into three Heads, namely, a fault in the Organ, Object, and things External and Internal. The fault in the Organ comprehendeth all diseases in the Stomach, whether they be Similar, or Organ call, or Common, all which may overthrow its actions, but distemper is commonly the cause of hurt Concoction; for since Concoction is made by a moderate heat according to Nature, if at any time it want its due moderation, the Concoction is hurt. So a cold distemper of the Stomach which diminisheth the Heat, if it be gentle it only weakeneth the Concoction, and make a Brylypepsia, or slow Concoction. If the cold distemper be greater, it abolisheth Concoction, and makes Apepsia. But a hot distemper doth deprave Concoction, and make a Dyspepsia, which is a difficult Concoction. These distempers are sometimes simple, and in such who have Naturally a weak Stomach, and small Natural heat; or have a sharp and burning heat, but they are commonly with matter: hence in Hypochondriack Melancholy, much phlegm and fermentation of a black Humour use to cause Crudities, Winds, Swell, Rumbling, and sour Belchings. The fault of the Object, that is, the nourishment which is the proper Object of the Stomach, comes many ways, when it offendeth in Substance, Quantity, Quality, time, or Order of being taken. Nourishment is vicious in respect of its substance, when it is too hard and difficult to be concocted, as Deers flesh, Hairs flesh, especially if old, and made hard with Salt or Smoak, Bread full of Bran, Mushrooms, Roots, Pulse, and the like, which are called Dyspepta. Meats offend in Quantity when too much is taken at once, and therefore cannot be overcome by the heat, hence come Crudities, which are most usual among them who do surfeit themselves. If there be less eaten than is required, it may seem to be crude, because too little meat will be burnt and dried in a Choleric Stomach. Meats offend in Quality which are too cold and moist, and windy, or they which are too hot, whereby the thinner part of the Chyle is burnt, and turned into nidorous vapours. To this may be reduced the Art of Cookery, and Sawce-making; for the divers ways of roasting, boiling, and making of Sauce, do alter the disposition of Meat, by which means they become more easy or hard of Concoction. The time and order of eating being preposterous, may also spoil the Concoction, as if any one should omit his usual time of eating, and fall to at midnight, or a little before he goes to sleep, fill his Stomach; or if after taking of solid and astringing things, as Cheese, Pears, Quinces, and the like, they take liquid things which do soon corrupt. Also external things may spoil the Concoction, if they be immoderate: so too cold Air by dulling the natural near, if it be weak or too hot, by dissipating the heat may hinder Concoction; as also immoderate exercise, especially after meat, by drawing the natural heat forth from the Stomach to the external parts, and so dispersing it extraordinarily; as also by throwing the Chylus yet imperfect into the Guts. The stoppage of the Belly and other excrements, or an immoderate flux, great watch, sleep in the day time, great passions of the mind, especially sadness, and deep study presently after meat, and the like, do not a little hinder the action of the Stomach. Besides the Causes mentioned, the Hermeticks of late time mention one less usual, and not noted by the Ancients, which also is not plainly demonstrated by them; but it is confirmed by some conjectures, not to be contemned; of which we made mention in the explaining of the Causes of Fame's Canina. First therefore they ashrm that the Natural Concoction of the Stomach is not made by heat only; but that quick melting of solid meats by which it is converted into Chylus, is from another cause; since Experience teacheth that meat boiling in a pot at a strong fire many days, will never be dissolved: and bones in a Dog's Stomach are quickly dissolved, and turned into Chylous Liquor; and in the bellies of Fishes which have no actual heat, all that is brought in is dissolved and concocted the same way. Therefore they lay down the principal Cause of this dissolving to be a certain Spirit or sharp Liquor sent from the Spleen into the Stomach, which hath great power to dissolve. And they take this opinion from Galen, by whom it is confirmed that a Melanchollick Humour sent from the Spleen into the Stomach, doth cause appetite, and that either by astringing or wrinkling the inner Tunicle of the Stomach, or pulling of it by its sharpness, which may be opposed; for if it do it by astriction, than all astringent things would do the same; and if by pulling, sharp things rather than sour would provoke Appetite. Therefore they think it more probable, that that humour should stir up Appetite by accident, by causing want of nourishment, by dissolving of that which comes in. And therefore they allow a more noble use of the Spleen than ever the Ancients thought of, namely, to be a chief instrument to serve the Stomach in Concoction: This may be conjectured from Birds which dissolve the hardest seeds, and have a Spleen round about their Stomach or Maw, that it may more powerfully inspire that dissolving Spirit, or communicate unto it sour Liquor. And Helmont from his own experience saith, that that sour Spirit is very strong in Birds; for he relates that when he was a Boy and kept a Sparrow, he gave it his Tongue, which the Sparrow catching with his Bill disired to swallow; and that touching the Throat of the Sparrow with the tip of his Tongue, he sound it exceeding sharp. The dissolving Spirit inherent in the Gizzards of Birds is proved from Physical Practice, in which the Gizzards of Hens for to help Concoction are usually prescribed in digestive powders, and it is credible that they produce that effect by helping the dissolution of the meat, and the same are prescribed in the Stone, and they do much dissolve them; and that is more manifestly declared in that from the Gizzards of Birds, there is a salt taken which is excellent to dissolve the Stone: out of which salt, being in great plenty in their gizzards, Nature being wi●e and provident knows how to draw a spirit in a living Creature, by help whereof with the natural heat she may dissolve solid nourishment: and it is ordinarily seen, that there is a spirit made of dissolving salt, as of Vitriol, Niter, Armoniac, and common salt, which is more powerful to dissolve. Therefore the Spirit or sharp Liquor which is sent from the Spleen into the Stomach while it is in its natural state makes a laudable Concoction, but if it be changed it overthrows he actions of the Stomach as aforesaid, from these Positions, That a Dog Appetite was stirred up, when that spirit or acid Liquor, is too active and powerful to dissolve: So on the otherside, if the dissolving power be too weak, or be detective, there followeth a diminished or abolished concoction. Hence Helmont says, That the 1. Aph. of Hipp. Sect. 6. which is this: In long raging of the Guts, if sour belchings arise, which were not formerly, it is a good sign; is thus to be interpreted, because that sour belching signify that that fermentation which was lost by the disease gins to return. Let us hold up this new Doctrine by our own Experiment, for in the year past, 1648. we had a great Flegnatick and Melanchollick Flux for four months, and were brought thereby to extreme leanness, by reason all our nourishment turned into a Phlegmatic and slimy substance, from the debility of the Stomach which could not well concoct the same, after many Medicines used all along that time, the chief part whereof profited little or nothing, at length by the often use of very sharp Vinegar in a few days we were perfectly cured of that violent disease; by the force of which Vinegar we may conjecture that the natural sowrness which was almost lost was much restored: We used this Vinegar at our meat with hard Eggs, which being cut in pieces we dipped therein, and for some days we continued the use thereof in all our meats: And we manifestly perceived that if the Vinegar was not very sharp it did our Stomach little good. The Knowledge or Diagno is of this Disease, according to the differences of hurt Concoction is divers: And 〈◊〉, Apepsia and Brady pepsia are known by the same signs only differing in degrees: and these signs are sour beloning, vomiting or purging forth of food either not, or but half concocted, some causes of refrigeration went before, there is a weight, extension and inflammation in the stomach, inconvenience by taking cold things; thin urine, waterish, and pale; sometimes thick and red from that impure and silthy juice which by reason of the imperfection of the first concoction could not be separated from the Chylus, but being sent to the Reins with the serous humour, makes the urine soul, such as m to be voided by Melanchollick and Scorbutic persons. See the Explication of this Urine more at large in Sennertus, lib. 3. practimed. part. 8. sect. 2 cap. 7. but the show Concoction depraved, or Dyspepsia, Nidorous stinking belchings, the like taste or stink in the mouth, sense of thirst and heat, inconvience by hot things. If the Stomach is affected principal, there will be the proper signs of its Disease; but if by consent, this sympathy is to be sound out from the proper signs of the part affected: but if the symprome depends upon the fault of external causes, or of the object, it will appear by the relation of the Patient and those that stand by, from the present or foregoing Constitution of the same. The Pregnostick is thus made; the fault of Concoction which comes from external causes is easily helped, by taking away those causes is easily helped, by taking away those causes, and by ordering a good diet. Concoction hurt is more easily cured when it comes of humours which are brought from other parts into the stomach, then when it is only from the stomach: for as if those humours are purged before they fasten any disease in the stomach, concoction is restored. The Abolished Concoction of the Stomach is worst of all, because the whole nourishment of the body is frustrated, from whence comes most deadly diseases, as Lientery, Dropsy, Atrophy, and 〈◊〉. The Concoction Diminished brings its inconveniencies, as Colic, Cachexy, or evil Habit, and so●●ume divers sorcs of Drops. The Concoction Deptaved is the Cause of many Evils; of Obstructions, Scabs, Fevers, and the l●ke. 〈◊〉 ●ure is wrought by taking away Causes external, antecedent, and conjunct, which do cause, 〈◊〉, and preserve this disease. And first observe, if the humours be brought from other parts into the stomach, and in this case they must first be Evacuated and Reveled, the disease of the part sending those humours is to be amended, and the stomach strengthened, the cures of the diseases of other parts must be taken from their proper Chapters: But the strengtnening of the stomach may be taken from the cure or the Want of Appetite. But the Hurt which comes to the Concoction from the proper fault of the stomach, that chief takes its beginning from cold or hot humours; and therefore requires the same cure, which was propounded for Want of Appetite coming of the same Causes, which we will not repeat. Lastly, If the proper Cause of the Hermeticks' be worth observing, you must look to it; first correcting the Evil state of the Lwer, and then restoring the Spirits dissolving, with some acid substance; of kind is Spirit of Sulphur, Vitriol, Salt, juice of Lemons, Pomegranates, Oranges, and Vinegar. Chap. 6. Of Singultus, or Hiccough. SIngultus or Hiccough, is a depraved Motion of the Stomach, by which it desires to expel something that is hurtful. It is distinguished from vomiting, because that which is so sent forth, is contained in the Cavity of the Stomach; and it is wholly turned to throw it out: But in Singultus the matter offending is fixed in the Tunicles of the Stomach, therefore it doth contract itself, and shakes its fibres, to exclude it. And that we may comprehend loathing also in this Definition, we say that the expulsive motion of the Stomach is three ways: For either Nature would sometimes rise to expel, and cannot; or it is not sufficiently raised to this motion, and then it is Nausea or loathing: sometimes it riseth and expelleth, and then it is Vomiting: or lastly, it riseth to expel, and cannot, and that is Singultus. This is a Convulsive Motion, not a Convulsion, which is only in the Muscles, and parts given to voluntary Motion. The immediate Causes of Singultus are propounded by Hipp. Aph. 39 Sect. 6. that is, Emptiness and Repletion, as of a Convulsion. But Galen and Avicen add a third Cause, namely, a provocation by a sharp matter. Some labour to bring the matter provoking to a kind of repletion, that they may excuse Hypocrates. But when the matter is plain, we need not confound and darken the evidences of things for Author's words: For what is more clear, than that Singultus comes from the expulsive faculty provoked? Therefore whatsoever can provoke is the immediate cause of Singultus or Hiccough. But Humours and Vapours offending either in quantity or quality may provoke the Stomach to expulsion, and so repletion and acrimony are two distinct causes. But it is not ea●e to show how emptiness makes a Singultus: For since its Essence is in defect, none will say that Nature riseth to expel a defect; but rather will be moved to refresh and repair it, and so it doth rather move the Attractive than the Expulsive Faculty. But if Singultus follow great Evacuations, as in sharp Fevers, and malignant, and purging with Hellebore, it is not simply to be attributed to the Evacuation, but rather to a malignant quality in the Stomach, coming from the Disease, or some Medicine taken. The Matter causing Singultus is either gathered in the Stomach, or sent from the Liver, Spleen Guts, or other parts; or from the whole Body. So sharp Nourishment, or sharp Medicines, or sharp Humours, or gnawing Worms contained in the Stomach, cause a Singultus by propriety: but inflammation of the parts adjacent by water or vapours sent to the Stomach, make it by consent: as also because the Tumour, especially when the Liver is inflamed, doth compress the Stomach by which the expulsive faculty is continually provoked. Finally, Humours may be brought from the whole Body, or sharp humours to the Stomach, in diseases of the whole Body, as appears in sharp and malignant Fevers. The Diagnosis, or knowledge of this Disease, is manifest of itself. But the signs of the Cause are thus to be distinguished, so that if it be by propriety, the disease is more lasting, and there will appear signs of the Humours contained in the Stomach, and the disease is assuaged by Vomit. The Humour contained in the Stomach is known by vomit, belching, taste in the mouth, and by other signs. And finally, if it come from a disease in any other part, you may take the signs thereof from their proper Chapters. As to the Prognostic: Singultus that comes from any principal Cause as Meat, Drink, or Cold, is not dangerous; as also that which goes before a Crisis by Vomit, and then other signs must be healthful. If any have the Hiccough in a great Fever, the Disease is very dangerous, Hipp. in Coacis. For it comes from sharp Humours, and malignant, which pull the Tunicle of the Stomach inwardly, and force its expulsive faculty. And Vallesius saith, that he never knew any extenuated persons taken with a hot and malignant Fever▪ who had a Singultus, to escape: So it is in Hipp. 3. Epid. Sect. 2. Aegr. 12. A woman living in the Market, had many Hiccoughs upon the twelfth day, and died the fourteenth day of her sickness. Also Platerus observed, that a Singultus coming upon burning Fevers, and continuing, is for the most part a forerunner of death, and the same is deadly in a Dysentery, or bloody flux. After Vomiting, Singultus and redness of the Eyes is evil, Hipp. Aph. 3. Sect. 7. These two signs coming after Vomiting in acute Diseases, and continuing any time, therefore are said to be deadly, because they declare an inflammation of the Brain or Stomach; which inflammation is not only the cause of Hiccoughs and redness of Eyes, but also of Vomiting. For if Vomiting come from sharp Humours that gnaw the mouth of the Stomach, and its Tunicles, when those Humours are thrown out by Vomit, the Singultus and vomiting would cease, nor would any sharp vapour be sent to the Eyes, which should make them red: But when Vomiting doth not only not profit, but also brings after it Hiccoughs and redness of the Eyes; it is most certain that these three, namely, Vomiting, Hiccoughs, and Redness of the Eyes, do come from the Inflammation of the Brain or Stomach: for the Brain being inflamed, doth through abundance of blood send it to the Eyes, and into their extreme Tunicles, whence comes redness; to which also the Stomach consenting by the Nerves of the sixth Conjugation, is easily from the Inflammation of the Brain brought to Vomit and Hiccough. Also the Stomach inflamed by a concourse of hot blood to the Eyes by reason of the great consent between those parts, brings Vomit, Hiccoughs, and redness of the Eyes, which the beginning of suffocations do demonstrate, and the appearance of things before the Eyes which are in the Stomach disordered; whence Hypocrates in his Book del ocis in homine, affirms that the Eyes are chief hurt by Vomiting. Singultus from Inflammation of the Liver is hurtful, Hipp. Aph. 17. Sect. 7. which comes then, as Galen shows in his comment upon that Aphorism, when the inflammation is greater and worse, for than it is so great in the Liver that it lieth upon the Stomach, and brings the Singultus: nay, sometimes by conflux of matter, there is sometimes an inflammation or Erysipelas in the Stomach: or else there comes gnawing from the same being sucked into the Tunicles of the Stomach. The Cure of this disease is directed to the Causes, which as I said, do either produce it by way of Sympathy, or Propriety. The Causes which produce it by sympathy, are the diseases of other parts, which being cured, this is cured, although these Medicines are to be administered then, which are good to allay the Symptom, which shall be afterwards declared. This Disease by Propriety comes of Phlegm, Wind, Choler, or some sharp or malignant Humour. That which comes from Phlegm in the Tunicles of the Stomach is cured by Medicines which cut the Humour, cleanse and purge it, and by strengtheners of the part, such as were prescribed for the Cure of want of Appetite coming of a cold Cause. To which we may add these following, as more proper to this disease. Take of Castor one dram: the juice of Mints four ounces: Mix them, let the Patient take one spoonful or two every fit: and you may anoint the Stomach with the same Medicine warm, twice or thrice in a day. He may take Vinegar of Squils' often to cut and dissolve the matter contained in the Tunicles of the Stomach, or instead thereof, Oxymel of Squils'. Cloves held often in the mouth do not a little profit. Also the Elixir Proprietatis of Crollius, is very profitable. Take of Dill seeds, two or three drams: boil them a little in eight ounces of the best Wine; of which let the Patient take one ounce first and last. Let the same Seed be put into a cloth, and often smelled to. When the Disease is violent, these Pills following are very good. Take of Castor and Myrrh, of each three drams: Sal gem. half an ounce: Diagridium, and Mastic, of each one dram: Agarick newly trochiscated three drams: Aloes, as much as all the rest: make them with Juice of Mints into a mass, of one dram whereof, make six Pills gilded. Let him take two or three in the morning twice in a week, two hours before meat. Plaine● Pills, and almost as good, may be made of Hiera with Oxymel, of which you may give a drama. In the days between the taking of Pills, give this Powder: Take of Dill seeds half an ounce: Zedoary, Lignum Aloes, Nutmegs, Cloves, and powder of Diambra, of each one dram. Let him take two scruples in a morning with a little sweet Wine, or put to them three ounces of Common Salt, and let him eat it with all his Victuals. Apply this Cataplasm following to the Stomach. Take of Roots of Aristolochium, or long Birthwort, Flowerdeluce, Bay-berries, dried Leaves of Ri●e and Mints, of each three drams: Castor and Myrrh, of each two drams: Cloves, and Hypocisti●, of each one dram. Make a Cataplasm with Honey of Rosemary. At length, when the disease is stubborn, you must use the Decoction of Guajacum and Baths of Brimstone, as the best Medicines. That which comes from wind, is cured by the same Medicines, adding thereto things to expel wind. Apply also Cupping-glasses to the region of the Stomach, which miraculously do presently abate, and take away the windy diseases of the Stomach. That which comes from a sharp Choleric Humour, besides those Remedies which were prescribed in want of Appetite coming of a cold distemper, most proper also to this Disease, must be cured by Phlebotomy (if there be Plethory or fullness) by vomiting and gentle purging every third day, thus made: Take of the powder of Rhubarb, sprinkled with Endive Water half an ounce: the pulp of Tamarinds, two drams: the seeds of Endive and Purslain, and of Spodium, of each one dram: yellow Saunders, and Diagridium, of each half a dram: with syrup of Lemons make a Mass of Pills of half a dram; whereof make Four or Five Pills to be given in the Morning as aforesaid. Upon other days let him take Conserve of Roses and borage, mixed with a little Triasantalon or the Opiate mentioned in the Cure of Want of Appetite. Emulsions often used, made of the Cold Seeds, do powerfully assuage the sharpness of the Humour; or in a disease not very hot, the milk of sweet Almonds. Syrup of Apples, with Syrup of Quinces is to be given in a spoon. He must take Broth often. And must drink cold or warm Water or Ptisans often. The Oil of sweet Almonds doth assuage the sharpness of the humours. Let the Stomach be Fomented with a sponge dipped in Rose water. Take of the Cerat of Saunders and Ointment of Roses, of each one ounce: Mastich half an ounce: Citron peels and pulp of Quinces, of each one dram: with Juice of Housleek and a little Turpentine, make two Emplasters, of which lay one to the fore part, another to the hinder part of the stomach. Anoint the region of the Liver with Cooling Ointments, because the Humours use to flow from thence to the stomach. If you suspect any infection, you must give Treacle and other Antidotes, and anoint the stomach with the Oil of Scorpions according to Matthiolus. These Medicines following are good against the Hiccough of what cause soever. First, Expel the Humour offending by Vomit, if the Patient can well endure it; and Repeat it, if the Disease abate, and give stronger if necessity requires. As Platerus showeth in his Practice, of which he gives an example, in his Observations in these words, A Chirurgeon being sick began to Hiccough day and night so that he could neither sleep, speakwell, or take meat: at last being thus weak and nothing profiting him, when he was in an agony, we gave him not without fear but at his own entreaty, a strong Chemical Vomit at hand, by which he vomited abundance of choler green and black, and so was cured. If the Patient abhor Vomits, Purge him. But prepare the Humours first or before you repeat it, with cutting and cleansing means; after use these following: Apply Cupping Glasses to the Back against the Stomach or before. Bind the Stomach that it may not be dilated. Use Ligatures to the remote parts. Take Annis-seed, for they say that doth specifically cure. And give often Clysters to draw the Humours from the Stomach. Apply young Creatures to the Stomach. And, Take Vinegar of Squils in a spoon. Neezing doth shake off the Matter which is compacted in the Tunicles of the Stomach; as Chrysimachus the Physician in Plato cured Aristophanes by Neezing, when he could not be cured by holding his breath, and gargling of cold water. Galen, 8. de comp. med. sec. loc. mentiones the Medicine of Asclepiades, of which he examineth every Simple, and approveth them as if it had all Faculties fit for this intention; namely, To discuss and Evacuate the Matter hurtful, by Stool and Urinal, to strengthen the stomach; and lastly to mitigate sharpness. The Composition is thus: Take of Costus or Galangal, Saffron, Spikenard, Roses, Mastich, of each four scruples: Asarabacca and Aloes of each two scruples: Opium one scruple: with the Juice of Fleabane make them into little Balls or Cakes, and let him take one of a scruple in weight every morning. In imitation of that you may quicklier prepare Pills for one Dose, of one dram of Aloes two or three grains of Laudanum; And if you will Purge more, give three or four grains of Diagridium. Duretus testifieth what excellent force Aloes hath in this Disease, in these words, Many when they have been almost dead with the Hiccough, have been cured with Purging five days together with Hiera after they have voided black glutinous humours. Platerus reports in his Observations, That he Cured a Boy of ten years old, that was troubled night and day for eight days together with the Hiccough, with the Water of green Nuts, distilled with Rhadish first macerated in Vinegar, which he gave as a Vomit; and though he vomited not, yet he was eased; and taking a draught thereof at night, was presently Cured. Forestus reports, That he Cured one with one draught of the Decoction of Dill-seeds, Carva, Purslain, and white Poppy-seeds, made in small Ale. Claudinus doth highly commend Diaphoenicum with Philonium Romanum, when the Cause and the Symptom are very violent. Lastly, Narcoticks only do alone Cure this when all other things fail, by stupifying of the sense of the part which is too exquisite. Chap. 8. Of Nausea, and Vomiting. NAusea and Vomiting differ only in degrees, and both are the motion of the Stomach by which it either expelleth or labours to expel things contained therein; therefore Nausea is a desire to Vomit with trouble, and only sending and pewking forth a thin waterish Humour by Salivation: whatsoever troubles the Stomach either in quantity or quality useth to stir that up, when it cannot be voided by reason of the weakness of the Stomach, or the strength of the upper Orifice, or thickness of the Matter, or sliminess. But Vomiting, which is called in Greek Emetoes, or Emesia, is a Depraved motion of the Stomach, which shaketh it, by which the Expulsive Faculty is stirred up by Contraction of the Fibres of the lower part and loosening those in the superior, doth sensibly with a violent Motion throw upward the Matter contained therein, which is troublesome unto it▪ it is called a Depraved Motion both in respect of the Object troubling it, as also in respect of the Motion itself, which is from the bottom of the Stomach to the Mouth of it, turning it, when the natural Motion of the Stomach is Compulsive towards the Guts and the Pylorus. The Differences of Vomitings are taken from their Causes, which are either External or Internal; therefore it is Divided first into Natural and Artificial; the Natural again, is either without a Disease, or in the Disease; from whence ariseth a Difference, one is called Periodical, another Critical, and another Symptomatical. Periodical is that which without a Disease, is used for preservation often, from whence we read in Hypocrates, That the Ancients did Vomit Twice every Month, either at distance, or together. And there are many in our times, who use either every Month, or Week, or Day to Vomit Choler, or Phlegm; by which they are Preserved from many Diseases: And this is not properly a Symptom, because there is no Disease present; but it is rather to be termed a Motion of Nature. Critical Vomiting often happens in Diseases, and by that the Matter of the Disease, if preparation be first made, is wholesomely Evacuated; either all, by which it is Cured; or in part, by which it is Diminished. Symptomatical Vomiting comes from Nature provoked and weakened and without ease to the Patient, because it is not enough, or it is nourished continually with the Matter that maketh the Disease. Other Differences of Vomitings are taken from the things vomited, for they are either Nourishable or Excrementitious; the first is of Meat, Chylus, or pure or mixed blood: the latter is of Phlegm, Choler, Melancholy, Water, Matter, Worms, and the like. Artificial Vomiting, generally is whatsoever is from an External Cause: The External Causes, are chief Strokes, Falls, Compression of the lower Belly, Southernly weather, or infectious Air, Poisonous Breath, Stinking Smells, Violent Exercise, Riding, Sailing at Sea, especially in a Southernly wind, beholding or conceiving of some filthy thing: And the like External Causes which provoke Nature, or move the Humours; but especially things taken in have great force, not only vomits called Emetica, and Poisons which we distaste; but also Nourishment either hurtful in their Nature, or hated peculiarly of some; as in Hypocrates, who speaks of one who with eating of Mushrooms or Toad-stooles, died Vomiting. The same happened to a Courtier of Antoninus the Emperor, who by eating much mouldy Cheese died Vomiting. The quality of Food will do the same if it be Fat or Oily, as also a preposterous order in eating, when moistening and loosning things are eat after astringents, and also too much food taken, though never so good, as appears in Gluttons; for then Nature being over charged, desires to throw out what she cannot concoct, to which she is also stirred up by the evil quality which is brought to those meats by corruption, or evil concoction. The internal Causes are either Antecedent, or Conjunct. The Antedent Causes either come from the whole Body, or from some proper peculiar part into the Stomach. They come from the whole Body in a Plethory, evil habit or Cathexy, Fevers, and other diseases of the whole Body. The Humours are often derived from some peculiar part into the Stomach in the Inflammation of the Liver, Spleen, or other Obstruction of the Mesentery, from the Terms stopped, or Hemorrhoids, from a Catarrh, or the like. To this you may add the evil Conformation of the Porus Cholidochus when it is not placed into the Duodenum, but into the Stomach, whence they are called Pichrocholi Ana, who are often troubled with Choleric Vomits, by reason of this evil Conformation. Al●o this vomiting cometh by the motion of the Guts, when they are stopped in the Colic, and the humours cannot well get forth, but come upwards; also Worms coming up into the Stomach from the Guts, and pulling the inward Tunicle thereof, do cause vomiting. And lastly, An Imposthume broken in the Splee●, Mesentery, and other parts of the Abdomen, useth to cause a vomiting of Matter. The Conjunct Causes of Vomiting, are them before mentioned, when they come to the Stomach; for while they were in other, they were antecedent Causes. These are especially divers Humours, some bred in the Stomach, especially Phlegm, of which there is often much in the Stomach, by Crudities, and want of Concoction when the Stomach is weak, and turns it into phlegm. So also is there sometimes green Choler in the Stomach bred of corrupt Humours, as Galen teacheth, Com. in 2. Progn. and this clearly appears in sucking Infants, who through corruption of Milk in their Stomach use to avoid green stools like Leeches, or Verdegreese. This green Choler which comes from corrupt nourishment in the Stomach, is not the same with that which cometh from yellow Choler by adustion and torrefaction. The Signs of Vomiting are manifest. But the Causes, as they are divers, so they have divers signs. First then, if Vomiting come from a fault in the Stomach, there are signs of that part being affected, as loathing of meat, heaviness, extension, swelling in the Region of the Stomach, slow and hand Concoction, sour and stinking belchings, and other signs that show the distemper of that part. So if it come from a Common and Organical Disease in the Stomach, as a Tumour, or Ulcer, the signs of these Diseases will discover themselves. But if Vomiting come by sympathy from the whole body or other parts, there will appear some Disease of the whole body, or some part. The whole Body is affected in Fevers, evil Habit, Jaundice, Atrophy or want of nourishment. But the Principal parts from which the Humours are sent more frequently to the Stomach, are the Brain, Liver, Guts, and Womb. If the Humours flow from the Brain to the Stomach, there will appear signs of distillations, frothy and flegmy vomitings, and a great loathing at meat time. If the Humour come from the Liver, it is commonly Choler; and Vomiting before meat, is worse than after; and there appears some▪ disease in the Liver, as pain or tumour. If the Matter come from the Guts, either there will be Colic or iliack passion, or the signs of Worms. Lastly, If it come from the Womb, there is Conception, suppression of Terms, or other Symptoms. We may also know by some signs whether the Humour be contained in the Cavity of the Stomach, or stick to the Tunicles thereof. For if it be in the Cavity it is easily cast forth, and there is stretching in the Stomach, and trouble after Meat, which will not cease till the Humours are sent out by vomit, which are for the most part thrown out alone, and the Meat retained. But if the Humours stick to the Tunicles, vomiting is chief after Meat, and the Meat is cast forth without the Humours, but when there is no Meat, there is a loathing, and that which is cast forth, is thick and slimy, and with great straining. The external Causes are known by relation of the Patient, as if he hath eat or drunk too much, or received a stroke, or eat any evil thing. The signs of Vomiting to come are showed by Galen, lib. 3. de cris. cap. ult. as Headache, dark giddiness, trembling of the lower Lip, gnawing at the mouth of the Stomach, often and much spitting. You must make the Prognostic thus: Vomiting from Choler and Phlegm, which is neither very thick, nor very much, and which hath both those Humours tightly mingled, is good. For it is commendable in substance, quantity, and quality. For of all excrementitious Humours, Phlegm and Choler are the mildest: if then they be vomited well mixed, and in a moderate quantity and consistence, it hath all the laudable conditions. Choleric and Phlegmatic Vomitings on a critical day are very good: For not only mixed are good, but vomiting of one single, if it cause the Disease. So in Choleric Fevers, when Choler comes forth critically, or Phlegm in Phlegmatic Fevers, the Disease is at an end, or at least there is great hopes of recovery. A Vomiting naturally after a long flux of the Belly, cures the disease, Aph. 15. Sect. 6. for there is a revulsion of the Matter to the contrary part. And this shows that Nature is refreshed, and gets strength: For as the Physician ought to labour for the retraction of those things that flow to any part. So Nature, when she gins to prevail, makes a repulsion of the Humour, which flows to the part affected, that the part may be refreshed and strengthened. Little and violent vomiting in a sharp Fever, is evil; for it is not good to void sparingly in a Crisis; for it signifieth one of these two things: Either abundance of Matter which Nature cannot bear, but must send some of it forth: or the weakness of Nature, which striveth in vain to send for●h that which is superfluous. Vomitings of divers colours are evil, it signisieth divers Humours lurking in the Body, and therefore Nature will be more put to it with divers enemies; for if it be troublesome to Nature to contend with divers Nourishments, how much more dangerous is it to strive to concoct and tame divers preternatural Humours, especially in acute Diseases, in which there is but short time to fight, which should be long, that there might be more hope of Nature being a Conqueror. Green Vomiting like Leeks, Verdugreese, as also blue, black, or stinking, is deadly: For it signifieth that there is abundance of Choler of those colours: And all these kinds of Choler use to produce malignant and deadly diseases. And if there be a stink, it shows a great corruption of Humours, with which Nature cannot long consist. In acute Fevers, Vomiting without mixture of Humours is evil, according to Hipp. 1. Porrhet. For a pure Humour is not only crude, but incapable of Concoction, because it excludeth not only the act, but the power of Concoction. Hypocrates calls every humour that is without mixture, and every Excrement that is hot and crude, Acriton, because it is bred either by the defect of some part, or by reason the watery, serous matter is exhausted by the heat of a Fever. Therefore in sharp Fevers it shows that there is a great inward inflammation, and for the most part such as Nature cannot conquer. As for the Cure: If Vomiting come from a disease in some other part, it needs no other Medicines than those which are agreeable to the disease from whence it comes. But if it come from Choleric, Phlegmatic, or Melanchollick Humours which stimulate and provoke the Stomach, either by their quantity or quality, you must throw out those Humours by Vomitive Medicines. But if they be thick and glutinous, or clammy, they are to be cut and cleansed, as we shown in the Cure of want of Appetite. The best Vomit in this case, is that which is indifferent gentle, and not too weak, as warm Oil: nor must you give strong ones made of Antimony, which draw violently from remote parts. But such as do cleanse and dissolve the glutinous Humours, as Gylla Theophrasti, or white Vitriol prepared: but Salt of Vitriol brought to a high redness by Calcination, is the stronger. If Vomits are unpleasant, you must take away the Matter with often Clysters and gentle Purgations with Rhubarb in them, which astringeth and strengtheneth afterwards. In Choleric Vomitings, these Pills following may be prescribed: Take of Aloes washed with Rose Water three drams: the powder of Rhubarb sprinkled with borage Water one dram: Mastich, red Sanders, and Coral prepared, of each one scruple: With Syrup of Roses Solutive make a Mass of Pills, of which take half a dram, or a dram every other day till the Vomiting be ceased. Or, Take of Rhubarb powdered one dram: yellow Myrobalans' one scruple: Spodium, or burnt Ivory, and Harts-born shaved, of each six grains. Make a powder, and give it twice in a week, in a ●●ttle Broth. Or make a Bolus of Hiera Picra, or three drams of Diacatholicon, with one dram of powdered Rhubarb. In a most violent Vomiting, give three grains of Laudanum, with two scruples and an half of Cochie Pills the less, the Vomit will be stayed, and five hours after they will work downwards. There i● a good quantity of the purgung Pills in this Receipt, because Laudanum doth astringe, and therefore it must be given with Medicines made of Diagridium, and Coloquintida. And if the Medicine do not come away, you must give a sharp Clyster. After sufficient purging, you must strengthen the Stomach with Syrup of Quinces, sour Pomegrantes, old Conserve of Roses, or Comfry Roots, Conserve of Quinces; or this following Julep, if it be very Choleric and vehement. Take of the juice of sour Pomegranates six ounces: the juice of ●lin●s clarified two ounces Sorrel Water one pint: white Sugar half a pound: make a ●ulep, in which white it is clarifying boil gently in a clout of yellow Saunders, red Roses, and Spodium, of each one dram: Let him take four ounces first and last. Take of Terra Sigillata, or sealed Earth, Bole Armonic red Coral, prepared Pearl, Purslain, and Sorrel seed, of each one dram: shave of Harts-born, and of dried Mints, of 〈◊〉 one scruple: red Roses half a pugil: Make a Powder to be taken in B●oth, or the like; or in a spoonful of Chalybiate Water. Or, Make Tablets thereof with Sugar dissolved in Plantain Water, or an Opiate with Syrup of Quinces, Conserve of Roses, or Comfry Roots. Some few Grains of the best Mastic, taken in the Morning, is good to stay Vomiting. Three Grains also of Balsam of Peru taken in a rear Egg, or in Sugar like a Pill, do it better. Also a Decoction of Beans, or Pease, after the first Water is cast away, with a little Vinegar, is much Commended. And the Crude Juice of Quinces, taken Two or Three spoonfuls at a time, doth Wonders. Camphire often smelled to, or taken with a little Rose Water, and a little Powder of Dia●oscum, is good for the same. The Spirit of Vitriol mixed with Plantain or Spring Water, to make it sharp, doth also powerfully stay Vomiting. If it be very violent, make the Water sharper with Spirit of Vitriol; or give it in Sack, or rich Wine; if you want Spirit of Vitriol, use the strongest Vinegar without mixture, one spoonful or two at a time. One Scruple of Salt of Wormwood, mixed with a spoonful of the Juice of Lemons, is a most Excellent Medicine; especially in those Vomitings which happen in Malignant▪ Fevers. If the Patient grow very Weak with Vomiting, give him Laudanum with Conserve of Quinces, or Syrup of dried Roses; and then apply a Cupping Glass to the Stomach, and a Cataplasm of Leaven, powder of Wormwood, and Orange peels, made up with juice of Mints. Apply also outwardly a Fomentation to the region of the Stomach, a new Sponge dipped in Rose-water and Rose-vinegar; or let the Sponge boil in strong Vinegar, and apply it hot to the Stomach. Or make a Fomentation of the Decoction of the Roots of Snake-weed, Plantan-leaves, Purslain, Mints, Bramble-tops, and Willow-tops, and then anoint it with this Ointment. Take of Acacia, Hypocistis, grains of Sumach and Myrtles, of each two drams: Mastich and grains of Kermes, of each one dram: Oil of Myrtles two ounces: Wax as much as is sufficient; make an Ointment: or apply this following Cataplasm. Take of Quinces boiled in Rose water and Vinegar, or Marmalate thereof well beaten, three ounces: the powder of Mastic, Grains of Kermes, and Myrtle berries, and Plantane-seed, of each two drams: with the Juice of Mints, or Quinces, or Syrup of Wormwood, make a Cataplasm. Or, Steep a Crust of Bread in Rose Vinegar, and sprinkle it with this powder following: Take of red Roses, and Pomegranate flowers, and Coriander seeds prepared, of each one dram and an half: Mastich, red Coral, Sorrel seeds, Spodium, of each half a dram: yellow Saunders one scruple: mix them into a powder. Or, Apply this following Emplaster: Take of Mastich plaster, one ounce: the powder of Myrtles, and Bistort-Roots, of each half a dram: with the Oil of Mastic make an Emplaster in the form of a Buckler. If the Vomiting be very violent, and bring a Fever Symptomatical, and the Body very full, it is good sometimes to let blood to prevent inflammation which may b● in the internal parts by reason of the violent straining; and this must be done warily, and but a little, lest the strength be abated. Moreover, It is good to apply Cupping Glasses to the Back and Navel, and to rub and bind the extreme parts. You may bind about the Neck Linen Clothes dipped in Oxycrate to repel the humours: putting of the hands into cold Water, doth stay all kinds of vomiting. And Last, When other things avail not, use Narcoticks which do very quickly stop all Evacuations. In a Phlegmatic Vomiting (if it will not be stayed with the aforesaid Vomits) give Pills of Hiera, with Rhubarb and Agarick, or other fit Purges. Then come to strengtheners for the Stomach, such as were prescribed for the Cure of Want of Appetite: to which add this following: Take of Conserve of Roses and Comfry Roots, of each one ounce: confection of Hyacinth, three drams: the powder of Diambra, and Aromaticum Rosatum, of each half a dram: Troches of Spodium, terra Sigillata, and grana Kermes, of each one scruple: with syrup of Quinces make an Opiate. The Spirit of Vitriol with Wormwood water, or Juice of Mints, doth mightily stay Vomiting, and Strengthen the Stomach. Or, One or two spoonfuls of Aqua Imperialis, given after Vomiting if the Stomach be very Cold. Apply these things following outwardly: Take of Wormwood, Mints, and Balm, of each three handfuls: boil them in a sufficient quantity of Vinegar and Wine, to the consumption of the third Part; make a Fomentation for the stomach. After apply the Plaster , or the Cataplasm of Quinces, using the Powder of Nutmegs and Cloves, instead of Myrtles and Plantain. Or, Take of Wormwood and green Mints of each one pound: a Toast dipped in Rose-water weighing half a pound: the Pulp of Quinces, or Marmalat of the same, two ounces: Mastich half an ounce: Mace and Nutmegs, of each two drams: beat them all well together with Oil of Quinces and make an Emplaster. Or, Make a Cataplasm of Quinces boiled in strong Vinegar and then beaten with a little Mustardseed and Powder of Cloves. Or, Apply a Toast dipped in strong Wine and Juice of Mints, and sprinkled with powder of Nutmeg, Cloves, Frankincense, Mastic, and Grains of Kermes. Villanovanus much Commends sharp Leaven, which he applieth to the Stomach twice or thrice, being steeped in strong Vinegar and juice of Mints: this doth most certainly stop Vomiting after convenient Evacuations, and Revulsions. In a long Vomiting where the Stomach is very Weak, you must use strong Astringents made thus. Take of the Roots of Snakeweed and Tormentil, Pomegranate peels and flowers, and Hypocistis, of each two drams: Leavs of Mints, and dried Wormwood, of each half an handful: Sumach and Myrtle berries, of each one dram: red Roses one pugil: Cinnamon, Cloves, and Mastic, of each half an ounce: green Galls, and Cypress Nuts, of each two drams: boil them in Iron water and Red Wine, in which dissolve a little Musk, for sweet things do much assuage Vomiting, of which let the Patient take two ounces every morning, and Foment his stomach with the same. After the Fomentation apply some Plaster or Cataplasm, made as aforesaid. Chap. 8. Of Vomiting Blood. THis Disease is a casting forth of Blood from the Stomach by the Mouth: And as all other Bleeding, it comes from the Veins either by Anastomosis, or opening of them by Diapedeses, or Rarefaction, by Rixis breaking, or by Diabrosis corroding, which Diseases of the Veins were showed in the Cure of Spitting of Blood, called Haemoptysis. The Causes also are the same. And First the Conjunct Cause; Excess of Blood in quantity or quality. Blood offending in Quantity, will break or open the mouths of the Veins, and so comes Rixis, or Anastomosis, which happeneth in full bodies. If it offend in Quality, as when it is too hot, or thin, it may cause an Anastomosis, because heat doth open the Orifices, and thinness makes it flow easily through; The same Qualities may Cause a Diapedeses; for heat doth make thin the Tunicles of the Vessels, and thinness Causeth the Blood to pass through their pores. Lastly, Sharpness gnaweth and Ulcerateth the Tunicles of the Veins, and so produceth a Diabrosis. The Antecedent Causes are the same with the Conjunct, but they differ in place; for when blood offending either in Quantity or Quality, doth immediately open the Veins: it is called a Conjunct Cause; and the same being contained in the Veins, is called an Antecedent Cause. The parts sending, of which the chiefare, the Head, Liver, Spleen, and Womb, are antecedent Causes. Often times Blood is carried from the Head to the Stomach by the and Gullet, or Oesophagus: and also a violent Catarrh of sharp and Salt phlegm, doth corrode the Stomach, and open the Veins thereof. It is carried from the Liver and Spleen by the Veins that go to the Stomach from the Womb, when blood by the stoppage of the Terms, runs back and opens the Veins of the Stomach, so that some Women have had their Terms by vomiting blood constantly at the time. Vomiting of blood comes oftener from the Liver and Spleen, than from other parts, and from the Spleen than the Liver, because it doth more consent with the Stomach. For it is evident by Anatomy, that the great branch of the Gate Vein, or Porta, goeth to the Spleen, from which many Veins are sent to the Stomach both above and below; and these are so great that being distended with wind or blood, they are as thick as the middle finger: this we have observed in Dissection. Moreover, the Vas breve being wide, as in a natural state, it doth continually send Melancholy into the Stomach; so being in a Preternatural state, it may send great plenty of blood. But observe here, that in this case, that blood is voided by stool as well as vomit, both because a part thereof which went to the Stomach, is sent downwards, and also because the Meseraick Veins are open, and send blood into the Guts, which by its long passage through the Guts groweth black, and comes forth like Tar. The external Causes are, all things that can wound or bruise, as also great heat which causeth boiling of the blood; hence it is that young men to the age of thirty five, are very subject to vomit blood, and other bleeding, as also great cold by too much astriction may endanger to break the Veins: the same doth unseasonable Motion and Labour, unusual Exercise, great hallowing, and the like, which move the blood violently in the Veins. And finally, All the Causes of Blood-spitting afore mentioned. For Blood being violently moved either in the Veins or Arteries, whether from an external, or an internal Cause, goes soon to that part which is weakest, and most fit to receive it; and therefore if the Stomach, or the Veins going thither are so disposed, there will be vomiting of Blood rather than any other way of bleeding. The Diagnostic of this Disease lieth chief in the discovery of the part from which the blood comes. If from the Stomach, the situation of the part, and the constant pain and heaviness thereof will demonstrate, and there is less blood, for the Veins of the Stomach are small, and it comes with loathing, and there is a biting when they swallow, as also sometimes it comes forth mixed with Meat, Phlegm, or Choler, If it come from the Head, there will be tickling about the Jaws and ; and some blood will be blown out of the Nose with Snot; there went before it some Headache or heaviness, which after bleeding ceaseth. If from the Liver or Spleen there is more plenty of blood, and sometimes a tumour or dolour in the part. From the Liver the blood is red and frothy, from the Spleen it is thick and black. Also Blood from the Liver goes most downwards, because it commonly goes from thence to the Guts through the Mesenterics, and must ascend from them into the Stomach to cause Vomiting, but it doth easier descend. Contrarily, that which comes from the Spleen, is rather by vomit, because the Veins from the Spleen to the Stomach, are shorter and narrower. Lastly, If from the suppression of the Terms, you may know it from the Woman, and it will come at those times which will be more probable, if there be no disease in any other part. As for the Prognostic: Vomiting of Blood, of what cause soever, is dangerous; for it either threateneth death suddenly; or if it stay in the Stomach, and putrify, it breeds faintings, swoonings, and suffocations. Vomiting of blood from suppression of the Terms, is less dangerous than that from the Liver or Spleen; for when they are brought down it is usually cured, as Hypocrates taught, Aph. 34. Sect. 5. in these words: When a Woman vomiteth Blood, if her courses breakdown, she is cured. And in this case only, the opening of the inferior Veins doth provoke the Terms, especially if she take something besides for that purpose. They who after Vomiting of Blood fall into the Dropsy called Ascites, do die thereof. Dodonaeus doth testify that he never knew any that escaped: and Experience teacheth that a Dropsy from any kind of bleeding is deadly; for it comes from a great dissipation of Natural heat, which cannot be repaired. For the Cure of this Disease use Medicines which revel the Blood from the Stomach, and correct its distempers and the open Veins with astringents and glutinatives. To which add those things which concern the part chief affected, from whence the Blood is sent into the Stomach, according to the divers Nature, and Disease of the part. And because Diet is of chiefest concernment in this Disease, let us show some Rules therefore. Let his Nourishment be commonly astringent and Emplastic, and cold both actually and potentially, as Barley, Almonds, Rice, Panadoes, Jellies, and especially Starch made without Chalk, and boiled in Milk, which is good also in spitting of Blood: to all these you may always add some Pomegranates, or Vinegar of Roses. Also hard Eggs steeped in Vinegar are good; Bread crumbs steeped in cold Water, and Chicken Broth, with Sorrel, Purslam, Plantain, and unripe Grapes; the feet and hips of Sheep, Kids, and Calves, boiled to a Jelly, for the first course, let him take that which is a stringent, as a Quince, or sour Apple, or Pear roasted in the embers, Marmalat of Quinces, or Jelly of sharp Cherries, Meddlers, or Services. Let him abstain from all sharp, salt, peppered, and fried Meats, as also from things that breed much Blood, except he grow weak, and then you may give him them sparingly. He must be but little nourished, for the less Blood is bred, the Disease will be the less, and the empty parts by their attraction will stay the flux. Let him drink little, only a little Iron Water with a little Juice of Pomegranates. He must drink no Wine except it be thick and sharp, which we call Tortium, and it must be when there is no Fever. Let the Air be cool, without Wind, Sun, or Moon shine; let him sleep little, and not in the day; for although all fluxes are said to be stopped by sleep, yet this by long keeping the heat in the Centre may be increased. Let his Belly be lose, and he kept free from passions. After his Diet is thus ordered, we must go on to Chirurgery and Medicine. And first take away a little Blood, often, for the greater Revulsion: and that out of the Liver Vein called Basilica, in the right Arm, if it come from the Liver; in the left, if from the Spleen; or from the Ankle Vein, if from stoppage of the Terms. Use Frictions and Ligatures to the extreme parts, and give cleansing Clysters. Apply Cupping-glasses to the Buttocks, Thighs, and Loins, and to the Hypochondria. Give half a scruple of Camphire with four ounces of Oxycrate, or Plantain Water. Which Rondeletius commends in his Counsels for excellent. If you suspect there is congealed Blood, give him a glass of Vinegar and Water, or Oxycrate, for it easily dissolveth blood, and sends it from the Veins of the Stomach, and shuts them up. And foment the Stomach cold with the same. When Vomiting ceaseth, to astringe the Veins, use these following: Take the white of an Egg, Rose Water and Vinegar, of each one dram and an half: Beat them well; then add two drams of Chalk. Let the Patient take now and then a spoonful. Or, Take of prepared Coral, Terra Sigillata, Bolearmenick, Bloodstone, and Troches of Amber, of each one dram: Plantain Water, and Syrup of Myrtles, of each two ounces: mix them for to be used as the former, or the powder in Broths. Or, Take of the Juice of Plantain four ounces: give it cold morning and evening. Galen saith there is nothing better for to stop any kind of Bloody flux. The Juice of Purslain and Polyganon, or Knotgrass taken with Sugar, is very good for the same. Take of Plantain and Purslain Water, of each one ounce and an half: the Syrup of Myrtles half an ounce: the Syrup of Poppies two or three drams: Sal Prunellae one dram: Mix them for a Julep often to be repeated. Or make a Julep of the Decoction of the said Herbs. Take of old Conserve of Roses, and of Comfry Roots, of each one ounce: of Cydoniatum half an ounce: one candied Myrobalan: Troches of Carabe, and Terra Lemnia, of each two drams: Coral prepared, and Crocus Martis, of each one dram: With the Syrup of dried Roses, make an Oplate to be taken often. The Troches of Carabe do not only astringe, but dissolve congealed blood, therefore use them often. The Syrup of Coral is good; but the Tincture drawn newly with the Juice of Lemmons is better. When Blood is vomited violently, and will not be cured by what hath been said, so that death threateneth; you must give Narcoticks, either at the Mouth, or by Clysters. Anoint the Stomach without with Oil of Roses, and Myrtles washed in Vinegar; and after sprinkle on the powder of Coral, Bolearmenick, and Terra Sigillata. Or anoint with this: Take of the Juice of Plantain, and Knotgrass, of each one ounce and an half: Vinegar of Roses one ounce: Oil Olive six ounces: Boyl them till the Juices are consumed: then ad os Sanguis Draconis, Mastich, Pomegranate peels, and Myrtles, of each two drams: Camphire one scruple: as much red Wax as will serve to make an Ointment. Let him drink ordinary Water, wherein Iron hath been quenched, with Syrup of Quinces, and Spirit of Vitriol: also make all his Broths of Iron Water. Let his Hypochondria and Loins be Fomented with the Decoction of Plantain and Purslain mad in Oxycrate. Let his hands be put into cold Water, for so all Vomiting is stayed. After use the Ointment of Galen, called, Refrigerans; washed in Vinegar, to the same parts. After sufficient Phlebotomy, you must appoint an often and gentle Purge to take away the 〈◊〉, and destroy the Disease, by which the blood will be purged from Waterish and Choleric Humours which produce this Disease. These kinds of Purges, given by a wise Physician, do Miracles; as we have learned by Experience. They must be made of Rhubarb, Myrobalans, Tamarinds, and Tryphera Persica; which Medicines do all astringe with their Purging, & do no ways stir the Humours, so that you need not fear they will provoke Vomiting of blood; you may give them in form of a Bowl, with Syrup of Myrtles, ●● of dried Roses; or in form of a Potion, with the Decoction of Succory, Sorrel, Purslain, or the like. In time of Purging, which may continue three or four days in a small Dose; at night you may give the aforesaid Opiate or Syrup of Coral, or some of the Astringent and strengthening Medicines. Finally, To prevent, you may give for a long time once in a Week, one dram of the Powder of Rhubarb, or the Magistral Syrup prescribed for to prevent Spitting of Blood; as also almost all other Medicines laid down in the Cure and Prevention of that, are very good here. Chap. 9 Of the Disease called Cholera. THis Disease is a violent sending forth both by Stool, and vomiting corrupt, sharp, and choleric Humours. It is called Cholera Apo tes Choles from Choler, as Galen shows from the opinion of the Gnidian Physicians, 2. m. c. 2. that it comes from yellow Choler and evil humours like it which is sent upwards and downwards. But Alexander Trallianus, lib. 7. c. 14. will not have this Name to be derived from a Choleric humour, because Choler is not always vomited, but also often times a serous and Phlegmatic Humour; but it comes rather Apo toon Cholastoon from the Intestines which were c●lled Cholados by the Ancients; because these Humours come from the Intestines and entrails: yet the first Etymology is more to be approved, because it is used not only by Galen, but by Hypocrates 7. epid. text. 19 by Celsus, lib. 4. cap. 11. and Aurelianus, lib. 3. acut. cap. 19 And although a choleric humour is not always sent forth, yet one like Choler, sharp, biting, and corrupt, is always voided. Some say the Stomach is the part affected, others the Guts, others both; but we must be of Galen's mind, who saith, 3. de sympt. cause. cap. 2. The part which is principally affected is the Stomach, whose expulsive Faculty is vehemently stirred up, so that it expels the noxious humours at both orifices. But there is no doubt but the Gullet and Guts are secondarily affected. Therefore this Affect is a Symptom of the expulsive Faculty being hurt, and vehemently stirred up, for it cannot depend upon the retentive faculty debilitated, for then the humours flow by degrees as in Lienteria and Coeliaca Passio: but we must confess that the Disease is more violent if the Retentive Faculty being weak do not resist the expulsive. Moreover, The Concoction is hurt also, by which evil humours are bred in the Stomach which stir up the expulsive Faculty: but this is an Antecedent Cause, Hipp. 4. de victus ratione in acutis textu 104. lays down Two kinds of Choler, the one Moist, and the other Dry; the Moist is that which hitherto hath been described, and which is meant only in this definition as being the more usual▪ but the Dry is more rare, and it comes from a windy spirit going from the Stomach and Guts, and gripping those parts through which it passeth. These Winds are produced either from the fiery heat of the Stomach corrupting the meat and making it stink, or from windy rank meats, and Onions, Radishes, and the like. Sennertus addeth another Cause, borrowed from the Hermetical Doctrine, namely, Salt Humours, and Adust in the Hypochondria, which grow hot by the mixture of another humour: For (saith he) as Salts and the Spirits of Salts mixed with sharp Spirits, make abundance of flatuous Spirits, as appears by the mixing of Oil of Vitriol and Aqua fortis with Salt of Tartar. So doth it fall out in man's Body, by the Commixtion of a Salt and Adust Humour with other Spirits, there are many windy Spirits produced. The immediate Cause of this Disease is a Choleric, Burnt, Sharp, Salt, or rotten Humour in the Stomach, Guts, Spleen, Mesentery, or Prancreas, or some nourishment of evil quality, some strong deadly Medicine, or poison taken. Hipp. 7. Epid. Text. 90. doth reckon up almost all the Causes of those evil Humours, in these words: Choleric Evacuations upwards and downwards, come from eating too much flesh, especially Swine's flesh not roasted: Also for meats not formerly used, from drunkenness with old Wine, and sweet, from Pine Kernels, Locusts, rotten Nuts, and from the use of Garlic, Leeks, Onions, especially from boiled Lettuce, Coleworts and the like crude things; also from Tarts, and sweet meats, Honey meats, Fruits soon perishing, especially from Cucumbers, Pompions: and these Evacuations happen most in Summer, for than they are easily corrupt, and are indigested. It is worth the observation from whence so many Choleric Humours should come, which in this Disease are sent forth by Vomit and Stool? It is usually answered, that they come from the Mesentery, and the places adjacent, and sometimes from the whole Body, which though it be probable, yet we may say, That Humours corrupted in the Stomach, and parts near thereto, do infect other Humours with their Malignity, and that Nature is constrained to send to the Stomach and Guts, as venomous Medicines, Antimony, Coloquintida, Elaterium, and the like, by corrupting of the good Humours, do make an Hypercarthasis, or over-purging. The signs of this Disease, are an often and plentiful sending forth of Choleric, sharp, and other corrupt Humours by vomiting and stool; a gnawing of the Stomach and Guts; a swelling with wind, pains, thirst, with much heat and disturbance; great Nauseousness, and loathing, which is somewhat appeased with cold drink, but presently is cast forth with hot. The Pulse is sometimes small and unequal; sometimes with great sweeting, and Convulsion of the Thighs and Arms, swooning, coldness of the extreme parts, and other grievous Symptoms. The Causes of this Disease are easily known. And first, the external are known by relation of the Patient, and those that stand by. If he have taken too much, or food of an evil quality, or poison, or some violent Medicine. The internal Causes are known by the quality of those Humours which are sent forth. We conjecture that it comes from the fault of the Stomach, if other parts are not distempered, and when there is a continual loathing, gnawing, and pain of the Stomach, the matter is sent forth green; but if it be bred in the Veins, there is commonly a Malignant Fever adjoined. You must make your Prognostics thus, If it be very violent, it brings commonly sudden death. If it come from some evil Food, it is less dangerous; for when that is sent forth, the Disease ceaseth. By how much the greater the Symptoms are, as Swooning, Convulsion and coldness of the extreme parts, by so much nearer at hand, is death. Hypocrates in Coac. showeth that this is sometimes Critical to Fevers called Lipyriae, which can no other ways be cured (as he saith) but by a great casting forth of Choler both upwards and downwards; and these Crises or Judgements happen seldom, and aught to be suspected, because they have not the conditions of a good and Health bringing Crisis. If vomiting begin to cease, and the wan and deadly colour of the Face to be restored, there is hope of Health. In the Cure of this Disease, in the beginning thereof, some evacuation may be allowed while the evil and corrupt Humours do flow forth. And you must help it forward with drinking warm Water with Syrup of Vinegar, or with a great deal of thin Chicken Broth; which if it provoke not Vomit, will allay the sharpness of the Humours. Or you may evacuate them with Rhubarb brought into a Pill with Syrup of Wormwood, and with cleansing Clysters. Also fat mollifying Clysters are to be given, made of Milk, Oil of Roses, fresh Butter washed with Rose Water, or made of Chicken Broth, or Veal Broth with Yolks of Eggs; with which, as the disease shall require, you may mix Narcoticks. Also Clysters of Oxycrate are good, or made of the Decoction of Lettuce, Plantain, with a little Vinegar, Syrup of Water-lillies, and Yolks of Eggs. Also you must qualify the Humours sharpness with internal Medicines; as with the Decoction of Purslane and Plantain with Syrup of Quinces and dried Roses, with Lapis Prunellae, if there be heat and thirst. And you must stop Vomiting with those things both internal and external, which were prescribed in the Cure of Choleric Vomiting, Chap. 7. Among which, the Narcoticks are best, and especially new Treacle, which given in the quantity of a dram, doth presently stop those violent Evacuations. Laudanum doth the same, if you give four grains thereof. If there be great weakness (as often happeneth) it is not safe to give the whole dose of Laudanum; but it is better to give one or two grains, and to give it once or twice in a day, as necessity urgeth: for so the force of the Humours will be restrained, and Nature will have time to tame and concoct him. After vomiting and purging are stayed by the Medicines aforesaid, & the strength is restored by Cordial means, the Patient seemeth to be past danger; which doth not only sometimes deceive the standers by, but also the Physicians themselves: for after a day or two of rest and intermission, the symptoms return more strong and violent, and destroy the Patient who was made weak by their former encounter; which danger you must prevent, not only with Restauratives, and things that take away the heat of the Humours, as before mentioned, which must be continued after they are appeased; but especicially with Blood-letting, which doth revel the and boiling blood, and greatly assuage it: and you must do it twice, or thrice, if the strength be not impaired by the first, but rather seem to be refreshed. Some Practitioners adventure in the time of the fit, when the strength is decayed, adventure to open a Vein, because they say the strength is oppressed. But it cannot then be done without danger: and sometimes the Patient presently after dieth, to their shame. For though we acknowledge that there is an oppression of the strength by reason of the superfluous Humour, which is contained in the Veins, being an Enemy to Nature; yet it cannot be denied but it is greatly decayed by those grievous vomits and stools. It is better therefore first to allay the violence of the Humours, and after the symptoms are assuaged to open a Vein. And because in this Disease the strength quickly fails by strong evacuations, you must be very careful in the restoring of it by that way which is showed in the Cure of weakness in the eighth Book, and the third Chapter. Chap. 10. Of Pain in the Stomach, called Dolour Ventriculi. IT is a sad and troublesome sense in that part, from some things that gnaw and stretch it till it break, or be wounded. In the Stomach, you must consider three parts, which much differ one from the other, namely, it's upper Orifice, and its lower, called Pylorus, and the rest of its Body which maketh up the whole Cavity. The upper Orifice is of exquisite sense, by reason of the great Nerve which it hath from the sixth Conjugation, and therefore pain therein is very sharp, and makes the Heart which is the most noble part, and near unto it sensible of the same; from thence it is called Cardialgia, and Cardiogmos: for there is such a near consent between the mouth of the Stomach, and the Heart, that the Ancients called it by the name of the Heart, Cardia. But if the Membranes of the Cavity, or the Pylorus be pained, it is called simply Dolour Ventriculi, and sometimes Colica Ventriculi, especially when it comes of wind. The immediate Cause of this pain, is solution of Continuity by things sharp and distending, and they are chief Humours, or Wind; and sometimes Worms gnawing the Tunicles. Sharp and malignant Humours, as green Choler, or black, salt Phlegm, corrupt Matter sent into the Stomach from an Imposthume broken in the Liver or Breast, and all other sharp Humours which may cause pain. Also sharp vapours coming from those Humours use to cause this pain. The Wind contained in the Cavity of the Stomach doth cause swelling and painful distension, especially if it be restrained within its Tunicles, which makes a very stubborn Disease, and cannot easily be sent out. The Diseases both of the Stomach itself, and of the parts adjoining, use to breed this pain, as any great distemper, either hot or cold, and especially an Inflammation, and sometimes a Schirrus or other hard Tumour which maketh a heavy pain; as also Wounds and Ulcers of the same part, and swell in parts adjoining by wind or other ways, cause this pain by compression of the Stomach. Now these Humours and Winds which cause pain in the Stomach, either come from the whole Body, or some parts thereof. From the whole Body, in Fevers, or when the Body is filled with evil Humours. And from other parts, especially the Liver, Spleen, and Brain: from the Liver there comes Choler; from the Spleen, Melancholy; and from the Head, salt Phlegm. Also this pain may arise from other extraordinary Causes not usual; as Schenkius observes from stones bred in the Stomach, lib. 3. observat. And Fabricius Hildanus, observ. 33. lib. 4 reports that a Woman had a piece of Rind or rusty Bacon two years in her Stomach, wherewith she was continually pained, and which after by taking a Vomit, she threw up, and was cured. The external Causes of this Disease, are either evil qualified, or of sharp Nourishment, which of themselves produce it, or things apt to breed Wind; or things taken in too great a quantity, which putrify and turn sharp; or things that are too hot, and breed much Choler: As also strong, sharp, deadly Medicines, either taken in too great a quantity, or not sufficiently corrected, and poison. The Diagnostic Signs are from the part affected, and the cause. And first, when the pain is under the Cartilege Ensiformis or Xiphoides, it shows that the upper Orifice of the Stomach is affected▪ but that it is a true Cardialgia in the mouth of the Stomach, you may know more certainly when there is a most sharp pain from the exquisite sense of the part with such trouble and disturbance that the Patient cannot stay in a place, or in one posture, but often 'swounds and fainteth by consent and sympathy of the Heart with the Stomach, not only by nearness to it, but also by reason of the dissipation of the Spirits by the pain. Sometimes the Brain consents, by Reason of the famous Nerve which is in the Stomach, and the sharp vapours which are directly sent into the Head from thence, from whence come Cephalalgia, Hemicrania, Vertigo, and Epilepsy. In other parts of the Stomach there are great pains, but they have not so great Symptoms, and therefore they are like the Colic, differing only in place. The Causes also are known by their proper signs. The most manifest are taken from the Excrements; for Choler, Phlegm, Wind, or Worms, are voided at the Mouth or Belly, it is easy to conjecture that the Disease depends upon these Causes. But if no Humour be discharged we may know when Choler, Phlegm, or Wind abounds by their proper signs; and the signs of Worms are to be taken out of their proper Chapter: As also the proper diseases both of the Stomach and parts adjoining which produce this Disease, are known by their proper signs. The knowledge of the Humour causing this pain, is also taken from the time of its coming, increase, and cessation. Some are troubled most violently before meat, and this shows that Choler is predominant, which is stirred in time of emptiness, and drawn to the Stomach, and made more sharp. Some are pained presently after meat, because the raw biting Humours, which before were quiet, and fixed to the Tunicles of the Stomach, are moved when Meat is taken, or they which were in the bottom of the Stomach, are raised up, and disturb the mouth of the Stomach. Others are pained in time of Concoction, because sharp gnawing vapours arise from the Matter, causing the Disease from the heat increased in the Stomach in time of Concoction. Others are pained four or five hours after meat, because it is corrupted by evil concoction, and so gnaweth the Stomach. Some are worst after sleep, and that comes from a Catarrh from the Head in the time of sleeping, which being heaped up in the Stomach, produceth pain afterwards. Sometimes the pain is appeased after Meat, because the sharpness of the Humours is qualified by the sweetness of the Meat. As for the Prognostic, it is most certain that Cardialgia is more dangerous than any other disease of the Stomach by reason of the exquisite sense of the Mouth of the Stomach, and its great consent with principal parts. The danger is more or less, according to the malignity of the Cause, and the vehemency of the symptoms. A continual acute Fever joined with a great pain of the Stomach, threateneth great danger; as Hypocrates saith, Aph. 65. Sect. 5. In Fevers, if there be great heat about the Stomach, and Cardiogmos, it is evil: for it signifieth that there is a great Inflammation of the Stomach, or abundance of bad Humours contained therein. The pain of the Stomach coming from Worms or Wind, is commonly least dangerous, because the Cause is not so bad, and not fixed to the part. But sometimes from Worms ghawing in the Stomach, great Symptoms happen, of which the Patient suddenly dieth. So when the distemper which begets wind, is stubborn and habitual, it is not without danger, for it turneth to a dry dropsy; Hypocrates, Aphor. 11. Sect. 4. In a Cardialgia, coldness of the extreme parts signifieth death at hand. The Cure of this Disease is to be varied according to the diversity of the Causes. If it come from the Diseases of other parts, you must cure them. But if the Cause be in the Stomach alone, the pain comes either from wind, or sharp Humours and Choleric, or from Inflammation, Imposthume, or Ulcer. That which comes from Wind is to be cured by Medicines that discuss and evacuate that flatulent Matter, as also the phlegm from whence it comes. And first you must give a gentle Emollient Laxative Clyster, and presently after another Carminative, that is, expelling wind, and discussing, of the Decoction of Origan, Calamints, Penyroyal, Rue, the lesser Centaury, Annis seeds, Fennel seeds, Carrots, and Cummin seeds, and the like: In which dissolve Benedicta Laxativa, Oil of Dil, Rue, and Honey of Rosemary. If the pain continue, you must make a Clyster of equal parts of Sack, or Hippocras, Oil of Rue, or of Nuts▪ with two ounces of Aqua vitae. Or make a Clyster of white Wine with Oil of Juniper, or eight drops of the Chemical Oil of Cinnamon or Cloves, which doth Miracles. Then foment the Stomach with this: Take of Cypress Roots, Galangal, Calamus Aromaticus, of each one ounce: Mints, Origan, Penyroyal, Marjoram, Hyssop, Sage, of each one handful: Annis, Fennel, Caraway, and Carrot seeds, and Bay berries, of each half an ounce: Chamomel, Melilot, Rosemary and Lavender flowwers, of each one pugil: beat them, and slice them: put them into two bags, and boil them in Sack; then squeeze them, and apply them one after another to the Stomach and all the Belly. When the Matter is not so cold, this Fomentation following may be prepared, which is highly commended by Forestus, because it hath presently cured when other things failed. Take of Althaea Roots half an ounce: red Roses, Chamomel Flowers, and tops of Wormwood, of each one handful: Boyl them in common Water, and Chamomel Water, to one pint and an half, adding in the end a little Rhenish Wine, Rose Water, and Vinegar. Make a Fomentation. After Fomentation, anoint with Oil of Rue, and Dill mixed with Aqua vitae, and a little Chemical Oil of Sage, or Cloves. After the anointing, apply a Plaster of Bay-berries, or instead thereof a Cataplasm of Honey and Cummin seed. While these are doing, if there be loathing, you may provoke vomiting gently, or give a Purge against phlegm. After Purging give Oil of bitter Almonds newly drawn, mixed with white Wine, or Hippocras mixed with Aqua Clareta, or Cinnamon Water. This following Juleps is most admirable to assuage pain, discuss wind, and strengthen the Stomach. Take of Wormwood, Centuary the less, and Agrimony, of each half a handful: boil them to five ounces, and ad to it being strained, one ounce of Sugar. Let him take it two mornings together. Amatus Lucitanus commends highly the distilled Water of Chamomel flowers as a most excellent Remedy to assuage the pains of the Stomach and Entrails, of which you must give three ounces warm. Or in the defect of that, you may make a Decoction of Chamomel flowers, which is so much commended by Forestus, who saith that he cured a Merchant with this only Decoction, once only given, of great pain of his Stomach, which made him to roar; which when he had drunk off, he belched, and fell into a sweat, and all his pain vanished, as by an Enchantment, so that he needed no other help. You may also make a Vomit at the beginning of the disease, which by evacuation may abate the pain, of this Decoction, made with Dill seeds, or Agarick, or the Roots of Asarabacca, dissolving therein, Oxymel, Syrup of Vinegar, or of Roses Solutive. Galen teacheth that a Cupping glass applied to the Stomach doth presently take away pain. But you must use this Caution, That no crude Humour, or very little, lie in the Stomach, otherwise the pain will be increased. Also you may with good success apply Bread hot from the Oven, cut in the middle, either by itself, or sprinkled with Spices. Lastly, If the pain continue violent, you must use a bath of the Decoction of mollifying Herbs that are hot, which is most safe and powerful, for it takes away the pain by discussing the wind, and sending it forth by the open pores, which it will better do, if you give some discussing Medicine to the Patient while he is in the Bath; for both internal and external helps concurring, the work will be done. The Bath must be very hot that the wind may be the better discussed, and the thick Humours melted. If by reason of the vehement pain, Clysters can neither be given nor retained, you must give a Purge in the Bath, and let him stay therein an hour, or half an hour, till the power of the Medicine touch the Stomach. Sometimes when the violence of the pain threateneth danger, you must give Narcoticks, which being wisely given, bring wonderful effects. Some mix Narcoticks with their Purges that the pain may be allayed, and the Matter evacuated: such as the Medicine of Elidaeus commended by Forestus, made thus: Take of Diaphoenicon half an ounce: Philonium Romanum two scruples: with the Water or Decoction of Chamomel make a Potion. After the pain is gone, let them who are subject to this Disease, be purged once or twice in a month, to take away the immediate cause of wind. And let them use strengtheners, such as were prescribed in the Cure of Concoction hurt. That pain which comes of Choler, is to be cured by the evacuation thereof, with a gentle vomit or Purge, or with frequent Clysters that are emollient, not sharp or hot. Afterwards, qualify the sharpness of the Humours with cooling Juleps that thicken, with Emulsions of the great cold Seeds, new Milk, new Oil of sweet Almonds, Yolks of Eggs, and the like. In the mean while omit not Opiates, and other strengtheners prescribed in the former Cures. And at last, when need requireth, use Narcoticks. Apply outwardly a Cataplasm of Bread and Milk, with yolks of Eggs, and Saffron. Or Bread from the Oven broken in the middle and dipped in Vinegar. Or Foment the part with the Decoction of Chamomil-flowers, Violets, and Water Lilies, or which is best, put the Patient in a warm Bath, for that is most proper. After the pain is gone lest it should return, let the Patient Purge twice every month, and let the hot Distemper of his Belly be corrected with a Cooling Diet and Convenient Remedies. That Pain which comes from Inflammation, Imposthume, or Ulcer, may be Cured with the Remedies Prescribed in the following Chapter. Chap. 11. Of the Inflammation, Ulcer, and Imposthume in the Stomach. ALthough all kinds of Tumours may arise in the Stomach as well as other parts, yet we will speak here only of a Phlegmon or Inflammation, which is most usual; the other happen seldom, and may be Cured by the same Method with the Tumours of other internal parts. The Inflammation of the Stomach is a preternatural Tumour coming of Blood which is sent into the substance of the Stomach and its Membranes by the Veins derived from the branches of the Vena Porta. This Blood is either pure and makes a proper Phlegmon, or mixed with Choler, Phlegm, or Melancholy, and makes a Phlegmon Erysipelatous, Oedematous, or Schirrous. The External Causes may be many, all that inflame the Blood, as hot meats, wine, or all that can drive it to the part; as a blow upon the belly, especially when it is full; to which you may add things that are very sharp and very hot, as Cantharideses, sublimate. The signs of this Disease, called Diagnostica, are a great Pain, burning, pricking, distending and beating, reaching to the back; you may feel a Tumour, and sometimes see it, the shoulders are drawn downwards; the breathing is difficult, as also swelling and belching, sometimes blood is vomited; there is a most burning Fever, with most grievous Symptoms. If the Inflammation be pure only from blood, it is somewhat gentler; but if it be with Choler called Erysipeals, there are grievous Symptoms, and the febris called Lipyria in which the exterior parts are cold, and the internal bourn, and there is an unquenchable thirst; such a kind of Fever useth to be in an Erysipetous inflammation of the intestines. Like to this Inflammation of the Stomach, is that which is in the upper part of the Liver by which the Stomach is covered or in that part of the belly which lieth upon it; which is only distinguished by the deadly Symptoms, for then the Stomach hath the most desperate. From what hath been said is easy to Prognostic and to pronounce this Disease to be for the most part deadly. But that is most Dangerous which is over the whole Stomach, or its upper part, or which is like to an Erysipetas. Galen 3. Prorrhet. shows, That much Loathing and Rumbling of the belly, is evil: For it shows that evil Humours do stick close to the Tunicle of the Stomach, and pull them to provoke Expulsion. If the Inflammation do not kill, nor is dispersed, it turns to an Imposthume, which is known by the mitigation of the Pain and the Fever, while the Tumour remaineth. After the Imposthume is broken there remaineth an Ulcer which is known by voiding of Matter by Vomit and Stool. But an Ulcer is produced in the Stomach, not only from an Imposthume, but from other Causes which we shall here reckon up, lest we seem defective in the Theory. The Causes of Ulcers in the Stomach, are either Internal or External. The Internal are sharp Humours bred in the Stomach, or sent thither from other parts, as yellow Choler, or black, or salt Phlegm. The External are sharp Medicines that Corrode, or Poisons, and Wounds of the Stomach not well Cured, which turn into Ulcers; as also the breach of some great Veins which could not well grow together, after much Vomiting of blood. An Ulcer bred in the Stomach is known chief by Matter which is cast forth by Vomit or Stool, to which principal sign there are others to be added: First there is perceived in the belly a pricking pain joined with burning, especially when any thing is taken that is strong in quality, either sharp, salt, or sour, or very hot, or cold: there is also no Appetite, stinking belching, and a constant lingering Fever. The Prognostic is always deadly, except the Ulcer be very little, and only in the superficies, and without a Fever. For the Membrane of the Stomach being ulcerated, being a Spermatick part, will hardly grow together again: the Nourishment will not be well concocted in a Stomach ill affected, but will be thrown out before concoction, and so rend the Ulcer. Moreover, Medicines do little good because clensers which are required for cure of Ulcers increase pain; and dryers which also are required, are continually hindered by the Meat and Drink, and Chyle, and other Humours which continually are in a weak Stomach. The Cure of the afore said Diseases, is several. And first, the Cure of Inflammation is to begin with Blood-letting often in both Arms, as the strength will endure. And although by reason of swooning and coldness of the extreme parts, the strength seem at first to be impaired, yet because it comes from oppression, it requires evacuation, and therefore blood-letting must not be denied. Moreover, the opening of the Hemorrhoids, if the Patient be used to that evacuation, doth revel Blood from the Stomach. Also Cupping-glasses both dry, and with Scarification to the Shoulders, Back, and Buttocks, with Ligatures and Frictions of the extreme parts, and heating of them (because they are usually cold) with hot , and anointing with Oil of Flowerdeluce, and Spike, and other hot things are very good. We disallow Purges in this case, because they trouble the Humours, and draw them to the part affected. But Avicen commends the Decoction of Tamarinds, or half an ounce of Cassia dissolved in Whey, or Endive Water if it be given every day to the seventh day, because they purge not by attraction, but by mollifying, mitigate sharpness, and assuage pain. But it is better in the beginning to abstain from all Purges. After the seventh day is past, when there appear some signs of Concoction and declination, you may give a Purge of Rhubarb one dram, with one scruple of red infused in borage Water, adding one ounce or two of Syrup of Roses, that the filth which sticketh to the part may be brought forth more powerfully. In the mean while, you must every day give Emollient, Cooling, and Lenitive Clysters, such as these: Take of Chicken Broth, or the Decoction of Mallows and Violets, of each one pint: Cassia new drawn, one ounce: Oil of Roses and Violets, of each two ounces: Sugar one ounce and an half: With two Yolks of Eggs make a Clyster. You must give altering and strengthening Medicines at the Mouth, they may be the same which were propounded in the Cure of the Pain of the Stomach from a Choleric Humour. But the Syrup of Water Lilies, and of the Juice of Purslain, are peculiarly good, especially in the beginning, because they supply the place of Repelling Medicines. Also Emulsions made of the four great cold Seeds, and white Poppy Seeds are good, for they assuage pain and heat. As also these following Juleps. Take of Rose Water three ounces: Plantain Water two ounces: the Juice of Sorrel and Pomegranate Wine, one ounce and an half: Sugar of Roses one ounce: Boyl them a little, and strain them. Let him take two ounces twice or thrice in a day. If the pain be great, you may give the Syrup of Poppy. Let his Drink be barley Water with Syrup of Violets taken cold. In the progress of the Disease, you must mix other Medicines with the aforesaid, which may help to dissolve. To this end you may prescribe these following Juleps: Take of the Syrup of Water Lilies, Apples, and of the Juice of Purslain, of each one ounce: Syrup of Sea Wormwood half an ounce: Lettuce, Sorrel, and Fennel Water, of each three ounces: the powder of Diamargariton frigid one dram: Make a Julep for three Doses to be taken twice in a day. To these you may adrestoring Opiates, Narcoticks, and the like, all which are to be varied many ways, according to the Judgement and Wisdom of the Physician. Turpentine washed with Wormwood Water, if it be given twice or thrice doth either dissolve or maturate the Imposthume of the Stomach. Let this following Fomentation be applied in the beginning. Take of Sorrel Roots two ounces: Endive, Succory, and Mallows, of each one handful: Lettuce, and white Poppy seeds, of each three drams: white and red , of each half a dram: Violets, and Water Lilies, of each one pugil. Make a Decoction, adding a little Rose Vinegar. Let the Stomach be fomented warm therewith. Or make one with the distilled Waters of Lettuce, and Water Lilies with a little Vinegar, and Powder of Triasantalon. After fomenting, let the part be anointed with Oil of Roses and Violets mixed, or with this following: Take of Oil of Roses one ounce and an half: Oil of Violets, and Rose Vinegar, and of the Juice of Sowthistle, of each half an ounce: Boyl them to the consumption of the Juices; then add of red one dram: red Roses half a dram: Lavender and Camphire, of each half a scruple: as much Wax as will make an Ointment. Cataplasms in the beginning are not good, because they burden the part with their weight, and by retaining the heat, increase the Inflammation. In the declination, when the Tumour is resolved, which is chief to be desired; you may apply a dissolving Fomentation, made thus: Take of Flower deluce Roots two ounces: the Leaves of Mints, Marjoram, Penyroyal, Sea Wormwood, of each one handful: Annis and Foenugreek seeds, of each two drams: Grains of Kermes one dram: the flowers of Stoechas, Rosemary, Chamomel, of each one pugil: Make a Decoction, adding in the end a little white Wine. With this foneent the Stomach. After fomenting, anoint the part with Oil of Wormwood, Nutineg, Spike, and the like; of which you may make an Ointment with a little Wax and Powder, Orris Root, or Cinnamon. But Emplasters and Cataplasms, because they burden the part with their weight, are not here good. But if the Tumour tend to Suppuration, foment the part with the Decoction of the Flowers of Chamomel and red Roses: Then apply this following Cataplasm: Take of Althoea Roots two ounces: Brank Vrsine, and Roses, of each one handful: Boyl them well, and beat them together: then add of Barley meal, Lin-seed, Foenugreek and powder of Chamomel, of each half an ounce: white and red , of each two drams: with Oil of Roses, and Chamomel. With a little Hen's Grease make a Cataplasin, often to be renewed. After the Imposthume is broken, let the Ulcer be cleansed with Hydromel, given in a small quantity: To which you may add the Manna of Frankincense, according to Galens Precept. Or give it with Barley Water with Sugar of Roses in the beginning, in time of heat. When the Ulcer groweth old, of what Cause soever it come, either from sharp corroding Humours, or burning Medicines, or Poison, Broths of cool Herbs, and drying of Barley, Almonds, and Sugar of Roses, or new Milk with Sugar, and a little Honey, are very good. At length, Chalybeate Milk and Iron Water for ordinary drink; or Water wherein a piece of Bolearmenick, or Terra Sigillata hath been steeped, is very excellent. To which you may put a little sharp Wine, if there be but little heat in the part. Then give this Apozeme: Take of Barley one pugil: Scabious, Agrimany, Burnet, and Maidenhair, of each half a a handful: Melone seeds two drams: red Roses dried, one pugil: make a Decoction to one pint, in which dissolve three ounces of Syrup of dried Roses. Make an Apozeme for four doses to be reapted often. Also the Decoction of China, is excellent for internal Ulcers, when there is no Fever, taken twenty days, or more, sweeting gently, for so the Ulcer will be dried by degrees. But if you fear a consumption, boil the China Root aforesaid in Chicken Broth, or Pigeon Broth with the aforesaid Herbs, and Barley made clean. In an old Ulcer, the drinking of Mineral Waters, either of Vitriol, Iron, or Alum, for a Month together, are very good. In the whole time of the Disease to keep the Stomach clean, use gentle Purges, as Rhubarb, Tamarinds, Myrobalans, Syrup of Roses, and Diacatholicon, taken once in a week. Lastly, To heal up the Wound, use these following: Take of Bolearmenick, Terra Sigillata, red Coral, and Bloodstone washed all in Rose Water, of each one dram: Sanguis Draconis, Gum Arabic and Traganth, of each half a dram: white Poppy seeds bruised and parched, Hypocistis, Frankincense, and Sarcocol, of each one scruple: Sugar of Roses one ounce: Make a Powder, of which take a dram in Plantain Water, or Conserve of Roses every day. Or make an Opiate of the same Powder with Conserve of Comphry and Roses, Syrup of Quinces, and Myrtles. Or you may make Troches of the same Powder, with the Mucilage of Fleabane seeds, or Gum Traganth. All which the Patient may use by turns, lest he grow weary of the same. Outwardly, to close the Ulcer, you may apply to the Stomach, a Fomentation of the Decoction of Wormwood, Roses, Pomegranate peels, Galls, Pomegranate Flowers, Myrtles, Frankincense, Mastic, or the like. And lastly, anoint the part with an astringent Ointment, or apply an astringent Emplaster. The End of the Ninth Book. THE TENTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Intestines, or Guts. The PREFACE. THE Perfection of all Nourishment consists in these Three Operations, to Ingest, Digest, and Egest; that is, To take in, Concoct, and send forth: The first respects the Appetite: The second the Concoction, & belongs to the Stomach: But the third respects the Intestines, whose office of Egestion or sending forth being moderate, and according to the rules of Nature brings great benefit to the whole Body: On the contrary, if it be defective as in the binding of the Belly, or abound as in divers Fluxes, there arise divers grievous Diseases: Moreover, the retaining of superfluous things doth cause Chollicks, Iliacks, and Hemorrhoids: And finally putrefactions in the Guts doth not only produce Fluxes, but Worms: That all these may be severally Explained, this Book shall contain Eleven Chapters: The First is of the Colic: The Second of the Iliack Passion: The Third of binding of the Belly: The Fourth of Lienterla or Coeliack Diseases: The Fift of Diarrhoea: The Sixth of Dysentery: The Seventh of Tenesmus: The Eight of the Hepatick Flux: The Ninth of the Worms: The Tenth of the Flux of the Hemorrhoids: The Eleventh of the pain of the Hemorrhoids. Chap. 1. Of the Colic. THe Colic takes its Name from the part affected which is the Gut called Colon: which is long and winding, and ordained for receiving the Excrements of almost all the Body; these Excrements retained too long, use to cause this pain. Therefore the Causes of the Colic are excrementitious Matter, which by distending, pricking or corroding can make a Solution of Continuity, and these are either Winds or Humours. Winds are bred of Crudities, or a cold Distemper of the Stomach or Intestines; and if they be not sent forth by reason of the hard excrements or other things that obstruct the Intestines, they are in great plenty shut up in the Guts, especially the Colon; and make a very violent pain. Also gross Humours, Cold and Phlegmatic, being fastened upon the Tunicles of the Guts cause the same pain both by gnawing, if they are sharp or salt; as also by cooling the part, which by consequence must suffer Constriction and Divulsion, as Galen speaks of himself, That having had a great Fit of the Colic did void glassy Phlegm that was actually cold; and by producing Wind which is easily raised from a gross, slimy, and slow Humour, by a weak heat. Lastly, Choleric and sharp Humours; as also Melanchollick and sour by pricking and twiching the Guts, make these pains: but we may doubt in the action of these Causes how the Colic should be sometimes more violent, sometimes more remiss, since the same matter remaineth in the Intestines? To which Doubt we thus Answer, That the matter doth sometimes lie quiet, and then it causeth none or very little pain; but sometimes it is moved and stirred up by divers Fermentations which happen among the Humours, as in an Epilepsy, the sits of the Mother and Agues. But you must observe diligently that those Winds or Humours do not only remain in the Cavity of the Guts, for than were they easily excluded by evacuating, cleansing, and carminative Medicines, but for the most part they are fixed to the very Coats of the Guts, whence it comes that they are not so easily taken off; but they make a long and a stubborn Disease which will not easily be cured: So thick Phlegmatic and Melanchollick humours to flow by degrees through the veins of the Cuts into their substance, and do not presently cause pain; but till they so increase that they provoke nature to expel them, and so being moved they cause pain; or send out Vapours which being included in the Tunicles of the Intestines, do stretch and extend them, and finding no passage, cause a long pain. And Choler being after the same manner spread and sucked into the veins of the Guts and the Tunicles thereof doth stir up sharp pains which use to be long, because the Choler is very hard to be pulled from the substance of the Guts. There is another kind of Choleric Colic, which turns into a Palsy, not known to the Ancients, which comes of a Choleric Humour, not in the Gut Colon as the former, but suddenly sent into the Membranes of the Abdomen, and it is carried thither from the Cystis, or bladder of Gall, or the Mesentery in the Crisis of continual Fevers, or from great anger, or some other external Cause, when by reason of Obstructions it cannot be sent by the common passages, but by a preposterous motion it is presently sent to the aforesaid Membranes of the Abdomen, hence comes a cruel pain like that of the Colic, which neither by Clysters, Formentations, or other Medicines can be Cured; but continueth many Months, by which means the body consumeth, sometimes it is like an intermitting Fever, sometimes and often like a continual lingering Fever: and at length when the pain gins to cease, there is a Palsy, by reason the Humour gets by degrees into the back by the Membranes of the Abdomen: This Palsy doth trouble the upper parts most; but the Thighs and Legs commonly are pained, in some they are wholly resolved and made numb, because the Choler being light flieth to the upper parts: Sometimes it gets into the Brain, and begets Epileptic Convulsions, from whence death commonly ensueth. There are other Causes of the Colic, but less usual; namely, Stones bred in the Guts, and knots of Worms which stop them: The compression of the Guts from Tumours in the adjoining parts, or narrowness by reason of Inflammation, and other Tumours of the Intestines, or Contorsion, or twisting of them by reason of Wind which is the way to the Iliack Passion; sometimes also the Matter causing the Colic is Poisonous and Malignant, and makes a Pestilent Colic; as Paulus Aegineta reports, That a Pestilent Colic in Italy infected most of the Roman Provinces. Finally all hard Bodies by Obstructing and Distending the Guts may make a Colic, as stones bred there, many Cherry-stones swallowed, hard Cheese, and the like: Platerus reports, That a certain Governor long labouring of the Colic with Convulsions, after the use of Clysters, voided a great quantity of hard Cheese which had a long time stuck in his Guts, because before his Sickness he had eaten immoderately thereof. The External Causes are Cold Air, which constringe and indurate the Belly; or too Hot Air, by which the Excrements grow hard, and lose their moisture; the use of meat and drink not agreeing with the Constitution; as raw Fruits, and binding; gross meats, and hard of digestion; too much rest, and immoderate sleep; unseasonable exercises, immoderate venery; and other External Causes which disturb the Concoction of the Stomach. The Knowledge of this Disease generally is easy: For first the pain is very sharp, for if it be light it cannot be called a true Colic from the Opinion of Galen, lib. 6. de loc. off. cap. 2. And it is sometimes movable, sometimes more in one place than in another: sometimes in the region of the Liver, sometimes of the Spleen, Stomach, Reins; sometimes above, sometimes beneath the Navel, and oftentimes it is most upon the left side; in which, as Bauhinus first observed, there is a little straightness; for when the Excrements in the upper and widest part of the Colon grow into hard lumps according to its Capacity great, and then by Wind are driven into a straighter part, they must needs pass with much pain, in which Symptom the Colic, and the Spleen, and the Stone, are not distinguished but by comparison of other signs; for sometimes the pain is like an Auger boring, or a Stick fastened, more fixed in some part. When the Stomach consenteth, there is vomiting of Phlegm, Choler, that is green or the like. After Meat the pain is greater, because the Stomach being filled compresseth the Intestines. The Belly for the most part is bound, so that the Patient cannot so much as break wind, and if any thing be voided either naturally or by art, it is for the most part windy, and like Cowdung, with water at the top, because it is most Phlegm which useth to be so. Sometimes the Belly is so bound that in the height of Pain, Purging Medicines that are very strong, will not work. The Signs of the Causes are thus to be distinguished: If the Pain come of Phlegm, it is not so great, unless it be mixed with wind which cannot get forth of the places wherein it is contained: for then the pain is very great; sometimes in one part, as if it were bored through with a wimble or stick; sometimes in many, if the wind do remove, the Patient is better for hot, and worse for cold things. He used a Diet formerly which bred phlegm, his water is sometimes more crude and white, not always, which deceiveth young unexperienced Physicians, and sometimes in a phlegmatic and flatulent Colic, the Urine will be yellow and reddish by reason of the extraordinary pain which doth inflame the Sp●ri●s and Humours contained in the Veins and Arteries. Which Avicen wisely observed, Fen. 13. Lib. 3. Tract. 3. Cap. 11. Let no man be deceived (saith he) to think by the foulness, inflammation, and redness of the Urine, that therefore the Disease is hot; for that is common to all Vrines. If the Colic proceed of wind, there will be a stretching pain, and a swelling of the Belly: the Patient perceiveth a rumbling of the Belly, and much wind, and he is better when he breaketh it: he used a Diet to breed it, as unreasonable drinking of cold water, often use of Pease, Rapes, Chestnuts, Salads, Fruits, and the like. And if the wind be contained in the Cavity of the Guts, the pain is movable, not in one place, and is sometimes greater. But if it be in the ●oats and Tunicles of the Guts, the pain is fixed because the wind cannot move, and it is constant because it cannot get forth. If the Colic come from a sharp and Choleric Humour, it is most grievous, pulling, and pricking, there is heat, thirst, and often a Fever, the Urine is very Choleric. It is worse for hot Meats and Medicines, and better for cold. By sending forth of Choler the disease is diminished, and there went before, a Diet breeding Choler. The pains of other parts under the Navel, are easily distinguished from the Colic by their proper signs, except the Stone, whose signs are so like with those of the Colic, that very skilful Physicians have been deceived by them: As Galen himself was, as he confesseth 2. the loc. off. cap. 5. when he was troubled with the Colic, he thought that he had the Nephritis, and that a stone was fastened in one of the Ureters till the Humour was purged away, and the pain ceased; after which he found it to be the Colic. But by these following signs these two Diseases may be plainly distinguished, if they be well observed. First, The Nephritis▪ or pain of the stone, is fixed in the Reins, and comes from thence to the Testicles, according to the length of the Ureter: But the Colic is movable, and girts about the middle of the Belly like a girdle. Secondly, The Colic increaseth after Meat by reason of the compression of the Intestines from the full Belly: but the Nephritis increaseth not, but rather decreaseth, because some of the Nourishment is carried to the Reins, which doth something assuage the pain. Thirdly, In the Colic, the vomiting is more vehement, and the Body is more bound, because the Colon lieth in the bottom of the Stomach, and the Intestines being stretched, or much provoked, do constringe themselves that they may expel what is noxious. But both the Symptoms are common to▪ both Diseases, so that you can hardly know their intention and remission, because a strong Nephritick pain, may cause a greater vomiting and astriction of the Belly, than a weak Colic. Fourthly, In a Colic there is more ease found after Evacuation than in a Nephritis. Fifthly, In a Nephritis or the stone, the Urine ●s●first clear and thin; afterwards there is a sediment, and at length sand and little stones are voided. But in the Colic the Urine is thick from the beginning. As to the Prognostic: The Colic for the most part, if it be gentle and little, and not long, nor in one place constantly, but intermitting and not binding the Belly, is curable, and without danger. But if the pain is very great and fixed in one place, not intermitting, and if the Belly be bound that nothing can get forth, with great watch, and if vomiting follow, hiccoughs, doting, and coldness of extreme parts, with cold sweats, it is deadly. A stubborn Colic coming of sharp and Choleric Matter degenerateth into other grievous Diseases, as Arthritis, Epilepsy, or Paralysis, which is most usual. An Epidemical Colic, which is contagious and pestilent, is commonly deadly. The Cure of this Diseale is divers according to the variety of the Causes. And first, there is the same Cure of a flatulent and pituitous Colic, which gins with an Emollient Clyster, after which followeth one Carminative and discussing, as was prescribed in the Dolour Ventriculi, from the like Cause, which must be repeated twice, thrice, or four times in a day, till the pain be gone; and if he go not to stool in one or two Clysters, as sometimes happeneth, you must give a sharp Suppository. In one of the aforesaid Clysters, you may do well to add four ounces of the Aqua Benedicta Rulandi. Or two or three drams of Coloquintida boiled in an Emollient and Carminative Decoction. If Clysters will not give ease, you must not stay too long upon them, but use some gentle Medicine. It hath been observed that when a sick man had taken three Clysters without benefit, that another Physician came and gave but one ounce and an half of Manna, with two ounces of the Oil of sweet Almonds in the fat Broth of a Hen, and cured the Patient. But in a pain that comes from grofs phlegm you must give stronger Medicines. Afterwards, Fomentations, Ointments, Baths, Emplasters, and the like, are good, which were declared in the Cure of the Dolour Ventriculi of the same Cause, to which you may add some specifical things, which are fit for this Disease. Wash the Guts of a Wolf in white Wine, then dry them in an Oven in an Earthen pot, till they may be poundered. Let the Patient take a dram thereof in white Wine, and he will be presently cured. Boyl fair Water, and ad to it the fourth part of Oil, and some gross Pepper; let him take three or four spoonfuls as hot as he can endure it, and the pain will be instantly gone. Take of the best Aloes one dram: Laudanum four grains: Diagridium six grains: Mix them and make six Pills gilded: Let him take them at a convenient time. They take away the pain aster one hour, and then purge out the noxious humour. Instead of these you may give Diaphoenicon, and Philonium Romanum, as is prescribed in the Cure of the pain of the Stomach. Hipp. Lib. de intern. off. propoundeth a Purge of Purslain, and Juice of Poppies. Six ounces of Oil of sweet or bitter Almonds, do assuage pain, and cast the Matter cleaving to the Intestines downwards. If you mix it with these things following, it will be better: Take of Oil of sweet Almonds, or Salad Oil for poor people, four ounces: Spanish Wine one ounce and an half: Syrup of Poppies one ounce: Mix them for a Potion. Also Oil of sweet Almonds mixed with Manna in fat Broth as beforesaid, doth ease pain, and evacuate the Matter offending. One dram of Annis seeds powdered and given in Wine, doth first assuage, and the second time it is given, quite take away the pain; applying at the same time a Cataplasm of Turpentine three ounces, laid on with Stuphes sprinkled with Pepper and Sanguis Draconis finely powdered, of each one dram. Galbanetum Paracelsi is good to discuss the Humour if the whole Belly be anointed therewith. The description is in Crato thus: Take of Gum Elemi, lvy, Galbanum, Oly of Bays, of each equal parts: distil them in Sand with a Retort; keep the Liquors asunder, first the Water, than the clear Oly, than the thick Oil like Honey, which you must use first. Take of Calamus Aromatious one ounce: Galangal three drams: the outward yellow of the Orange peel four ounces: Cinnamon, Annis, and Fennel seeds, of each three drams: Cummin seeds six drams: Juniper berries green half an ounce: Bay berries three drams. Powder them finely, and infuse them in six pints of the best Spanish Wine in a bot place six days; then distil them in Balneo Mariae. The Dose is one ounce after Evacuations. You may with good snccess apply to the Belly Gum Caragna, and Tacamahacha; but first let a great Cupping-glass be applied to the Navel. Although you apply not the Plasters, yet you must not forget to cup; which as Galen, saith, doth discuss pain that comes of wind like an Enchantment. If the Disease last long, you may cure it with a Decoction of Guajacum continued for many days, Purging sometimes, and giving often Clysters. And if it come of glassy phlegm, let Guajacum be boiled in Wine, as Amatus Lusitanus used it with good success, Curate. 32. Cent. 1. After the pain is allayed, use an Apozem to purge phlegm for the carrying away of the relics, or instead thereof, the Decoction of an old Cock made with incising, attenuating, and purging things. Or that excellent Julep prescribed in the Colic of the Stomach. A Choleric Colic is cured by Emollient Clysters, and such as temper the acrimony of the Humours. Let the Belly be Fomented with an Emollient Decoction, which is Anodine; or which is better, make a Bath of the same. Also Cataplasms made of Barley and Linseed Flower, boiled in Oil of Chamomil, applied to the bottom of the Belly are good. As also a Cooling Epithem to the Liver, made thus: Take of the Juice of Endive and Succory, of each half a pint: the Juice of Lettuce, and Rose-Vinegar, of each two ounces: mix them and make and Epitheme. Give Juleps of Poppy, Lettuce, Endive, and Sorrel Water, with Syrup of Violets, Apples, and Lemons. If the Pain be urgent, come to Narcoticks. When the pain is mitigated, give the infusion and expression of Rhubarb in Succory Water with Syrup of Roses, often, till all the filth be evacuated. If this be too gentle to eradicate the Disease, give Mercurius Dulcis, which being sometimes given with some Purging Diagrediats, doth finish the Cure. They who are not to take Diagredium, may take Mercurius dulcis alone made into a Pill with conserve of Roses, drinking after it the infusion of Senna with Rhubarb, adding a little Manna and syrup of Roses. After this you may give your sharp Vitriolated Waters. When the pain is violent, fly to Baths and Laudanum, to which you may sometimes mix Purgers, but in a great quantity; because their force will be hindered by the Laudanum. Galbanetum Paracelsi, although hot, is fit to discuss the Humour if all the Belly be anointed therewith: it is described formerly. Sometimes Blood-letting is good where there is fear of a Fever by the heat of the blood: and if the Fever be begun, do it presently. When there is a great Thirst, give cold Water. as Galen teacheth, lib. 12. m. cap. 7. And Amatus Lusitanus saith, That he Cured one presently with it: And Septalius shows in Two Stories in the Seventh Book of his Practical Animadversions, That he hath given the same, and taken it with very good success. For the Cure of that Colic which turneth into a Palsy, after the Belly is loosened with many Clysters, and the first ways being made open by a Purge, put the Patient into a warm Bath made of an Emollient Decoction, twice, thrice, four, or five times in a day, that the sharpness of the humours may be allayed, and the pores of the Membranes opened. The day after let the Humour be Purged with a fit Medicine; then let him be bathed again, and if his strength will endure it, let him do it every other day, till the humours are Purged and the pain gone, and the Patiented Cured. In the mean time let the Clysters be continued, especially those made of Milk are best to assuage pain, to which you may put Cassia, Oil of Violets and Lilies. Let the Belly be often anointed with Oil of Chamomil, Dill, sweet Almonds, Lilies, or with fresh butter, Then let him use Whey and sharp Waters. And Lastly, When the Disease is of long continuance, you may use those things which were prescribed for the Cure of Hypochondriak Melancholy. Nor must you omit Phlebotomy from the beginning of the Disease before Purging, and it must be often repeated if the Blood be evil, or the pain come of a Catarrh any ways. Finally, All the Medicines mentioned in Choleric Colic may here be applied, which if it avail not, some Physicians use this following Potion, which though it be forbid and not sit for men well educated, yet they say it Cureth presently. Take of Horse-dung one ounce: break it in pieces, and infuse it in one pint of Poppy-Water with eight or ten drops of spirit of Vitriol: strain it gently, and divide the Liquor into three Doses, for the time of the violent pain. But if it turn into a Palsy, you must anoint the Spina or back Bone and the Paralytic parts with a Resolving and a Nerve Corroborating Balsam if there be no Fever; but if there be, bind Wool dipped in Oil, or some digesting Ointment, to the Paralytic parts, taking heed of Cold, by which the humour will be fastened to the parts, and the breathing forth of it hindered. Galbanetum Paracelsi is best, if it be applied to the parts aforesaid, and the Navel. Chap. 2. Of the Iliack Passion. ILEOS', or Iliack Passion, took its name (as some say) from the Gut Ileum, which chief is Affected in this Disease; although the other thin and sometimes thick Guts are capable of the same: Or, rather from Eilesthai, which signifieth to be rolled and girt about; therefore the Latins call it Volvulus, or Convolvulus, because the Guts in this Disease seem manifestly to be rolled about, and to be moved upwards: it is also called Rordapsos, because the Guts, if you lay your hand on them, seem to be like a stretched or twisted cord. The Barbarians call it Miserere mei, because it is a miserable Disease and commonly deadly, and therefore needs divine Commiseration. This Iliack Passion is a preposterous motion of the Intestines, in which the Belly is always bound; and the Excrements which should be carried downwards, are brought to the Stomach, and cast out by vomiting. It is known that the Intestines have a natural motion by which the Chylus and Faeces are by degrees carried downwards, which is called Peristalticus; this motion is by the Orbicular and Transverse Fibres which contract the Intestines, and is compared to the motion of Earthworms which move the parts of their bodies successively. And this motion is sometimes inverted by preternatural Causes, as when the Fibres of the Intestines which ought to be contracted from above downwards, are contracted upwards; and whatsoever is in the Guts is not sent towards the Belly but towards the Stomach, and then is this Iliack Passion: We observe something like this in Vomiting; for when the Fibres of the Oesophagus contract themselves from the upper part towards the Stomach, the meat is swallowed down; but when by an inverted order they contract themselves from the part beneath up wards, there is vomiting. This inverted motion comes from the vehement stirring up of the Expulsive Faculty of the Guts, which when it cannot throw downwards the superfluous Excrementitious matter, doth by a violent motion cast it upwards. This motion is sometimes so violent, that not only Chyle, and Wind, and Excrementitious Humours, but the Faeces also, and Excrements which should be sent out by the Anus are thrown forth by vomiting; So that Clysters and Suppositories also are snatched up and vomited out: So Matthew de Gradi reports of a Girl of twelve years old, who in this Disease for three days together, did not only vomit up Dung and Clysters, but also along Suppository a short time after it was administered unto her; and when another Suppository was tied to her Thigh, that was presently broken off and vomited up with a piece of the Thread at it: And when Thirdly, a Suppository was tied with four strong Threads as before, that also was broken off and Vomited up with part of the Threads: And at length when the Mother, as desired by the Physician, to administer another, it was drawn upward with so much violence, that she was constrained suddenly to draw it out lest it should be again Vomited up. There are the like stories in Authors, which for brevity sake we omit. This stirring up of the Expulsive Faculty of the Guts comes from divers Causes: The chief is Obstruction; therefore whatsoever doth so violently obstruct the Guts that nothing can descend, doth beget this Disease: for after the Faculty hath long laboured to throw out superfluities the ordinary way, and is frustrate of her intention; desiring to satisfy the necessity of exclusion, she takes another Course, and by a preposterous motion drives them upwards, and vomiteth them out. The Causes obstructing are hard Dung long retained, gross vapours gathered in abundance into the Guts and violently distending them; Inflammation, and other great Tumours, which wholly shut up the internal Cavities of the Gut, and the circumvolution of it, so that it is as it were tied in a knot, which often happeneth in a Hernia or rapture, and also in the Colic, after which often follows this Ileos', because the Intestines being stretched with wind, do roll together, and sometimes knit a knot. The more unusual causes which do so provoke the expulsive faculty that are constrained to alter their motion, are great Ulcers, or sharp Humours which twitch the Guts; for when the faeces or other Humours going downwards, do touch the ulcerated part, they so prick it that the faculty is provoked not to suffer so noxious a thing to pass, but driveth it upwards with violence; which motion the other Intestines stirred up by sympathy, do follow till the noxious Matter goes to the Stomach, which following the same Motion, by the help of the aforesaid faculty, drives it forth by vomit. The Signs of the Iliack Passion are partly Common to those of the Colic, and partly proper. The Common Signs are, pain in the Abdomen, swelling and puffing up of the Belly, a bound Belly, loathing of Meat, Nausea, Vomiting, want of Rest, difficulty of Breathing, and Pissing. Those which are Proper and peculiar to this Disease, are a sharp pain and most violent, puffing up and very violent distension, an eminent hard tumour in the Hypogastrium, a total suppression of siege, so that nothing is voided that way. In progress of the Disease, there is irregular vomiting, first of Choler, then of Phlegm, and Chylous Matter, and at length of dung, or rather of a Matter like it, of corrupt and stinking Meat, for the faeces are seldom sent upwards, when they are near death, there is abundance of cold sweat, refrigeration of the extreme parts, trembling of the Heart, disturbance and fainting. Galen in Comment. Aph. 10. Sect. 7. affirms that the proper and inseparable sign of this Disease is not to go to stool at all. But Hypocrates seems to affirm the contrary, 3. Epid. Sect. 2. Text. 7. in an History of a Woman thus affected, which dwelled at Tisamen, saying there were thin, few, and crude dejections. To which difficulty we answer, That in the beginning of the disease, some stools may be from the faeces contained beneath the Gut affected, which by Nature or Art may be excluded before all the Intestines consent and lose their proper and Natural faculty. But when the Disease is confirmed, and the motion of all the Guts is peristal like and inverted wholly, there is nothing more sent downward. The signs of the Causes are these: If Ileos' come from Inflammation (which often happeneth) the Disease is most acute, and comes quickly to the height, there is an intense fever, a most vehement pain, Choleric Vomitings and phlegmatic do soon appear, and faeces and dung do presently, and other deadly signs before mentioned. If it come from the faeces endurable there went before it a constriction of the Belly for many days, and in the beginning there is no pain, but afterwards there is, the Disease is of longer continuance, nor is it so acute as that which comes from Inflammation, neither is the pain so great, nor the Fever so strong, and sometimes there is none. If it come from wind or phlegm, it followeth for the most part the Colic, and signs of the Colic, of phlegm and wind went before, which are laid down in the Chapter afore going. As for the Prognostic. Every Ileos' is dangerous, but one more than another. That is most deadly, in which first there is choleric, then phlegmatic, and after stinking vomiting; and Galen, 6. de loc. off. cap. 2. saith none of these escape; but Experience teacheth that some do, as when the disease comes from retention of the faeces, or Hernia Intestinalis, or Rupture in the Guts. They who have this Disease with the Strangury, die within seven days, except a Fever coming, the Urine be more plentifully voided. Hipp. Aph. 44. Sect. 6. if the Strangury come of thick and and phlegmatic Humours which are plentiful in the Veins and Guts, a Fever coming thereupon, they may be concocted, melted, and attenuated, and pissed forth, by which means the Ileos' is cured. Although Galen in his Comment upon this Aphorism, saith that he is ignorant of what Hypocrates saith here, and that it cannot be confirmed by Reason and Experience. If Symptoms be remitted, and either Medicines or meat taken at the Mouth, pass through, there is hope of recovery. The Cure of this Disease, is to be varied according to the difference of the Causes. And first, if the obstruction comes from the Faeces indurate, or from gross and slimy phlegm, you must use Emollient and Laxative Medicines, both internally and externally. First then, give Clysters of the Decoction of Althaea, Mallows, Violets, Chamomel, and Melilot, with Lin-seed and Foenugreek seed, or of common Oil to a pint, in which you may dissolve the third part of Butter, or of the Broth of a Sheep's Paunch, in which dissolve Butter, Honey, and Sal gem. To which Decoction, if there be wind (as commonly there is) it is good to put Carminatives and Discussers. After the Matter is somewhat mollified with these Clysters, you must give first some gentle Purges, than stronger, and last the strongest. In the mean while you must apply Fomentations and Liniments that are Emollient, to the whole Belly, and continue them long. The Paunch of a Gelding warmed in hot Water, applied to the Belly, is good; but mollifying Baths are better, especially if they be made of Air only. Also you may give inwardly the Oil of sweet Almonds either alone with white Wine. To which if the pain be great, you may add the Syrup of Poppies, as was showed in the Cure of the Colic. And lastly, If there be vehement pain, and much flatus, you may give those other Medicines which are prescribed in the Cure of the Colic, not omitting Purges, which being opportunely given, take away the Cause. That which comes from Inflaruation of the Intestines, is to be cured by often Blood-letting, if strength permit, both in the Arm and Foot, and by applying of Cupping-glasses with Scarification to the Groins. Also Emollient Clysters and cooling, are to be given, made thus: Take of Althaea Roots two ounces: Mallows and Violets, of each one handful: Guord seeds half an ounce: Line and Fleabane seeds, of each two drams: Water Lilies and Roses, of each one pugil: Chamomel Flowers half a pugil: make a Decoction, in a pint whereof dissolve two ounces of Oil of Roses; Cassia one ounce: make a Clyster, and in progress of time ad Oil of Violets and Chamomel. The aforesaid Emollients must be boiled in Oxycrate. Or give new Milk with a little Sugar, and the white of an Egg, or the Mucilage of Fleabane seeds one ounce, to assuage pain. Or you may make a Clyster of Oil of sweet Almonds, Barley Cream, strained from the Decoction of it, adding a little fresh Butter and Sugar. A Clyster may be made of simple Oxycrate, and be every day given, which is excellent against the Inflammation of the Guts. Anoint with Oil of Violets, sweet Almonds, and Chamomel, with Mucilage of Linseed, Faenugreek seed, and Quinces, with Axungia of Hens and Ducks, and sweet Butter. Also make a Fomentation of the Decoction of those Simples which were prescribed for a Clyster. Also Foment in the beginning with Oxycrate, and after let the Simples aforesaid, be boiled in Oxycrate. And make a Catataplasm of the residence of those things in the Decoction with Barley Meal, Foenugreek, Lin-seed, and Butter, with Axungia's and Oils aforesaid. Also a Bath of warm Water, in which cold and Emollient things have been boiled, is most convenient. After bleeding, give two ounces of Oil of sweet Almonds to appease pain, and if it be very great use Narcoticks. If there be no vomiting, you must provoke it with a draught of warm Water with Oil of Violets, for so the upper parts will be purged, and the Humours will be reveled from the part affected. In the whole time of Cure, you must give Juleps and Emulsions prescribed in the Inflammation of the Stomach. Let his Drink be Barley Water: and in the beginning let him abstain from all Nourishment for twenty four hours, that some of the Matter may be consumed; then give him Chicken Broth. This Disease is to be attended with diligence, for it is for the most part deadly. The chief business in the Cure, is by abstinency; and this is taken from the example of those that are wounded in the Guts, for they are almost famished for forty days. Therefore let men in this disease for four or five days, take only three spoonfuls of Broth every day, that vomit may be hindered which doth increase the Disease. Moreover, Food bringeth no comfort to the sick, for it turneth not to nourishment, but is plainly corrupted, and the▪ Chyle which goes from the Stomach into the Guts, is mingled with the excrements retained, and increaseth vomiting. He may drink more freely, because it goes more easily to the Liver, and it may be fit to oppose the Disease, if it be well tempered Oxycrate, and in a small quantity. Lastly, It comes sometimes but seldom, from the circumvolution of the Intestines; and this is either from Wind, which tottureth them; or from a Hernia called Interocele, or Rupture. That which comes from Wind, is cured by the same Medicines which Cure the flatulent Colic. But if after long use of these Medicines, the belly will not be opened, but all things taken are vomited up, that there is little hope of health, the last Remedy must be used, which Hypocrates propounds 3. the morbis, namely, That a pair of Smith's Bellows be applied to the Anus, and that they blow into his Belly. Then give an Emollient Clyster with Troches of Alhandal to bring out the faeces. This is good not only against the Ileos' from contorsion of the Intestines, but in that which comes from a grievous obstruction, for by dilating the Guts it takes away the obstruction. Amatus Lusitanus, Curate. ult. Cent. 1. testifieth that he cured one desperate by this means: as also Epiphanius Ferdinandus in his Physical Histories, Hist. 74. reports that the son of John Altimar of Naples, a most expert Physician, was ready to die of this Disease, and taken as it were from the Graves mouth by this means. But Aurelian disalloweth it, because the wind coming from the Bellows may much hurt with its cold. But this may be avoided if the Bellows be filled with wind by the fire. Paraeus also propounds another unusual Medicine, by which he boasteth that he cured many at death's door, namely, by drinking three pound of Quicksilver in Water alone, for with its weight it doth untie the Gut, and open, and sends down the hard excrements, which Remedy is commended by others, who say that it may be taken without harm. But we may well fear so great a quantity, lest it extinguish the Native heat with its coldness, and coagulate the Blood in the Veins; therefore in a desperate case it is better to give a less quantity. Some give two ounces in a rear Egg, and think good to repeat it if the first Dose do not succeed well, but you may see in our Observations, that one ounce hath done well. But when the iliack Passion comes from the Guts falling into the Cod, all the care is to place them right, which must be done by the gentle hand of a Chirurgeon, long fomenting the part affected, first with an Emollient Decoction, and Relaxing Oils, giving often Emollient and Carminative Glisters, so placing the Patient that his Head be low, and his Thighs high, for some having been hung by the Heels, were quickly cured. If the Hernia comes with Inflammation of the Intestine, it is cured with a fomentation of cold water. If wind stretch the Gut, discuss with a Fomentation of Spirit of Wine. See the examples of both Cures in our Observations. Chap. 3. Of Astriction, or binding of the Belly. BY Astriction of the Belly, we do not understand all kind of supression, by which nothing is ●et forth downwards, as in the Ileos'. But only a dull and slow dejection, by which the faeces and relics of Meat are seldom and not according to the quantity of Food thrown forth; therefore they are necessarily indurated, because of their long continuance being dried with heat, and some moisture is always drawn from them by the Meseraick, which reach not only to the thin, but thick Guts. It is a Symptom of the Expulsive faculty diminished, or the retentive increased, and it is the cause of many diseases; therefore the Excreta and Retenta are reckoned among the six things not Natural, which not keeping the Law of Nature, produce divers Diseases, so it being bound, sends vapours to the Head, and produceth Catarrhs, and other Diseases of the Brain, disturbs the Concoction of the Stomach, and the actions of other parts. The Causes of this Symptom are many: And first, hardness of the faeces, and dryness, are not only Effects, but also Causes of them, because being hard, they are more difficult to be voided, and do less provoke the expulsive Faculty. They become dryer and harder chief, and oftenest from the excessive heat of the Liver, which powerfully draws away all the moisture contained in the Intestines, and leaves the faeces dry. This is also caused by violent motion, especially riding: also by few Excrements through want of food, or because they have no actimony to prick the Intestines, as it happens in cold Meats; and when the Choler doth not go to the Guts, as we observe in the Jaundice. And lastly, Many diseases of the Guts may cause this constriction, as a cold and dry Distemper, Tumours, Obstructions, Numbness of the Anus, and Palsy, and many others. The Signs depend upon the knowledge of the Causes, which must be taken from their proper Fountains. The hot distemper of the Liver is to be taken out of its proper Chapter. Also Tumours, and other Diseases of the Guts, have their proper Diagnosis, or signs, and so the external Causes, as little Meat, or coldness thereof, riding, and the like, are known by relation of the Patient. As for the Prognostic: The Constriction of the Belly is more or less dangerous, according as the Cause is greater o●less. For if it come of Inflammation, or other Tumour of the Intestines, it is very dangerous: but from other Causes less. It useth to be contumacious and long when it comes from the faeces indurate; and thence come often Chollicks, which return after they have been cured, by reason of the new dryness of the faeces; as also because though the Belly seems to have been made sufficiently soluble by purging, and many liquid Excrements are discharged, yet there remains sometimes many hard Excrements in the Guts, which breed new pains, and cannot be taken out, but by many Clysters given after Purging. The Cure of this Disease depends upon taking away the Causes, which are to be taken from their proper Chapters. But because it is commonly long, especially when it depends upon a hot distemper of the Liver, and dryness of the Guts; and in the mean time the Belly bound brings many inconveniences. We will speak of its Cure by its self, which is generally done by Emollients, and Laxatives made thus: Take of Althaea, or Marsh-mallow, and Lily Roots, of each two ounces: Mallows, Marsh-mallows, Mercury, Violets, and Brank Vrsine, of each one handful: Lin-seed and Foenugreek of each half an ounce: Annis seed one dram and an half: sweet Prunes three pair: Chamomel and Meltlot flowers, of each one pugil: boil them to a pint and an half. Dissolve in the straining Oil of Lilies and Lin-seed, of each two ounces: fresh Butter one ounce and an half: Diacatholicon, and Diaprunis simple, of each six drams. Make a Clyster to be given as often as need requireth. Sometimes instead of this use the following: Take of the Decoction of Sheep's entrails one pint: fresh Butter two ounces: Cassia, Diacatholicon and Diaprunis simple, of each half an ounce: red Sugar one ounce: Make a Clyster. Also twice in a month, or thrice, you may give one pint of common Oil alone for a Clyster. And because Nature will grow dull by too much use of Clysters, and at length will never officiate that way; but when she is provoked by one, you must endeavour to mollify the Belly with other means. For this end, sweet Prunes and roasted Apples with Sugar, may be taken one hour before dinner, as Galen showeth 2. defacult. alim. cap. 31. For if they be taken immediately before dinner, they will not work. Or take Chicken Broth, or other Broth, in which have been bouled, beets, borage, and some Apples, or one spoonful of Oil of sweet Almonds newly drawn without fire, with as much Syrup of Maidenhair, or two spoonfuls of this Syrup following: Take of the Mucilage of Fleabane seeds, and of Quinces drawn with Mallows Water, one pound and an half: white Sugar one pound. Make a Syrup according to art. That the Prunes may work better, let him drink half a glass of Vinum Lymphatum, or Wine and Water, before and after he taketh them, fresh Butter taken an hour before Dinner the bigness of a great ●ut, and drink Wine and Water will do the same thing. Once in a week let him use one of these following Medicines: Take of Cassia new drawn one ounce: Cream of Tartar one dram: Make a Bolus. Take of 〈◊〉 one ounce, or an ounce and an half: Mix it with Broth, and take it in the morning. Or, Take of Oil of sweet Almonds, and Manna, of each one ounce: Dissolve them in Broth to be taken two hours before dinner. Take of pulp of Cassia two ounces: Tamarinds and Manna, of each one ounce: the powder of Senna half an ounce: Cremor Tartari two drams: With Syrup of Roses solutive make an Opiate. Let him take half an ounce or an ounce. Or dissolve in the Decoction of Prunes half an ounce, or an ounce of Manna: let him take it one hour before dinner as all the aforesaid, for so they will work better. Ptisans of Succory, Agrimony, and Sorrel, cast into Water that gins to warm, and infused one night, either drunk alone, or with Wine, for ordinary Drink doth keep the Body lose. This following Broth doth most certainly loosen the Belly, and keeps it so. Take of Beets and Mercury, of each one handful: Boyl them in Broth, and take it one hour before dinner. Or, Take of Conserve of Damask Roses with Manna and Sugar, of each equal parts, one ounce for adose. Lastly, A Bath, or Tub with a Decoction of Emollient Herbs is very profitable to moisten all the parts Natural and mollify the Belly. Chap. 4. Of Lientery, and Coeliack Passion. LIentery is a kind of Flux of the Belly, in which the Meat is quickly sent through the Belly, as it was taken unchanged. But in the Coeliack Passion the Meat comes forth crude, and imperfectly concocted, whence it appears that these two Diseases differ only in degrees, so that Lientery is referred to the act abolished, and Coeliack Passion to the act diminished. For although the Meat is sent forth, either altogether unconcocted, or imperfectly concocted, yet these Diseases are not to be referred to concoction hurt, but rather to the retention; for they are either il concocted, or not at all, because they are quickly sent forth, and are not long enough retained to be concocted. Hence it is collected, that though this Disease bereckoned among the Diseases of the Guts, yet the Stomach is much affected, and sometimes more than the Intestines: Hence Galen 6. de loc. off. cap. 2. saith that a Lientery and Coeliack Passion come both by fault of the Stomach and Guts. Many Causes of these Diseases are propounded by Authors; all which we may refer to three Heads; the cold distemper of the Stomach and Liver, the provocation of those same parts; and a great debility of the retentive faculty from some deadly disease. The cold distemper generateth great plenty of phlegmatic and glutionous humours, which covers and 〈◊〉 over the wrinkles of the Stomach, so that it cannot retain the food. Hence we may admire why Galen 6. Aph. 1. doth speak against the old Greeks, who called this Disease Lienteriam, or smoothness of the Intestines therefore, because the internal superficies, or the Stomach being made smother, doth not retain the Meat; whereas the Stomach doth not retain the Meat till a perfect concoction be made so much by the roughness of the inward coat, as by an innate propriety of astringing. For as we must confess that the principal cause of retent on is the faculty; so also must we acknowledge that the faculty doth want instruments fitly disposed, without which it cannot act: and therefore since the in ward Tunicle of the Stomach is made rough and wrinkled, that the Meat may be retained in the Stomach, it is no doubt but if that roughness be taken away while the wrinkles are filled up with phlegm, the retention of the Stomach will be hurt, so that the Food will slip away unconcocted. The like is in the Womb whole inward Tunicle is rough and wrinkled, that it may the better retain the Seed for Conception; but if it be covered with glutinous Humours, it doth not retain, and the Seed presently comes forth, whence many Women are barren. But let us note, That if any will strictly exmine this word, he shall find that this Symptom is rather to be called the Smoothness of the Stomach than of the Intestines: neither doth it comprehend all its sorts, but only that which comes from Phlegm, which because it is most usual, the rest have their denomination from it. The provocation of the Stomach and Guts is by sharp Humours which by twitching those parts 〈◊〉 them to send them forth too soon, as it is in the Bladder, which being pricked by Acrimony, doth often piss: Hence comes the Strangury, Galen 6. Aph. 1. saith, That by those sharp humours there is an Ulcerous Disposition in the Stomach, as the Aphthaes, or Thrush is in the mouth of Children. The great imbecility of the Retentive Faculty in great and deadly Diseases often causeth a Lientery, as you may see in a Dysentery, which when nature is conquered degenerateth into a Lientery; the Stomach being drawn to consent with the Guts which are so grievously affected, and its Faculties being overthrown; so also in Malignant Fevers there happeneth often a Lientery whereby the broth as soon almost as taken is cast forth unconcocted; and the same is when Poisonous and Hurtful things are taken. There is also another Cause different from the former, which peculiarly makes a Coeliake Passion, namely, The Obstruction of the Mesaraike Veins which hinder the passaage of the Chylus to the Liver; whence it must needs be cast forth by the Belly, but that this may be, it is necessary that all the Mesaraick Veins, or the greatest part of them be stopped, as in Children who have the Struma, or Kings Evil, whose Mesentery is found full of Glandles, by which the Mesaraike Veins are stopped: and these continually have a Chylous and Coeliake Flux: They eat much and grow leaner till they fall into a Marasmus. Aetius and Celsus, and many of their followers, do propound another Cause of the Lientery, namely, A Smooth and Thick Scar in the Guts remaining after a long Dysentery, by which the mouths of the Veins being stopped, the distribution of Nourishment is hindered, and thence comes a Lientery, which Cause we cannot entertain for then all the Guts should have been Ulcerated, and the Scar in them all should stop all the meseraiks which is not agreeable co reason: because it is impossible that all the Guts should be ulcerated, and the man not die. The chief Signs of these Symptoms do appear by what is said, for if crude meat and unchanged descend quickly and often through the Guts signifieth a Lientery; but if it be somewhat changed and seem like Chylus; it shows a Coeliack Passion. The Signs of the Causes are thus gathered, If Lientery or Coeliake Passion come of a cold distemper and Phlegmatic humours, there will be sour belchings, the excrements of the belly are Phlegmatic, there will be thirst and want of pain: if the Phlegm come from the Head, as it often doth, the excrements are frothy, and the Flux is greater after sleep; And there are other Causes which altar the Head, and other Signs of a Catarrh. If it come from Irritation, or provocation, there is sometimes a gnawing in the Stomach, a heat in the Hypochondria, there is great thirst, sharp excrements and choleric. As for the Prognostic, Thus, Lientery and Coeliack Passion lasting long is dangerous, because it catcheth a way the nourishment from the whole body, from whence comes an Atrophy, or a Dropsy: and if it follow great and acute Diseases, it useth to be deadly. The Cure of this Disease is to be altered according to the variety of the Causes that produce it. And First, That which cometh from Phlegm may be Cured by those Remedies which were propounded for the Cure of Want of Appetite coming of a cold Cause; Choosing those things which are most Astringent to stay the Fux of the Belly. Therefore you must begin with Purging of the peccant humour with Medicines made of Aloes, Rhubarb, and Myrobalans. Clysters are here of little force, while the Stomach is chief distempered; except an immoderate Flux do require them: and then they must be Astringent and strengthening according to the Forms which shall be propounded in the following Cures. After Purging sufficiently you must strengthen the Stomach with Opiates, Powders, Fomentations, Plasters, and other Remedies mentioned in the place above quoted, in which (as I said) you must not omit Astringents, as Mastic, Citron peels, Coriander seeds, Snake-weed Roots, Tormentil, Coral, etc. And besides others, the Opiate following which is greatly Commended by Amatus Lusitanus is Convenient, by which he saith he Cured an Old man, after many other Medicines failed. Take of Conserve of old Roses six ounces: of the best Treacle six drams: Syrup of Quinces as much as will make an Opiate, of which let him take half an ounce in the morning, not drinking presently after. That which comes of Choler is to be cured by those Remedies which were laid down against Choleric Vomiting; as also by those which shall be described in the Cure of a Choleric Diarrhoea. That which comes from the imbecility of the Retentive Faculty in a deadly, or at least dangerous Disease, is to be cured first with Fomentations applied to the Region of the Stomach, thus made: Take of the Roots of Snakeweed, Tormentil, and dried Citron peels, of each two ounces: the Leaves of Mints, Plantain, and Sea Wormwood, of each one handful: Nutmeg, Cloves, and Cinnamon, of each three drams: red Roses four pugils, beat them and cut them according to art, and fill two bags pinked therewith, and steep them in equal parts of Iron Water, and red astringent Wine; or in Wine alone, if there be no great Fever, and let them be applied to the Stomach warm one after another. After wards use this Ointment, or some Emplaster made of those which are prescribed for Choleric Vomiting. Also anoint the whole Belly with Oils, or astringent Liniments. Give Clysters of Broth in which red Roses have been boiled, dissolving therein Sugar and Yolks of Eggs, and sometimes Confectio de Hyacintho, if the Patient be very weak. And finally, You may give at the Mouth, strengthening and astringent things, as in the Cure of Vomiting before mentioned; as also thus, which shall be showed for the flux of the Belly. In a Coeliack Passion the Food is sent forth crude and imperfectly concocted. It only differs from Lientery in degree, and is cured with the same Remedios. But if the stools be altogether Chylous, this Disease doth not depend upon the fault of the Stomach, but upon the obstruction of the Meseraick Veins, which is usual, especially in Children. And therefore it is to be cured by Remedies which open obstructions and strengthen the Liver, because that is commonly also weak; but you must use no astringents, lest another kind of flux should sollow. These Medicines are at large set down in the Cure of the Diseases of the Liver. Chap. 5. Of Diarrhoea. Dlarrhoea is that kind of flux of the Belly, by which the excrementitious Humours are sent forth without Blood or Food, and without the Ulceration of the Intestines. By the Conditions of Diarrhoea properly so called, is distinguished from other kinds of fluxes, because in Lientery and Coeliack Passion, the Food is cast forth unconcocted, or half concocted; in a Dysentery and Tenesmus, Blood is mixed with the Excrements, as in the flux of the Liver, called Hepaticus, and in the Haemorrhoidal. Many are the Differences thereof; which that they may be clearly explained, are to be referred to three Heads: The first whereof respects the Matter which is voided; the second the place from whence it comes; the third, the Manner, and efficient Cause which produceth the flux of the Belly. In respect of the Matter voided, this flux is divided into a Choleric, Phlegmatic, Melanchollick, and serous, or watery. In respect of the place from whence it comes; either it comes from the whole Body, or some peculiar Part, as the Brain, Stomach, Guts, Liver, Spleen, Mesentery, Womb, and other Parts. Thirdly, In respect of the Manner and Efficient Cause; one Diarrhoea is Critical, another Symptomatical; one comes from an internal Cause, as a distemper, or evil disposition of the internal parts; another from an external, as from some Medicine or Poison. These Differences are seldom found single, but they are often complicated in one and the same flux. So a Choleric flux is from the Liver or the whole Body, a Phlegmatic from the Brain or Stomach, a Melanchollick from the Spleen, and a Serous from the whole Body. Also these Differences are complicated from a divers mixture of Humours, so that sometimes Choler, Phlegm, and Water, are sent forth by the same flux. There is another kind of Diarrhoea different from the rest, which is called Syntectice, or Colliquativa, coming from the melting away of the substance of the Body, and Humours by the violent hot distemper of the solid parts: such as happeneth sometimes in the Inflammation of the Bowels, in a strong burning Fever, hectic, or pestilential; in which a fat Matter as it were mixed with Oil or Grease is voided. Lastly, Fluxus stercorosus, or a dungy flux, is another kind, in which much liquid excrement is often voided, which comes from excrementitious Meats corrupted in the Stomach, or a great plenty of Excrements heaped up in the Intestines. The Knowledge in general is manifest, namely, when more liquid Excrements are voided, and oftener than usually Nature doth allow. The Signs of these Differences which are taken from the matter are manifest to the Senses, namely, Whether they be Phlegmatic, Melanchollick, Choleric, or Serous. The Parts Sending have a more difficult Diagnosis or way of Knowledge, yet they are thus Distinguished: If the Humours flow from the whole body, there either is, or hath lately been, a continual Fever, or some other disease of the whole body, as Cachexia, evil Habit, or Leucophlegmatia, or white Dropsy; or there hath been over-eating or drinking, and there is no sign of any Disease of any peculiar part. If it be Critical, it is a benefit to the Patient, and is easily endured; and thence the Disease is either Cured, or Diminished. Sometimes there happeneth a Critical Diarrhoea without a Disease in some bodies which use to lay up evil Humours; and being strong, do throw them forth at times when they abound and burden nature as Galen taught, 7. m. Cap. 11. of which Flux Celsus maketh mention, lib. 4. cap. 19 in these words, It is healthful for to go often to the Stool in one day, and in many days together if there be a Fever, and if it cease before the seventh day; for the Body is purged, and that which inwardly would have hurt, is now sent forth. Among Critical Fluxes, the Serous is one; which comes without a Disease aforegoing; in them who have much Water in their Veins, and that chief in the Harvest time, or Autumn: namely, when the night and morning cold of Autumn, finding the passages external and pores of the skin open, by reason of the heat of Summer aforegoing doth therefore insinuate itself deeper into the body, pressing forth internally the Serous Humours contained in the Veins, which Nature afterwards being over-burdened with, sends by the Meseraick Veins into the Intestines, and many times into the Ureters. Hence it is that many in the beginning of Autumn, and in the first cold weather, do make abundance of Urine for many days together. But if a Diarrhoea be Symptomatical, it troubles the patiented much, and weakeneth him; and the Disease upon which it comes, is increased; or at least is in the same state. This Symptomatical Flux in burning Fevers and Malignant, is often melting; and hence it is known, because the Excrements appear unctuous, and the body forthwith becomes lean, and consumed, and almost in a Marasmus. If the Diarrhoea comes from the Brain, the Stools are frothy, as Hypocrates taught, Aphor. 30. Sect. 7. which is not always so; For Phlegm may flow from the brain without Wind, which is the only cause of froth: as also Wind may be mixed with Humours that are bred or contained in the stomach or intestines, from whence the Excrements may be frothy, though they come not from the Head. Therefore we must join other Signs to this, namely, If the Brain have any manifest Disease, as a Catarrh, Deafness, Lethargy, Apoplexy, or great Heaviness, Pain, or Sleepiness; and if the Flux be more at night than day. If it come from the fault of the Stomach, there will be the Signs of the Concoction of the Stomach Hurt: As if the Food be corrupted, and have a sharp and stinking quality, by which the Expulsive Faculty is stirred up to expel them. Also there will then be the Signs of a Hot Distemper of the Stomach: So, if the Stools be Crude and Phlegmatic, and if Concoction be slow and diminished, we argue that the Concoction of the Stomach is hurt by a cold Distemper: and lastly we know that the fault is in the Stomach, if the Patient did before fill himself with evil Food which would easily corrupt. The Flux of the Belly comes from the Guts, when they are full of Worms, and then there will be signs of Worms which you may take from their proper Chapters. If from the Liver, The Stools will be Choleric, because Choler is bred there; and there will be Signs of a Hot Distemper, Inflammation, Obstruction, and other Diseases of the Liver. If from the Spleen, The Stools will be commonly black or blackish, a distension in the left Hypochondrion, a heaviness also or pain there, and other signs of the Spleen Distempered will appear. If from the Mesentery, There will be extension, stretching, or pain in that part: But Humours gathered in the Mesentery, come commonly from the Liver and Spleen. If from the Womb, There will be stoppage of the Courses, or the Symptoms of the Womb affected, which use to be more violent, and the Flux also at that time when the Terms ought to flow. The Prognostic of a Diarrhoea is made thus, A Flux of the Belly which is easily endured, and in which the Patient finds refreshment, is good: On the contrary, that which is painful and weakeneth, is evil: The first is to be accounted Critical, the last Symptomatical. When the Liquid Excrements grow thicker, it is good: For it signifieth, That the Faculty Worketh well by Concocting of evil Humours: which is done by making them thick. Thin Excrements with pain often voided are evil, for they signify great sharpness of Humours which do violently pull, stimulate, prick, and gnaw the Guts. Liquid Stools without Feeling when they are voided, are evil: For they either signify Disturbance of Mind, or Doting, or Dissolution of the Natural Heat, which is followed by the loss of Sense. Liquid Stools beginning with an acute Disease, and continuing with the same, is evil: for it signifies great plenty of Matter, or an evil quality therein, which forceth Nature to so sudden a flux. If a strong Diarrhoea comes upon him who hath the Leucophlegmatia, it causeth recovery, Hipp. Aph. 29. Sect. 7. For there is an Evacuation of the Matter, which was in the whole Body. But this wants a limitation. The Aphorism is true, if this flux happen in the beginning of a Disease while the strength is good; otherwise it doth not take away the disease, but the Patient. If a Woman with Child have a flux of the Belly, she is in danger to miscarry; Hipp. Aph. 34. Sect. 5. For the food which should nourish the Infant, is for the most part carried away, and the strength is abated; as also the Ligaments of the Womb are relaxed by a continual flux of Humours thither; as also the Child and the Womb are infected by the vapour of those excrements which are continually voided. Yellow Stools like Yolks of Eggs; green, like Verdegreece; livid, black, of divers colours, or very stinking, are evil: For the reason which we gave in the Chapter of Vomiting. As to the Cure: Since a Symptomatical Diarrhoea comes commonly from corrupt Humours, Choleric, Phlegmatic, Melanchollick, or Serous, and especially from Choleric, which provoke the expulsive faculty of the Intestines by their sharpness. You must begin the Cure by Evacuation of the Humour offending, which must be done by a Medicine which doth astringe by purging, lest that flux should be increased by motion of the Humours; and you may make it thus: Take of the best Rhubarb one dram: Citrine Myrobalans half a dram: Yellow half a scruple: Infuse them in Plantain Water, dissolve in the Liquor strained half a dram: the powder of Rhubarb, and one ounce of Syrup of Roses. Make a Potion. You may ad Diacatholicon, or other Medicines, according to the condition of the Humour to be purged. Also Vomiting is sometimes good, because it Revelleth and Evacuateth the Matter of the Disease. If there be signs of blood abounding, and strength, you must first let blood. And if there be a Fever, you must open a Vein, though there appear no Plethory, or fullness. Before and after Purging, give cleansing Clysters, such as these: Take of whole Barley two pugils: Bran and red Roses, of each one pugil: Liquoris scraped, and Raisins whole, of each one ounce: boil them to a pint: Dissolve in the straining of white Sugar one ounce; Yolks of Eggs two. Make a Clyster. After the Body is sufficiently emptied, you must give astringents, and strengtheners, both at the Mouth, and by Clysters, as also to the Belly; the Forms whereof you may take out of the Cure of Dysentery. Besides, You may conveniently use these that follow: Take of Chalybeat Vinegar one part: Chalybeat Water two parts: the Leaves and Fruit of Myrtles, Quinces, Medlars, Cervices, of each two handfuls: Cypress Nuts six pair, boil to halfs. Foment the Belly warm with the strained Liquor often. Take of Oil of Mastic, Quinces, and Myrtles, of each one ounce: Sanguis Draconis, Frankincense, and Gum Traganth, of each one dram: Wax as much as will make an Unguent to anoint after the Fomentation. Or, Take Crumbs of toasted Bread infused in Chalybeat Water▪ and Quinces roasted in the Embers, or Marmalade, of each three ounces: Frankincense, Mastic, Sanguis Draconis, of each two drams: With Syrup of Quinces and Wormwood, make a Cataplasm. Take of Mastic two drams: Boyl it in three pints of Water for ordinary drink, Iron Water is also good; but in a hot Disease, it is good to use the Tincture of Roses, or Conserve of Roses mixed with Spring Water, or Water wherein Gold hath been quenched, mixed with Syrup of Quinces. Amatus Lusitanus reports of one that was cured of a Choleric Diarrhoea by taking much cold Water in the Summer time. We also once prescribed to a Sanguine man who was troubled with a Choleric Diarrhoea in the midst of Summer with great thirst, Sal Prunella in his ordinary drink, and Juleps made of Lettuce and Purslain Water to be taken thrice in a day, and he was cured in twenty four hours. If the Humour be very sharp, and adust or burnt, the Patient must be purged sparingly with mild Medicines, otherwise the Disease will increase, and he is to be cooled and moistened; as also to be blooded a little. In the same case a warm Bath is very good; the Example whereof is in our Observations. Plantain boiled in Broth, is excellent. And lest a Diarrhoea turn into a Dysentery, you must give Clysters of Chalybeate Milk, and Emulsions of the cold Seeds, and of white Poppy Seeds, to assuage the sharpness of the Humour. As also this Syrup following. Take of the Juice of Quinces six ounces: the Juice of Endive and Sorrel, of each three ounces: Sorrel and Plantain Seeds, of each two drams: red Coral one dram: Plantain Water four ounces: Boyl them to the Consumption of half: strain and press them well; put to it as much Sugar to make a Syrup to be taken two drams first and last. In all Diarrhoea's, after universal Medicines, this following Bolus is good. Take of Conserve of old Roses half an ounce: Candied Quinces one dram: the powder of Tormentil one scruple: With Sugar make a Bolus to be often repeated. Or if the Disease be old you may make an Opiate of the same, or the like, in a greater quantity to be taken at many times. Or to astringe more powerfully give this Powder: Take of Sanguis Draconis, Frankincense, Mastic, Mummy, Terra Sigillata, Lapis Haematitis, or Bloodstone, Troches of Amber, of each one dram: true Bole three drams: make a Powder, of which give two drams inconvenient Liquor. Rhubarb twice infused, and then twice or thrice washed in Rose Water and dried, is good. The Lozenges of the three , with four times the quantity of Rhubarb given twice in a day, the weight of two drams, do take away the Matter, and strengthen the Bowels. The Leaves of Fleabane laid upon fire so that the smoke may be taken through a hollow Chair, do stop the flux of the Belly by a specifical quality. As also if the same Herb be beaten with Vinegar, and applied to the Stomach. Also the smoke of Mullin taken through a hollow Chair, is excellent; the example of which is in our Observations. Syrup of Coral is excellent, and much more the Tincture or Magistery of the same. The Conserve of the wild Rose, or sweet Briar Rose, is good against a Choleric flux, especially if it be mixed in astringent Opiates. But when there is danger of weakness through a long and often flux, you may give Laudanum with Mastic and Terra Sigillata. When it is very violent, a Clyster of Broth and new Treacle is excellent. Pills of Bdellium taken twice or thrice in a week, or every other day, are good against all old fluxes. For the same is the often use of Medlars; as Forestus confirms by experience, obs. 1. lib. 22. in these words: One that had a constant Flux, and spent all he had upon Physicians, came to me for counsel, whom I advised to eat Medlars, though green, as many as he could, by which he was speedily cured. As it was with a Zealand Merchant that came to John Spirinchius, a Physician of Lovan, who having been long sick, and of a Dysentery at last, and could not be cured by any, was at length by his advice cured only with Medlars, and gave the Physician three hundred Crowns for his advice. Thus Forestus. But we must observe that the Body before the use of Medlars be cleansed from Excrements. In an old Diarrhoea, the following Medicines are excellent: Take of the shave of Ivory three drams: Confection Alkermes one dram: Sugar dissolved in Rose Water four ounces. Make Lozenges. Take of Crocus Martis six grains: Bezoard Mineral half a scruple: Conserve of Roses two drams: Spirit of Vitriol three drops: Mix them in a Bolus to be given twice a day, long after and before Meat. Take of the Juice of Persicaria Maculata, and of the great Housleek, of each three ounces: boil them till the third part be consumed, and give them in the morning, they do certainly cure any flux though very old. Mercurius Diaphoreticus given some days together, twelve grains at a time, taketh away all the impurities of the Body, which use to beget fluxes. The Decoction of Juniper Berries in Wine given three days together, is good; and also one dram of the Powder of Grasshoppers given in white Wine. These two by deriving the Matter of the flux to the Ureters. The Decoction of Juniper is thus made: Take of Juniper Berry's one handful: red Wine one pint and an half: boil them to the consumption of two thirds. Let him take the straining three days together. The Water of Brimstone Mines cure an old Diarrhoea by purging the whole Body, and by strengthening the Stomach. Of which there is an example in our observations. If a Diarrhoea come from a Catarrh, you must look to the Brain, as the part that sends it, with the Medicines prescribed in the Cure of a Catarrh. But if it depend upon the Obstruction or weakness of the Liver or Spleen, you must cure them as shall be showed in their proper places; and then there is little or no use of astringents. Platerus in the Cure of the Hemorrhoids, saith that hot blood given as a Clyster, doth wonderfully cure a flux. Chap. 6. Of Dysenteria, or Dysentery. A Dysentery is an often and bloody looseness of the Belly, with pain and torment depending upon the ulceration of the Intestines. The word Dysenteria is taken commonly among the Ancients for every bloody flux of the Belly: but strictly and properly it is taken only for the bloody flux, which comes from an Ulcer in the Intestines. Gal. 3. de symp. cause. cap. 2. nameth four kinds of bloody fluxes, which he commonly calls Dysenteries. The first is when any part of the Body is cut, or when any exercise is omitted, or any bleeding is omitted, as usual bleeding at the Nose and Haemorrhoids, that by reason whereof the blood abounding is sent by the Meseraick Veins to the Intestines, and so evacuated by the Belly. The second is, when by reason of the weakness of the Liver, Watery blood like that water wherein flesh hath been washed, is voided; as it is in the Hepatick or flux of the Liver, of which we shall hereafter speak. The third is when Melanchollick and shining blood is cast forth, which by reason of the long continuance in the Liver or Spleen is burnt, and mixed with Melancholy. Shining signifieth burning, because blood which groweth black by cold doth not shine, but loseth that brightness or splendour which it had before. The fourth Difference, is when the Patient at some short distance voids blood with Humours or Excrements, with which sometimes there is mixed Pus or Matter, and that with pain and torment, by which we may conclude that there is an Ulcer of the Guts. And this is properly called a Dysentery, of which only we here discourse. The Internal Causes of a Dysentery, are sharp and ulcerating Humours, as yellow Choler, green like Leeks or Verdegreece, and black; as also salt phlegm bred in the Head from great heat, or in the Belly by putrefaction, and so brought to the Intestines, where cleaving a long time, it doth ulcerate. Here is a great Doubt propounded by Authors; How yellow Choler in a short time should cause a Dysentery? When green Choler in a long time maketh only a Diarrhoea, which never turneth into a Dysentery, since the green is made of the yellow by adustion, and hath more sharpness. Mercatus answereth, That there must be a clamminess, by which it may remain long in the Guts to corrode and gnaw them, as well as a sharpness. And therefore if yellow Choler be such, it causeth a Dysentery; on the contrary, if green Choler be more fluid, and stay less while in the Guts, it makes but a simple Diarrhoea. Sennertus saith that this answer is probable; but it doth not satisfy, because oftentimes there are fluxes, in which there is clamminess with sharpness, and yet there is no Dysentery. And contrariwise, often times there is no clamminess in Choleric Humours which cause a Dysentery, and therefore he thinks that the Humours which produce a Dysentery have a peculiar occult quality, with which the Intestines are offended and ulcerated, as the Lungs are with the fish Lepus, and the Bladder with Cantharideses, and no other part. And he proveth that malignant quality in that a Dysentery is contagious for the most part, so that the infections which come from the vapours rising from the excrements of those that have a Dysentery, do only infect the Guts of them that are infected, and not upon other parts. The same happeneth in other Epidemical and infectious Diseases, in which the poison doth go only to some peculiar part; so their Pleuresies, Peripneumonia's, or Imposthumes in the Lungs, and Squinzies which are infectious. So the Poison of a mad Dog doth only infect the Head. This is more clear to be seen in Purging Medicines, which have a peculiar virtue to move the Humours in the Body, and bring them to the Guts, which will not only, being taken at the Mouth, purge by stool, but laid to the Navel are taken by vapour at the Nose; it is probable that they piercing into the Veins and Arteries by the Pores of the Skin and extremities of the Vessels, do stir up motion, and Fermentation or working in the Humours, because the bad Humours are separated from the good, and by pricking or stimulating of Nature, they are driven to the Intestines by the force of the Medicine, directing the expulsive faculty to those parts. By the same reason, but after another manner, do Sudorisicks, or Sweeting Medicines, and Diuretics, or such as provoke Urine work; the former forcing the Humours to the Skin, the latter to the Bladder. From which we may collect that the insection of a Dysentery, by what manner or part soever it is admitted into the Body, doth cause a certain fermentation or working in the Humours by giving them a Disposition like itself; which being an enemy to the Guts, doth provoke the flux of the Humours to them, by which they are ulcerated; and they being infected with the like disposition, do infect the Humours and Nourishment; from whence comes a true and proper Dysentery. It is demanded of divers Authors, What is that snotty and white Matter which is voided in such great plenty in Dysenteries, mixed with Blood and other Humours? Some think that it is the fat of the Guts; others that it is that with which the Intestines are lined for the better passage of the excrements; others, that it is phlegm from the Head or other parts; others, that it is Pus or Matter from the Ulcers. But we conclude, That it is nothing else but a preternatural excrement of the Guts; for they being decayed from their Natural Constitution, cannot convert their proper Nourishment into their own substance, but by an imperfect way change it into that Matter; which when it is unfit for nourishment of those parts, is expelled forth, and then the parts wanting again Nourishment, attracteth or draweth new, which is changed as the former, and there must needs be a great increase thereof, because the part affected continually draweth Blood from the Veins, which is changed into this slimy substance, by which it is deceived of its expectation, and therefore again draweth new for its Nourishment, which it continually aimeth at, but cannot turn into its own substance, but into th● slimy Matter, of which there is so great an increase. The same thing is done in other parts, and especially in great and profound or deep Ulcers. For the part Ulcerated when by reason of its evil disposition, it cannot be well nourished, draws blood continually from the Veins, which is changed into Pus or Quittor, by which means the whole body by degrees consumeth. Nor doth this befall only parts ulcerated, but others that have no Ulcer or Imposthume; so that although the aforesaid Excrement be like Quit r, yet is not true Pus or Quittor; for that comes only from an Ulcer or Imposthume. This chief appears in an Ophthalmy or Inflammation of the Eyes, in which when there is no Ulcer or Imposthume, there is a continual Excrement like Quittor, which comes only from the distemper of the part, and the depravation of the Homiosis, or quality by which it makes Nourishment like itself. The same befalls men in Asthma or Ptisick, and other Diseases of the Lungs, for their Lungs being distempered, do il concoct their own Nourishment, but turn it into an Excrement like Quittor, which is expelled by coughing, and yet they have no Ulcer in their Lungs; as many learned Physicians will conclude when they see the Matter. The External Causes of a Dysentery, are all things that produce sharp and evil Humours, or give them being produced, a disposition to cause a Dysentery. The Principal are, sharp Meats, or very subject to putrefaction, as Fruits soon rotten, and all unripe things, Waters that are drunk ordinarily, wherein there is Crudity or a Mineral, and Medicines which are deadly qualified, and evil Air, as Hipp. Aph. 11. Sect. 3. when the Winter is too cold or dry, the Spring too wet, and too full of South winds, than there will be Dysenteries in the Summer. And Aph. 12. Sect. 3. If the South wind blow much in Winter, and it rain much: but if it be dry, and the North wind blow much, in the Spring, those seasons produce Dysenteries. But the proper Distemper of the Air to produce a Dysentery is known in a contagious or Epidemical Dysentery, which sometimes is more dangerous than others. As also there is an Infection in the Excrements of those that have this Disease to them that smell them, and if th●y be cast into the Privy they infect most of the Family that sit over them. The Signs of a Dysentery are taken out of the Definition mentioned, an often bloody Evacuation with pain and torments of the Belly, and sometimes a Fever, watching, thirst, loathing of Meat and other Signs common to many Diseases. But it is hard to know whether the thick or thin Guts are ulcerated. Usually if the pain be above the Navel, they say it is in the thin Guts, and if below, in the thick; but this is contrary to reason, because both the thin and thick Guts are carried both to the superior and inferior parts. Therefore this sign is rather to be taken from the quality of the pain, and the excrements. For if the thin Guts are affected, there is vehement pain, like pins pricking, because they are more Membranous, and of more exquisite sense. As also they go not to stool presently after the pain, and there is blood in every stool; for because the Blood and purulent Matter comes far before it be voided, it is more mixed with the Dung; but if the thick Guts are affected, the pain is less vehement and lasting, there is presently after a going to stool, the Blood and Matter swim upon the excrement, or are very little mixed, and in a great Ulceration there are as it were little pieces of flesh. The Signs of the Causes are taken especially from the Colour of the Excrements, when they are yellow, green, white, or black, to which you may add the Signs of Humours abounding from the Age, Temperament, time of the year, and course of Life. The Prognostic is thus made, If the Thin Guts are Ulcerated there is more danger, for they are more Nervous, and being nearer the Liver they receive more pure Choler. Dysenteries coming from black Choler, or Melancholy, are deadly; Hypocrates, aph. 24. sect. 4. because the Ulcer grows Cancerous, which is seldom Cured outwardly in the body. But if this Melancholy comes by Crisis, of Judgement, it is not so dangerous. But you must beware lest you take Congealed blood for Melancholy. A Dysentery from Choler or sharp Diet is easily Cured: from salt Phlegm it is worse than from Choler, because by reason of the Clamminess it stays longer in the Guts to ulcerate. In long Diseases of the Guts, Loathing of Meat is evil, and worse with a Fever: Hypocrates, Aph. 3. Sect. 6. If in a Dysentery there be as it were little pieces of Flesh voided, it is deadly: Aphor. 26. Sect. 4. for it signifieth a deep Ulcer which takes away pieces of the guts. Much Watching, Stools without mixture of Humours, black, stinking, much blood, a Lientery coming after, Hickets, Choleric Vomits, pain of the Liver, Midriff, great thirst, do commonly declare that it is deadly. A Dysentery coming to those which have the Gout or a Disease in the Spleen, is good: Hypocrates, 2. progn. & aph. 46. sect. 6. but this is rather a simple Diarrhoea which sends forth the matter of those Diseases. Old Men and Children more commonly in this Disease than Men of middle Age, Hipp. 2. progn Children because of their tenderness, and their not observing rules: Old Men because their strength is spent, and because there is a great overthrow of their natural state thereby: for they do not easily produce excrements that are fit to cause a Dysentery. The Cure of this Disease is wrought by Medicines that assuage, cleanse, and evacuate sharp humours that Consolidate and dry Ulcers and stop the flux. At first you must evacuate the Humour offending lest it do more mischief, and you must Purge often; and it you think it not safe to purge every day or every other day, do it every third or fourth day: Rhubarb is the best for purpose, either given in substance with Broth, or made into a Potion, as in Diarrhoea, Or thus, Take of Plantain half an handful: Liquoris scraped, and whole Raisins, of each three drams▪ Red Roses one pugil: Tamarinds six drams: yellow Myrobalans rubbed with Oil of sweet Almonds, two drams: boil them to three ounces: Dissolve in the straining, of Rhubarb infused with Lavender in Plantain Water one dram: Syrup of Quinces one ounce: Make a Potion: Or, Take of Tamarinds half an ounce: Citron Myrobalans, two drams: boil them in Barley and Plantain Water, infuse in the straining, of Rhubarb one dram and an half: yellow Saunders half a scruple: to four ounces of the straining add one ounce of the syrup of Roses solutive: make a Potion. The Decoction of Myrobalans made thus, and given in many Draughts, is Commended of many. Take of the rinds of Myrobalans Chebs, ten drams: Citron Myrobalans five drams: Currans two ounces: boil them in twenty six Pints of Water, to the Consumption of the third part: strain them, and add ten drams of Sugar, clarify it, and put to it half an ounce of Cinnamon. Penotus Commends the following Potion as good against both Dysentery and Diarrhoea. Take of the Bark of Guajacum beat two ounces: boil them to halfs in a sufficient quantity of Water, adding of red Roses, Pomegranate Flowers, and Plantain, of each two drams: boil them for an hour, and then add to the straining of powdered Rhubarb one dram: Diacatholicon, three drams: make a Potion. Many give Parched or Torrified Rhubarb, that the Purging Quality may partly be taken away: But Amatus Lusitanus takes the second Infusion of Rhubarb, and saith, That in the first Infusion all his sharpness is taken away, and it is better so than Parched, for by so doing it is burnt. The Preparation is thus made: Take of Rhubarb one dram and an half: infuse it in three ounces of Plantain Water some few hours, strain it, press it gently, and then infuse it again in three ounces of new Plantain Water, and dissolve in the straining half an ounce of Cassia: make a Potion. If you desire, by reason of the abundance of crude Humours, to Purge more, than you may make Syrup of Roses, or Diacatholicon, or other mild things, but beware of strong. Sometimes a Vomit is very good, if the Patient be inclinable, and the Humours stand in the Stomach; for it makes a revulsion of the Humours from the part affected. Which Amatus Lusitanus wisely mentioned, Curate. 44. Cent. 2. in these words: If the Physician can draw upwards, and cast out by Vomit a Humour that is Choleric and sharp, flowing to the Guts to make a Dysentery, it would be contrary to the Precepts of Galen, in his Book of Medicinal Art, and Method of Cure, to carry the matter by the Guts which are full of Ulcers. But when the Physician cannot do it, although he ought to try his best skill, he must then use Purges, and especially Rhubarb. This Hypocrates taught, Aph. 15. Sect. 6. After a long flux of the Belly, if Vomiting come of itself, the disease is cured. But Galen in his Comment upon this Aphorism, saith, That this is the example of those things which are done rightly by Nature, which a Physician ought to imitate. And Mercatus confirms the same in these words: Divert the Humours another way by bleeding if thou canst; also purge, and Vomit, especially in salt phlegm, for thus we have seen old Dysenteries cured. Angelus sala prescribeth this following Vomit in a Dysentery: Take of Salt of Vitriol half a dram, or a dram: Syrup of Quinces, and Bettony Water, of each one ounce: Cinnamon Water ten drams: Mix them and drink it off. There is great Dissension among Authors concerning Blood-letting in this Disease. And it is the Opinion of the wisest, that in a Fever and Inflammation of the Intestines (which is commonly joined with an Ulcer) that it ought to be in the beginning of the Disease, before the strength be decayed by it: for so there is a revulsion of Blood, and sharp Humours flowing to the Guts. And Valescus de Taranta, and Amatus Lusitanus in an old Dysentery drew Blood. Valescus saith, That a very old man had a Dysentery three months; I being sent for, when other Physicians opposed it, commanded a Vein to be opened, he presently amended. And Amatus saith thus; That an honest Physician went to a man, who had a Dysentery thirty days with a great Fever, and after the use of divers Medicines was brought very low, and lean, his flux continuing with much Blood, and drew Blood from the Liver Vein of his right Arm: and observe with what success; Presently, miraculously the blood stopped, though his flux continued. But by Clysters with Sugar, and astringent Medicines, both internal and external, his belly was bound, and he cured. In the mean while give many Clysters, first assuaging, mild, and cleansing; then glutinous and astringent; and sometimes in one Clyster all together, or most of them. Mild, gently, and anodine Clysters that assuage pain, are made of Milk, either alone, or with two or three yolks of Eggs, or with the Mucilage of Fleabane Seeds and Quinces, of each four ounces; with Sugar or Honey of Roses one ounce; Goats Suet one ounce; or with Milk wherein Gold, Iron, or Flints have been quenched, that the serous part may be consumed, and so it may be more glutinous. In want of Milk, you may give Almond Milk, or Barley Cream, or Rice Milk, alone or together; as also the Broth of Mutton, Chicken, Capon, or a Sheep's Head, and mix the former things therewith. It is usual to boil Roses, and the Herb Horstail with a Sheep's Head. Or this following: Take of Marsh-mallow Roots one ounce: cleansed Barley, or Rice one Pugil: Lin-seed and Quince seed, of each one ounce: Fleabane seed half a dram: Chamomel flowers one pugil: Boyl them in Milk or Broth, adding the Suet and Yolks of Eggs, and other things before mentioned. Or you may make it of Milk alone, boiled with Marsh-mallow Roots at the first, to cleanse and assuage the pain. If the Pain be great, you must mix Narcoticks; as Philonium Persicum, one or two drams: Pills of Hounds-tongue one or two scruples: Syrup of Poppies one ounce and an half: Laudanum five or six grains, in your Clysters. If there be an Inflammation in the Guts, which may be known by constant pain, and increasing when it is touched, also by a Fever and dryness of the Tongue; let blood again, give Clysters of Rose Water, with Salt of Lead, and foment the Belly with Oxycrate, or Wine and Water. Also you may give Salt of Lead at the Mouth to ten grains, with Conserve of Roses. Cleansing Clysters are made of Barley Water, Bran, red Roses, Sugar or Honey of Roses. But for the greater cleansing and glutinating the Ulcer, ad one dram of Turpentine dissolved with the Yolk of an Egg. When the Ulcer is more foul, you must use greater clensers, as Beets, Pellitory of the wall in the aforesaid Decoction. The strongest Clensers are, Centaury, Wormwood, Gentian, Brine or Pickle, from Galen 12. Meth. Cap. 1. and the like; the use of which is now very rare. Zacutus Lucitanus durst use Arsenic, and yet with good success; as you may see Obs. 18. Lib. 2. of his Admirable Practice of Physic. Some Chemics use of the Oil of Wax in Clysters one dram; and anoint the Belly with the same. To glutinate or heal up the Ulcer, first use gently Dryers in Clysters, and a little astringent; then such as are more drying and binding. Therefore make them first of Chalybeat Milk, in which Roses have been boiled, or of Barley Water, or Water of parched Rice, and red Roses one pugil, adding to both Clysters two Yolks of roasted Eggs, sometimes Honey of Roses; and when you will have it work better, one ounce of the Juice of Plantain. To bind and glutinate more, make it thus: Take of the Roots of Com●bry and Mullein, of each one ounce: Plantain and Com●bry leaves, of each one handful: red Roses, and parched Barley, of each one pugil: Myrtles two drams: Make a Decoction in Cistern Water; in one pint of the straining, dissolve of Honey of Roses one ounce; one white of an Egg, or one ounce of the Mucilage of Gum Traganth, Goat's Suet two ounces: the Juice of Yarrow and Knotgrass one ounce. Make a Clyster. Take of Snakeweed Roots, or Tormentil, one ounce and an half: Shepheards-purse, Knotgrass, Horstail, and Mousear, of each one handful: Pomegranate flowers, Acorn cups, Cypress Nuts, of each two drams: parched Rice one pugil: make a Dcoction in Forge Water: in a pint of the straining dissolve two ounces of the Juice of Plantain, and two Yolks of roasted Eggs. Make a Clyster. Angelus sala wonderfully commends the following Clyster: Boyl a Sheep's Head cloven in two, till the flesh come from the bones, add to the Broth strained of the tops of St. john's Wort two or three handfuls; Tormentil Roots grossly bruised two ounces: Infuse them three or four hours upon the Embers. Let the straining be twice or thrice given as a Clyster. The Juice of Plantain alone, or with the Milk or Barley Water, is good. Gum Traganth two drams, or the Infusion of it in Rose or Plantain Water, is good to put in Clysters; or it makes a very good one if it be mixed with Juice of Plantain and Goat's Suet instead of Gum Traganth. Or with it you may with profit use Gum Arabic, Frankincense, Mastic, and Sarcocol. All which being dissolved in the aforesaid Liquors, do work by glewing, neither do they exasperate the Ulcer as the strong Astringents. Ama●us Lucitanus doth much approve Clysters made of them, because they do cover, as with a Plaster, the internal Superficies of the Guts against the gnawing of the Matter; he makes them thus: Take of Barley Water ten ounces: one white of an Egg well beaten: Gum Arabic and Goat's Grease, of each half an ounce: Oil of Roses two ounces: Bolearmenick and Gum Traganth, of each one dram: mix them for a Clyster. But lest those Emplastic Clysters should fasten the sharp Matter, and shut it up by their clamminess, you must use cleansing Clysters also, which must not be long retained; and you must sometimes use cleansing Clysters intermixed with astringent. In the astringent you may put Acacia, Hypocistis, or Conserve of Sloes, Sanguis Draconis, Bloodstone, the Juice of Maddir taken out with Rose or Plantain Water, Bole Armenick, Terra Sigillata, or sealed Earth, the Troches of Amber, and the white Troches of Rhasis to one or two drams. Other Powders are hurtful, because they settle in the Liquor, and provoke the part to pain. And it is better to infuse the aforesaid Powders in Liquor, or in a Decoction, and to give them strained. While you give Clysters, you must give at the Mouth, Medicines of the same Nature, and that oftener when the upper Guts are ulcerated, to which the Clysters cannot reach. If there be no Fever, you may profitably, when you intent to cleanse, give Goats Milk; and when you intent to glurinate, Cow's Milk, both with Sugar of Roses. But Chalybeat Milk, that is, Steel infused, doth knit or glutinate better; three ounces thereof with Juice of Plantain, and Sugar of Roses, of each one ounce, make an excellent Medicine. Or boil Comphry Roots in Steeled Milk. Or make Bread of the finest Barley with Yolks of Eggs, and set it into the Oven after the Bread is drawn: Crum Milk and Sugar there with till it is as thick as a Pultis; of which let him take five or six spoonfuls twice or thrice in a day. Veal broth boiled very long doth assuage pain in the Ulcers. And Cream of Rice doth heal them up. Lerius reports in his History, That many troubled with Dysenterles, in a long voyage almost starved, and were cured with Rice boiled in Milk with Yolks of Eggs, and Juice of Ground Ivy. Also you may boil Rice in Almond Milk, in which Gold hath been quenched. Cream of Barley with Sugar doth clese and cool. Broth made of Burnet with Butter, given three days together morning and evening, doth much further the Cure, and the more if the Decoction of Burnet at the same time be given for ordinary Drink. The Rinds of two greenish Oranges boiled in eight pints of Water for ordinary Drink, doth half the Cure. Of the Powder of a deadman's Skull one dram twice or thrice given in Broth or other convenient Liquor doth quickly cure perfectly. Two spoonfuls of the Mucilage of Gum Tragacanth drawn with Rose Water or Gum Arabic half a dram, may be dissolved in all his Broths; as also one spoonful of the Jelly of Hartshorn is good. After the Body is well Cleansed, give astringent Decoction to complete the Cure; which must be made of the Roots of Snake-weed, Tormentil, Comfry, Plantain Leaves, Yarrow, Shepherds-Purse, Horse-tail, Mouse-ear, Agrimony, Plantain and Sorrel Seeds, Sumach, Grape-stones, Red Roses, etc. in Cystern Water; dissolving therein the Syrup of Quinces, Myrtles, or of dried Roses, as also sometimes Acacia Hypocistis, Conserve of Sloes, Bowl Armenick, Spodium or burnt Ivory. The Juice of Quinces boiled to the consistence of a Syrup or Rob, without an addition given a spoonful or two often is very profitable. The like Juices may be made of Pears, Cornel, or Dog-tree Berries, and other sharp Fruits. Take the Fat Guts of a Sheep, boil them till the Liquor come to half a Porringer, than put a little sweet Oil thereto and let him drink it; if the Dysentery be not very stubborn it cureth it at the first or second draught. Oil and Rose Water given in equal parts do the same. Let two yolks of hard Eggs, and mixed with Rose Water, be taken with Sugar and a little Nutmeg twice or thrice. The Juice of Plantain only given, three or four ounces at a time, or mixed with other proper things, is excellent; and if there be an inflammation it allayeth it. Hollerius saith, That the Juice of Ground-lvy taken, hath saved many a man's life. Juleps of Waters or Decoctions and Astringent Syrups are to be often given. Syrup of Coral, as also the Tincture and Magistery thereof are very good, which must be taken often in a spoon; Or these following, Take of syrup of Grapes, Myriles, and of Juice of Plantain, Quinces, and dried Roses, and syrup of the Juice of Purslain, of each one ounce: mix them for the use aforesaid. In the end of a Dysentery the suyce of Wormwood and Mints well purified, and made into a Syrup with Sugar, is very available: For Mints mixed with Wormwood hath great force to strengthen the Stomach. And it the Dysentery came by eating much Fruit, in the beginning Syrup of Wormwood with Cinnamon or Treacle Water is excellent, if you at the same time use Fomentations and Emplasters to strengthen the Stomach. A Quince made hollow and filled with the shave of Virgin's Wax, roasted under the Embers, given for some few days together, is a most proper Remedy. Quercetanus makes the same Medicine of pomum Curtipendulum made hollow and filled with Gum Arabic and Wax, of each one dram, then roasted, and after'tis eaten let him drink a draught of astringent Decoction. Others roast a young Pigeon stuffed with Wax, and give it for a dinner. The use of Meddlers, according to Forestus, cures old Dysenteries, lib. 22. obs. 1. which we mentioned in Diarrhoca. Bruyerinus, lib. 8. de recibaria, cap. 12. writes that he was Cured of a desperate Dysentery by eating raw Service-berries, by the advice of an Old Woman. Nor let us omit the Oak Grape mentioned by Martin Ruland, which he saith is under the Earth upon the Roots of an Oak in Spring time, of a binding taste outwardly like Purple, inwardly white and like Milk, which dieth in Summer and turns to a stick, and therefore must be dried in the shade, powdered in the Spring: He saith, That there is no more excellent Powder to staunch Blood and Dysenteries than this. Also Encelius, Bauhinus, and Skenkius mention the same. In every Flux of putrid Humours let the Guts be strengthened with bread twice baked, first boiled in Vinegar and then dried; after it is twice or thrice thus prepared, powder it, and thicken Broth therewith. Also there are many Powders for this: As, Take of Snake-weea and Tormentil Roots, of each one dram: Red Coral and Pearl prepared of each half a dram: make a Powder to be taken one dram at a time in Broth, or the like: You may make it more Astringent with Red Roses, Myrtles, Pomegranate Flowers, Harts-born burnt, or Ivory burnt, or Troches of Spodium: Or for more Binding, with Sanguis Draconis, Acacia, Galls, Bowl Armenick, sealed Earth, Bloodstone: And if you desire to glutinate, also add Fleabane-seeds, Starch, and Gum Tragacanth. The Eastern Bowl, given one dram in Broth, doth cure the Dysentery if sufficient Purging went before. Or, Take Powder of Tragacanth one dram: Nutmegs, Coral prepared, of each half a dram: mix them, and let it be given at twice or thrice with a rear Egg, or Broth. Or, Take of Gum Arabic one dram: Coral and Bowl prepared, of each half a dram: mix and use it as the former. Or, Take of Harts-born, Bowl armonic, both Corals, all the Saunders and Mastich, of each half a dram: Frankincense and Tragacanth, of each half a scruple: mix them for a powder of which take half a dram often. Forestus doth highly Commend the following Powder, Take of Citrin Myrobalans and Rhubarb a little parched, of each scruple: make a Powder for one Dose. Hercules Saxonia saith, That all new Dysenteries are presently, and surely Cured by this Powder: Take of Cuttlebone burned two drams: sponge dipped in Pitch and burnt in a Pot, and of Eggshells the inward skins taken away, of each one dram: make a Powder, the Dose is one dram in a convenient Liquor. The Powder of Elderberries is by Experience approved, it is prescribed by Quercetanus in his Dispensatory, and there you may see the use of it. You may give Opiates made after this manner, Take of conserve of old Roses and Quinces, of each one ounce: conserve of Comfry Roots half an ounce: Coral prepared one dram and an half: Crocus Martis, Bole Armonic, sealed Earth and Plantain seeds, of each one dram: Spodium two scruples: with syrup of dried Roses or Myrtles make an Opiate; of which give the bigness of a Chessnut twice or thrice in a day; Or with an equal weight of Sugar you may make a Compound to be used often. Mycleta Nicolai is good for the same. Crato wisely admonisheth, That before the seventh day, before the Ulcers of the Guts are well cleansed, you give no astringents at the mouth, nor externally, but after the seventh day you may begin with gentle astringents. Montanus doth wholly forbid them, and useth only Clensers' Assuagers of pain and thickners: But when the matter of the Disease is well evacuated, the weakness of the retentive Faculty by which the Flux is nourished, may be well taken away with astringents. Therefore it will be profitable, after sufficient Purging to give for many days Bowl, Terra Lemnia, powder of Elderberries, or other astringents and dryers with Sugar, till the patiented be well: but if too much binding seem to hurt, you must purge again, then bind and after purge; and you must observe that those Earth's do avail too ways, namely by Binding, and by Opposing the evil quality which is in the Disease: And the Obstruction which is feared by their use is taken away by Sugar mixed with them. To allay Pain, and health the Ulcer, this Electuary is best. Take of the mucilage of Quince-seeds, Comfry Roots, and Gum Tragacanth, all extracted with Rose Water, of each one ounce: Starch one dram; Red Coral two drams: Bole Armonic prepared one dram; Pomegranate Flowers half a dram: Rob, or conserve of Services, or Quinces two ounces: Sugar of Roses one ounce: make it like an Electuary: the Dose is two dram. narcotics, or things that bring rest given at the mouth do wonders, for they take away pain, stop the Flux, provoke sleep, and refresh the strength: but they are better when they are mixed with Astringents and Strengthens. As, Take of old conserve of Roses two drams: Laudarum three grains: Confectio Alkermes, half a scruple: make a Bolus. In a Malignant, and Epidemical, or Common Dysentery, Medicines of Bezoar and Sudorific, or Sweeting Medicines, are powerful; for it is observed that by these Remedies, that the matter hath been discharged, and the Dysentery cured: Therefore observe at first the nature of the Humour; for if it be Malignant, as in a Common Epidemical Disease it is, you shall in vain try other Medicines, except at the same time, and in the beginning you give Antidotes or Cordials. Here you may use all things proper to a Malignant Fever: And besides those things that provoke Sweat, as Bezoar and Aqua Theriacalis, or Treacle water; Hartshorn, sealed Earth, Bole Armonic, Unicorns-horn, Coral, Amber, Scordium, St. Johns-wort, Plantain, Tormentil, Burnet, and many others are very good. Outwardly to the whole Belly apply Oil of Quinces and Roses; or if you will have it more astringent Oil of unripe Olives, or put the third part of Vinegar to them, and boil them to the Consumption of the Vinegar: If the Stomach be Affected also, add Oil of Mastic, and Wormwood. After Anointing, Sprinkle the part with some Astringent powder, made of Myrtles, Pomegranate peels, Galls, Cypress Nuts, Acron Cups, Red Roses, Pomegranate flowers, Frankincense and Mastic; to which for the more binding, ad Bole Armenick and Terra Sigillata, or Sealed Earth. Of the same Powders without the Oils, you may make an Ointment for the same Use, with a little Wax: Or, You may use Unguentum Comitissae alone, or with other Ointments. The Cataplasm prescribed before for Diarrhoea, and this following, if you will Bind strongly, may be used: Take of Bowl six drams: Frankincense six ounces: Sanguis Draconis, Mastich, and Mummy, of each two drams: make a Powder, which you may apply to the Belly beneath the Navel if you mix it with Vinegar and the white of an Egg and lay it upon a Cloth. Or, Take three ounces of Spider's Webs, and one white of an Egg well beaten: fry them in a pan, and apply them hot to the Navel. A Cataplasm of Treacle and sealed Earth to the Belly, is good in an Epidemical or contagious Dysentery. This following Cataplasm to strengthen the Liver, is much commended of Solenander in every flux, both of the Liver, called Hepaticus, and in a Dysentery, and old Diarrhoea. Nor must you fear Astringents, saith he, because they are tempered with things to strengthen the Liver. Take of Liver-wort and Schaenanth, of each one handful: Indian Spike half a pugil: Mastich, and Mace, of each half an ounce: Lignum Aloes three drams: Myrobalans Chebs, and Emblicks parched, of each one ounce: Bole, sealed Earth, and Bloodstone, of each six drams: Coriander seeds prepared one ounce and an holy: Spodium or burnt Ivory, two drams: Roses one ounce: the Species of three without Camphire half an ounce: Rust of Iron prepared one ounce: Barley flower two ounces: Oil of Mastic and Myrtles of each as much as is sufficient: make an Emplaster to cover the whole Belly, from the Cartilege called Ensiformis or Xiphoides, to the Os Pectinis, or the Bone at the bottom of the Belly. You may also make a Fomentation for the whole Belly of a Decoction of astringent things made in Iron Water, with a little red Wine and Vinegar. Or, Take of red Roses two handfuls: Wormwood and Mints, of each one handful: Nutmeg and Cypress Roots, Mastic and Galangal▪ of each one dram: With a linen cloth make a bag as big as the belly, which being warmed in red Wine, or Vinegar, may be laid upon the belly. Or, Take of Wormwood, Mints, Plantain, Oak Leaves, and tops of Brambles, Horstail, and Knotgrass, of each one handful: Chamomel flowers two pugils: red Roses half a handful: Myrtles one dram: Seeds of Sumach, Plantain, and Coriander, of each six drams: Nutmegs three: make a Decoction in steeled Water, and red Wine for to foment the Belly. Rulandus doth apply a bag of Bran boiled in Vinegar▪ If the pain be great, apply a linen cloth wet in steeled Milk that is warm. But if Fomentations will not Cure, you may use Waters to sit in called Insessus. These are commended by Matthew de Gradi, Savanarola, and Jachinus, who saith that they are a great secret for the Cure of Children, for by their actual heat they do drive the Humours somewhat towards the Skin; and by their astringent quality stop the flux. But you must not use them if the Body be very full of evil Humours; or if the Dysentery be malignant, and joined with a Fever. They are made of Oak buds, green Cypress Berries, green Pine-nuts, or Leaves, Barks, and other such like boiled in Water, of the aforesaid Decoctions for Fomentations. You may make Fumigations that the Patient may receive the vapour of them through a hollow Chair. Especially a Decoction made of Mullein, and the Fume thereof received, is commended in this Disease, and also for a Diarrhoea. Faventinus commends a Fumigation made of Turpentine cast upon a hot Iron, taken up into the Body twice a day. And he commends also this Fomentation: Take of Balm one pound: Mullein one handful: Put them in a long bag; boil it well in red Wine and strong Vinegar, and apply it to the Fundament. Rulandus useth a Decoction of Acorns in Vinegar for a Fomentation. And Faventinus propoundeth this following Lotion as a secret to stop the Dysentery: Take of the dross of Iron, and filings of Steel, both prepared in Vinegar, of each one pound: then boil them in two pints of very strong Vinegar to the consumption of half. Let the Patient put his fee● and his hands half an hour every morning and evening therein. In a long Disease, and when there are Ulcers in the Guts, Quicksilver is good, if it be mixed with Ointment of Roses, and the belly anointed therewith. As also the Clysters afore mentioned for filthy Ulcers. At the same time, you may give Milk, and Syrup of Myrtles. Also one dram of true Balsam given in a Wafer doth wonderfully heal all inward Ulcers. For asswaging pain, apply the Caul of a new killed Sheep to the belly, and bind it on, especially to Children, and repeat it often. If the Liver, Stomach, or Brain, cause this flux, you must use proper Medicines to them, always making choice of those that do astringe and strengthen. For his ordinary Drink, give him Spring Water with Conserve of Roses, the Tincture of Roses, a Decoction of Oaken Leaves, or Water wherein Terra sigillata is infused, or wherein red hot Gold hath been quenched with Syrup of Quinces, Myrtles, or dried Roses. Or when there is no Fever use a weak Decoction of Mastic with the Syrups aforesaid. According to Crato's Judgement, you must not use any chaly beat or steeled Drink; for it doth not astringe, as commonly they suppose, but troubleth the belly. Others commend the Decoction of Gramen or Dog's Tooth, because▪ it is good to dry and divert by Urine. Lastly, 'Tis worth the Observation, which Aetius speaks, Lib. 3. Cap. 8. and Paulus, Lib. 1. Cap. 35. that old fluxes are dried up by Venery. Which Hypocrates said formerly, 7. Epid▪ in the end: Excessive Venery doth cure fluxes of the belly. Amatus Lusitanus learned this Truth by Experience, Curate. 41. Cent▪ 2. One troubled with a Dysentery (saith he) very violently, was married, and the first night he lay with his Wife, was cured. Let this be added for a Conclusion, which is related in the Cure of Diarrhoea, out of Platerus in his Cure of the flux of the Hemorrhoids; Hot Blood of either Man or Beast given in a Clyster, doth wonderfully stop and cure the flux. Chap. 7. Of Tenesmus. TEnesmus, is a continual desire to go to stool, and voiding of nothing but Slime or bloody Matter. The immediate Cause of this Disease, is an Ulcer in the straight Gut called Intestinum rectum; from which, Quittor or filthy Matter continually floweth, and stirreth up the expulsive Faculty, by which means there is a continual desire of going to stool. Moreover, there is voided a slimy Matter mixed with blood, from the depravation of the Homoiosis (or quality that converts things into its likeness) of the ulcerated part, because it cannot well concoct its proper Nourishment, and make it like itself, but turns it into another slimy substance; as we shown more at large in Dysenteries, and other Ulcers of the Guts. But in regard we said in the Chapter of Dysentery, That all the Intestines might be ulcerated in that disease; thence it seems to follow, That the Ulcers of the strait Gut called Rectum belong to a Dysentery. Yet Custom hath so prevailed, that when the Rectum is only hurt, it is called by the name of Tenesmus: And because when other Guts are affected, if the Rectum suffer, there is also Tenesmus or needing, although the disease be then called a Dysentery; therefore Dysentery and Tenesmus are of the same Nature, and have the same Cause, and differ only in respect of the part affected: And therefore we need not repeat the Causes, because they are the same with those that produce a Dysentery. For the Knowledge of this Disease, there is no more required but to distinguish it from a Dysentery, which you may learn from the definition. For in a Tenesmus, there is a continual needing; but in a Dysentery it is by fits: besides, in that, after great straining, there is voided only a little slime, bloody or mattery; but in a Dysentery, both Excrements and Humours are continually voided. The Signs of the Causes are the same with a Dysentery. As for the Prognostic, Celsus Lib. 4. Cap. 19 saith that a Tenesmus is easily cured, and that of itself it never kills any, yet Galen, 5. de usu partium, cap. 4. reckons it among the chiefest Diseases of the Belly; and truly it may very well be accounted grievous in respect of its troublesomeness and long continuance; yet it is not dangerous except it come of Melancholy, for than it tends to a Cancer ulcerated: besides, it brings great inconveniences, as Miscarriage or Abortion to Women. So Hipp. Aph. 27. Sect. 7. saith, If a Woman with Child have a Tenesmus, she will miscarry. For the continual straining at stool doth much disturb the Womb, which is so near to the strait Gut. Besides, the same Muscles which serve to throw out the Excrements, are employed for delivery; therefore when they daily compress the lower Belly, they cause Abortion. Lastly, the Ulcers of the Rectum Intestinum being near the Anus or Fundament, if they contitue long, turn to an incurable Fistula. The Cure of a Tenesmus, little differs from the Cure of a Dysentery. And therefore first, the sharp Humours that come from the Liver and other parts, are to be purged with Medicines that leave an Astringent quality, as chief Rhubarb, which must be so often given till the Humour seem to be spent. If there be an Inflammation (which is chief known by a Fever) or if much blood, you must open a Vein. And in case it continue after bleeding, and cause a strangury or difficulty of Urine (as it often doth) it is very good to open the Hemorrhoids with Horsleeches. Also you must use asswaging Clysters when there is much pain; and cleansing, glutinating, and astringent, according as the Ulcer requireth; the Forms whereof are to be found in the Cure of Dysentery. But in the use of Clysters, observe first, that you give them often, and in a small quantity, only half a pint, because they will be hardly kept any time, by reason of the continual needing. And the pipe must be warily conveyed in, lest the pain be increased. And you must diligently apply Fomentations, Insessions or Baths to sit in, Fumigations, Suppositories, and Ointments. You may make a Fomentation thus, Take of Mullein & Wormwood, of each six handfuls: boil them in new Milk and put them into two Bags, which apply to the Anus and whole belly one after another very warm. Or, Take of Chamomel Flowers, and Roses, of each one handful: Red Wine two Pints: infuse them two hours upon hot Embers: Foment the Fundament as hot as can be suffered with four times doubled : After let the Patient sit upon a sponge dipped and strained from the same Liquor. Or, Fill two Bags with Barley Bran and boil them in Vinegar: Let the Patient sit one while upon one, another while upon another as hot as he can. If he void much Blood, make the Fomentation thus, Take of Mullein Leaves and Roots two handfuls: Red Roses one pugil: Pomegranate peels, and Galls, of each half an ounce: boil them in two parts of Iron-Water, and one of Red Wine for a Fomentation: which you may make stronger if you add half an ounce of Alum. Insessus, or Baths to sit in to assuage Pain, are made of Emollients boiled in Water, or Broth of Sheep's Heads and Feet, to which you may add Violets, Nightshade, Gourds, and Melons sliced, but for healing of Ulcers you must make them of Astringents . Fumigations are good to dry the Ulcer made of Frankincense burnt, or the Decoction of Savin made in Oxycrate, or other things mentioned in the Cure of a Dysentery, the Fume whereof must be taken sitting in a hollow Chair. But this following is Commended by Forestus. Take of Mastic one dram: Frankincense one scruple: Myrtles one dram and an half: Red Roses two scruples: make a Powder for a Fumigation. Suppositories are good in this Disease, they must be gentle and mild, lest they exasperated the part which is so sensible: They are fitly made of Goat's Suet cut into the form of a Suppository; for they appease the pain & heal the Ulcer: but they will be better against Pain if you mix the seed finely powdered of Poppies or Henbane, & tie them in a knot in Paper like a Suppository: But far best if you instead of these things put three drops of the Oil pressed out of these Seeds to every Suppository: or one grain of Opium dissolved in half a scruple of Oil of sweet Almonds. The Ulcer will be sooner healed, if you first dissolve the Suet, either alone, or with white Starch, Gum Tragacanth beaten, and first steeped in Plantain Water, or else with some Narcoticks: Or, thus, Take of Gum Tragacanth as much as is sufficient, sprinkle it with Plantain Water that it may only swell and not dissolve; then add as much of the mucilage of Fleabane seeds, or Quince seeds, and mix them with the white of an Egg roasted; then with melted Wax make them into a Suppository: You may also add Narcoticks: as likewise to Cure the Vcer better, the Powders of Ceruse, Tutty, Bole, Pomegranate Flowers, and the like which dry without Acrimony, and sharpness; And these must be very finely Powdered and sifted, lest the Part be Exasperated. You may apply Oils and Ointments as in a Dysentery, to the Belly and Fundament: As Ointment of Roses, Populeon, or of the Mucilages, of the whites of Eggs, Oil of Roses, and the like, to take away Pain and Inflammation: and other things that shall be mentioned in the Chapter of Haemorrhoids, or to Cure the Ulcer, the white Ointment of Rhasis or Pompholygos, melted in Hydromel, or in Honey and Water. Lastly, In a more desperate Condition, use Narcoticks both inwardly and outwardly; but three or four grains of Laudanum is best given with Mastich and Terra Sigillata, or mixed in a Clyster made or a Decoction of the Flowers of Chamomel. Chap. 8. Of Fluxus Hepaticus, or Flux of the Liver. A Flux of the Liver, is that in which serous and bloody Humours like water wherein flesh hath been washed, are voided This Disease is produced from the Liver being weak and out of tune; by reason whereof it cannot breed good blood, but turneth the Chylous Matter into thin and ferous blood, which because it is not fit to nourish, is sent by Nature into the Intestines, from whence comes this flux of the Liver. This weakness and disorder may come from any distemper: For by the excess of any of the first qualities, the native heat, and its power to make blood, is dejected. Yet this hath a doubt rising from Experience, because we see often, that great distempers of the Liver, and excess in the first qualities, do produce other diseases, and not this. And again, this flux is many times without the excess of the first qualities. That therefore the Nature of this Disease may be declared, we must say with wise Varandaeus my Master, There is something more than an ordinary distemper for producing of this disease. And it is occult or hidden, consuming the radical moisture in the Liver, which also destroyeth the Natural heat. This evil disposition, and occult distemper may come by burning and swooning Fevers by a hot distemper of the Bowels, which melteth the Oily substance by occult corruption, and corruption of Humours, by a great coldness from phlegm and Melancholy abounding, which doth oppress and corrupt the Natural heat; and it may come by outward Causes, as great draughts of cold Water, Snow, or Ice, extraordinary eating of raw Salads, Poison, and Medicines that purge too vehemently. By drinking of too much new Wine, salt, sharp, and peppered Meats, and strong things which parch the substance of the Liver. To these you may add all other Causes which by too much cooling or heating do dissolve the strength and tone or order of the Liver. Hitherto is declared a true and proper flux of the Liver which hath this sign, there are Liquid and ferous stools, like washings of flesh, from the weakness of the Liver, which cannot sanguify or make blood well, or from a malignant distemper which spoileth the Natural heat and moisture. There is also a bastard flux of the Liver, which comes of a simple distemper without any fault of the radical moisture; by which distemper the faculty is not hurt, but the work hindered, so that instead of pure blood, there comes impure and corrupt, or the good turns into evil, when in a true of the Liver there is never any good blood in the Liver. The Blood is corrupted, either by the mixture of Choler, or Melancholy, or some other impure Matter, or from its too long staying in the Liver, and the parts adjacent, by which it is made thicker or burned, or rotteth; or from the fault of the Spleen, which doth not suck away the drossy blood; and in this bastard flux, sometimes thick, sometimes black, and sometimes blood is voided mixed with Humours of divers colours. The signs of this Disease may be gathered from what hath been said. For in a true flux there appear moist stools like washings of flesh, which is not in other bloody fluxes, if in a Dysentery at any time, it is seldom, and then there is choler, phlegm, and excrements of divers colours voided: and in a Dysentery there is pain and torment of the belly, but in this none. The Signs of the Causes are known by their proper Characters: For if the weakness of the Liver come from a hot distemper, there went a burning and consuming Fever before, or there is green vomits or stools, thirst, and a Fever, foulness of Body, and want of appetite, and stinking Evacuations; but if it come from a cold cause, the stools are less stinking, neither is there thirst or consumption; the whole Body is colder and bluish. Sometimes there comes a Fever from the putrefaction of Humours, which changeth the said symptoms; but you must examine the Causes afore going, which will declare both distempers. Also in this cold distemper the Patients desire much strong Wine. A moist and dry distemper are known by the contrary effects. A moist causeth more and oftener stools, very thin; but a dry, little and thicker stools, but there is also great thirst. Lastly, The external Causes are known by the relation of the Patient, and those that are with him. A bastard flux of the Liver hath almost all signs of a Dysentery, only there is no pain of the belly, nor pieces of flesh in the stools as in a Dysentery. The Prognostic of this Disease useth to be evil and deadly; for when a principal part is very ill, by consumption of the radical moisture, whose reparation is scarce to be hoped for, we can expect for the most part nothing but destruction, especially when the Disease comes of heat. When this disease comes in Fevers, there presently follows a melting of the Body, and great putrefaction, which presently kills the party: For in malignant and pestilent Fevers the danger is increased according to the evil condition of the Cause. But when this Disease comes of a cold distemper, it useth to last longer, and turn into an incurable Dropsy. Lastly, A bastard flux of the Liver, although it be dangerous, yet is it less than a true, because it comes only from a simple distemper and evil disposition of the Humours, the tone and strength of the Liver remaining sound, and may be cured by taking away the Causes that defile the Blood▪ The Cure of this Disease is wrought by Medicines that strengthen the Liver, correct its distemper, and stay the flux. And because it comes oftenest of a hot distemper, therefore we will first speak of the Cure of that distemper, because it comes seldom of a cold Cause, and is to be cured as a Dropsy. First therefore (although Evacuations seem to be needless by reason of the greatness of the flux) you may give Rhubarb either alone, or with Myrobalans, as in the Cure of Dysentery, because it doth strengthen the Liver, and the rather if you sinned any filth in the stools: for many Patients have been cured by only one scruple of Rhubarb given many days together in Conserve of Roses. Clysters are here of little worth, because the Liver is affected; yet sometimes you may give one of chaly beat or steeled Milk, or of a gentle astringent Decoction, lest the Guts should be too much relaxed. But you may make Juleps to strengthen the Liver, and correct its distemper, thus: Take of Succory, Graminis (or Dogs Teeth) and Sorrel Roots, of each one ounce: Endive, Succory, Plantain, and Dodder, of each one handful: Sea-wormwood half a handful: red one dram and an half: the shave of Ivory and Spodium, of each two scruples: Cor●ander seeds prepared one dram: red Roses one pugil: boil them to ●●e pint and an half; dissolve in the straining Syrup of Quinces, and simple Syrup of Vinegar, of each two ounces: Make a Julep for four Doses to be taken morning and evening. Or, Take of Plantain Water four ounces: Syrup of dried Roses one ounce: Spirit of Vitriol a● much as will make it moderately sharp: make a Julep to be repeated often. He may also take of these Syrups following, often in a spoon: Take of Syrup of Myrtles, Quinces, and dried Roses, of each one ounce: the Syrup of Succ●●● simple or compound with Rhubarb, one ounce and an half: mix them. There is an excellent Syrup made of the Tincture of Roses, made in Rose Water, and with Sugar of Roses brought into a Syrup. Also this following Powder given to the quantity of half a dram or a dram once or twice in a day in a rear Egg, Broth, or other fit Liquor may be used with profit. Take of Plantain and Sorrel seeds, of each one dram: Endive, Purslane, Dodder, and Coriander seeds, of each one scruple: red Roses, and Troches of Spodium, Gum Tragacanth torrefied, of each half a dram: the inward skins of Hen's Gizzards dried, half a scruple: make a very fine Powder. Or the Lozenges made of the three , with a double quantity of Rhubarb given to two drams at a time, are good to strengthen the Liver; as also this following Opiate: Take of Conserve of Succory Roots one ounce: Conserve of old Roses half an ounce: the pulp of Currans six drams: Crocus Martis one dram: prepared Coral, shave of Ivory, and Hartshorn, of each one scruple: with the Syrup of dried Roses make an Opiate, adding half a scruple of Spirit of Vitriol, of which let him take the bigness of a Chestnut three hours before meat. You may also add the Liver of a Wolf prepared, which is a specifical proper Medicine according to divers Authors. Raisins of the Sun, because they are good for the Liver, are commended in this disease, therefore you may eat them in great plenty with their stones: which that they may be better taken, may be beaten first in a Marble Mortar. Or make a Rob or Syrup of Raisins, boiling them in red Wine, if it be not too hot, and then straining out the Juice, and boiling it again till it is thick: which you may use alone, or in some of an Opiate, with these following: Take of Currans half a pound, boil them to the thickness of a Pultis in old Wine; pass them through a sieve, and mix with the straining, candied Citron peels half an ounce: the powder of the three , and Diamargariton frigid, of each one dram: Coral prepared, and red Roses of each four scruples: the Liver of a Wolf prepared three drams: make an Opiate. The Syrup of Coral is very excellent to strengthen the Liver, and stay the flux thereof: but the Tincture thereof is far better: As also the Extract or Magistery given in Plantain Water. The Juice of young Nettle tops given either by itself to two ounces, or with Water and Vinegar every morning for three days together, stops the flux, and purifieth the corrupt blood. But because in this Disease the Body is much consumed, a restoring distilled Water that will also stay a flux, either must be given often by itself, or with all other Drinks. Take a fat Capon▪ and a Partridge, and pulling of the Feathers and the Guts ou●▪ ●ill their Bellies with Succory, Agrimony, and Snails, of each one handful: Conserve of Ro●es three ounces: Plantain and Coriander seeds prepared, of each two drams: Citron Myrobalans one dram: Blood-wort half a handful: the Troches of Amber and of Spodium, of each four scruples: the powder of the Electuary de Gemmis (or precious Stones) the three , and D●amargariton frigid, of each one dram: Sprinkle them all with astringent Wine, and putting them into the bellies of the Fowls: boil them in a close vessel in four pints of Water till half be consumed: then put them all into a glass Limbeck with three ounces of good Wine; distil them in Balneo Mariae for the use aforesaid. For Drink, let the Patient take the Tincture of Roses, or the Decoction of Succory, and Dogs-tooth, with Syrup of Quinces, and some few drops of Spirit of Vitriol. Things made of Barley, Almonds, and Rice, are best in his Meats. Outwardly to his Belly apply those things which were prescribed in the Cure of Dysentery, with some things for the Liver, as Wormwood, Roses, all the , Spodium or burnt Ivory, etc. Which anointings of the Belly must reach to the region of the Liver. You may all o apply the following Epitheme to the Liver: Take of Endive and Succory, of each one handful: Dodder, and both sorts of Wormwood, of each half a handful: red Roses one pugil: red one dram and an half: Spodium two scruples: boil them to one pint and an half, and dissolve in the straining two ounces of Rose Vinegar: boil them again gently, and make an Epitheme. Let the same part be anointed with the following Ointment: Take of Cerat of Sanders two ounces: Oil of Quinces▪ and of Wormwood, of each three drams. Mix them for a Lineament. Lastly, If the Patient be troubled for want of sleep, as is usual, because this kind of flux is most in the night, you must use Narcoticks, such as were propounded for the former fluxes. Chap. 9 Of the Worms. ALthough Worms breed in divers parts of the Body, yet because they are more usual in the Gut than in other parts, therefore we will speak only of those. By some it is questioned, to what kind of Disease that is preternatural the Worms are to be referred? But we can take away all occasion of doubting, by saying that after a divers consideration they may refer to all kinds of Diseases; for as they prick and pull the Guts, or obstruct them, and produce other diseases, they may be said to be causes of diseases. But as they are substances added to those which ought naturally to be contained in the Guts, they are reckoned by Galen in the number of those Diseases which are in the number increased wholly against Nature, as the stone also. And lastly, as they are sent out preternaturally by the belly, or the mouth, they are to be referred to the fault in Excretion, or sending forth. Galen in his Comment upon the Aphorisms, Aph. 26. Sect. 3. propounds three kinds of Worms: The round Worms, which are often bred in the Guts, and get often up into the Stomach; the Ascarides, or little Worms like small thirds, which use to lie in the inferior part of the thick Intestines, and over against the Sphincter Muscle; and the broad Worms, called Fascia, because they are long and broad like children's Swathing bands. This kind is more rare to be seen than the rest, and a Physician shall scarce see them in his practice twice or thrice in a year, yet there are great Controversies among Authors about them; some say it is one Worm only; some that it is made of many united, which they call Cucurbitinos, or Gourd Worms, and say that they are parts of the broad Worm; others make a fourth kind, containing the Gourd Worms; but we do not intent here to show their Reasons and several Experiences they have so much boasted of: the curious Reader may search for his better satisfaction, Rondoletius, Platerus, Sennertus, and many others. Moreover, There is a great Controversy of the Causes of Worms: some say they come of putrid heat, others from the Natural, others say that both concur for the production of them. The first say, That all Infects or Vermine come from corruption, according to Aristotle. The second say, That putriu heat is strong, ●iery, and destructive, and therefore is not fit to produce a live body. The third ●ort, to reconcile the former, say that the Matter is disposed by the putrid heat to generate Worms and the Natural heat doth turn it so prepared into worms by way of Concoction. But this Reconciliation will not hold, because according to the axiom in Physics it is the property of the same thing to dispose the matter and bring in the form, and therefore the preparation of the matter, and the introduction of the form, aught to be from the same agent; besides, Worms breed in Carcases where there is no native heat, we may say that the heat which is putrid, in respect of the matter putrifying, is native in respect of the Worms, because the natural and putredinal heat differ but in degree, but divers degrees of heat are required for the generation of divers Creatures; and therefore heat which is putrid in respect of us may be natural in respect of another Creature: So the heat which is natural to a Lion, would cause Fevers in us; and by consequence is putrefactive: Many fly to the heat of the Sun which is the universal Cause of all generation; but we must always acknowledge a particular Cause from whence the effect is immediately produced, by the Concurrence and Co-operation of the universal Cause: but here is a greater difficulty, because it is a common axiom or theorem, That nothing can beget a thing more Noble than itself; and therefore heat is not the chief agent in breeding of Worms which are in the predicament of substance, and heat is but an accident; and whatsoever is spoken of the Sun, the form of a Worm is more Noble than the form of the Sun, because it is the form of a living Creature; and that of the Sun is Forma mixta, or the form of a mixed body only: This Doubt brings us into that large and weighty Disputation of an Aequivocal Generation, in the Circuit whereof very excellent Philosophers have Writ whole Volumes, to which we send our Reade●, and chief to Fortunius Licetus his Book of the Spontaneous Generation of Living Creatures: Let it suffice in this place to say that many of their Opinions are brought to this, They believe Seeds of many things to be in divers Substances, which according to their divers Change, come to light; even as the matter is more or less disposed by putrefaction, or other alteration to receive this or that form: and the Seed which is more agreeable to that Disposition is brought into act, and bringeth into the matter a form proper to its self. This Opinion doth not much differ from the old Philosophy, which teacheth, That Forms proceed from the power in the Matter: but they think it safer to hid the Seeds of things in their Matter, which are truly efficient, than to acknowledge only the power of the Matter, which hath no power to be an efficient, for we must find out some efficient with the power in the ●atter which may raise a Form from it, or rather introduce, or bring a Form into it. The material Cause of Worms is commonly sweet Phlegm which groweth putrid, by which it gets a Disposition to be turned into Worms; but we think it no ways necessary, that food which will breed Worms, should be first turned into Phlegm: For Worms may breed of their immediately being putrified, as we see in Flesh, ●hee●e, Chestnuts, Apples, Pears, Cherries, and other Fruits which bring forth Worms by being putrified: So it is in our bodies, especially in Children which are given to Glutt●ny and eat the aforesaid things, and take new commonly before the old is Concocted. Hence is it that they putrify and breed Worms. But let young Physicians observe this, It is daily observed in Practice, That Sucking Children, that eat meat are most troubled with Worms, and because their Stomaches are not able to digest it, therefore it is corruption and turned into Worms; moreover, Milk is quickly digested in the Stomach, and presently sent to the Guts; and if it hath meat mixed with it which could not so suddenly be digested, it will be sent into the intestines with the Milk, and therefore corrupt and breed Worms. And observe, That Worms never breed of Milk only, so that as often as you consider the Disease of an Infant, take notice, Whether it have the Worms or no, which Women always proclaim and say all their Diseases came from thence, as they ascribe all the Diseases of Women to the Mother; and the Physician may certainly pronounce that the ●hild hath not the Worms, if it live only upon Milk, and have eat neither meat nor Broth: Galen ●● his come. aph. 26. sect. 3. taught this, saying, That in Children that Suck milk only no Worms do breed; the Reason whereof is not plain. Many say, That in sucking Children the Heat is not strong enough to breed Worms. And this is confirmed by Galen in the place cited; where he saith, That strong Heat is required for the Generation of Worms; and thence he saith it comes that Worms are more in Youth, than Infancy; which also Hypocrates teacheth in the Aphorism aforesaid; and which he seems to gainsay in lib. 4. de morbis, where he saith, That Worms breed in Children before they are born; but these have not stronger heat than they that suck: And Hypocrates gives another Reason why Children in the Womb should have Worms, because their Excrements are retained; but when they are born they do not breed Worms, because than their Excrements are not retained. But this will not satisfy, because oftentimes in Children that Suck the Excrements are retained, and yet they have no Worms while they live only upon milk; therefore since the aforesaid Reasons do not content solid wits, we expect the new Thoughts of Wise men touching this matter; and in the mean while, we will briefly declare our Opinion, and leave to the Judgement of the Learned: We say then, That Milk putrifying doth grow sour, and then is unfit for to breed Worms, but rather hindereth them; for it is known that all sour things do kill Worms: Hence it is that the Juice of Lemons is so ordinarily given against them, and in ordinary drink a little Spirit of Vitriol to sharpen it doth wonders. It is Commonly thought, That among the Material Causes of Worms, Sweet things are the chief; wh●ch is to be doubted or, because it is confirmed by a Common Axiom, That Sweet things do easily turn into Choler and Choler by its bitterness doth kill Worms: but we can easily answer this doubt thus; In Choleric Bodies, and such as are sharp with heat, sweet things do easily breed Choler, because by over Concoction, they grow bitter, as we see daily in artificial Concoction: but in other Constitutions that are not Choleric, sweet things do not breed Choler, but rather phlegm, when they are sent too soon from the Stomach into the Guts, and so being crude, and only half concocted, they putrify, and become a fit Matter to breed Worms. But there is yet a difficulty concerning Sugar and Honey, which since they have a substance not subject to Putrefaction, but rather that doth preserve other things from it, cannot breed Worms. This Reason convincing, we say that Sugar and Honey will not breed Worms, because their substance is incorruptible; but being once bred, they do feed and maintain them, because the Worms loving sweet things, do stir themselves at the approach of Honey and Sugar, and get into the Stomach, where they grow with speed; from whence those Symptoms do arise which are proper to Worms. The signs of Worms in the Guts are divers; not all in all people alike. The usual and most ordinary signs, A●●●inking Breath somewhat sour, as the women call it, and stools like Cow dung, of a grey colour like Potter's Earth dissolved. Other signs are less usual, as a continual Fever, which is often in a day, more violent from the motion of the Worms, with heaviness, cold sweat sometimes, and fainting, loathing, vomiting, and unquenchable thirst. The Pulse is unequal, the Cheeks are by turns red or blue, the Eyes shine, the Nose it●heth, the Teeth gnash, and sometimes chatter, there is a small dry Cough, much Spittle: sometimes there is heaviness of head, and sleepiness; sometimes doting, and Epileptic Convulsions. There is often a pain in the Belly, by gnawing, sometimes by inflammation and distension or stretching forth like men in dropsies: sometimes there is starting in the sleep, and some tremble, and rise up, and fall asleep again; sometimes all the body pineth, and the Patient hath a Dog's Appetite, insatiable, which is most usual in the flat worms, which eat up all the Food. Moreover, If Gourd Worms, called Cucurbitini, be voided, they are a sign of flat. The Ascarides are known by the itching of the Anus, or Fundament, and the Excrements are many times filled with them. For a Conclusion, The consuming, putrefaction, and eating away of the Gums, is to be reckoned among the signs of the Worms, which is confirmed by this following Observation: A certain Boy was a long time troubled with eating away of his Gums, many Medicines both internally and externally were applied, and all in vain; at length he died:- The body being opened, there were found so many Worms, that in some places the bowels were eaten through, and many were found in the empty places of his Belly. As for the Prognostic: Many Worms are worse than few, great than little. Many times they are dangerous, and bring great Diseases; as a strong Fever by fits, swooning, speechlessness, doting, epilepsy, colic, and dogs appetite. In the beginning of a disease, it is evil for Worms to come forth, either alive or dead, especially if they come forth alone, and without dung; for when they are alive, and come forth, they signify great crudity, or want of nourishment; but dead, they signify great putrefaction, by which they are killed. Worms in the declining of a Disease, coming forth with the Excrements, signify Health, if concoction appear; for it appears then, that Nature ruleth and mastereth the Excrements. The Cure of the Worms is by driving them out, because they are wholly against Nature. And this is done by purging Medicines, which kill Worms, and evacuate the Matter that breedeth them. Rhubarb is the best, which you may give in a Flux or Fever. But you must first give things that kill them, or at least that drive them to the inferior Intestines by things taken at the Mouth, or those things that draw them down by Clysters. The usual forms whereof, are these: Take of Dogs-tooth, and Purslane Water, of each one ounce and an half: Syrup of Lemmons one ounce: Confectio de Hyacintho one dram: the Powder against Worms, one scruple. Make a Potion; give it presently, and then this Clyster: Take of whole Barley, Bran, and red Roses, of each one pugil: Liquoris and Raisins, scraped and stoned, of each half an ounce: Boyl them to half a pint, or three quarters of a pint: Dissolve in it strained, red Sugar one ounce, and one Yolk of an Egg. Make a Clyster. You may add Cassia, or Diacatholicon, if you desire it stronger. After those Medicines have been given once or twice, give this Potion: Take of Rhubarb one dram: yellow half a scruple: infuse them in Water of Dogs-tooth or Purslain, two or three ounces: strain them, and dissolve in it, the powder of Rhubarb, and powder against the Worms, of each one scruple: Syrup of Roses one ounce: Mix them for a Potion. Or, Take of the powder of Rhubarb and Coralline, of each half a dram, more or less, according to the age: Dogs-tooth Water two ounces: Syrup of Violets one ounce. Make a Potion. If the Fever be not great, two drams of Hiera Picra more or less, are to be mixed in a Potion: for by its bitterness it killeth and expeileth Worms excellently. If these things will not Cure them, use these following: Take of Dogs-tooth, and Sorrel Water, of each one ounce: Endive, Succory, Sorrel, and Purslane, of each one handful: the tops of St. Johns-wort, Scordium (or Water Germander) and Centaury the less, of each one pugi●● Coralline three drams: boil them to a pint; dissolve in the straining three ounces of Syrup of Lemmons. Make a Julep for three or four Doses, to be taken twice in a day. Take of the Ointment de Artanita, or (Soubread) three ounces: Quicksilver one dram: mix them, and anoint the whole belly. Then purge again, and often, till the body be cleansed. And you may add to the former Decoction, Senna, Agarick, Rhubarb, etc. and give it but once in a day. Rondoletius highly commends the Electuary Diacarthamum, as an excellent Remedy to expel Worms, and to purge Phlegm and corrupted Chyle, of which worms breed and are nourished; as also he commends the infusion of Agarick in Oxymel. Which Remedies are proper, if there be no Fever. But because often times the diseases of the worms in some Children cannot be cured without much labour and time, there are many Remedies found out by Authors, both internal and external. Among the Internal, first we will treat of Powders, whereof there are divers Forms in Authors. The chief are these following; the dose whereof, is from one scruple to a dram, according to the age of the Patient in some convenient Liquor. Take of Wormseed half an ounce, Coralline three drams: Hartshorn two drams. Make a Powder. Or, Take of Wormseeds, Coralline, and Hartshorn burnt, of each equal parts. Or, Take of Hiera simplex two drams: Wormseed, Scordium, the lesser Centaury, and Coralline, of each one dram. Make a Powder. Take of Rhubarb and Agarick, of each one dram: Troches of Alhandal one scruple: Diagridium half a scruple: Coralline and Hartshorn, of each half an ounce: Myrrh, Zedoary, and tansy flowers, of each one scruple: Salt of Wormwood and Tartar, of each half a dram. Make a fine Powder. In the use of these Powders, observe that they which are made of hot things, are to be given seldom, and in small quantities to hot Natures, and in Fevers. Women use to give to Children troubled with the worms, Wormseed made up with Sugar, or mixed with Honey; which is an excellent Medicine, because the worms desiring sweet things, take in the Honey, and withal the Wormseed, whereby they are destroyed. But because Wormseed is very hot, it may be made temperate by infusing it two hours in Vinegar, and after mixing it with boiled Honey into the form of an Opiate, which Amatus Lusitanus doth praise as a principal Medicine against Worms. Hartshorn is commended by Forestus, given with Raisins, or otherwise, and some have been cured with that alone. But it is chief good for them who have the worms, and a flux withal. In which diseases coming together, he commends also the Juice of Plantain, and the Decoction of Knotgrass given to drink. To which may be added Topics applied to the Belly, partly astringent, and partly having virtue to kill worms. Women do use common Oil given with Wine, for that Oil stops the pores of the Worms, and so choke them for want of breath, and Wine kills them by its sharpness. But when there is a Fever, it is better to give Oil with the Juice of Lemons or Pomegranates; or which is better, Oil of bitter Almonds with the said Juices, or Orange flower water. Stocherus in his Empirical Medicines, commends the Oil that is taken out of a dried Hazel stick, if it be given but a drop or two at a time to a child; or to a youth, three or four in a crumb of Bread; For (saith he) it doth immediately kill them, and cast them forth by stool; also by but touching of Worms or Lice out of the Body, it killeth them. The best Authors will have this Oil of Hazel to be the Oleum Heraclinum, by which Martin Ruland did cure Children of the Worms in a moment, by anointing only their Lips and Navils, as you may see in his Centuries. But we have found by Experience that the Oil of Juniper given but a drop at a time in Broth, to be excellent for children so troubled, if they have not a Fever. But Quicksilver would exceed all, if we durst give it inwardly; which great Doctors say may be done. Some of whom I will mention, so that they who please to try it, may have Authority for it. Mathiolus in his fourth Epistle to Stephanus Laureus, the Emperor's Physician, saith, Because Quicksilver (as Dioscorides saith) doth not otherwise kill, but by tearing the Guts with its great weight: we fear not that it will do it in a small quantity, especially because its weight and roundness will easily carry it through the Body. Therefore let us not wonder why Brassavolus that famous Physician of our Age, hath written that he gave Quicksilver to Children without any inconvenience. And also a padua Physician used it with good success, but never would tell us the way of giving and preparing of it. And I, though I never gave it, have seen Midwives give a scruple, or half a dram to Women that had hard labour, without inconvenience, and always with good success. Thus Mathiolus. Fallopius in his Tractate of the French Pox, Cap. 76. If (saith he) Quicksilver be drunk down, it doth not so much as when it is used with an Ointment; I have seen Women to cause Abortion take a pound thereof without hurt. I give it to Children for the Worms, and it doth bring no symptom, but only kill the Worms. Platerus in the Cure of the Worms, saith the same; Give a drop or two, or half a scruple of Quicksilver, and it kills the Worms, or makes them crawl out of the Body, and it may be done without hurt, as we shown elsewhere. Fabricius Hildanus in his 71. Observation, Cent. 2. saith, of a woman troubled with the Worms, sent to him by Gilbert Saracenus, thus: Having reckoned up many Medicines to these (saith he) I added the excellent Medicine of Quicksilver, a dram and an half strained through Leather, and yet she was not freed of them. John Baptista Zappata, in his Book of women's Secrets, Chap. 5. tells many famous Stories of the Cure of Worms by Quicksilver, when Aloes and Wormwood would not do it. He shows two ways of giving it. The first is this: Take of Quicksilver one dram, but a scruple or two for little Children: Benjamin half a scruple: four or five drops of Aqua vitae, mix them in a glass mortar with a glass pestle; then put to it a little Conserve of Roses or Violets for a Bolus, which let the Patient take in the morning by itself, or with a little Bread. The second way is this: Take a little course Sugar, and three or four drops of Spring Water: mix them in a glass mortar till they are like Honey: then put to it as much Quicksilver as was aforesaid: mix them together, with six or seven drops of Oil of sweet Almonds, which will keep the Quicksilver from coming again to its body: And with a little Conserve of Roses, make a Bolus. Baricellus in his Book called the Genial Garden, saith thus: Quicksilver, which some account poison, is safely given against worms, and it is accounted so certain a Medicine in Spain, that the Women there give three grains thereof to children which pewk up their milk. I cured a Widow which vomited nine days together by reason of Worms, and scarce eat in three days, neither could retain any thing she took; to whom I gave two scruples of Quicksilver, with a little Conserve of Quinces, and she voided downwards above an hundred Worms, and was cured the same day, and went about her business, to the great admiration of her Parents, being formerly weak and lean. I have given it also to others, and with good success always; and I keep continually at home, Quicksilver infused Water, which Water I give to children for Worms; nor did I ever receive any discredit thereby. Mathiolus used the same, Horatus Angenius, and many other famous men, who all do extol the benefit of this Medicine. You may give it to Children in substance, one scruple, and to youths two scruples or a dram. It is mortified and corrected with red Sugar, in a glass, mortar, wherein it must be so long stirred that it be invisible, and lest it should return to its former condition, you may add thereto two of the Oil of sweet Almonds. Give it with Sugar of Roses Violets, or Quinces, fasting. Thus Baricellus. Sanctorius in m. vitand. error. lib. 5. cap. 11. saith, That except we use strong Medicines to kill worms, as washed aloes, or a scruple of Quicksilver, with a little Turpentine and Aloes made into a small Pill, we do nothing. They who fear to use Quicksilver crude, may give it prepared, as Mercurius dulcis, not only thrice, but six times calcined (for by often preparation the malignity of it is abated) with some few grains of Diagridium, to carry it sooner out of the Body, and expel both the Worms, and the Matter of which they breed. You must enlarge or diminish the quantity, according to the Age of the Patient. As for example, to a Boy of eight or ten years old, it may be thus given: Take of Mercurius dulcis twelve grains: Diagridium six grains: Make Powder to be given with a roasted Apple and Sugar, or the like. For ordinary drink, the Water made of Quicksilver, which was formerly mentioned, is very profitable, or that in which Quicksilver hath been shaken in a glass half full, for the space of one hour. Also Water wherein melted Tin hath been often quenched. But if you will rather use Quick silver, it is better to let the Water boil with it, and so it will be stronger. Also Spring Water made sharp with some few drops of the Spirit of Virriol or Sulphur, is of no less force. For sharp things do properly kill Worms, and the Water is to be made more or less sharp according to the age of the Party. The Decoction of Dog-tooth with Coriander seed prepared, is used vulgarly for ordinary drink, mixed with Syrup of Lemons or of pomegranates; Or you may put Sugar and a little Vinegar in the Decoction. While the aforesaid Remedies are used, you must give Clysters often the whole time of the Disease, first made of sweet things to attract and draw down the Worms, as at first we said: which may be made not only of a Decoction of Liquoris, Raisins, and Figs, but also of Chicken-broth and Sugar, and Honey of Roses, or of Milk if there be no Fever, otherwise it will be easily Corrupted. But if we conjecture that the Worms are already in the thick Guts, because than they can scarcely ascend into thin Guts you may give Clysters to kill them, made thus: Take of Dog-Tooth Roots, one ounce: Beets, Mallows Pot Mercury, and Purslain, of each half an handful: Coralline one pugil: Coriander seeds prepared. and Wormseed, of each two drams: boil them in a Quart of Water, in one Pint of the straining dissolve two ounces of Oil of Roses, Cassia newly drawn, six drams: Hiera Picra, two drams: Honey of Violets one ounce: make a Clyster. If you will have stronger, Take of Gentian Roots one ounce: common Wormwood and Southernwood, of each one handful: the lesser Centaury half an handful: Lupins half an ounce: Wormseed two drams: make a Decoction: In as much of the straining as you think fit, dissolve the Oil of Wormwood one ounce and an half: Salt one dram and an half: ●●ake a Clyster which must be repeated, and in the last that the Worms may be borough forth after they are killed, dissolve of Benedicta Laxativa, and Hiera Picra, of each three dram●, or half an ounce. If there be a Flux of the Belly, give this following Clyster: Take of Tormen●l Roots, and of Round Buth-wort, of each one ounce and and an half: Pomegranate Peels and Myrcha ans, of each one ounce: Pease a small handful: Myrtle berries one dram: Red Roses one pugil: make a Decoction and dissolve in the straining of Oil of Mints or of Wormwood, one ounce: make a Cryster. Outwardly may divers Topics be applied, not only those that were mentioned, but these following. Take of Gentian Roots one ounce: Birth-wort Roots six drams: Orange Peels one ounce: Coloquintida one dram: Hartshorn two drams: Saffron half a dram: make a Powder, which mix with Oil of Wormwood, or Bitter Almonds, and with a little Wax make an Unguent. Also common Oil boiled with the Pulp of Coloquintida is powerful. Also Oil of Wormwood, and St. Johns-wort, must be applied to the whole Belly, morning and evening. Take of Oil of Wormwood, Mints, and bitter Almonds, of each half an ounce: the Juice of Wormwood and Rue, of each two ounces: Tormentil, white Dittany, and Zedoary, of each half a dram: Ox Gall three drams: Aloes one scruple: Powder them, and with a little Wax make an ointment: Or, Take of Coloquintida six drams: Powder it, and with an Ox Gall lay it to the Navel, by which both the Worms are killed, and the belly kept lose. Take of Murrh seven drams: Mast ch eight ounces: Aloes eighteen ounces: common Salt one pound: bruise them all and Distil them by a Retort with a gentle Fire, and great diligence; first you will have a Water, than an Oil; with which if you anoint the Navel of a Child, all putrefaction will be cleansed which is in the Mysentery. Also you may make a Cataplasm thus, Take of the meal of Lupins two ounces: Myrrh and Aloes, of each two drams: Ox Gall as much as is sitting: Oil of Wormwood two ounces: make a Cataplasm for the Belly. If a Looseness hath Continued long, apply this following Cataplasm: Take of Oil of Quinces and Wormwood, of each one ounce: the Juice of Purslain extracted with Vinegar, one ounce and an half: Peaseflowr an ounce: Lupine flower half an ounce: Red Coral and Hartshorn, of each three drams: mix them together with as much Turpentine as will make a Cataplasm. A Cataplasm also made of only Hiera Picra, is most powerful. Sometimes you may use Fomentations, when there is a great stretching and puffing up of the Belly. Made thus: Take of Wormwood, Southernwood, tansy, Scordium, Mallows, and Violets, of each one handful: beaten Lupins half an ounce: Centaury one pugil: boil them in Vinegar and Water, and Foment the whole Belly hot therewith very often. Finally, For Flat Worms and Ascarides, or Ars-Worms, Clysters made of bitter things are good; to which you may add the Purging things aforesaid, while the filth of which they breed be purged away. Chap. 10. Of the Immoderate Flux of the Hoemorrhoids. ALthough the moderate Flux of the Hoemorrhoids be healthful, and preserveth a man from many and grievous Diseases, as Hypocrates taught in epidemii, and in his Aphorisms, as from a Pleurisy, Peripneumonia, or Inflammation of the Lungs; nephritis, or the Stone in the Kidneys; Madness, Melancholy, and innumerable other: Yet the immoderate Flux is most dangerous, and brings other pernicious Diseases, as Weakness of the whole Body, Coolness of the Bowels, and especially of the Liver; an Atrophy or want of nourishment, an evil Habit, and Dropsy by the loss of Natural Heat, by spending too much Blood which is the treasure of Life, and the cheerisher of the whole Body. And this Immoderate Flux hath the same Causes which use to provoke other sorts of Bleeding: namely, Blood offending in Quantity or Quality; when it offendeth in Quantity, and is brought in great plenty to the Haemorrhoid Veins, it doth violently dilate them and open their Orifices, by the strength of the Expulsive Faculty: but sometimes too much Blood coming thither, doth oppress the Retentive Faculty. Hence it comes that she being Defective in her duty, there is a great Flux which must be restrained by art. But while Blood off ends in Quality, as sharpness, it stirs up the Expulsive Faculty, to cast forth by those Veins not only the unprofitable but profitable Blood, the Blood Causing this Flux is made sharper by a mixture of Choler, or sharp Water. This immoderate Flux is known by the loss of Strength, and a Sense of Weakness coming from a long Flux and loss of Blood: As also from an evil yellowish colour of the whole Body, as if it were the Jaundice. If the Disease come from Quantity of Blood, there went before Causes of increase of Blood, and the Patient bears it well in the beginning, and is more cheerful; but afterwards the Flux continuing, he grows weak, and dejected. But if it comes from sharpness and thinness of the Blood, there went before Causes that breed cholet or sharp Water, the body is of a Choleric Constitution and burnt: the blood floweth violently, and it is very red, shining, and as it were flaming, when otherwise offending only in Quantity it useth to be black and Melancholy. The Prognostic is gathered easily from what hath been said, when we reckon up those grievous Diseases which come from this. For the Cure, The Blood must be staunched, or moderated at least, which must be done by Revulsives, Derivatives, Thickners, and Astringents. And first, Phlebotomy is a Revulsive Remedy in every Flux of blood, therefore in the Haemorrhoids thus flowing, draw blood from the Arm; and more plentifully if there be signs of fullness and much hath not been lost, otherwise take but little, and at divers times. Also Frictions and Ligatures of the Superior parts do revel the blood, as also Cupping Glasses applied to the Shoulders, Breasts, and Hypochondria, which for the better Revulsion may have Scarification in the Shoulders, but they must be often applied to the places . Also a Gentle Purge doth derive the Choleric Humours which make the blood so violent in the Guts; and this must be made of Purging things that have an Astringent Quality, as Rhubarb, Myrobalans, and Tamarinds, such as were prescribed against Vomiting of Blood: And Mercurialis teacheth, That Tamarinds have an especial power to stop this kind of bleeding, whether they be taken boiled or in substance. Also sharp French Pruens which are somewhat like Tamarinds being often eaten afore meat, are good: and their use is convenient to keep the body lose, and if these will not suffice you may add other things which were propounded for the Cure of a Belly bound, because by use of Astringents the belly will be bound, and by straining to discharge the Excrements that are hard, the Veins will be more open and bleed more. Afterwards you must use those things that thicken the Blood, and astringe the lose Veins, such as were prescribed for vomiting and spitting of blood, in form of a Julep Powder, Opiate, and the rest; coming to Narcoticks, as is there said, if great need require. And besides those Remedies, the Pills of Bdellium are much commended by Authors; which Rondeletius rejecteth, because the Apothecaries have not true Bdellium, and use Myrrh instead thereof, which causeth bleeding. But Solenander opposeth him, saying by Experience, that he hath found these Pills make of ordinary Bdellium, so clearly to produce their effect, that he will not doubt of the composition. Except some should think that the Myrrh is made dull by drying things, and astringents that are mixed therewith. To this we may add what Bauderon in his Dispensatory, and other Modern Writers say, That we have true Bdellium brought from India at this day, which is hard to be distinguished from Myrrh. The use of these Pills, is after this manner: Take of Pills of Bdellium one dram: the Troches of Amber, and Terra sigillata, of each one scruple▪ With the Mucilage of Quince seeds extracted with Rose Water. Make a mass of Pills, of which let him take a scruple twice a day, before Dinner and Supper. At the same time you must use Topics made after divers forms. A Fomentation of Mullein boiled in Smith's Water, or astringent Wine, is best; for that Plant is proper for the pain and bleeding of the Hemorrhoids. But you must diligently observe in the use of Fomentations, that they be either cold, or moderately hot. A more compound Decoction may be made thus: Take of Snakeweed Roots half a pound: Plantain, Mullein, Bramble and Oak buds, of each two handfuls and an half: Sumach berries, Pomegranate flowers, green Galls, and Pomegranate peels, of each one handful: Myrtles half a dram: red Roses two pugils: Alum one ounce: boil these in three parts of Forge water, and one of old red Wine, for a Fomentation. Martin Ruland commends a Fomentation made of two bags, applied hot by times, made of red cloth, and filled with beaten Acorns and Oak Leaves, and boiled long in strong Vinegar. Of the Decoction before mentioned, with a greater quantity of every Simple, you may make a Bath to sit in, which the ●ick man must use somewhat cold, as is said of a Fomentation. Vnguentum Comitissae is very good, if you anoint the Back and Hemorrhoids therewith: or you may make for the present this following: Take of Oil of Roses, Olives, and Myrtles, of each two ounces: the Juice of Plantain and Mullein, of each one ounce and an half: red Wine Vinegar one ounce: boil them till the juices are consumed: then add of Bowl, Sanguis Draconis, Frankincense, and dross of Iron finely powdered, of each one dram: Wax as much as will make an Unguent. Rondoletius approves rather of those Ointments which are made without Oil, because they are more astringent▪ and they are thus made: Take of the Juice of Plantain, Shepheards-purse, and Mullein, of each two ounces: the simple Syrup of Vinegar three ounces: boil them gently; then add of Bowl, Terra sigillata, and Snakeweed Roots powdered, of each one dram and an half: Sanguis Draconis one ounce: Ceruse washed two scruples: mix them into the form of a Lineament. If the Hemorrhoids be ulcerated, you may make this following: Take of Oil of Roses two ounces: Frankincense and Aloes, of each one dram: Sarcocol, Sanguis Draconis, and Bole, of each half a dram: Spodium, and Carabe, of each one scruple: white Starch three drams: Juice of Plantain one ounce. Make an Unguent. The Fat of an Eel, which comes out when it is roasted, put to the Ointments, makes them better by a proper Virtue. Also you may with profit apply a Cataplasm to the said parts, made thus: Take of Bowl, Aloes, Mastic, Frankincense, and Sanguis Draconis, of each half an ounce: the stones of Myrobalans, and Galls, of each one dram: mix them with the white of an Egg, and Juice of Plantain. Make a Cataplasm. Or the Hairs of an Hare burnt, and Spiders webs mixed with the white of an Egg, will make a Cataplasm, which you must apply to the Vein where it is open, if it appears, or put it gently in. Suppositories are good for this use, because they are put up into the part. The Form of them is, Take of Colophony, and Frankincense, of each three drams. Bole half an ounce: Ceruse and Lead, of each one dram: Acacia half a dram: powder them finely, and make them into a Suppository with Goats Suet. Make Injections into the part by a Syringe of the Juice of Plantain, and other things mentioned for a Fomentation. The blood of any Creature newly drawn, and injected whi●e it is hot, doth wonderfully restrain any flux of blood from the belly. The Lungs of a Sheep being hot and bloody, being sat upon, have great power to stop this Blood. Also Fumigations made of the Decoctions of the Fomentations aforesaid, are good for the same end. To which you may add those things mentioned in a Dysentery. As also this following: Take of Frankincense, Aloes, Mastic, red Roses, Myrtles, and Wormwood, of each half a dram: Troches of Carabe one dram & Make a grass Powder to be cast upon the hot coals; and let the fume thereof be received in a large funnel by a hollow chair, tying a wooden or silver pipe to the narrow hole, and putting it into the Fundament. A Fumigation made of Mullein is the best of all. If you can apply Remedies to the Veins that bleed, it is best therefore that they may appear And therefore let the Patient be laid upon a Table, and strain as if he were at stool till they appear; using an Instrument if there be need. And then apply the afore mentioned Cataplasm of the Hair of an Hare and Spider's Webs, or other very drying Remedies; Bole, Alum, or burnt Vitriol. Also to touch the Vein with Oil of Vitriol, is good; or in extreme danger with Aqua fortis. Which things, if they prevail not, Hypocrates in his Book of Diet, in acute Diseases, and of the Hemorrhoids, shows the way of tying, cutting, and burning of them; which operation is out of fashion now, as being most painful and perilous. Although Massaria saith that he once saw it, the story whereof will be profitable to be related; for by that you may learn the way of working, and the event. The History is this: Frederick Corsicus of Vincentia, first had the pain, than the immoderate flux of the Hemorrboids: And when he had in vain tried many things, went to Milan; where the Physicians by a common consent, concluded that the blood must be stopped. But when many means inwardly and outwardly, were in vain used, in the end finding no Remedy, they concluded to try this Manual Operation: But having no fit Chirurgeon, they sent for a Neapolitan, who professed this Art, and he cut, tied, and burned the Hemorrhoids of Fabricius thus: First he bond him so that he could no ways move; then he separates the Hemorrhoids from the Intestine; then with a Needle, he passeth throw, and seweth them, and toeth all about strongly: then cutting off the part of the Vein which is above the sewing, he burns it with a hot Iron. It was a painful Operation from the Ligature, Section, and Burning: So that Frederick had a Fever, and great pain. But the Chirurgeon gave him a few Medicines by which he was freed both from fever and pain in a few days to the admiration of all men there, and recovered from bleeding. But it is not to be omitted, how he being too confident, and neglecting bleeding and purging, which he stood after in need of, keeping no orderly diet; the next year he was taken with a pestilent Fever, and died. From whence we may observe the Precept of Hypocrates, Aph. 12. Sect. 6. That one Hemorrhoid must be kept open. Except the Patient, as Aetius observeth, had rather prevent the danger that comes by stopping of it by a good diet, exercise, bleeding, and purging. But in an ordinary Cure by Medicines, you must consider the Liver and Spleen, because the Meseraick Veins are inserted into them, especially if they be hot or weak. And therefore not unprofitably do we apply Epithems, or cooling and strengthening Ointments, such as we prescribed in the flux of the Liver, and shall more at large be laid down in the hot distemper, and inflammation of those parts. Sometimes the Obstruction of the Bowels, and Meseraick Veins do cause this Disease; which are to be taken away for the Cure of the Patient. And we have sometimes done it with Pills of Steel, which are prescribed in the Obstruction of the Liver. The whole time of Cure, let the Patient drink ordinarily Iron Water, or the Decoction of Yarrow. At the same time, above all things you must rectify the blood, which is the chief cause of this flux. Therefore if it be sharp and Choleric, it is often to be corrected with the infusion of Rhubarb and Tamarinds. If it be hot and thin, with thickening and cooling Medicines: if watery, with dryers: if much, with a slender Diet. For it is vain to think of stopping of the blood, except the original of the evil be first taken away. Which Solenander observed, Cons. 22. Sect. 4. in this following History. I remember (saith he) that I had one Ann, a Duke's Daughter, of a great flux of the Hemorrhoids; and because she was far spent, I took much pains to stop the flux. But when I perceived that the first day after they were stopped, she began to swell about the Heart. Being sent for again, the seventh day I opened the Veins again; nor could I safely stop them before I had given gentle Evacutions, and altering and strengthening things for the Liver. After you have cured the flux of the Hemorrhoids, you must prevent their return: which is done by good Diet, and bleeding twice or thrice in a year, and with an ordinary Purge of a Magistral Syrup, or other Medicine, with an issue made in the Leg, and the like; which are to be altered according to the divers dispositions of Bodies. Moreover, Mineral Waters of Vitriol, Alum, and Iron, are very convenient. Fonseca commends the Decoction of the Mastic Tree, or the Infusion of it in Wine, for a Prevention, thus made: Take of the shave of Mastich wood two ounces: infuse them in twelve Pints of Wine twenty four hours in a warm place, then strain it and drink of it a whole month for ordinary drink: for it hath strength to stop the Haemorrhoids, and strengthen the Stomach. Chap. 11. Of the Pain of the Haemorrhoids. THe Haemorrhoid Veins that are in the end of the Rectum Intestinum, or straight Gut, sometimes do swell and cause very great pain. This swelling comes of the same Cause with the Flux or bleeding of the Haemorrhoids; namely, Of blood offending in Quantity or Quality, which if it findeth not away, and cannot open the ends of the Veins, there it settleth, and by filling of the Veins causeth a Tumour with Inflammation, and pain. The principal Cause why Blood cannot get out of the Veins, is the thickness of it, because it is Melancholy: for commonly the Hemorrhoid Veins, especially internal, are said to receive Melancholy from the Spleen, and sometimes to purge it forth. Authors give many differences of Hemorrhoids, from their greatness, number, figure, and place: whence some are called great, others little; some more, some less; some are like Grapes, Mulberries, Warts, or Bladders; thence termed Uval, Moral, Verrucal, or Vesical. Some are External, some Internal. From these things the knowledge of them is easy; for from a Tumour in the outside of the Fundament, from its greatness, colour, and consistence, the differences are known. And they are to be distinguished from other Diseases which use to be in the Fundament, as Rhagades, Clefts; Condylomata, Swell with Inflammation; Thymi, Kernels; Fici, Piles, and the rest. Rhagades are certain Ulcers like Clefts in the Hands and Lips, from vehement cold. They have no likeness with the Hemorrhoids; but we will explain them with the rest, although they are properly to be referred to external Diseases, that you may with the knowledge of the Hemorrhoids know all diseases of the Fundament. Condylomata are certain Tumours of the Skin, which being wrinkled, if it swell by Humours, it is called Condyloma. It is distinguished from a Hemorrhoid, because a Hemorrhoid is greater, black, and round in a Vein; but this is long, of the same colour, and not in the Veins. Thymi are carnous swell, which are not only in the Fundament, but Privities of Men and Women, like Warts, and like the flowers of Thyme, from whence they have their name. These are little, white, or reddish, without pain; but the Hemorrhoids are greater, black, for the most part painful. Fici are also fleshy Swell, but greater than Thymi; also they are blue and painful, and therefore more like Hemorrhoids: but they are distinguished from them, because they are all flesh; but the Hemorrhoids show the Veins full, and enlarged at the ends. Moreover, Fici for the most part ulcerate, and are malignant, so that they are like a Cancer. Those Caruncles, or pieces of flesh which grow in the Fundament, are like these Fici, called Cristae, or Tufts, usual in Italy, but unusual among us, because they come from an impure and unnatural Lechery: they look like the Combs of Cocks, and thence they have their name: Because they are nothing like the Hemorrhoids they need no distinction. But let this be for a Conclusion, All the aforesaid Diseases are cured only by Chirurgery, so that a peculiar way is not to be laid down here. As for the Prognostic, The Swelling Hemorrhoids, they are seldom dangerous; but sometimes so inflamed, that you may fear a Gangrene; or else they extremely torment the Patient. Hemorrhoids, if they come to Suppuration, or an Ulcer, often times leave a Fistula, which is many times incurable, by reason of the tenderness of the part, and the great moisture which hindereth the healing of it. For the Cure hereof, first let blood in the Arm, and make a Revulsion from the part affected. Which being sufficiently done, you may also open the Vein in the Ankle for revulsion. The same is done by Cupping of the Hypochondria for Revulsion, and the Hips for Derivation. Strong Purges are not good in this case, because they draw the Humours to the part, and increase the Tumour. But you must constantly keep the Body open, because hard Excrements, and voided with straning, increase pain. An Infusion of Cassia given morning and evening, is good for this, thus made: Take of Lettuce, Bugloss tops, Mallows, of each one handful: Liquoris scraped, and Raisins sioned, of each half an ounce: Bugloss, borage, and Violet flowers, of each one pugil. Boyl them to eight ounces. In the straining infuse Cassia new drawn one ounce; strain it, and clarify it; and then put thereto one ounce of Syrup of Violets. Give it twice a day as aforesaid. Sometimes to assuage the sharpness of the Humour you may give the Emulsions of the cold Seeds, made with the aforesaid Decoction. In the mean while, divers Topics are to be used to appease pain, take away Inflammation, and discuss the Humour. Or Oil of sweet Almonds newly drawn, and which is better, the Oil of Peach Kernels, or Gourd Seeds, Poppy, or Henbane Seeds. Oil of Box-tree is best, because it is stupifying: And as it cures all Toothache miraculously, so doth it mitigate all other: and this, if you lay but a drop with a little Lint upon the Hemorrhoids; or if you mix it with Lin-seed Oil, in this proportion, that there be half an ounce of that, and one scruple of Oil of Box. Quercetan highly commends the Oil of Nuts in which Sows or Hog-lice have been boiled. You may also boil Hog-lice in common Oil, and it will much assuage pain. Plain Oil of Eggs, or made in a Leaden Mortar, doth the same. Divers Liniments and Ointments may be prescribed for the same: Some whereof do only appease pain; some discuss the Tumour, and dry; others heat the Ulcers. And you may apply them with Lint. Take one Yolk of an Egg; as much Oil of Roses, or Violets as will make a Lineament: To which if you put Populeon, it will assuage pain better; and when the pain is very violent, you may add a little Opium. Or, Take of Hen's Grease half an ounce: the pap of an Apple roasted in the Embers one ounce: Saffron half a dram: Populeon half an ounce: With the Yolk of one Egg make a Lineament. Or, Take of Oil of Violets two ounces: Populeon half an ounce: With one whole Egg make an Ointment: or let the white of an Egg be beaten with Breast-milk, and applied to the part, with clouts dipped therein. Or, Take of the Mucilage of Fleabane seeds two ounces: Oil of Violets three ounces. Make a Lineament. Or, Take of the Mucilage of Fleabane and Foenugreek seeds extracted with Wine, of each two drams: Fresh Butter three ounces: Goats Suet one ounce. Mix them in a Leaden Mortar for a Lineament. Or Butter alone, set in a Leaden Mortar in the Sun till it wax black, is an excellent Medicine. Also fresh Pomatum is very Anodine. Take of the Juice of Purslain and Honey, of each four ounces. Mix them in a Leaden Mortar into the form of a Lineament. Take of Unguent of Roses two ounces: Quicksilver two drams. Mix them into a Lineament. Or, Take of white Diachylon mollified with the Oil of Chamomel two ounces: Saffron one scruple: Opium three grains. Make an Unguent. Horstius much commends an Ointment made of wild Flax, with its flowers boiled in Hog's grease. To which being strained, and a little cooled, you must add the Yolk of an Egg, and apply it to the part with Lint. He saith that it assuageth these kind of pains miraculously, and that he had from John Wolf that famous Physician of Hesse, who refused to discover it to his Prince, the Landgrave of Hesse, till he promised him every year a fatted Ox. These Liniments following are good to discuss the Tumour, and assuage pain. Take Leeks and roast them in a wet cloth in the embers, and beat them with fresh Butter, and they will take away pain and swelling. A red Onion doth the same boiled with the pap of a Lily, and beaten with Oil of Myrtles. Take the Oil of Peach Kernels, and bitter Almonds, of each two ounces: Liquid Storax and Bdellium, of each two drams. Dissolve them in Oleo, and mix them for a Lineament. The Balsam of Sulphur made of the Flower of Brimstone, and Spirit of Turpentine, is good to assuage pain and swelling, and to cleanse the Ulcers of those parts. And better, if instead of Oil of Turpentine you use the Oil of St, Johns-wort, and of Eggs. Also when there is great swelling with Inflammation, you may use Oil of Roses, or of Violets instead of the Oils aforesaid. Also Cataplasms are good for the same purpose. Of which the most common for taking away all pains, is that of white Bread and Milk boiled, adding Oil of Roses, and Yolks of Eggs. Aquapendens commends a Cataplasm of Plantain, Pellitory of the wall, and Mallows boiled in Water, and after with Oil of Roses; to which, when he would have it more drying, he adds Barley Meal, and Millet Meal: And if the pain be great, he makes it of Milk. He commends also the Cataplasm of Leek Heads, boiled in Common Oil or Oil of Myrtles, or made of Pilewort boiled in Water. Green Elder Leaves boiled to slime in Water, and then spread upon a cloth as big as the Palm of your Hand, and applied hot to the Patient lying upon his Belly; if it be often renewed for many hours, and the part first anointed with common Oil, or the Decoction of the same, is very excellent. The Leaves also of Elder stamped and applied cold, do take away the pain the third dressing. Also Purslain stamped and applied, assuageth pain and swelling, heats the Ulcers, and consumeth proud flesh. A white Onion roasted in the Embers, and made with fresh Butter into a Cataplasm, doth assuage pain, and discuss the Tumour. Let Fomentations be applied to the part to take away pain, made of the Decoction of Mullein, Mallows, Holyhocks, Pellitory, Lin-seed, Foenugreek seed, Marsh-mallows, Chamomel flowers, and Dill boiled in Milk, or in the want of Milk, in Water and Oil, or Tripe Broth. You may make a Bath with a greater quantity of the same Ingredients. Cold Water alone, is a good Fomentation, and a Bath also. But in Winter warm it. Also foment in Rose Water in which Salt of Lead hath been dissolved, especially if the part be inflamed. To take away swelling, it is good to foment with red Wine wherein Alum is boiled. Polypody of the Oak, and St. Johns-wort boiled in equal parts of Wine and Water, doth sensibly abate the swelling of the Hemorrhoids, if the Decoction be squeezed in by degrees with a sponge, the Waters of hot Baths applied with Sponges, or to sit in, are also good. Aquapendens applieth a Sponge dipped in Time Water and squeezed, and after bound upon the part; a Fumigation of the aforesaid Decoction while it is hot, or of Mullein boiled in Milk with Rye Flower, doth also appease pain. Or, Take of Housleek two handfuls: boil them in white Wine, and let the Patient receive the Fume through an hollow Chair. To consume and dry up the Piles, a Fumigation made of the Powder of Darnel, Mullein, Pilewort, cast upon hot coals, is good, and better if you mix Brimstone therewith. Also it is made of Brimstone only, which taken in with a Funnel, drieth up the blind Hemorrhoids. Also a Fumigation made of a Firestone quenched in Vinegar. And this following Injection is marvellous good for the same, if often used. Take of Juice of Plantain, and Oil of Violets, of each four ounces: Natural Balsam half an ounce. Make an Injection into the Anus. Amatus Lusitanus in the 91. Cure, Cent. 2. doth praise this following Suppository, in these words: A Roman Lady which lived at St. Angelo's Bridge, having her Womb forth, complained also of the pain of the Hemorrhoids: And after we had used many choice Medicines, by which she received no benefit, we gave her a Suppository of Goat's Suet and Opium, by which she was cured perfectly. But we washed the part afterwards with strengthening things warm, as aught to be after stupefying Medicines have been applied. The same Amatus, Curate. 6. Cent. 3. commends this following Topick in these words: A Reverend man was grievously troubled with the Hemorrhoids; and after divers means used by Physicians, was cured by us with this Medicine immediately. Take an Orange, and make it hollow, and fill it with Oil of Roses, and of Spike: then roast it, and apply it hot, repeated often, it is wonderful. The Lungs of a Goat are used commonly, applied hot to the part, or some slices made hot between two Dishes with a little Water, to assuage pain. Both the aforesaid Ealsom of Sulphur, and these following Ointments, are good for the Piles ulcerated. Take of new Oil of Eggs two ounces: Stir them in a Leaden Mortar, and apply them. Take four ounces of Oil of Roses, and one ounce of Ceruse: With half an ounce of lethargy, and six drams of new Wax, and four grains of Opium. Make an Ointment. Or, Take of Frankincense, Myrrh, and Saffron, of each one dram: Opium two grains: One Yolk of an Egg; Oil of Roses, and Mucilage of Fleabane seeds, of each as much as will make an Ointment. If they will not easily be dissolved, you must open them after convenient Revulsions, rubbing them with a rough cloth dipped in the Juice of Onions, in which there was dissolved one dram of Aloes. This is Hartmans Secret. But they are soon opened, and with less pain, with a Penknife, or Horsleeches. Some special things are taken by the Mouth to assuage pain, and consume the Hemorrhoids. The chief are these: The Decoction of Yarrow taken three days as ordinary Drink, and the seed of three Leaved Grass given many days together with the Yolk of an Egg, is also excellent. The Powder of Mullein given in Milk, or otherwise, is much approved against the Swelling of the Piles. The Powder of Yarrow and Tormentil, are commended to do the same. The Juice of Mullein by its self, or mixed with Sugar of Roses, or Penedies; or made into a Syrup with Sugar, is also excellent. Finally, Pills of Bdellium taken often, do consume the Piles, and take away the cause of them insensibly. An Issue made in the Leg, is very good for them who are subject to this Disease. The End of the Tenth Book. THE ELEVENTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Liver. The PREFACE. THe Liver (as other parts) is subject to all kind of Diseases: For as it is compounded of similarly parts it hath divers distempers, and as it is an organical part, it is Affected with Tumours and stoppages, as also with solution of Continuity, which is Wounds and Ulcers. And although the Dropsy be in the whole Abdomen or Belly, as in an Ascites or Tympanites; or in the whole Body, as in Anasarca: yet the Original thereof for the most part is from the Liver. We intent here only to show the chief Diseases which are most ordinary, and we shall Comprehend them in Six Chapters: The first whereof is concerning the Hot distemper of the Liver: The second of the Inflammation, Ulcer, and Imposthume of the Liver: The third of Obstruction of the Liver: The fourth of the Jaundice: The fifth of Scirrhus: The sixth of the Dropsy. Chap. 1. Of the Hot Distemper of the Liver. MAny men have a Hot Distemper of their Liver, from their Birth; of which here we shall not treat, but only of that preternatural Disease which manifestly hindereth the Actions of the Liver. This Distemper is either Simple, or Compound; either with Matter, or without; but for the most part it hath Matter joined with it, because a Hot Distemper of the Liver useth to produce Hot and Choleric Humours. The Causes of this Distemper are Hot Wether, immoderate Exercise, much Anger, and other great Passions of the Mind, and especially hot nourishment, and Physic, or things Spiced, a pure and strong Wine drunken plentifully: To these you may add the Heat of the Part adjacent as in strong Fevers, the Liver waxeth Hot from the heat of the Heart. The Signs of a Hot Distemper of the Liver, are Loathing of Meat, especially Flesh; Thirst, binding of the Belly, vehement heat in the whole body, especially in the palms of the hands and soles of the feet; leanness of the whole body, the Patient is worse for hot things, and better for cold: and if there be plenty of hot Humours, there will sometimes be Vomiting and purging of Choler; there is a bitterness in the mouth, and for the most part a Fever. As to the Prognostic, A Hot Distemper of the Liver is not very dangerous, because it is not much contrary to the Constitution of the Liver, but it useth to be the Cause of many Diseases not only of the Liver, but also of other parts: It is hard of Cure, especially when the Stomach is cold, as often it is; for those things which are given to Cool the Liver hurt the Stomach and enlarge its Distemper. The Cure consists altogether in the correction of the Distemper by cooling Medicines, and by the Evacuation of the Choleric humours which comes from the Liver, increasing the Distemper, and that Distemper it, and is the Cause of other Diseases. And first, Opening of a Vein doth much cool the Liver, takes away some of the Choler, and opens the Obstructions which comes from Choler; therefore you must open the Liver Vein of the Right Arm, and let such a quantity of blood as is agreeable to the fullness and strength of the Patient, either at once, or divers times, according to the greatness of the Disease and the continuance of it, and that after a Clyster or Laxative Medicine hath been administered. Then you must give a Medicine which doth gently Purge Choler, and Repeat it often at distance; or an Apozem for divers Doses; or the Magistral Syrup, or Syrup of Succory, Compound with a proportion of Rhubarb which is most convenient, because it doth innocently purge the Choleric Humours, cooleth the Liver, strengtheneth it, and opens Obstructions. The Forms of these Medicines, are these that follow: Take of cleansed Senna and Tamarinds, of each half an ounce: Annis seeds one dram: Succory and Sorrel, of each one handful: scraped Liquoris three drams: the three Cordial Flowers, of each half a pugil: boil them to three ounces: and dissolve in the straining, of Rhubarb infused with a little Lavender Spike in Succory Water, one dram and an half: double Catholicon three drams: syrup of Roses one ounce: make a Potion, give it in the morning with due custody. For the finer sort of People you may make Clarified Potions which are lately invented, which are in form of a Julep, but somewhat unpleasant to the taste, and in them there is prescribed a double quantity of Purging Medicines because the much strength of them is lost in the Clarifying, so that they do seldom work upon strong bodies; especially in a dry Country where the Humours are less flowing and not so obedient to purges; but in moist Countries, these kind of Medicines work successfully. This following is an Example of Clarified Potions. Take of clean Senna one ounce: Annis seeds one dram: Succory Leaves and Maidenhair, of each one handful: scraped Liquoris half an ounce: boil them to ten ounces, and infuse in the straining two drams of Rhubarb: Cassia new drawn, and double Catholicon, of each one ounce: bruised Tamarinds half an ounce: Coriander seeds prepared one dram: syrup of Roses one ounce: strain them and clarify them according to art: make a Potion. An Apozeme to Purge Choler is thus made: Take of Sorrel, Dogs-tooth, Succory, and Dock Roots of each one ounce: Endive, Succory, Dandelion, and Maidenhair, of each one handful: of the Four great seeds, of each three drams: scraped Liquoris one ounce: Succory, Bugloss and Violet flowers, of each one pugil: clean Senna two drams: Tamarinds one ounce: Mace, and Cloves, of each one dram: boil them to a Pint and a Quarter: in the straining dissolve half an ounce of Rhubarb infused in the aforesaid Decoction with a little Cinnamon, of compound syrup of Succory, and Roses solutive, of each two ounces: make an Apozeme, clarify it, and aromatize it with two drams of yellow Saunders, for four morning's draughts▪ A Magistral Syrup may be made of the ingredients of the former Apozeme, with a triple quantity of Purgers, and adding an equal proportion of Sugar to the Decoction. A Syrup made of Juices is most used amongst us, it is of great power in Chronical Diseases, which come from a Hot Distemper of the Liver, and from yellow and Choler: And it is made thus: Take of the new made Juices from their Faeces, of Endive, Succory, Sorrel, Fumatory, Borage, and Bugloss, of each three Pints: the Juice of sweet Apples newly drawn and purified two Pints: fresh Polypody of the Oak, half a pound: clean Senna eight ounces: Dodder of Thyme three ounces: Agarick newly Trochiscated half an ounce: Mace and Cloves of each half a dram: infuse them, and boil them according to art while there remains one Pint and an half of the straining, in which dissolve of Rhubarb infused with a little Lavender in the aforesaid Juices and strained, one ounce: white Sugar one pound and an half: make a Syrup well boiled, clarified, and aromatized with two drams of Triasantalon: keep this syrup in a Glass: give two ounces at a time, or three, twice or thrice every month with Chicken Broth wherein Endius, Succory, and Sorrel have been boiled; or in Whey. These things following are excellent to cool the Liver. And first for ordinary Drink, use the common Ptisan made of Barley Water and Liquoris, or with Dog-tooth and Sorrel Roots. Or mix such a Decoction with Syrup of Lemons, or Maidenhair. Or they who are more dainty may take only the simple Spring Water, mixed with the aforesaid Syrups. And if you desire to cool more, you may put as much Spirit of Sulphur, or of Vitriol, as will make it a little sharp. And when the heat is very vehement, you may give a dram of Lapis Prunellae therewith. There is also made a most pleasant Drink of Conserve of Roses mixed with Spring Water and strained: to which you may add some drops of Spirit of Sulphur or Vitriol to make it sharp and red like Wine. You may also make a Tincture of Roses thus: Take of red Roses dried one ounce: warm Water three pints: Spirit of Sulphur or Vitriol one dram and an half: Infuse them three or four hours: add to it being strained, three quarters of a pound of white Sugar. Keep it for your use. The Alexandrine Julep for this purpose, is made thus: Take of Spring Water one pint: Rose Water, Juice of Lemons, and white Sugar, of each four ounces: Boyl them with a gentle fire till they are skinned. These two last Remedies are used two ways, either for ordinary Drink, or as a Julep twice or thrice in a day. Also divers Juleps to cool the Liver use to be prescribed; of which, the Forms following may be Examples. Take of Sorrel, Succory, Dog-tooth, and Dock Roots, of each one ounce: Endive, Succory, Sorrel, and Maidenhair, of each one handful: Succory, Bugloss, and Borrage Flowers, of each one pugil: boil them to a pint. In the straining dissolve Syrup of Lemmons three ounces: ●●ake a clear Julep for three Doses, to be taken twice in a day. If you will make it cooler, add a little Spirit of Sulphur or Vitriol to every Dose to make it sharp. And to make it colder yet, add a dram of Sal prunellae. When Herbs are wanting, you may make a Julep of stilled Waters thus: Take of Endive, Succory, and Sorrel Water, of each three ounces: Syrup of Lemons, and Pomegrantes, of each one ounce and an half: Make a Julep for three Doses. You may also make Juleps that are good and pleasant, of Juices: an Example of all which, may be this that followeth: Take of the Juice of sweet Apples newly drawn, and taken from the faeces, four ounces: the juice of Lemmons three ounces: Rose Water two ounces: the Juice of Pomegranates one ounce: white Sugar half a pound. Make a Julep for three Doses. Instead of Juleps, Physic Broth may be made for the dainty folk, of the Herbs aforesaid boiled with a Chicken. To which you may add one dram of Lapis Prunellae, that it may cool the better; or make it sharp with some drops of Spirit of Vitriol. Blood of Succory and Germander, brought into a Syrup as followeth, are good to cleanse the blood, open obstructions, and cool the Liver. Take of Succory Water made in Balneo Mariae, as much as you please: the Leaves of Succory two parts: Germander one part: Steep them together, and digest them in Balneo Mariae three days: then strain them, and add to the Liquor, fresh Succory, and Germander: then digest them again three days; then strain them: and let this way of Infusion be repeated eight or ten times. The Liquor will turn red like blood, to which you must put as much Sugar, and make it into a Syrup. Besides, You may make Opiates and Tablets to cool the Liver, and strengthen it, thus: Take of Conserve of the Flowers of Succory, Violets, Water-lillies, and Bugloss, of each one ounce: the powder of the three one dram and an half. With Syrup of Lemons make an Opiate to be taken often. Take of the Lozenges of the three , with a double quantity of Rhubarb, four ounces. Let him take every morning two hours before meat, one of the weight of two drams. Conserve of Hips of the Canker Rose, well cleansed, and boiled with Sugar into the Form of a Marmalade, doth powerfully cool the Liver, if the Patient taketh it instead of the former Opiate. The Tincture of Coral, made with Juice of Lemmons doth cool and strengthen the Liver, if you give two spoonfuls thereof every day, or twice in a week at the least. A Bath of warm Water used often, doth more powerfully and profitably cool and moisten the Body than any other Remedy, especially in lean folk. Whey is good for the same, if it be used fifteen days, or more, together. It is made best by boiling the Milk, and pouring in a little Vinegar or Juice of Lemons, and afterwards straining it. Amatus Lusitanus prepareth it thus: Take of Whey one pint: very sharp Syrup of Vinegar three ounces: Mix them, and after a little boiling let it be taken as Mineral Waters, twice or thrice, and then walk upon it. The Ancients took it five pints at a time. Quercetan prepareth it thus: Take of Whey two pints: Juice of Lemmons two ounces: the new made Juice of sweet Apples three ounces. Clarify them all together at the fire with the white of an Egg, and put to them a little Sugar. When it is strained, take six or eight ounces every morning, for fifteen or twenty days together. And if the Body be lean and consumed, you may give Milk alone, especially if it be of an Ass, for many days. The Decoction of China prepared with the Juice of Lemons, is also good for this purpose, especially if there be Obstructions. It is made thus: Take of China Roots sliced one ounce: Spring Water six pints: the Juice of Lemmons three ounces: Steep them twenty four hours: then boil them till the third part be consumed; then strain them through a Hippocras Bag, and let him take six ounces thereof morning and evening, and mix it with Wine when he pleaseth. Lastly, Mineral Waters that have Vitriol, are good, because they open and cool. If the Disease continue after all this, open the Hemorrhoids with Horsleeches once or twice in a month. And also use outwardly Epithems and cooling Ointments to the Region of the Liver. Make Epithems of Sorrel, Succory, Rose, or Plantain Water, or of Vinegar and Camphire: to which for the strengthening of the part, add a little Powder of the three . The Ointments are, Galens cooling Ointment, and the Cerat of Sanders. Chap. 2. Of the Inflammation, Imposthume, and Ulcer of the Liver. THe Inflammation of the Liver, is a hot Tumour arising from Blood, which is out of its Vessels, and sent into the substance thereof. And as the Blood is either pure, or mixed with other Humours, so doth it produce divers kinds of Tumours. For if it be pure, it makes a true Phlegmon; but if it be mixed with Choler, Phlegm, or Melancholy, it produceth an Erysipelous, Oedematous, or Schirrous Phlegmon. And if the said Humours predominate over the Blood, there is a Phlegmonous Erysipelas, oedema, and schirrus. There is another difference in respect of the place in which the Inflammation is; it is either in the gibbous part, or Cavity of the Liver. Which is thus to be understood according to Galen, 5. de locis, off. cap. 7. An Inflammation cannot be in either part of the Liver distinct, so that the other shall be free, because the flesh in the part is contained in all parts, and therefore when one part suffereth, the other also suffereth in some measure. Moreover, That which Galen taught 13. Meth. Cap. 14. is worth observation: When the hollow part of the Liver is offended, it is necessary that the Inflammation reach to the Veins of the Mesentery, which come from the Gate Vein. And Experience teacheth that they who have died of this Inflammation have had, not only an Imposthume in the Liver, but also in the Mesentery. We must also observe from Hypocrates, Aph. 45. Sect. 7. That an Imposthume sometimes is only in the Membrane which covereth the Liver, and sometimes in the substance, or Parenchyma of it: For (saith he) they who have a hot Liver suppurated, if pure white quittor or matter flow from thence, do escape; for it is contained in the Tunicle: But if it be like Lees of Oil, they die. Galen in his Comment, saith thus: They who have matter in the Tunicle of their Liver, and the substance not suffering, do all escape: but they who are corrupted in the very fleshy substance of the Liver, die; and there is good reason to be given why they do. The immediate Causes of this Disease are, too much Blood, or the boiling heat, thinness, and sharpness of the same; or the motion and stirring of it in the Veins; from whence by the aforesaid Causes, it is easily thrown into those parts which are most fit to receive it. The Liver is most sit to receive blood abounding when it is too hot, or hath any pain, for heat and pain do attract, or if it have any Natural or adventitious weakness: For all parts that are burdened with any Humour, do disburden themselves upon the weakest. Among these Causes you may reckon the obstruction of the Liver, by which the thick Humours are retained, and are inflamed by a Preternatural heat. The External Causes may be many, as too much heat of the body from immoderate Excercise, the Sun, or fire: but Meats sharp and spiced, immoderate taking of two much strong Wine, too much Lechery, Fear, a Stroke or Fall upon the Liver side, also hot Medicines applied without reason thereto; as Fabricius Hildanus reports of one who having a cold distemper of the Stomach had Emplasters and hot Ointments of Pepper, Cardamons', Oil of Cloves, and the like applied to him, by which means the Inflammation of the Liver was increased: for the Liver covereth the Stomach, and the Medicines which are applied to the Stomach, do first touch the Liver with their Virtue. Cupping Glasses applied to the Region of the Liver will do the same, of which Fabricius Hildanus brings an Example concerning one who bled at the Nose, to whom he applied great Cupping Glasses upon the Region of the Liver which stayed the blood; but a great Inflammation of the Liver followed. The Signs of this Disease are many according to Galen and other Authors, which we shall lay down severally, because many errors are committed in the discovery thereof. The First Sign is Heaviness in the right Hypochondrion which comes from the Repletion and Distension of the Liver; because being of its own nature large and very compact, if it be filled with much Humour it will grow very heavy: which the Patient apprehends when he tur●eth from one side to the other. The Second Sign is Pain, which sometimes is perceived in one place, sometimes in two or three: in the Region of the Liver there is a weighty Pain; sometimes it is very extending in the lower Ribs when the Inflammation reacheth to the Ligaments of the Liver which are fastened to the Ribs: sometimes the Pain is communicated to the Throat, by the continuation of the Membranes, which have consent with the Membrane which covers the Liver. The Third Sign is a Fever, which is commonly at night, and is more or less sharp according to the Humour offending: for in a Choleric Inflammation it is most burning; but in a Phlegmatic, gentle; and in a Sanguine Inflammation, moderate between both. The Fourth Sign is Difficulty of Breathing, because the Liver is tied to the Diaphragma, or Midriff; and therefore by its weight forceth it downwards, as also presseth it with greatness and swelling; so that both ways the free motion of the Diaphragma is hindered. The aforesaid Signs are Universal or proper to declare the Disease: there are many other equivocal Signs, which also do much avail to the knowledge of the Disease: As a dry Cough, a hard Pulse unequal, and like a Saw: the colour of the Tongue first read, and then black: great Loathing of meat: unquenchable Thirst: vomiting of Choler, and sometimes of Phlegm: a pale Colour of the whole Body tending to the Jaundice, yellowish: red and flaming Urinal, which is sharp: when the Patient lieth with his face upwards, he is more at ease than when he lieth on either side; because when he lieth upon the right side the Liver is pressed upon by the Stomach; when he lieth upon the left, it is extended by its own weight, hanging down; the Belly is bound, by reason of the Heat which consumeth all the moisture of the Chylus matter: Sometimes it is lose, namely, when a great weakness of the Liver is joined with the inflammation; for then the Excrements are sent forth moist like the Water wherein Flesh hath been washed. The Signs of the Differences are these; If the Gibbous or Convex part of the Liver be affected, there is a Tumour to be felt in the right Hypochondrion, and it makes the figure of the Liver like a half Moon: there is great pain in the Breathing, and it reacheth to the right side of the Throat, so that it seemeth to be pulled down: There is a greater Cough and Difficulty of Breathing, and greater weight. But if the Hollow part of the Liver be affected, the Tumour is not so easily felt; but because as I have said, one part of the Liver cannot be inflamed, but the other must also suffer; when the part is touched and pressed down, some pain is perceived. Moreover, Because this part lieth upon the Stomach, there is a greater loathing of Meat, vomiting, thirst, and looseness of the Belly, from the food corrupted in the Stomach which is distempered by the nearness of the Liver to it. The Signs of the Causes are these, If the Inflammation come from pure Blood, there is either a perfect Red or duskish colour in the face; the Pulse is great, soft, and waterish; the Urinal is red and thick; the Body is full of flesh: there is sweetness in the mouth, the party is young and hath fed high. If Choler predominate, the Face is yellow, the Pulse swift, hard, and unequal, the Urinal thin and very yellow, sometimes flaming: the Body is lean and thin: the Eyes hollow: the Mouth bitter: there is vomiting of Choler, and Causes that bred Choler went afore. But because the Inflammation of the Muscles of the Abdomen or Belly is very like the Inflammation of the Liver, there we must distinguish them by their proper Signs. In the Inflammation of the Muscles of the Abdomen, the skin is so extended that if you lay hold of it you cannot move it; the humours of the straight Muscles are long and over the whole belly comprehending the Navel: and the inflammation of other Muscles is in the form of them. On the contrary, the Inflammation of the Liver is in the shape of the part affected; and if you lay hold on the Muscles, they yield and the Tumour is somewhat deeper. Moreover, The colour of the whole Body is of much concernment for the distinguishing of these Diseases; for in the Inflammation of the Muscles, it is fresh, and almost in its Natural condition; but in the Inflammation of the Liver, it is pale, yellow, and like the Jaundice. There is a famous Example of this in Galen, 5. de loc. off. cap. 7. of one Stesianus, who when he was judged by other Physicians to have an Imposthume in the Liver; Galen being sent for, at the first view of his face, presently said that there was none, and searching his Belly▪ he found it in the Abdomen: He judged upon this ground, Because the Patient had not his face so discolored, as useth to be in the Inflammation and Imposthume of the Liver. The like Example is in Valeriola, Lib. 4. Obs. Cap. 5. of a certain Woman which was thought by another Physician to have a Phlegmonous Tumour in the Liver. But saith he, When she sent for me▪ I judged it not to be so, but in the Muscles. And a little after he saith, When I first came, I touched the place, and I found a long swelling in the right Hypochondria, down to the very Navel; the Face was red, fresh, and of a Rosy colour, mixed with white, continuing all the time of the Disease in the same state; the Urine was very good, both in colour, and in respect of the things contained: From all which it appeared, that not the Liver, but the Muscles over it were affected; for when the Liver is affected, there is always a discoloring of the face. For Galen saith, that he knew many diseased in their Livers by their colours, Lib. 5. de loc. off. cap. 7. for the colour in such is commonly yellowish, white, and inclining sometimes to green. Moreover, It is troublesome to distinguish a Pleurisy from an Inflammation of the Liver: as you may observe in Galen, 5. de loc. off. cap. 7. in his History of S●c●ilus the Physician, who was deceived in himself, supposing that he had a Pleurisy; because he had a Fever, little and frequent breathing, a small Cough, and a pain near the lower Ribs: but Galen by his stools, which were like water wherein flesh had been washed, knew that his Liver was inflamed, for such a flux doth show that the Liver is greatly disordered. But this sign cannot always distinguish a Pleurisy from an Inflammation of the Liver. For as Galen teacheth in the place cited, such kind of moist and bloody stools come only when the Liver is inflamed, when it is also very weak, otherwise one sign of the Liver inflamed is (by Galen) costiveness. Therefore when the Liver is not weak, you must look for other signs, by which you may distinguish them. If then the Inflammation be in the Pleura towards the right Hypochondria, the pain will be vehement and pricking, the breath more difficult, there will be no change of colour, the Cough will be greater, and not dry, but commonly (especially in the increase of the Disease) with bloody Spittle, somewhat at least discolored; and lastly, the Pulse will be hard, and like a Saw: But in the Inflammation of the Liver, the pain is less, joined with heaviness, the colour is yellowish, there is a dry Cough now and then, the Pulse is not so hard; and lastly, there is a Tumour in the right Hypochondrion. And if the Inflammation be in the Mesentery, the Tumour will appear beneath the Region of the Liver, there will be no change of colour in the Face, the stools will be moist, in which at first there will be thin and unconcocted Matter, afterwards concocted, in those of whom there is hope of recovery. The Prognostic of this Disease, is thus made: Every Inflammation of the Liver is very dangerous, and for the most part deadly. And if it doth not kill presently, it ends in a Dropsy, or Atrophy, or Consumption. All the hope of recovery is from the strength, as Galen, 10. m. cap. 5. An Inflammation of the Gibbous or bunchy part of the Liver, is more dangerous than that which is in the hollow part, by reason it is nearer the Heart, the Midriff, and hollow Vein. An Inflammation coming from Choler, is more dangerous than that which cometh of pure Blood, because then the Fever is stronger, and other symptoms greater. The Hiccoughs in an Inflammation of the Liver are evil, Hipp. Aph. 17. Sect. 7. For it shows the increase of the Inflammation, and malignity, which doth by consent disturb the Stomach. A Looseness joined with an Inflammation of the Liver, is deadly, except the Matter voided be concocted, and the flux be Critical. If the Inflammation of the Liver cannot be discussed, as it seldom can, and if the Faculty be strong, it turns into an Imposthume; otherwise it turns into a Gangrene or Sphacelus. The Suppuration for the most part will be within twenty days. And this Imposthume is very dangerous, and few escape thereof. But if it be little, and only in one part of the Liver, and the matter white and even which comes forth by Urine or Stool, they escape. Also a Tumour in the Convex, or outward part of the Liver, which appears in the Skin as it were movable, may be opened with an actual Cautery▪ and if the Matter coming forth be pure and white, they escape, for the Matter is contained in the Tunicle; but if it be like Lees of Oil, they die. After the Imposthume is broken, if the Putient live, there remains an Ulcer, which is very troublesome to cure; and if it be not superficial, it causeth a Dropsy or Marasmus. Also an Ulcer may be in the Liver from sharp Humours that corrode it, especially if they be choleric, and spread through the substance of the Liver, which putrifying by degrees, get a malignant and venomous quality. The knowledge of this Ulcer, which comes from the sharpness of the Humours without Inflammation afore going, is difficult. But it may be known by some signs. And first, there is an ulcerous pain in the right Hypochondrion, and the Patient waxeth lean; and if it be in the hollow part of the Liver, there are stools with Pus or Matter, and sometimes with Blood, and pain of the Guts by reason of the sharpness of the Humours, like a Dysentery, which is distinguished from this Disease in this, Because there is a weight and pricking about the Liver. And sometimes Authors have observed that pieces of the Liver have been voided by stool. But if the Ulcer be in the gibbous or outward part, the Water is Mattery without any distemper of the Reins or Bladder. There is a small Fever in the increase of the Disease, which turneth into an Hectic. The colour is yellow, and sometimes there are small pustuls which come from the adustion of Humours in the Face. There is a loathing of Meat, and especially of flesh, a stinking breath, and often fainting. Concerning the Prognostic, It bringeth a linger Hectic Fever. And if the Ulcer be not small, superficial, and cured betimes, it is deadly. Those Exulcerations of the Liver which follow Inflammations and Imposthumes, are more dangerous than those that arise without them. The Cure of the Inflammation of the Liver, is the same with that of the Inflammation of the Stomach afore mentioned, and chief in respect of Phlebotomy, Purges and altering Remedies are to be given in the beginning of the Disease. You must also give often Clysters, such as were prescribed in the Inflammation of the Stomach. But afterwards, cooling, cleansing, and opening Juleps, such as were described in the Chapter aforementioned, bewaring that they be not too sweet, for by sweet things, the Liver being inflamed, grows larger, as Trullian teacheth, Lib. 4. Cap. 10. Let his Drink be the Decoction of Barley, Dog-tooth, with a little Liquoris, Syrup of Violets, or Maidenhair. In the Decoction you may add to the former Juleps, the Roots of Smallage and Parsley, the Leaves of Agrimony, Maidenhair, etc. And afterwards Turpentine, washed Agrimony, or Parsley Water given twice or thrice, takes away the relics of the Disease. But if the Disease be stubborn, and last long, you must prescribe an Apozeme of opening and loosening things, thus: Take of the Roots of Smallage and Parsley, of each two ounces: new Polypody of the Oak three ounces: the Leaves of Agrimony, Burnet, Ceterach, Maidenhair of each one handful: Annis, Fennel, and Parsley seeds, of each one dram: Chamomel and Violet flowers, of each one pugil: clean Senna one ounce: Boyl them to a pint and a Quarter. Dissolve in the straining Rhubarb infused with a little Lavender in Succory Water, two drams: simple Syrup of Vinegar four ounces. Make an Apozeme for four Doses, to be taken every other day. Outwardly, many Topics are good to be used the whole time of the Disease. And in the beginning, Epithems, Liniments, and cooling Plasters, such as stop Fluxes, made thus: Take of Endive, Succory, Sorrel, Plantain, and Rose Water, of each three ounces: Vinegar of Roses one ounce: the powder of the Electuary of the three , one dram and an half: Camphire half a scruple. Make an Epithem to be applied warm to the Region of the Liver. Or, Take of the Leaves of both Endive, Succory, Plantain, Bugloss, Borage, and Water-lilly flowers, of each one handful: Roman Wormwood half a handful: red Roses two pugils: red and yellow , of each two drams: boil them to one pint and an half. Dissolve in the straining half a pint of Rose Water, Rose Vinegar one ounce; Camphire one scruple. Make an Epithem. If you desire to cool more, you may add the Juices of the aforesaid Herbs. Take of Oil of Roses two ounces: Oil of Wormwood half an ounce: mix them and wash them with Oxycrate, and anoint the place therewith after the use of the Epithem. Or, Take of Oil of Roses, and of Myrtles, of each two ounces: the Juice of Endive and Succory, of each one ounce: Vinegar half an ounce: boil them to the Consumption of the Juices: then add the powder of red , and Roses, of each one dram: as much Wax as will make an Unguent. Or you may use the Ointment of Roses alone, or Galens cooling Ointment washed with Oxycrate. In the progress of the Disease, when the Fever and pain decrease, you must mix dissolver's with Coolers, either in equal, or unequal proportion, as the Disease grows nearer to the state or declination, these must be wisely composed. But that you may know what to make them of, we will show you some Examples. Take of Oil of Roses two ounces: Oil of Wormwood one ounce: Oil of Chamomel half an ounce: Powder of the three one dram: Spicknard half a dram: Wax, as much as will make a Lineament. Take of clean Dates ten: whole Raisins three ounces: boil them in Oxycrate; then beat them with Chamomel, Melilot, and red Rose Flowers, of each one pugil: Spicknard and Schoenanth, of each one dram: Smallage and Parsley seeds, of each half a dram: Endive and Purslain, of each one dram and an half: Oil of Wormwood and Roses, of each one ounce: Barley meal two ounces. Make a Cataplasm. Or you may make one not so hot, thus: Take of Barley meal three ounces: red two ounces: Oil of Roses three ounces. Mix them with the Decoction of Endive and Succory, for a Cataplasm. In the declination, when the Fever is gone, you must use dissolver's, with Emollients, lest any hardness should remain, and some Astringents to strengthen the part. Take of Marsh-mallow Roots three ounces: Cypress Roots, and Calamus Aromaticus, of each half an ounce: Mallows, Violets, and Agrimony, of each one handful: both the Wormwood's, of each half a handful: Foenugreek, Annis, Fennel, and Line seed, of each half an ounce: Chamomel, Melilot, and Dill flowers, of each one pugil: Spicknard, Schoenanth, and Mastic, of each one dram and an half. Make a Decoction of them, and foment the part affected with it, somewhat hot. Take of Oil of Chamomel, Lilies, and sweet Almonds, of each one ounce: Oil of Wormwood and Spike, of each half an ounce: the Powder of Schoenanth, Rosata Novella, and Wormwood, of each one dram: Wax so much as will make a Lineament to be used in the declination of the Disease. If the hardness of the part continue, it will be good to add to the former Lineament, Gum Ammoniacum dissolved in Vinegar. Or this Plaster: Take of the Emplaster of Melilot and Diachylon with Flowerdeluce, of each one ounce. Mix them, and spread them upon Leather, cut like a half ●Moon, to be laid to the part. Or, Take of Gum Ammoniacum dissolved in Vinegar one ounce: Labdanum and Mastic, of each two drams: Oil of Wormwood and Wax, of each as much as will make a Plaster. If the Inflammation tend to suppuration, which is known by increase of the Fever, and the pain, according to Hipp. Aph. 47. Lib. 2. there is great danger, and few escape in this case. Yet you must further the Suppuration with the aforesaid Emplasters, which will dissolve the Matter which will be dissolved, and suppurate that which will be suppurated or ripened; as also with mollifying Cataplasms, and you must give inwardly Chicken Broth wherein Mallows, Marsh-mallows, Figgs, and Prunes have been boiled. After the Imposthume is broken, if white Matter flow by stool or urine, you must cleanse with Barley Water, or Whey with Honey of Roses, or with those Remedies which are prescribed for the Cure of the Ulcer of the Stomach. But if the Suppuration tend outwardly, you must open it with a red hot Incision Knife, according to Hypocrates. And if the Matter come forth white and concocted, there is hope of Cure; but if red, filthy, and stinking, the Patient is near death. Chap. 3. Of the Stoppage, or Obstruction of the Liver. THe Obstruction of the Liver is a preternatural closing or straightness of the Branches of the Vena Porta, and Cava, that is, of the Gate and Hollow Vein, and sometimes of the substance of the Liver, hindering the passage of Natural Humours, and the distribution of the Nourishment, coming from some Matter which filleth their Cavities. Hence it is that Obstruction is an Organical Disease, namely, in the way and passage obstructed, which hinders the distribution of Blood for the Nourishment of the parts. These ways or passages are not only the Veins which are dispersed through the whole substance of the Liver; but also the Pores and insensible Passages, with which the whole substance of the Liver, and also of other parts, is very full; which being shut up by a preternatural Humour; neither can the heat of the Liver be cooled, nor can the thin vaporous Excrements be evacuated. The Matter that Causeth the Obstructions, commonly is a gross Excrement, viscous and clammy, which being not able to pass freely, sticks in the passage, and is more and more thickened by the heat of the part, so that the longer Obstructions continue, the worse they are. Sometimes plenty of Humours cause an Obstruction, as Galen showeth, 10. m. cap. 2. in there words, Of Obstructions some come of abundance of Humours, and some from the Quality, as when they are gross or clammy; Blood letting is the best Remedy against those which come from plenty, and the use of attenuating things is best against those that come of Quality. This Obstruction which comes from plenty of Humours, happens chief in the Vessels and their cavities when being too full, they are so distended, that they cannot contract themselves for the sending forth of the Matter contained: As we may observe by the Bladder when it is stretched ou● by long retention of too much Urinal, that it cannot contract itself; from whence there comes a stoppage of Urinal, or difficulty of voiding thereof. Not only Humours, but also sometimes many gross Vapours, which cannot easily be discussed (because the way is not open, as in the Colic) may be the Cause of Obstruction, as Galen teacheth, 3. de loc. off. which Causes are very rare, and absolutely denied of some. The Humours which stoppeth with its thickness is chief Phlegm, which will easily grow gross and clammy. Melancholy is next, which by its coldness, thickness, and drossiness, may cause Obstructions: Also Blood may do the same by its quantity and thickness: And lastly, Choler staying long in the Liver grows thick, and breeds dangerous Obstructions. The Antecedent and Principal Causes, are all things that produce thick and clammy Humours, and thick and cloudy Air, Meats of gross Juice, viscous, hard of Concoction, and distribution, astringent, cold, and not fit for to be eaten, as Pears, quinces, Services, Medlars, Mushrooms, Cheese, Pulse, Pease or Beans, Beef and Pork, slimy Fish, and dried in the smoke, Bread not well baked, Rapes, Chessnuts, thick, red, and astringent Wine, and muddy Ale. Also an evil Disposition of the Liver, especially a cold distemper, which may also produce Obstructions from good Juice, as when it doth not well Concoct, but turns the meat into a salt tartarous and mucilagnous or slimy Matter. Also the Distemper of the Stomach may be a Cause of Obstructions, when it begets too crude a Chyle, which cannot after be well ordered by the Liver, because the salt of the first Concoction is not amended by the second. The Signs of this Disease are to be divided into divers sorts, some signify the kind of the Disease, others the part affected, and others the cause that produce it. The Signs that show the kind of the Disease are common to all natural parts that are subject to Obstructions: for they show only Obstructions lying in the lower Belly, and these therefore will serve for the knowledge of the Obstructions of the Spleen, and Mesentery especially. These Signs show that there are Obstructions in the said parts, The Excrements of the Belly being out of their natural condition, especially when they are moist, white, chylous, or bloody: white Urine, thin and watery, and as it were strained, because the thicker parts cannot pass through by reason of the Obstructions, but only the pure water comes through unmixed; and it may be yellow if there be heat. Difficulty of Breathing, especially when the Patient walketh fast, or goes up a hill, or pair of stairs, because the parts obstructed do draw the Midriff downwards, and hinder its free motion; the Face is pale; there is leanness and dulness over the whole body; the Pulse is unequal; and lastly, there is such a sense of weight in the Hypochondria as they who have been feeding very hard; Therefore Hypocrates, 4. de victus ratione in acut. calls that heaviness a fullness of the Hypochondria, attributing that Disease to the Hypochondria, which properly belongs to the Stomach: for as often as the Spleen and Liver are filled with evil Humours, and swell, they are pressed and feel a heaviness, after the least eating of the lightest meats, as they who have over-gorged themselves. This Sign doth so surely declare the Obstruction of the Hypochondria, although there be neither pain nor apparent swelling, that Prosper Martianus in his Comment upon the aforesaid Book of Hypocrates, affirmeth, That he hath concluded that the Bowels were obstructed, before ever he handled the Hypochondria. The stretching of the right Hypochondrion showeth the part affected, together with the other signs, and sometimes pain, that is heavy and dull, which increaseth after meat, especially if exercise immediately follow; sometimes a dry Cough; difficulty of Breathing by reason of the nearness of the Diaphragma, and a greater weight of that part than of any other. The Signs of the Causes are if it come from Humours, the pain is more heavy, extending and fixed: if from Wind, it is sharper and more movable: if from cold Humours, there is more sense of weight in the right side, the Face is more pale; there is no Fever nor thirst; there was a cold and thick diet without exercise that preceded: if it comes from hot Humours, there is less weight, more thirst, the Face is yellow by reason of Choler, or red by reason of Blood, there is a Fever and a pricking pain sometimes, and hot diet went before. The Prognostic of this Disease is to be made thus, A New Obstruction is easily taken away, an Old hardly. An Obstruction of the Liver, except it be speedily and wholly taken away, useth to bring many Evils, namely, Putrefaction of Humours, Fevers, Inflammations, divers Fluxes of the Belly, constant and vehement, because the nourishment can pass to the parts: the Colic, Jaundice, Evil Habit of body, Dropsy, Scirrhus, and other infinite Diseases, so that Avicenna calls Obstructions the Mother of Diseases. An Obstruction made by Humours, is worse than that which comes of Wine. That which comes of Crude and Phlegmatic Humours, or of Wind, is sometimes cured by a Fever; because the Heat doth discuss the Flatus, or Wind; makes Phlegm thin, and more apt to flow. The Cure of an Obstruction is to be begun with an universal Evacuation of the whole body; by a Potion agreeable to the nature of the Disease: Afterwards if there be signs of Plethory or sulness, and if the body be not very thin, you must draw blood out of the Liver Vein in the Right Arm. Then prescribe this Apozeme, Take of Smallage, Parsley, and Fennel Roots, infused a whole night in white Wine, of each one ounce: the Roots of the greater Celandine, two ounces: Fearn Roots, Elicampane barks, the Roots of Capars, the inward bark of an Ash, and Tamarisk, of each half an ounce: Wormix ood, Agrimony, Maidenhair, Germander, the tops of Saint Johns-wort, and the Lesser Centaury, of each one handful: Smallage, Parsley, annis, and Fennel seeds, of each half an onnce: clean Senna, Polypody of the Oak, and the Kernels of Carthamus' seeds, of each two ounces: Epythimum, or Dodder of thyme, one ounce: Ginger and Cloves, of each one dram: the flowers of Tamarisk, Marigolds, and Red Fitches, of each one pugil: make a Decoction to a Pint and a quarter, dissolve in the straining of the Syrup of the Five Roots, and of Roses Solutive, of each two ounces: make an Apozeme, clarified and aromatized with two drams of Cinnamon for four morning's draughts, adding to every Dose one dram of Cream of Tartar, salt of Wormwood and Tamarsk, of each half a scruple. In the last Dose (if the first hath not sufficiently purged) dissolve of the Electuary of Citrons Solutive and Diacarthamum, of each one dram and an half. Sometimes we put white Wine in the Decoction before mentioned. Sometimes a little Vinegar, according to the nature of the Patient. If the Patient be dainty, and will not take an Apozeme, instead thereof you shall give these Broths, Take of Smallage, Parsley, and Asparagus Roots, of each half an ounce: Agrimony, Hyssop, Maidenhair, of each one handful Crystal of Tartar one dram: boil them with a Chicken or a neck of Mutton, make Broth for nine days together every morning. The Crystal of Tartat dissolved in new made Broth and strained is better, for when the Decoction is cold, for the most part it congealeth again, and is separated from it: and when you give it in the Broth, you must stir it about well with a Silver Spoon afore it be taken, or you will leave the greater part in the bottom of the Dish. Every other day, infuse in his Broth, half an ounce of Senna and one dram of Annis seeds. As long as he taketh these Medicines, and after, as often as need requires, let the Region of the Liver be fomented every morning one hour before he taketh his Broth, and every evening one hour before Supper, with this following Fomentation: Take of Marsh-mallow, and Briony Roots, of each one ounce and an half: the Roots of Danewort, Cypress, Eryngus, the Barks of the Roots of Capars, and the middle rind of Tamarisk, of each one ounce: the Leaves of Mallows, Marsh-mallows, Violets, Agrimony, Germander, Mints, and Wormwood, of each one handful: Lin-seed, Foenugreek, and Juniper Berries, of each half an ounce: Coriander seeds, and yellow , of each three drams: Broom, Elder, Chamomel, and Melilot flowers, of each one pugil: boil them all in two parts of Chalybeate Water, and one of white Wine, added in the end: and when it is strained, add half a pint of Vinegar: Foment the part as aforesaid. After the Fomentation, let the part be anointed with the following Ointment. Take of Oil of Lilies and Capars, of each two ounces: the Juice of the Roots of Briony and Smallage, of each three ounces: Boyl them till the Juices are consumed, adding the Ointment of Marsh-mallows, and Gum Ammoniack dissolved in Vinegar, and strained, of each one ounce: Carrot seeds and Spicknard, of each one dram and an half: yellow Wax as much as will make an Unguent. Use it as aforesaid, adding in the time of anointing, a little Vinegar of Roses. After the use of these Remedies, this Opiate following is good to wear away the relics of the Obstructions, and recover strength to the part. Take of Conserve of Wormwood, Maidenhair, and the Flowers of Tamarisk, of each one ounce: the Conserve of Elicampane Roots, and Citron peels candied, of each half an ounce: one candied Myrobalan: candied Nutmegs three drams: Confection Alkermes two drams: the Powder of Diarrhodon Abbatis, one dram: Salt of Wormwood, and Tamarisk, of each two scruples: Saffron one scruple: Ambergris half a scruple: with the Syrup of Citrons make an Opiate, of which let him take the bigness of a Chestnut every morning two hours before meat, and drinking after it, a little Hippocras. Warm Baths are also very good, in which softening and opening things have boiled. If the Obstructions are very stubborn, these following Pills are very good. Take of the best Aloes infused in the Joyce of Wormwood very well, half an ounce: Gum Ammoniack dissolved in Vinegar and strained, three drams: Myrrh dissolved in warm Wine, and strained, two drams: the powder of the three , and Crystal of Tartar, of each one scruple: Agaricknewly made into Troches, and of the best Rhubarb, of each two drams: the Salt of Wormwood and Tamarisk, of each half a dram: Saffron half a scruple: With the Syrup of Roses solutive, make a Moss of Pills, of which let him take half a dram two hours before dinner twice in a week. Instead of the Apozem aforesaid, you may make an old Cock Broth, when the Obstructions are old and stubborn. Take of Polypody of the Oak, and Carthamus' seeds, of each one ounce and an half: the tops of Time and Epithimum, of each one pugil: Annis, Fennel, and Caraway seeds, of each two drams: clean Senna two ounces: Crystal of Tartar half an ounce: beat them, and fill the Belly of an old Cock therewith: boil them in three parts of Water, and one of white Wine, till the flesh of the Cock fall from the Bones. Make Broth, and let the Patient take it four mornings. Or (which is better) make a Decoction for one draught every day of the fourth part of the Ingredients. To this Broth you may add Herbs, and opening Roots in a small quantity. Quercetan commends exceedingly in his Dispensatory, the Compound Powder of the Root of Cuckoo-pintle, to open Obstructions; of which you may give two drams for divers days together, in a convenient Decoction. But of all Remedies, to take away old Obstructions, Medicines made of Tartar, Vitriol, and Steel, are the best. Of Tartar there is made Crystal, Salt, and Spirit, which are to be given in divers forms. The use of Crystal of Tartar is formerly mentioned in the Apozeme, and Physic Broths, made either of a Chicken, or old Cock. Concerning this Medicien, young Physicians are to be admonished, that it is of more-force than it is commonly supposed to be, although we seldom observe it in Practice, by reason of the negligence of Apothecaries, the deceit of false Chemists, and vulgar Distillars, which still Chemical Medicines to the Apothecaries, of which, few are good, but most adulterate. The negligence of Apothecaries for the most part is, That they had rather buy Crystal of Tartar of such fellows, than make it themselves (though it be the easiest of all) because they sell it cheaper than they themselves can make it: for those Impostors will sell a pound for seven pence, or eight pence, from which alone the Apothecaries might argue deceit, perceiving that they would be loser's in so selling, if it were rightly made. The deceit lieth here, Those Impostors put a little Tartar, and a great deal of Alum into their Decoctions; not because Tartar is sold dearer, but because it yields but a little Crystal; but Alum will run all into Crystal. Hence it is that the Physicians are deceived of their intentions, because Alum is astringent, which is contrary to the opening Faculty which they desire. Moreover, There is another wrong done to this Medicine, when it is made in a Brass Kettle, which leaves a malignant quality upon the Medicine; for it is a known and vulgar saying among Apothecaries, You must not boil sharp things in Brass Vessels, because they easily pierce, and attract a noxious Tincture from them. But the Crystals of Tartar are most sharp, called by some Acidum Tartari, or the sharpness of Tartar. This Error is often made by Apothecaries; and almost all they who make this Crystal themselves use Brass Vessels, so that I have seen some Tartar look Skie-colored from the Verdugreece which it hath taken from the Copper. Therefore Physicians shall do conscientiously, honourably, and for the good of their Patients, if they cause their Apothecaries to make Crystal of Tartar themselves, and in Glass, Iron, or Earthen Vessels glassed. The Salt of Tartar hath great power to open Obstructions, and may well be mixed with Apozems, Opiates, and opening Pills. But the chief use of it is in a loosening Ptisan, or Barley Water, made of two drams of Senna, infused in eight ounces of cold Water, with one scruple, or half a dram of Salt of Tartar, by which the Tincture of the Senna will be powerfully extracted; so that this Ptisan shall work better than any ordinary one; and continued many days it takes away all Obstructions: we have seen Quartan Agues cured, by the use of it fifteen days together. If you fear the sharpness of the Salt of Tartar, you may correct it with the Spirit of Sulphur, or of Vitriol, putting fifteen drops of Spirit, to half a dram of Salt. You may find the use of the Spirit of Tartar in our Observations for the Cure of the Dropsy, under the Title of a Diuretical Spirit. Of Vitriol, only the Oil or Spirit is used in Apozemes, Syrups, and other Forms of Medicines. This following Syrup, which is good against all Obstructions of the Liver, Mesentery, and Veins, may be for an Example, by which, many through continual Fevers falling into evil Habits and Dropsies, have been perfectly cured. Take of the Roots of Smallage, Elicampane, Asparagus, Eringus, of each one ounce: Leaves of Agrimony, Ceterach, Maidenhair, Dodder, Carduus, of each one handful: the tops of Sea Wormwood, and of the lesser Centaury: of each half a handful: Winter Cherries one ounce: Spring Water six pints: boil them till two pints of the straining remain; in which dissolve of the Juice of Succory, and Burnet refined, of each one pint: the juice of Fumitory and Hops, of each six ounces: Fennel and Parsley juice, of each three ounces: Vinegar of Squils' one pint and an half: white Sugar six pound: make a Syrup, to which add of the Oil of Vitriol as much as will make it sharp; of which let the Patient take three spoonfuls before Breakfast, and as much before Dinner and Supper. The Natural sharp Baths show the Efficacy of Vitriol, the use whereof is frequent and profitable in all Diseases coming of Obstructions. But the Spirit of Vitriol mixed with the Salt or Spirit of Tartar, is much commended by the Chemists, and of them they make Tartar Vitriolate, and that rare mixture of Spirit of Vitriol, Tartar, and Treacle which may be mixed with other openers. Lastly, There are divers Medicines made of Steel, both by Galenists, and Paracelsians, which plainly opening Obstructions presently, compel all men to use them, even those who reject all Medicines made of Metals, as Enemies to our Natures. These Medicines of Steel are made either in the Form of Wine, Syrups, Opiates, Pills, or Lozenges. Steeled Wine is made thus: Take of the Filings of Steel four ounces: Eryngo Roots, and Elicampane, of each one ounce and an half: yellow one ounce: red Coral and shave of Ivory, of each six drams: Cloves, Nutmeg, and Cinnamon, of each two drams: Flowers of Broom, Rosemary, and Epithimum, of each two pugils: the best white Wine six pints: steep them eight days in Balneo Mariae, or behind an Oven: then strain them through a Hippocras bag, and let the Patient take two or three ounces every morning two hours before meat for fifteen days, or more if need require. Or make it thus: Take of Steel prepared with Sulphur, one ounce: Elicampane, and the middle rind of Tamarisk, of each half an ounce: Senna three ounces: Epithimum one ounce: Foecula Brioniae, and Cinnamon, of each two drams: Powder of the three , one dram and an half: Agrimony Water, and white Wine, of each one pint: Infuse them three days in Balneo Mariae. Let him take three or four ounces when it is strained, three hours before meat. Commonly they use the Infusion of Steel in white Wine, or Claret, for ordinary Drink, with much Water for two or three months together. You may make a Syrup of Steel thus: Take of Filings of Steel steeped in Vinegar, two ounces: the inward rind of Tamarisk half an ounce: Ceterach half a handful: Cinnamon three drams: Wormwood and Agrimony Water, of each half a pint: white Wine one pint: Infuse them six days in a warm place: add to the staining, Sugar one pound and an half: make a Syrup. Let the Patient take every morning two or three ounces. For the Preparation aforesaid of Steel, you must steep it in Vinegar in the Sun, while the Vinegar is consumed three times, and then grind it upon a Marble. This Syrup may be made Purging, and better, if you dissolve the Sugar with a pint of Water wherein three ounces of Senna, and half an ounce of Rhubarb have been steeped a whole night. The Powder of Steel is made thus, taken out of Quercetan's Dispensatory. Take of the shave of Steel, either commonly prepared, or with Sulphur, one ounce: the faecula of the Root of Cuckow-pintle one dram and an half: Ambergris half a dram (for the Poor, a Cordial Species will serve instead of Ambergris) Coral and Pearl prepared, of each two drams: Amber prepared and Cinnamon, of each four scruples: Sugar as much as is sufficient to make a pleasant Powder, of which let him take half a spoonful, or two drams with Wine for fifteen days. Of the same Powder and Sugar dissolve in Turnip Water and Confection Alkermes, may be made very pleasant Lozenges to be taken as the former: Or, Take of Steel prepared with Brimstone half an ounce: confection Alkermes two drams: Ambergris one scruple: Sugar dissolved in Rose Water four ounces: make Lozenges: Let him take two drams every morning. Instead of the Powder the Extract of Steel may be used, made in white Wine for those who are dainty. Divers Opiates are made also of Steel; these following are best. Take of the conserve of the Flowers of Tamarisk and Maidenhair, of each one ounce and an half: conserve of the Roots of Elicampane six drams: Steel prepared either with Sulphur or Vinegar one dram: Salt of Tamarisk one dram: Spirit of Vitriol half a scruple: with the syrup of candied Citrons make an Opiate, of which let him take two or three drams every morning: Or, Take of the filings of Steel half a pound: white Wine one Pint and an half: mix them in a Glass, set it to the fire, let be boiled gently, stirring it up and down, till a scum arise, then take the frothy and fat part of the Steel which is separated by the heat, and put it with Wine into another Glass: do thus four times, adding fresh Wine, heating, and separating them, set it on a gentle fire, till it be hot and grow thick as Honey, keep it for your use, which is this, Take of Steel so prepared six drams: Parsley and Carret seeds, the species of Diacurcuma, and Diarrhodon Abbatis, of each one dram: Cinnamon half a dram: with clarified Honey make an Opiate, of which take three drams or half an ounce every morning. Or, Take of Steel prepared with Brimstone one ounce: the best Senna, Rhubarb, and Agarick, of each two drams: Diarrhodon Abbatis one dram: Saffron one scruple: with syrup of Roses solutive, make an Opiate: of which let him take two drams every morning for fifteen days, three hours after meat. Pills of Steel are as good as the rest, and they may be made thus, Take of Steel prepared with Brimstone half an ounce: the best Aloes, Senna, Agarick and Rhubarb, of each one dram: Diarrhodon Abbatis half a dram: Saffron half a scruple: with syrup of Roses solutive make a mass of Pills: of one dram whereof make six guilded Pills, which give in the morning for fifteen days, three hours afore meat. To these Pills you may add according to the kind of the Disease and the Patient's occasion, of Gum Ammoniack, Sagapenum, Opopanax, Myrrh, Gentian, Birth-wort, Mastic, Nutmeg, and the like. In all Medicines made of Steel, this is always to be observed, That Exercise be used after them, as Walking, to make the strength of the Medicine to go into the parts obstructed: This Walking must two hours after; after which give a little Broth, in which opening Herbs and Roots have been boiled. Besides all these Remedies, the Chemists commend Mercurial Purges, of Mercurius dulcis, especially given with ordinary Pills, or Extracts, because Mercury doth violently penetrate, and open Obstructions. The Bezoard Mineral is very much commended, and given with Mercurius dulcis: You may give it thus made. Take of Bezoard mineral twelve grains: Mercurius dulcis six grains: conserve of Roses one or two drams: make a Bolus which must be given many days. If there be an Obstruction of the Liver in a Choleric body, with a hot and dry distemper of the part, then must you give cooling or temperate Openers, which shall be showed in the Cure of Flatus Hypochondriacus, mentioned among the Diseases of the Spleen. For his ordinary drink let him take Water and small Wine wherein Steel hath been infused: Or, a weak Decoction of Tamarisk, Agrimony, Ceterach, Maidenhair, Burnet, all or some with Wine, Some commend the Infusion of the Wood against the Stone called Lignum Nephriticum for ordinary drink: Others the Decoction of Eglantine or Sweet-briar which opens very powerfully, and strengtheneth; and they say that many have been Cured of desperate Diseases by that alone. But the Infusion of the filings of Steel made in white Wine, or thin red Wine, doth open better mixed with the aforesaid Waters, or with ordinary Water: for by this Medicine alone many Virgins have been Cured of the Green Sickness, and this Wine will work better, if they take every morning two ounces of clear Wine, besides the ordinary drink. Chap. 4. Of the Jaundice. THe Jaundice is a yellow colour of the whole Body, coming of Choler, spread over all the Skin. It is therefore a Symptom of the Quality changed. And now presently, that vulgar difficulty which is controverted by almost all Writers, offers itself; namely, That the yellow colour in the Cornea, doth immediately hurt the Sight, making all objects appear yellow. To which (that I may answer in a word, without circumstances) I say, That it is a disease in the increase of Number; for since the Cornea ought to be void of all colour, that it may let the Species of Objects pass through pure and unchanged, if it have any preternatural colour, it hath a Disease in the increase of Number, that is, more than what is necessary to the Natural Constitution thereof. Authors do make two sorts of Jaundice; Yellow, and Black. The Black proceeds from the Spleen and is very rare: therefore here treating only of the Diseases of the Liver, we will speak only of the Yellow Jaundice. The spreading of Choler upon the Skin, comes from many Causes; which may be reduced to three Heads: namely, An Evil Disposition of the Liver; An Obstruction of the Bag that contains the Gall; And the malignity of the Choleric Humour. The Evil Disposition of the Liver is divers; as Dstemper, Inflammation, Obstruction, Schirrus, and whatsoever may so weaken the part, that Excrementitious Choler cannot be separated from the Blood, but is with it distributed through the whole Body. The Obstruction of the Bag or Cystis, which contains the Gall, hinders the passage of it into the Guts, whereby it remains in the Liver, and goes from thence with the Blood into the whole Body. This Obstruction is either from gross Phlegm, or Choler abounding; sometimes from little stones which are often bred in the Bag of Gall; which may also be made narrow in the Passage, by the compression of some part nigh unto it, which is inflamed or schirrous. The Evil of the Choleric Humour consists, either in the great quantity thereof, which cannot be regulated by Nature, nor be separated from the Mass of Blood, or which so filleth the Bag of the Gall, that it cannot contract itself to expel it; or it consists in an evil quality, which by corrupting of the Humours, doth hinder their due Evacuation, or stirs up Nature suddenly to cast it forth, as you may observe in a Critical or Symptomatical Jaundice. This Corruption happens in continual Choleric Fevers; as also after Poison is taken, or from the biting of some venomous Creature, by which the whole Blood is turned into Choler. The Signs of the Yellow Jaundice are manifest; namely, a yellow colour through the whole Body, especially in the white of the Eyes. Also an itching, and laziness, bitterness of the Tongue, sometimes Choleric Vomitings, and Hiccoughs. The Signs of the Causes are to be taken from their proper Fountains; for if the distemper of the Liver be hot, this Disease comes from Inflammation, Obstruction, Schirrus, or the like: the knowledge of which is to be taken from their proper Chapters. These things properly show the Obstruction of the Bag of the Gall, white Excrements, and a Belly bound through the want of Choler, which useth to make the Excrements yellow, or red, and to stir up the Expulsive Faculty of the Guts like a Clyster. The Urine is very yellow, inclining to red and if you put a Linen clout therein, it will die it yellow. If it come from the malignity of the Choleric Humour, the Excrements of the Belly are high coloured, and also the Urine, especially if it follow a putrid Fever, when the Jaundice is a Symptom, and then after the coming of the Jaundice the Fever remains: but if it be critical, the Fever ceaseth, and the Excrements with the Urine are well coloured. The External Causes, as Poison, and venomous bitings may be declared by the Patient, and those about him. The Prognostic of the Jaundice is various, according to the variety of Causes. That is more Curable which comes from the Obstruction of the Bag containing the Gall, because its passages are nearer the Guts, and the Matter cleaving thereto, is easily sent into them, provided that the Obstruction come not from a stone, which because it cannot be dissolved, renders the Disease incurable. The Jaundice coming from an Inflammation or Schirrus of the Liver, is most dangerous; for one commonly ends in an Imposthume, the other in a Dropsy. They who in a Fever, have the Jaundice before the seventh day, are desperate, Hipp. Aph. 62. Sect. 4. against which Aphorism, there is another of, Hypocrates opposed, which is in 4. de victus ratione in acutis, in these words: In a Choleric Fever, if the Jaundice come before the seventh day, with chillness, the Disease is cured; but if it come without chillness, it is deadly. There is Reason for what he saith; for when in the third, fourth, and fifth day, the Crisis (or ground of Judgement) is healthful, if it be by Sweat, Urine, or Stool, why should not a Critical Jaundice fall upon those days? And Experience from many allowed Authors doth testify that the Jaundice doth often happen with safety before the seventh day. Now these Authors do interpret the aforesaid Aphorism thus; namely, That Hypocrates by the seventh day, understands any Critical day, and he mentioneth the seventh as the most noble day, and to be taken for all the rest. But that is a true Critical Day of Judgement, afore which, a full Concoction of the Matter causing the Fever, did appear. The Cure of the Jawdice, is by taking away of the Causes: For if it come from a hot distemper of the Liver, or a Tumour in that part, you must consult with the Chapters afore mentioned for the Cure of them. But that which comes upon acute Fevers, if it be Critical needs no Cure. Yet if it be Symptomatical, the Cure of it depends upon the Cure of the Disease upon which it depends. That which comes from the Obstruction of the Cystis, or Bag of the Gall, is cured by taking away of the Obstruction, which may be conveniently done by the Remedies mentioned in the former Chapter. To which we may add these as more proper. First take away part of the Humour with this following Bolus: Take of the Electuary of the Juice of Roses, and Diaprunis solutive, of each three drams: the powder of Rhubarb one dram: Saffron half a scruple: With Sugar make a Bolus; which you may give once or twice, if the Body be of a very ill habit. As for Phlebotomy, though Galen denyeth it, as unprofitable, yet if you perceive abundance of Blood, it is very good to abate it. After general Medicines this following Infusion used six or seven days, doth commonly pluck this Disease up by the Roots, if it be but young. Take of Madder Roots half an ounce: the greater Celandine one handful: the tops of Sea Wormwood, and of the lesser Centaury, of each one pugil: Cinnamon half a dram: Saffron half a scruple: Infuse them a whole night in eight ounces of white Wine, and add to the straining half an ounce of white Sugar. Let him take it in the morning three hours before dinner. Or you may make this Decoction following: Take of Celandine Roots and Leaves one handful: the Leaves and Flowers of St. John's wort, of each half a handful: the shave of Ivory and powdered Goose dung, of each three drams: Saffron half a dram. Put the Powder of Goose dung and the Saffron in a clout, and boil them all in equal parts of white Wine, and Wormwood Water to one pint: and when it is strained, add one ounce of Sugar. Give it for three morning draughts, and repeat it if you think sit. Quercetan commends for this purpose, the Dung of a green Goose that eats Grass in the Spring; and the dried white Dung of an Hen, given or divers days to the quantity of half a dram or a dram; and he saith that the Dung of these Aerial Creatures, is full of Nitre and Sulphur, and hath a wonderful Faculty to cut, attenuate, and dissolve. Dioscorides commends the Juice of Horehound for this Disease, and since his time, others, and especially Forestus, who reports that some were only cured by the use of the Syrup of the Juice of Horehound, when other means failed. Gesner commends the Nettle Root thus prepared: Take of Nettle Roots one pound: Saffron one scruple: beat them well, and take out their Juice with white Wine, and let the Patient take four ounces every morning for four or five days, and cover himself to sweat after it. While inward Medicines are given, let the Region of the Liver be anointed with this following Ointment. Take of the Juice of Smallage, Parsley, and Succory, of each one ounce: white Wine Vinegar half an ounce: the Oil of Tamarisk two ounces: boil them till the Juices and Vinegar be consumed; then add of yellow and Spicknard, of each one dram: Wax, as much as will make a Lineament. After the Obstructions are taken away, the yellow colour will presently vanish by the strength of Natural Heat, which will discuss the Humour from the Skin. But that it may sooner be gone, make a Bath of warm Water, and rub the Body therein with a Bag of Earley and Bean Meal. Chap. 5. Of the Scirrhus of the Liver. THe Scirrhus of the Liver, is a hard Tumour without pain, bred of a thick Humour, fastened and hardened upon the Liver. This Scirrhus is Twofold; either it is Exquisite, or Perfect; or Imperfect. That which is a perfect Scirrhus, is laid down in the Definition propounded, which is without Pain or Sense. That which is not exquisite or perfect, hath some kind of pain, and comes from a Matter less hardened; in a word, it is a Scirrhus' beginning, and not confirmed: but that which is exquisite is confirmed, so that they only differ in Degrees. A Scirrhus breeds in the Liver two ways; either from Defluxion, or Congestion of a thick and glutinous Humour upon the part; or from Inflammation, which dissolveth the thin Humours, and leaveth the thick. The Matter of the former, is Phlegm or Melancholy, either sent from other parts, or bred in the substance of the Liver by an evil Concoction. For the producing of this Humour, evil diet is a main cause, if it be of thick, cold, and viscous, or clammy Nourishment; as also a Phlegmatic or Melanchollick Constitution, and a Natural straightness of the Liver. From whence Galen saith, 13. Meth. That a Scirrhus easily breedeth in the Liver, Spleen, and Reins: In the Liver, because the Passages are narrow, and it is nourished with thick blood in the Spleen, because it receiveth the thick blood: and lastly, in the Reins, because they are nourished with thick blood. The Causes of the latter Scirrhus, which followeth other Humours, is the immoderate use of discussing Medicines, or of Repercussives, which by cooling and binding, do thicken the Matter, and keep it from dissolving. Besides, the Matter of the Disease, which is properly cold and thick, and will not be dissolved; or the weakness of the part, which cannot help the breathing forth of the Humours. And lastly, a cooling and thickening Diet. The signs of a Scirrhus in the Liver are, a hardness in the right Hypochondrion, and that more than in an Obstruction, next a heaviness in that part, especially when there is violent breathing, no Fever, nor pain, by which it is distinguished from an Inflammation, or there is but little pain, as when the Schirrus is not exquisite or perfect: There is less repose upon the left side, because the Liver being hard and heavy, doth then lie upon the Stomach, and burden it: the colour of the Face is pale, and and greenish, because when the Liver is Schirrus, there is no good Blood produced by it: The whoI Body also, is fallen away, because there is neither Sanguification, nor distribution of Nourishment as it ought to be. The Prognostic of this Disease is given by Galen, 2. ad Glaucum, cap. 4. in these words: An insensible Scirrus is incurable, but that which is a little sensible is curable, though with much difficulty. Also Galen, cap. 5. of the same Book, saith, We have cured a Schirrus of the Liver often in the beginning of it; but when it hath been of long continuance, neither could I, nor any other that I ever heard of, cure it. An old inveterate Scirrhus turns to a Dropsy incurable, of which some die sooner than others, if they have a looseness of the Belly therewith of long continuance. A Scirrhus which followeth the Jaundice, or causeth the same, is dangerous. Whence Hypocrates, Aph. 42. Sect. 6. saith, that if the Liver grow hard in them who have the Jaundice, it is an evil sign. The Cure of a Scirrhus, is first by the taking away of the Antecedent Cause, by the Apozem which is prescribed in the Obstruction of the Liver. To which you may add other Medicines proper to open Obstructions. Afterwards you must discuss the hard Matter with mollifying and opening things. For this end the Steel Pills above mentioned, are excellent, especially if you add thereto, Bdellium, Ammoniacum, and Sagapenum. But if the hardness be very great, you must give these Pills following, many days together. Take of Gum Ammoniacum dissolved in Vinegar, and strained, and again made thick, two drams: Bdellium, and Storax, of each four scruples: mix them. Take one dram every other day. And in the days between, let him use the Opiate, or strengthening and opening Lozenges prescribed in the Cure of Obstructions. These following Pills have a wonderful Virtue to soften a Scirrhus, and dissolve it. Take of the best Aloes, and Gum Ammoniack dissolved in Vinegar, strained, and again made thick, of each half an ounce: Mercurius dulcis two drams: Diagridium one dram: With Oxymel of Squils' make a Mass of Pills; of which let him take half a dram four hours before Dinner, for twenty or thirty days together. Zacutus Lusitanus, Obs. 41. Lib. 1. Praxis Admir. reports that there was a strong Scirrhus cured by the use of Conserve of Horehound forty days together. Some Practitioners commend the use of Turpentine thus prepared: Take of Turpentine washed with white Wine one ounce and an half: Sugar half an ounce: Give one dram every day, or every other day, for it is an opening Medicine that provoketh Urine, and looseneth the Belly. All the time of Cure, let the Patient take white Wine, or thin Claret steeled, for his ordinary Drink. Also the other Preparations of Steel before mentioned, are very good. Outwardly you must apply Fomentations, Ointments, and Plasters, thus made: Take of Marsh-mallow Roots, Briony and Lily Roots, of each one ounce: Mallows, Viole●● Pellitory of the Wall, Wormwood, and Agrimony, of each one handful: Linseed, Foenugreek and Dill seed, of each half a dram: Chamomel, Melilot, and Risen flowers, of each one pugil: boil them in three parts of Water, and one of white Wine, or in Water and Vinegar. With the straining, let the Region of the Liver be fomented every morning and evening. If the Scirrhus be very great, add to the Decoction, Flowerdeluce, wild Cucumbers, and Dwarf-Elder Roots, and make the Decoction in Tripe Broth, and white Wine. Take of Oil of Lilies, Chamomel, Melilot and sweet Almonds, of each one ounce: Oil of Roses and Wormwood, of each half an ounce: Gum Ammoniack dissolved in Vinegar three drams: Wax two drams: make a Lineament, with which anoint the part aforesaid, after the Fomentation. If you desire a stronger Lineament, Take of the Juice of Briony and wild cucumber, of each two ounces: the Oil of Capars and Tamarisk, of each three ounces: white Wine one ounce: boil them till the Juice and the Wine be consumed, then add two drams of Wormwood in powder, Gum Ammoniack dissolved in Vinegar half an ounce: with a little Wax make a Lineament. Take of the Emplaster de Mucilaginibus one ounce: Melilot half an ounce: Gum Ammoniack melted in the Juice of Wormwood three drams: soften them with a little Oil of Wormwood 〈◊〉 Lilies, and make a Plaster to be laid on after the Lineament. The Leaves of Henbane boiled in Vinegar are good to be outwardly applied to the part, made ●● to the form of a Cataplasm or Pultiss, with Oil of bitter Almonds. To these you may add Baths made of softening and digesting things, and of strengtheners, such as we prescribed for Fomentations; and let the Patient use them by turns. And finally, Make an Issue in the right Leg, that part of the Matter offending may be that way drawn forth. Chap. 6. Of the Dropsy. HIppocrates makes two kinds of Dropsies; namely, An Universal, and a Particular. An Universal Dropsy, is that which is in the whole Body, or over the whole Belly: a Particular, is that which is only in one part: hence there is the Dropsy of the Head, Breast, and Womb; of which, here we shall not speak, but only of the Universal. Galen gives three kinds of this Universal Dropsy; namely, Ascites, Tympanites, and Anasarca, or Leucophlegmasia. Ascites is a swelling of the Belly, caused of a serous Humour; nor doth the Belly only swell, but many times the Feet, Legs, Thighs, and Cod. Nay, an Ascites sometimes gins with a swelling in the Feet, which ascends after to the Legs, and so to the Thighs and Belly. This serous Humour, as it is of the Nature of Water, it is cold; but as it is salt, it hath in it heat, which then is increased by the nearness of the Bowels, and more by the putrefaction which it gathereth by long continuance: hence comes a Fever and Thirst, namely, from the stinking salt vapours which do infect the mouth of the Stomach. It falls out sometimes, that this Watery Humour, is not contained in the Cavity of the Belly, but in certain Bladders growing to the parts of the lower Belly. An Example whereof is given by Schenkius, Lib. 3. Observation; and Mauritius Cordaeus, Com. 5. in Hipp. Lib. 1. of Diseases in Women. Galen supposed (and almost all Physicians, new and old, have followed him) that every Dropsy comes of a cold Liver, which cannot Sanguisie or make Blood completely, but instead thereof much Water, Phlegm, or Wind. Which Opinion, as it is most true in Anasarca, and approved; so in Ascites and Tympanites it is much questioned by many Modern Writers, because in the opening of many that died of Dropsies, the Liver hath been sound very sound, as is manifest by many relations in those Authors mentioned. Moreover, Hypocrates 2. Prorrhet. wittily affirms that a Dropsy may come either from the Liver, or from some empty part: by an empty part, he meaneth all that space from the Ribs to the Guts, and the parts contemned in it. Also Hipp. 4. de morb. Mulierum, mentions a Dropsy coming from the Spleen. To which places of Hypocrates they usually answer thus, That the Liver is always affected either primarily or secondarily; so that there is never a Dropsy before there is a hindrance of Sanguification, or breeding of Blood. But two Reasons do strongly oppose this Doctrine: The first is from the Experience before mentioned, namely, That if the Liver ought necessarily to suffer in the producing of a Dropsy, it would never be found free and unknit in the Dissection of a dead Body. The second is, That if the Liver should breed watery Blood, it would be sent into the whole Body, as in Anasarca; nor can a sufficient reason be given, why that serous Humour bred in the Liver should be sent to the Belly, and not to other parts. As for the cold distemper of the Liver, that is denied by Trallianus, Avicenna, and others, who affirm that a Dropsy may arise from a hot distemper of the Liver, and cannot be cured but by cooling means. And this may be maintained by the Authority of Hypocrates, in 2. Progn. A Dropsy (saith he) coming after an acute disease, is evil, for it doth not take away the Fever. If therefore a Dropsy may come while the Fever is, it is clear that there is still a hot distemper. Neither could that ever please me, which is usually spoken by Galens Servants, That the Native heat is dissolved by a hot distemper, and much diminished, and that diminished heat may be called cold. For so in a Hectic Fever, and other constant Fevers, in which the Natural Heat is much diminished, we should always blame a cold distemper, and the Symptoms which follow should be impured to cold, and not to heat. From whence, who doth not perceive that there would arise a great consusion in the searching into the Causes of Symptoms. Among the late Writers, Carotus Piso, whom Sennertus followed, hath dived most deep into the true Causes of Ascites, which he affirms to come from a serous Matter contained in the Meat and Drink, which by reason of some preternatural Cause, is stayed too long in the Gate and Hollow Veins, not sent into the Body, as in a Natural state and condition it useth to be, but into the capacity of the Abdomen. This serous Humour is retained in the Veins, from the whole Body, by reason the attractive faculty of the Parts, to which it should be carried, is either hurt or hindered. Now the chief parts which draw the serous Matter, are the Liver and the Spleen. For they attract the Chylous Matter in which the moisture of Meat and Drink is contained. As also the Spleen draws Drink to its self, pure and without mixture; as Hypocrates taught, and Experience confirms, That they who drink much after Meat, do presently avoid it by Urine; which learned Authors say, is by reason the Spleen sucks the watery Matter before there is a perfect Concoction made in the Stomach. The Attraction or drawing quality of the Liver and Spleen, is lost chief by defect and weakness of Natural Heat: the Natural heat is debilitated by a cold or hot distemper, or by Suffocation. A cold distemper coming either from too cold a Diet, from loss of too much Blood and Spirits, or any other Cause, doth destroy the Natural Heat of the Liver and Spleen, and so hinder their Actions. A hot Distemper doth disperse the Native Heat; whence being made weaker, the Liver and the Spleen become less Active. This comes from Fevers, much Wine, or hot Meats. Lastly, The Natural Heat is weakened by Suffocation, when there is too much Blood in the Veins, especially if it be foul, as when the Terms of Hemorrhoids are stopped, by which the blood was cleansed formerly, but now by stoppage corrupted. Also the Attraction or drawing virtue of those parts, is hindered by Obstructions, which hinder the free passage of the serous Matter. So a Dropsy followeth a Scirrhus of the Liver and Spleen, not only because those parts being weakened cannot produce good Blood, but especially because they are not able to attract, and send to other parts whatsoever is drunk. Here it may be objected, That in a Dropsy the whole Body is nourished by Blood bred in the Liver of a Chylous Matter, which it draweth to itself. We answer, That the Liver doth better attract that which is most familiar unto its self, and most sit to be made blood; but it draweth to it less than is sufficient, by reason of the weakness of the attractive faculty. Hence it is that the Body grows lean, because it draws some water along with the Chylus, and leaves the rest in the Meseraick Veins, and the Veins of the lower Belly, which is by degrees carried into the Capacity of the Abdomen. We do not deny that Sanguisication or making of Blood, is hindered in a Dropsy, especially when the distemper is very cold or very hot, or the Obstruction or Scirrhus' great, for then there cannot be a perfect making of blood. But we deny that that is the next and immediate Cause of a Dropsy; but rather an effect thereof, when the Water corrupted in the Abdomen, doth also corrupt the Bowels that swim therein. Next to the Liver and the Spleen, the Reins do attract the watery Matter which is in the hollow Vein, and free the whole body from the superfluity thereof, so that if at any time they do not their office, there remains much matter in the veins, which being sent to the Abdomen do quickly make an Ascites; now the attraction of the Veins may cease for divers Causes, because of a Cold Distemper, Tumours, Ulcers, and Obstructions, which will Diminish, Abolish, and intercept their Function. Lastly, The distribution of Water is hindered from some external Cause, as when much cold Water is drunk, which Nature cannot govern, nor sufficiently distribute into the Veins: So Carolus Piso reports of a young man that had a Tertian Ague, and drinking Water exceedingly in his Fit into an Ascites, from which by the taking of one Lozenge of Diacarthamum he was Cured by discharging the Water which was in the Abdomen, but if he had continued drinking so much water any louger, he had not been so easily Cured, because it would have brought great obstructions and a cold distemper of the Bowels, by reason of the loss of natural heat. But it is questioned of many by what ways that serous matter should be carried by the Veins into the Capacity of the Abdomen, to whom we may plainly answer, by saying from Hypocrates that in a living body all things are passing to and fro, so that in time of necessity not only thin and serous Matter, but also that which is very thick may be sent through the insensible passages: So in a Pleurisy blood and matter will pierce through the thick substance of the Pleura and Membrane which covers the Lungs, and be spit forth at the mouth: So in a Fracture of the Leg or Thigh, which hapens without hurt to the Muscles and Skin, the matter which floweth from the broken bone, pierceth through the substance of the other parts and wets the bolsters and rulers. So also in a Dropsy often times a great quantity of Water is vented in one day by giving of Quicksilver, which cannot be except the Water contained in the Abdomen do pass through the Tunicles of the Guts. Nor is the Objection of Fernelius of any force, when he saith that Nature had in vain made so many open ways, if the Humours can pass through those invisible passages: For we Answer, That in an ordinary and natural motion of Humours ordained for the nourishment of the whole body, those passages are necessary through which they may easily flow, but in an extraordinary case, provident Nature doth find out extraordinary ways by which she may cast out hurtful Matter, or at least send it to a place less dangerous. Fernelius Objects again, That in them who have died by a stoppage of Urine for twenty days together, it was never perceived that any Water went through those blind passages: We Answer, That Nature doth not always work the same way in preternatural Causes, nor send hurtful Humours to the same places, but especially to those parts which are more disposed to receive them through weakness. So in the Suppression or Stoppage of Urine, the Serous Humour flows openly through the Veins and Arteries and fills them, and if it find any part weaker than the rest it falls forceably upon it: hence it is that some die of the hurt of one or other remarkable part. So nothing hinders (if the parts of the Abdomen in which the Veins and Arteries end) be grown weak, but that the Watery Humour may be sent into its capacity or hollowness. Nor is that true which Fernelius would infer, namely, That a Dropsy never comes from suppression of Urine, for Reason and Experience teacheth the contrary: as we shown afore in the Discourse of the Loss of Attraction in the Reins: but you must observe that the Stoppage of the Urine doth make an increase of Water rather in the branches of the hollow Vein, then of the Gate Vein or Vena Porta, by which the watery Humour chief flows into the capacity of the Abdomen as appears by what followeth. Therefore we may Answer this Question, by saying, That the water got into the hollow of the Abdomen, by the insensible passages though there are also other manifest ways by which it may pass. Hypocrates, Aph. 55. Sect. 7. hath showed them, for (saith he) they who have much Water about the Liver, if it get into the Omentum, or Kels, their belly will be filled with Water, and then they die. The meaning of which Aphorism is (though Galen did not plainly see it) that the Water from the Liver doth flow into the Branches of the Vena Porta which go to the Omentum, and when they are filled, either by their Tunicles made thin by Diapedeses or Rarefaction, or by the mouths of the Vessels being opened by Anastomosis, the Water gets into the Cavity of the Abdomen: This happens often in the Spleen also, when it draws Water in abundance from the Stomach, as appears by many say of Hypocrates; and in lib. 4. de morbis, he saith, That Water may press from the Spleen to the Omentum or Kell, in these words, Drink is also carried into the Stomach with which when it is filled the Spleen takes it from thence and sends it to the Veins and the Omentum. From which we may perceive, That Water chief gets into the Abdomen, by the Veins of the Omentum which are called Epiploicae, and Gastrepiploicae, although it may pass also through their Veins. Besides the aforesaid Causes of a Dropsy, which are more ordinary, there are mentioned by Authors some less usual, confirmed by Observation: and these come from the disorder of some peculiar part, not only of the Liver and Spleen, but also of the Mesentery, Sweetbread Stomach, Guts, Reins, Bladder, and Womb, namely, when the Homiosis, or faculty to convert nourishment into themselves is hurt, from s●me great Disease, so that their proper nourishment is corrupted and turned into Water. So Galen, Comment. Aph. 55. Sect. 7. saith, that watery Bladders are sometimes in the outside of the Liver, which being broken, send Water downwards into the Cavity of the Abdomen, the increase whereof breeds a Dropsy. Fernelius supposeth that the Liver being very dry, hath clefts like the parched Earth, and that through them there flows a constant Water which fills the Cavity of the Abdomen. Others say that a Dropsy may come from the Guts, if they be perforated or pierced through, and yet the Patient dieth not presently but a watery Humour still flows through them into the Cavity. It comes also from the Kidneys, if they be much Ulcerated, and water flow from them. So Platerus reports of one that in a Dropsy had many Ulcers in both Kidneys, from whence both matter and water flowed into the Cavity. There is also a Story in Sennertus, taken out of John Heinzius, of a certain Woman who had a Dropsy from the distemper of the Womb, whose Bowels were all sound, except the Testicles or Stones, which were found to be swollen as big as the Head of a newborn Child, being blue, hollow, and full of Ulcers, from which there came a serous Matter which caused the Dropsy. The Dropsy called Tympanites, hath its name from Tympanum, a Drum, because the Abdomen is stretched out like a Drum, and if you strike it with your hand, it sounds like it. This stretching comes from wind shut up in the Cavity of the Abdomen. But sometimes this wind is in the Cavity of the Guts; which Platerus observed, saying in some that have been thought to die of a Tympany, after they were opened, have had no wind coming forth of the Cavity of the Belly; neither did their Bellies, but their Guts sink, especially the thin Guts, which were so stretched with wind that they came forth so rolled together that they could not be again thrust into the Belly. But we must observe that the wind which causeth a Tympany, is seldom contained in the Belly alone, but for the most part mixed with Water; as in an Ascites, not only Water, but Wind also is contained; and both these Dropsies have their name of that which predominateth: if there be more wind than water it is a Tympany; but if more water than wind, an Ascites: but if they be equal, it is between both; ●o that we may doubt whether that Dropsy be a Tympany, or an Ascites. The Material Cause of Wind, is a crude Humour and thick, whether it be Phlegm or Melancholy, which being stirred and made thin by heat, sends forth thick vapours, which are hard to be dissolved, and these are called Flatus. This Crude and thick Humour, is partly in the Stomach and Guts, but especially between the Membranes of the Midriff and Guts, from whence it is more hard to be moved than from the Cavity of the parts aforesaid. The 11. Aph. Sect. 6. of Hypocrates, makes this very probable; They who have pains and gripe about the Navel and Loins, which cannot be removed, have a dry Dropsy. For because the Mesentery is joined to the Guts by the fore part, and to the Loins by the hinder part, we may easily perceive that the pains which reach from the Navel to the Loins, come from the Mesentery. Besides, The greatness of the pain, shows that the Cause is deep in the substance of the part, and cannot be removed: For if it were in the Cavity of the Stomach and Guts, it would easily be remedied. Concerning the Efficient Cause, Authors differ; some say from a cold, some from a hot distemper. They which accuse a cold distemper, think they have Galen on their side, who says that wind is bred of a weak heat. To whom we answer, That heat may be said to be weak in respect of the Matter which cannot be discussed or dissolved thereby. But this is to be imputed to the Matter, which is rather defective than the Heat, which is commonly too great and Preternatural. And we must acknowledge with the Learned, That a Melanchollick Humour is most fit to breed a Tympany, which proceedeth from the parching heat of the Bowels; which heat doth stir that Matter, and produceth from it thick vapours that are hard to be dissolved. The Dropsy called Anasarca, comes of a Phlegmatic Humour spread through the whole Body, and therefore the Body is swollen and white; from whence the Disease is called Leucophlegmatia. This Phlegm comes from a cold Liver, which instead of good Blood, produceth crude and phlegmatic; which when it cannot be turned into the substance of the parts, leaveth the crude part that is unfit for Nourishment upon them, and makes them swell; hence comes Anasarca, or Leucophlegmatia. This Disease beginning, is called Cachexia, or an evil Habit, and turns into Leucophlegmatia, from which it differs but in degree. The Antecedent Causes are, all things that cool the Liver too much, and hinder its Concoction, as too much cold and moist Diet, the stopping of the Terms or Hemorrhoids, Obstructions, cold Tumours, Scirrhus and large bleeding, and other great Evacuations, by which the Native heat is diminished. The Signs of a Dropsy, and every sort of it, may be known by what hath been said. In an Ascites, you may know that there is water in the Abdomen by its greatness, lost Swelling, and broad, and if you press the sides, you shall easily hear a noise of Water, and when the Patient turns from one side to the other, and then the whole Belly lieth as it were on that side: then the Feet and Cod swell, but the higher part grow less; the Urine is little and thick, sometimes red, because there goes but little water to the Reins and Bladder, and stays long there, by which means it becomes red and thick. In the progress or increase of the Disease, there is difficulty of Breathing, by reason of the abundance of water which lieth upon the Diaphragma or Midriff, especially when the Patient lieth down, and therefore he is forced to stand or sit most usually. There is a troublesome thirst from the saltness of the Humour, with which the Stomach swimmeth. And lastly, there is a constant linger Fever from the corruption of the Water, which at length doth corrupt all the Bowels swimming therein. In a Tympany, the Belly being struck, sounds like a Drum; the Bulk of the Belly is less burdensome than in an Ascites: There were formerly pains about the Navel and Reins, when the Patient lieth with his face upwards, his Belly remains hard and stretched forth, nor doth it turn aside when he turneth himself. Lastly, In an Anasarca, not only the Belly, Thighs, and Legs, but also the Hands, Arms, Breast, Face, and whole Body swell; and wheresoever you thrust your finger upon it, it will pit, and leave an impression. The colour of the Skin is pale and Earthy, the Flesh soft and lose, the Water thin and white, breathing difficultly, and sometimes a linger Fever. As to the Prognostic: Every Dropsy is dangerous, and hard to be cured, and the more hard by how much the elder, but Anasarca is least dangerous; but Ascites and Tympany are sometimes one more dangerous than another, according to their Causes. So if Ascites come from a Scirrhus of the Liver, or Ulcer of some internal part, it is more dangerous than a Tympany; but if it come of drinking too much Water, or new Obstructions, it is less dangerous. A Dropsy is more easily cured in Servants than in Freemen, in Country men than in Noble men; for they will be better constrained to abstain from Drink and the like, and be more patiented than they who have liberty. A Dropsy from the hardness of the Spleen, is less dangerous, than from the hardness of the Liver, because the Spleen is not so Noble a part. A Dropsy coming upon an acute Disease, is evil; nor will it abate the Fever, but cause pain and death. Hipp. 2. Prognost. They whose Liver being full of water, discharge it into the Omentum or Caul, their Belly is filled with Water, and they die. Hipp. Aph. 55. Sect. 7. He who hath Water between the Skin, or an Anasarca, if that water which is in the Veins flows into the Belly, the disease is cured. Hipp. Aph. 14. Sect. 6. This Aphorism seems coutrary to the former. But this contrariety is answered, by saying that Hypocrates in the former, by Belly, understood the Cavity of the Abdomen; but in this, Belly its self; for if the water flow through the Belly, the Disease is at an end. Which Opinion is more clearly explained by Hypocrates, in Coacis, in these words: In the beginning of a Dropsy, if there come a flux of the belly, without want of Concoction, or Crudity, it is prevented. You must mark that it is in the beginning; for if a flux come upon an old Dropsy, it is not so safe, because commonly there is some fault in the Bowels by continuance, as a Scitrhus, or corruption of substance, which begets new matter, and death also. Henee Hipp. in Prorrh. saith, that they who are to be cured of the Dropsy, must be Euspiagchnous, that is, those that have sound Bowels, free from the great Diseases mentioned. Otherwise, if a flux of the Belly happen with a Scirrhus or corruption of the Liver, they die presently, as Galen shows 2. ad Glau. cap. 5. And Avicen saith thus: Straitness of breath, and flux of the belly signify death within three days. Little Urine in Dropsies, is evil; the less, the worse, because the Drink runs into the Belly, and not into the Reins. Hence Hipp. in Coac. saith, Little and thick Urine, and a Dropsy that is Feverish, is deadly: but if the quantity of Urine increase, we may hope well. Which is elegantly laid down by Celsus: And then (saith he) there is hope of Health, when they void more Urine than they drink: Therefore it is good every day to measure the Urine, and the Drink, and the Belly with a string, especially while Physic is given, to see whether it grow less or not; for if it increase notwithstanding the Medicines, it is desperate. Imposthumes, or spots in the Legs or Hydropical men, are deadly. Hypocrates confirms this 7. Epid. in the History of Bion and Ctesipthon; the one whereof died presently after an imposthume which ran in his left Knee: the other after he had a red and bluish gathering in his right Thigh. Men that are cured by Medicines for Dropsies, if they fall again into the same, are desperate, Hipp. in Coac. For it signifieth that there is some incurable fault lurking in the Bowels, which after the water is emptied, reneweth it again. If the Patient have sound Bowels, and strength, eat his meat, and concoct well, and be not sick after; breathe freely, have no pain, cough, or thirst, and his tongue grow not rough, so much as in his sleep; if Medicines presently purge him; and if without Medicines he be bound, and in a Natural order; and if his Urine change according to his Diet, or if he be not faint. If all these things be present, the Patient is recovered; if some of them, there is hopes of amendment; if none, he is desperate. In a dry Dropsy, to piss by drops is evil. Hipp. in Coacis. A Tympany in a Melanchollick Body, is deadly, and Remedies are given in vain. If in a Leucophlegmatia, a strong Diarrhoea follow, the Disease is cured. Hipp. Aph. 29. Sect. 7. but this Diarrhoea must be at the beginning, or at least before the Disease be old, or the strength of the Party weakened; but if it happen when the Patient is weak, it is dangerous. The Cure of the Dropsy consists in the Evacuation of the Matter, whether it be in the whole Body, or in the Abdomen or Belly; in taking away the Cause that produced that Matter, and in strengthening of the Bowels, especially the Liver. The chief and most ordinary Causes are, great Obstructions, and Scirrhus or hard Tumours, the Cure of which Diseases is to be taken out of their proper Chapters. But if they will not suffice, you must use these following, which are more proper in Dropsies, and vary them according to the variety of Causes, and the Bodies sick. And first, you must give an ordinary Purge, by an opening Apozem that expels slegm and water, made thus: Take of the Roots of Eryngus, Madder, Smallage, Parsley, and Elicampane, of each one ounce: Valerian, Asarabacca, Dwarf-Elder, and Flower deluce Roots, of each half an ounce: the Bark of the Roots of Capars, and inward Bark of an Ash and Tamarisk, of each six drams: the Leavs of Agrimony, Ceterach, Maidenhair, Germander, St. Johns-wort, Wormwood, and the lesser Centaury, of each one handful: Sold anella, or wild Mercury half a handful: the seeds of Carrots, Parsley, and Fennel, of each half an ounce: scraped Liquoris, and Raisins stoned, of each one ounce: clean Senna one ounce and an half: Agarick tied in a clout three drams: the seeds of Dwarf-Elder, and jalap Roots, of each one dram and an half: Ginger and Cloves, of each one dram: Broom, Elder, and Tamarisk flowers, of each one pugil: Boyl them in equal parts of steeled Water, and white Wine added towards the end, to a pint and a quarter. When it is strained, dissolve therein, Syrup of Succory with Rhubarb, four ounces. Make a clear Apozeme, aromatized with three drams of Cinnamon, for four morning draughts. After Universal Purging, let the Patient take this following Powder once a week: Take of Clean Senna, Gummy Turbith, Hermodacts, Dwarf-Elder seeds, Jallan, and Mechoacan, of each one dram: Cream of Tartar two drams: Cambugia, half a dram: the powder of Diamber, Diarrhodon Abbatis, and Fennel seeds, of each one scruple: Sugar candy three drams: Make a Powder of them all, of which infuse two drams, or two drams and an half all night in four ounces of white Wine. Let him take the Wine and the Powder in the morning. The Syrup of Rhamus' solutivus, or Buckthorn, made of the Juice of its Fruit, called Rhein Berries, with Sugar, given one ounce at a time, doth wonderfully purge water. It must be taken presently after Dinner. Or give the Magistral Syrup made of the Decoction of the Apozeme afore mentioned, the dose of Purgers being increased; or this following: Take of the Juice of Damask Roses two pints: the Juice of the Roots of Danewort, Flowerdeluce, Succory Leaves, and Agrimony, of each half a pint: the seeds of Danewort, Mechoacan Roots, and of the best Rhubarb, of each two ounces: Spicknard three drams: yellow two drams: Crystal of Tartar one dram and an half: infuse them a whole night, and after a little boiling strain them; then put as much white Sugar as is of the Liquor: boil it into a Syrup; and add to it of the salt of Wormwood half an ounce. Let him take two drams with opening Broth once in a week. Or instead of this Syrup, or at other times when it is not taken, you may give these Pills, which purge the evil Humours, and also open Obstructions. Take of the best Aloes, steeped in the Juice of Wormwood, half an ounce: Gum Ammoniack dissolved in Vinegar and strained, the best Myrrh, and Crocus Martis prepared with Sulphur, of each three drams: Salt of Wormwood and Tamarisk, of each two drams: Diagridium, and Troches of Albandal, of each one dram: Saffron, Ginger, and Salgem, of each one scruple: With Oxymel of Squils' make a Mass of Pills, of which give half a dram twice in a week two hours before Dinner. Also Purging Wines are much commended for the cure of the Dropsy, of which there are divers Forms. But these are best: Take of the Roots of Asarabacca, and Mechoacan, of each two ounces: the French Flowerdeluce, and Bark of the Roots of Danewort and Elder, of each one ounce: Elicampane Roots half an ounce: dry Wormwood and Dodder of Time, of each one pugil: clean Senna one ounce: Soldanella or Sea-foal-foot two drams: the Troches of Rhubarb and Agrimony, of each one dram: Mace and Cinnamon, of each half a dram: Scammony four scruples: white Wine two pints and an half: Infuse them three days in Balneo Mariae; the vessel being well stopped, keep it without straining. Let him take two or three ounces in the morning, twice or thrice in a week. Among Medicines for drawing forth of Water, the Juice of French Flowerdeluce is very much commended, if it be drawn forth with white Wine, it may be given to three ounces; it provoketh stool and urine very powerfully. But because it is very offensive to the mouth and stomach with its sharpness, it useth to be mixed with Manna or Honey. Massaria gives it thus: Take of Juice of Flowerdeluce newly drawn with white Wine, three ounces; the best Manna one ounce and an half. Mix them for a Potion. Platerus in his Observations; I gave (saith he) to one in a Dropsy, of the Juice of Flowerdeluce to drink with Honey two ounces, and he often pissed and purged; and after he had taken it twice or thrice, his Belly ceased swelling, and his Feet, and he was cured. Rhubarb is commended of some, because it purgeth noxious Humours, and strengtheneth the Liver. And Stocherus saith that he cured many with the use of Rhubarb given every third or fourth day, one or two drams in an opening Decoction. Also in Scoltzius his Epistles, there is a famous Story of one who was cured of a Dropsy, only by the use of Rhubarb, which he took every day in such a quantity as was necessary to purge. The Troches of Rhubarb are much commended by all Authors. And Mathaeus de Gradi reports that a certain Duke of Orleans, was cured with them alone, taking two drams twice in a week. Michael Paschalius saith that he cured a Dropsy with the same, making them into Pills, by reason of their bitterness. The Chemists commend the Extract of black Hellebore., Aquila Coeleftis, and Mercurius vitae, and they mix them with other vulgar Medicines, from whence followeth a plentiful Evacuation of Water. But they had need of strong Bodies who take them. Mercurius dulcis works most gently, and Mercurius Diaphoreticus. But Antimonium Diaphoreticum cures without manifest Evacuation, if it be calcined with Salt-Peter till it be white: but the Diaphoretic or Sweeting Medicine made of the Butter of Antimony, cures all kinds of Dropsies best. But you must observe in the giving of all sorts of Purges, That they, especially if strong, are not to be given often, as Galen teacheth Lib. 9, Cata Topous, because they weaken the body, and then there will more water be bred afterwards. Therefore you must prescribe strengtheners and openers oftener than purgers. And Experience teacheth us, That the Evacuation by Urine in this Disease hath better success than that by stool. Instead of Purgers, you may give Clysters, which discuss wind, purge water, and take down the belly, made thus: Take of Mallows, Mercury, and red Coleworts, of each one handful: Soldanella or wild Mercury half a handful: Annis, Caraway, and Dill seeds, of each three drams: Chamomel, Melilot, French Lavender and Broom flowers, of each one pugil: boil them to a pint. In the straining dissolve of Diacatholicon one ounce: Hiera Picra half an ounce: Oil of Dill and Lilies, and of common Honey, of each two ounces. Make a Clyster twice in a week. Or, Take of very sour Leaven half an ounce: common Salt one pugil: Boyl them in as much Water as is sufficient: strain it, and add to it, the Urine of a Child four ounces: Oil of Rue three ounces: Clarified Honey one ounce. Make a Clyster. This Valeriola commends highly. This following Clyster, brings forth Water in abundance: Take of Coloquintida one dram, Infuse it for a night in three ounces of white Wine: when it is strained add thereto, Tripe Broth one pint: common Oil two ounces: Salt-Peter melted one ounce: strong Vinegar one spoonful: make a Clyster. Or, Take of the Pulp of Coloquintida one dram: Clean Bran one handful: boil them in white Wine for a Clyster. Or, Take of Carthamus' seeds one ounce: the best Agarick half an ounce: the pulp of Coloquintida three drams: Centaury the less, Germander, and both the Wormwood's, of each half a handful: boil them to a pint. In the straining dissolve of Oil of Chamomel, Rue, and Capars, of each one ounce: Honey of Roses two ounces: make a Clyster. Or, Take of the Emollient Decoction one pint: thick vomiting Wine, the Infusion of Crocus metallorum four ounces: Diaphoenicon one ounce: make a Clyster. Blood-letting here, is for good Reason omitted, except the Disease come from stoppage of the Terms or Hemorrhoids. And then you must not bleed except it be in the beginning of the Disease, before the Liver be grown too cold. Issues, Blisters and Scarrifications, use to cause Gangrenes, or mortifications in a Dropsy, because the heat of the part being small, is quickly extinguished: Therefore it is better wholly to abstain from these kind of Remedies, although sometimes they have done some people good. Paracentesis, or cutting of the Skin, is seldom to be used, because few are cured thereby, especially because the Patients, or their kindered will not yield to it before the Disease is confirmed, and the Bowels are so putrefied that there is no hope. Therefore for the most part they die the second or third day after they are cut. The wiser sort will have the Incision made in the beginning or increase of the Disease, before the Bowels are corrupted. Neither is it necessary at that time, because the disease being small may more safely be cured with other Medicines. Among emptying Medicines, Sweatings are accounted most profitable, which, as they are always good in Anasarca, so in a Tympany, or Ascites, they sometimes hurt, namely, when dryness of the Liver (which is usual) causeth the Disease. Moreover, it is commonly impossible to make men in Dropsies sweat. But if the Liver be not dry, Sweats are good in all kinds of Dropsies, especially when they decline, to discuss the relics of the watery Humour by the Habit of the Body. So Valeriola reports that he cured an Ascites with a Decoction of Guajacum given forty days together. It is good to make the Decoction with steeled Water and Wine. The Chemics commend Antimonium Diaphoreticum. Martinus Rulandus makes a Sudorific of Juniper Berries, which because they are forceable to provoke Urine, may do good both ways. It is thus made: Take of Juniper berries bruised three handfuls: Sack as much as is sufficient: boil them to halfs and give two ounces every morning, covering warm after it. Horatius Reserus in Scholtzius, boasteth that he hath cured many Boys, and some Women of the Anasarca with Syrup of St. Ambrose, which is a Sudorific: Its description is in an old Dispensatory called Luminare majus, thus: Take of Gromwel seeds husked two ounces: spring Water half a pint: boil them till three or four ounces of water only remain; which being strained, mix it with as much Sack, and give it warm; it will sweat him plentifully if he be covered warm. But those Medicines are best which purge by Urine, and the Cure is commonly better this way. One of the chief, is two ounces of the Juice of Chervil given every morning in Wine for many days. Opening Wines that purge by Urine are good in this case; as this, Take of Elicampane, Smallage, Fennel, and Flowerdeluce Roots dried, of each one ounce and an half: Roots of Valerian, Gentian, Asarabacca, and Squils or Sea Onions, of each one dram: the middle Bark of an Elder, and Sassaphras, of each six drams: dried Wormwood, Agrimony, Germander, and Maidenhair, of each two drams: the tops of Centaury the less, and Broom flowers, of each one dram: Parsley, Annis, and Dill seeds, of each one dram and an half: Cinnamon two drams: Spicknard half a dram: bruise them together, and infuse them in white Wine some few days, and let him drink thereof every morning. The steeled compound Wine prescribed in the Obstruction of the Liver, is good for the same. The Decoction of Juniper mentioned, is to be reckoned among the Diuretics. And if you fear it is too hot, you may make it in Water, and put a little Spirit of Vitriol to it. Fonseca commends the use of Turpentine washed with Barley Water, and he gives half an ounce thereof twice in a week. And lastly, The Spirit of Salt, Tartar, and Vitriol, given in a true quantity with an Apozeme, or other opening Decoction for some days, do wonders: because they being very thin, do run into all the parts of the Body, and open them. The Salts of Wormwood, Juniper, Bean Stalks, and the like, given in white Wine, do the same. Or in want of Salts you may make a Lee of the Ashes of the same, which will be sufficient Mathiolus upon the 87. Chap. Lib. 1. of Dioscorides, saith, That a Lee made of Juniper Ashes with white Wine, and four or five ounces thereof taken, doth powerfully provoke Urine, so that I have seen some men cured of a Dropsy with it alone. Moreover, In the whole time of the Cure, you must use strengtheners to the Liver; for it is in vain to purge water, if you do not hinder the increase of it: which you cannot do except you refresh the Liver, and bring it to its former temper. Among the chief Strengtheners is Cinnamon Water; of which you may give one Spoonful every morning, and before Supper. But Galen in his Eight Book Kata Topous commends the Electuary called Cyphoides by the Arabians from the Wine whereof it is made, of which you may give half an ounce in the morning, according to Hollerius it is thus made, Take of Curans cleansed half a pound: boil them in old Sack to the consistence of a Pultis, strain them after they are pounded, and then add of the conserve of Rosemary flowers, Citron barkcandied, and Cinnamon, of each one dram: the Powder of Aromaticum Rosatum, Diamargariton calidum, and Diacinamom, of each two scruples: Lignum Aloes half a dram▪ Saffron half a scruple: mix them for a soft Electuary. The Opiates prescribed for the Obstruction of the Liver are here very profitable. The Conserve of Sea Wormwood is very good, made of one part of the Leaves and three of Sugar with which Matthiolus in his Chapter of Wormwood saith some have been Cured. Poterius makes an Opiate of Conserve of Roses, Specificum, Somachium, and Crocus Martis, and Oil of Vitriol, by which only Medicine he saith he hath Cured Dropsies. The Specificum Stomachium, is Antimony fixed. The Cure of men in Dropsies lieth much in their drink: therefore there must be care of that, that he drink sparingly, and endure thirst as much as may be: for it is known that many have been Cured only with abstaining from drink and eating of dry meats without other means: For Drink let him take Elicampane or Wormwood, Juniper, or Steeled Wine, or let him use the aforesaid Steel Medicines. Avicen forbids men in a Dropsy to see Waters. But if you fear too much Heat or Dryness, or if the Patient be Abstemious, he may use the Decoction of Juniper, of Guajacum, or Sassaphras, or of Madder, which provokes urine very much, either alone, or with white Wine: But because he must abstain from Drink (as we said) and yet there is great Thirst, it must be assuaged by Fits with washing the mouth with steeled Water and Vinegar, or with often chewing Mastic or the like; for it will draw water to the mouth, not only (as some think) out of the head alone, but from the Stomach and Cavity of the Abdomen, and therefore it will do much good. Of Meats we say thus, That he must choose the Driest and avoid Sweet meats as the Plague. While you use Internals, forget not Externals, for they are of great force to discuss the Humour of the Belly; as Fomentations, ●ags, Ointments, Pultisses, and Plasters: The Chief are made thus, Take of Marsh-mallow and Lily Roots, Cypress barks, Capar barks, middle barks of Ash, Tamarisk, dwarf-Elder, & the greater Snakeweed of each three ounces: Wormwood, Agrimony, Marjoram, Organ, Calamints, Penyroyal, R●e, Ground-pine, Southernwood, and Elder, of each one handful▪ Parsley, Dill, and Cummin seeds, of each one ounce▪ Chamomel, Melilot, and Broom flowers, of each three pugils: Spickenard, Schoenanth, Nutmegs, Cloves, and Cinnamon, of each half an ounce: Salt and Alum, of each half a pound: boil them all in a Lee made of Oak Ashes, or branches, with this Foment the whole Belly with Sponges dipped therein and strained. Or, Take the Urine of a sound Boy, four Pints: Lapis Prunellae, three ounces: boil them to the consuming of the third part for a Fomentation. Aquapendens Commends Lime Water, in which he dips a new Sponge which will compass the whole Abdomen; this he strains and binds on, by which he affirmeth, That the Waters that Cause the Dropsy are consumed, the cold and moist distemper of the Bowels are taken away, and the hardness of the Spleen dissolved. Claudinus quencheth the Lime in a Salt Bath Water, that is either of Brimstone or Salt-peter, and bindeth close the Sponges dipped therein and strained with Rulers to the Belly, and keeps them there long, and then changeth them. You may make Bags of the ingredients of the former Fomentation boiled in white Wine, and applied warm to the belly. After the Fomentation let the belly be anointed with Oil of Dill▪ Rue, or Flower-de-luce, mixed with Powder of ammoniacum, Galangal, Dill, Bay-berries, and the like. It is also good to anoint with the Oil of Scorpions according to Matthiolus, and with a little Oil of Rosemary. Many do make Ointments and Liniments of strong Purgers, which draw Water violently from the Dropsy, and assuage the Swelling of the belly, but they are dangerous, for the Purging Quality getting between the Muscles and the Membranes, doth often stir up a deadly Looseness. After Liniments, or if they be omitted you may apply Cataplasms or Emplasters: This following is the best, Take of the Roots of wild Cucumbers well bruised and steeped twenty four hours in Vinegar of Squills, one pound: clarified Honey two Pints: mix them, and boil them to the consistence of a Cerat, and ad in the 〈◊〉 your ounces of the Powder of Cumminseed, make an Emplaster for the belly to be renewed ev●●y day: Or, Take of dried Cowdung one pound: Brimstone and Cummin seeds Powdered, of each two drams: New Wine boiled called Sapa: or of the Urine of a Boy, as much as will make a Cataplasm. A Cataplasm of Rhadishes bruised and laid to the Navel and Reins, doth provoke Stools and Urine. Galen Commends a Cataplasm of Snails bruised with their Shells, which must be kept to the belly till it fall off of its own accord; it draws water forth violently. Valeriola makes it in form of a Plaster thus, Take of Cowdung one pound: Goats-dung half a pound: boil them in strong Vinegar, and beat them in a Mortar with three ounces of Brimstone, and one ounce of Alum: the Juice of Spurge and dwarf-Elder newly drawn, of each three ounces: Lupine and Orobus meal, of each two ounces: the Powder of Soldanella, Annis, Fennel, and Cummin, of each two drams: common parched Salt, three drams: Turpentine, four ounces: Pitch, six ounces: make a Plaster. It is worth the Observation which Wierus and Varignana say they have found by Experience that a Toad found in the Woods, cut through the belly and tied to the Reins, doth provoke Urine violently; and when you will evacuate more, apply another. Petraeus also reports that the Powder of the same Toad dried and calcined in an Oven, drunk half a dram in Wine or other Liquor, doth wonderfully expel the Dropsy by Urine. The first Inventor of which Experience desiring thereby to destroy himself, was cured thereby contrary to expectation. Also this following Cerat made of a Toad is excellent, Take of Toads two pound: the Juice of dwarf Elder three Pints: Oil one pint: Wax half a pound: boil them in a luted Pot to the consumption of half, strain them for a Cerat; spread this upon a Leather and lay it to the Spleen it evacuateth all waters. All the time of the Cure you must▪ strengthen the Liver and Stomach, if the humour doth begin to abate, or is not so great that it hinders the Virtue of outward Medicines from coming to the part. Take of the Oil of Orange flowers one ounce: the Oil of Spike three drams: the Ointment of Roses, the stomach Cerot of Galen, of each two drams: distilled Oil of Mastic two scruples: the distilled Oil of Wormwood one scruple: Oil of Nutmegs one dram and an half: white Wax a little: mix them for a Lineament to be applied to the stomach. Take of Sea Wormwood three drams: Horehound and Rosemary, of each two drams: Red Roses two pugils▪: Ghamomil flowers and Bay Leaves, of each half an handful: Orange peels and sweet wood, Aloes of each three drams: Cypress Roots, Schoenanth, and Spikenard, of each half an ounce: with two parts of the best Wine, and one part of Wormwood and Agrimony Water make a Decoction, with which Foment the Region of the Liver with a sponge first washed in Wormwood Water. Take of the Ointment of Roses and Cerot of Sanders, of each three ounces: Red Roses, Endive and Sorrel seed, of each one dram: Spikenard, Schoenanth, dried Wormwood, and Styrax Calamita, of each four scruples: Oil of Mastic or Wormwood as much as will suffice to make a Lineament to be applied to the same part after the Fomentation. For the most part in a Dropsy the Thighs, Legs, and Feet have a cold swelling, and for the discussing of it a Lie is good in which the Roots of Dwarf Elder, and Elicampane, Rosemary Leaves, Margerum, Thyme, Bays, Organ, Salt and Alum have been boiled. Although the things aforesaid are chief used, yet sometimes they are not necessary, namely, when the Dropsy comes in a hot and dry Constitution from hot causes which disperse the natural heat, as in vehement Choleric Fevers, for then cold things for the Liver mixed with warm Openers are best, such as are used in continual Fevers: And the Magistral Syrup above mentioned made of the Juice of Roses, Succory, and Agrimony. For ordinary Drink give a Decoction of Succory Roots and Calcitrapa, or white Chameleon, which is not unpleasant; or of other Openers, but in a greater quantity than above, which may quench thirst, assuage the heat of the Liver, and moisten the dryness thereof: It is not amiss to confirm this Doctrine by a famous example (though it be allowed by Avicen, Trallian, and others) because it seems strange to some▪ and is of great Consequence: Baptista Montanus reports, Cons. 263. in these words; I saw (saith he) in Venice a certain Predicant Friar that was cured of an Ascites and Tympanites: there were▪ with me many famous Physicians; namely, Papiensis, Eugubinus, Trincavella, and others: He had (as I said) an Ascites with a Tympany, and a Consumption with a Hectic Fever; therefore we were bound both to dry and moisten: therefore we were in a great contention; I was willing that he should drink much, but things that Open, because he had many obstructions▪ and that moisten because he had a Consumption: I prescribed the Syrup of Vinegar with all things that provoke Urine: Eugubinus would not allow him to drink, and told a story of one who was cured by dry things: Papiensis to end the controversy, said, That he should neither drink much, nor at all; we argued till night: the Noblemen brought their Physicians to their Boats, and there Papiensis said to a Nobleman, what he had concealed formerly, If you would have this man cured, there is nothing to be done but what Baptista Montanus saith. In this case also Medicines of Steel, Tartar, and Vitriol are excellent, because they strongly Open and provoke Urine without any great heat. But the tart, Vitriol Mineral Waters are best, because they powerfully open the Bowels, provoke Urine, and correct the Distemper of the Bowels, whence experience showeth us that many Dropsies are every year cured at the Spa. Avicen reports in the Chapter of the Cure of Ascites, of a Woman which had a great Dropsy and eat an incredible number of Pomegranates, whereby she was cured. And Varignana reports out of Platearius, That an Old Woman boiled the Juice of Plantain to the Consumption of half, and gave it to one that had a Dropsy from a Hot Cause every day, and so Cured him. By these Examples it is plain, That sometimes a Dropsy is Cured with Cold things; and to these we may add the testimony of Christopher a Vega, lib. 3. art. med. sect. 8. cap. 12. who saith there, We saw one that had a Tympany from the Hot Distemper of the Liver whom we cured with cold things, laying upon the Liver the Juice of Endive and Succory with a little Vinegar, and giving Endive and Succory to be eaten. The End of the Eleventh Book. THE TWELEFTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Spleen. The PREFACE. ALthough the Spleen may be afflicted with all kinds of Diseases, both Similary, Organick, and Common: yet we will only speak of those which are most ordinary in practice; and we will contain them in six Chapters. The first shall be of the Inflammation of the Spleen. The second of the Pain. The third of the Obstruction and Tumour, or puffing up of the Spleen. The fourth of the Scirrhus, or hard Tumour. The fifth of Hypochondriack Melancholy. The sixth of the Scurvy. Chap. 1. Of the Inflammation of the Spleen. THe Inflammation of the Spleen is of the same Nature with that of the Liver: only it differs in this; That it seldom comes from pure, but from Melanchollick Blood. It hath the same Causes, both Conjunct, and Antecedent: but the Diagnosis, or knowledge by signs, is different. The signs of the Spleen inflamed, are swelling and pain in the left side under the Ribs, which sometimes reacheth to the Midriff, and the left Shoulder; also heaviness, and beating in the same side, a constant Fever, loathing of Meat, Thirst, blackness of the Tongue, trouble some lying on the right side, by reason of the heaviness of the part lying upon the Stomach then; sometimes troublesome lying upon the left, if the Tumour be great, for than it is pressed both by the Stomach, and the Liver; sometimes the Tumour is in the shape of the Spleen, sometimes it fills the whole left Hypochondrion, sometimes it appears below the Navel, when the matter is increased, and when the Inflammation reacheth to the parts adjacent, and especially to the Navel. These signs are greater or lesser, according to the divers mixtures of Humours. For if Choler be mixed with Melanchollick Blood, the Urine is more red, the Mouth bitter, the Thirst greater, the Fever stronger and worse every third day; great watch, and sometimes do●ing: if it be mixed with Phlegm, the Colour is pale, the Fever and Thirst is less, and the pain less: But if the Blood be only Melanchollick, the hardness is greater, the colour is black, and sometimes the Urine, and there is other signs of Melancholy predominating. The Prognostic is almost the same with that of the Liver inflamed, but less dangerous, because the Liver is the nobler Part. If it kill not the party, either it ends in a Crisis, or it is dissolved or suppurated, or grows hard and turns into a Scirrhus. A good Crisis is when the left Nostril bleeds, or when there is a purging by Stool or Urine. The Cure of this Disease, is the same with that of the Liver: only observe these Differences. First, You must open the left Arm in this, and not so often as in the Inflammation of the Liver, because the Liver being the Fountain of blood, wants greater Evacuation. That which is reported of the Salvatella Vein to discharge the Spleen so properly, is but a conceit, and is now out of use: you may better take blood out of the Liver Vein▪ called Bastica. Secondly, You must apply those Topics, or outward Medicines now to the left side. Thirdly, You must not take such care in the use of binding Medicines outwardly, because the Spleen is not so noble a part, and needs less strengthening. Other things are to be taken out of the Cure of the Inflammation of the Liver. Chap. 2. Of the Pain of the Spleen. Sometimes the Spleen is pained without Fever or hardness; and this comes from wind which doth not only stretch the substance of the Spleen, which is almost insensible, but the Membranes that covereth it. It is easily distinguished from the Inflammation by the Fever, and hardness being absent, but hardly from the Colic, because the Colon is just under and over the Spleen: yet the pain of the Spleen is weighty, and in one place; but the pain of the Colon is stretching, sharp, and movable, and runs about the whole Belly. The Cure of this Disease, is with Clysters that are Carminative, or that expel wind with convenient purging, and with Emollient and Discussing Fomentations mixed with Vinegar: As also with Liniments made of Oil of Lilies, Chamomel, Capars, and Wormwood, with a little Spike and Vinegar. If the pain remain after the use of these, apply a Cupping-glass to the left Hypochondrion, if there be no suspicion of the Inflammation or Defluxion. Chap. 3. Of Obstruction, Tumour, or Puffing up of the Spleen. THe Spleen is no less subject to Obstructions than the Liver, but more, because it receiveth thicker and fouler blood, which is more easily contained in its Veins, or insensible Passages, by reason of the softness and looseness of the part, which is more fit to receive thick Humours. And when thick Humours stick in the substance of the Spleen, it makes a Tumour, and an Inflammation in the part. And if the Humour by long continuance grow thick and hard, it breeds a Scirrhus; but as long as it is moist with Phlegm, it is like an Oedema or phlegmatic Tumour, which is most usual with them who live in Marshy moist places, or who live upon cold Diet. But if this Tumour be soft and lose, it is called simply an Inflammation, or puffing up, the cause whereof, is partly phlegm, and partly wind. They are commonly called Splenitick people who are thus afflicted. The Causes of the Obstruction of the Spleen, are the same with them of the Liver, and this or that part is, as it is more or less disposed to receive them: Sometimes both Liver and Spleen are affected together; for a gross Humour can hardly be in one part, but some of it must be carried to the other. The Obstruction of the Spleen is distinguished from the Obstruction of the Liver, from the Situation of the part; for there is a heaviness in the left Hypochondrion, and sometimes pain, especially after running o● great walking or riding: and when you handle the Hypochondrion, there is a stretching and resistance; Besides, the Face is bluish, and there are other Signs of Melancholy. This Disease is stubborn and of long continuance, by reason of the softness and looseness of the part, which cannot therefore easily discharge the humour; and if it last long and be not Cured speedily, it turns into a Scirrhus. The Cure is the same with that of the Obstruction of the Liver, by adding some things which do more properly respect the Spleen, and are fit to prepare and purge Melancholy. The Pills of Ammoniacum which follow, are to be added as most excellent, and to be used often, Take of the best Ammoniacum dissolved in Vinegar of Squills one ounce: the extract of Aloes half an ounce: Crystal of Tartar one dram: Myrrh and Saffron, of each half a dram: Mastich, Benjamine, Salt of Ash, and Wormwood, of each one scruple: with Oxymel of Squills make a mass of Pills. The Dose is half a dram twice in a Week, with Purging between. In Apozemes and other Opening Drinks, Oxymel simple, and of Squills, or Sea Onions may be very well dissolved, to cut and dissolve powerfully the gross and earthy humours. Of all other Medicines those which are made of Steel are the best to open the Obstructions of the Spleen. Also you may give Steeled or Ironed Waters for ordinary Drink, which are known to lessen the Spleen (as Celsus saith) by this, because Beasts that are brought up at Smith's houses have little Spleens. To the Fomentation put Vinegar instead of white Wine, which will make them pierce better, which is requisite in a gross humour. Moreover Galen Commends Vinegar exceedingly in the Diseases of the Spleen, used both inwardly and outwardly. Put Hemlock to the Cataplasms; as being most Powerful to Soften, and Discuss Humours. There is an Excellent Cataplasm made of Green Tobacco; boiled in Oil, and White Wine. Of which also boiled to the Consumption of the Wine, you may make a Rare Lineament. Amatus Lusitanus, curate. 6. cent. 5. mentioneth a Cure of an Obstruction of the Spleen remaining after a Quartan Ague, That it was taken away with a Decoction of China used twenty days after convenient Purging. Chap. 4. Of the Scirrhus, or Hard Swelling of the Spleen. THe matter of the Spleen causing obstruction by continuance grows thicker, and makes a Scirrhus: And since the Scirrhus of the Liver and Spleen are both of one Nature, whatsoever we have said of the Scirrhus of the Liver, may be here also useful. The Knowledge also of the Scirrhus of the Spleen is the same with that of the Liver, but only the hardness is on the contrary side. It is Distinguished from a Windy Tumour; because there is more Heaviness in a Schirrhus, than in a Windy Tumour, which yieldeth to the Finger, and maketh a Noise; all which are not in a Scirrhus. If it come only of Melancholy, there will be evident signs thereof; but if it be mixed with Phlegm, there is apparent in the whole body a Phlegmatic evil habit. The Prognostic also is the same with that of the Liver; only this of the Spleen is more easily Cured; because the less Noble the part is, the stronger Medicines may be Applied without Danger. And Lastly, The Cure is the same with that mentioned in the Scirrhus of the Liver. And because it is to be done by degrees, from mild to stronger Medicines: first you must use those Remedies which we said were good for the Obstructions of the Liver and Spleen: and among the Chalybeat Medicines there commended, the Principle is the Pills of Steel, made with Amoniacum, and other things mentioned in the Obstruction of the Liver. Pills of Aloes, Ammoniacum, and Mercurius dulcis, are the best among the Medicines for the Scirrhus of the Liver. But this following Opiate is the Medicine will Cure, if it be not incurable: Take of Gum Ammoniack, Opopanax, and Bdelium, of each two drams: dissolve them in white Wine: strain and boil them, then add of confectio Hamech, and Diaphaenicon, of each two drams: double Catholicon half an ounce: Pilulae foetidae two drams: make an Opiate, of which let him take half an ounce with twenty grains of Mercurius dulcis for many days together, and so the Tumour and hardness will vanish. And besides what was said concerning the Liver, you must observe these following Precepts in in this Disease. First, Because Blood-letting is much questioned, we resolve that it may be good in the beginning. But it is good for nothing when the Disease is old. Secondly, The dead or blind Nettle called Galiopsis, or Pliny's Archangel, is commended by Solenander and Fonseca, for a special Remedy; the Italians call it the Spleen Herb: this is given boiled in Wine, the quantity of an ounce, or one dram in Powder, with Wine or other convenient Liquor or Decoction, with most admirable success. Thirdly, Besides the Fomentations there mentioned, Aquapendens in his Chirurgery, commends the fomentation of the Belly, with a Sponge dipped in Time Water, and squeezed; and with that he saith he hath cured the Scirrhus of the Spleen and Dropsy. Fourthly, Besides the Ointments afore mentioned, Amatus Lusitanus commends this following as admirable, by which he saith he cured a Scirrhus of the Spleen; and he saith that he had it from the Physicians of Ferraria. Take of Common Oil three pints: the Marrow of an Ox bone one pound: fresh Butter half a pound: the Juices of Briony and Showbread, of each one pint: boil them gently till the Juices are almost consumed. Add to the straining, yellow Wax eight ounces: the Powder of Ceterach or Spleenwort, Capar barks, Tamarisk, and Agnus Castus seeds, of each three drams. Mix them into an Ointment. Thus it is described by Amatus; but there is too much for one Patient, therefore you may lessen it thus: Take of Common Oil three ounces: Ox Marrow one ounce: fresh Butter half an ounce: the juice of the Root of Briony and wild Cucumbers, of each one ounce and an half: boil them as afore, and add one ounce of Wax, and of the powder of Ceterach: Capar and Tamarisk Barks, and Agnus Castus seeds, of each two drams. Fifthly, The Cataplasms following are excellent: Take of the Roots of wild Cucumbers one pound: Mallows and Violets, of each three handfuls: boil them till they are soft, beat them and strain them: then add of the Oil of Capars and Tamarisk, Vinegar of Squills a little: make a Cataplasm. Take of sour Leaven two pound: Boyl it in equal parts of Oil and Wine to a Pultiss. Besides the Plasters mentioned in the Scirrhus of the Liver, these are very good: Take of Gum Ammonial ●our ounces: Dissolve them in strong Vinegar: then strain them, and boil them till the Vinegar be consumed: then with a little Wax make a Plaster. Take of Hemlock four handfuls: Ammoniacum half a pound: Infuse them in Vinegar eight days: then boil them till the Ammoniacum be dissolved: then strain them through a linen cloth, and boil the Liquor again a little while, and with Wax and Oil of Almonds, make a Plaster. Take of the Juice of Mallows, Cressonis, the Stalks and Roots of Fern, of each two ounces: Gum Ammoniack four ounces: With a little Vinegar, first dissolve them with a gentle fire, then boil them, and strain them: then boil them again to the consistence of a Syrup, and with one ounce of Oil of Capars, and a little Wax, make a Sparadrap for the Spleen, to be renewed every third day. Aquapendens in the place cited, saith, that he cured many with this Plaster, which is made of two parts of Ammoniacum dissolved in Vinegar, and one of the Juice of Tobacco; one of the Rozin of the Pinetree, Turpentine, and Juice of Danewort; one of Oil of Capars, and a little new Wax in the Form of a Cerat. Chap. 5. Of Hypochondriack Melancholy. ALthough all the parts beneath the Ribs, called Hypochondria, are affected in this Disease, yet it's thought the Spleen is most, because it receives the Melancholy, and therefore it is fitly placed among the Diseases of the Spleen. This Disease comes of Preternatural Melancholy, and other adust Humours, especially Blood, or Choler, or Natural Melancholy. This Melanchollick Humour is not pure by its self, but commonly mixed with others, as Choler, Phlegm, and Water, from whence come the diversity of Symptoms, which hereafter shall be mentioned. These Humours breed in the Spleen, especially when it is distempered with heat, and also in the Liver: hence it is that they draw meat and drink to themselves, which is not concocted, that which is thin of the Chyle sooner than that which is thick: and then the thicker part for want of something to carry it, stays in the Meseraick Veins, and the longer it stays, the thicker it grows, and sometimes is burnt: and afterwards coming to those parts, it is not well concocted. Moreover, thine parts in their Natural state should concoct by boiling, now do it by roasting; hence comes this great adustion of Humours. It may also be, that this Disease may be bred without the distemper of the●e parts, from evil Nourishment that breed Melancholy blood; and also from good blood retained too long in the vessels, and being too much, as in the stoppage of the Terms and Hemorrhoids, which continuing long in the Vessels is burnt, and turned into Melancholy. It may also come from the Stomach not well concocting, but turning it into a parched Crudity, from which those evil Juices are bred in the Liver, and the Spleen. And Galen, 3. de loc. affect. cap. 7. following Diocles, thought the proper seat of it was in the Stomach, because in this Disease there are commonly signs of an ill Stomach: But it is more probable that the Stomach should be afflicted secondarily from the Liver or the Spleen, as we will clearly show hereafter. These evil Humours are gathered into the Veins and Arteries, which are in the bottom of the Stomach, especially in the great branches of the Gate Vein, the Spleen Veins, and those of the Mesentery, Caul, and Belly, in which they have often great and grievous ferventations or workings; from whence stinking Vapours are sent to the Brain, Heart, and Midriff, which cause those divers Symptoms in those parts, which we shall after mention. Also the Humours are contained in the Bowels, especially in the Spleen and Sweetbread, and the Glandles of the Mesentery, the substance of which parts is foft, and like a Sponge, and therefore is more ready to receive them, and harder to cast them forth. Besides, the Glandles which are dispersed through the Mesentery, to be a prop to Veins and Arteries, and to hinder lest they should be pressed by the Guts being full, or by any other thing: If these swell much, they do press upon the Vessels, and hinder the passage of the Humours, whence come Obstructions in those passages. Boys and young men are little subject to this Disease, by reason of their moist temper unfit to breed Melancholy: but men often, because the Humours are burnt by heat in youth; and when that heat decays, and the thin parts are exhaled, there is a great increase of Melancholy. The Antecedent and principal Causes of this Disease, are first Meats of evil Juice, and hard of Concoction, which are fit to breed Melancholy; as brown Bread, or unleavened, or crusty, Pulse, Cheese, hard Eggs, and fried Meats, Water Fowl, Beef, Venison, Hairs, and all Salt and smoked Meats, and many other things of hard substance. Secondly, Great Passions of long continuance, especially Sadness, are very powerful to breed this Disease because they disperse the Spirits, by which means the Concoction is weakened, and so there is great Crudity, which being burnt by the hot Bowels turn into Melancholy. Thirdly, Idleness, by which the Excrements are retained, especially if there be much study and watching; hence it is that learned men, and such as ●it much are very subject to this Disease. Lastly, The stoppage of the Terms and Hemorrhoids, both in respect of their quality and quantity produce it: For when Melanchollick, Salt and Humours, used to be discharged by those ways, if they are stopped they return to the Hypochondria and cause this Disease. The Knowledge of this is taken from the Symptoms which follow, and they are many, because almost all parts of the Body suffer thereby when it is high: We shall reckon them up, admonishing first, That all do not happen to all Patients, but some to one, some to another, according to the diversity of the Humour, and the part affected. First therefore, the Stomach commonly suffers, not principally, as Galen from Diocles supposed; but secondarily: When Blood coming from the Branches of the Gate Vein, to nourish the Stomach is not good; from whence the Stomach being ill nourished, doth ill concoct, and turns its Meat into corruption. Hence comes a circular Evil, when the Liver and Spleen send evil Blood to the Stomach, and the Stomach breeds evil Chyle to return to them, of which they make bad blood. Therefore in this Disease the Stomach commonly concocteth ill, and turns the chief part sometimes into Water, sometimes into sharp, sour, and clammy substance; which being not drawn by the Guts and Meseraick Veins, because unfit for nourishment, stays in the Stomach; and coming upwards sometimes fills the Tongue with Spittle, so that the Patient's 〈◊〉 much, and sometimes vomit. Sometimes the Matter in the Stomach boileth, and fermenteth; from whence comes wind, which doth not only stretch the Stomach, but the parts adjacent, and make the Heart so sick that sometimes the Patient swooneth. Sometimes the Wind is sent out upwards and downwards, and by insensible transpiration, or the Matter causing them is vomited forth. Yet you must observe that all that is vomited out is not bred in the Stomach, but is sent from the Spleen and other parts to it: for sometimes the humours vomited are so sharp that they set the teeth on edge, and these are sent by the short vessel from the Spleen to the Stomach. In some there is blood so sent, with Melancholy and other evil Humours, which is cast forth partly upward, and partly downward; as we shown at large in the Vomiting of Blood. In this Disease there is often belching and noise beneath the ribs, by reason of the abundance of Wind made of those Crude Humours: hence it was wont to be called the windy Disease. Now, how Wind is bred of Melancholy, we shown in the Tympany. Sometimes pains arise in the Stomach and Hypochondria, of the same Wind, which reach to the Back and Loins, so that you would think it the Stone of the Kidneys, especially if the Urine be thick and red, as usually it is. The Belly is often bound, because the Meat is turned into clammy Matter, which sticks to the Guts, which the expulsive Faculty cannot cast out without help of Medicines, and therefore the Patients are constrained to take Purges and Clysters often. Sometimes there is a Flux of the Belly, if the Humours grow sharp, and have in them much Choler or Melancholy. There is a heat in the Hypochondria, and a certain Inflammation inward, sometimes in one side, sometimes in another, from hot Humours contained therein, especially when they are moved by inward or outward means; so that the Face will grow hot and red from those vapours; and sometimes there is an Ephemeral, or Fever, for a day, by those vapours sent through the whole Body. The Urine is sometimes thick, sometimes thin. Thin, when thick Humours stop the passages through which it is as it were strained, thick, red, and troubled, by reason of the mixture of the thick Matter, which is very salt, and therefore is called (Materia Tartary) and it lies at the bottom of the Urinal like a thick Sediment. Or some part of it sticks like red Sand to the sides, which makes many fear the Stone without cause, because this same is not bred in the Reins, but in the Liver, from a and salted Humour, and you may know this, because it dissolves between the Fingers like Salt, which will not when it comes from the Reins. Sometimes there is a Palpitation, or beating of the Heart, by reason of the vapours ascending, which while it labours to expel, make it move violently; and then the Patient thinks himself in great danger. Sometimes there is a beating in the left Hypochondrion, when hot Humours are there; from whence vapours arise, and make the Pulse or Systole and Diastole of the Arteries greater; so that both the Patient and the standers by may feel it, which is chief after heat with Anger, motion, or drinking of much Wine. This beating is chief in the Coeliack Artery, which is the chiefest in that part. In an old Disease, it is sometimes constant; and this signifies an Habitual and incurable Disease. An Aneurism sometimes followeth this great breathing, from the enlarging of the Coeliack, or some other Artery, and from the hot blood in them, which being very thin and full of many hot Spirits, continually dilateth and stretcheth the Arteries while there is an Aneurism, such as Fallopius observed, Lib. de tum. preter naturam, cap. 14. in an old woman, who being opened had an Aneurism in her Belly, into which he put his fist. From which, mark by the way, the great providence of Nature, which fearing the breaking of an Artery through too much enlarging, hath made the coat of it as hard as a bone, as Fallopius observed in the same place. Also Paraeus in his sixth Book, Cap. 28. tells the like story of an Aneurism, found not in the Belly, but the Breast, in the Venal Artery, which was so stretched that it could contain his sister; and also the inward Tunicle thereof was like a bone. And we have seen the like about two years ago, namely, an Aneurism in the Breast by the dilatation of an Artery, which would hold the fist of a Boy of fifteen years old; and the Tunicle thereof was grown like a Gristle. The evil vapours that ascend from the Hypochondria, produce many Symptoms: for being sent to the and Tongue they dry those parts, and cause a thirst: when they go to the Lungs and Midriff, they cause shortness of breathing; when to the Membranes of the Brain, Headache; when to the Brain, noise in the Ears, dimness of Sight, Giddiness, Fear, and Sorrow, and divers Melancholy Fancies. And if they be malignant, and very sharp, they cause an Epilepsy, or Falling-sickness: if they come to the Nerves, Convulsions: and if they be stupifying they cause a Numbness, and bastard Palsy, Coma, and Apoplexy, if they get into the Brain. But if these vapours be hot and dry, they dry the Brain, and cause watch, troublesome sleep, and frightful Dreams: and at first, though they sleep well after Supper till midnight, afterward they wake, some three or four hours, and some sleep again about three or four a clock, others not at all. The reason whereof is this: Because while the Chyle is carried to the parts that serve for the second Concoction, than the evil Humours lying in the Vessels, are stirred, and send up vapours, which being sent by the Veins and Arteries to the Head, cause watching, and if they be quickly discussed, they sleep again; but if they continue long, they watch the other part of the night. We have formerly spoken of all these Symptoms, and we say again, That all are not in all men, but more or sewer, according to the variety of the Humours, and parts affected. This also is to be marked; It is not Essential to Hypochondriack Melancholy, that stretching, hardness, pain. and swelling, should be in the Hypochondria, because the cause is for the most part in the Branches of the Gate Vein, and Arteries adjoining, and sends from thence vapours to the Heart and Brain. Oftentimes there is stretching in the Liver and Spleen, which signifieth, That the Humours stick in those parts: but if there be no stretchings, it is a sign that the evil Humours lie in the Veins of the Mesentery, Caul, Sweetbread, and Stomach. These proper Symptoms show that the Stomach is affected with sour belchings, and stinking, or loathing, vomiting, want of concoction, and sometimes flux of the belly. As for the Prognostic: This Disease is not deadly for the most part, but of long continuance, many times the whole life, therefore it is commonly called the disgrace of Physicians, because they do seldom cure it; and if the Patient seem to be cured, it returns again in a few months: it is also called the Scourge of Physicians, because they who have it are continually ask new Medicines, and presently satisfied therewith, and daily complain to the Physician for others. The Flux of the Hemorrhoids doth good in this Disease, if it be moderate; but if it continue long it is dangerous. A thick Urine is better in this Disease, than a thin and watery, which shows that the thick Humours are detained in the Body. Black Urine without a Fever, doth often Cure this Disease. It's good in this Disease to have a lose Belly, and bad to be bound. Also Vomiting, if the Patient be refreshed thereby, is profitable; but if it continue long, it is dangerous. A Giddiness, and continual pain in the Head in this Disease, ends in an Epilepsy, Blindness, or Apoplexy. The Cure of this Disease, is in three things chief: first in opening Obstructions: secondly in amending the distempers of the Bowels: and in discharging of the peccant humour, not omitting strengtheners: For which a wise Physician may use these following. First give a Clyster, than this Potion: Take 〈◊〉 Senna half an ounce: Annis seeds, and Cream of Tartar, of each one dram: Borrage flowers, Fumitory, and Sorrel, of each half a handful: Liquoris three drams: boil them to three ounces. Dissolve in the straining, Rhubarb infused in Lavender Water one dram and an half: double Catholicon three drams: Compound Syrup of Succory one ounce. Make a Potion; to which you may well add in a strong Melancholy, one dram of Confectio Alkermes. The day following, let Blood from the left side chief, or as the Liver or Spleen are most affected. Then give these Broths: Take of Asparagus, Dog-tooth, and Succory Roots, of each half an ounce: Agrimony, Ceterach, Maidenhair, Bugloss, and Succory, of each half a handful: Cream of Tartar one dram: boil them with a Chicken, and make Broth ten or twelve days, adding four drops of Spirit of Vitriol to cool and open more. In old Obstructions, you may add to the former, China Roots, Sassaphras, white Sanders, Smallage Roots, and ●●le Fern Roots, Bettony, Scabious, Coriander prepared, Raisins, and the like. If the Belly be bound, or the Body very foul, give in every third draught of Broth, half an ounce of Senna, with Annis seeds. Or this Apozeme instead of the Broth: Take of Bugloss, Sparagus, Succory, and Sorrel Roots, of each one ounce: the middle rind of Tamarisk and Ash, of each half an ounce: Agrimony, Ceterach, Maidenhair, Dodder, Succory, Fumitory, Hops, Bugloss, and Borrage, of each one handful: the four cold seeds, Annis and Fennel seeds, of each two drams: Currants one ounce: Senna and Polipody of the Oak, of each two ounces: Dodder of Time one ounce: the best Agarick and Rhubarb infused by themselves in Cinnamon Water, of each two drams: Mace and Cloves, of each one dram: the three Cordial Flowers, of each one pugil: Boyl them to a pint, and dissolve in the straining, Syrup of Succory with Rhubarb, and of Roses solutive, of each two ounces. Make an Apozem clarified and aromatized with two drams of yellow , for four morning draughts. Or give Cock Broth thus made: Take of Roots of Asparagus, Bruscus, and the bark of Capar Roots and Tamarisk, of each half an ounce: Agrimony, Ceterach, and Maidenhair, of each one handful: Annis, Citron, and Carduus seeds, of each one dram: Senna half an ounce: Polipody of the Oak, and Epithimum, or Dodder of Time, of each three drams: Cinnamon one scruple: Crystal of Tartar one dram. Boyl them all with half a Cock, which let him take four mornings. After you have sufficiently purged, a Bath of warm Water is most convenient, used many ●●ie●, in which cool Herbs have been boiled, and sweet Apples. Sometimes it is made of Barley and Almo●●● beaten, and put into a Bag and boiled in Water. It must be often repeated, if the season will permit; for Galen, 8. de loc. off. cap. 6. saith that he cured many melancholhck men, only with the use of hot baths, without any other Medicine. And if the Patient cannot endure a whole bath, let him have one for half the body. And lest often washing should hurt the Stomach, when he enters into the Bath, let it be per●●●● with Oil of Nutmegs by Expression, or the like. When he goes forth of the bath, let the Region of his Liver be anointed with the Cerat of Sanders, or Ointment of Roses washed in Oxycrate. After his last bath, let the Hemorrhoids be provoked with sharp Suppositories, or with rubbing the Anus with Fig Leaves, or with a rough linen Cloth; and with two or three Horsleeches apphed to the most apparent places, take away five or six ounces of blood. And this must be done every Spring and Fall, and sometimes once a Month. They who are used to have the Flux of the Hemorrhoids, if it hath been long stopped, so that they will not appear, must have a Cupping Glass applied. If after the Leeches are fallen off, they bleed still, as sometimes they will, stop them with Clay, or Powder of Coal, or with Spider's Webs, or with Powder of Lime, or with astringent Powders taken up with the white of an Egg and pledget's. And if you cannot conveniently open them, it is good to draw blood from the inferior Veins, that the most impure may be voided. An Issue burnt in the left Legg doth purge the Spleen and other Bowels from superfluous Humours, and therefore forget it not. But because this Disease useth to be very stubborn, and after Purging, new Humours return, you must purge by sits, that the Body may be freed from them by degrees: which may be well done by a Magistral Syrup, made thus: Take of new drawn purified Juices, of the Flowers of borage, Bugloss, Endive, Succory, Fumitory, and Sorrel three pints: the Juice of sweet Apples newly drawn and cleansed two pints: fresh Polipody of the Oak half a pound: clean Senna eight ounces: Dodder of Time three ounces: Agarick newly made into Troches one ounce: Ginger and Cloves, of each one dram. Infuse them and strain them according to art, till there remain five pints and a quarter of the Liquor, in which dissolve the straining of an ounce of Rhubarb dissolved in the said Juices by themselves with a little Cinnamon, and one pound of Sugar. Make of these a well boiled Syrup; clarify it, and aromatize it with two drams of the Pounder of the three , keep it in a Glass, and let him take into ounces thereof, twice or thrice in a month, with a little Chicken Broth, boiled with Endive, Sorrel, borage, and Burnet. Or instead of the Syrup, you may give Pills, especially in Winter, such as were mentioned in the Obstruction of the Liver; or if you fear they are too hot, you may make these following: Take of Polypody of the Oak half an ounce: Asarabacca Roots, and Broom buds, of each one dram: Currants three drams: Crystal of Tartar one dram and an half: Bugloss and borage flowers, of each half a pugil: Boyl them in Spring Water. Take half a pint of the straining being well clarified, and six ounces of the Juice of sweet Apples also well clarified; and infuse therein one ounce of clean Senna: Turbith and Agarick, of each three drams: Mace, Cloves, Cinnamon, and Dodder of Time, of each one dram: digest them four days in Balneo Marioe: then strain them, and add to the straining, one ounce of the Extract of Aloes made in Endive and Sorrel Water; Myrrh dissolved in Wine and strained, two drams: Salt of Tartar one dram. Evaporate them all, and inspissate and thicken them at a gentle fire, adding towards the end when the matter is almost evaporated, Diarrhodon Abbatis Loetisicans Galeni, and the Troches of Dialacca, of each half a scruple: bring them into a mass for Pills; and let the Patient take half a dram once in a week, two hours before meat. Pereda witnesseth, that the hath cured many Melanchollick men with this following Powder; and he calls it Blessed, and Divine. Take of Dodder of Time half an ounce: Lapis Lazuli, and Agarick in new made Troches, of each two drams: Scammony one dram: Cloves twenty: mix them into a Powder, and give two drams twice or thrice in a month with, Whey or borage Water. If you cannot conveniently give often Purges, it is good every other day to give a Clyster to revel vapours, and draw forth some part of the Humour: for if they go deep into the Guts, they take away the greatest part of the filth from the Mesenterics. We knew a Noble Man, who being long troubled with this Disease, was cured by often Clysters, when other Medicines did nothing. While you give intermitting Purges, let the Body at other times be moistened with Baths, or half Baths, or Fomentations, by which both the violence of the Humour is restrained, and the Body made moister. Also at those times, you must use strengtheners, which will also open Obstructions, and they use to be made often like Opiates, or a hard Electuary, or Lozenges, thus: Take of Conserve of Bugloss Roots half an ounce: Conserve of borage Flowers, and Violets, of each one ounce: Conserve of Roses, and candied Citron peels, of each half an ounce: one candied Myrobalan: Confection Alkermes three drams: Powder of Ivory, Hartshorn, and Bezoar stone, of each one dram: Loetisicans Galeni, and Diarrhodon Abbatis, of each two scruples: Coral and Pearl prepared, of each half a dram: Ambergris half a scruple: the best Musk five grains: Gold three Leaves: with Syrup of Apples, and of candied Citrons, make an Opiate, of which give the quantity of a Chestnut two hours before meat, every day drinking after it a little white Wine. A plainer and better tasted Opiate, is made of one part of Confection Alkermes, and four parts of Conserve of borage Flowers. And to open more powerfully, if you fear no hurt by hot things, add Conserve of Tamarisk flowers, Elicampane Roots, Wormwood, Maidenhair, and the Salts of Wormwood and Tamarisk, etc. You may make Lozenges thus: Take of Diambra, Diamoschi dulce, and Loetisicans Galeni, of each one scruple: Confectio Alkermes three drams: Sugar dissolved in borage and Rose Water, four ounces: make Lozenges of two drams in weight, gilded. Let him take one every day two hours before meat. Or you may make them more pleasant thus: Take of Confectio Alkermes two drams: Ambergris one scruple: Sugar dissolved in Rose Water four ounces. Make Lozenges. Ambergris alone, given five or six grains at a time every day with Wine or Rose Water, doth cheer the Spirits and the Natural Heat, and much rejoice the Heart. Some Authors do much commend the use of Bezoar stone against all Melanchollick Disease, because it doth much strengthen the Heart, and you may give five or six grains in Rose Water, or other Liquor. After the Body is well purged, if it be Spring or Summer, you may give Whey for fifteen or twenty days, which will open the Obstructions of the Bowels, and amend the hot distemper. Make it by boiling and clarifying it, and putting into it every night two drams, or half an ounce of Epithimum. You must proportion the quantity according to the strength of the Stomach. For if it can easily pass through the Veins, being somewhat open, and be sent forth by stool and urine, it is good to give it in great quantities, as Mineral Waters prescribed in the hot distemper of the Liver, with this Caution, That you strengthen the Stomach with Baggs, and other things hereafter mentioned, and give every day at evening a Cordial strengthening Opiate. Instead of Epithimum, you may mix with the Whey, the juice of Succory, borage, or of any other proper cool Herb, thus: Take of Goat Whey four or five pints: the juice of fresh Lemons four ounces: the new juice of sweet Apples six ounces: Conserve of Roses or Violets, or white Sugar, one ounce. Clarify these with whites of Eggs. Let him take every morning three or four more Cups thereof, if his Stomach will bear it. In Bodies that are very lean, after the Obstructions are a little opened, you may give Ass' Milk with Sugar of Roses; and if there be rumbling in the Hypochondria, a little Aromaticum Rosatum, or Diarrhodon Abbatis will do very well. But your sharp and Vitriol Mineral Waters, are beyond all Medicines, which by correcting the distemper of the bowels, do powerfully open Obstructions, especially the warmest, which do make the Humour thin, and cleanse it. There is great dispute among Authors concerning drinking those Waters. Some (with Sennertus) do allow it, because they receive Virtue from their Minerals, and do thereby both cleanse the passages, and send forth the filthy Humours which stick to them by stool and Urine: they warm the Stomach, and strengthen the Liver and Spleen: And we may rather fear that these Waters will hurt by the use of them external than internal, by heating and drying. Others (with Claudinus) do altogether deny them, by reason of their drying quality. Others (with Montanus) do neither altogether reject them, nor wholly approve of them; they say they are good, by reason of the coldness of the Stomach, which is always in this Disease, and by reason of Obstructions. But in regard the Liver and Spleen are hot, they will have them defended with the cool Ointment of Galen. And also the Loins, for then (saith he) the water will not hurt, because it stays longer in the Stomach, and cold places, but only passeth through other parts. We suppose that the use of them is convenient, if the Stomach being cold have much thick and clammy phlegm in it, and if the heat of the Liver be not very great. Which part is not like to suffer, if the aforesaid Ointment be not only given, but also cool Broths after the Waters; and after they have been used enough, cold and moistening baths for some days. Medicines made of Steel, use to be of great Virtue to open these Obstructions, such as are mentioned in the Obstruction of the Liver, and of the Spleen, avoiding those which do heat and dry much. In hot bodies you may give Steel prepared with Brimstone or Vinegar, with Conserve of borage and Succory, made in the form of an Opiate. For dainty folk, the Syrup of Steel afore mentioned in the Obstruction of the Liver and Spleen, is excellent; or the Froth which remains in the Glass after the Evaporation of the Wine which hath been often steeled, mixed with the aforesaid Conserves. But Salt or Vitriol of sron goes beyond all Medicines, because it opens Obstructions, strengthens the Bowels, and qualifies their heat. The Dose is from twelve to twenty grains, with a fit Liquor, Syrup, or Conserve. But because it is displeasing to the taste, I use to make it into Pills with the Mucilage of Gum Tragacanth. You must use it long, and therefore get a great quantity, which is not easy to be got after the way that Beguinus and others make it. We will show you the easy way of making it, which few men know. Take of the Oil of Vitriol, or of Sulphur, half a pint: the Spirit of Wine one pint: Put them in a new Iron Pan that is clean, and cover them well; within fifteen days of them there will be a Salt-like gathering, which you must set in the Sun to dry it throughly, sometimes stirring it with an Iron Spatula: In Winter you may dry it upon a gentle fire, or in a Hothouse. Let the Salt being well dried, be kept in a close Glass; for if it be exposed to the Air, it easily turneth moist. Also the Pills that are made thereof, of Tragacanth, must be hardened with the Powder of Tragacanth, and after put in a Glass, otherwise they will grow moist. You may continue this Medicine for a month or two, not only without hurt, but with great profit. Fonseca commends these Pills following, which he calls Diatartarum, for opening Obstructions by degrees, and purging Melancholy gently, and for allaying it. Take of the Powder of Senna, and Salt of Tartar, of each one dram: Powder of Cinnamon half a scruple: with Syrup of Lemons make a Mass, of which give three Pills made of half a dram one hour before Supper, to give him two or three stools, for Salt of Tartar hath great Virtue to allay black melanchollick Humours; for it draweth to itself by certain propriety sour things, as you may perceive when it is mixed with Vinegar, or Spirit of Vitriol, whose sowrness it taketh away: For we must know, that Fonseca by Salt of Tartar, meaneth Crystal of Tartar. Yet you may as well infuse your Senna with the Salt of Tartar, and some drops of Spirit of Vitriol in some convenient Liquor. To open the same Obstructions, some commend the Decoction of China, as we said in the Obstruction of the Spleen; which a wise Physician may do with good success. Some commend the Juice of Wormwood thickened into the form of a Pill, given either by its self, or with Gum Ammoniacum; and after that presently, Oxymel made of the Decoction of Asarum Roots and Liquoris. Others say, That Hypochondriack Melancholy hath been cured with the Decoction or Wine of Wormwood taken thirty or forty days together. The Juice of Bugloss is excellent, not to open Obstructions as Wormwood, but to qualify the Melanchollick Humour. Therefore they give two ounces thereof with two drams of Sugar, and as much Wine as of both, for ten or twelve days every morning. The principal thing for this Cure, is to keep the Body always soluble: Therefore the Patient must have some familiar Medicines, which he may often use before meat, sometimes one, sometimes another, lest he grow weary of them. For this he may take the Magisterial Syrup, and the aforesaid Pills, and those which were prescribed for a costive Belly. To which he may add (out of Montanus) Venice Turpentine, which he order to be swallowed in the quantity of an Acron, three hours before dinner, once, twice, or thrice in a week: for besides that it looseneth the belly, it also cleanseth the Stomach, opens Obstructions, provokes Urine, warms the Stomach, and doth not heat the Liver, but doth it good by opening and cleansing it. For his ordinary Drink let him use Water wherein Gold hath been quenched, or the infusion of Tamarisk, Agrimony, Burnet in thin Wine, either alone, or made Physical in Vintage time with the Roots of Bugloss, borage, with a little white and Rosemary Flowers. The Decoction of the Sweet Briar Root, is commended for ordinary Drink; for it openeth and strengtheneth all natural parts. The Decoction of Lignum Nephriticum doth open the Obstructions of the Bowels without any manifest alteration. But steeled Water is more usual. All which Waters and Decoctions, you may also mix with Wine. While in the internal Medicines mentioned or any of them are used, you must apply External, as Fomentations, and Ointments to the Hypochondria, such as are prescribed for the Obstructions of the Liver and Spleen, making Choice of the Coolest. You must also apply strengtheners to the Stomach, because that part doth always suffer in this Disease; therefore you may use those Fomentations, Ointments, and Emplasters mentioned in the Diseases of the Stomach: Also those Internal which will not inflame the Liver; and especially the Digestive Powder to be taken after meat: in a Fit when the Vapours arising from the Hypochondria do trouble the Heart, Brain, and other parts, and produce great Symptoms, as Swoonings, Palpitations, Tremble, Convulsions, Headache, and the like; you may use those things which are given in Swooning, or the Mother; but among the rest Laudanum used wisely, doth wonders. Chap. 6. Of the Scurvy. THe Scurvy is usual in the North, in most places thereof Common, but almost unknown in the South; so that all Writers that have Practised in these Parts, have never mentioned it: and we may well leave it out, because in our Preface to this Book we promised to meddle only with the usual Diseases of the Spleen; but Experience hath taught us, That our Country is not altogether without it, for though it be not in every Symptom the same with that of the North, yet it hath enough to confirm it to be the same: for the aforesaid Authors say that one Symptom is sufficient to discover it; we have seen many Symptoms of it in many people, but because it is not familiar here, and all our Physicians say we have it not, we would not absolutely call it a Scurvy, but we thought it better to call it a Scorbutical Disease, such an one as comes next to it, though it be not a true Scurvy. For the Scurvy is nothing else but an Hypochondriack Disease, having a peculiar degree of Malignity from which more Symptoms arise than in the Hypochondriack Disease: this malignity comes from the putrefaction of Melancholy, not of every kind of melancholy, for it is often corrupted, from which other Diseases arise and not the Scurvy, as a Quartan Ague ●● Imposthume in the Mesentery, and other parts; but of a peculiar and proper Melancholy which is a●●●●able to that Malignity. This is known by the Infection which is found in this Disease, because author's hold it to be infectious. And because all the degrees of malignity which lie in the Humours and produce divers Diseases are unknown unto us and 〈◊〉, therefore is this of the Scurvy obscure 〈◊〉 hidden; and it is wonderful that so many Diseases should arise from the variety of malignity which is in the Humours, as malignant Pestilential Fevers, 〈◊〉 〈◊〉 〈◊〉 Measles, Cancers and Elephantiasis, the Pox, and many others. And especially Elephantiasis comes from a peculiar malignity in a Melanchollick Humour, and so doth the Scurvy, and yet these two Diseares differ so much, that none can tell their divers degrees of malignity. Divers Symptoms common to both, do show a great likeness of the Scurvy and Hypochondriack Melancholy: for all they which were mentioned in the former Chapter, are found in this Disease, as crudities and want of Concoction in the stomach, often spitting, phlegmatic, sharp, and stinking vomitings, noise in the Hypochondria, belchings, breaking of Wind downwards, vomiting of blood, and purging of blood, pains from wind under the ribs and in the stomach, sometimes Costiveness, and sometimes Looseness, heat in the Hypochondria, beating of the Left side, Urine now thin, than thick, heart beating, thirst, drought of the mouth, short breath, headache, noise in the ears, dimness of sight, giddiness, sorrow and sadness, and divers dolings, convulsions, falling-sickness, numbness, coma, watch, troubled sleep, and terrible dreams: The Reasons of all which were showed in the Chapter above, and they may agree with this of the Scurvy. But if any Symptoms appear besides these, which are not found in that, nor mentioned by Authors, nor belong to another Disease; you may conjecture that it is the Scurvy: The Chief are these, which are not all sound in one Patient; but one of them is sufficient to show that the Disease is such. The First most remarkable Sign is in the Gums, Mouth, and Teeth, in the Gums redness, itching, and putrefaction, and sometimes bleeding and stink, which are sometimes in the Palate, Jaws, and Teeth, which are lose and black. The Second, which is an evident Sign also, is Spots in the Legs which at first are Red, and after Purple, blue, and black: Sometimes there are in the Legs broad spots, black or blue, or both; these come from the serous filthy part of the blood which is unfit to nourish the body, and therefore is sent by nature out of the Veins to the Skin, by the Nausiosis of the Veins, as Hypocrates says of Fractures, and this happens often in the Shins and Legs, because nature useth to send the worst Humours to the most ignoble and remotest parts; sometimes when there is more plenty of matter you shall find them in the back, arms, neck, and face. The third sign is shortness of Breath, and straightness of the Breast, which comes commonly from thick vapours, arising from the Hypochondria, that get to the Midriff, as also from Tumours and swell by wind of those parts that press upon the Midriff, especially from the Twelling of the Sweetbread, which commonly in this Disease is fulled with gross Melancholy: Hence the Patients complain not of their Breast, but of the part affected, whereby they feel the weight, and by reason whereof the Breath is short, as Eugalenus noted well, who was much acquainted with this Disease, and many Observations therein: yet he knew not the cause of this weight, namely, the swelling of the Sweetbread; nor doth any that writ hereof make mention of it. Yet we observed it in My Lord Audeyer, Precedent of the Senate of Gratianopolis, whom we thought had the Scurvy, as you may read in his History, at length, in our Observations, Cent. 3. Obs. 85. For being very lean, we did easily perceive with our fingers, a hardness in the Sweetbread; and by handling of the part, he confessed that all his shortness of Breath and straightness came from thence. The fourth sign, is Laziness, and heaviness of Body, especially in the Legs, which comes from watery and foul Humours, which come through the Veins to the Muscles, and the whole Body. The fifth sign is in the Urine, which is divers, as in Hypochondriack Melancholy; but in this they sometimes differ, because they are clear and red like a Lie, from the plenty of salt Humours. The redness is higher and inclining to black, by how much the more salt humour there is. As in a Lixivium sometimes the Urine is very thick, with a red thick sediment, like the Powder of Bricks, and sometimes this Humour is so much, that it causeth burning and pissing by drops, especially in them who have this Disease from stoppage of the Hemorrhoids; and after it is settled, the third or fourth part of the Urinal is filled with thick and black filth, which makes some think it to be the Stone or Ulcer of the Bladder. Sometimes the Urine varieth without manifest cause; to day thick, to morrow thin; now pale, then yellow, or red. The sixth sign is from the Pulse, which is now weak and unequal, leaping, or formicans, that you would wonder he should live with it; anon it is great and hard, without Inflammation. And this is to be observed, That in time of fainting and swooning, with which he is often troubled, his Pulse is greatest and strongest. Which comes from the Heart contending to cast out those vapours with which it is oppressed. The seventh sign, is pain in divers parts: in the Thighs heavy, and sometimes stretching; sometimes Ostokopos, or at the bone; sometimes in the Shins, Ankles, Sols of the Feet, in the taps of the Fingers, in the Hips, Knees, and other Joints, or parts to which the Salt Humours flow; sometimes in the Belly, like the Choleric Colic; and it comes from these Humours flowing upon the Caul: these in the Arms, Thighs, and Legs, are like those of the Pox, and may well deceive a Physician in France, where the Scurvy is rare, and the Pox common. But they may be thus distinguished; The pains in the Pox are between the Joints and if they stay long, make knots, and there are, or have been then also other Symptoms of it, as running of the Reins, Ulcer of the Yard, Bubo, and the like, or Uncleanness with Women. But the Scurvy pains seize upon all parts indifferently; and then there are other signs of it, or at least a Melanchollick Constitution; and the Matter is certainly known, if the Patient will truly say that he hath not been with unclean Women. Which caused our suspicion in a Magistrate, who had a long time great pain in his Feet, Shins, and Thighs, and was brought very lean, ●o that you would have thought that he had the Marasmus, or Consumption: And when no Medicines for a long time would do him good, we from his Melanchollick Complexion, and other signs, especially because he le● a ●ost chaste life, and because for many years his Gums did bleed at certain times, conjectured that it was the Scurvy, and by using of things against that Disease for some time, he was cured. Sometimes those pains remain in the Hypochondria, sometimes in the Loins, so that they are weak, and can scarcego. Hence this Disease is called Lumbago. Sometimes the pains are like the Stone, and the Urine is very red or black; and if you do not diligently observe, you will think they are bloody, and that it comes from the Reins wounded by the Stone, when it is from a scurvy salt Matter in the Spleen, and parts adjacent, sent into the Urine. Some have Headache, and heat at nights, if they caught this Disease from stoppage of the Hemorrhoids, by reason of the vapours which ascend, and all the night after they are as in a Fever all over their Bodies, which the next morning vanisheth by sweeting. They have often the Toothache, without any evident reason or cause; and it is not in one place, but movable from one Tooth to another, making them lose, and they again fix of their own accord, the pain and tumour being discussed. Sometimes the pain of the Scurvy is in the sides, imitating the Pleurisy; from which it is easily distinguished, because it is without a Fever, at least a strong one; the breath is not hindered, there is no Cough, no spitting, nor is the pain constant, but coming by fits. Also it will be in the Joints; and we must declare how it is distinguished from a true Arthritis, or Joynt-gout. The pain of the Joints in the Scurvy, is not fixed and constant in the same place, but runs from one Joint to another, either on the same, or on the contrary side; sometimes it vanisheth, and then returns; so that he which now seems free, and in perfect health, is suddenly taken with pain, sometimes with swelling, sometimes without. But a true Joynt-gout seldom changeth the place. The Joint Scurvy hath this peculiar distinction: It is for the most part joined with a small Palsy, by reason whereof the Patient can hardly move the part affected; and when the Passey seizeth or returneth, the pain doth so also. The eighth sign is from the divers hindrances of Motion, they have a bastard Palsy; the Examples whereof we laid down in our Observations: and it is distinguished from a true Palsy, because this is constant; but in the Palsy from the Scurvy, he that yesterday could scarce set one foot before another, can now stand, and walk with a little help, and it may be presently after he cannot move at all: and sometimes the motion is trembling, and with Convulsion, which doth not happen in a true Palsy. And this kind of Palsy cometh from a filthy kind of Matter or vapour, which gets into the Nerves and Muscles. And if the Matter be sharp, it causeth trembling and Convulsion by pulling the Nervous parts. And Convulsions are not only in some peculiar part, but sometimes in the whole Body like an Epilepsy, by a windy or watery matter full of sharpness, and malignity, which is sent to the Brain, which being discussed doth give ease, and gathered again, maketh new Convulsions. Also in this Disease there is a Contraction of the Members, sometimes of all; so that the Patient cannot move one Joint; sometimes of one, and that principally in the Leg, when the Tendons which are made to move the Leg grow hard and stiff in the Hams. This contraction comes by reason of the salt Humour that flows with much moisture to the Nerves and Tendons; and when the thin and watery part, through continuance of time is consumed, the thick is dried and made hard; from whence come these contractions of Nerves and Tendons. Sometimes there is a contraction in the Gullet, so that the Patient can scarce swallow, and is in fear of strangling. And this comes from astringent vapours, which contract the Oesophagus, or Gullet. The ninth sign, is the Flux of the Belly, either with, or without blood. The simple Flux which is without blood, is distinguished from others, in that the Excrements are thicker, and more than the quantity of meat that is taken; when a common Flux is more thin, and of Humours only. The Flux of blood in this Disease is distinguished from a Dysentery, because it is without pain of the belly, and it is thick blood which is sent into the Guts by the Meseraick Veins. Sometimes the Hemorrhoid Veins do receive that filthy blood, and send it forth: but if this flux of the belly continues long, the Vein●swell, and send forth not only much blood, but also other salt and slimy Humours. The tenth sign, is a stinking Breath, which is common to all in the Scurvy, as Eugalenus witnesseth, so that they which stand by cannot endure it, but must turn aside their Nose. The eleventh sign, is often shivering, with none or little heat following it. The twelfth sign, is an intermitting Fever, which sometimes they have, which are unlike the other ordinary Agues of Fevers: for in them the Pulse is weak, slow, and unequal, especially in the declination; but in the height it is commonly great and hard. Besides, at the first coming there is such a twitching in divers parts, especially the Legs, that they suppose their flesh to be torn; and sometimes they have convulsive motions therewith. And though sometimes this Ague is a Quotidian, Tertian, or Quartan, yet sometimes the fits are disorderly, coming once it may be, or twice in a month, without certainty. The Thirteenth Sign is Tumours in divers parts; sometimes hard, sometimes soft like bladders, and sometimes like an Erysipelas, or red Tumour. The Fourteenth Sign is Atrophy or Consumption; which is so great in this Disease sometimes that they are nothing but skin and bones like a Sceleton or Anatomy; especially after long sickness, which comes from the evil blood; so changed from its natural Condition that it cannot be made like unto the parts which should nourish. Eugalenus propounds many other Signs of the Scurvy, and Sennertus with others: some whereof are Common to many other Diseases, which we will Conceal, lest they breed Confusion. And though (as we said before) the Scurvy is not ordinary in France, as in Poland and other Northern parts, and almost unknown; yet if any in Practising Physic shall observe all the Symptoms of Melancholy he shall find some inclining to the Scurvy, in whom some of the former Symptoms proper to the Scurvy will appear. As to the Prognostic: This Disease is hard to be Cured, as all other that come of Melancholy, and here much more hard, because of the malignity in the Melancholy which doth more cruelly overthrow the body, and will not obey the greatest part of Medicines. It is also dangerous because it many times brings a Consumption or Dropsy, and destroys others by sudden death, by an Apoplexy, Swooning, and other acute Diseases. Yet sometimes they who have seemed desperate have been Cured, and oftener in this Disease than in any other: And we have seen some brought to a Consumption by long pain, and bloody Flux (which by many circumstances we conclude to be from the Scurvy) to have been perfectly Cured. Moreover, The Pulse is deceitful, especially in the Fits; it will be so quick, small, and unequal sometimes that the Patient seems to be at death's door; yet after his Fit he will rise from his bed, and is as formerly; As we peculiarly observed in a Dutch Scholar, unto whom we being sent for in the time of his Fit, thought that he would presently die; but the next day we saw him seemingly in very good health; and when we had examined the Circumstances of the Disease, we Concluded that he had the Scurvy, which he brought out of his own Country where it is very usual. The same Cure is to be used in this Disease as in Hypochondriack Melancholy: because as we said at the first it comes from the same Humour more differing from its natural state; therefore for the most part it needs stronger Medicines. But because this is a general Rule in Physic, That we always begin with the weakest Medicines, and so proceed to stronger, if the former will not cure: It will be good in this Disease to appoint the whole course of Cure for Hypochondriack Melancholy, because a stubborn disease requires a long course; and if that will not root out the Disease, let us then use the Medicines more specifically proper: And it will not be amiss to mix some such with the other at the beginning. These Specifical Medicines are called Antiscorbutica, or Medicin●● proper for the Scurvy, and there are many of them in Authors that have written of this Disease; whose strength chief depends upon a Volatile or flying Salt, of which they are very full, by which means they make thin and fluid, that thick, earthy, and salt humour, and at length discuss it. Moreover, they have a certain preservative and opposing Virtue against the poison of the Scurvy which is in the Melanchollick Humour. Among these, the chief is Dutch Scurvygrass, which is not in France. Another is, Cresses of both sorts (but the Water-cress is best) Brooklime, Hors-Rhadish, the lesser Celandine, Wormwood, and Fumitory. To which may be added many others, but of less virtue, and all they are such which can prepare, correct, and tame the Melanchollick Humour. Hence it is that we directed the Cure against Hypochondriack Melancholy to be used here: Those are, Carduus, Ceterach, all the Capillar Herbs, Hyssop, Germander, Bettony, Agrimony, borage, Bugloss, Elicampane, Asarum, Ditch Dock, Polypody of the Oak, Capar, Ash, and Tamarisk barks, Flowers of Elder, Tamarisk, and Dodder of Time. In the choice of these Plants, you must always observe this, That you give the least quantity of hot things, and that you always mix with them cold or moderate things, and in a greater quantity, especially in hot Countries, in which Melancholy is burnt. And besides the Capillar Herbs with borage, Bugloss▪ and Agrimony before mentioned, when there is a Fever, or we fear heat, you may add Endive, Succory, Sorrel, Juice of Citrons, Lemons, Oranges, and also Spirit of Sulphur, or Vitriol, or whey. Of these former Plants you may make many sorts of Medicines, which are all gathered by Sennertus out of all Authors, which every man may imitate as he pleaseth. Yet this we must mark, which all Author's mention, That the aforesaid Plants work more powerfully if you ●ake their Juice, or make them into Conserves; because the flying salt wherein all their virtue remaineth is gone by decoction, as also if the Plant be dried. We have used these following forms with good success. Take of c●eer Juices, of Water-cresses, and Brook-lime, of each one ounce: the Juice of Fumitory two ounces: white Sugar two drams. Make a Potion. Or, Take of the Juice of Fumitory, and Water-cresses, of each two ounces: mix them. Or, Take of the Juices of Sorrel, Fumitory, and Water-cresses, of each two ounces. Mi● them. You may give more Juice of Sorrel, if you desire to cool more, or Juice of Lemmons▪ o● th● like. The power of the Medicines, will be more to dissolve that sticking clammy Tartar, if you add one dram of Salt of Tartar with Spirit of Sulphur, or Vitriol, one scruple or half a dram; and because in the use of these Medicines, we purge often, it is good to infuse one dram or two of Senna all night in the said Juices, and give it every other day, or every third day. It is worth your while to give sometimes also some steeled Medicines, such as we prescribed in Hypochondriack Melancholy; as also the strengthening and opening Opiates, and others, as in wisdom you shall think fit. And last, Mineral Waters that are sharp, and of Vitriol, used in due season, are very beneficial for the Cure of this Disease. The End of the Twelfth Book. THE THIRTEENTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Mesentery, Sweetbread, and Caule. The PREFACE. MAny Authors are very short in the explaining of the Diseases of the Mesentery, Sweetbread, and Caul; and the most of them have left them out, because they are hard to be known, and for the most part only from Dissection of dead Bodies; as appears by stories in Schenkius, Sennertus, and others. Yet they are very ordinary and usual: from whence Fernelius saith, That oftentimes there are causes of many Diseases in the Mesentery: as of Choler, Melancholy, Diarrhoea, Dysentery, evil Habit, Consumption, Faintness, of linger Fevers, Vomitings, colics, Tumours, and Imposthumes. And Silvius called the Mesentery, the Mother of many Diseases: by others she is called the Physician's Nurse. We may say the same of the Sweetbread and Caul; for they are ignoble parts, and as it were sinks of the Body, to which the noble Members do send their Excrements. And although these parts (as all other) are subject to all kinds of Diseases, Similary, Organical, and Common, and many Symptoms arise from them; yet we will only speak of those which are most in practice, and comprehend this Book in five Chapters. The first shall be of the Obstruction of the Mesentery. The second of the Inflammation of the Mesentery. The third of the Imposthume, Scirrhus, and Ulcer of the Mesentery. The fourth of the Diseases of the Sweetbread. The fifth of the Diseases of the Caul. Chap. 1. Of the Obstruction of the Mesentery. THese Obstructions in the Mesentery, come of the same Causes which are mentioned in the Obstructions of the Liver and Spleen; but they happen more easily, and more often, by reason of the straitness of the Meseraick Veins, and especially of the Milky Veins, which carry the Chylous Matter to the place of the second Concoction: and when that Chylous Matter is filled with crude and thick juice it comes to pass that not having a free passage, it sticks in those little Veins and makes Obstructions. Also the Meseraick Veins are stopped by thick Humours sent from the Liver, Spleen, and other parts, and there continuing till they grow thicker, so that sometimes they cause a Scirrhus. With these Humours sometimes gross Vapours are mixed, which use to be the cause of great Symptoms. To the Obstruction, or rather making narrow of these Veins, we refer compression, which comes from the Glandles which are spread through the whole substance of the Mesentery: for when these grow beyond measure, as in those who have the King's Evil, or Struma, they compress the Meseraick Veins, and hinder both the passage of the Chylus, and of the Blood. The Signs of these Obstructions are to be divided into three kinds, as we did in the Obstructions of the Liver; namely, into such as show the Disease, the Part affected, or the Cause. The Signs of the Disease (that is) of the Obstructions lying in the Hypochondria, and also the Signs of the Causes are the same with the Obstruction of the Liver and Spleen, and are from that Chapter to be taken. But those Signs which properly show the peculiar Disease of the Mesentery, are stretching, and resistance in the middle of the Belly, and under the Stomach, and about the Navel; a weight in the same parts, and sometimes a dull pain, and sometimes a most sharp, when wind is contained in those parts; sometimes there is pain in the back, because the Mesentery is tied to that part: there is rumbling in the Belly, belching, and vapours flying to the Head, from whence come divers Symptoms: and lastly, all those which use to happen in Hypochondriack Melancholy, signify Obstruction of the Mesentery, because that also proceeds, and is maintained by the same Obstructions. As for the Prognostic: This Disease of its self, is not dangerous, because an ignoble part can endure great evils without danger of death: moreover, you may apply strong Medicines for the Cure, which being well administered, do commonly bring about the desired effect; except Hypochondriack Melancholy rise from thence, which useth to be called the shame of Physicians, by reason of the rebellious Nature of the Melanchollick Humour. But because this part hath not exquisite sense, and the Obstructions do not always greatly disturb the Patient, they are often neglected, and become the causes of other most dangerous diseases. The Cure of this Disease is the same with that of the Obstruction of the Liver, and you must fetch it from the Chapter treating thereof. Chap. 2. Of the Inflammation of the Mesentery. WHen the Mesentery, as I said, is as it were the sink into which the Noble Parts do send their superfluous Excrements, which afterwards are sent forth by Nature, either by Vomit or Stool; as you may see in some who send abundance of Humours forth at divers times by Vomit and Stool: if those Evacuations be hindered by stoppage of the ways by which they are made, or by any other cause, those Humours which are there detained, staying long in the part, do get a preternatural heat, from whence come putrefactions, inflammations, divers Fevers, and imposthumes. But an Inflammation is peculiarly made, when blood heaped up in the Meseraick Veins, by the opening of some branch is sent into the substance of the Mesentery: but because by reason of Obstructions it is chief gathered in those Veins, therefore all the causes of Obstructions may be referred to the Causes of Inflammation. For the making of this Inflammation, that sharpness and gnawing of the Humours gathered together, do much conduce, a fall or stroke upon the Belly, the weakness of the attractive concoction, or retentive faculty of the Liver; too much heat of the body, or inordinate use of cooling things; the critical motion of Nature in malignant Diseases, or small Pox, by which it sends the peccant Humours into this sink; a Diarrhoea, or Dysentery suddenly stopped. The signs of the Inflammation of the Mesentery are, a linger Fever without Thirst, and great Symptoms, want of Appetite, a sense of stretching and heaviness beneath the Stomach, without great hardness, and which is not felt but by the hand pressing of it, and without pain, worth the speaking of, because the part is of dull sense; Choleric stools, which commonly hath thin matter, without pain, sometimes pure, sometimes mixed with Excrements. If the Mesentery be only inflamed, all the aforesaid Symptoms are milder: But if the Liver or Spleen, or Guts, are also inflamed, all the Symptoms are stronger: And besides, the signs of the aforesaid parts affected will appear, which are to be taken out of their proper Chapters. And because the Inflammation and Imposthume of this part, are very hard to be known if they be alone, by reason of the dull sense of the part, and because it performeth no action in the body, whose hindrance may be perceived; but only serveth for the distribution of the Chylus and the Blood: therefore they are rather to be discovered by consequence, than directly, and according to artificial conjecture; namely, when there is a Fever and other Symptoms, and no sign of the Liver, Spleen, or Guts distempered. A half Tertian Ague showeth that the Guts are inflamed with the Mesentery; which Spigelius observed to come commonly from the Inflammation of these parts. Also this Disease is distinguished from the inflammation of the Muscles of the Belly, because the Tumour and pain is enlarged according to their proportion, and they are commonly long, or over the whole belly, and more in the outward parts, so that they are perceived by the least touch, and they use to bring great pain, and a Fever. Lastly, This Disease is to be distinguished from the Humours of the Midriff, which have been, as yet, known to few Physicians: for in them there is always great difficulty of breathing, removing of the Hypochondria, a Pulse hard and small, without any sense of Tumour in the Hypochondria. And if the Tumour come of a hot cause, a sharp Fever, great pain, doting, and Convulsions do follow▪ which Symptoms never happen when the Mesentery is only inflamed. As for the Prognostic: This Disease is very dangerous; for it either ends in an imposthume, or there follows a rottenness, and corruption of the Mesentery. Oftentimes the Matter of the Disease is sent by Nature another way, and yet is not clean taken away, whence the Disease returns, and continueth for many years, sometimes till death, now with a Fever, than a Colic, or Inflammation. The Cure of the Inflammation of the Mesentery, is not unlike to that of the Liver and Spleen, and therefore you must peruse that. Chap. 3. Of the Imposthume, Ulcer, and Scirrhus of the Mesentery THe Inflammation of the Mesentery often turneth into an Imposthume, yet every Imposthume thereof is not from Inflammation, but many times from vicious Humours therein contained, which putrefy, so that these Imposthumes come by degrees without a Fever afore going, or other great Symptoms; as we see in other parts, when Atheromata, Steatomata, and Melicerides, and other kinds of Imposthumes are bred without Inflammation going before. And when they are broken, the Matter being voided, there remains an Ulcer which is hard to be cured. ●●t if those Humorsare very phlegmatic, or Melanchollick, and resist putrefaction, they grow, and sometimes are hardened, and turn to a Scirrhus: sometimes they are as hard as a stone, as many affirm who have fou● ston●● in the Mesentery. The Knowledge of the Imposthume in the Mesentery, is sometimes easy, sometimes hard; for if it comes from an Inflammation of that part, that being perceived by the signs in the former Chapter, it is a sign that the Inflammation could not be discussed, but suppurated and turned into an Imposthume. But when an Imposthume comes from evil Humours remaining long in the Mesentery, and at length putrefying, it is hard to know it; so that many Authors who have written Observations upon such kind of Imposthumes, say, that they never were known, but after death, when the Bodies were opened. For although for the most part, they may be known by the touch, yet sometimes they lie so deep, that they cannot be touched, and the part being dull in sense, that they will not be discovered by pain. But because they come divers ways, they must be thus distinguished. If the Imposthume of the Mesentery, hath a visible Tumour, it is first to be discerned from an Inflammation and a Scirrhus: It is distinguished from an inflammation if it come not from it, when there is no Fever, or at least but small, when none went before, nor any other signs that may s●ew an Inflammation; but if it follow an Inflammation, it can no other ways be distinguished than by hardness & continuance; for if the signs of Inflammation have continued twenty or thirty days, it is a sign that it is turned into an Imposthume. It is distinguished from a Scirrhus by hardness, which is great in a Scirrhus, but in an Imposthume there is some kind of softness, as also by the want of pain altogether; for in an Imposthume there is always some pain, especially if it be pressed hard. Moreover, this Tumour is distinguished from the Tumour of other parts, by the Situation thereof, as we said before of the Inflammation of the Mesentery. But if the Imposthume lie in the Mesentery without any visible Tumour, there can be no certain sign, but by an artificial conjecture we may suspect, namely, if there be loathing of Meat, or vomiting without manifest fault of the Stomach, and a great fullness after little Meat, weariness of the whole Body, and fainting without manifest cause, if the Belly be unaccustomarily bound, or lose, and void stinking Excrements, and sometimes bloody, without suspicion of a Dysentery. To these you may add great watch, and if they sleep they faint, and have great Sweats. And though sometimes there appear neither Fever nor pain, yet there is commonly an obscure one; of which, if there appear no manifest cause, we must conjecture that it comes from this Disease, especially if any of the aforesaid signs be joined there with; as also if the Abdomen be violently pressed, the Patient will perceive some inward pain: it is true, that by violent compression you may cause pain in sound places; but if you perceive more pain in one part than in another, after all parts have been pressed, and when that part is always most pained, and the more by pressing, you may strongly conjecture that the imposthume is there. If at length there come forth Matter, than the Imposthume will be manifest. Commonly it is voided by stool of divers sorts according to the disposition of the part affected, and of those adjacent. Hence one while the Matter is pure and white in great plenty, without sense of pain, when it is sent by the Meseraick Veins into the Guts, sometimes when the Imposthume is in the thick and lowest Guts, the Matter is mixed with the Excrements, sometimes it is sent to the Reins, and cast forth by Urine; sometimes being sent in great quantities between the Peritonaeum, and the Muscles of the Abdomen, it falls into the Cavity of the Belly by breaking of the Peritonaeum, or breaks outwardly by an Imposthume, so that a great quantity of Matter flows from the Navel, and sometimes Worms therewith, through the corruption of the Mesentery. And that which sent forth by stool (which is the usual) is sometimes white and laudable, as was said; sometimes mixed with blood or water, sometimes black blood, and stinking, sometimes other black Matter, or of divers colours. But whether this purulent Matter come from the Mesentery, Liver, Spleen, or other part, it is known by the proper signs of every part affected. When the Imposthume is broken, and the Matter floweth, it is certain that there is an Ulcer in the Mesentery, which sometimes is quickly cured, and sometimes it is of long continuance, and brings rottenness upon the whole part, and a Gangrene. As for the Prognostic: The Imposthume of the Mesentery is dangerous; for if it continue long in the part, as it often happens, it breeds filthy rottenness, or a Gangrene, or brings the Patient into a Consumption or Dropsy. If it break, and the Ulcer be not quickly cured, but gets an evil condition, it hath the like event, a Gangrene, Consumption, or Dropsy. Sometimes when the Imposthume is broken, and very stinking Matter is sent into the Cavity of the Belly, the Patient dies suddenly. The Scirrhus, or hard Tumour of the Mesentery is lest dangerous, and if it be new will admit of a Cure; but if it be old, it brings the Patient to a Dropsy. The Cure of these Diseases, is to be varied according to the diversity of them. And first, an Imposthume bred requires opening and evacuation, and it must be softened with opening and purging Medicines, such as are laid down in the Obstructions of the Liver and Spleen, not omitting outward Softeners and Looseners, Fomentations, Cataplasms, and Liniments, which do make the Matter of the Imposthume thin, and open the passages that the Matter may better be voided. After the Imposthume is opened, you must cleanse the Ulcer and heal it; for which purpose the Remedies mentioned in the Cure of the Ulcers of the Stomach, Liver, Reins, and Womb, are very good; of which a wise Physician may take his choice according to the divers dispositions both of the Bodies, and the Diseases. And a Scirrhus of the Mesentery is cured with the same Medicines, which are set down for the Cure of the Scirrhus or hard Swelling of the Liver and Spleen. Chap. 4. Of the Diseases of the Pancreas, or Sweetbread. THe Ancient Anatomists knew no action of the Pancreas, or Sweetbread, but the use only▪ namely, to prop the Vessels, lest they should be in danger of breaking, and to be instead of a Pillow to the Stomach, lest when it is full it should be hurt by the hardness of the Vertebrae or Backbone. But the Modern Anatomists have ascribed very great action unto it; namely, the first preparation of the Chyle, and cleansing of it, so that it may be brought to the Liver more pure; which the milky Veins seem to confirm, because they are dispersed through the Pancreas. Besides, in the middle of it there is an open passage which goes to the Guts, by which it is probable that the Excrements of the Chyle are purged; therefore the Pancreas hath its Diseases, which hurt the whole Body, especially Obstructions and Tumours, as the Mesentery hath; namely, when the Chylous Matter is crude and thick, and is brought to it from the Stomach, not sufficiently digested, and when it doth not freely flow from it. Riolanus observed a Scirrhus of the Pancreas, in Augustine Thuanus, that wrote the History of his Times most elegantly in Latin; who when he had for four years, among other Symptoms, a heaviness continually in his Stomach, especially when he walked or stood still, without Swelling or hardness in the Hypochondria, had a Pancreas as big as his Liver, after he was dead, hard and Scirrhus, full of knots like Pigeons Eggs. But because the Pancreas is covered with the Stomach, its Tumours are scarce to be felt; and this is the cause because there is no mention commonly of them, and they have been found only after death: Yet you may make a handsome Conjecture of them, from what Riolanus observed in Thuanus, namely, If there be a sense of weight or heaviness in the Stomach, and no Tumour or hardness in the Hypochondria; and other signs of Obstructions than are mentioned in the Obstructions of the Liver, Spleen, and Mesentery. To which you may add pain, and other Symptoms of the Stomach, by reason of its nearness, shortness of breath, by reason of the compression of the Diaphragma; By which signs we suppose that the Lord Audeyerius, Precedent of the Senate of Gratianopolis, had a Scirrhus of the Pancreas, and we could perceive it by touching, by putting our hand deep to the sides of the Stomach about the middle, because he was lean; and we found a hardness there, which being touched, pained him: the story whereof, is at larger related in our 81. Observation, Cent. 3. And in the knowledge of the Scurvy we observed (which none that ever wrote thereof did) That in all Scurvyes there is a Tumour of the Pancreas, because you may find a straightness, oppression, and weight in the Region of the Stomach: And this Sign is laid down for a clear one by Eugalenus, Sennertus, and others. There are some stories in Authors, of Imposthumes found in the Pancreas, which were not discovered while the Patients lived. But by the Symptoms they had they may be partly known; as some like those of the Scirrhus; to which you may join these, a linger Fever, which is the companion of almost all inward Imposthumes, much watching, short sleep, and after it, pain, swooning, and cold sweats. The Cure of the Obstruction, Scirrhus, and Imposthume of the Pancreas, is the same with those of the Liver, Spleen, and Mesentery. There you may fetch Medicines from the Chapters concerning them. Chap. 5. Of the Diseases of the Caul, or Omentum. BEcause the Omentum is a soft part and fat, fit by reason of its looseness to receive Humours that come from other parts: It is subject to divers Diseases, as the Mesentery and Pancreas: And these are not described by Authors, because they can scare be seen in living men, but only by Anatomy, as you may see in some Stories in our Observations. Vesalius saith that he saw in a Body opened, an Omentum so swollen that is weighed five pounds, when in its Natural condition it would weigh scare half a pound. Roussetus in lib. de partu Caesareo, reports that in Paris there was found a great Imposthume in the Omentum. Riolanus in his Anthropographia, saith that he saw an Omentum in a Noble Youth of ninteen years of age, so full of kernels, by which it received abundance of filthy Humours, the Mesentery and Pancreas being imposthumated, and the Spleen almost consumed. We also saw a Scirrhus Omentum in a Friar of Montpelior all over the lower part of the Belly, and four fingers thick; it was of the colour of the Spleen, so that it was probable that it was caused by Melancholy from thence, because he was of a Melanchollick temper, and the passage is very open by the branches of the Spleen Veins, to the Omentum; by which branches (as Hypocrates teacheth, the water in a Dropsy is brought from the Spleen to the Omentum, from which by degrees it distils into the Cavity of the Abdomen. But because the swelling of the Omentum can by no means be distinguished from that of the Mesentery, therefore we cannot appoint a distinct knowledge. It is true, that the Tumours of the Omentum are easier known at the first touch, because it is immediately under the Peritonaeum; but the Mesentery is so united to it, and the Muscles of the lower Belly, that they are sent forth by suppuration through the Navel, or other external parts. Yet this Difficulty of Knowledge, doth not hinder the Cure, because the same Medicines serve for all Tumours that are alike in all the parts of the belly: but the Cure is worse to be made in the Omentum, because it hath not fit way, as other parts have for the purging of its self. The End of the Thirteenth Book. THE FOURTEENTH BOOK OF THE PRACTICE OF PHYSIC. Of the Diseases of the Reins and Bladder. The PREFACE. THE Reins and Bladder have divers, and all sorts of Diseases, both Similary, Organical, and Common; from which, divers Symptoms arise, both in the actions hurt, and also in the fault of the Evacuations. We will comprehend the chief in Nine Chapters. The First shall be of the Stone in the Kidneys, and the pain of the Reins, called Dolour Nephriticus. The Second of the Stone in the Bladder. The Third of the Inflammation of the Reins and Bladder. The Fourth of Pissing of Blood. The Fifth of the Ulcer of the Reins and Bladder. The Sixth of Diabetes, or Involuntary pissing. The Seventh of the not holding of the Water. The Eighth of Ischuria, or stoppage of the Water, and Strangury. The Ninth of Dysuria, or scattering of the Urine. Chap. 1. Of the Stone in the Kidneys, and Pain in the Reins, called Dolour Nephriticus. THat is called Dolour Nephriticus which doth afflict the Ureters or Reins; the common people call it the Stone-Chollick, because of the great affinity it hath with the Colic, so that it is hard to distinguish them, as you shall see in the Diagnostic, or Signs. The Cause of this Pain in manifold, but chief the stone or thick phlegm. A stone continuing in the Reins, causeth either little or no pain, because the substance of the Reins hath little Sense: but if it fall upon the Head of the Ureters, or get into the passage, and distend it, and cannot be brought to the Bladder by reason of its greatness, than it causeth grievous pain. But gross phlegm fastened upon the Ureters, doth distend them, and causeth the Nephritical pain. The less ordinary Causes are, thick blood fixed in the Ureters, or thick Matter coming from the Kidneys, or other parts; sometimes wind gets into the Cavity, and causeth great pain. There are many Controversies in Authors about the stone, which is the chief and usual cause of the pain of the Reins, which we shall not accurately declare, but only touch those things which are necessary to declare its Nature and Causes. And first, they doubt under what kind of Disease they should reckon the stone; Galen placeth it among the Diseases in number, of those things which are wholly besides Nature, as also the Worms. For though a Disease in number properly doth respect living parts, whose number being increased or diminished, maketh an organical Disease; yet those things which are preternaturally added to the number of those things of which the Body is compounded, aught to be referred to the Diseases in number, so that sometimes the bare qualities are sometimes referred to Diseases in number; when they do immediately hurt the actions, as yellowness in the Eye of one that hath the Jaundice, a noise in the Ears, and a bitter taste upon the Tongue. Oftentimes the stone is reckoned among Causes of Diseases, as it breeds Obstruction or Distension. It may also be placed among the Symptoms, those that are voided or retained: for if it be retained in the Kidneys, Reins, or Bladder, when it should be voided, it is to be reckoned among those things that are preternaturally retained: but when it is voided, it is to be reckoned among those that are voided wholly against Nature. But there is more difficulty about the cause of the stone, both material and efficient. Galen and his posterity, thought that phlegm was the material cause of the stone, which is thick and slimy, fit to be hardened, and (as they say of late) feculent, slimy, and Tartarous, and heat the efficient, which drieth and hardeneth that matter, and at length turneth it into a stone Which Doctrine is opposed with strong Reasons. First, If it should come of a slimy and thick phlegm, than it would often be bred in the Brain and the Stomach, in which such phlegm doth chief abound. Neither will it suffice to say that there is not sufficient heat in those parts to harden it; because according to the Doctrine of Hypocrates and Galen, a gentle heat by a continual action is sufficint to congeal; and hence is the reason why old men do more often breed the stone, when young men have hotter Kidneys; because the matter of the stone lies longer in old men's Reins, by reason of the weakness of the expulsive Faculty, and so it's longer concocted by the heat, and at length hardened. Secondly, From Aristotle, 2. meteor. cap. 4. they which grow together by heat, are melted by moisture, as Clay. But the stone is never dissolved with water. Neither doth it hinder to say that a strong heat makes such a Concretion or growing together, that it cannot be dissolved by moisture, as in Bricks. For first, in Man there is not so great a heat; then the not dissolving of Bricks with Water is not because of the strong heat they had, but rather from the disposition of the Clay; for Clay made of common Earth, although it be baked in a Furnace, will never be hard as a Brick, but always be dissolved with moisture. Thirdly, From Aristotle in the place mentioned, the heat that makes concretion must be dry. But there is a continual flowing of moisture into the Reins and Bladder, therefore such a drying and hardening cannot be in those parts. Fourthly, Stones bred in Rivers and Fountains, in which there is no heat, and in some Dens and Holes that are very cold, the water that falls turns into a stone; from whence strange shapes do arise. Therefore we must find another cause besides heat, and another Matter besides clammy and glutinous Phlegm. Fifthly, Phlegm made hard is like Chalk, and is brittle, as you may see in the knots of the Joints. But some stones are like flints, which they cannot be from Phlegm: nor is there so much heat in man's Body to make it so. This slimy phlegm hath deceived the Physicians of all Ages, which is found in the Urine of many Patients, and they thought it to be the immediate Cause: But they were out. For first, In the stone of the Kidneys such Urines are seldom made, but often in the stone of the Bladder. But if this were the matter of the stone it would be alike in both. Therefore this Matter depends especially upon the proper Disease of the Bladder, for it is an Excrement of it distempered. The disease of the Bladder is this: we have seen in the Bodies of them who have died of the Stone in the Bladder, and who voided much of that matter, that the bladder grew fleshy, as thick as ones finger or thumb, so that it filled the whole Cavity, and lay next to the stone till by stopping the Urine it killed the Patient. But in those who made thin clear Urine, their bladder was not altered. The Reason of these accidents are taken out of Hipp. Aph. 66. Sect. 5. If there be no Tumour in great and evil wounds, it is evil. And Galen gives the Reason because there is a suspicion that the Humours which should come by reason of pain to the wound, are gone to some noble part. Moreover, it is Natural to all parts; as Galen, lib. de diff. febr. cap. 11. that they which are stronger, send that which hurteth them to the weaker, nor do they cease so doing till it come to the weakest. So when the part wounded is very weak, and therefore fit to receive Humours, if they come not thither, it is a sign that other parts are very weak, which cannot send, and that others are weaker than the wounded, to which the humours are carried. Not only the bad Humours are carried to the wound, but also good blood, which Nature sends to refresh it. All these things are in the bladder that hath the stone. A great uneven stone, or sharp, hurts the Tunicle of the Bladder; hence comes pain and weakness. And Nature to help it sends more than usual blood, and the stronger parts send their superfluiteis. These the bladder concocteth as much as may be into its self, and so groweth thicker. But when it cannot take in all, especially the evil Humours, hence come many foul Excrements, which from the Nature of the part turn so phlegmatic. But in them who have clear Urine, either the stone hurteth not, which causeth the attraction, or some other parts are weaker than the bladder, to which the humours flow. But because this Doctrine doth destroy an old Opinion, we will confirm it by a clear Example of the Womb. The Womb is Membranous, as the bladder: but in Women with Child it is rleshy and thick; so that in the last months it is two fingers thick; because Nature all the time sends much blood to it to nourish the Child; which when the Child doth not wholly consume, some part of it is taken into the Womb: and so it increaseth. The same is in the Bladder, though Preternaturally (which in the Womb is Natural) that when much blood comes to it, it coverts it into its self, and grows thicker. But if without being with Child, the Womb be distempered and made weak, than Humours superfluous from other parts come to it, which when they cannot be taken into its substance, turns to the Whites. And that flux is a proper Excrement of the Womb, as the phlegm is of the bladder. The same thing is in the Reins, though not so often; as when by a stone in them there is pain and weakness, Nature sends much blood and humours to them, which when they cannot be turned into the substance of the part, they are turned into a slimy Excrement, which is voided in abundance; and this vulgar Physicians take for Matter or Pus, which is only phlegm, or mixed with a little Pus, as when by the grating of the stone there is an Ulcer. Some Modern Writers being converted with the aforesaid Reasons, have made a Juice, which will turn into a stone to be the material cause of the stone called Succus Lapidescens; and the efficient to be Spiritus Lapidescens. They call the former a certain Humour naturally proper to turn into a stone: And this they desire to prove by the breeding of stones in the Earth, which are by many Authors said to come of Waters and things cast there into to be hardened presently; some Waters in Caves to be made Stones, and some part of the Wine groweth to the Vessel, called Tartar; and Urines that are clear, when they are cold grow to the glass. And although the peculiar fitness of the Matter to be thus turned, is not sufficiently known; yet some say they have found it out, saying that it is of Salt mixed with Earth. Some Salts do grow hard in the Sun, and are easily dissolved in Water; and if they be joined with Earth like themselves, by the force of the efficient cause they may be stones. So we see in Wines turned to Tartar: but Tartar calcined goes all into Salt, which shows that it is chief made of Salt. So in Urines that have much Salt, especially in those which have slimy matter, we see a tartarous Matter cleaving to the glass. This Salt Matter, which is mixed with the Urine, comes from Meat and Drink so affected, and they are cast forth in a sound Body, nor are they retained in the Reins when the efficient Cause is absent. We have called the efficient Cause, Spiritum Lapidisicum, or a Spirit that makes a stone: Fernelius calls it a stony disposition, which is in the Reins commonly Haereditarily. But we like the foremost Title best. For first, some have stones which have them not Haereditarily if they eat or drink things that breed them, because in them there is both the Material and Efficient Cause; therefore the Hermit's impute the Efficient Cause of stones to their proper seeds, which in a Matter rightly disposed, produce their form. Moreover, Many Histories show that Stones come from a Stone making Spirit, of Men, Beasts, and other things turned into Stones by a Breath or Spirit out of the Earth. So in Aventinus, lib. 7. Annal. Bavar. an. 1343. that more than fifty Country men and their Cows, were turned into Stones. And so says Ortellius in his Description of Russia, of whole Herds of . So also Camerarius reports of a South wind that bloweth some times of the year, in the Province of Chilo, in Armenia, by the blasts whereof, whole Troops of Horses are suddenly turned into Statues of Stone, and stand in the same rank and file in which they were. This Stone making Spirit, is not only in the Reins of those which have this Disease, but also in the Juice of those things that are eaten and drunk separated from them; so that sometimes both come together: Hence it is that some that eat but any Meats that incline to the breeding of the stone, do presently produce it, because there is a Stone-breeding disposition, or Stone-making Spirit in their Reins. But if their Reins be free from this Spirit, such meat will not breed stones, because their stone-making force is not strong enough without the assistance of the Reins to convert that matter into stone. On the Contrary, if the stone-making power be greater in the meats that are taken, and they are often eaten, stones will be bred, although the Kidneys have no such disposition or stone-making Spirit. So we see in divers places, where the Water or Wine are full of stone-making juice, the greatest part of the Inhabitants are subject to the stone; as we may see in Ovid concerning the Thracians, in these Verses: The Thracian Waters, all things Marble make, Their Guts turn Stone that inwardly them take. And contrary, If there be that stone-making virtue in the Kidneys, it makes stones of any nourishment, though never so wholesome. So about three years since, I saw one who for three or four months voided more than twelve little stones every day by Urine, when all that while he kept his bed, very sick, and fed only upon Broth and Panadoes. The Antecedent and Primary Causes, either respect the supply of Matter for the stone, or the constitution of the Reins, by reason whereof the stones do more easily grow. The Stomach, Liver, Spleen, and Reins, do much cause the breeding and heaping up of Matter for the stone; chief the Stomach, if it do not well concoct, there is a crude Chyle brought to the Liver; and from thence impure and Earthy Juices are sent with the Serum or Water into the Reins. A hot liver doth bake the Chylous Matter, and makes it fit to breed a stone; as also being too cold it makes crude blood most fit for the same purpose. A Spleen weak or stopped, or otherwise disturbed, doth not sufficiently purge the drossy part of the blood, but sends part of it to the Reins, which will more easily be turned into a stone. And lastly, the Reins besides their conjunct cause, which is a stony disposition, are an Antecedent Cause in two respects; namely, in respect of their Temper, and of their Form. In regard of their hot Temper, they more violently draw the Stone-making Matter, and thicken it more: but in respect of their Form, they are an Antecedent Cause, if the Emulgent Veins are more lose, so that that thick and Tartarous Matter may be more easily received into the Reins; or if the Ureters, and those Vessels that send the serous Matter to them, be too narrow, so that the thick Matter hath not a free passage, but is retained in the Reins. Thick and slimy Nourishment doth chief afford Matter for the Stone, such as are full of Salt, as Beef, Pork, Hairs, Geese, or things dried in the Smoke, or powdered, as Saltfish, Shellfish, Eels, Pulse, Cheese, and all Milk meats, hard Eggs, Chestnuts, Pears, Quinces, Medlars, unleavened Bread, and Rice; thick Wine, sharp or black, or new Wine not purged, standing Waters, and such as are full of stone-breeding Juice. To these add very hot Meats, as Pepper, Ginger, Garlick, Onions, old strong Wine, which makes the Liver and Reins too hot, too strong Diuretics, which carry the Matter that will cause the Disease too violently to the Reins; thick Garments, Down Beds, Baths, inordinate Lechery, which is a great Enemy to the Reins, violent Exercue, especially after meat, too much feeding, or long fasting, great anger, and other passions. The Signs of the Stone taken by themselves, are equivocal, and common to other Diseases: but if you consider them all together, you may have certain Knowledge by them. The First Sign, is a fixed pain about the Loins, sometimes heavy when the Stone is fastened to the substance; which being of a dull sense, hath a weighty pain; but as often as the Stone gets into the Head of the Ureters, than it causeth a sharp and pricking pain, and this is called the Nephritical pain, or pain of the Reins, and it continueth while the stone is there; neither will it cease to torment the Patient till the stone get into the Cavity of the Bladder, or turn back into the hollow of the Kidneys. The Second Sign, is bloody Urine, which comes from the opening or corrosion of the Veins which are dispersed into the substance of the Reins, which comes from the rubbing of the Stone that sticks in the substance; but if there be but little blood voided, being mixed with Urine it looseth its colour, so that the Urine looks like a Lye. This Sign is not always, but sometimes depends upon other causes. But when it doth appear, it is one of the chief, which distinguisheth the Stone from the Colic. It useth to be caused by riding, much walking, and other violent exercise; for then the stone if it be rough and snaggy, being removed from its place, doth cut and tear the tender Flesh of the Kidneys. The Third Sign, is thin Urine, water-like, and little, in the beginning of the fit; after which sometimes followeth a total stoppage, if both Ureters are stopped: but when the fit is past, and the stone that was fixed in the Ureters is fallen into the bladder, there comes forth much thick troubled Urine, with a sandy Sediment. The Fourth Sign, is often voiding of sand and stones. Concerning voiding of a stone, it is evident, That if the Patient voided any formerly, though never so small, when he had a fit, it is most certain that the Disease is the Stone. But concerning Sand we cannot speak so infallible; for we may see many all their lives time void Gravel, and never be troubled with the stone; for sand comes often from adustion of Humours in the Liver and Veins, and it sticks to the sides of the Urinal, and goes not to the bottom, as that which comes from the Reins. Besides, if you rub it between your fingers, it dissolveth, and is like Salt, when the other will not yield to the fingers, and will not dissolve. And finally, because this Sand is salt, it is dissolved in hot Urine, nor will it appear while the Urine is so; but when it is cold it grows together to the sides of the Urinal, not unlike the Crystal of Tartar; which being dissolved in warm water, when it grows cold, congealeth and sticks to the sides of the Glass; so the Nature of them both is very like. The Fifth Sign, is a stone voided, and this is most certain: For if any former Sign, though equivocal do appear, and a stone be voided, you may be certain of the Disease. The Sixth Sign, is a numbness of the Thigh on the same side that the Back is pained of: for the stone being great, doth oppress the Nerve which is in erted into the Muscles of the Loins, under the Reins, called by the Anatomists Psenas, and those Muscles go to the Hip for its motion such a numbness is perceived by sitting upon the Thigh, through the compression; or in the Arm by long leaning thereon. The Seventh Sign, is the drawing in of one stone, on that side where the pain is: For the Kidneys and Ureters being provoked with the greatness of the pain, do vehemently contract themselves, and then the Spermatical Vessels and all the parts adjacent are also contracted, and these Vessels do raise up the stone which is joined to them, so that it seems sometimes to be fixed to the Groin. And this retraction or drawing in of parts reacheth to the bladder and Guts: For in great pain the belly is bound, and Urine stopped; so that then Purges will not work by reason they are hindered by that Contraction. The Eighth Sign is, loathing and vomiting by the connexion of the Kidneys with the Stomach, by the Membrane that comes from the Peritonaeum, and by the Nerve of the sixth Conjugation, two branches whereof reach from the Stomach to the inward Tunicle of the Kidneys. Therefore when those sensible parts in the Kidneys are pulled, the Stomach consenting, is stirred up to exclude that which hurteth; and first it sends out Phlegm, then yellow Choler, after green, if the evil continue, because through long pain and watching the blood is altered in the Veins, and that part which is most disposed for it, is turned into green Choler. Finally, The Nephritical pain is so like the Colic, that Galen himself was deceived in the distinguishing of them, as we shown in the Diagnosis or Knowldg of the Colic: where also we laid down signs by which we may distinguish them, which we shall not need to repeat. The Signs afore mentioned are equivocal, and one of them can scarce give a certain knowledge. Some Authors mention others, which are more equivocal and uncertain, but joined with others they help the knowledge of the Disease, therefore it will not be amiss to mention them. Hipp. Aph. 34. Sect. 7. saith, They who have bubbles in their Urine, have an old Disease in the Reins. For these bubbles come from thick Humours full of gross vapours, which are either bred in the Reins, or sent from other parts to them, that matter is proper to breed the stone, and cannot be presently cured, therefore the Disease is long. Galen in his Comment upon this Aporism, saith that the mouths of the Arteries which come to the Reins, are opened by the sharpness of the Urine, and thence comes a Spirit which being mixed with the Urine, maketh bubbles. But it is not probable that such a gross Spirit that will remain so long, should come from the Arteries, and Urine being cold may long time so continue, as we see many bubbles many hours swimming thereupon. And also when the Arteries are opened by the sharpness of the Urine, blood will also come forth. And the mouths of the Veins having thin Skins, would be more easily opened, and so there would be also blood mixed with the bubbles. Hypocrates also Aph. 76. Sect. 4. saith, They who void little bits of flesh, and things like hairs, with a thick Urine, do it from the Reins. The bits of flesh come from the Ulcer of the Reins, of which we shall speak hereafter: but these thirds or hairs are said by Galen, in his Commentaries, to come from thick and crude phlegm, made long and round by the extraordinary heat of the Reins. Yet Galen confesseth, 6. loc. off. cap. 3. that after a long search he was ignorant of the cause of their length. Avicen saith that these thirds grow long in the vessels of the Reins, or others; for in regard these are taken away by Diuretics, and the Patients acknowledge pain in the Reins, it is credible that they receive their form from thence. Actuarius doth directly say they come from the Ureters: For when the Reins abound with phlegm, it goes with the Urine into the Ureters, and sticking to them and growing thick by heat, it gets a long shape like a third or hair. But Fernelius writes that those hairs come from the Parastatis or kernels, from his Observation, in which they grow long like hairs from the matter of the seed, which by force of the Disease flowing down by degrees, grows thick by heat, and that they appear much in those who have lately had a filthy Gonorrhoea, and in those women who have the Whites, or a foul Womb, and in that Urine which they make next after they have known a man. Others suppose, that those thick Humours of which those filaments or hairs are made, are first bred in the Veins, but take their form in the narrow passages of the Reins, through which, as through a sieve, they turn small, and after they descend into the Ureters, in which they grow dryer, till they are sent into the bladder, neither can they be broken by reason of their toughness. Whatsoever the cause is, since the best Authors do agree that these hairs breed of thick phlegm in the Kidneys, or come to them from other parts, it is certain that they may turn into a stone, if there be an efficient cause fit to produce it. And therefore this may be a probable sign of the stone. As for the Prognostic. The stone of the Kidneys is very dangerous, for it useth to bring great evils; as Inflammation, Exulceration, great Pains, Watch, dejection of strength, Fevers, stops of Urine, and the like dangerous Symptoms. If this Disease be Haereditary coming from the Parents, it is incurable. And because Hypocrates saith that the Diseases of the Reins are hard to be cured in oldmen, Aph. 6. Sect. 6. The Stone of the Kidneys in old men is difficult, if not incurable. If the pain of the Kidneys continue many days, and cannot be cured with any Medicines, there is danger of death, and it is near at hand when they are cold externally, and have a cold sweat in the face. Urines that are first thin, and after thick, and have sand at the bottom, do signify that the fit is towards an end. A Stone joined with an Ulcer in the Kidneys, is incurable: for those things which break the Stone, do exasperate the Ulcer. The Cure of the pain of the Kidneys, and stone sticking in them, or in the Ureters, is by enlarging of the passages, and relaxing them by throwing forth the stone, and any other thing that hurts them, by removing or taking away the antecedent cause, and by taking away the pain. Which you may do with these Medicines. Take of Marsh-mallow and Lily Roots, of each one ounce: Mallows, Violets, Pellitory, Bearfoot, of each one handful: Lin-seed and Fenugreek seed, of each half an ounce: fat Figgs, six: Chamomel and Melilot Flowers, of each one pugil: boil them to a pint. Dissolve in the straining, Cassia, and Diacatholicon, of each six drams: Oil of Lilies and Violets, of each one ounce and an half: fresh Oil two ounces: make a Clyster to be given presently. Afterwards open the Liver Vein of the right or left Arm, and take away eight or nine ounces of blood, according to the strength and fullness of the Patient. Phlebotomy is very necessary to prevent Inslamation, which useth to come from continuance of pain. After blood-letting, give this Clyster. Take of the flowers of Chamomel and Melilot, the tops of Dill, Pellitory of the wall and Rue, of each half a bandful: Annis, Fennel, and Cummin seeds, of each half an ounce: Make a decootion to one pint; in which dissolve Diaphoenicon half an ounce: Turpentine dissolved with the Yolk of an Egg one ounce: Oil of Dill and Scorpions, of each three ounces. Make a Clyster. To mollify more, and assuage the pain after your Laxative, you may make one of Oil thus: Take of Oil of Dill and of Chamomel, of each half a pound: Oil of sweet Almonds two ounces: Oil of Rue one ounce: mix them for a Clyster. At the same time appply a Fomentation to the part pained, made of the Decoction of the first Clyster, with Annis seeds and Fennel seeds, Oil and Water, with Sponges. Take of Oil of Scorpions compounded two ounces: fresh Butter, Hen's Grease, Oil of Lilies, and of sweet Almonds, of each one ounce. Make a Lineament to be used after the Fomentation. Or this Cataplasin: Take of Mallows and Pellitory, of each two handfuls: Parsley with the Roots one handful: Rhadish Roots two ounces: boil them soft and beat them: then add of Onions roasted, two: Oil of Lilies, bitter Almonds, and sweet Butter, of each two ounces. Make a Cataplasin, which you must put between two thin linen , and apply warm to the Belly, according to the length of the ureters, and heat it as often as it grows cold. You may also apply one either made of Pellitory alone, or with Eggs fried in a Pan with Oil of Chamomel, bitter Almonds, Scorpions in a cloth. Or make it of Onions shred and fried with Hog's Grease, or the Oils aforesaid, with five or six warm Eggs applied. And because in this Disease, there is abundance of crude Humours, after Clysters (which must still be repeated as the pain cometh) you may give a purging Medicine, especially in form of a Bolus, lest it be easily vomited up, because these Patients are commonly squeazy stomached. Take of Cassia new drawn with Oil of sweet Almonds one ounce: Diaphoenicon three drams: Powder of Rhubarb one dram: with the powder of Liquorin and Tragacanth, make a Bolus. If the Patient cannot swallow a Bolus, dissolve purging things in the Decoction of Mallows. But you must diligently observe that you must not give a Purging Medicine before the pain be allayed. For when the pain is great, a strong Purge seldom works, because then all the parts contract themselves, and refuse to help the Medicine. But at that time you may give a Vomit, by which the plenty of Humours may be abated, and a revulsion is made from the part affected; and often Nature of the self, when the pain is urgent, doth endeavour the same, and after it finds ease. A gentle Vomit which will also assuage pain, may be made thus: Take of warm Water four ounces: Salad Oil one ounce: simple Syrup of Vinegar one ounce and an half: Make a Vomit. If you will have a stronger, you must use Salt of Vitriol, or Mercurius vitae, with which Angelus Sala saith, that he hath often cured this disease. Before and after purging, you must give at the mouth, those things which open the passages, and abate the pain: for which purpose the Syrup of Marsh-mallows proscribed by Fernelius often given, is excellent. But because it is not always ready in the Shops, you may make it simply thus: Take of Marsh-mallows three ounces; boil them to a pint: dissolve in the straining half a pound of Sugar. Let him take it often. This following Julep given often, is good to mollify the Passages. Take of Barley one pugil: grey Pease half a pugil: Mallow and Marsh-mallow seeds, of each two drams: the four great cold seeds, of each one dram: fat Figs, eight: Scbestens, six: Liquoris half an ounce: boil them to a pint and an half. Dissolve in the straining, Syrup of Maidenhair four ounces. Give it at four draughts, twice or thrice in a day. Give for his ordinary drink, a decoction of Marsh-mallow Roots, one ounce and an half: Barley two pugils: Liquoris six drams, in sive pints of water to a pint. Or make Broths of Mallows, Marsh-mallows, and grey Pease, with much butter, and a little salt: or boil the same in fat broth. Or give Emulsions made of the four great cold seeds. But Oil of sweet Almonds above all Medicines, doth mollify and relax the Passages, and assuageth pain, if it be new drawn: give three or four ounces by its self, or with white Wine, or a Decoction of Marsh-mallows, Liquoris, and grey Pease; or make Potion of equal parts of Oil of sweet and bitter Almonds, because bitter Almonds are good also to expel the Stone. The day after you have opened the Arm, you may open the Ham or Ankle Vein on the same side, for that will derive the Humour, and the Patients find much ease thereby. Which Rule is given us by Hypocrates, 6. Epid. Part. I. Aph. 6. and by Aetius, lib. 11. cap. 5. And if the Disease last long, you may open the Hemorroids; according to Hipp. Aph. 11. Sect. 6. who saith, That it is good for Melanchollick men, and such as have the stone, to have their Hemorrhoids bleed. From the same branch of the Spleen there are Veins which go to the Reins, bladder, and Hemorrhoids. If the pain be not assuaged by Fomentations, Liniments, and Cataplasms aforesaid, put him into a Bath made of the Emollent Decoction, with white Wine added, for it assuageth pain, at least while the Patient sits therein; but you must not use it much lest it take away strength. And lastly, When the pain is very great with watching and weakness, you must give Narcoticks, and put two drams of Philonium Romanum, or five or six grains of Laudanum in a Clyster, or three or four grains at the mouth, or one ounce of Syrup of Poppies in a convenient Julep. After these Topics have been used, in a long pain, it is good to apply a Plaster of Melilot, malaxed with Oil of Chamomel and Dill. This pain useth to be bred with some of these Medicines, and with repeating Purges (if they be needful) or giving Cassia often. But if after the use of them it continue, it is most certain that they are great stones which stop the Ureters, which must be sent out by Diuretics, which will break them. But you must first begin with the mildest, lest by strong and sharp you inflame the Blood and the Reins. And you must consider the habit of the Body: For a full Body will endure things that do more pierce and make thin; but a slender, less. There are abundance of this kind in Authors, that diminish, break, and expel the stone, but we will give you only the most choice. Take of Smallage, Parsley, Butcher's Broom, Couch-grass, and Asparagus Roots, of each one ounce: Mallow and Marsh-mallow Roots, of each half an ounce: Pellitory of the wall two bandfuls: Annis, Fennel, Dill, Caraway, Carret, Amye, Carthamus, Cummin, Rue seeds, and Bay-berries, of each two drams: Chamomel, Melilot, Dill, and French Lavender, of each one pugil: boil them in white Wine to the consumption of half. Dissolve in the straining, being one pint, fresh Butter four ounces; Honey of Roses two ounces; red Sugar one ounce; Benedicta Laxativa half an ounce; one Yolk of an Egg; Oil of Nuts, Lin-seed, and Dill, of each three ounces: mix them for a Clyster, which let him keep two hours, if he can. Take of Strawberry Water, and Saxifrage Water, of each two ounces: the best white Wine six ounces: Oil of sweet Almonds two ounces: Spirit of Vitriol one dram: mix them for three doses. Give the first as hot as may be endured; after six hours give the second as the former, and if this will not do (as it seldom misseth) let him take the third. You may sooner make a Julep of Saxifrage Water, and Syrup of Violets, with fifteen or twenty drops of Spirit of Vitriol. Take of the Juice of Pellitory drawn without fire three ounces: Juice of Lemons, and Oil of sweet Almonds drawn without fire, of each one ounce and an half. Mix them for a Julep to be given three or four times morning and evening. Or, Take of the Juice of Lemons and white Wine, of each two ounces: Sugar candy half a dram. Take it instead of the Julep. Concerning Juice of Lemons you must note, That it must be used warily, for being given often and much, it maketh Exulcerations in the Stomach, from whence cometh the Flux called Lienteria. These Pills following are excellent: Take of Sal prunella, Crystal of Tartar, Salt of Ivy Berries, and of Water-cresses, of each equal parts: with some proper Syrup or Turpentine, make a Mass of Pills; of which give one dram every morning. This following powder of Quercetan is much commended. Take of the inward skin of Hen's Gizzards, and their white Dung, of each half an ounce: the inward skins of Eggshells powdered, two ounces and an half: Rupture and Cinnamon, of each four scruples: Medlar stones two drams: Annis and Fennel seeds, of each one ounce: make them into very fine powder, and give half a dram or a dram thereof in white Wine. The Ashes of Eggshells from half a dram to an ounce given in white Wine, doth powerfully expel the Stone that sticks in the passages of the Ureters. Goat's blood prepared is commended of all Authors, old and modern, as the best Medicine to dissolve the stone. The Dose is from half a dram to a dram. The Water of Goat's Blood distilled in a Glass in Balneo Mariae, doth wonders. But you must feed the Goat one month with Saxifrage, burnt Juniper berries, Parsley, and other Diuretics, without Drink. Hartman commends the Urine of a Goat in these words as a wonderful Remedy: In the stoppage of the Reins by a greatstone, or when the ureters and Bladder are stopped by stones sent thither, so that one drop cannot be voided, it is excellent if you take the Urine of a Goat taken out with his Bladder while he is yet alive, and drink and apply his Paunch and Guts to the Belly and Privities, for so the stone will be presently consumed without hurt to the Vessels, and the Patient cured. The Powder of Millepedum, or Sows, is excellent to dissolve the stone, and we will teach the use thereof in the stone of the Bladder. Also the infusion of the same in white Wine, and continued There is a Wine of Winter Cherries commended of Arnoldus Villanovanus, and they say it doth so bring forth the matter of the stone that you may take it up in your hand. And this is done by beating the Winter Cherries in white Wine, and giving the strained Liquor. These also following are good: Take of Lapis Judaicus, or Jews stone, Pulvis Lithontribi Justini, of each one dram: Peach Kernels, Gum Tragacanth, and Cherry-stone Kernels, of each half a dram: bring them to Powder, and with Turpentine make a Bolus, which give in three Doses morning and evening. Take of Hors-Rhadish scraped two ounces: white Wine four ounces: steep them a few hours; then strain them strongly. Let the Patient take the straining twice or thrice, at convenient hours. Savin Water given to an ounce or two, doth purge stones and gravel. Take of Mallow Roots cleansed in white Wine, six ounces: Burdock and Couch-grass Roots, of each four ounces: Asarum, Pa●sley, Valerian, and Fennel Roots bruised, of each two ounces: Maidenhair, Saxifrage, Burnet, Golden rod, and Betony, of each four handfuls: Bazil, Burdock, Carduus, Mountain Osier seeds, Medlar stones, and Peach stones, of each one ounce: Gromwel seeds two ounces: Lapidis Lyncis, and Judaici, of each one ounce and an half: Turpentine three ounces: Goats Blood prepared two ounces and an half: Saffron two drams: white Wine four pints: bruise them that must, and mix them all; distil them in Balneo Mariae. Take two ounces of this Water three hours before Supper, drinking after four ounces of white Wine. Take of the bark of the Roots of Carduus Asininus one ounce: Liquoris two drams: boil them to six ounces: let him take the straining many days. It doth wonderfully cleanse Stone and Gravel. Take four pounds of shred Onions that are white; two pound of Sugar; one pint and an half of white Wine: distil them in Balneo Mariae till they are dry. Give every morning two or three ounces for many days together. The Ashes of a Scorpion is commended by Practitioners, if you take one scruple at a time, with Wa●er of Couch-grass, Pellitory, or white Wine; but it is seldom used. Mathiolus his Oil of Scorpions is more in use; a dram taken at the Mouth with the aforesaid Liquors. The Chemists brag much of their Salts: among which the best is, Salt of Bean Cod, or Stalks, half a dram whereof, with white Wine works very well. And also Tartar vitriolate in the same quantity, They commend also Spirit of Salt, Vitriol, Mercurius dulcis, with their proper Vehicles or Liquors. Outwardly you may help the Stone, if you continually chafe the Reins and Ureters with warm hands anointed with Oil of Scorpions. Also many Cupping-glasses from the Kidney affected downwards, applied without Scarification. Then anoint the Part with Mathiolus his Oil os Scorpions; to which add a little powder os Cantharideses. Or make a Lineament of Oil of Wax, Bricks, and Scorpions, of each equal parts; it is very piercing and good, if you fear no inflammation of the Reins. You must observe in the use of Medicines to break and expel the stone, That they must not be used twice or thrice, but often, till the passages stopped are open; and while you give them, you must cherish the Reins and Bladder with Baths, Fomentations, Ointments, and Cataplasms, that the other may work the better. And you must give thin Liquor, as white Wine, often; and use inward Emollients, Looseners, and Openers, to enlarge the Passages, and temper the sharpness of other Medicines. By these Remedies the pain of the Reins is cured, and stone dissolved and expelled. But because they who are diposed to this Disease, and cured, do often relapse: therefore we must appoint some Preservatives that we may hinder it as much as may be. And first, if there be a Plethora or fullness, or the Reins and Liver hot, it is good to open a Vein, Spring and Fall, a Clyster or gentle Purge being first given: And then to purge the Matter away which is proper to breed the stone before it come to the Kidneys, which you may do by a Vomit twice or thrice in a month, to those which easily vomit. Or you may give a Purge by a Bolus of Cassia, Diaphoenicon, and Rhubarb, prescribed in the Cure, or some other convenient Medicine every month; or two or three, according to the habit of the Patient, and the plenty of Humours, and that in the last quarter of the Moon. Or if there be evil Humours, they must be purged Spring and Fall with a convenient Apozeme: for by that, not only the Antecedent and remote cause will be taken away; but also some part of the conjunct cause; as also the Obstructions of the Bowels, which usually accompany this disease, will be taken away, if you mix therein cleansing and cutting Medicines. Or instead of the Apozeme, you may use the Decoction of an old Cock made thus: Take of Polypody of the Oak, Carthamus' seeds, of each one ounce and an half: Thyme and Epithimum, of each one pugil: Cummin, Annis, Dill, Fennel, Caraway, and Carduus seeds, of each two drams: Senna one ounce and an half: Gummy Turbith half an ounce: Cinnamon one dram: Crystal of Tartar two drams: beat them and mix them together, and put them into the belly of an old Cock; and then boil them till the flesh come from his bones. Let him take the Broth being strained, at four morning's draughts. Or you may give this following Powder commended of Solenander, by the use whereof he testifieth, that he cured many of the pain of the Reins, giving it in the fit. Take of Senna two ounces: the best Rhubarb half a dram: Turbith one dram and an half: Hermodacts two scruples: Polypody half a dram: Cinnamon, Ginger, Gromwel seeds, Saxifrage, Broom seeds, of each one dram; powder them finely. Give one dram, or a dram and an half in white or thin red Wine, once in a month. Carolus Piso doth extol this following Powder: Take of Annis, Fennel, Caraway, and Cummin seeds, of each one dram: Coriander prepared half a dram: Liquoris and Burdock seeds, of each one dram and an half: Cinnamon and Galangal, of each one scruple: Gromwel and Broom seeds, of each half a dram: Diatragacanth frigid two drams: Diagridium one scruple: Senna as much as all the rest: make a Powder. The Dose is one dram, with the Broth of grey Pease. Or you may make a Magistral Syrup thus: Take of Asparagus, Couch-grass, Marsh-mallow, Kneeholm, and Parsley Roots, of each one ounce: Bettony, Burnet, Saxifrage, and Pellitory of the Wall, Maidenhair, of each one handful: Bazil, Parsley, Gromwel, Broom, and Burdock, and Mountain Ofier seeds, of each two drams: Liquoris, Raisins, and Polypody of the Oak, of each one ounce: Make a Decoction to one pint and an half. Infuse in the straining, four ounces of Senna: white Agarick two ounces: Ginger two scruples: boil them a little, and strain them: after dissolve in it one pound of white Sugar. Boyl it up to a Syrup, and give thereof two ounces once or twice in a month, with the Decoction of Barley, Couch-grass, and Grey Pease. Or if the Body be very foul, make Pills of Aloes and Agarick, and give two or three of them every other day before Dinner. After Purging, give Diuretics, to bring forth the slimy Matter, and Sand that is about the Ureters. For this end, make Decoctions of the Diuretics mentioned in the Magistral Syrup, with Sugar, into the form of a Julep, or Apozem. Or Chicken, Goat, or Mutton Broth, to be taken many days together after general Evacuations. Also after every Purge, take some of these following, once or twice in a week. Take of the stalks and flowers of Beans three pound: Calcitrah one pound: beat them, and add one pound of Sugar candy; the Juice of Lemmons one pint and an half: the Juice of Oranges half a pound: the Decoction of Mallows, and Marsh-mallows well strained two pound: Honey one pint: Distil them with a gentle fire, and let them not be burnt, nor the Liquor wholly consumed. Let the Patient take four ounces of this Water every morning. Take of the stones of Medlars, and the powder of Diatragacanth frigid, of each one ounce: dried Restharrow Roots, Liquoris, Melone and Gromwel seeds, of each two drams: Saxifrage, Broom, Rhadish, Knee-holly, Calcitrap seeds, of each one dram: Marsh-mallow and Asparagus seeds, of each one scruple: Sugar candy two ounces: make a Powder. Of this let him take one spoonful thrice in a month in the morning, about New moon, Fullmoon, and Wain, drinking after a little white Wine, or red Pease broth, Sea-holly, and Liquoris, exercising after it. Carolus Piso highly commends this following Powder, which he gave with his purging Powder before mentioned, and took away many boxes of small stones from a Precedent of Lorraine. Take of Marsh-mallow and Violet seeds, of each half a scruple: Gromwel seeds, and Liquoris, of each one scruple: the Jews stone, and Sponge stone, of each six grains: the powder of Dates, Medlar, and Cherry stones, of each two scruples: Melone Seeds three drams: make a Powder. Give one dram with unleavened bread dipped in white Wine three days together of the New moon, and let him drink red Pease broth after it, wherein the Roots of Marsh-mallows, Fennel, Sea-holly, Restharrow, and Parsley, and Juniper berries bruised have been boiled, adding a little white Wine, Honey, Butter, and Juice of Lemmons. This following Electuary prescribed by Zappata, is excellent. Take of the Seeds of St. Johns-wort dried, and finely powdered, three ounces: Conserve of Roses of Violets one pound: mix them into an Electuary, of which let the Patient take half an ounce every morning three hours before meat the first two weeks two days together; and after for fifteen days once in a week; and after that once in a month, or oftener, according as the Disease requireth. Conserve of Roses, is better than Violets, because it correcteth the scent of the Turpentine which comes forth of the Seeds of St. John's wort beaten. But Violets agrees best with the Reins. These following Lozenges are very safe, and most excellent. Take of the four great cold seeds, and of Liquoris, all cleansed one scruple: Burnet, Bazil, Parsley seeds, and Nutmeg, of each half a dram: Aromaticum Rosatum two scruples: Sugar dissolved in Winter Cherry Water, four ounces: make Lozenges of three drams in weight. Let him take one in the morning three hours before meat, drinking after it four ounces of Restharrow, or Rupture-wort Water, with two ounces of white Wine. The Wine of Winter Cherries described in the Cure, if it be drunk sometimes, doth take away the Matter that breeds the Stone, saith Villanovanus. In the use of all Diuretics observe this, They must not be used too often because they draw to the part affected; there once or twice in a month, or sometimes seldomer, is sufficient, purging before, lest the Humours of other parts should be carried to the Reins. Turpentine may be used oftener: for Amatus Lusitanus in Curate. 68 Cent. 2. reports of a Monk that had the Joynt-gout, and the Stone both, and could find help by nothing; at length by the use of Turpentine he was cured within six months of them both. Every morning he swallowed the quantity of a small Nut with Sugar. And the reason why Turpentine often used doth not hurt as other Diuretics, in my Judgement is this; Because it looseneth the Belly withal; so that those gross Humours, which by other Medicines would be carried to the Reins, are sent out by stool. But commonly Turpentine is used seldom, as other Diuretics, either alone, or with other Medicines, thus: Take of Turpentine ten times washed in Saxifrage or Pellitory Water, half an ounce: With Sugar make a Bolus. Or, Take of Cassia newly drawn six drams: Turpentine half an ounce: Powder of Liquoris two drams: mix them for a Bolus. Or, Take half an ounce of Turpentine, and one dram of powdered Rhubarb: mix them for a Bolus. Or, Take Four ounces of Turpentine, burn it upon a hot Iron that it may powder, and give two drams with convenient Liquor. Or, Take Turpentine half an ounce: Powder against the Stone, called Pulvis Lithontribus, t●o drams: mix it for a Bolus. Zacutus Lusitanus, Obser. 58. lib. 2. Praxis admire. doth much commend Natural Balsam for expelling stones, and that a man of three score years of age that had his Water stopped eighteen days with stones, was cured thereby. First he took some drops of it with Oil of sweet Almonds, increasing the quantity of both till he came to half an ounce of Balsam, and three ounces of Oil of sweet Almonds, within ten days he voided six stones; and afterwards he was preserved by the same Medicine, by taking in a morning half an ounce of Oil of sweet Almonds, and six drops of Balsam, by which means he made a Sandy Urine, and lived long. If you want Eastern Balsam, you may take that of Peru. The same Zacutus in the same Observation, doth commend Tobacco Water, in these words: I remember (saith he) that I took away many great stones fastened in the hollow of the Reins, with distilled green Tobacco Water. If you want that, then use the Decoction. Most wi●e Varandaeus, my Master, commends the Waters of some Baths, Balervacan or Bitumenous for Preservatives against the Stone, of which we have seen rare effects. We 〈◊〉 his words: There is (saith he) no better Medicine after Purging, than the drinking of Balervacan Waters; for by the heat which comes from the Bitumen, they dissolve gross humours and stones, and by their Nitrous quality they cleanse, and by their great quantity, do not only cleanse the Guts, but Reins; so that it is incredible to tell what abundance of thick Water some have made after it. But when we fear the Inflammation of the Guts, we ordered them to abstain from Wine, and gave them Chicken Broth with cold Herbs and Juleps. Therefore we put fat Phlegmatic men into them once a day in the morning, having first anointed their Reins and Liver with some proper Ointment, and bound them with doubled linen , that the Excrements might be received from the Pores opened. And if their Bewels grow hot, they may after use sweet Water Baths that cool and moisten. Sharp Mineral Waters, or Vitriol, are also good to prevent, for they do not only dissolve the slimy Tartarous Matter that breeds the Stone, but correct the hot distemper of the Liver and Reins, and therefore in hot distempers these are best. And because hot Bodies are hurt by hot things, we will prescribe more temperate; as Bean and Rupture-wort Water, and Lemmon Water distilled. Slice them and distil them in Balneo Mariae. And for their better cooling, still them with Milk. The Conserve of Hips, is Diuretic and cooling, and is commended by Crato in this case also. The Conserve of Marsh-mallow and Mallow flowers, which by mollifying and moistening helps the stones to come forth. The inspissate Juice of Purslain made into Pills, and given one dram at a time, doth powerfully cleanse the Reins. The dried Flowers of Pomegranates in one dram, doth purge the Matter causing the Stone. And the like Quantity of the Dried Sponge of white Thistle, given in like quantity, is excellent. Fresh Butter with as much Sugar candy taken every morning fasting, doth cleanse the Passages of the Urine, and hinder the breeding of the Stone. Bitter Almonds taken ten or twelve in a morning, do the same. Filberts also taken before meat, are commended by Crato, who says that he found by Experience, that many long affected with the pain of the Reins, were cured by them. Which Amatus Lusitanus Curate. 78. Cent. 7. wisely confirmeth, where he thus saith: A man that had the pain of his back, and pissed often red hairs, complained of his Loins and Guts, for which he had took many things in vain; but contrary to all hope he was cured with eating of Filberts. For one counselled him that if he would be cured, he should eat Filberts with their inward Husks before Dinner and Supper. But he considering the Innocency of the Medicine, eat them at meat, and after also: by which he was cured perfectly, and his pain never returned. Amatus Lusitanus in his Notes, adds this: That not only that man, but many others have been cured thereby. These are those vulgar Nuts that Avicen reckons among the Medicines that consume the Stone. But the question is, by what faculty they work? whether by the dryness of the inward skin? But some say that they work by their Oily quality. The Chemists commend the Spirit of Salt, and give some drops thereof in a morning with Broth, or other Liquor. Zechius commends boiled Water given warm, the quantity of six or seven ounces, once or twice in a day, before meat. For it cleanseth the Reins, and extinguisheth the heat, so that they cannot after breed stones. Let his Drink be thin Wine, with the Decoction of Sea-holly. This Crato commends. And we have seen excellent effects thereby. Sour Wine called in French, Vnies, drunk often, doth so much good, that some have Vineyards of those Grapes on purpose. To correct the hot distemper of the Reins, is the best Preservative, by such things as are mentioned in the hot distemper of the Liver. For they help the Reins and the Liver, from whence many times they are distempered. Among the rest, Whey drunken in Summer, a whole month together, is the best. And sharp Mineral and Vitriol Waters, to cool all the Bowels. You may apply this following Epithem often to the Reins. Take of Lettuce, Water-lilly, and Rose Water, of each three ounces: Rose Vinegar two ounces: Apply them very warm morning and evening. This following Lineament is good, especially in Winter. Take of the Oil of Roses, Water Lilies, and Violets, washed in Vinegar and Rose Water, of each one ounce: the Mucilage of Marsh-mallows drawn in Pellitory Water, six drams: Wax, a little. Make a Lineament for the Reins morning and evening. The extraordinary heat of the Reins, is allayed with a plate of Lead, always warm. And lastly, Because the Crudities of the Stomach do breed the Stone, you must have an eye to that, and strengthen it with such things as are prescribed in the Chapter of the Weakness thereof. Chap. 2. Of the Stone in the Bladder. ALthough we should speak of these Diseases of the Reins in order, yet because the Stone in the Kidneys and Bladder a●e of the same Nature, and what hath been said of the one, may agree with the other, we shall speak next of the Stone in the Bladder. The Material and Efficient Cause is the same of both: only this Difference there is; That Children are most subject to the Stone in the Bladder, and Men to that in the Kidneys. The Reason of which, is given by Galen, 6. Epid. Sect. 3. because thickness of Urine, which Children often have by Reason of their gluttony, is dissolved by their gentle heat; neither doth it stay in the Reins by the help of the Expulsive Faculty of the Reins, which is stronger in that age; but being fallen into the Bladder, there it stays longer, because children given to play and sleep, piss more seldom. Moreover, their Urine is not so sharp, neither doth it provoke the expulsive faculty of the Bladder, while the quantity is burdensome, and so the dregs remain because the Passage is very narrow; besides, the bladder being stretched by the plenty of Urine cannot so exactly contract itself to empty out all the Urine, but some remains in the bottom, which is thick, and fit to breed the Stone. On the contrary, old men do often piss forth that Matter which is in the bladder, and their passage is larger; but the thick humour remains in the Reins, because it is clammy, and cannot be dissolved by their weak heat, or strain through by reason of its dryness. Hence Hypocrates in Coacis, saith that the Stone in the bladder is not bred after fourteen years of age, to three score, except it was there before. Fernelius mentioned a new Opinion of the Stone, breeding in the Bladder, saying, That every stone in the bladder, had its beginning from the Kidneys, and grows afterwards in the bladder: For when in a fit of the stone, it falls from the Reins, if it be great, it stays in the Bladder, and by getting new Matter it increaseth by degrees. For he affirmeth that in grinding of some stones taken out of the Bladder, he found as it were a Kernel which fell from the Reins of another colour and substance, and that he never knew any that had a stone in the bladder, who was not formerly vexed with pains in the Reins. But this Opinion is cast off by divers very good Authors, who by their Experience have found the contrary, and have taken many stones from the bladders of children, which have been wholly of the same colour and substance within. And common Experience teacheth us, that Children have the Stone in the Bladder, who never had pain in the Reins, which would be otherwise if the stone came first from the Reins. It is true, that in men many times stones fall from the Kidneys into the Bladder, and increase by the addition of new Matter; but we deny that it is always so, and we constantly affirm, that many stones have taken their beginning in the bladder. The knowledge of the stone in the bladder is difficult, especially in the beginning, when it is little; but when it is great it is evident. But we shall discover it as much as we can by Art. The First Sign is, pain in the neck of the bladder, which is worse towards the end of pissing, and reacheth to the end of the Yard, like that which is in difficulty of Urine from Inflammation, called Dysuria, and it is scarcely at first distinguished from it, but when other signs appear. The Second Sign is, Itching in the Yard, which makes the Patient scratch it often. The Third Sign is, Weight in the Peritonaeum, or inward covering of the Guts, and all about the Pecten where the Hair groweth, with a heavy pain, when the stone is great. The Fourth Sign is, When there is a great stone there is great stoppage of Urine, with pain like women in travel, and dropping of water, and often endeavouring to pills. The Fifth Sign is, Stoppage suddenly in time of pissing, by reason of the stone falling to the Orifice of the Bladder. The Sixth Sign is, Easier making Water lying upon the back, because it puts the stone from the Orifice to the bottom of the bladder. The Seventh Sign is, Often standing of the Yard, which comes from stoppage of Urine, and of the Inflammation of the bladder by the stone rubbing against it. The Eighth is, An often desire to go to stool, which follows the desire of pissing, by reason of the consent of the Sphincter Muscles of the Anus and Bladder; for when one is provoked, the other is provoked, because they have branches from the same Nerve. The Ninth is, The Patient cannot rest in a place, but shakes his Legs, and if the stone be great he can scarce stand upright, ride, or walk in rough places; for then the mouth of the bladder is much afflicted with the stone. The Tenth is, That the Patient is helped by no Remedy, but worse commonly; for all Medicines that go through the passages of the Urine, either do bring new matter, and increase the evil, or carry away the phlegm, which being about the stone made it less offensive, but being bare, doth grate the inward Tunicle of the bladder. The Eleventh Sign is, When the Patient is in pain of the Reins, and after a fit useth to void stones which caused it, but now voideth none as formerly, it is a sign that the stone causing the pain is sent to the bladder, and there remains, where by degrees it increaseth, and causeth the aforesaid Symptoms. Therefore if any after such pain, voids no stone, and after a time gins to be stopped from making urine, it is very probable that there is a stone in the bladder. The Twelfth Sign is from Hypocrates, Aph. 79. Sect. 4. They who make a sandy Urine have a stone in the Bladder. Which Aphorism hath troubled many Wits. Galen in his Commentary thereupon, saith, that it is manifestly lame, and defective, because Hypocrates left out half of it; for whether the stone be in the Kidneys or Bladder always the Urinal is sandy. And Hypocrates himself contradicts this Aphorism, Lib. de internis Affectionibus, where he reproveth the old Physicians that supposed sand in the Urine to be the sign of the Stone in the Bladder. Cardanus in his Comment upon the same Aphorism, saith, That he voided for thirty years, first red, then white sand, every day in abundance without any suspicion of the stone either of the Kidneys or Bladder; and he further saith, that there are scarce one in ten who doth not void Gravel, yet few there are that are troubled with the stone in the Kidneys, and fewer with that in the bladder. The Spaniards void much Gravel, and yet are not subject to the stone. We distinguished of sand in the former Chapter, which may signify the stone: But we said it was an equivocal sign. For that sand is sometimes sent forth by the strength of the expulsive faculty, and is not kept in the Kidneys and Bladder any while. And if this sand did show the stone more surely, yet it would never declare that of the Bladder only. And therefore that Aphorism, as the words are is false. Beverovitius and Salmasius, have greatly contended about this Aphorism (both Learned men) and good to open dark Sentences) and they have written both whole Volumes of the same. It is not our intention to stay long upon it, determining this one thing for an end of all Controversies; That the Opinions of Authors, which at first seem contrary to Truth and daily Experience, are always to be taken in that sense which is most conformable to Truth, although the words will not bear it, which in such a case are to be thought to be added by simple fellows in the Translation, or the whole Sentence to be put in by them; as Galen saith often of some of Hypocrates his Say, That they are thrust in by others, when they carry not the weight and Majesty of Hypocrates. And the Opinion of Beverovitius concerning sand in the Urine, seems not to be according to the mind of Hypocrates, nor to be of great use in Practice. First, it seems not to agree with Hypocrates, who in his foregoing Aphorisms, takes signs from things contained in the Urine; and following his matter in hand, saith, That Sand in the Urine, signifieth the stone of the Bladder. But Beverovitius inverts the Sense, and saith that Hypocrates is to be understood of Sand, which formerly used to be voided, that if they subsist, that is, be retained in the Bladder, and be no more sent forth, it is a sign that the Sand so retained is turned to a stone in the bladder. This Interpretation, as I said, doth agree with Hypocrates his Intention, and it nothing avails for Practice: for they who use to void gravel, have some time of intermission, in which there is not a stone bred in the Bladder. Nor hath it much weight that Beverovitius observeth, That Hypocrates in his other Aphorisms, where he lays down the signs to be taken from the things contained in the Urine, doth not use the word Subsidentia, or set●ing▪ or falling down; but the Word Excretion, or voiding. As for example, they who piss matter or blood, with thick and branny Urine, etc. But here he useth the word that signifieth settling, to show that he meaneth something else. But we bringing all things to Practice, say that Hypocrates in this Aphorism, could not use a word which signifieth only sending forth, or Excretion because he ought to distinguish that sand which signifieth the Stone, from that which doth not. This Sand as we said in the former Chapter, settles in the bottom of the Urinal; but other Sand doth only stick to the sides; and therefore Hypocrates, that he might distinguish them, said well. They whose sandy matter settleth; for others which do not settle, are not a sign of the stone in the bladder. But that we may bring this Aphorism to Truth, and Practical use, we suppose that the Opinion of Johannes Zechius, is the best; who makes it a proper sign of the stone of the bladder, and there is great use of the Aphorism in Physical Practice, when by all other Interpreters, it is made unprofitable. And that Zechius may be honoured by them who have not his Works, we think it work our labour to repeat his words, which are in his Book of Consultation, 58. Consult. Hypocrates (saith he) Aph. 79. Sect. 4. said thus, which was never understood yet, either by Galen, or any other. They whose Urine hath a sandy settling or sediment, have the stone in the bladder. Which Sentence, if we should take it according to Galen, woudl be false, because we observe that many men do piss sand all their lives (whereof I am one) without any suspicion of the stone in the bladder. From whence I cannot but wonder at Galen, and all the rest after him, that they should either not understand so useful an Aphorism (which I can scarce believe) or by reason of its ambiguity pass it by. The whole difficulty is in the signification of the word [Sabulosa] in Greek called Psammodea: Hypocrates would have nothing understood thereby but thick gravel mixed as it were with fat Earth like Day or snot in the bottom of the Urinal; a certain sign of a great stone in the bladder. But because there is nothing constant in man, it is not to be admired that some that have this Disease have not this sign; as when the stone is small, as we observed m Cardinal Paleotus. Now the cause of this muddy Excrement hath showed in another place. So far Zechius; but where he shown the cause of it we could never find. But we plainly shown it in former Chapter, when we said that this snot-like matter is the proper Excrement of the bladder distempered, when it cannot concoct the great quantity of blood, and superfluous humours which are sent thither, and turn them into its self, but turns them into that consistence like snot; and this evil disposition of the bladder comes from the stone therein. Let that be perused, for it maketh much for the understanding of what hath been said. But there still remaineth one difficulty, for some have daily phlegmatic, slimy matter in their Urine, and yet are free from the stone in the bladder. And Cardanus reports of an Augustine Monk called Leo, that shown him often so much congealed phlegm in the bottom of the Chamber pot as was bigger than a Goose Egg, and yet he had not the Stone. To this doubt we answer, That the slimy matter that comes from the bladder, is to be distinguished from that which comes from other parts, because that which comes from the bladder, is more clammy and glutinous, so that it sticks fast to the bottom of the Pot or Urinal, and cannot be shaken off when the Urine is poured forth; but that which is from other parts doth so cleave, but comes presently forth with the Urine; Experience hath taught me this, which hiterto no Author ever yet observed. This clamminess comes from the Nature of the Bladder, which is a Membrane, and apt to produce this glewiness, as you may see Glue is made of Membranous Skins of Beasts. This tough glutinous Matter, I say, comes from the evil disposition of the bladder, which is caused by the stone there, and we can thus prove it besides what hath been said; Because we have known a Child twelve years old, that had a stone in the Bladder, and pissed continually a glutinous matter that cleaved to the bottom of the Glass. And after the stone was cut forth, he voided the same for a month, but afterwards none at all. Which clearly shows that that Matter comes from the evil disposition of the Bladder, which could not presently be cured after the Bladder was cured, that matter appeared no more, which shows that it came from no other part but the bladder. For a Conclusion of this, let us take notice, That whensoever this slimy matter appears with all the aforesaid conditions, there is a stone in the Bladder; but when it doth not appear, it doth not follow that there is no stone, for it often happeneth that the stone is smooth, or little, and so doth not hurt the bladder, and then the Urine is always clear. This is a true sign, that there is a stone when it appears; but when it is absent, it is not a sign of no stone. Nor would this Objection, or rather Cavil, become a wise man, because from our Observation before mentioned, we proved that such matter might be voided by Urine, and yet no stone in the bladder, for it was cut forth. It is sufficient that either a Stone was lately there, which was the cause of this Disease; and so this kind of Matter signifieth, either a Stone there now, or lately hath been there. The last sign is by trial with the Catheter, and putting the finger into the Anus, which operation must be used to take away all doubt; for the most part it doth: for sometimes the Stone is covered with slimy matter, so that the Cutters themselves are deceived thereby. But the Catheter is more uncertain than the finger, by which you may not be certain of the Stones being there, but of the form and bigness of it. As for the Prognostic of this Disease: It is always painful and dangerous; painful, because only very small stones can pass through the Neck of the Bladder. The great ones, if like flint, cannot be dissolved; if soft like Chalk, or brittle, they may be dissolved with long use of powerful Medicines, which for the most part the Patients will not stick to, and therefore they are seldom cured; therefore there is often cutting, which how terrible it is, daily Experience will declare, because many die under the Operation. Hence Hypocrates in his Oath, commands his Disciples that they use it not, but leave it to men of that Profession only. But in Women, the Operation is less dangerous, because their Passage for Urine is wider, and it may be done without cutting, only by enlarging the part. The way of Cure is the same with that of the Kidneys, first Evacuation of the antecedent matter, Revulsion, and hindering of the breeding of it: and let the Matter conjunct, or the Stone itself, be diminished, worn away, or dissolved; for which there are good Medicines in the Chapter aforegoing. Of which, the distilled Water of Onions is most excellent, by which continued twenty days we saw a stone bigger than a Bean thrown out of the Bladder. But the best Authors and Experience teach, That things taken at the mouth cannot dissolve the Stone in the Bladder. Hence it is that we commonly refer them to the Cutter. But because there are many stories of men cured by such Medicines, we will speak of the chief, that every one may try them, if he please, before he go to the terrible Chirurgeon. Sometimes the Stone is so soft and newly congealed that it is not impossible to dissolve it; but hard flinty stones cannot. Horatius Augenius, Tom. 2. Epist. Med. Lib. 9 Epist. 8. I (saith he) have twice seen the stone broken in the Bladder. Once by chance I had the same of one Janetus' a Printer at Rome in cure, whom I purged that he might be cut with more safety. For he had tried all the Venetian and Florentine Physicians. But when nothing did him good, be sent for the Priest to consult about his soul, and resolved to be cut. The Priest being a Jesuit, and hearing his Confession, and the condition of his Disease, told him a Medicine, of which he had made trial in himself and others. He tried, and was cured in the space of nine days. The Medicine was this: Take of the Powder of Hog-lice or Sows, one dram, or four scruples at the most: Aqua vitae half an ounce: red Pease Broth, nine or ten ounces. Let him take it five hours before dinner. I cured one of eighteen years of age, of a hot and dry complexion, by taking away some part of the Aqua vitae, and gave it him but every other day, and at other days of Bean and Strawberry Water, of each five ounces, with six drops of Oil of Vitriol, and one ounce of the Julep of Violets to cool him, thus: Take of the powder of Sows prepared, one scruple: Aqua vitae two scruples: red Pease Broth eight ounces. Mix them, and give it six hours before meat. Thus Augenius. Sennertus in his Chapter of the Stone in the Bladder, tells a famous story of William Lauremberg, Professor of Rostoch, who being old, and troubled with the stone, was unwilling to be cut, and therefore sought for other Remedies. First he tried the famous Water against the Stone, which is so much prized by Princes, which is thus made: Take of Salt of white Tartar one ounce: Parsley Water one pint: Mix them, and strain them with a brown Paper; and with Orange peels make it yellow. He used also the Indian Jewel, called in Spanish, Igiada, which is most famous for breaking the Stone; but both to no purpose. Therefore be desired to make trial of the Medicine of Sows, which Horatius Augenius saith, cured two young men. In imitation of whom, after general Physic, and good Diet, he took of Sows one scruple; the Spirit of Juniper two scruples; red Pease Broth ten ounces: which he took in the morning; but the first and second time he found a straightness in his Breast, and a fainting, so that he was constrained to take one dram of Treacle with the Potion; and so used it fifteen days: but all this while he voided no gravel. And then he added other things, and made it thus: Take of prepared Sows two ounces: a Hares and Goat's Blood prepared, wild Rose Flowers, and purple Violet seeds, of each one ounce: Species Lithontribi, two scruples: mix them for an Antidote, of which take two scruples: the Diuretic Decoction ten ounces: the Spirit of Juniper two scruples. Which Medicine after he had taken it the second time at five a clock in the morning, four hours after he felt a great pain under the Os Publis, about the Neck of the Bladder: A little after he made a little Water, and therewith some thin red things like scales of fishes; which though they seemed to be slimy, yet when they were touched turned to sand. So that it plainly appeared that they were the outside of the Stone. By the continuance of this Medicine, every fourth or fifth day he voided the like scales, and sometimes bigger pieces, especially when he used a sweet bath. But when the neck of the bladder was wounded by the fragments and the stone, he used Medicines to assuage pain; and by the use of these Medicines, was in seventeen months cured. The Decoction was. Take of Liquoris four scruples: Roots of Marsh-mallows, Couch-grass, Restharrow, of each half an ounce: Winter Cherries twenty: red Pease six ounces: Raisins one ounce: the four great cold Seeds, of each one scruple: Barley two handfuls. Boyl them in Winter Cherry Water, Restharrow, Strawberry, and Bean Flower Water, of each one pint and an half: to the straining add of the Syrup of Marsh-mallows four ounces. The Sows are thus prepared: Take of live Sow's two pound; wash them in Restharrow Water: then drown them in Spanish Wine; then power the Wine out, and put them in Glasses, the more Glasses the better, because than they will dry better: Put these Glasses well stopped into the Oven when the Bread is drawn, that they may dry gently till they will powder: then put some Spanish Wine upon this Powder, as much as it will take in, and dry it again; do so thrice: and fourthly wash it with this Liquor: Take of strawberry Water three ounces: Spirit of Vitriol half a dram: mix them Then dry it, and make it fine, and keep it in a Glass for your use. Besides the aforesaid, the use of the distilled Water of Goat's blood, or of the Urinal of a Goat newly slain, which was formerly mentioned in the Stone of the Kidneys. If the Stone cannot be broken with Medicines, necessity requireth the manual operation, though it be dangerous, lest the Patient die with linger pain. This requires a skilful and well exercised Artist, and that it may have good success, as we have observed. It is the Duty of the Physician, before the operation to prepare the body by bleeding, purging, and diet, as the state of the business requireth. And observe, that the taking away of a stone from a Woman hath no danger, because it is done only by enlarging the Passage of the Urine, which in them is very short. If the Patient fear cutting, or want a good Chirurgeon, he may use asswaging Medicines lest the Stone should cut and ulcerate the neck of the bladder, such as are prescribed for heat of Urine. But if a stone fastened in the neck of the bladder stop the Urine, it must be shaken back with lying upon the back with the leg up, and the body shaked; and then by a good somentation or bath, and with a Catheter, let the stone be sent back into the bladder. Chap. 3. Of the Inflammation of the Reins and Bladder. BEcause the Inflammation of the Reins and Bladder are cured with the same Medicines, therefore we will put them in the same Chapter, although the Signs are different, as shall be showed. This Inflammation is a Tumour of those Parts, from the flowing of Blood or Choler unto them. This is not very ordinary, because the substance of those parts is solid and thick; but sometimes it happeneth, because the Kidneys are fleshy and apt to receive blood: but the Bladder, though it be without blood, and spermatick, because it receives blood for its Nourishment through the small Veins, is without question subject to Inflammation by too much blood; as other Membranes of the Brain, or meanings, the Pleura, Mediastinum, and the like. We said that these Inflammations come from Blood or Choler, as when Phlegm or Melancholy in the Blood make the parts thicker, because they cannot pierce into their thick substance. The Causes of this Disease, are either from things Natural, not Natural, or Pretematural. From Natural things, when there is a Natural Infirmity of those parts from the Parents, or a great looseness of them, a great heat originally in them, by which they draw plenty of Humours: In Youth these conduce much to an Inflammation. From things not Natural, as much Venery, which weakeneth those parts, and draws much blood or other Humours to them; Gluttony, Drunkenness, and eating of Salt and Spiced Meats; great Passions of the Mind, lying upon the back in a soft bed, great Exercise, stoppage of some great Evacuations, as of the Months and Hemorrhoids, or usual bleeding at the Nose, those things which cause repletion and evil concoction, and drive the humours to the inward bowels. From Preternatural things, as a stroke or wound upon the Reins, or about the Bladder; a pressing or bruise of those parts; constant Fevers, foulness of the Vessels, or other parts that purge themselves by Urine, as in a Pleurisy, Empyema or imposthume in the side, Obstruction of the Spleen, breaking of the Mesentery, and the like. And lastly, Disease of those parts do cause Inflammation, as the stone, great pain, exulceration, heat of Urine, and stoppage thereof, or the like. The Signs of the Inflammation of the Reins, are a weighty pain in the Reins, sometimes beating, if the place be affected where the Arteries are: And this pain extendeth to the parts adjacent, so that the Patient can neither lift himself up, not stand upon his feet, and scarce turn himself, and neither lie upon his side, nor his Belly, because then the part inflamed will hang down; therefore he lies always upon his back, and if he either sneeze, or otherwise move his Body, the pain is increased. He hath a numbness or pain in the Leg on the same side, by reason of the Nerve that goes from thence to it. He hath difficulty of pissing by reason of the heat which is sent to the Urine, and filth mixed with it coming from the inflamed part. The Urine is first thin and yellow but after red and thick; ●e hath a constant sharp Fever, which is attended often with watch, dote, and other great Symptoms; also loathing and vomiting, by which he voids Choler, Phlegm, and other Humours. Sometimes the Gut Colon is inflamed, and if it be that part which is near the Liver, it brings the like Symptoms: but here is the difference; In the Inflammation of the Reins, the pain reacheth to the short Ribs, the Back, and Bladder; but that of the Colon tends more to the Belly, and there is a greater change of Excrements of the Belly, than in the Inflammation of the Kidneys. But in the Inflammation of the Kidneys, there is a pain about the Pubis and Perinaeum, in which there is heat, and sometimes redness. There is constant heat of Urine, but that is stopped when the part swelleth, and stoppeth the passage. The strait Gut suffers by reason of its nearness; hence it is that there is often desire to go to stool with burning, sometimes the belly is bound, when the Gut is stopped by the inflamed Bladder. There are also other common Symptoms mentioned in the Inflammation of the Reins, as a Fever, watching, doting, thirst, and the like. There can be no good Prognostic in this Disease: For the inward Inflammation of the noble inward parts, do threaten continual danger of death. It is most deadly when a Convulsion or dotage followeth, or the like great Symptom: and if there be a cold sweat, death is at hand. In the Inflammation of the Reins, if the Hemorrhoids follow, it is good. If the Inflammation Suppurate, and the Imposthume break, and go into the passage of the Urine, there is hope; but if it go by the Emulgent Veins into the Liver, and labour to get way through the Guts, it is dangerous. A final Inflammation of the Bladder with a Sediment in the Urine that is white and equal, promiseth health. An Inflammation of the bladder, is sometimes cured by an Erysipelas, or Choleric Humour arising in the Skin suddenly, and by making much Urine. The Cure of both Inflammations of the Reins and Bladder, is made by revelling, deriving, cooling, and moderately repelling, by anodynes, resolver's or Ripeners, if need be, and the like: whose Matter and way of using, shall be as followeth: And first, Phlebotomy is very necessary in the Liver Vein, on the same side the pain is, twice, thrice, or four times, or oftener, if the strength will bear it, till the defluxion ceaseth, which you may know by the abating of the pain. But in the Inflammation of the bladder, the right side is to be chosen by reason of the Liver, from whence, as from a Fountain, the blood floweth to the part. After much blood is taken away, and revulsion is made by the upper Vein, you must also open the inferior for derivation sake, in the Ham or Ankle; as also the Hemorrhoids are to be opened, especially if they be swelled. Cupping-glasses with Scarification, are also good for Revulsion, both above and beneath, and Frictions with strong Ligatures of the extreme parts, to draw the humours outward. After, and before blood-letting, give a mollifying and cooling Clyster that is a little loosening, and let it be of a small quantity, lest it oppress the Tumour, thus made: Take of Marsh-mallow Roots one ounce: Mallows, Violets, Lettuce, of each one handful: sweet Prunes four pair: Barley and Violet Leaves, of each one pugil: make a Decoction to eight or ten ounces. In the straining dissolve of Cassia, or Diaprunes simple, one ounce: Oil of Violets four ounces: two Yolks of Eggs: Make a Clyster. Alloy the heat of the blood with Juleps and Emulsions made thus: Take of Endive, Littice, and Purslain Water, of each four ounces: Syrup of Pomegranates two ounces: Syrup of Water Lilies one ounce. Make a Julep for three draughts, morning and evening. Or, Take of Sorrel Roots two ounces: Mallows, Plantain, Purslain, and Endive, of each one handful: the tops of white Poppies half a handful: Annis and Lettuce seed, of each one dram: borage, Violets, and Water-lilly Flowers, of each one pugil: boil them to a pint and an half: then add four ounces of the juice of Pomegranates. Or, Take of sweet Almonds blanched one ounce: fresh Pine-nuts half on ounce: Lettuce, Sorrel, Purslain, and Poppy seeds, of each three drams: beat them according to art, powering on by degrees, of Barley, Lettuce, and Purslain Water▪ one pint and an half. Dissolve in the straining, Sugar of Roses one ounce. Make an Emulsion for three Doses, in which we leave out the great cold Seeds, because being Diuretic they may draw something to those parts, especially in the time of the defluxion, but in the declination they may be useful. You may profitably add to the Emulsion, the Syrup of Poppies to stop the flux more violently. Also the parts inflamed may be cooled by Clysters, made of the Decoction of the Julep aforesaid, with Oil of Roses or Violets two ounces. In the beginning of these Inflammations, purging is not proper; for it is to be feared lest the Humours being moved, should flow to the parts affected; so that if there then be a great flux of the Belly, it is to be stopped for that cause. But when the Inflammation is a little allayed, and the disease declineth, a Purge made of gentle things may be good, as of Manna, Cassia, Rhubarb, Tamarinds, Diaprunes simple, Catholicon and Syrup of Roses with a Decoction of Lettuce, Purslain, and other cooling things prescribed in the Juleps. Or you may make a Bolus of some of them. Out wardly, All the time of the Disease, you must apply cooling things that gently repel, as moist Epithems of the Water and Juice of Plantain, Sorrel, Endive, Nightshade, Roses, with a little Vinegar, red Sanders, and Camphire. Liniments also of Oil of Roses and Olives, Violets, Cerat of Sanders, white Ointment, or Populeon alone, or mixed with a little Vinegar, which you must apply to the parts aforesaid, every hour cold. Or you may make a Lineament of an Egg well beaten, with a little Oil and Rose Vinegar. Or you may make that which is excellent, of Oil of Roses, with Vinegar and Juice of Knotgrass, or Purslain; to which add, if you please, a new Yolk of an Egg. Let these be applied cold upon a Cloth. If the pain be very violent, it is not amiss in these Epithems and Liniments, to mix a little Opium or Saffron. Also you may make a Cataplasm of Barley Meal, with Juice of Endive, Purslain, and Nightshade, with Oil of Roses and Populeon. But this must be often changed lest it grow hot. Three things are to be diligently observed: First, That you use not Coolers too long, lest the Matter be kept from breathing forth, and the Tumour grow hard or scirrhus. Secondly, In the Inflammation of the Bladder, you must use less astringents and coolers, lest you stop the Urine, which Symptom alone, is very usual and dangerous in this case. Thirdly, Cataplasms in the Inflammation of the Bladder, are less necessary than Ointments and Liniments, because they burden the part, so that it is more hard to dilate itself. After you have used Coolers a short space, and often bleeding, when the defluxion is somewhat stopped, you must use Softeners and dissolver's; such are, Fomentations of the Decoction of Marsh-mallow Roots, Mallows, Violets, Pellitory, Lin-seed, Foenugreek, Mallows, Cotton-weed, with Mehlot, Chamomel, Rosemary flowers, and Rose Leaves to strengthen the part. Then apply a Lineament of Oil of Lilies, with a little Oil of Chamomel. Among the dissolver's and anodynes together, there is none better than the Cataplasm made of Crumbs of Bread, made thus: Take of white Bread Crumbs one pound; boil it in Goat's Milk to a Pultiss: then add three Yolks of Eggs; four ounces of Oil of Roses: half a scruple of Saffron: make a Cataplasm, change it often. You may add a little Opium and Campbire if the pain be very great. In the Inflammation of the Bladder, if you fear a Gangrene, you may make a strengthening Cataplasm of Bean Meal, and Orobus Meal, or Lupins boiled in Wine. When the greatest part of the Inflammation is abated, than you must use Decoctions and Liniments which do only dissolve, that the relics may be consumed. In the whole time of the Cure, you must have a special care of great Symptoms, as the Fever, pain, watching, stoppage of Urine, and belly; of the stomach and other parts. And as for the Fever, pain, and watch, it is most certain that the things mentioned to evacuate and alter, do much for the mitigation of them. But to them you may add Epithems, Liniments, and Rose Vinegar, such as use to be applied to the Region of the Liver, Heart, and Brain; and in time of necessity, Narcoticks both by mouth and Clyster. There are special Anodine Suppositories to take away the pain of the Bladder, or knots, made with Yolks of Eggs, and a little Opium, and juice of Henbane, or the like. If the Strangury or stoppage of Urine follow this Inflammation, you must cure them with Medicines taken from their proper Chapters. If the Inflammation of the Reins cannot be cured by what hath been prescribed, but it tendeth to suppuration, which you may know by the increase of the fever, pain, and other Symptoms; as also by trembling and vomiting, by greater weight about the part, especially when the Patient lieth on his sound side; you must help Nature with Cataplasms of Roots and mollifying Herbs, Lineseed, Chamomel flowers: To which being boiled and beaten, you must add Meal, Butter, Grease, or Oils of the same virtues With which, if the Imposthume break not presently, and come forth by Urine, the Matter will get into the Cavity of the Abdomen, whence will proceed either sudden death, or a Hectic Fever. Sometimes the Tumour appears outwardly, and then you must open it either with a Potential Cautery, or an Incision Knife. Sometimes those Tumours grow hard, and scirrhus, when the Fever is gone, and the pain remains with a greater sense of weight, and a kind of numbness of the subject parts: And this is commonly incurable, and brings an evil habit, or a Dropsy. Yet you may try with mollifying, cutting, and digesting Medicines, such as were mentioned in the Scirrhus of the Liver. Chap. 4. Of Pissing of Blood. BLood may come from divers parts to the passages of the Urine, and be mixed with it, and make it look like blood: but because this happeneth but seldom, and we here treat only of the Diseases of the Reins and Bladder, we shall speak only of that bloody Urine which is made so from the defect of the Reins and Bladder. Blood flows from these parts, as from all the rest (as we said in Haemorrhagy, Haemoptysis, vomiting of blood, and Haemorrhoids) either by Anastomosis, or opening of the mouths of the Veins, by Rixis, or Rupture, by Diabrosis or Corrosion, and seldom by Diapedeses, or Rarefaction. The usual causes are much or sharp blood, or a stone fastened in the Reins: the Veins are often broken with plenty of blood; but Corrosion, or Anastomosis, or opening comes from sharpness: also corrosion or tearing may come from the stone, when being fixed in the Reins or Kidneys through violent riding, or other exercise, it is moved so that it hurts the parts with its roughness. Also other causes may break the Vessels besides repletion, as a fall or stroke, lifting, carrying, vehement motion, and the like. That Blood which is brought forth by Urine from Plethory, is not always a Disease or Symptom, but sometimes for the good of the Patient, when Nature lays that which is burdensome unto her by that means, as Aret●us reports that some piss blood at several times, and when they do not, they have the Headache, mists before their Eyes, and giddiness. Also the Bladder may bleed if it be wounded by a stone, or corroded by a sharp humour; but it is but little, because it is membranous, and without blood; but if the Sphincter Muscle be hurt, or the passage of the Yard, there will be much blood, as in extraordinary Venery is seen often, especially when the Prostates are inflamed by a Gonorrhoea, or running of the Reins. The Signs of this Disease are from the Kind of it, from the Part affected, and from the Cause. The Kind of this Disease is apparent to the Senses, for it is easy to know when blood is mixed with Urine, for it is like the washings of flesh, with small clodders at the bottom; sometimes the Urine is like a Lie, when it stays too long it the Bladder, by which means it grows black. The place of the pain shows the part affected, for if it be in the Loins, it signifies that the Kidneys are affected; but if it be in the belly below the Navel, the bladder is the part suffering. Moreover, if the blood comes from the Reins, it is mixed perfectly with the Urine; but if from the bladder, it is not mixed. Hypocrates showeth this Sign in two Aphorisms, namely, in Aph. 78. Sect. 4. They who suddenly piss blood without force, have a Vein broken in their Reins; and Aph. 80. of the same Section; If men piss blood, or there be clots or drops in the Urine, and pain in the lower part of the Belly, the Pecten, or Perinaeum, these have their disease from the Bladder. If it come from the stone, the signs thereof which are mentioned in its proper Chapter, will appear; if they do not, you must conclude that it comes from too much blood or sharpness thereof. The abundance of blood will be known by the signs of repletion, and sharpness by the signs of Choler or Melancholy predominating; also salt phlegm in the Urine will make a great stoppage of Urine, and pissing of blood; this happeneth often in old men that are very apt to be troubled with salt phlegm. And the pissing of blood from sharp humours, is distinguished from that in the stone, that in which there were first pains of the Reins, and voiding of stones; but not in the other whose Urine is clear, with no strange things therein, And the Disease proceeds not only from immoderate Exercise, which is ordinary to both causes, but also from the passions of the mind, when it comes from sharp humours which are much stirred up by passions; so that they who are subject to this Disease after Anger and Sadness, or great disturbance of the mind, use commonly to piss blood. As for the Prognostic. A plentiful and often pissing of blood is very dangerous; for it will bring either a Consumption or a Dropsy: And if it continue long, it may cause an Ulcer in that part from whence the blood floweth; if much blood flow at one time, it will cause a great stoppage of Urine in the Bladder, or some other evil Symptoms, as it increaseth therein, and grows evil qualified. The Cure of this Disease is divers, according to the variety of the cause. And first, if it come from blood abounding, or from sharpness, it must be first cured with Phlebotomy on the same side, often and little for the better revulsion: And by Cupping, Friction, and Ligatures in the upper parts; and if blood flow violently, Cupping-glasses must be applied to the Hypochondria. For derivation, let the Vein of the Ankle be opened, and the Hemorrhoids. When watery Choleric Humours cause it, let them be purged with Medicines mentioned in spitting of blood, often repeated at distance. To which also you may add these following, at your discretion. Take of the Powder of torrefied Rhubarb one dram: prepared Coral half a scruple: Goats Whey, or Plantain Water three ounces. Make a Potion. Take of Cassia newly drawn half an ounce: the Pulp of Tamarinds six drams: Eastern Bolearmenick half a scruple. With Sugar make a Bolus. After due Evacuations and Revulsions, or at that time, if need require▪ you may use things to stop blood, and knit the Veins. And these are not presently to be used at the first, left being stopped too suddenly it should grow cloddy in some part. For this purpose the Juice of Plantain newly drawn, is much commended, given four or five ounces in a morning and evening, which is good for any kind of bleeding. But if you fear it will cool the Stomach too much, you may boil it a little with Sugar. Sheep's Milk is much commended by Forestus, Lib. 24. Observe. 13. Often (saith he) I have cured pissing of blood with only Sheep's Milk six ounces, and one dram of Bolearmenick. The same is an Experience of Gatinaria; who also commands that none do sleep presently, or exercise after it. Also Hollerius and Duretus, from Avicen and Hypocrates, commend the same. Also Decoctions of Knotgrass, Horstail, Purslain, and Bramble tops, are good for this, adding the third part of the Juice of sharp Pomegranates or Quinces. Or to allay the heat of the Blood, let him take the Apozeme following many times, morning and evening. Take of Lettuce, Purslain, Plantain, and Comphry, of each one handful: all the cold seeds, of each one dram: Jujubes three pair: Liquoris half an ounce: Water-lillies, Violets, and Roses, of each one pugil: boil them to a pint and an half. In the straining dissolve of Gum Traganth one dram and an half: Syrup of Violets and dried Roses, of each one ounce and an half: Lapis prunellae half an ounce: the Troches of Winter-cherries without Opium, half a dram. Make a Julep for four Doses. To thicken and stop the blood more, put one ounce of Syrup of Poppies thereto. Also you may give the Powders that stop blood, as of red Coral, Bloodstone, Bolearmenick, fealed Earth, either with the Apozeme, or with Rose or Plantain Water. If the Disease continue, give this Opiate: Take of Conserve of Roses, and Comphry Roots, of each two ounces: Sealed Earth, Bolearmenick, Sanguis Draconis, red Coral, Bloodstone, and Troches of Amber, of each one dram: Hypocystis, or Conserve of Sloes, Kermes berries, and Plantain seeds, of each one scruple: with Syrup of Poppies and Myrtles, of each equal parts: make an Opiate, of which let him take the bigness of a Chestnut morning and evening, drinking after a little Plantain Water. If it yet continue, it is good to give at distance the Decoction of Myrobalans in Whey, or the like. Hollerius affirms, and Du●etus, that the Troches of Gordonius are the best for it. Christopher Vega commends the Troches of Amber given with Plantain Water, and saith that he cured this Disease with giving them only once at night. For ordinary Drink, give the Infusion of Mastich wood in Wine, made thus: Take of sliced Mastic wood one ounce: spring Water four ounces: Infuse them in Balneo Mariae very warm in a close Vessel. Keep the straining for your use. But because clods of blood are often retained in the bladder, which beget grievous Symptoms, give warm Water and Vinegar, or Mallow Water and sharp Vinegar warm. Let the Vinegar be so little that it is scarce tasted. Apply Topics to the Loins that cool and astringe. Take of Snakeweed and Comphry Roots, of each one ounce: Plantain, Purslain, Horstail, Knotgrass, and Sbepheards-purse, of each one handful: Pomegranate peels half an ounce: Sumach, and Myrtle berries, and Hypocystis, of each two drams: Acron Cups, red and yellow , of each one dram: red Roses three pugils: boil them in Smith's Water, and a little Vinegar. With the straining, let the Reins be fomented hot. Of the same Decoction you may make a Bath to sit in, adding more simples. Take of Vnguentum Comitissae, and refrigerans Galeni, of each one ounce and an half: wash it with Oxycrate, and anoint the Loins therewith. Or to bind more, Take of the Juice of Plantain and Blood-wort, of each two ounces: Vinegar half an ounce: Oil Olive six ounces: boil them till the Juices be consumed: then add of Sanguis Draconis, Mastich, and Pomegranate peels, of each two drams: Camphire half a dram: Vnguentum Comitissae four drams: Wax as much as will make a Lineament: put a little Vinegar to it when you use it. Also a Plate of Lead full of holes worn about the Reins, is good. You must guard the Liver when it comes from sharp Humours, with Epithems, and Ointments. When it comes from the Stone and Gravel; after Purging, Revulsion, and things that alloy sharpness, mentioned; you must use those things that may gently cleanse, as these that follow: Take of Pills of Turpentine, with Rhubarb one ounce: give half a dram in a morning, with two spoonfuls of Syrup of Scurvygrass every other day. But when he takes them not, give this Powder and Confection following: Take of Liquoris two drams: the four cold Seeds, of each one dram: Purslain and Lettuce seed, of each half a dram: the Troches of Amber and Hartshorn prepared, of each one scruple: Sugar as much as all the rest; make a fine Powder: give one dram with Mallows Water in which Quince seeds have been infused. Take of blanched Almonds, and Pine seeds cleansed, of each half a dram: Marsh-mallow seeds, and Winter Cherries, of each one scruple: Lettuce and white Poppy seeds, of each half a scruple: Starch and Tragacanth, of each half a dram: Liquoris two drams: Sugar six ounces: With Pellitory Water make a Confection in Morsels. Take it morning and evening half an ounce. Stronger Diuretics are not convenient, for they will provoke the flux. And lastly, Vitriol Waters are good to stop blood, cool the Reins, and expel stones. Chap. 5. Of the Ulcer of the Reins and Bladder. THe Ulcer of the Reins and Bladder, comes of three Causes; from an Imposthume broken after Suppuration; from the sharpness of Humours, such as causeth pissing of blood, which being violent and continual, doth ulcerate the parts, or from a sharp stone that corrodeth them; the last is most usual, the former seldom. Among the Signs, the chief is voiding of Matter with Urine, which lasting long, doth show that there is an Ulcer certainly in the Ureters. But whether the Reins, or the Bladder be affected, is known by the place of pain, whether it be in the Loins, or near the Privities. Moreover, If Matter come from the Reins, it is better concocted, white, thin, and not stinking, because the body of the Kidneys being fleshy doth better concoct; besides, the Matter is more abundant, and more mixed with the Urine, which is voided like Milk, till after long standing it settle to the bottom. That Matter which comes from the Bladder, is little, and not much mixed with the Urine, not so well concocted, but crude, of divers colours, and stinking; for that part being without blood, and having little heat, cannot concoct sufficiently. But often pure Matter is voided without Urine, from the neck of the Bladder, and then there is a continual difficulty of Urine, and pain in that part, which is not in an Ulcer of the Reins but by fits. When the Ulcer is in the Reins, sometimes much Blood is voided, which is hard to be stopped, and sometimes pieces of flesh and matter, or blood, sometimes so big as they hardly pass, and cause pain; but from the bladder come scales, or skins, or bran. And from an old Ulcer of the Bladder that is callous or hard, there flows that snotty phlegm which we spoke of in the stone of the Bladder. As for the Prognostic: All inward Ulcers are dangerous, but these most, because of the constant flux of Humours to these parts; for although the serous humour hath a cleansing quality; yet here being mixed with other qualities, it doth not as in its Natural condition; and if evil, salt, and sharp humours are mixed therewith, they will make and nourish an Ulcer. New Ulcers of the Reins and Bladder are curable, old not. They are incurable in old men, sometimes incurable in young men, with much difficulty. Ulcers that come from the Stone, and are maintained by it, cannot be cured before it be taken out. The pain and Symptoms which accompany the aforesaid Ulcers, cause watch, and consume the Body. The Cure is by cleansing drying, and heating, as all other. For this purpose use these following. First, If there be a repletion, or inflammation in the part affected, let blood, first in the Arm, then in the Hand. Then purge often, to take away the vicious humours that flow to the part affected, but with gentle things, as Cassia, Manna, Syrup of Roses, Agarick, Rhubarb, made into a Bolus; because in a moist form being drunk, they quickly go to the Ureters, and increase pain. You may give this Opiate following: Take of Polypody of the Oak, and Liquoris, of each half an ounce: the four great cold seeds, of each one dram: borage and Violet flowers, of each half a pugil: Jujubes six pair, Damask Prunes three pair: small Raisins half an ounce: Senna one ounce and an half: Infuse them all night in Barley Water; then boil and strain them: then dissolve of Manna one ounce and an half; Cassia three ounces: boil them to an Opiate, adding in the end half an ounce of Rhubarb in powder. Give one ounce at a time, once in a week, two hours before meat. Or, Take of Cassia two ounces: Manna one ounce and an half: the Mucilage of Fleabane seeds six drams: the four great cold seeds, of each one dram: the Juice of Liquoris two drams: With Syrup of Roses solutive make an Opiate. These Opiates will be better if you put Mercurius dulcis to them, because Mercury doth cleanse and heal all Ulcers both internal and external. Turpentine is purging, and excellent in this Disease, because it cleanseth the Ulcer. And you must give half an ounce thereof washed at once, with Powder of Liquoris. But it is chief good when the Urine is thick. Avicen commends Vomiting for this Disease, Cap. de Ulcer. Renum, A Vomit (saith he) is the best way to cure an Ulcer in the Reins, because it cleanseth and emptieth, and draweth the Humours from the part. But Aetius in his Chapter de suppuratis Renibus; If (saith he) any man will take a strong Vomit every month, he will happily cure the Ulcer of the Reins, or any other evil that ariseth from them. Many Modern Physicians follow these; some gave warm Oil and Water one hour before meat: which only Medicine being often repeated hath cured this Disease, as they say. But Rondeletius will have them vomit after meat, because then men vomit most easily; and he gives warm Water and Oil, and anoints the Stomach with Oil of Lilies. But you must never give a Vomit, but to them that are easy to vomit; for otherwise it would Inflame the Ulcer. After due Evacuations and Revulsions, you must use Clensers. The chief is, Whey taken every morning in abundance; or thin Hydromel, six or eight ounces in a morning in ordinary drink, or the Decoction of Barley and Liquoris with Sugar, and give Water and Sugar for ordinary Drink. You may boil in Hydromel, if you fear heat, the cold Seeds, Liquoris, and Mallows. Ass' Milk doth not only clese with its Wheyie part, but heal with its cheezy part, but you must not give it in a Fever, or you may make this following Decoction to cleanse and ease pain. Take of Marsh-mallow Roots half an ounce: Plantain, Agrimony, Maidenhair, and Mallows, of each one handful: Mallows and Melone Seeds with their Husks beaten, of each half an ounce: Winter Cherries six drams: scraped Liquoris one ounce: Barley one pugil: boil them to two pints. Dissolve in the straining three ounces of Honey, and two ounces of Sugar candy: make a Julep. Take eight ounces every morning for ten days. Those Medicines you give for the Reins or Womb, must be given in great quantities lest they lose their virtue before they come there. Instead of them all, you may use Mineral Waters of Alum and Iron, by the constant use thereof the heat is corrected, and the Ulcer mundified and healed. Some commend the Decoction of China, Sarsa, or Sassaphras, or of Guajacum given thirty days or more together, with a second Decoction thereof for ordinary Drink, and a thin drying Diet; and lest the Bowels should thereby be too much inflamed, they give cool Broths at night, and anoint the Reins with cold Ointments. And this course is taken to dry up the matter, to purge and cleanse, especially in them that are phlegmatic, or have the French Pox, and have neither Fever, nor Flux of Blood. But in any case you may use with more safety this following: Take of Sarsaparilla three ounces: Shave of Mastich Tree two ounces: Sassaphras one ounce: Shave of Ivory and Hartshorn, of each six drams: Jujubes and Sebestens, of each half an ounce: Lignum Nephriticum four ounces: Barley two ounces. Infuse them twelve hours in five pints of spring Water: boil them to three pints, for six draughts, to be taken twice in a day; aromatize them with two drams of Cinnamon. After the use of Clensers, when you see by the decrease of the quantity of Matter in the Urine, that the Ulcer is cleansed, as when it is white, and even, and not filthy, give drying, astringing, glutinating, and heating things; as these Troches following: Take of Bolearmenick, sealed Earth, and red Coral, of each three drams: Gum Arabic and Tragacanth, of each half an ounce: with Agrimony Water make Troches of two drams apiece. Let him take one every morning with boiled Milk, or the Decoction of Comphry. The Troches of Gordonius are best of all, because they assuage pain and heat. Their Dose is two or three drams, with Hydromel, or Barley Water, when you will cleanse more; or with Goat's o● Sheep's Milk, when you will glutinate more. For the same, use this following Opiate: Take of Conserve of old Roses three ounces: Purslain and Plantain seeds, Myrtle Berries, Bole, sealed Earth, Sanguis Draconis, of each one dram: the shave of Ivory, and Troches of Winter Cherries, of each half a dram: with Syrup of dried Roses make an Opiate, of which give the quantity of a Chesnutiwice in a day. You may make knitting Juleps thus: Take of Comphry Roots two ounces: Plantain and Mousear, of each one handful: the tops of Mallows and Maidenhair, of each half a handful: Liquoris half an ounce: Starch and Gum Arabic, Tragacanth and Bole, of each one dram: Lettuce and Purslain seeds, of each one dram and an half: red Roses one pugi●● boil them in Rain Water to one pint and an half. In the straining, dissolve four ounces of Sugar of Penides two ounces: make a Julep. Give eight ounces in a morning for ten or twelve days. Also the following Pills are good: Take of Turpentine washed in Plantain Water one dram: Juice of Liquoris and Gum Tragacanth, of each two scruples: Bole and Troches of Winter Cherries, of each half a scruplr: With the Juice of Horstail make Pills. Let him take half a dram morning and evening. They are stronger made thus: Take of Marsh-mallow Roots and Comphry dried, of each two drams: Gum Arabic, Cherry and Plum-tree, of each one dram: Oli●am●● and Myrrh, of each four scruples: white Poppy seeds, and Winter Cherries, of each one dram and an h●lf: Camphire two scruples: beat them finely 〈…〉 of the third part of them all of Antimonium Diaphoreticum; and with 〈…〉 make a Mass. Give one dram morning and evening long from meat, and after it a little ●● his ordinary drink. If Turpentine cause pain, give instead thereof Juice of Liquoris dissolved in Pellitory Water. And above all, new Milk from the Cow with one dram of Bolearmenick that is true, every morning, is excellent, as Forestus says: And it is a secret of his Master Helidaeus, because it cleanseth and healeth the Ulcer. Quercetan in his Dispensatory, commends the Water that is given for the Gonorrhoea, as good for the same, as well as other Ulcers. Hartmannus commends an Opiate made of Conserve of Roses two parts; and the Powder of the Seeds of St. John's wort one part, given in the end of the Cure many evenings together. And also two or three grains of Mercurius Dulcis given every day in Plantain Water. But Mercurius Diaphoreticus is better, if well made, and as it were fixed: this cures all internal ulcers miraculously. In old Ulcers, the Decoction of round Birthwort in white Wine with Sugar, is very good. Also observe what Garcias ab Horto says, That in Goa they give Aloes and Milk for Ulcers in the Reins and Bladder, or to such as piss filth, and it presently cureth. Outwardly to knit give this Ointment: Take of Juice of Plantain and Nightshade, of each four ounces: Oil of Roses three ounces: Vinegar one ounce: Litharge finely powdered one ounce and an half: washed Ceruse half an ounce: fine Powder of Tutty two drams: Sanguis Draconis one dram. Make them into an Ointment. Also you may use this following when there is no Inflammation. Take of Oil of Roses and Mastich, of each two ounces: Myrrh, Aloes, Sarcocol, Sanguis Draconis, of each one dram: Starch and Gum Tragacanth, of each four scruples: Styrax Calamita one dram: white Wax as much as will make an Ointment. In the Ulcer of the Bladder it is proper to make Injection twice in a day; first with Hydromel, or Whey, or the Decoction of Barley with Honey of Roses to cleanse; then with Astringers and Binder's made of Iron Water, in which Comphry Roots, Myrrh, Alum, and Sarcocol with Tragacanth have been boiled. But especially with the Troches of Gordonius dissolved in Milk. Fabricius Hildanus cured a great Ulcer in the Bladder with this following Injection, and some few other Medicines, Obs. 69. Cent. 3. Take of the Roots of Comphry one ounce: Agrimony, Paul's Bettony, Water Germander, Lady's Mantle, Sanicle, of each half a handsul: boil them to a pint. In the straining dissolve two dram● of Honey of Roses: mix them for an Injection. And you must observe that these Injections are not only to be made with a Syringe, because they will not enter into the Cavity of the Cavity of the Bladder, the Sphincter Muscle being shut, but you must convey it in with a Catheter. And because in these Ulcers the pains are usually great, you must through the whole Cure abate them with anodynes inwardly and outwardly. Inwardly with Syrup of Poppies▪ Laudanum, and the Troches of Alkekengi made for this purpose; as also with Emulsions made of the cold Seeds, and white Poppy Seeds, with a little Syrup of Poppies, or with the often giving of Conserve of Marsh-mallow flowers. Outwardly you may apply this Fomentation following, to the Reins. Take of Marsh-mallow Roots two ounces: Mallows, Pellitory of the wall, Violets, of each one handful: Lin-seed, Foenugreek, and Winter Cherries, of each three drams: Chamomel, Melilot flowers, and Water Lilies, of each one pugil: make a Decoction, with which foment the part, not with Sponges, because they have a saltness in them from the Sea. After the Fomentation you may apply this Lineament: Take of the Oil of Violets, and of sweet Almonds, of each one ounce and an half: Oil of Roses one ounce: Mucilage of Marsh-mallow seeds, and Foenugreek, of each two ounces: Saffron one scruple: make a Lineament. Make this following Injection against the pain of the Bladder. Take of Foenugreek and Quince seeds, of each one scruple: steep them one hour in one pint and an half of Barley Water: after strain them, and make a moist Mucilage; to which add of Oil of sweet Almonds two ounces: Honey of Roses strained one ounce: mix them for an Injection. And if you inject warm Milk, it is excellent for the same purpose. In which if you dissolve the Troches of Gordonius, you will completely ease pain, and cure the Ulcer. Chap. 6. Of Diabetes, or extraordinary Pissing. DIabetes is a quick and plentiful sending forth of Drink by Urine; after which there comes a violent Thirst, and consuming of the whole Body. It is called Diabetes apo tou diabainein, from passing through, as Water through a Conduit pipe, which is called Diabetes. This Disease is also called Dipsacoes, from the unquenchable Thirst, and the Pisspot Dropsy, from the continual making of Water. It is seldom seen, for Galen in 6. de loc. off. cap. 3. saith that he saw it but twice. The next and immediate Cause of this Disease, from Galen, and all his followers, is held to be a hot distemper of the Reins, which makes them draw Water violently from the Veins, and send it to the Bladder being not able to contain it themselves; the Veins being drawn dry, suck from the Liver; the Liver from the Guts and Stomach; hence comes a continual Thirst after drink, which as soon as it is taken, it is forthwith carried from the Liver and Veins into the Reins▪ where by its quantity it stirs up the Expulsive Faculty, and burdening the Retentive Faculty, it is sent to the Bladder. Some suppose that this cause is insufficient, because the hot distemper of the Reins is an usual disease, but Diabetes is very rare; therefore there must be something else that is less usual, namely, a sharp or salted Matter in the Kidneys, either of ●holler or of Phlegm, which doth continually provoke the attractive virtue of them; as in Choleric Fevers there is a Thirst which cannot be quenched, from the Choleric Humour which is fixed to the coat or Tunicle of the Stomach, or from Choleric Vapours sent from some adjacent part into the Stomach, by the motion of some putrid Choler which lodgeth there. This Opinion is probable; but we think good to add thus much to it, That the Kidneys alone are not affected in this Disease, because Choler and other burnt Humours are first bred in the Liver; and therefore they cannot be in any quantity in the Kidneys, but the Liver must participate of them. And if we may reason where Nature seems to be silent, we can say that there is a venomous quality concurring for the producing of this Disease. For that kind of Serpent called Dipsacoes, found in Lybia, when it bites any man, doth send into him such a poison as begets an unquenchable Thirst. The like kind of venom may be bred in our Bodies, by a peculiar corruption of some humours, which may cause such a Thirst; for Galen testifieth that divers kinds of poisons may breed in our Bodies. And if such a kind of poison may be bred in our Bodies as may cause a detestation of Drink, as in Hydrophobia, in which the Patient cannot endure the sight of Water, or any Drink, why may not then there be produced another poison, which hath the contrary quality, to cause a great and unquenchable Thirst? And hence may be the reason why this Disease is so rare; because this kind of poison is seldom bred, but Choler and Salt Phlegm, and the Diseases from thence, are ordinary. And as the Disease called Dogs Appetite, which is compared to this for the unsatiable desire of meat, is ascribed by the wisest Physicians to an occult quality; so this unquenchable thirst may be said to come from a peculiar and hidden quality. The Signs of this Disease are clear from what hath been said; as an extraordinary making of Water, an unquenchable Thirst, and a sudden pissing forth of what is drunk, a decay of the whole Body; for the moisture which would nourish the Body, is pissed forth with the drink. And though there be often a large Evacuation of Urine in sharp Fevers, and other cases, yet that is not to be called Diabetes, because the aforesaid Symptoms, as great Thirst and Consumption of the Body are not joined therewith. The Prognostic of this Disease is deadly, for it is incurable, except it be in the beginning thereof; for it presently brings a Consumption. In old men it is more dangerous; and when it comes after inordinate Lechery, or Agues. The Cure is wrought by allaying the hot distemper of the Kidneys, and by strengthening them by thickening the Humours that flow unto them, and by opposing the malignant quality thereof; all which may be done with these Medicines following: In the beginning of the Disease while there is strength, you may open a Vein, for to revel or pluck back, and cool the Humours; but it must be done divers times, and but a small quantity of blood taken away. But if the strength be decayed, or if this follow another Disease, Phlebotomy must not be. You must give Mollifying and Asswaging Clysters to draw forth the Excrements, made thus: Take of Lettuce, Purslain, Mallows, and Plantain, of each one handful: cleansed Barley, and red Roses, of each one pugil: make a Decoction to one pint and an half. In the straining dissolve of Diaprunes simple six drams: Honey of Roses, and Salad Oil of each two ounces: make a Clyster, and use it often. You may also give a gentle Purge with Cassia, and Pulp of Tamarinds, or the Decoction of Plantain, Purslain, Lettuce, Tamarinds, and Myrobalans, with Syrup of Roses. Some commend Vomits made of the Decoction of Rhadish Seed, and Dwarf-Elder with Oxymel, which doth Evacuate and draw from the Ureters. To correct the distemper of the said parts, and to thicken the Humours, Juleps made of the Waters or Decoctions of Lettuce, Purslain, and Plantain, with Syrup of Myrtles, Quinces, and the like, and Syrup of Poppies, in a small quantity, adding the Powder of Diatragacanth frigid, and the Troches of Sealed Earth, and the like. Or to astringe more, make them thus: Take of Comphry and Plantain Roots, of each one ounce: Plantain Leaves one handful: Pomegranate Flowers, and yellow Myrobalans, of each one dram: Plantain and Purslain seed, of each half a dram: red Roses one pugil: boil them to a pint. In the straining dissolve of Syrup of Quinces three ounces: make a Julep for three Doses. For the same end you may make a Powder, or an Opiate thus: Take of Plantain, Purslain, and Coriander seeds prepared, and red Roses, of each one ounce: prepared Coral, Bolearmenick, prepared Pearl, and Tormentil Roots, of each one scruple: Nutmeg half a dram: mix them into Powder. Take of old Conserve of Roses, four ounces: Bole, prepared Coral, and burned Harts-born, of each one scruple: with Syrup of Quinces make an Opiate. Erastus highly commends the Syrup of Comphry Roots and Sloes, which he saith he used with good success in these Diseases. Also Narcoticks, or Stupefactives used wisely, are very good, as new Treacle, Syrup of Poppies, and Laudanum. If it continue long, Sheep's Milk, Cow, or Ass' Milk, are excellent, if you first consume the Whey thereof, with often quenching Flints therein, and he may use it in the morning, as we shown in other Cures. Sweeting is commended by Authors, by which means the serous Humour is drawn outward. But it is to be mistrusted, because it is very like to purge by Urine, and increase the distemper of the Bowels. But if it be used at any time, it must be of the mildest sort, as of Roots of China, Sarsa, Endive, borage, Sorrel boiled in Water, or for those who are consumed, in Chicken Broth; but we think it safer to provoke sweat by outward means; as by a vapour from some convenient Decoction in a wooden Instrument. Such Sudorificks as are prescribed in malignant Fevers, are excellent, especially if Spirit of Vitriol be in them, to quench Thirst, stay the flux, and resist the malignity. For Drink, let the Patient use Ironed Water with sharp and astringent Syrups, or a Decoction of Sloes, and the inward Bark of an Oak; by which Medicine even alone, Erastus saith that he cured this Disease in a Boy. Outwardly, Apply a Fomentation to the Loins made of Sorrel Roots, Plantain, Pomegranate peels, Sumach Seeds, and the like, with a little Vinegar; or, which is most proper, make a Bath of the same Decoction to sit in. And anoint the part with Unguent of Roses, Sanders, and Comitissa mixed together, or this following: Take of Oil of Roses and Myrtles, of each one ounce: red , red Roses, and red Coral, of each one scruple: Juice of Plantain one ounce: Wax, as much as will make an Ointment. Then you must allay the Symptoms that accompany this Disease, as thirst, watching, consumption, and the like, by their Remedies mentioned in their proper Chapters. Chap. 7. Of Pissing the Bed, of Involuntary Pissing, or not containing of Urine. THe not holding of the Urine consists in the hurting of the Retentive action of the Bladder, as Diabetes, or extraordinary pissing, comes from the hurt done to the attractive faculty, and Dysuria from the distemper in the Expulsive: so this comes from the disorder in the Retentive Faculty of the Bladder. This comes sometimes to people awake, and then the Disease is worse; sometimes to them asleep, and then it is less, because then the animal Functions are exercised less freely. And this in time of sleep comes two ways, either from weakness and looseness of the Sphincter Muscle of the Bladder, as in sucking Children, weak people, and sometimes in them of years, or from the hurt of the Imagination: for many do piss their Beds, either from too much drink, or from the exquisite sense of the Bladder, and the Urines sharpness, with some consent of their will, when they dream they are pissing against a wall, or other place; and they are so accustomed to it, that it is done without any distemper either of the Bladder, or its Sphincter; nor are they to be cured with Medicines, but by change of their foolish Imagination, as Children by whipping; or in those of years, by adorning those places which they dream they piss upon, with some costly things, and showing them often. The true cause of this is in the Sphincter Muscle, which suffers either from its self, or by consent from other parts. It comes divers ways by consent, as when the whole Body is weak, and the vital heat spent, as in dying men, or when the whole Body, or half of it is taken with the Palsy, or those branches of Nerves which come from the Os Sacrum to the Bladder: sometimes the looseness of the Muscle comes from the pain only, and nearness to other parts affected, as in Women with Child, from the swelling and pain of the Womb, and in the great Disease of the strait Gut. The Sphincter Muscle suffers divers ways by its self, as when it is wounded, as in cutting for the Stone, or in deep Ulcers which hinder its contraction and shutting. But the chief and usual cause is, a cold and moist distemper, which is most fit to weaken and make lose the part. Which is produced of a cold and moist Native temper, Youth, old Age, Women, and the Diseases of the whole Body, or some parts thereof, coming of a moist and cold distemper: to these you may add external causes, often mentioned. But here we may dispute how contrary Effects may be produced of the same Cause: for Hypocrates in Coac. says that stoppage of the Urine comes of a cold cause, in these words; A stoppage of Urine coming of cold is worst of all; now not holding, and stopping, are contrary. We must answer that when a cold distemper doth only hurt or abolish the sense of the Bladder, there may be a suppression of Urine, because the Bladder cannot be sensible of provocation to expel Urine: but if the motive faculty which is in the Sphincter Muscle be hurt, by reason of the looseness of it, the Urine cannot be retained. The Signs of this Disease, either show this Disease to be by consent, and these must be taken from the Diseases before mentioned, which are apt to produce this not holding the Urine, which if you find, you may conclude that the disease comes from them: but if they be absent, than you must bethink yourself of the propriety of the Disease to the part, which will be easily discovered if it come from a wound and Ulcer, or the like Disease of the Sphincter: but if neither of these appear, you must consider of the cold and moist distemper of the part; and this is known by the causes both internal and external, and by the effects which depend upon them, as softness of the whole Body, whiteness, looseness of the Nerves and Privities, Childhood, Age, evil Phlegmatic Concoction, and the like. As for the Prognostic. This Disease is incurable in old men, by reason of their great moistness, and the loss of Vital heat, which cannot be repaired. In an acute Fever, involuntary Pissing is very dangerous; for it comes either of a Delirium, or from a great destruction of all the Faculties, which followeth the extinction of the Natural hear. In Children it is cured when they grow elder, and the superfluous humidity is by degrees consumed, and the parts that were lose, are more knit: But if they be not cured before twenty five years of age, they are incurable. The Cure is wrought by amending the cold and moist distemper, and looseness of the Sphincter Muscle; but that which comes by sympathy from other diseases, must be cured by the removing of them: as also that which comes from Wounds, Ulcers, and other manifest Disease●, depends upon the Cure of them. Therefore we shall lay down a way of Cure proper both for Children and men, provided that the Physician be skilful in the choice of his Medicines, to give the gentlest to Children, and that he increase and diminish the quantity according to the Patient's age. First, Here is little use of Phlebotomy, because it comes from a cold distemper, and phlegm; except there be a general Plethory in the whole Body, being youthful. But Purging is always necessary in this Disease, made of things that purge phlegm, mixed with some astringents that are not only Alterers, but Purgers, as Rhubarb, and Myrobalans, and the like. After, to dry up the Matter that is slegmatick, and to knit the part, you may use Powders, Opiates, and Physic Wines, and the like, made thus: Take of Cypress Nuts, and Myrtles dried at the fire, shave of Ivory, Coriander seeds prepared, red Coral, and Amber, of each two drams: Spodium, or burnt Ivory one dram, Cypress Roots▪ and Galangal, of each half a dram: With the Syrup of Citrons make an Opiate, of which let him take the quantity of a Chestnut morning and evening. Drink after it a little red Wine. Or you may give the aforesaid Powder from half a dram to a dram, with red Wine twice in a day, long after, and before meat. Take of Comfry Roots half an ounce: Cypress Roots, and Galangal, of each one dram: Plantain, Horstail, and Five-leaved Grass, with the Roots, of each one handful: Cypress Nuts, Acron Cups, of each four scruples: Rue seed, Agnus Castus, Frankincense, and Ivory shave, of each half a scruple: red Roses one pugil: red Wine four pints. Infuse them twenty four hours, strain them through an Hippocras Bag, adding of Cinnamon half an ounce: Sugar as much as is sufficient to make a Claret, of which let him take three or four ounces twice in a day. Many proper things are propounded by Authors, which do conduce to the Cure of this Disease. Galen in his Book of Local Medicines, and of things easy to be prepared, commends the Brain and Stones of a Hair burnt. Also a Snail burnt, with its shell given to Drink. The Modern Physicians give Hares dung, powder of Mice, the Hoofs of Hogs burnt, the ashes of Date stones, roasted Hazel Nuts, powder of Egg shells. But above all are commended the Powder of Agrimony, and the inward Skins of Hen's Gizzards dried, given either by themselves, or mixed together with red Wine. Solenander witnesseth that he saw happy success in a Medicine invented by one Gilbert Holland, a Roman Physician: He took the Throat of a Cock, and dried it at the fire till it would powder. He gave it before supper in red Wine, or with Oxycrate, for some days together. In people of years, sweeting Decoctions used twenty days together, are good to dry the Body, made of Guajacum, and Sassaphras; or Stuphs, Hothouses, Brimstone Baths, and those of Niter. For his Drink, let him take sharp red Wine without mixture, or with a little Ironed Water. They who can drink only Water, may take Ironed Water, or that in which Coriander seed, or a little Mastic hath been boiled. Or lastly, for the better astringing, let them take Water in which new Tiles have been quenched, and boil their meat with the same. But they must drink but little, especially at Supper. And let the Patient make water when he goes to bed, and be raised again at midnight, and in the morning for the same purpose, and this will alter custom. Outwardly to the Privities, apply warm, strengthening, and drying things, thus made: Take of Elicampane Roots, Calamus Aromaticus, Acorus and Cypress Roots, of each half an ounce: Mints, Sage, Organ, Calamints, and Wormwood of each half a handful: Cypress Nuts, Myrtles, Galls, and Pomegranate flowers, of each one dram: red Roses one pugil: boil them in equal parts of Smith's Water, and red Wine to two pints. In the straining, dissolve of Salt and Alum, of each one ounce. Foment the Privities and Perinaeum warm, morning and evening. Or you may make a Bath of the same things in larger quantities. After the Fomentation, anoint the same parts with an Ointment of Oil of Foxes, Rue, Flowerdeluce, Unguentum Martiatum, Aregon, with Powder of Mastic, Cypress, and Myrtles. Or you may use Storax Liquid, or Indian Balsam, dissolved with a little Wine; or for rich folks Musk and Civet dissolved in Muskadel. Or apply this Plaster to the parts aforesaid. Take of Labdanum, Mastic, of each two drams: Wood of Aloes, Styrax Calamita, Cinnamon, Turpentine, of each one dram: Myrtles, and Cypress Roots, of each half a dram: Juice of Mints, and Horstail drawn with red Wine, as much as will make a Plaster. Lastly, If there be a defluxion from the head, which causeth the weakness; you must divert by Errhines, Masticatories, and Caustics to the Neck or Arm, and other Remedies, mentioned in the Cure of the Catarrh. Chap. 8. Of stoppage of the Urine, and Strangury. THe stoppage of Urine is called by Author's Ischouria; but when little is voided, it is called Strangouria: although this word be larger, and comprehends all dropping of Urine; but if it be without pain, and the Urine come by drops, with straining, it is a small sschuria; but if it be with pain, it must be referred to Dysuria, or scalding of Urine. Therefore Ischuria, or a whole suppression of Urine, is twofold, namely true, when the bladder is full; or Spurious, when the Bladder is empty, and not thing comes to it from the Reins. A true Ischuria comes of three Causes: The first is when the sense is lost in the Bladder, by reason of the Palsy, and obstruction of the Nerve that comes to it, or by the eversion of the Spirits, by whose defect it comes, so that the Bladder feeleth no pricking to expel, as in doting, and sleepy diseases. The second cause is a distemper of the Bladder, coming from internal or external cold causes, which dull the sense of the Bladder, and weaken its expulsion. The third Cause is the narrowness of the Neck of the Bladder, which will not suffer the Urine to pass. Galen gives three causes of this, 1. de loc. affect. cap. 1. either the Muscle is swollen by an Inflammation, Scirrhus, or Imposthume, or the like; or there is a little flesh grown in the passage, by reason of a former Ulcer; or there is a hardness from some thick Humour of long continuance. Also the Passage is stopped by the Stone, by a Crude and Thick Humour, by a Clod of Blood or Matter. Besides, The Urine may be stopped by a Tumour in some part nigh to the neck of the Bladder, from the swelling of the Womb, from the Excrements in the strait Gut, or from the Hemorrhoids growing big. Sometimes it comes from the long holding of the Water, by which the Bladder is so stretched that it cannot contract itself to expel Urine, by which stretching, the passage is stopped and contracted. Now the Bladder is filled by Urine too long detained, two ways. First, when a sound man by urgent occasions in the Market, Senate, Church Banquet, Running, and the like, holds his Urine for want of opportunity to void it, which stretcheth it so that it cannot again contract itself; and the pricking of the Urine is not perceived by reason of its dull sense from the distemper of the Nerves which come thither, when those Nerves which are for the contracting of the Muscle, are well and sound, which Galen saith befell one 6. de loc. off. cap. 4. when his Back bone was strained. That is called a bastard Ischuria, in which the Urine is stopped, and the bladder empty, because no Water descends into it. There is a twofold Cause why no Urine comes to the Bladder, either because the Kidneys do not draw that whereof the Urinal is made, and send it down, or because the Ureters will not receive it, therefore either the attractive or expulsive Faculty of the Reins is hurt. The attractive or drawing Faculty is hurt by the Error of the Object, or in its self. This is from a strong distemper, especially cold, or from some stoppage in the Reins, or in the Emulgent Veins. These Obstructions proceed from the Stone, thick phlegm, or Matter that falls down thither. The obstruction of the Emulgents comes sometimes from too much blood, or serous Matter; a Story whereof we have in our Observations, Observe. I. Cent. I. By the fault of the Object, the attraction of the Reins is hindered, when the serum or water is spent, as in burning Fevers; or sent to other parts, as in a Dropsy. The Expulsive Faculty is hurt by the same Causes, namely, distemper, the stone, clods of blood, matter, or gross phlegm, or Inflammation. The Ureters do not receive the Serum, nor send it to the Bladder, by reason of Inflammations, or Obstruction by the Stone, a clod of Blood, Matter, or thick phlegm, or by a compression from some humour in a part adjacent. We must observe that both Kidneys or Ureters are affected, for the total stoppage of Urine; for if one be open, the Urine may pass. The aforesaid Causes, if they be violent, may make a total Obstruction of Urine, which is called Ischuria; but if they be small, or remiss, they make only an evacuation in part, which is called a Strangury; and both Diseases come from the same cause, different in degrees. A true Ischuria is known by the weight and enlarging of the lower part of the belly, and by a Tumour in form like the bladder. The Causes are known by things aforegoing, or that accompany it: For if it come from too great a quantity of Urine, which hinders the Contraction of the Bladder, the Patient will tell you how that he forbore to piss by reason of long riding, or the presence of some people of Honour, and that before he never had any distemper in those parts. But if he hath had a Delirium, a Palsy, or the like, you may refer the stoppage to them. The Stoppage which comes from Tumours of those, or the adjacent parts, or other Causes before mentioned, will be known by their proper Signs. The stopping of the passage of the Bladder is known by a searing Candle put in, or a Catheter; which if they cannot pierce, but are stopped by the way, show that there is a either stone, or a Caruncle, or a little Excrescens of flesh, or the like in the passage. And these are to be distinguished; for if it be a Stone, there was formerly a pain of the Reins, whether it came from the Bladder or Reins. If a Caruncle, there was a stinking Gonorrhoea, or running of the Reins, or an Ulcer in the passage of the Yard that did long run. And lastly, If there be a Clod of Blood, or Matter, or Phlegm, you shall see some part of it come out of the Yard, or it will stick to the Catheter. A Bastard Ischuria is hence known, There is neither extension, nor Tumour, nor weight about the Privities, but rather a kind of emptiness thereabout; there is no desire to piss, no tickling in the bladder, and no Urine made, there went before the signs of the Stone in the Kidneys, or Ureters, or of Inflammation, or great fullness, or much drink was taken, which was not plentifully pissed forth: whence the Veins might be swollen, or else there is a burning Fever, or a Dropsy, which signify the revulsion, and turning away of the Water or serous Matter. As to the Prognostic. The stoppage of Urine is very dangerous, and if it continue above seven days, it is deadly: for the Serum being retained in the Veins, doth oppress the Liver, infect the blood, and runs into the whole body, it brings danger of choking, and being carried to the brain, produceth a Coma, or kind of Lethargy. The stoppage of Urine which comes from the back, being wounded, or by a fall, or straining of the Vertebrae, or backbone, is incurable. If the Patiented stink of Piss at his mouth or nose, it is deadly. If a Tenasmus or Needing follow a suppression of Urine, it is death in seven days. And also if the Hiccough follow upon it. The Cure of the stoppage of Urine, whether it be total or partial, must be by aiming at the Causes. And first, that supprestion which is called spurious, and depends upon the Diseases of the Reins or Ureters, is to be found in the Cure of the Inflammation, pain, or stone of the Kidneys; that which comes from the fullness of the Emulgent Veins, is to be cured by large bleeding, and Medicines that purge Water. A true Ischuria is cured by things that take away the cause: and first, if it come from Inflammation of the bladder, or parts adjoining, you may find Medicines for it in the Cure of the Inflammation of the bladder. But if it come from a stone in the neck of the bladder, you must use these Remedies following. First, you must lay the Patient upon his Back with his Thighs lifted up, and then shake him sound to make the stone return into the Bladder: And if this will not do it, use the Catheter. But if the stone be in the passage of the Yard, and you must labour to get it out with your fingers, gently stroking it to the end of the Yard; and you must put the Yard into warm Water or Milk, or the Patient into a Bath to open the Passage. But if you can neither get it out nor in, Practitioners say that you may bind the Yard on both sides of it, and take it out by Incision. The Obstruction of the neck of the bladder, which comes from Inflammation, will be cured with the proper Medicines against Inflammation. But in the mean while, if the Urine be there long detained, you may gently convey in a searing Candle dipped in a little Oil of sweet Almonds, avoiding the Catheter, left it cause pain, and so increase the Inflammation. If the stoppage of Urine comes from a Caruncle, you must take that away. This is done by proper Medicines conveyed thither with a Wax Candle, which must be done by a skilful hand. And if the Caruncle swell and stop the Passage necessity will constrain you to use the Catheter to draw away the Urine, although there be danger lest the part disturbed should swell more. But you must first make use of Revulsions, by bleeding, vomiting, and Repellers to the Privities, to take away the Inflammation of the Caruncle, that way may be made for the Urine. If suppression of the Urine come from thick phlegm, first it is good to purge with a Bolus made of Diaphoenicon and Rhubarb, and then to give Turpentine often with Powder of Liquoris; afterwards a Decoction of opening Roots, with Oxymel, or Syrupus Bizantinus; not omitting in the mean while, Clysters, Fomentations, and Baths, that mollify and open. And all those things will be proper which were propounded for the dissolving and expelling of the Stone. And among the r●st, Experience hath taught us that these following are excellent. Take of Benedict a Laxativa half an ounce: the Troches of Myrrh two scruples: the Decoction of Savin three ounces. Mix them for a Potion. By this a woman was presently cured of the stoppage of Urine. If there be abundance of Phlegm in the whole Body, or in the Head, after blood-letting, from the beginning of the Cure, you must purge with an Apozeme three or four days together. Also the Julep mentioned in the Cure of the Stone of the Kidneys, made of the juice of Pellitory of the wall, Sea-fennel, and Lemons, with Oil of sweet Almonds. The Syrup of Rhadishes, of Fernelius his Prescription, given two ounces at a time, is very excellent. Dodonaeus in Observat. Cap. 48. reports of one of fourscore years of age, that was cured of a stoppage of Urine with dropping, by a Lixivium or Lie made with ashes of Eggshells, and Rhenish Wine, once taken. Arnaldus Villanovanus commends the Wine of Winter Cherries in this following History, mentioned in his Book of Wines. There was in my time a Cardinal, who had not pissed for four days, who was desperately swollen, and cured by the advice of a weak Physician, with Winter-Cherry Wine, and he voided as much Urine as would fill a Basin. By that only Experiment, that Physician being poor, and of small parts, became a great rich man. Many God bestows his Blessings upon, his ways are unsearchable. This kind of Wine, as Arnaldus shows, is made by taking five, or seven, or more Winter Cherries, and beating them with good white Wine, and then straining them, and giving them to be drunk Hog-lice also beaten with white Wine, and given to be drunk, are good for the same. The Oil of Scorpions, as Mathiolus prescribed it, given five or six drops in Broth or other Liquor, doth powerfully provoke Urine. The often use of the Crystal Mineral, doth provoke Ur●●● especially when you fear inflammation, which is often caused in the inward Skin of the Bladder, by ●●● stoppage of Urine. The Spirit of Salt doth it better. The Vulgar Medicine of the Juice of Pellitory of the wall ●efined, four ounces with half an ounce of Sugar, doth very much good. You may mix therewith Sal Prunellae, or Spirit of Salt. If these stops from Phlegm, do often return, there is nothing better than Brimstone, and Niter Bath-Waters; which both by drinking and bathing, do easily dissolve, cleanse, and consume that slimy matter. A certain Noble man having his Urine suppressed many days, after other Medicines taken in vain, by this following Clyster kept two hours in his Body, was cured. Take of the Roots of Smallage, Parsley, Butcher's Broom, Dogs-tooth, Asparagus, Mallows, and Marsh-mallows, of each two drams: Pellitory of the wall two handfuls: Annis, Fennel, Dill, Caraway, Carret, Ameos, Carthamus, Rue, and Cummin seeds, with Bay-berries, of each half an ounce: Chamomel, Melilot, Dill, and French Lavender flowers, of each two pugils: boil them in white Wine to halfs. In a pint of the straining, dissolve of fresh Butter four ounces: Honey of Roses two ounces: red Sugar one dram: Benedicta Laxariva half an ounce: one Egg: the Oil of Nuts, Dill, Lin-seed, of each two ounces. Make a Clyster. The Chemists brag of their Medicines against this Disease; namely, Spirit of Salt, Vitriol, Sulphur, and Turpentine, which they give to half a scruple in convenient Liquors, or Chicken Broth. They Commend also the Salt of Tartar and of Bean Stalks, given from half a dram to a dram. And for Revulsion of the Humour from the part affected, they give Vomits, and they boast that very many have been cured thereby. You must all the time of the Cure, use Liniments, Fomentations, Cataplasms, and Baths, and other external things which must be the same that were before mentioned for the pain in the Kidneys: Among the rest a Cataplasm made of Pellitory of the wall, fried in Butter or Oil of Scorpions, is excellent. Also a Bladder half full of Oil; which will be of more force, if you boil Spanish Flies, called Cantharideses therein. Commonly they apply a Cataplasm of fiyed Onions with Hog's Grease to the Loins and Privities, with some Eggs. But raw white Onions beaten with Oil into the form of a Cataplasin, do far better, if they be applied to the Kidneys, Ureters, and Privities. A Cataplasm made of beaten Rhadishes, is good for the same. When the Ischuria comes of clotted blood, you must dissolve it. For this purpose use Troches of Amber, the Rennet of a Kid or Hair, Mummy, simple Oxymel, and Oxymel of Squils', Syrup of Vinegar, and the like. Outwardly, a Cow-turd doth wonders, according to the Judgement of Learned Aetius, Tetr. 3. Serm. 2. Cap. 27. Lastly, When the Urine is stopped by Matter, or comes only dropping, you must use Clensers and Cutters, such as were set down in the Cure of the Ulcer of the Reins and Bladder. Chap. 9 Of Dysuria, or Scalding of the Urine. BY the word Dysuria, we understand all painful pissing, which the Modern Writers call Scalding of the Urine. Many Authors make it all one with the Strangury, because there is painful pissing; but they will have it differ from Dysuria in this only, but because in Dysuria there is a greater quantity of Urine made, than in Strangury, which is therefore called pissing by drops. But we had rather for Instruction sake, call that Strangury which is pissing little, without pain, and put them in one Chapter, because they must be cured both the same way, and to treat here of all painful pisling under the name of Dysuria, being they come all of the same Causes, and are cured by the same Medicines. The immediate Cause of painful pissing, is a solution of continuity in the Sphincter Muscle, or the passage of the Bladder: and therefore whatsoever can cause a wound in those parts, may cause heat of Urine. The most usual Cause is sharpness of Urine, sometimes without mixture of other Humours, which is caused by a hot distemper of the Bowels, or of the whole Body, or by eating of hot and sharp Meats; but it often comes by mixture of hot and sharp Humours, as Choler and salt Phlegm. Sometimes matter coming from the Reins or Bladder, being ulcerated, may cause such a sharpness of Urine. Sometimes a white Humour like Milk comes plentifully forth with the Urine, and causeth scalding, which is commonly thought to be Matter from the Reins; but Sennertus denies it for this Reason, For if all the Reins were turned into Matter, they could not afford so much as is many times voided at once, every day for a week together. And he supposeth that it comes from an evil Concoction, first of the Stomach, then of the Liver, because the error of the first Concoction cannot be mended in the second, hence the Chylus, and then the Blood remains crude, not freed from its Salt and Tartarlike parts, which ought to be separated in the first Concoction, and they being after sucked into the Reins and sent to the Bladder, cause pain in pissing. He saith that he was brought to be of this Judgement, because a Learned man, who was troubled some weeks with heat of Urine, which he voided plentifully with half an Urinal full of such white Matter, was (when nothing else could assuage his violent pains) cured only with drinking of Sack. Also a stone in the Bladder, if it strike against the Neck of it in time of pissing, causeth pain; and also large Gravel which grates upon the passage of the Urine. Also Inflammation, or Ulcer of those parts, causeth heat of Urine, because the sense is more quick at that time, and though the Urine be well tempered, it is troublesome; as we see externally how the least touch is offensive to a sore place. So in a Gonorrhoea, as long as the Parastates are inflamed, there is a continual heat of Urine. The Knowledge of this Disease is evident, for the Patient is forced to roar sometimes with pain. But you must distinguish the Signs of the Causes thus: If it come from sharpness of Urine, it will be thin and high coloured, sometimes like fire, or there will be a visible mixture of Choler, Phlegm, or Matter; the Bowels will be distempered, or the Patient hath eaten hot and sharp meats, and endured great heat. The Stone and Inflammation of those parts are known by their proper Signs. As for the Prognostic. This Disease of itself, is not dangerous, but very painful: and according to the cause, it is sometimes hard to be cured, especially in old men, which if they be decrepit, die thereof; and in all ages, if it continue long, it ulcerateth the neck of the Bladder. The Cure is, first by taking away the Cause. And therefore if it come from the Stone, Inflammation, or Ulcer, you must cure them according to the Rules in their proper Chapters. But these things after mentioned, will be good to allay the Symptom. They who have it from the sharpness of Urine mixed with hot Humours, are to be cured by the Medicines following. And first, Phlebotomy is good to correct the distemper of the Liver and other parts. This must be often, according to the Plethory and Inflammation; first from the right Arm, to evacuate and revel the Matter; and after in the lower Veins, to derive it from the part affected; for which cause, Hypocrates, and Galen who followed him, do command the lower Veins to be opened in Diseases of all parts beneath the Reins. Purging also is good, of mild and gentle things, that cool, lest the heat be increased. Therefore do not give any thing but a Bolus of Cassia alone, and indeed that is best. But you may make it cooler if you add the Pulp of Tamarinds. Or you may mix it with the Decoction of Lettuce, Purslain, and Mallow Tops, and give it many days together, that the sharp Humours may be brought back from the part by stool. But if you desire to purge more by reason of the plenty of Humours, use this following: Take Lettuce, Purslain, Plantain, and Mallow tops, of each half a handful: Tamarinds half an ounce: yellow Myrobalans' one dram: boil them to six ounces, and add to it strained, one ounce of Cassia: strain it again, and then add one dram and an half of Rhubarb infused in Lettuce Water, with yellow , Manna, and Syrup of Roses, of each one ounce. Make a Potion. In an old Dysury, the purging Opiate prescribed in the Ulcer of the Bladder, is very good. A gentle Vomit is excellent, for it revelleth from that part affected, and hinders those inconveniences which use to come by purging: Therefore give it once or twice in a week to them that can vomit easily. By often Clysters, the sharp Humours are not only brought to the Guts, and sent out by degrees, but the distemper of the parts is qualified. They are made thus: Take of Marsh-mallow Roots one ounce: Mallows, Violets, and Lettuce, of each one handful: Water Lilies, and cleansed Barley, of each one pugil: boil them to a pint: Dissolve in the straining, Cassia new drawn one ounce: one Egg: and two ounces of Oil of Violets. Make a Clyster. The Mucilages of Seeds of Marsh-mallows, Quinces, and Foenugreek, may be mixed with Clysters to assuage pain. But Clysters of Milk only, or mixed with the aforesaid things, use to be so powerful to allay heat and pain, that we have known some of long continuance cured by them alone, and a Bath, whereof we will speak hereafter. Experience hath found out many things good to be taken at the mouth, to allay heat, and to correct the distemper of the parts. The chief are these following: Take of Water Purslain, Lettuce, Roses, and Water Lilies, of each one ounce: Syrup of Violets and Water-lillies, of each six drams: Sal prunellae one dram. Mix them for a Julep, repeat it often. Take of Marsh-mallow Roots one ounce: Lettuce, Endive, Purslain, and Mallow tops, of each one handful: Melone, Guord, Mallows, Lettuce, and white Poppy seeds, of each three drams: Jujubes and Sebestens, of each six pair: Violets, Roses, and Water-lillies, of each one pugil: boil them in a pint and an half. Dissolve in the straining, Syrup of Violets, Jujubes, and Poppies, of each one ounce and an half: Sal prunellae half an ounce: make a Julep for four Doses to be taken twice in a day. Emulsions also may be used although they be Diuretic, because they cool and cleanse the passage of the Bladder. Make them thus: Take of the four great cold Seeds, and white Poppy Seeds, of each three drams: sweet Almonds blanched and infused in cold Water half an ounce: beat them in a stone Morter, pouring on by degrees the Decoction of Barley, Liquoris, Purslain, and Mallow tops one pint and an half: make an Emulsion for three Doses, adding to each Dose one ounce of the Syrup of Violets, and one dram of Lapis prunellae, and if the pain be great add a little Syrup of Poppies, and one dram of Gum Arabic in powder, or the Syrup of Marsh-mallows, according to Fernelius, or of Mucilages. You may make Broths thus: Take of Marsh-mallow Roots half an ounce: Mallows one handful: Liquoris half an ounce: Quince seeds one dram: boil them with Chicken Broth: make it often. The Whey of Goat's Milk is very good given in great draughts, as we said in the hot distemper of the Liver. And if there be no Fever, you may with more profit give Milk by itself, because it doth not only cleanse, but alloy pain, and temper the sharpness of the Humours. In an old Disease, it is good to give Mineral Waters that cool, especially Alum, Iron, and Vitriol Waters; for by Experience we find that they have cured this Disease when it hath been inveterate. Instead of the aforesaid Juleps, the simple Decoction of Mallows, with Syrup of Violets, may be used; by which Forestus saith, Obs. 4. Lib. 25. he cured a grievous Dysury many times, and that there is nothing like it. Forestus also Obs. 3. of the same Book, that an Apothecary cured himself and others, with the white of an Egg beaten with Rose Water. He also reports that a woman cured an old man of Delf, with Chamomel flowers boiled in Milk. Amatus Lusitanus, 58. Curate. Cent. 6. saith that a Woman was cured when all means failed, with Conserve of Mallow flowers; she took one ounce morning and evening, and drunk after it three ounces of Mallows Water. And Curate. 59 he saith that one who had a Dysury, after he had voided a stone was cured by the same in three days. The Conserve of Marsh-mallow flowers, is of the same or greater Virtue. Some commend the Troches of Winter Cherries given with convenient Liquor, the quantity of a dram because they are Diuretic, abate sharpness and pain. When the pain is very great, it is good to put the Yard when you piss, into warm Milk, or a Decoction of Mallows and white Poppy seeds, or warm Water only. A small Decoction of Mallows with Syrup of Violets and Conserve of Roses, is good for ordinary Drink. You may also make Injections into the passage of the Bladder, of Milk, or of an Emulsion of cold Seeds, Plantain Water, or Whey, with the Water of a white of an Egg beaten, or one scruple of the Troches of Winter Cherries. External Medicines are also good, as Baths, half Baths, Fomentations to the Privities made of cool Herbs, Liniments of Oil of Roses, Water Lilies, Unguent of Roses, Galens cooling Ointment, Populeon with Camphire, and the Mucilage of Fleabane made with Plantain Water. Also you must apply Epithems that cool to the Reins and Liver, and the aforesaid Liniments, and the things mentioned formerly for the same. When sharp and choleric Humours flow from the Liver, you may derive by an Issue in the right Leg, or by opening the Hemorrhoids, which is very good in all diseases of the Reins and Bladder; according to that of Hypocrates, Aph. 11. Sect. 6. because from the Spleen Vein called Ramus Splenicus, there are branches go to the Reins, Bladder, and Hemorrhoids. The End of the Fourteenth Book. THE FIFTEENTH BOOK OF THE PRACTICE OF PHYSIC. Of women's Diseases. The PREFACE. THose are called women's Diseases which are proper to them only, and come from the defect of that part which is distinct in them from men, viz. the Womb; of which Democritus in his Letter to Hypocrates said that it was the cause of six hundred miseries, and innumerable Calamities. But we to lay down those Diseases of the Womb which are most usual, will divide them thus: Some come from the Vessels, and some from the Body of the Womb, or Cavity; others are in respect of its chief and noblest act of Generation. From the distemper of the Vessels of the Womb, and the preternatural causes, come Chlorosis, or green Sickness, stoppage of the Terms, immoderate Flux, the Whites, Rage of the Womb, and the Mother. In the Cavity of the Womb are, Inflammations, Ulcers, Scirrhus, Cancer, Gangrene, Dropsy, coming forth, and shutting up thereof: these may hinder Generation but by accident. The Diseases which are in respect of Conception, Breeding, and Bringing forth, are, Barrenness acute and Chronical Diseases of Women with Child, Abortion, difficult bringing forth, dead Child, Secundine retained, immoderate flux, or suppression of blood, and the acute Diseases of women in Childbed. All which Diseases we will speak of in as few words as the dignity of the Matter will permit. Chap. 1. Of the Green-sickness, called Chlorosis. THis Disease by Hypocrates, is called Chlorosis; by the Modern Physicians, the white Fever, the Virgin's Disease, the Pale colour of Virgins, the white Jaundice, but vulgarly the Green-sickness. It may be defined thus: An evil habit of Body from the Obstruction of the Veins of the Liver, Spleen, and Mesentery, and especially of those which are about the Womb, which is accompanied with a heaviness or unwildiness of the whole Body, beating of the heart, difficulty of breathing, a desire of evil Food, and the like. This Disease depends immediately upon the Obstruction of the parts in the lower Belly, especially of those Veins which are about the Womb, whereby the free passage of Blood to the Womb is hindered, which abounding in Virgins when they begin to have their Terms, and being hindered of its Natural course by those Obstructions, runs to the upper parts, and oppresseth the Heart, Liver, Spleen, Diaphragma, or Midriff, and other parts, destroys their Natural heat, stops the Vessels; hence is there an evil Concoction in the Bowels, and from thence their Body is full of Crudities, which being carried forth, make an evil Habit. In other parts they produce divers Symptoms in the Hypochondria, a swelling of the Bowels, by which the Midriff is oppressed, which causeth shortness of breath. And because gross blood and wind are carried by the Branches of the hollow Vein, and great Artery into the Heart, which contend against them for fear of Suffocation, by often moving of its Arteries, there is a palpitation of the Heart, and often a beating in the Temples. Besides, they have in this Disease a loathing of meat, because the Stomach is filled with crude Excrements by reason of its evil Concoction and distribution: which excrements having gotten an evil quality by a peculiar kind of corruption, cause a desire of evil meats, and things not ordained for nourishment, as Salt, Spices, Chalk, Coals, Ashes, and the like, which Disease is called Pica Malacia, or strange Longing, which we have at large spoken of in its proper place, among the Diseases of the Stomach. The Causes of the Obstructions in the Veins of the Womb, and the Hypochondria, are thick, slimy, and crude Humours, coming commonly from evil Diet: for these Virgins drink great draughts of Water at bedtime, or in the morning fasting; or eat Vinegar, Herbs, unripe Fruits, Snow, or Ice; hence it is that they lose their Natural heat, and there is abundance of crude Excrements. Others sleep too much, or are very idle, as Seamsters, which by sitting still all day are very cold. Others watch too much, and use unseasonable exercise, as dancing presently after meat, and so continuing with their Sweethearts all night. Moreover, they have great cares and disturbances of mind by which the Concoction is destroyed, and the Body filled with evil Juice. The Knowledge of this Disease is easy from the Symptoms following: First, The Face and all the Body is pale and white, sometimes of a Lead colour, blue, or green; for crude, phlegmatic, and ●erous Humours abounding, and being carried to the habit of the body, do discolor it; and if Choler or Melancholy be mixed with that phlegm, the colour will be yellowish, greenish or blue. The Second is, Swelling in the Face and Eyelids, especially after sleep, because the motive heat being closed and contracted at night, raised more vapours than it could discuss. The Legs also and Feet, especially about the Ankles, and the whole Body is lose and soft by reason of the abundance of phlegm. Thirdly, Heaviness and Idleness in the whole Body, a lazy stretching forth of the Legs from the Humours being fallen down. Fourthly, There is difficult breathing, especially when they move themselves, or go up Hills or steep places, than the thick blood grows warm, and thence arise many vapours, which cause shortness of breathing. Fifthly, There is Palpitation of the Heart and beating of the Arteries in the Temples when the Body is exercised, by reason of the same evaporation, which is raised from thick Humours heated by Exercise. Sixthly, There is often a great Headache, and sometimes in the hinder part of the Head, when the Womb suffers; but in the Forehead when the vapours arise most from the Hypochondria. Seventhly, The Pulse is swift and quick, as if they were in a Fever, and therefore this Disease is called the white Fever, by reason of the quickness of the Pulse, which is so for this reason; The vital faculty being weak, makes the Pul●e little, therefore Nature supplies the smallness of it with often beating. Eightly, The sleep is very sound, they sleep till midnight, except they be forcibly awaked; and this is from many thick vapours which arise from the filthy phlegm. Ninthly, There is a great loathing of wholesome meat, by reason of the great collection of Crudities in the Stomach and parts adjacent; and these Humours when they grow worse, cause the Pica, or longing for things that are not to be eaten. Lastly, When the evil increaseth, and the Obstructions are multiplied, the Terms stop, which shows the Disease to be at the height, and confirmed. As for the Prognostic: That Disease commonly is not dangerous, and continueth a long time. But if it be too much neglected▪ and suffered to take root, so that the Nourishment is hindered, there follow great Diseases of the Natural parts, as Scirrhous and other Tumours, and corruption of the substance of them, which cause death, by Dropsies, long Fevers, and the like. When the Disease is less, and comes only from the Obstruction of the Veins of the Womb, in young women it is cured by Marriage. Women that have long been in this Disease, either are barren, or their Children are diseased, and weak. There is great hope of recovery when the Terms keep their ordinary course, and their due quantity and quality. The Cure of this Disease is by opening Obstructions, by emptying of the filthy Humours from the whole Body, and correcting the distemper of the Bowels, and strengthening of them. The Obstructions are taken away by the Medicines which were mentioned in the Cure of the Obstructions of the Liver and Spleen, adding some things which respect the Womb, and that are more proper to open those Veins. First then, give a purging Medicine agreeable to the Patient's temper, made of gentle things, to cleanse the first Region only, and a Clyster before it, if the Body be bound. Then open a Vein, if the Disease be not very old, and the Maid very much without blood, and inclining to an evil habit. Let the Vein of the Arm be opened first, although the Terms be stopped; for if then you draw blood from the Foot, the Obstructions of the Veins of the Womb will be greater by their fullness. And if the Liver be most stopped, take blood from the right Arm; if the Spleen from the left. After you have bled sufficiently, you must give an ordinary Purge, by way of an Apozeme, such as was prescribed in the Cure of the Obstructions of the Liver. To which you may add some Herbs that are proper to the Womb, as Mugwort, Feaverfew, Penyroyal; and if the Spleen be stopped you may add proper things for that, as Capar barks, Ceterach, or Spleenwort, Harts-tongue. It the temper be Choleric, and there be signs of a hot and dry Liver, you must take all the hot simples out of the Apozeme, and put in cold openers instead thereof. For the more delicate Virgins, instead of Apozemes, you may give the Broths prescribed in the aforesaid Cure of the Liver, and change the simples as we said of the Apozeme. In the mean while you may use Fomentations and Liniments prescribed in the same Chapter, not only to the Liver, but to the Spleen and Womb. After Purging 〈◊〉 this Bath following, to open and loosen the Vessels, and to dissolve and digest the Matter 〈◊〉 Obstructions, which are of such force that we have known sometimes the Terms to begin to flow at the third or fourth bathing, when they have formerly been long stopped. Take of Marsh-mallow Roots, Lily Roots, Elicampane, Briony, wild cucumber, of each two pound: Mallows, Violets, Mercury, Penyroyal, Feaverfew, Balm, of each four handfuls: Linseed and Fenugreek beaten, of two ounces: boil them in spring Water for a Bath. Let her go into it warm twice in a day, not sweeting, long before and after meat, for two days, renewing each day the Decoction. The day after the last Bath, if the Terms be stopped, let the lower Veins be opened, and take away three ounces of blood: and this may be done twice or thrice at that time, in which the Terms used to flow. Or if they never did appear at that time in which the Patient is most afflicted. After these Medicines to strengthen the Bowels, and to wear away the relics of the Obstructions, an opening and strengthening Opiate will do very well, described in the place mentioned; to which you may add two drams of Foecula Brioniae, and as much of Salt of Mugwort. But because sometimes the Obstructions are so great that they will not presently be cured, you must make a Magistral Syrup of the Ingredients to the Apozem before mentioned, with an increase of the purging Medicines in quantity, and let the Patient take it twice or thrice in a month. The ordinary Pills mentioned in the Cure of the stoppage of the Liver, are most excellent; to which you may add the Medicines there mentioned, of Tartar, Vitriol, and Steel. Zacutus Lusitanus, Observe. 99 Lib. 2. reports of a certain Woman which had the Green-sickness ten years with stoppage of her Terms, and could not be cured with divers opening and purging Medicines, and some made of Steel, that he cured her with nothing but Conserve of Mugwort, given thirty days together, drinking after it the distilled Water of Savin, in which Rhubarb had been a whole night insused. The same Zacutus, Observ. 117. Lib. 3. tells of a Virgin, which eating much Salt every day, felinto a Diarrhoea of Choler, mixed with a Consumption, which he cured after general Medicines, with Goat's Milk steeled and cold things applied to the Liver. In the greatest Obstructions, an Issue made in the right or left Legg, as the Liver or Spleen is affected, is very good. After the Obstructions are opened, you must diseuss the phlegm like serous humours that remain in the Veins, and in the habit of the Body by sweats; for which you must use the Decoction of Guajacum in cold Constitutions, or of China and Sarsa in those that are hot, for fifteen or twenty days; with this Caution, That every fourth or fifth day, you give a Purge to cleanse the Bowels of Humours which cannot be sent forth by sweat; and which if they continue will grow hard and putrefy, and be the occasion of Fevers, and other Diseases. For this Purpose you may use Brimstone Baths, both for drink and bathing: for by the drinking thereof, when the passages are first open by the Medicines aforesaid, the Humour that is contained in the first and second Region of the Body, is cleansed and sent forth by the belly and urine; and the third Region is cleansed by sweeting in them. And lastly, Copulation, if it may be legally done, after the use of opening Medicines, is very good; for thereby the Natural heat is stirred up in parts Natural, by which the Vessels of the Womb are much enlarged. And Experience teacheth, that sometimes these Women have their Terms the first night after Marriage, and that others who in good health, have them before their accustomed time. Chap. 2. Of the stoppage of the Terms. THe Terms are said to be stopped, when in a Woman ripe of Age, which gives not suck, and is not with Child, there is a seldom, small, or no evacuation of blood by the Womb, which used to be every month. The cause of this stoppage is either in the Womb, or in its Vessels, or in the blood which comes, or aught to come that way. Divers Diseases of the Womb may cause this Disease; namely, a cold Distemper, and dry, which thickeneth and bindeth the Body of the Womb; or a hot and dry distemper by drying the part, or burning up the nourishment thereof, from whence come evil humours, which being fastened in the part, hinder the Terms from flowing. Also the Organical Diseases of those parts, as inflammation, or scirrhus, the turning of the inward mouth thereof, or compression from the Tumours of the parts adjacent, or the Omentum or Caul growing too thick. The thickness of the Womb itself, Ulcer, or Scars, which they leave, or from the tearing of the Cotyledones, or Mouths of the Vessels, in a great Abortion. The Vessels of the Womb do often suffer Obstruction, which is the chief cause of stopping of the Terms, and they come from cold and thick Humours: sometimes there is a suppression of those Veins by binding of them, and that is from the parts adjacent being stretched and swollen, as we said in the binding or closing of the Womb. The blood offending either in quantity, quality, or motion, may be cause of the obstruction of the Courses. It offends in quantity, when it is too much or too little; too much, when it stretcheth out the Veins, so that they cannot contract themselves to expel it; as in the bladder when it is too full of Urine, it cannot contract itself to send it forth; too little, when the Body hath not blood enough to nourish it. The blood offends in quality, when it is thicker, and more slimy of its own Nature, by reason of the cold distemper of the Liver, and other parts, or from the mixture of thick and phlegmatic or melanchollick humours, from whence commonly Obstructions come. The blood offends in motion, when it passeth other ways, as by the Nose, vomiting, spittle, urine, hemorrhoids, and many other parts. I saw a Maid who had a Sore in her head, which opened every month, and bled plentifully; and we have seen many that have sent forth blood at fixed times by their Lungs; and this evacuation was instead of a Menstrual flux. The external Causes, are cold and dry Air, Northern winds, often going into cold water, especially in the time of their flux; too little or two much meat, either too thick and cold, or too astringent; also hot things, as too much Salt and Spice by drying of the substance of the Liver, and other parts, and by drying up the blood, by which it groweth thick, and fit to stop; violent exercise and watch, which do consume the blood; long sleep, and idleness, which do weaken the Natural heat, and cause Crudities; too long retaining of Excrements; by usual bleeding at the Nose, Hemorrhoids, Diarrhoea, and other evacuations by vomit, urine, or sweat; and lastly, great passions of the mind, anger, sudden fear, sorrow, jealousy, and the like. The Knowledge of this is to be taken from the Patient's relation; but because it comes either from Natural or Preternatural Causes, we shall lay down some distinguishing signs, left the Physician be deceived by Women that would dissemble their being with Child, and left he should rashly prescribe Medicines to provoke Terms to Women with Child. First, If they be with Child, they have commonly their Natural Complexion; but others are pale and ill coloured. Secondly, The Symptoms which Women with Child have at the first, do daily decrease; but in others stoppage of the Terms, by how much the longer the Terms stop, by so much the more the Symptoms increase. Thirdly, In Women with Child, after the third Month, you may perceive the Situation and Motion of the Infant, by laying your hand upon the inferior Belly; in others there is a Tumour to be felt, but it is oedematous or phlegmatic, not hard; neither is it proportionable to the Womb. Fourthly, If a wise Midwife touch the inward Mouth of the Womb, it will not be so close shut as in women with Child, but rather hard, and contracted, and full of pain. Fiftly, Women with Child are commonly merry, and little disturbed; but when the Terms are otherwise stopped, they are sad and sorrowful. The Signs of the Causes are these: The faults of the Womb which use to cause stoppage of the Terms, shall be laid down in the following Chapters; but the greatest part of them is found out by touching, seeing, and relation of the Patients. The Obstruction and straightness of the Vessels of the Womb are known by pain in the Loins, and parts adjacent, especially in the time the Terms should flow, and if any thing flow at that time, it is slimy, white, and blackish. Now the Diseases of the adjacent parts, which may shut the mouth of the Womb, or the Veins, will appear by their proper signs. You may know the abounding of blood in the Veins, by the swelling of the Veins in the Thighs and Arms, especially if the Woman be fleshy and red, and have fed high. You may suppose there is want of blood, if the Woman be fat, if she have had a long Fever went before, or loathing of meat. The evil quality of the blood is known by the evil habit of the Body, by the distemper of the Liver, and other parts, and especially by the blood itself, if you can see some of it. The preposterous motion of the blood, when it flows another way, is manifest of itself. As to the Prognostic. The stoppage of the Terms is very dangerous, and many great diseases come thereof, and some in the Womb itself, as swell, imposthumes, and Ulcers; others in the whole Body, and divers parts thereof, as Fevers, Obstructions, evil Habits, Loathing, Dropsy, Heart-ach, Cough, short Breathing, Fainting, sore Eyes, Madness, Melancholy, Headache, Joynt-gout, and the like. Hypocrates, Lib. 1. of women's Diseases, hath showed the increase of Diseases from the stopping of the Terms, in these words. The third month after the stoppage of the Terms, they begin to feel suffocations, or shortness of breath, with horrors, heaviness of the Loins, and sometimes a Fever. But if it last long, the Belly grows hard, they piss much, they loath meat, and watch much, they grate their Teeth in sleep; and if they continue longer stopped, the pains will be greater; but in the sixth month, that Disease which was formerly curable, will be then incurable: then she will be troubled in mind, and faint, vomit phlegm, thirsty, the Belly about the Privities will be pained, there will be a Fever, and the Body bound, and the Urine stopped, the Back will ach, and she will stammer. Afterwards the Legs, Feet, and Belly will swell, and the Urine be red, bloody, and pain over all the Body, especially the Neck and Backbone, and groins, and so they die of a Dropsy. Thus far Hypocrates. But here is a doubt, because the Author saith, That in the sixth month the Disease is incurable, when Experience teacheth the contrary: and Hypocrates himself, 4. Epid. reports that a Maid who had her Terms stopped for seven Years, was restored to health by the return of them. Hypocrates may be reconciled to himself, by saying, That after six months the Disease is incurable, when the Terms are in the Body or Cavity of the Womb, because there they putrefy, and come to suppuration, as in the Afterbirth, or Blood retained. But this is not to be understood of every Suppuration. That Stoppage is least dangerous which comes from plenty of good Blood, or fat, bleeding, or other Evacuations, because those Causes may easily be removed. That is harder to be cured which comes from heaviness of Humours, Obstruction of Vessels, or straitness, because that stubborn Humour, getting into the innermost passages, cannot be got forth but by long pains and Medicines, which Women are very unwilling to receive. That stoppage which cometh from the distemper only of the Womb, is worst, because the part being hurt by propriety is hard to be cured by reason of the continual flux of Humours, which the part is disposed to receive, and therefore is called the Jakes of the whole Body. The Cure of this Disease is divers, according to the variety of the Causes. And first, if it come from too much blood, you must abate the quantity by Phlebotomy in the Arm; for if the lower veins should be first opened, the blood would be drawn more to the Womb, where it would make greater obstruction and distension of Vessels, and break them, or cause Inflammation of the Womb. After the Plethory, or abundance of blood is taken away, you must draw the blood down by opening the lower Veins about the time that the Patient used before to be cleansed, as also by Frictions, Ligatures, Cupping-glasses, dry, and with Scarification. These things done, you must relax and soften the parts of the Womb with Fomentations, and Baths, and moistening Unguents; which if they cannot master the Disease, you may give Hysterical Purges, and such as do properly provoke the Terms, which we shall after descrhibe, cusing the mildest. If want of Blood be the cause, as after long Fevers, great Evacuations, and Extenuation of the Body, you must not provoke them till you have used Restoratives, and blood be renewed, and whatsoever is the cause of extenuation be removed; which things being done, the Terms do commonly flow of themselves; which if they do not, but Nature forgets her office, you must open the inferior Veins, and use the Medicines afore mentioned, so that you take not away too much blood, because the strength is little, and lest the Patient fall into a Consumption. But here you must diligently mark, That every extenuation of the body doth not signify want of blood, but only after great evacuations & consuming Causes; for it comes to pass sometimes, that the Terms stopped in the Veins get an evil quality, which makes the blood unfit to nourish: hence comes leanness, although the Veins be filled with much bad blood, and then large bleeding is very good, as Galen confirms, Comment. 3. in Lib. 6. Epid. I (saith he) cured a Woman that had her Courses stopped eight months, when she was lean by drawing much blood; as also others. But what happened to that famous Woman was remarkable; I opened a Vein when other Physicians feared the success, and were against me, saying that it must hurt her, not only because she was lean, but also because she had no stomach to eat. But these young Physicians had a more Sophistical way, to observe what happened to the Patients, and to neglect the affects and Causes, which are the ground of Cure. I took (to my best remembrance) the first day, a pint and an half of blood from the woman; the next day one pint; the third, not above half a pint, or eight ounces. Thus Galen. By which it is manifest, That from lean women, of this disease, you may take a great quantity of blood, although the women of our Age will not endure it. The stoppage of the Courses comes from a preposterous motion of the blood, when it is sent forth by the Nose, Vomiting, spitting, or Hemorrhoids, and the like: The Cure is by repelling it from those parts, and bringing it to the passage of the Womb. First (while they bleed) you must wash Arms, Head, and Face, with cold Water, and keep them from the use of those parts, especially loud speaking; than you must open a Vein beneath. Two or three days before they bleed, apply Cupping-glasses to the Thighs and Calves of the Legs, sometimes dry, sometimes with scarification; by provoking the Hemorrhoids, by Frictions, Ligatures, Walking, Fomentations, Baths of opening Herbs, Ointments, Pessaries, Clysters for the Womb, and the like, which shall be described hereafter. The use of a Natural Bath is principally commended, if it be of brimstone or Bitumen; into which let the Patient go often, long before, and after meat, not above the Wast, and at the same time, let the upper parts be cooled with a Fan, lest by the heat of the Bath, they also wax warm. If Blood flow from the Hemorrhoids being diverted from the Womb, it is hard to be cured; for if you use Attractions to the lower parts, they will go by stool, and if you use Astringents below, they will repel from the womb by the nearness of parts. Therefore there is no way of Cure but this, That after you have used Attractive things beneath, you apply Topical Medicines to the Womb, which may draw the Humour now in motion, more unto the Womb. But that Suppression of the Courses is of all other most frequent, which is caused by obstruction of the Veins of the Womb. The Cure whereof, is in a manner the same which hath been propounded in the Case of Pale and discolored Virgins, some things only being added, which do more specifically respect the Womb. In the first place therefore, All those things may be used in their order one after another, which have been prescribed for the Cure of the Green-sickness. And for the most part it falls out that the Obstructions of the Bowels being opened, the Courses flow of their own accord: whose Eruption may yet be furthered by the use of such things as cause the Humours to work downwards; as opening of the Inferior Veins, about that time when the Courses have been wont to come down; or instead of Blood-letting, Cupping-Glasses fastened unto the Hips and Ankles, both without and with Scarification, frictions of the same parts, and painful bindings. If the Disease be so rebellious as not to give way to the former Remedies, we must proceed to such as by a proper and specifical virtue, do move the Courses, which are wont to be used under divers forms. And in the first place, most effectual Powders, and grateful to the Taste, are thus made: Take Cinnamon and Amber, of each one scruple: Saffron half a scruple. Mix all, and make them into a Powder, to be taken divers mornings one after another. Or, Take Powder of the Roots of Madder, such as Dyer's use, and Sugar Powdered, of each one ounce. Mix them, divide all into three parts; of which, give one at the time in which the Courses should flow, early in the morning in hot Wine, while the Patient is yet in her bed; wherein let her continue five hours, well covered with . If her courses shall not flow the next course of the Moon, at the wont time, give her the second part: If yet they come not, give her the third part at the third return of the time of her Courses. Or, Take Roots of round Birthwort half a dram: Savin Leaves dried one dram and an half: Dictamnus Cretensis, and Troches of Myrrh, without Assafoetida, because of the strong smell, of each one dram: Elect Cinnamon two drams: white Sugar two ounces. Make all into a most fine Powder, of which let her take two drams in the morning for certain days together, with broth of red Vetches, wherein two drams of Cinnamon, and half a dram of Saffron have been boiled. Most excellent Pills are made after this manner: Take Troches of Myrrh one dram: Castorium half a scruple. With Juice of Mugwort make small Pills. Among familiar Medicines easily provided, are accounted the flowers of Lavender eaten with Honey many days together, or Conserve of Marigold flowers, given to the quantity of two drams at a time. The Blood of a wild Goat, and likewise of a tame one, hath mighty virtue to bring down the stopped Courses according to that preparation and dose propounded in our Cure of the Pleurisy. In hot Constitutions, Cream of Tartar used many days together in Broth, or some Melanchollydriving Decoction, does further the Courses stopped. But the Pills of Montagnana are mightily praised, being thus compounded: Take Troches of Myrrh one dram and an half: Parsley seed, Castorium, Cinnamon, of each one scruple: Musk ten grains. With Juice of Smallage form all (being powdered) into twenty two Pills, gilded with Gold. Let her take two in the morning, or at her entrance into bed, for some days together. Or, Take Madder Roots, and round Aristolochia, or Birthwort, of each three drams: Agarick and Cinnamon, of each one dram: Saffron one scruple: With Juice of Mugwort, make a Mass of Pills; whose dose is one dram. Old Leven is commended by many, the quantity of a Chestnut, with the same quantity of Sugar, given three days together. Yet it will do more good, if powder of the Troches of Myrrh, Dictamnus, or some such like be mixed therewith. The most usual and profitable Decoctions are made in this manner: Take Roots of Parsley, and great Madder, of each two ounces: red Vetches four pugils: boil them to a pint and an half. In the strained Liquor boil Cinnamon Powder one dram: Saffron half a dram: Honey as much as shall suffice: mix them. Let her take six ounces warm, in the mornings twice a day, before her Courses break forth, or when they begin to flow, if they flow but sparingly. Or, Take Roots of Smallage, Asparagus, Fennel, of each one ounce: Feaverfew, Maidenhair, Nep, Penyroyal, of each one handful: Boyl all to a quart. To four ounces of the straining, ad one ounce of Syrup of Mugwort. Let her drink it hot twice a day as before. Or, Take Cyperus Roots, Angelica, Valerian, and Madder of the Dyer's, of each half a dram: Leaves of Mugwort Penyroyal, Savin, of each half a handful: Seeds of Carrots and Seseleos, of each one dram: Dictamnus Cretensis one dram and an half: Choice Cinnamon four scruples: Saffron one scruple; make a Decoction to four ounces. In the straining add Syrup of Mugwort and Hyssop, of each ha●f an ounce: make a Julep for one dose. Let her take it every other day. Quercetanus in his Pharmacopoeia, doth exceedingly commend two Decoctions: the first of which is thus made: Take Gromwelseed, Annis seed, Misselto of the Oak, of each three drams: Dictamnus Cretensis one dram: Saffron one scruple. Beat what is to be beaten, and steep all in rich white Wine twenty four hours: afterwards let them boil a little. Of this Decoction give the Patient four ounces. The other Decoction is thus described: Take the whole Spleen or Milt of an Ox: cut it in bits, and put it in a capacious Glass, so as it may fill the Glass half full, adding of Cinnamon grossly powdered, one ounce: Cloves half an ounce: Saffron two drams: of the best white Wine as much as shall suffice only to moisten all that is in the Glass. Let the Glass closely stopped, be put into a Balneum Mariae exceeding hot, so that it boil twenty four hours together, until the Spleen shall be boiled and consumed into little crumbs, and there remains a great quantity of Broth excellently well boiled, and of a very fragrant smell; of which let the Patient take in the marning four ounces, continuing the same for four or five days, when her Courses ought to flow. Distilled Waters ought to be preferred before other Liquors, as being more pleasant to the taste: and because of their subtle thinness of parts, they pierce more easily to the obstructed Vessels of the Womb. The Pre-eminence above all the rest, is by Mercatus, Rodericus a Castro, and Sennertus, given to this following: Take a Loaf almost as sour as Leaven, indifferently baked, and hot; take away the Crust, and add thereto, of Honey twelve ounces, Pounder of Nettle seeds, Carrot seeds, Amy, Annis and Fennel seeds, of each one dram: Troches of Gallia Moschata, red Myrrh, of each one scruple: Cotula foetida, or stinking Fennel, half a dram. Infuse all in three pints of the Decoction below described, which is made of red French Beans, and red Vetches, of each half a pugil: Juniper berries one ounce: Roots of Madder, Butcher's Broom, wild Rhadish, Asparagus, Smallage, and Parsley, of each two ounces: Green Germander one handful: Seeds of Amy, Annis, and Fennel, of each two ounces: Boil all according to Art. Then still the liquor out in Balneo Mariae; of which give to the Patient two ounces early in the morning. Also there may be added Syrup of Maidenhair, of Opening roots, of Mugwort. Also the Doses may be augmented, the following days, if the Stomach be not offended. A Decoction of Guajacum or Sassafras is good in phlegmatic bodies, also Dictamnus Creticus may be added; taking the same twelve or fifteen days without sweeting. Jacchinus relates an Experiment thereof, writing upon the ninth of Rhasis, Chap. 66. I boiled (says he) the Indian wood, and added Dictamnus thereto. By which I procured both her Courses, and Childbearing to a Woman which had wanted her Courses five years, and had been Barren. The Chemists commend Tartarum, Vitriolatum, Spirit of Tartar, M●xtura Spirital●s, Salts of Mugwort, Bawm, Celondine roots, and Valerian. This Treacle-Water following is mervailously effectual to this intent. Take old Venice-Treacle five ounces, Red Alexandrian, Myrrh two ounces and an half, Elect Cinnamon, Oriental Saffron, of each half a dram; Camphire two drachms. Pour upon them of the best Spirit of Wine, till it stand three singers breadth above the Ingredients, and draw out the Tincture with a gentle heat, whereunto being poured off without straining, add a sixth part of the Spirit of Tartar; The Dose is one spoonful with some appropriate Water, or Wine. Whilst the aforesaid Remedies are in Use, Clysters frequently injected are exceeding good, because the Womb does rest upon the strait Gut, or Intestinum Rectum; and they may thus be compounded. Take roots of Lilies one ounces, of Orice and Valerian, half an ounce of each, of Mercury leaves two handfuls, Mugwort and Savine of each one handful, Chamomel flowers and Lavender, of each one pugil, Seeds of Caraway and Nigella of each one dram; boil all to one pint. In the strained Liquor dissolve of Hiera simplex, and Benedicta Laxativa, of each half an ounce, Oleum Che●rinum two ounces, Electuarium de Baccis Lauri half an ounce. Mix all into a Clyster, Yea, And the truth is Purgations repeated at certain convenient seasons will be very good, which may be in divers manners prepared. And in the first place Galen exceedingly commends the Pills of Hiera, simple and compound; because over and above their purging of superfluous humours, they have a faculty of opening the narrow passages, and of cleansing the Womb. Or, Take Aloes three drachms: Mass of Cochie pills one drachm, with juice of Savine form twenty pills; of which give the Patient three before dinner, every third day. Or, Take Aloes one drachm: Choice Rhubarb one drachm and an half: Diagrydium one scruple: Myrrh and Asarum roots of each half a drachm: Spicknard one scruple. With Syrup of Mugwort make a Mass of Pil-Paste. The dose is from two scruples, to a drachm, made into pills. Or, Take of the Mass of Chochie-pil-paste half a drachm: Mercurius dulcis twenty grains, with Syrup of Roses solutive form eight pills, or six, Let her swallow them early in the morning. Also outwardly, the Courses suppressed, are wont to be helped with these Topick Medicaments following, which must be outwardly applied, to widen the passages, make thin the humours, and to rouse and awake the Expulsive faculty. Take roots of Briony, Lilies, Cyperus, Valerian, Angelica, Asarum, Orice, and of Parsley, of each an ounce Leaves of Mugwort, Bayss. Rue, Savine, Time, Rosemary, Penyroyal, Nep, Mallows, Mercury, of each one handful: Flowers of Elder, Cheiri, Chamomel, of each two pugils: Juniper berries two ounces: Boil all in Water and white Wine, with the strainings, let the Patient's belly and the parts about the Privities be fomented with a sponge. With the same Decoction, the Quantity of Ingredients being augmented, may be made a Bath to ●it in; wherein the Patient may sit up to her Navel, and the boiled Herbs being put into a bag must be applied to her belly. But let her take heed of sweeting, which doth stop the Courses. Take Oil of Lilies, Dill and Rue, of each one ounce and an half: Generous Wine three ounces: Squinanth, roots of Bindweed, Angelica, the two Birthworts and Savin leaves of each half an ounce. Let them boil till the Wine be consumed. Let them be strained and the Oil pressed out; wherewith warmed, let the share and parts about the Privities be anointed, after fomentation, or sitting in the Bath. Moist suffumigations are made of the Vapour of the Decoction for the Fomentation, and for the sitting-Bath, which being moderately heated, must be covered with a cover that hath a hole in it, whereunto must be fastened a long pipe, which must reach into the neck of the Womb, through which let her receive the smoke morning and evening, being covered with ▪ A dry Suff●●migation may be thus made. Take Cloves, Cinnamon, Mace, of each two drachms: Juniper berries half an ounce: Nigella seeds one drachm: Storax two drachms. Make all into a gross powder, which being laid on Coals, let her receive the smoke into the Womb, after her manner aforesaid. Or, Take Storax two drachms: Frankincense one drachm: Benjamin, Alipta Moschata, of each half an ounce: Cloves, Lignum Aloes, Cinnamon of each two scruples: With the Mucilage of Gum Tragacanth, extracted with Cinnamon Water, make little Cakes for to burn as aforesaid. Pessaries may be made after this manner. Take of leaves of Mercury bruised one handful: Powder of Hiera picra, and Benedicta Laxativa, of each two drachms: Powder of long Birthwort one drachm: Honey and juice of Mercury, as much as shall suffice, make all into a Pessary, Or, Take of Agarick, Myrrh, of each two drachms: Galbanum half a drachm: Saffron one scruple: With clarified Honey make all into a pessary, which put into a warm thin rag, and convey into the Womb; but let it not abide long there for fear of inflammation. Pilulae Cochiae minores, brought into the form of a pessary, doth excellently move the Courses. Also injections are wont to be made into the Womb, which are wont to be called Womb-Clysters; for they wash away the filth which cleaves to the sides of the Womb, and they open the internal Orifices of the Veins. Now they are made of the Decoction of the Fomentation aforesaid, ●leaving out the more sharp things; or with a Decoction of fat Figs, with Mugwort, Penyroyal, and Mercury; or of the juice of Mercury alone, purified, in which a little Benedicta Laxativa is dissolved. For we must by no means use more sharp Ingredients for fear of Inflammation. Yea, and after the use of the aforesaid Injections, which ought to be retained but an hour; it will be good to Inject a Decoction of Mallows, Barley, and Violet leaves, or a little Hydromel tempered with Whey of Goats-Milk▪ In an old inveterate Disease, Issues made in the Legs may do very much good. For although Sennertus approves not of them, because they rather derive from the Womb, and teach the humours which were wont to flow unto the Womb, to come rather that way, and hinder their inclinations to the Womb: Yet have they been found to do much good by the frequent experiences of Mercurialis, Varandaeus, and others. For by those Issues the superfluous humours are continually evacuated, and the Course of the humours is guided into the inferior parts. And the derivation of superfluous humours from the Womb, is so far from hindering the Flux of Courses to the Womb; that it rather furthers the same, by making the Blood more pure, and more obedient to the command of Nature, which with the Humours aforesaid, is not drawn unto the Issues. And hereunto, that these Humours, if they be not by these ways evacuated, being retained inthe Veins, they double the Obstructions, and so do augment the suppression of Courses. Howbeit, We are of opinion, that the menstrual purgations being restored to their due Course, the Issues ought to be closed up, that Nature may accustom herself to exclude superfluous Humours by the Womb. In the Use of the Remedies aforesaid, some precepts are to be observed worthy of Note. First, That we must never use Medicines that move the Courses, but after Universal Purgations; lest the Humours being plentifully carried to the Veins of the Womb should increase Obstructions; or being much attenuated, should reach into other parts of the Body, and produce grievous Diseases. As Schenkius relates in his Observations, that a Physician of Venice gave a Woman that wanted her Courses a certain Apozeme to move them, not having first purged her Body of Phlegm; and a little after she had taken her Apozeme, she fell into a Palsy. Secondly, That in giving such things as bring down the Courses, we must begin with the gentler, proceeding by little and little to such as are stronger. Thirdly, That Medicaments procuring the Flux of the Courses, must be given in greater quantity than ordinary, because their virtue is abated in their long passage from the Stomach unto the Womb. Fourthly, That the Medicaments aforesaid, are to be given either in the morning, when the Patient is fasting, or sometimes at her going into, or coming out of the Bath: For so the Medicine slipping into a warm and opened Body, doth powerfully exercise its strength; and this it doth yet more effectually, if it be given a little before the inferior Veins be opened. Fifthly, That Pessaries, and Womb-Clysters, or Injections, are only to be prescribed to married Women, and such as have been carnally embraced by Men; but to Virgins we must prescribe Nascalia (viz. Wool dipped in the Medicament) Fomentations, Baths to sit in, and Suffumagations. Sixtly, In Choleric or Melanchollick Constitutions, all hot Medicaments are to be avoided, and only the gentler and milder sort are to be used; and with them temperate Aperitines, or openers, as also moistening and softening Medicaments are to be mixed. Chap. 3. Of the Immoderate Flux of the Courses. women's monthly Courses, being moderate in quantity, and flowing in due season, are Natural: But if they exceed in quantity, or come too often, or stay too long: They are to be accounted Immoderate, and besides the intent of Nature. The Causes of this Immoderate coming down of the Courses, are the same which (we in its proper place have showed) do concur to Cause spitting of Blood; viz. An opening of the ends of the Veins, a soaking of the blood through the Coats of the Veins, a forcible rending of the Veins, and heir being eaten through by sharp humours; all which are caused by the bloods over great abundance, Heat, Thinness, or Sharpness: By some blow, fall, or wound: Which we have at large declared in our Speculations touching spitting of blood, so that it is needless here to repeat the same. Let the reader be pleased to peruse that Chapter. The Signs of this Infirmity, are either of the Disease itself, or of its Cause. Immoderate Flux of the Courses is known by the il-bearing of the Patient, decay of strength, want of appetite to meat, indigestion of Humours, ill Habit of the whole Body, colour of face like a dead Corpse, swelling of the Legs, and other more grievous maladies, caused by decay of Natural heat passed away in the Blood. To know the Causes, observe these signs following: A thin Habit of Body, and softness of the Flesh, with such a diet as tends to increase the wheyish, and thinner parts of the Blood; and especially the Blood itself appearing thin and watery, in the coming from the Patient, doth show that the Blood hath soaked through the Veins. That the Immoderate Flux is caused by an opening of the ends of the Veins, or a breaking of their Coats, is known by the Foregoing of Wounds, Falls, or Bruises; by the use of dance, long outcries, carrying unusual weights by a Person corpulent and full of Blood: By some foregoing great heat, extreme Cold, Immoderate carnal embraces, great Anger, and the like. The same may also happen after fore labour in Childbirth, or by the unskilful handling of a Midwife; after a miscarriage, or after a long stoppage of the monthly Blood, which makes the same being collected in too a great quantity, breaks out on a sudden with violence. That there is an Exulceration in the Womb, whereby the Veins are eaten through, appears by the Bloods dropping out by little and little with a sense of pain and sharpness; and by the Bodies being replenished with salt and sharp Humours. Also the blood which comes away, is at first Matterish, Wheyish, Blackish, or Yellow; and afterward if the Exulceration increase, some bits of the parts affected are eaten off, whereupon follows a great effusion of Blood, hard to be stopped. Also there have proceeded such things as are wont to breed bad Blood, such as are the use of sharp things in Diet, the use of Salt meats, of meats putrefied, and such like. As for the Predictions belonging to this infirmity, we are to know that, all large and long-lasting Issues of Blood are dangerous; especially those from the Womb, which hurts not only her that suffers them, but hinders posterity. That which comes by a soaking of the Blood through the Veins, is of all others the least dangerous, as causing less expense of heat and Spirits, yet it continues longer, by reason of the continual supply of raw and Wheyish Blood. The breaking of Veins, and the opening of their mouths, cause greater danger, because they do suddenly Issue forth great quantities of Blood; yet are they sooner cured, as happening for the most part, only in Bodies over full of Blood, and otherwise healthy. But of all others, that which Springs from Exulceration is most hard to cure, because where the Ulcer is, there some part of the substance of the Veins is perished, which hinders the growing together again of that breach, whence the Blood Issues. If the sick party grow daily weaker and weaker, and the Disease stronger and stronger, it portends her death. In an elderly Woman, over great Flux of her Courses, is commonly incurable, and deadly. The Cure of Immoderate Flux of Courses, must be in a manner the same, which we have prescribed to cure the immoderate running of the Hemorroids. For in the first place, to draw the Blood from the part affected, the Patient must bleed in her Arm, not all at once, but by degrees, now and then stopping the Orifice with your singer, and then letting it bleed again. She must bleed plentifully, as much as her strength can bear. For Hollerius in his Comment upon the 50. Aphor. of the 5. Sect. doth testify that he hath seen many Women cured by large Blood-letting, when the Issue of their Blood, could by no other remedies be stopped. Rubbing, Binding, and Cupping-glasses, eaten good to cause revulsion, as in the cure aforesaid we have showed, especially if the Cupping-Glasses be fastened upon her Dugs, according to that Sentence of Hypocrates; If you would stop a Woman's Courses, fasten a very large Cupping-Glass unto her Dugs: Howbeit, if upon the setting on of the Cupping-glass, she grow short breathed, you must quickly take it off again. Likewise the same Purgation may serve which we propounded in the Cure of the Hemorrhoids; and it must be reiterated once or twice in a week, until the impurity of the Bowels, and the Veins be taken away. For when the Choleric and Wheyish Humours are taken away, which make the blood thin and sharp it leaves running of itself. If the Wheyish parts seem most to abound, Mechoacan with Rhubarb will be a good Purge. A Vomit likewise doth powerfully draw the Blood upwards, and is commended by Hypocrates, in his Second Book of women's Infirmities. But the Vomit must be gentle, and often repeated. Also it may suffice for the Patient to put her finger into her Throat, and so procure Vomit: Yea, and the Truth is, it may serve the turn, and will be very profitable for her to provoke herself to Vomit before her Dinners, but so as not to vomit, only to use some forcing thereunto. Unto which Remedies, these which follow may profitably be added, as being tried by very learned Physicians. Take the Shells of two new laid Eggs burnt, Frankincense, Mastic, of each half an ounce: Pearls prepared, red Coral prepared, and Amber, of each two drains: Bloodstone and Smaragd prepared, of each half a scruple: Barley made without Bran, two pugils: four whites of Eggs, and if need be, add a little Water, in which red hot Steel hath been quenched, and make two Cakes, which must be baked so hard in an Oven, that they may be beaten to Powder. Of which Powder give from half a dram to a dram early in the morning, in a draught or mess of Broth made of Sheep's Trotters. John Michael Paschalius doth witness that many Women long troubled with this Infirmity, have been cured with this Powder. Also the Powder of Eggshells alone is commended, a dram there of being given divers mornings together; and it is accounted by some for a Secret. Forest●● commends the following Powder, which he says was one of the Secrets of his Doctor or Instructor, Helidaeus. Take a Turtle Dove moderately fat, draw it, and wash it with astringent red Wine, and Rose Water mingled together, and put an ounce of Mastic in the Belly of it, and sow up the belly that none of the Mastic may fall out: Then roast it upon a Spit, and instead of Butter, baste it with Vinegar of Roses, and save the fat which shall drop from it for your use. When it is excellently well roasted, put it into a new glazed pot or pipkin, closed up with such Materials as the Chemists use to close their Vessels with, that nothing may vapour out. Then let it be set into the Oven, till it be so dry that it may be bea●●n into a Powder, Of which Powder, let the Patient take one spoonful every morning in Plantain Water, or in some astringent Decoction. And with the fat which was reserved at the roasting, let the Reins of her back, her groins, and Privy-part, with the share, be anointed. Our Country-women have an ordinary Medicine of the flowers of the long-stalked common Thistle, wherewith they use to curdle their Milk when they would make Cheese. They administer these Flowers in Broth, or other convenient Liquor. Others use of the Runnet of a Kid or an Hare, to ●●e quantity of ten grains, which both stops the flowing of the Blood, and dissolves that which is clotted together in the Womb. ●alen accounts Juice of Plantain newly made, to be the best Medicine in the world, being given to the quantity of three or four ounces. Solenander adds to the aforesaid Juice, a quantity of Colophony, and avouches it to be remedy that never fails; his words are these: To stop an old flux of the Courses, take two ounces of the Juice of Plantain, and mingle therewith a dram of Colophony powdered, and give it the Patient to drink. Let her take it four times, and she shall be undoubtedly healed, with God's Blessing. The Juice of Yarrow is very convenient in this case, if two or three ounces thereof be given with Syrup of Coral, or some other convenient Syrup. The Juice of Nettles is no whit inferior to, or rather exceeds the former in efficacy: It may be given alone, or in mixture with others of little faculty: Or a Syrup may be made of Nettles, to be ever in a readiness. A Water drawn out of the most tender Oak Leaves, which are of a reddish colour, stops the aforesaid flux. Mercatus makes up a very effectual Water, after this manner: Take a Loaf made of Wheat Flower, Barley Meal, and Rice: break it in pieces, and power upon it seven pints of Water in which red hot Steel hath been quenched: Whereunto add, red Rose Leaves dried, three pugils: juice of Plantain a pound: the Roots of the larger Comfry, being green and braised, two ounces: the Herb Horstail, or Shave-grass, one handful: the pulp Choak-●ears, and Quinces, of each two ounces: Purslain two handfuls: Bole Armonic one ounce: Balaustians, and the three sorts of , of each half an ounce. Let all these be distilled in an Alembick. Let Patient take of this Water three ounces mixed with half an ounce of Syrup of Purslain, or of dried Roses. For the more tender sort of Women, Broths may be made of Calf's feet, with Plantain Leaves, or Bloodwort. Or to thicken the Blood, a Broth may be made of red Rose-Water alone, and the Yolks of new laid Eggs. Likewise Conserve of Bramble Roses is good for them, being often used, especially if their Liver be distempered with heat. In all Fluxes of Blood, Practitioners do use to administer Water and Vinegar in a large quantity to be drunk down. But in this Flux of the Courses it is to be feared as an Enemy to the Womb, which is a Menbranous Part. Among the Specific or appropriated Medicines, are reckoned, Filipendula Roots, with the outer Rind of the Mulberry-tree Root, whose Powders are administered to the quantity of a dram, in some convenient Liquor. The Flowers of the Nut-trees are gathered when they are ripe and ready to fall, and powdered, and adram given in a Cup of Wine warmed in the mornings, for divers days together. Solenander witnesseth that all are cured with this Medicament. Also it hath a peculiar propriety to help fits of the Mother. Spicknard in very fine Powder, and taken to a dram in some convenient Liquor, stops the Courses: Also being conveyed into the Womb in Lint, Wool, Cotton, rude Silk, etc. Milk in which red hot Steel hath been quenched, being drunk many days together, is very effectu●lin an old flux of the Courses; for it the sharpness of the Humours, and thickens them; it nourisheth the Body, and stops the Flux. Avicenna, Rhasis, and the rest of the Arabian Physicians, extol this Medicine to the Skies: and so doth Horatius Augenius, a noted Italian Phylitian. Yet it is not to be used, if we suspect the Body is not yet clear of the vicious Humours. The Acid Mineral Springs, whether they have their Tincture from Vitriol, Iron, or Alum Mines, do much conduce to the stoppage of immoderate Courses, both by removing the Causes, and by strengthening the Bowels affected. The Chemists do much commend the Tincture of Coral, and Vitriolum Martis [Vitriolated Steel] and many other Medicines, which you shall find in their Books. Let the Patiented use to drink the Decoction of Mastic, Yarrow, or of the dried Lentisch, or Mastich tree. Also the Lentisch or Mastich Wood, may be steeped in black harsh Wine, which doth very much strengthen the Bowels, and stop defluxions. It must be diligently remembered, That in an old Flux, very astringent and thickening Medicaments, are not to be used long together. For it is to be feared, lest they should fill, straighten, and shut up the secret passages of the Body, and so breed Obstructions, and very much hurt the principal Bowels, which are wont to suffer very much in this Disease. But it is much better to persist in the use of such things as strengthen the Liver, which have some astriction, but so moderate as can do no harm. Ludovicus Septalius in his Medicinal Animadversions, in the 144. Article, gives such commendations of the Decoction of Orange Peels, as of a Medicine that never fails, that it will worth our while to transcribe his very words. When such Medicines as these (quoth he) have been judiciously administered; in the next place, such Medicines as havea thickening and astringing quality are to be used; among which there is one which I cannot omit to set down, wherewith I have cured almost an infinite Number of Women troubled with this Infirmity; which I kept long as a Secret, and afterwards communicated to some young Students, whom I did inform in the Art of practising Physic, and now publish the same to the whole World for the good of Mankind: which Medicine hath scarce ever failed me, when there was no Vessel of the Womb exulcerated, that fed the Flux. It is a Medicine, easily gotten, and easily made, thus: Take Seven pints of Water; boil therein the rinds of three sour Oranges not throughly ripe, being cut into little thin bits or chips, and boil them till two parts of the Water be consumed. Give eight or nine ounces of the strained Liquor to the Patient in the morning to drink. If you would have it more effectual, put an handful of Mousear into it, when it is almost boiled. And it will be yet more powerful, if you boil it in Tunbridg water, or the like Medicinal Spring water: or if you boil the aforesaid Ingredients in eight pints of water, till two third parts be consumed, and then strain it, and quench red hot Steel divers times therein. Externally this flux may be stopped by Medicaments applied to the outward parts of the Patient's Body. And in the first place, Fomentations may be thus made: Take the Roots of Bistort [Adder-wort] Tormentil, and the peels of Pomegranates, of each one ounce: The Leaves of Plantain, Knotgrass, Shepheards-purse, and Horstail, of each one handful; Cypress Nuts, Balaustians, Myrtleberries, Sumach, of each one ounce: Boil them in Water that hath had Iron quenched in it, and in red harsh Wine mixed together. Strain out the liquor, and Bath therewith, the whole Share and Privy-parts, warmish, but not hot. Also, Boil a piece of Sea-sponge in strong Vinegar, and lay it upon the Patients Share, and Privities, and it will powerfully stop the immoderate Flux of Courses. A Bath made of the aforesaid Decoction, the Dose Being augmented, will be good for the Patient to sit in: But care must be taken that it be not hot, but only warmish; otherwise it will by its heat, the more open the Veins of the Womb. A Bath made of the Decoction of Alum is very effectual; but it causeth barrenness. After Fomenting and Bathing, the Patient must be anointed upon her Loins, her Share, and Privities, and between the Water-gate, and the Dung-gate (which space is called Perinoeum, and wants an English name) with an Ointment made as followeth. Take Oil of Myrtles, of Mastic, and of Quinces, of each one ounce: , Dragons-blood, and Carabe, of each one drachm: Vinegar one spoonful. Make all into an Ointment. Vnguentum Comitissa may also be used, or Vnguentum de bolo newly made, or this following Cerate, which is very effectual. Take Ship-pitch half anounce: Male Frankincense one ounce: Mastich half an ounce: Turpentine one ounce: Dragons-blood, Red Roses, of each two drams. Make thereof a Cerate to be applied to the Reins of the Back. Plasters are also profitably applied unto the Navel, and Loins, made of the Mass of Plaster against Ruptures, the Plaster against the Mother, and of Mastich Plaster, either alone, or mingled together: Or of the Plaster of Vigo for Fractures, which is most excellent; and works its effect without heating the Part. The following Cataplasms, are much more effectual, and very prevalent in a large Flux of Blood, causing danger of Death. They are made, either of , incorporated with juice of Plantain and a little Vinegar, and so applied. O● of Plaster of Paris, lib. 1. incorporated with ten drachms of one pound toasted at the fire, and laid upon the Parts aforesaid in Cotton-Wool: The Whites of four Eggs being first mingled with it. Solenander saith, that this Cataplasm stops all women's Fluxes in one day. A Cataplasm, or Pultis made of Nettles, fried in a Pan, and laid upon the Share and Privities, works more kindly than the former; rather by a specifical property, then by its astringency. Injections made of juy ce of Plantain alone, are likewise conveyed into the Womb by an Instument for that purpose; which is very effectual, and much cried up by Practitioners. Juice of Knotgrass may be used to the same intent. And sometimes we are wont to add to the aforesaid Juices, of the Mucilage, of Gum Tragacanth one ounce: Starch one drachm: Water of Rose-stalks, and Seeds three ounces, which are mixed, and Injected into the Womb. Or, Take of the leaves of Knotgrass, Plantain, Yarrow, Shepherds-purse, Horstail, of each half a handful: Boil all in Water sufficient to half a pint. In the strained liquor dissolve three drams of Acacia, Dragons-blood, , and Bloodstone, of each one ounce: Mix all, and make thereof a Clyster for the Womb. A Fume made with Vinegar, poured upon a red hot Iron Plate, and received by the Patient sitting over a Close-stool, is very profitable; or a Fume may be compounded after this manner. Take of Frankincense, and Mastic, of each two ounces: Myrtles and Labdanum, of each one ounce: Amber, Red Roses, Balaustians, of each half a drachm: With the infusion of Gum Tragacanth in Red-Rose Water, make Cakes to burn under a stool as before. John Michael Paschalius doth test me that he cured a Woman troubled near seven months with this Disease, with the smoke of Frogs: and he affirms that the smoke of a Mules Hoof, is an experimented Remedy, wonderfully effectual in this Case. Astringent Pessarles, are likewise usual in this Cure. Howbeit, they profit little, seeing they can hardly reach unto the Orifice of those Veins, which are opened in this Disease. But if the Veins of the Neck of the Wombare opened, they may be useful; and are thus Compounded. Take of Juice of Plantain, or Knotgrass two ounces: Troches of Carabe in powder, and Acacia, of each one arachm▪▪ Mix them with the White of an Egg, roll them in silk, and make a Pessary. Or▪ Take of the powder of Hyposistis, Acacia, , Dragons-blood, Comfry roots, Lambs-tongue, Plantain, Galls, of each half a drachm: Juice of Purslain, or Plantain, or Syrup of Red Roses, or Myrtles, as much as shall suffice, and with Cotton Wool make a Pessary. Pessaries are likewise made of the leaves of Purslain, Plantain, or Knotgrass, or some other convenient Herb bruised, and rolled in a piece of fine Linen; or the Countess' Ointment wrapped in Wool, and put into the Womb. Neither are we to neglect the washing of the Patient's Legs with cold Water, or some astringent Decoction, which is commonly used by Practitioners, and doth not a little further the stoppage of the immoderate Courses. Touching the administration of Topical Medicaments, it is to be observed, That astringent Medicines, especially the stronger sort of them, are not to be applied before sufficient Revulsions have been made, especially by Blood-letting: for it is to be feared lest they cause Tumours, or other worse Diseases in the Womb. Wherefore always, as far as the Disease will allow time, the Cure must be begun with internal Medicines of a thickening and astringent Nature, before we make use of the Topical Medicines aforesaid. This Method of Cure aforesaid may with Judgement be accommodated to the Flux of Courses, arising either from an opening of the mouths of the Veins, or from a draining of the blood through their Coats, or from a breaking of the Coats of the Veins: But if it arise from an eating or exulceration of the Coats of the Veins, it ought to be cured after the same manner, as an Ulcer of the Womb is cured, of which hereafter. In the whole Course of the Disease, while the foresaid Medicaments are used, care must be had to strengthen the Bowels, and to correct the vicious quality of the Blood, as we shown in our Cure of the Hemorrhoids. And to conclude, When the Flux is allayed, the same Rules of Prevention are to be used in this disease, which we prescribed concerning the Hemorrhoids. Chap. 4. Of the Whites. A Woman is said to have the Whites, the Woman's Flux, the Flux of the Womb, or the White Menstruals; when Excrementitious Humours do flow from her Womb, either continually, or at least without any certain order, or course of time observed in their flowing. And the said Excrementitious Humours are sometimes white and phlegmatic, very like to Whey, or Barley Cream; sometime they are pale, or yellow, or green by the mixture of Choler; sometimes watery by the admixture of serous Humours: sometimes blackish, by the admixture of Melancholy; sometimes sharp and Corrosive, so as to eat into, and exulcerate some parts of the Womb; sometimes they are of a strong and beastly smell, and other whiles again, not at all offensive in that kind. This Disease is wont to seize upon grown Women for the most part, and such as are of riper Age; yet are not Virgins always free from the same: so that some have done ill in daring to affirm, That such Maids as are troubled with this disease, have parted from their Virginity, taking their Ground from the straightness of those Passages Naturally: For if Virgins have the Veins of their Wombs so large, that their wont Courses can flow through them, why may not the Whites likewise drop out by the same passages, seeing they are many times more thin and fluxive than the Blood itself, as being wheyish and choleric. The same is confirmed by the produced Experience of most learned Physicians, and daily Practice teacheth me as much, viz. That the most chaste and perfect Virgins in the World have had this Infirmity, of whom there could be no suspicion that they had been corrupted. And Fernelius doth witness, That he saw a Girl eight years old which had this Disease, and was afterward a long time grievously troubled therewith. The Excrementitious Humours aforesaid, are bred either in the whole Body, or in some principal Part of the Body, or in the Womb itself. If the Humours flow from the whole Body, they proceed either from bad Diet, or from a vicious habitual distemper of the whole Body, and they take their course unto the Womb as unto a Sink, or Common-shore, whereinto the rest of the parts of the Body disburden themselves. The particular parts, by whose consent the Womb suffers in this Disease, are chief, the Brain, Stomach, Liver, Spleen, Mesentery, and the Bladder, which dispatch their Excrements unto such parts as are more weakly, and so more disposed to receive them. These Excrementitious Humours are bred in the Womb, because when it is unable to digest its proper nourishment, by means of the weakness of its Retentive or Concoctive Faculty, the greater part of its Aliment is turned into Excrements, being imperfectly digested, or corrupted rather. It is imperfectly digested in cold distempers of the Womb; and it is corrupted in hot distempers thereof. And seeing the Womb by want of Digestion, is defrauded of its Nutriment, it presently draws new Aliment, which being turned into Excrements, is by the Womb expelled as unprofitable; and new Aliment is continually drawn, whereby this flux of evil Humours from the Womb, becomes both plentiful and continual. The Womb is weakened and more disposed to the Reception of these Excrements by Childbearing, travelling in Childbirth, Abortion, and Contusion, Inflammation, Imposthumes, or Ulcers. The Signs of this Disease, are referred to the Infirmity itself, to the part affected, or to the cause producing the Disease. The Disease itself is easily known by relation of the sick party, and it is often times attended with divers Symptoms, viz. Paleness of Face, want of Appetite, sickness of Stomach, short breathing, weakness, swelling of the Eyes, fullness, pensiveness and sadness, thick Urines, turbulent, and many other accidents, which differ according to the diversity of the Humours offending, as we shall declare more distinctly by and by. The part affected, and the place in which these Excrementitious Humours causing the flux are bred, may beknown by these following tokens. If the matter of the Flux is bred in the whole Body, these signs do show it; viz. Weariness and heaviness not proceeding from any work, of which the Patient is eased, having disburdened herself by the flux plentifully; and then again, when new matter is collected, she gins to be weary and heavy as before; her Veins are full; her Feet, Hands, and Thighs, are apt to be numbed. And these signs do especially discover only a plenitude of Humours. But that corrupt Humours do abound in the whole Body, is known by an evil habit in the whole Body [that is, an ugly sickly appearance in the looks, and whole outward state of the Body] a puffing up of the Hands and Feet, an itching and stinging in the whole Body, if the Humour be sharp, and many such signs as these. If the matter offending reside in some peculiar part; the Symptoms and Excrements proper to that part, discover the same; as for example: A pain, heat, and swelling of the Liver, with Choleric Excrements, do show the Liver to be affected; and the same Symptoms happening on the left side, with Excrements of a Melanchollick appearance, do argue the flux to spring from the Spleen: Phlegmatic Excrements, Stomach-sickness, want of Appetite, and sometimes extreme Appetite, frequent corruption of the meat, and sour belchings, or fatty (as of the Dripping-pan, or over-scorched flesh) are sure tokens of the Stomaches faultiness. Pain of the Head, Frothy Excrements, some usual evacuation by the mouth or nostrils being stopped, do witness that flux springs from the Head. If none of the aforesaid signs of some part affected appear, than we may conjecture that the flux proceeds primarily from the womb. Also the Woman (in such a case) is well coloured, the matter flowing is but little in quantity, being the excrement of the womb alone. There have preceded such causes as weaken the Womb, as are hard Travel, Abortion, a Fall upon the Belly or Back, immoderate Carnal Embraces, especially if the woman have been too young married, Tumours, Ulcers, and other Infirmities of the Womb, whose signs are propounded in their proper Chapters. The Humour causing the Flux is known chief by the colours of that which comes away, which were a little before declared, and which appear in the wherewith it is received, if, as Hypocrates teacheth in his second Book of women's Infirmities, the said being dried, shall be after washed in Water alone, and dried in the shadow: for so they manifestly declare the colour of that Humour which most abounds in the Excrements. Hereunto may be added the signs of an Humour abounding in the whole Body, usually delivered in that part of the Institution of Physic, which treats of Signs. In the last place, We are to propound such Signs as distinguish this Disease from others like unto it; as namely, Excretion of Purulent matter proceeding from an Ulcer of the Womb, and the Gonorrhoea, or flux of Seed. It is distinguished from purulent Matter by the signs of an Ulcer in the Womb, which shall be set down in their proper Chapter; as likewise, because the Purulent Matter or Quittor, is much thicker, whitish, and lesser in quantity, if it be digested rightly; but if it be of a gory, sanious, and fleshy appearance, like blood and water mingled, there is then blood amongst the matter, and it is wont sometimes to come away with strings from the Womb, and with exceeding pain; also the Women that have Ulcers in the Womb or its Neck, admit not of Copulation but with pain, which exasperates their Disease; but those which are troubled only with the Whites, do willingly and patiently suffer themselves to be embraced by their Husbands. In the Gonorrhoea, the matter which comes away is not so much in quantity, is thicker, of a more shining whiteness, holds up longer from flowing, and seldom or never stinks. But if it be a virulent or venomous Gonorrhoea (such as accompanies the Lechers Pocks) it is known by sharpness of Urine, Ulcers of the Privy parts, and other Signs that argue Malignity. The Predictions or Prognostics of this Disease, are as followeth: This Disease in one respect may be called good, in another respect bad: Good, forasmuch as commonly it is not attended with any danger of death; and bad, because it is a stubborn Disease, long lasting, and most exceeding hard to be cured; forasmuch as the flux of evil Humours having once taken this course, is very hardly turned out of its Channel, because the Womb (as we said before) is the Draught of the whole Body, whereby even in time of Health, the superfluous Humours of the whole Body are monthly evacuated. If this Infirmity get head, it may bring many other Evils upon the Patient, as Barrenness, falling down of the Womb, Exulceration, Cachexia, Dropsy, and Consumption. A Flux of Whites, bluish, bloody, stinking, is worse than the white, pale, not stinking. The longer this Disease hath lasted, the harder it is to cure. It attends old Women to the grave for the most part, because of their abounding with phlegm, and the weakness of their Concoctive Faculty. The Cure of this Disease is to be begun by a convenient purging of the Peccant Humour And because phlegmatic and wheyish Humours do most commonly offend, such things as purge those Humours, must chief be used, and with them Purgers of Choler, or Expellers of Melancholy must be mingled, according as Choler or Melancholy is adjoined to the Humour offending. An Apozeme therefore may be appointed both altering and purging for four or five days by way of a solemn purgation, always remembering that to the purging Medicaments, some astringent and corroborating things are to be added, lest the Humours of the Body being stirred, should fall more abundantly into the Womb. Touching Blood-letting, it is a question, whether it be convenient in this Disease or not: For seeing this Flux is caused by ill Humours in the Body, which by Blood-letting are drawn into the Veins and so may corrupt the Mass of Blood; it seems there is in this case no place for bleeding. Also, since in this lingering Disease, the Patient's strength is much abated, and the Body often brought into a Consumption, it seems unfit to weaken it yet more by blood-letting, and so defrauding it of its nourishment. Which Controversy is thus decided; That if the flux be not pure and simple, but in some measure mingled with Blood, and it appear reddish, that then a Vein may be opened; as also if the Liver be very much heated, and the sharpness of Choler be joined with the flux. In other Cases, especially if the flux have endured long, it is better to abstain from Blood-letting. Bindings of the upper parts of the Body, and Cupping-glasses applied to the shoulderblades, and to the back, will be very useful to draw the Humours upward; also rubbings of those parts will be specially profitable, first with finer and softer , than with rougher and courser, which Galen daily practised upon the Wife of Boetius, whom he cured in the space of thirteen days, as himself relates in his Book of Prognostics dedicated to Posthumus, Chap. 8. And besides the Universal Purgation already propounded, ordinary Purgations are also to be administered, and frequently reiterated, that the superfluity of Excrements may be the better evacuated by little and little, and that Nature may get a custom to void those Humours by stool, which formerly had their recourse unto the Womb. To this intent, Magisterial Syrups, Pills, and usual Opiates may be compounded, suitable to the temper of the Patient, and the Humours offending. In this Disease caused by phlegm, Mercatus commends a Syrup of the Decoction of Lignum vitae, with Senna, Turbith, and Agarick; as also the following Pills: Take of the Mass of Pills of Hiera picra, one dram: Agarick trochiscated one dram and an half: with Honey of Roses make them into Pills, of which let the Patient take early in the morning six or seven every third day: afterward, only three of them every fift or sixth day. Or for the greater Astriction, as well as purging, they may be thus compounded, in whatever Complexion. Take Choice Rhubarb ofttimes sprinkled with the Juice of Roses, two drams: Citrine coloured, white and black Myrobalans steeped in the Juice of Roses, of each one dram: Mastich one scruple: Spicknard half a scruple: With Syrup of Roses make all into a Mass of Pills. Let the Dose be one dram twice in a week. For a Flux arising of Serosity, or Wheyish Excrements, jalap is most excellent, which may be thus used: Take jalap finely powdered one dram: Cinnamon finely powdered half a scruple. Mix them, and with a draught of Chicken Broth, give it the Patient in the morning. A Laxative Ptisan daily taken for a month together, hath cured a stubborn Flux of Whites, when nothing else could, as is to be seen in our Book of Medicinal Observations. Vomiting is likewise much commended in this Disease, especially in such as are easy to vomit, because such indigested humours as are wont to be gathered about the Stomach, are hereby both evacuated, and powerfully reveled or drawn back from the Womb. Among convenient Vomits, Diasarum of Fernelius his Invention is commended, half an ounce whereof, given in Water and Honey, or with one ounce of Oxymel, and warm Chicken Broth, twice or thrice in a month, moves three or four Vomits, without any trouble. After sufficient Purgations, sweat may be procured to expel the remnants of the Excrementitious Humour; and also to cause a further Revulsion of the Humours falling into the Womb. To this intent, a Decoction of Lignum vitae, and Sassaphras, will be good in such as are phlegmatic; and of China and Sarsaparilla in such as are Choleric and Melanchollick, cooling and temperate Herbs being added, lest the evil Humours be more exasperated, and become more sharp. Or Sweat may be provoked by a Decoction of hot Herbs, as Nep, Calaminth, Fennel, Hyssop, Elicampane, Chamomel, Dill, and such like, the evaporation of which Herbs being artificially received upon the Patient's Body, will procure sweat. A Bath may also be made of the same Decoction, by which sweat may be provoked. But in hotter Constitutions, a Bath of fresh fair Water bloodwarm, will be sufficient, in which moderate and gentle sweats only may be procured. Sulphurous Baths do also powerfully cause sweat, and consume the relics of this Disease: and by help of such Baths we have known some Women cured, that no other means could help. As touching Piss-driving Medicines, it's a weighty question whether or no they are fit to be administered in this Disease? For they do not only provoke Urine, but the Courses likewise, by heating and attenuating the Humours contained in the Veins. Yet are they allowed by all Authors, and by Galen himself, who used them in the Cure of the Wife of Boetius: And the reason is, Because Piss-drivers do provoke Urine Primarily, and the Courses Secondarily, and as it were by accident or chance. Again, the Kidneys do perpetually draw Wheyish Humours unto themselves, whereas the Womb does only receive them; whereupon it is credible that the greatest part of such Humours, will have recourse into the ways of Urine. Now the Piss-driver which Galen used in the foresaid Woman, is a Decoction of Asarum and Smallage in fair Water; howbeit, it will be better tempered, if it be made in Succhory Water. A more compounded Piss-driving Broth, may be thus made: Take the Roots of Asarum, and of Smallage, of each one ounce: Leaves of Calaminth, and Soldanella, of each one handful: Elder flowers half a handful: Polypody, and Carthamus' seeds, of each half an ounce: boil all to a pint. Give five ounces of the Liquor or Broth strained, in the morning. If you would make it purgative, add a little Agarick, and a little Turbith boiled with the rest, in a Rag. It's questioned whether Issues in the Legs are good for this Disease; for by drawing the Humours downwards, they may decrease the Flux. Howbeit, experience hath showed that they do good in old Fluxes, because by such passages, some part of the Excrementitious Humour is voided. If Choleric and sharp Humours cause this Disease; not only purgers of Choler are to be given, but likewise Alteratives which cool and thicken, and are moderately Astringent; such as these Juleps following. Take of the leaves of Succory with the roots, of Endive, borage, Lettuce, and Purslain, of each half an handful: of new Sebestens and Jujubes, of each seven in number: of the four greater cool Seeds, and white Poppy Seeds, of each half a drachm: of red Rose-leaves a pugil. Boil all in Water sufficient, unto a pint, and in the strained liquor dissolve Syrup of Quinces, or of dried Red Roses three ounces, and make a Julep, for three Doses. But if Melanchollick humours abound, they are to be altered and Purged away, by Medicines proper to that intent. The use of Chalybeate milk taken forty days together, the quantity of four or five ounces is very proper for either of the aforesaid Humours; whereunto may be added towards the end, a little Bolearmoniack, or Terra Sigillata. In the whole Course of Curing, it is to be considered, whether any part of the Body be misaffected, and so may send the matter of the Flux into the Womb; and if so, then care must be taken for the use of that part. For if Humours flowing from the Brain, do cause this Disease, Remedies are to be applied to that part; especially such as revel and divert the Fluxion, viz. Cupping-glasses frequently fastened upon the shoulders and Back, Medicines snuffed up into the Nostrils, Masticatories, Vesicatories, and Issues made in the hinder part of the Head, or in the nape of the Neck; instead where of Setous may be used, which are more effectual. And Febritius Hildanus in the forty one Cure of his first Century, relates that he cured a Woman long troubled with the Whites, and thereby Barren, by a Seton. If the Humours flow from the Stomach, Liver, or any other part, suitable Remedies must be applied to that part. The Body being prepared, and the offending Humour for the most part evacuated, or derived another way: We must proceed to corroborating and Astringent Medicaments. But they must never be used until the Antecedent matter be well evacuated, and diverted. Otherwise, those Humours retained, do rush into the more noble parts, and stir up more grievous Symptoms. As Galen in the place relates to have befallen the Wife of Boetius, Whose Belly, swelled, by means of the unseasonable use of Astringents, by which the Wheyish Humours were retained in her Body, which were wont to pass away in the Flux. It is likewise to be remembered, that whilst we are in the use of Astringent Remedies, we do then divert the Antecedent Matter, and hinder the same from increasing, by the Remedies aforesaid. Amongst these principal corroborating Medicines, Treacle is reckoned, which is to be used in phlegmatic Constitutions. Conserve of Roses, and of Wormwood, may be mingled with the Treacle; Or the following Opiate may be compounded, Take Conserve of Rosemary flowers one ounce: Conserve of Calamus Aromaticus two drachms: Species of Diarrhodon Abbatis, and of Aromaticum Rosatum, of each one drachm: Red Coral prepared half a drachm: Treacle two drachms; with Syrup of preserved Citron peeles Make all into an Electuary. Or, Take old Conserve of Red Roses, Roots of Comfry, Bugloss, and Citron peeles, of each one ounce: Red Coral burnt, shave of Ivory, , Terra Sigillata, Dragons-blood, of each one drachm; with Syrup of Red Roses dried: make all into an Opiate. The powder of Sage, Salsaparilla, and Baula stians taken every morning in broth, is the Court-Ladies Medicine. Zecheus commends this following Electuary, which he had often used with happy Success. Take Gum Arabic, and Gum Tragacanth, of each two drachms: white and red Coral, Eg-shels, Hartshorn, Dill seeds, Amber, of each four Scruples: Honey of Roses, as much, as will make all into an Electuary. Of which give half an ounce two hours before meat. Let the Patient swallow it down, and drink after it four ounces of Plantain Water, mingled with two drachms of red Wine. Juleps may be made of Rose-water, Knotgrass, and Plantain waters, with the Syrup of Myrtles, dried Roses, and the like: Some of the aforesaid powders being added. Mercurialis says he frequently used a Decoction of Oak-leaves, with the Runnet of an Hare; wherewith he cured many Women of this Disease. His manner of making his Medicine was thus. Take of the Decoction of Oak-leaves five or six ounces: of the Runnet of an Hare, one dram: Let her take this Medicine eight or then days. When the Disease comes from Choler, the following Syrup may be prepared, which is strengthening, Astringent, and cooling. Thus, Take red Rose Water four pints: Spirit of Vitriol, so much as will make the Water a little sharp; but so as scarce to be perceived by taste: red Roses dried three pugils: Steep them in the Water cold, two days, S●ain it, and add thereto so much Sugar of Roses, as will make a Syrup. And Finally, Those Astringent remedies mustered up in the former Chapter, touching the Immoderate Flux of Courses, may be likewise useful in this Cure. The Patient may use instead of ordinary drink, a Diet drink of Chinaroots, or Mastich wood, with Astringent Wine mingled. The same time that the Patient takes in such things as are Astringent, and do strengthen the Womb, she must likewise use outward Remedies applied to the place affected, viz. Fomentations, Baths to sit, it, Ointments, Plasters, Injections, Fumigations, and Pessaries; such as have been prescribed against Immoderate Courses. But before these external Astringents are applied, the Womb must be well cleansed. Otherwise such impurities would be therein retained, as returning back into the Body, may cause more grievous Diseases. And in our cleansing, we must regard the Humour offending; for one sort of Clensers are fit for Phlegmatic, another for Choleric Humours. If the Humour be Choleric, let the Cleansing Injections be made of Barleywater, Whey, Water sweetened with Sugar. If it be Phlegmatic, let them be made of Hydromel, or of the Decoction of Wormwood, Fever-few, and the like. Also a Detergent Pessary may be made of Treacle, and Turpentine; or of Mercury leaves bruised, and wrapped up in a fine Linen rag very thin worn. Let the Patient use these Clensers, before the Astringents be applied, until her Womb be well purified; which may be known, if little or no Humours come therefrom. After the Use of the Clensers, the Fumes are first to be received over a Close-stool, because they dry and strengehen the Womb; and they may fitly be made of Frankincense, Laudanum, Mastic, Sanders, Nutmeg, and Red-Rose leaves. And afterwards we must proceed to other Astringent Remedies. Chap. 5. Madness from the Womb. WOmb-Furie is a sort of Madness, arising from a vehement and unbridled desire of Carnal Embracement, which desire disthrones the Rational Faculy so far, that the Patient utters wanton and lascivious Speeches, in all places, and companies, and having cast off all Modesty, madly seeks after Carnal Copulation, and invites men to have to do with her in that way. This Immoderate desire of Carnal Conjunction, springs from the abundance of Seed, from its Acrimony, and heat transcending the bounds of Nature, whereby it is made to heave and work in the Seminal vessels, as Yeast works, whereby the parts made for generation, are vehemently stirred up, and Inflamed with lustful desires. And from the same Seminal matter so affected, Vapours ascend unto the Brain, which disturb the Rational Faculty, and depose it from its throne. Howbeit, The Immoderate appetite of carnal Conjunction alone, without the help of any such vapours, is able of itself to master the Rational faculty, as also all other Immoderate passions; but especially Immoderate Love, which is called Eroticus affectus, or Love-Melancholly. Now the Seed acquires the aforesaid qualities, when it is over long retained in Bodies prone to lust, and full of heat; and therefore this Disease is incident to Virgins, and young Widows peculiarly; although it may also betid married Women, that have impotent Husbands, or such as they do not much affect, whereby their Seminary Vessels are not sufficiently disburdened, or their amorous affections duly satisfied. Some hold, That the Seed being corrupted, acquires a malignant quality, which causes these grievous Symptoms. But they are not well able, so holding, to show any difference between this Disease, and fits of the Mother, which arise from the Seed being corrupted, and thereby infected with a malignant quality. For although several degrees of putrefaction do produce different degrees of malignity, from whence a great variety of Symptoms are wont to arise; yet these manifest qualities aforesaid, viz. great plenty of Seed, it's heat, Acrimony, and Fermentation in excess, together with the great heat of the genital parts; are sufficient to produce this Disease we treat of. Now the Causes producing so hot, plentiful, and sharp stinging Seed, are youthful age, Sanguine complexion, and Choleric, or melancholy adust; meats that nourish much, a plentiful table, especially if the meats be spiced; the frequent smell of Spices, Musk, Ambergris, and such like: large sleeping, and upon soft beds filled with Feathers, or down; amorous Court, reading of lascivious Books, Dance, and other pleasures usual in the meetings of youthful persons. The Signs of this Disease may easily be gathered out of what hath been already said. But because it is wont to discover itself gradually, by little and little; it is sit to relate its progress. In the beginning, whilst the sick persons do yet enjoy their understanding, they are more sad, and silent than ordinary, but with a wanton rolling of their Eyes, and a ruddyness of countenance; which ruddiness, is sometime more than at others? especially when mention is made of matters belonging to bodily lust, for then their breathing is changed, and their Pulse too, by Sympathy of the Heart, which made Galen boast that he knew the furious lusts of Women by their Pulse; because such Lovers, do of a sudden undergo divers▪ changes of their Pulse, when desirable objects are presented unto them, or brought into their remembrance. Afterwards when the Disease is exasperated, they begin to scold, and to weep, and ever and anon they fall a laughing, they speak many things without rhyme, or reason unadvisedly, out of which no certain sense can be gathered; a while after, they repent of this their folly, until another fit take them, by reason of the inordinate motion of the peccant matter, which observes no certain period in its Fermentations. Women possessed with this kind of dotage, when the Disease is come to its height, do openly before all the world ask men to lie with them expressing the actions of Generation in the most proper, and broadest language, their mother tongue affords. As for the Prognostics of this Disease. It is a curable sickness, if means be used in time. But if it continue long, and take firm rooting, it turns into a true and perfect Madness. There is a great hope of Recovery, when the distances between the fits begin to be longer than ordinary, or when the Patient's Body, being grown lean becometh fat again, and when mention of matters pertaining to Generation, doth no longer affect or disturb them. The Cure of this Disease tends to correct the hot distemper of the Bowels; especially of the Womb, and the Blood, and Seed; likewise to evacuate the sharp Humours, and Seminal matter offending. All which may be done by the following Remedies. And in the first place, Blood must be often drawn, as far as the Patient's strength can bear: that so the whole Mass of Blood, and the Womb itself may be cooled, and the fervent Blood may be withdrawn from the Veins of the Womb. And if the Patients monthly Courses be stopped, the inferior Veins are afterwards to be opened, that they may by that means be brought down. But if the Blood seems to have recourse to the Hemorrhoid Veins, which is known by their swelling and redness; the said Veins are to be opened by Application of Leeches Afterwards a Purgation is to be given, made of the gentler sort of Medicines purging Choler or Melancholy, according as the one or other Humour shall seem to abound. This purgation is to be followed by Juleps that prepare the matter offending, Viz. such as cool and gently open; which must be given three days together. Then a more strong purgation is to be administered, which may wholly extirpate the foresaid humours. To which intent these Purging Medicaments may be used, which was set down in our Cure of Madness, which must be now and then repeated. After iterated Purgations, the following Bath being frequently used in the whole course of the disease, will be very useful to cool the whole Body, and temper the fervour of the peccant Humour. Take Leaves of Lettuce, Willow-tree, Water-lillies, Vine-tree, Purslain, Penny-wort, of each a handful: Flowers of Violet, Water-lilly and Roses, of each two handfuls. Boil all for a Bath, into which Bloodwarm let the Patient enter, twice in a day, without sweeting, far from meal-tide. And forasmuch as a complete, and entire▪ Bathing cannot conveniently be continued for so many days together; at least the Patient may Bathe her lower parts frequently in a part of the aforesaid Decoction, yea or of mere Water, and the liquor must be only warmish: For the prime intention of this Cure is, that the Womb may be cooled to the purpose: which is confirmed by a remarkable Experiment propounded by Dr. Harvey, in his Treatise of the Childbearing of a noble Lady, who had been more than ten years beside herself, by reason of this Womb-fury; whose Womb (after all things had been tried to reduce her to her wits, in vain) fell out, which they did not put up till the coldness of the external Air had healed its distemper; the event was, as the Doctor imagined, and she grew quickly well, and her Womb was at last restored to its proper place. For the greater cooling of the Body, it may be convenient to give the Patiented Whey to drink many days together. And to be brief, Whatever hath been prescribed in our Cures of Madness and Hypochondriacal Melancholy, will be good in this Disease, according as it shall be caused either by Choler or Melancholy. Unto all which may be added such things, which by a peculiar property, diminish and cool the Seed: Among which take these that follow for example. Take Leaves of Water-lilly, Willow, Agnus Castus, of each four handfuls: Lettuce, Purslain, Penny-wort, or Twopenny Grass, of each a handful: the four larger cooling Seeds, Lettuce, and white Poppy seeds, of each half an ounce: Dill seeds two drams: the flowers of Water-lilly, and Violets, of each one handful. Let all be stamped, being fresh, and let them be sprinkled with Juice of Lemons, and distilled in Balneo Mariae, and to every pint of the Water, add a dram of Camphire. Let the Patient take an ounce divers times. Or of all, or some of the Simples aforesaid, a Decoction may be made, and sweetened with Sugar, and a little Camphire put to it, to be taken divers times one after another. Or an Emulsion may be made of the greater cool Seeds, Lettuce seeds, and white Poppy seeds, extracted with the Waters of Lettuce, Willow and Water-lillies, and sweetened with Syrup of Violets. An Electuary may be prescribed after this manner: Take Conserve of the Flowers of Water-lillies, Violets, and Agnus Castus, of each half an ounce: Conserve of Roses half an ounce: Lettuce Stalks preserved one ounce: Coral and Smaragd prepared, of each one dram: with Syrup of Violets, and water-lillies, make an Opiate. In the greatest extremity of the Patients raving, such things as procure sleep, are very profitable, both inward and outward Medicaments, as they are set down in the Cure of Frenzy and Madness. In the whole course of the Disease, Clysters which cool and gently purge, are to be used, taking heed of sharp Clysters, and such as vehemently purge, which do exagitate the Humour contained in the Womb, or its Vessels, whereby the Symptoms are wont to become more fiery. Also Injections may be made into the Womb, of the Decoction of such Herbs as have formerly been set down for Baths and other▪ Remedies, whereunto Sal Saturni may profitably be added. Frequent Clysters may likewise be good to the same intent, being made of Vinegar allayed with Water. Also cooling Ointments are to be applied to the Loins, Privity, the Share, and between the Water-gate, and the Dung-gate, made of Oil of Water-lillies, Ointment of Roses, Vnguentum Album Camphoratum, with the Juices of Nightshade, Henbane, and Water-lillies, melted together, adding a little Camphire. Also a Plate of Lead is good to be worn continually upon the Reins. In regard of the immediate Cause, seeing the evacuation of the sharp and corrupted Seed, may cure the Disease; it is very good Advice in the Beginning of the Disease, before the Patient gins manifestly to rave, or in the space between her fits, when she is pretty well, to marry her to a lusty young man. For so the Womb being satisfied, and the offensive Matter contained in its Vessels being▪ emptied, the Patient may peradventure be cured. But if the Patient cannot so conveniently be married, or the condition of her life will not bear that estate, some advice that the Genital Parts should be by a cunning Midwise so handled and rubbed, as to cause an Evacuation of the over-abounding Sperm. But that being a thing not so allowable, it may fuffice whilst the Patient is in the Bath, to rub gently her Belly on the Region of the Womb, not coming near the Privy parts, that the lukewarm temper of the Water may moderate the hotness of the Womb, and that it may by the moisture be so relaxed, as of its own accord to expel the Seminal Excrement, and that nothing else be done with the hand, save a little to open the Womb, so as the Water may pass into its more inward parts; forasmuch as the water will operate as much as any of those Medicines which are used to extinguish the seed withal. Pessaries may be compounded to the same intent of the Leaves of Mercury bruised, with a little Myrrh, or the Powder of Aristolochia or Birthwort; which must be put up, when the Patient is in the Bath, lest otherwise the Womb should be overheated; and after an hour, it must be taken away. And afterward, let an Injection be made into the Womb of Whey, or Barley water, with a little Juice of Nightshade, Housleek, or Hemlock, which is specially commended in this Disease. To purge out the Seed, the following Bolus or Morsel will be very profitable. Take of Venice Turpentine three drams: Agaricktrochiscated one dram: Carrot seed, Hempseed, and Lignum Aloes powdered, of each eight grains: With Sugar make all into a Bolus or Morsel to be swallowed. If the Disease do yet continue, let Issues be made in her Thighs; for nothing is better than by such means to draw the matter downward, from the Womb, to those inferior parts. And if swell of the Spleen shall arise, and Obstructions, during this Cure, as it often times happens; they must be carefully cured with their proper Medicaments. Finally, Because in this Disease the Brain and Heart, are grievously affected, by reason of Vaporsarising from the Womb, they are both of them diligently to be provided for; the Brain being secured by rubbing and chafing the lower parts, and by Cupping-glasses frequently fastened upon the Hips, and Groins; and the heart defended by Cordial things out wardly applied, both Liquid and Solid, such as are described in our Chapter, touching decay of strength. Chap. 6. Of the Mother-Fits, or Womb-sickness. WHen Seed and Menstrual Blood, are retained in Women besides the intent of Nature, they putrefy and are corrupted, and attain a malignant and venomous quality: from whence venomous Vapours are elevated and carried to divers parts of the Body, from whence divers Symptoms do arise, and those so divers, that Democri●us might justly say in his Letter to Hypocrates, That the Womb is Author of a thousand sad Sorrows, and innumerable Calamities. And Hypocrates himself says in his Book of Virgin's Diseases, That miserable Womankind is commonly laded with incomprehensible and manifold Diseases. All which Infirmities we intent to explain in this Chapter, under the name of Mother-Fits: herein imitating Galen, who in his sixth Book of Parts Affected, and the fift Chapter, says that the Mother, or Hysterical Passion, is but one name indeed, yet comprehending under it divers and innumerable Accidents. Notwithstanding all late Writers in a manner, do handle ●he Suffocation of the Womb, under the Title of Hysterical Passion, calling a particular Symptom by such a name as is common to many others, because it, of all the rest, is most frequent, and most troublesome. But herein the very best Authors seem to have been superfluous in their Treatises of women's Diseases, while in different Chapters they describe several Diseases springing from the Womb, viz. Suffocation of the Womb, Headache, Epileptical fits, Palpitations of the Heart, Pulsation of the Arteries about the short Ribs, and in the Back, the Diseases of the Stomach, Liver, and Spleen arising from the Womb, and divers pains in sundry parts of the Body arising therefrom; seeing all these Infirmities do arise from one and the same cause, and are to be cured by the self same Medicines; so that the aforesaid Authors, are fain to repeat the same things over and over, in several Chapters, not without much weariness to the Reader. We therefore, That we may more briefly, and methodically set down the Nature of all these infirmities, think it worth our labour, first to set down the universal Causes of them all; and afterwards to declare how those Diseases arise from the said Causes. We have showed in the beginning of this Chapter, that there are two special Causes of all these Symptoms, viz. the Woman's Seed, and the Menstrual Blood, being retained beside the intent of Nature, and corrupted, and possessed of a malignant, and venomous quality; out of which malignant Vapours, do arise, and afflict divers parts of the Body. Unto which Doctrine generally propounded, two other things of greatest moment must be added, viz. First, That not only the Seed and menstrual Blood, do produce Hysterical, or Womb-sicknesses; but divers Humours also of an excrementitious Nature flowing into the Womb, and by a long abiding, growing putrefied, and sending out filthy Vapours. This is verfied by many Ancient Women, who being destitute of menstrual Blood and of Seed, are yet very much subject to these Womb-sicknesses or Hysterical passions. Secondly, that not only vapours arising out of the aforesaid substances, are causes of these distempers, but the very Humours themselves are a cause, which finding no free vent by the Veins of the Womb (into which as a Common-shore Nature disburthens superfluous Humours) by reason of the stoppage of the Monthly Courses or of the Whites; they flow back again into the superior parts of the Body, and do infect the said parts with that vicious quality, which they have contracted by their long abiding in the Vessels of the Womb, or by their mixture with Seed, or Menstrual Blood corrupted. These Foundations being thus laid down, let us see how Hysterical Symptoms are stirred up by the Causes aforesaid, beginning with the Suffocation, or strangling fits of the Mother, which is the most frequent and principal Sickness of these kind of Women, being accompanied with very many, and those most grievous Symptoms. For besides their breathing impaired, and sometimes abolished, their whole Body becomes cold, their Speech and Pulse is intercepted, so that they lie like dead Women; and some have been accounted dead, and laid out for Burial, and yet afterward Revived. Now this Sickness comes by fits, which makes their returns sometimes sooner, sometimes later; and endure sometimes a longer, sometimes a shorter time, according to the quantity of the Humour offending, which is sometimes quickly collected, and sometimes long in gathering; sometimes soon discussed, and sometimes long before it can be discussed: For such like Causes of Diseases in the Body of Man, have their times of digestion and exaltation; which having arrived unto, they do suddenly, and as it were in a moment, break forth into action. Yea, and such Humours being already collected in the Body, may for a season lie hid, until being stirred by some internal or external Cause, they shed forth their poisonous blasts and vapours into other parts of the Body. Now the most frequent and noted Caused of this Commotion and Agitation of these Humours, are sweet smelling things coming near the Patient's Nose, or sweet Meats taken in, which quickly bring Women subject to this Insirmity, into their fits; also vehement Anger, Terror, and other grievous Passions of the Mind. Now there are divers Degrees of this Sickness, according as the Matter offending differs in Quantity, or Malignity. For sometimes the Choaking-fits, with want of breathing, are light and soon go over; sometimes it is extreme, so that the Patient breathes not at all, and is attended with other Hysterical or Womb-sicknesses, such as Vomitings, Rave, Convulsions, and Swoonings, or Faintings away. And for the most part, more grievous Symptoms do arise from corrupted Seed, than from Menstrual Blood, or other corrupted Humours. For look how much Seed retaining its Natural Disposition, is of a more excellent Nature than Menstrual Blood, by so much does it degenerate when corrupted, into a greater or worse kind of Venom or Poison. There are likewise other Differences of this Choking Mother-sickness, to be observed, viz. That sometimes the Patients have their Breath stopped as it were, sometimes they complain that they are choked, as it were with a Rope that strangled them; and sometimes their breathing is much abated, or abolished, without any pain or sense of strangling. The Reason of which diversity is this; That the simple Suffocation, and difficulty of breathing, do arise from abundance of Vapours, which do sometimes very much abound in Hysterical or Womb-sick Women, especially when the Hysterical Passion, and Hypochondriacal Melancholy are joined together. Which Vapours or Winds, do compress the Midrif and Lungs, as it is wont to fall out in the windy Asthma; but the sense of choking, in which the Patient feels herself as it were strangled in her Throat, depends upon a special property of the venomous Vapour; as there are other Poisons in the greater World, which have such a property of throatleing and choking, as is known of one sort of Mushrooms. And, that the venomous qualities bred in Hysterical Women are divers, Galen does sufficiently hint in his sixth Book of the parts affected, Chap. 5. where he compares the malignity of this Vapour, to the venom of the Fish Torpedo, and to the sting of a Scorpion; which Poisons, though in quantity they are small, in operation they are mighty, and being received into man's Body, they do in a short space of time, grievously afflict the same, and produce therein most vehement Symptoms. As for Respiration diminished or abolished, it is caused by the said Vapours being endued with a Narcotick or Stupefactive power, which being mighty contrary unto the Heart and Vital Spirits, their action is thereby hindered, whence follows a cooling of the whole Body through defect of that Spirit which should flow from the Heart, and a cessation of Respiration, because there is now no need thereof. For seeing that drawing of Breath is necessary to cool our Hearts, when the Heart is extremely cooled by the venomous Vapours aforesaid, it needs none of that cooling which is caused by drawing in the Air, and so breathing ceases, because there is no use thereof. We may also say, That the said venomous and stupefying vapour, does assault the Brain, and hinder the Influx of the Animal Spirits, whereby the motion of the Midrif, and the Muscles serving for respiration, is hindered; ad hereunto, That the Vital Spirits being destroyed, the Animal Spirits, which are made of the Vital, must needs be destroyed likewise. In the place before alleged, Galen resolves a Doubt, which is this: That seeing it is generally held that a man cannot live without breathing, therefore it is impossible that Hysterical persons should in their fits be quite deprived of breathing. To which he answers, That in an extreme cooling of the Heart there is no need of respiration, which if it were stopped, and the Heart vigorous and hot, present death would follow; but that little warmth which is yet remaining in the Heart, is cherished only by transpiration, or ventilation through the Pores of the Body; even as Creatures lying all the Winter in holes do live only by transpiration, because they are exceeding cold, and that little heat they have, needs no ventilation by way of drawing in Air into their mouths. Besides, The fore mentioned cause of Womb-suffocation, viz. A malignant and venomous vapour, some add another, namely, The ascending or rising of the Womb into the superior parts of the Body, whereby the Stomach and Midrif are compressed; from whence, not only Hysterical Suffocations, but other sicknesses also do arise. This ascending of the Womb, Hypocrates propounded in his Book of the Nature of Women, in these words: The Wombs of Women being turned from their Natural posture, do strive towards the Liver, and bear violently upon the Midrif; for they are carried upwards, seeking moisture to refresh them, being over dried with Labour; and the Liver is the fountain of pleasing moisture. And Fernelius in his sixth Book of Pathology, that is, of Diseases and their causes, Chap. 16. says, he had often felt the Womb thus ascending, bearing up against the Stomach like a round Globe, and grievously oppressing the same, from whence it hath been often thrust down by force of hand, and manifestly driven back into its own proper place. Eustachius Rudius in the Second Book of his Practice, in the 51. Chapter, says the same thing, viz. That he with his own hands hath felt the Womb raised as high as the Navel, and sometimes above the same, and hath by little and little thrust the same down into its proper place. But Galen in his sixth Book of Parts affected, Chap. 5. opposes this Opinion, and teaches that although the Womb may in some sort be moved, and ascend, yet that motion and ascension is very little, neither is it any ways possible, That the Womb should ascend unto the Stomach, so far is it from being able to transcend the same so far as to reach unto the Midrif. A very strong Reason hereof is brought from Anatomy, seeing the Womb is so fastened in its proper place by four very strong Ligaments, that cannot be lifted up so high. Whereunto the Defenders of this Opinion do make answer, That in the falling out of the Womb, those Ligaments are so relaxed that it is wont to come without the Warer-gate, and therefore it may ascend as far up as it can go down, when those Ligaments are relaxed or slackened. To this we reply, That the falling out of the Womb comes to pass by little and little through length of time, by the moistening and softening of the Ligaments, caused by a defluxion of Phlegm thereupon; but that which they call the Ascent or Rising of the Womb or Mother, happens in a moment, and is as soon restored; and it is requisite that the Ligaments should have been first relaxed, and consequently all Women should be troubled with the falling out of their Wombs, who are subject to this Ascent or rising we speak of, because the occasions of this Ascent being ceased, the Womb would of its own accord, and by its own proper weight fall down wards, and lie continually without the Body. It is harder to make Answer to the Experience of Fernelius, Rudius, and others; of which they testify themselves eye witnesses, who profess they have with their own proper hands perceived the Womb to ascend like a Globe or Bowl to the Navel and higher, being after wards by them thrust down into its own proper, place. Sennertus makes answer to this, that the round body which was by them so felt, was not the Womb, but the Stones, with that blind Vessel, which from Fallopius the finder or first Observer thereof is called Fallopious his Trumpet, becavse he likened the same to the broad end of a Trumpet. For the Stones appertaining to the Womb being pendulous (that is, Hang dangling movable as on strings) and the Body of the Trumpet aforesaid being hollow as a pipe, lax and apt to move this way, and that way; when they are filled with corrupt Seed, with vicious Humoes, and with windy Vapours, and swell and strut again, they may move this way and that way in the lower Region of the Belly, and ascend as high as the Navel. And that such a round swelling may happen in the Stones and Trumpet, as is sometimes felt in hysterical Women. The observations of Riolanus may teach (propounded in his Book called Anthropographia, where he relates) that in hysterical Virgins such as have had the Womb-sickness, He had found their Stones greater than his Fist, strutting with wheyish seed; also the Trumpet of the womb amplefied or enlarged and very much widened. And salius observed some such thing in a certain noble young Damsel troubled with suffocations or strangling of the womb, in whom one stone was swelled to the greatness of a large hand-bal, being filled with a saffron-colored humour, very stinking, and sending forth a filthy and poysonsom kind of vapour: Which humour died the adjacent parts yellow, just as we see the Gut Colon where it is carried under the Liver, is by the Bladder of Gall rendered of a clay-like yellowish Colour Yet is not Sennertus very far from the judgement of the Author's aforesaid; for granting, as he says, that the Stones and Trumpet of the Womb, being filled with corrupt sperm, vicious Humours, and vaporous winds, do strut again, move to and fro in the lower Region of the Belly, and can ascend as high as the Navel; seeing those parts are contiguous with the Womb, they cannot be moved in the Region of the lower Belly, nor ascend unto the Navel, unless the Womb be moved with them: so that this motion may be ascribed to the whole Womb very well, as it consists of its own perfect parts together with such parts as are knit there unto. Again if the Stones and Trumpet being filled with vicious Seed, Humours or vapours, may be diversely moved to and fro: Why may not the Womb being filled with like Humours and vapours, be moved with the same motion. Thereason indeed of Sennertus, which he borrowed from Galen does convince, that the Womb tied with four ligaments, cannot ascend so high as the Midrif, no not as high as the Stomach; but it must not be denied, that it may be carried as high as the Navel, where the Authors aforesaid perceived that Globe, both because those Ligaments may be somewhat stretched by matter working in them like yeast, and likewise because the womb whiles it is blown up, sils a greater space, and may be perceived towards the Navel; so that whether the whole womb, or the parts fastened there unto. viz. The Stones and the Trumpet be moved upwards, we may still call it the Rising of the Womb or Mother and cleave to the Doctrine of Hypocrates. Headache from the womb, comes divers ways; for sometime it possesses the whole Head, otherwhiles the forepart, and then again the hinder part thereof, and sometimes it is felt about the Eyes, in such manner as if the Patient's Eyes would leap out of her Head. Now these pains are caused by the aforesaid sharp and malignant Vapours mounting into the Head, and twitching as it were, or grating upon these Membranous parts: Also evil humours brought from the womb to the Head, may cause the said pains. For vicious Blood; especially the more thin and wheyish part thereof, ascends from the womb into the Head, and being shed into the Membranous parts, bre●ds those pains. Which pains are sometimes, pricking, smarting, and sore as an Ulcer, by reason of the sharpness of the Vapours, or Humours ascending: Sometimes they are stretching, as it were, and swelling, because of the plenty and multiplicity which descend and stretch: Sometimes they are pulsatory pain, beating like the Pulse; when the Vapours or Humours are carried thither in the Arteries, or when the Arteries of some peculiar part of the Head are filled with over hot Blood. The Falling-sickness springs from the womb, being caused by the aforesaid sharp and malignant Vapours, which being possessed with a very great Acrimony and malignity, do vehemently, and sharply smite the Nervous parts, whereby they come to be contracted, and whilst they endeavour to expel what offends them, they draw themselves together, and express these convulsive motions. Palpitation of the Heart, is often caused by the said Vapours, being carried from the womb to the Heart. and provoking the expulsive faculty to the Heart. Also a Pulsation is caused in the Arteries of the Back, and about the short Ribs, by reason of an over hot Blood, carried from the womb into those Arteries, and distending them, whereby their Pulsation becomes greater, which smiting the adjacent parts, causes a feeling of the said Pulsation in them: Yet, sometimes such Pulsations are caused in Hypochondriacal melancholy, which when we come to the Signs of this Disease, we shall distinguish. Divers disorders are likewise raised from the womb in the stomach, liver, and splee●; from the stomach disorders arise, as appetite lost, or more than is fit, or desirous of absurd things; or Hiccoughs, Vomitings, Belchings, & Heart-burnings: all which Symptoms do spring from the aforesaid vapours sent into the stomach by the Hypogastrick, and Caeliack arteries, or other blind passages; & those vapours do stir up this variety of Symptoms, according to the diversity of their Nature, and the different degrees of their putrefaction, and malignity. For by their heat they cause want of appetite, and thirst; but if they be cold they hurt digestion. And the coveting of absurd things (as Chalk, Oatmeal, Smalcoles', Linsey-wolsey cloth, etc.) is caused by the malignant quality of the Humours, and Vapours; as we have showed in our Discouse touching that Symptom: and according to the different kind of malignity it comes to pass that the Patient's appetite inclines her too long, for this, or that odd thing; as some for Coals, others for Clay, or Mortar, Salt, Cinnamon, Nutmegs, etc. And from a certain kind of malignity springs likewise, the loathing of some certain meats; and which is more wonderful, in some hath been observed an universal loathing of all kind of Drink; as Ludovicus Mercatus relates concerning a noble Gentlewoman, which would not away with any Drink, and of another, who though she desired Drink, yet did she Vomit it all up again, being likewise vexed with other grievous Symptoms. Where we may conjecture, that the evil Humours in that Gentlewoman, had attained such a kind of malignity, as that is which causes Water-Fear in such as have been bitten with a Mad-dog. It is, notwithstanding, undeniable, that the diversity of parts into which these Humours, and malignant Vapours are carried, conduce not a little to the variety of the Symptoms. For, If they are carried unto the mouth of the Stomach, they stir up Belchings, and Vomitings; if they stick to the Coats of the Stomach, they induce perpetual inclinations to Vomit; if they are endued with any singular Acrimony, they cause Hiccoughs, or pains of the Stomach; which pains may also arise from the plenty of Humours, weighing heavy upon, and stretching the parts containing. The Liver is easily offended by menstrual Blood retained, and by the Veins ●lowing back thereinto; hence springs the Green-sickness, by reason of bad Blood flowing from the Womb into the Liver, and from the Liver shed abroad into the whole Body. Hence come Swell, Fevers, and other Diseases very many, in the whole Body, and several parts thereof, forasmuch as all of them are nourished by the Liver. But if the vicious Blood aforesaid do flow back from the Womb unto the Spleen, Swell, Stops, and melanchollick, and Hypochondriacal Diseases are wont to be raised. And, To conclude, Women feel divers kinds of pains in their Loins, Thighs, and other parts, which arise from filthy Humours, and Vapours conveyed from the Womb into the said parts: All which Symptoms, taking rise from the Womb, shall be distinguished from others which arise from other parts, and are like them, but produced from different causes; in our following Description of the Signs of this Disease. In the first place therefore, Womb-sickness is known for the most part by what hath already been said of it. For the fore recited Symptoms do appear therein, not all in every one, but some in one Patient, some in another, according to the differing condition of the Causes. Now these Symtoms are, Breathing, depraved so, as, sometimes the Patient seems to be choked; other whiles her breathing is lessened▪ or wholly taken away, without any trouble or Sense of Suffocation; Refrigeration, or cooling of the whole Body, and stopping or Interception of the Pulse; sometimes also a taking away of Sense and motion; sometimes Rave, Convulsions, Swoonings, Vomiting, and Hiccoughs are joined together. But for a more clear Discovery of this Disease, those Signs are first to be propounded, which show the Disease approaching, such as have a noise in their lower Belly (first from the Navel downwards) with belching or inclination to Vomit; Wearinesses, Yawning, and stretchings, proceeding from a flatulent matter, which gins to mount from the Womb into divers parts of the Body; a sad Look pale Face▪ caused by the drawing back of the Natural heat, from those Parts, to its Fountains. When the Disease gathers strength, a sense of strangling gins to trouble the Patient, as if they had swallowed some great morsel which stuck in their Throat. Afterward their breathing stops, and their Suffocation is increased. And in conclusion all▪ their Vital, and Animal actions, are depraved, diminished, or abolished. Hence spring Rave, Convulsions, and other grievous Symptoms. In some the Womb is sensibly tossed and tumbled, and gathered round like a Football; and felt after that manner in divers parts of the lower part of the Body. And when the Hysterical, or Womb-Fit gins to go over, a certain moisture flows out of the Water-gate, their Guts rumble, they lift up their Eyes, redness springs up in their Cheeks, Sense and motion is restored, their Body grows warm, they fetch deep Sighs, and so the Sick-Party by little and little, is freed from her Fit. By the Signs propounded, Womb-sickness may easily be distinguished from such infirmities as are of kin, or otherwise like the same, viz. the Syncope (Swooning-sickness) Apoplexy (blasting Plane●-striking)) and the Falling-sickness: howbeit the difference between Womb-sickness, and those diseases aforesaid is peculiarly to be noted. And in the first place, by three general Signs we may conjecture that these Symptoms which are common to Womb-sickness, and the aforesaid maladies, do proceed rather from the Womb, than from any primary misaffection of the Heart or Brain. The first whereof is, that if the sick Patient be subject to Womb-sickness, and hath been often annoyed with aforesaid Symptoms; when they come afresh, we may conclude the Disease to be no other than Womb-sickness. The second is, That when Women begin to feel those Symptoms, they complain that their Womb is out of order. A third is, That in Womb-sickness Women do feel great ease when stinking things are put to their Noses, and sweet smelling things are put in by the Water-gate, which in those other infirmities falls not out. And the Hysterical, or womb-sickness is more peculiarly distinguished from that which we call Syncope, or the Swooning-Fits, because in the Syncope, the breathing and Pulse do wholly cease; but in the Womb-sickness, it remains in a small measure, till they come into the very height of the Fit, wherein is most danger. Secondly, The Swooning Fits come more quickly, and seize upon the Patient, as it were on a sudden. But in the Womb-fit, there proceed evident tokens of the approaching Fit. Thirdly, The Patient's Face is paler in the Swooning-fits, than in the Womb-fits; yea verily, some Women have a ruddy countenance in their Fits of the Mother, and than the Disease is sufficiently known by that Sign alone. Fourthly, In the Swooning Fits, we find commonly cold, and Diaphoretic Sweats, which in the Womb-fits appear not. Fiftly, The Swooning Fits a●e shorter, and the Patient is soon either well or dead; but the strangling Fits of the Mother last longer, continuing a whole day, or divers days together sometimes. But it is to be remembered, that the Swooning-sickness, and the Womb-fits are sometimes joined together, when the Heart is more grievously afflicted than ordinary, or when the Patient's strength hath been much weakened by protraction of the Disease; and then the Symptoms of both Diseases may be mixed one with another. The Womb-Fit is distinguished from the Apoplexy; First because that in the Wombs-Choaking-Fits, the Joints are not so loosened, neither is the Sense of feeling wholly gone, as in the Apoplexy; but if they be pricked, or have their hairs pulled off, they give a sufficient Sign with their Hands that they feel the pain. Secondly, In persons Apoplectical, Planetstruck (as the simpler sort do phrase it) there is a perpetual snorting of the Patient, but in the Womb-stranglings, not. Thirdly, Womb-strangled Patients when their Fit is over, remember what was done and said, during their extremity; but in the Apoplexy it is not so. It is distinguished from the Falling-sickness; First, Because convulsive motions are not always ●●yned with Hysterical Suffocations; and those that do accompany the womb-Fits, are not so Universal as in the Falling sickness, but molest only one or two members. Secondly. The Pulse is greater in the Fits of the Falling-sickness, than it uses to be when the Patient is well; but in the Mother-Fits it is quite contrary. Thirdly, In the Falling-sickness, the Patient foams at the mouth, but in the Mother-Fits there is no such foaming. Fourthly, In the Falling-sickness, the Patient remembers not what was done to her during the Fit, but in the Mother-sickness she remembers all, as we shown before. Fiftly, Those that have Fits of the Mother, do in the end of the Fit come to themselves like persons awaked from sleep, with a noise in the lower part of the Belly, the Womb as it were becoming quiet, and returning to it's Natural place, and sometime much humour flows from the Womb, which doth not befall such as have the Falling-sickness. We must also inquire how such as are in the Fits of the Mother, may be distinguished from those that are quite dead; seeing many Histories relate that some Women in that Case have been accounted dead, appointed to burial; yea, and some buried. The ways which Authors prescribe to make this trial, are divers: For either they lay teazed wool, or light Feathers upon the Patient's mouth, and if they stir not she is given over for dead; or they apply a bright looking Glass to her mouth, which will be dulled with her breath, if she be yet alive; or they set a cup full of water upon her breast, and if the water stir not, they account the party dead. These Signs do for the most part hold good, but they are not perpetual, neither do they put the matter past dispute; seeing as was said before, some Women in these Fits do live only by Transpiration, as those live-wights which live in holes all the winter, and fetch no breath at all by their mouths. Which though it very seldom falls out, yet it is a very good Caution, not to suffer women which die of this Disease, to be buried till the third day after their death, or at least till they begin to stink. The Signs of the Causes are likewise to be declared; which Causes we have showed to be three, viz. Seed retained and corrupted; Menstrual Blood in like manner retained and corrupted; and vile humours contained in the vessels, or in the cavity of the womb. If this Disease arise from Seed retained, or corrupted, there have preceded all those Causes, which might increase, gather together, and corrupt the Seed in the vessels; as flourishing age, ripe for Generation, or formerly accustomed to the actions thereof, which of late it hath left off; Sanguine complexion, an idle life, and given to pleasures; a rich and plentiful table, with the use of such meats as are easily corrupted. In such persons if the womb-Fits happen, they having their Courses well, we may guess they come from Seed retained. If these womb-Fits depend upon the Menstrual Blood retained and corrupted, as their cause; the Patient's Courses are either wholly stopped, or flow very little, and to no purpose; and she herself is not to seek for carnal Embracements: but well provided; And some Symptoms do attend this suppression, as Melancholy, Waspishness, Sluggishness, Drowsiness, Headache, swelling of the Dugs heaviness of the Loins and Thighs. That this Disease comes from evil Humours is known, by the Patient having her Courses well, being exercised sufficiently with actions of Generation, by her being stepped into years, or being very full of evil Humours, or being troubled with some other Disease in her womb. We must also set down these Signs of those other Symptoms which we formerly described, as springing from the womb. Headache coming from the womb is known, because the Patient hath not her Courses right, the pain does chief trouble her, or is most increased, at, or near the time of her Courses flowing, and her womb is out of order. Also we may distinguish whether an Humour, or a Vapour cause this pain; for if the pain be not great, heavy, and pressing, and come by fits; it comes certainly from a Vapour: but if the pain be continual, joined with heaviness, it shows an Humour contained in the part; which if it be Choleric, the pain is biting, pricking, and acute or sharp; if it be Phlegmatic, it causes sleepiness; if Melancholy, Sadness. Pant of the Heart, and beat of the Arteries about the short Ribs and Back; Diseases of the Stomach, Liver, and Spleen; and divers pains may be conceived to arise from the womb, if these other Signs and Symptoms of the womb affected, before recited, be likewise present. As also, if by putting sweet smelling things to the water-gate, and stinking things to the Nose, the Patient do find some kind of ease. What concerns the Prognostic, or Predictions of this Disease; It it is a malady which seldom kiils the Patients, but use; to stick a long time by them. But sometimes they are in danger of death by reason of swooning fits that happen, or by some extraordinary Convulsion. Likewise if the fits are frequent and hard to be removed, it is to be feared, lest Respiration being so often hurt, the Native heat should be suffocated, and the Patient come to die. The Womb-paision is worst, in which more parts are drawn into consent; and that is bad which springs from corrupted Seed, or from a long suppression of the monthly Courses. In Elderly persons, this Disease is hardly curable, because of that plenty of Corruption wherewith they are wont to abound. In younger Women, it commonly ceases when they begin to bring forth Children. In Women with Child, and that lie in Childbed, it is a dangerous Disease; in the former, for fear of Miscarriage; in the latter, because of their weakness after Childbearing. For a Woman troubled with these Womb-fits, to sneeze is good, for it signifies strength of Brain; and by the motion of sneezing, the Malignant Vapours which besiege the Brain, are discussed; and likewise the vicious Humours contained in the Womb evacuated. A twofold Cure belongs to this Infirmity: one in the fit, another out of the fit. In the fit, those vapours which cause it are to be discussed and drawn back from the part affected; the Humours contained in the Womb which send up those Vapours, must be voided; and the Womb when it is removed out of its proper place (which often happens according to Hypocrates) must be restored to the same again. First therefore, The sick party must be laid upon a bed in such a posture, that her Neck and Shoulders lie high and sloaping, but her Thighs and Privy parts lie low and shooting downwards, for so the Womb is more easily reduced. Then must her lower parts be tied very hard, so as to cause pain; likewise they must be well rubbed and chased; also Cupping-glasses are to be set upon her Hips; and a very large Cupping-glass set upon her Share is very profitable. But take heed that you do not apply a Cupping-glass upon the Patient's Navel, which many ignorantly are wont to do, for by that means the Womb is drawn upwards again. When Convulsions happen, or swooning fits, hard rubbings with course are good upon the sols of the Feet, also with Vinegar and Salt; it is good likewise to pluck off some Hairs from the Head and Share, to cramp the fingers or the Patient, whoop aloud in her ears, and such like. It is also good to lay unto the sols of her Feet, this Epispastick, or drawing Cataplasm or Pultis. Take Leaves of Artemisia (Mugwort) Feaverfew, Rhue, of each a handful: Sage, half a handful: Pigeons dung powdered three ounces: Black Soap an ounce and an half: Amber, Frankincense, Masticb powdered, of each a dram and an half: Juice of Rue, and Vinegar, allayed with Water, as much as sufficeth to make all into a Cataplasm. At the same time, stinking and strong smelling things are to be put unto her Nose; as Partridge feathers burnt, old Leather burnt, and Brimstone fired, Jet or Agate Oil, a Pomander of Assafoetida, Castoreum, Galbanum, Rue, moistened with Syrup of Artemisia, or with Vinegar; Garlands of Rue, Tanzie, Wormwood. But if the Woman be Epileptic, or subject to the Falling-sickness, we must abstain from the stronger things before mentioned, because the Brain being therewith offended, is put into a Commotion, by which means the Humours are tumbled suddenly into the Ventricles thereof, and the Syptomes are made more grievous. The smoke of Tobacco blown into the Mouth and Nostrils of the Patient, does quickly free her from the fit. Contrariwise, sweet smelling things must be put unto the Womb, as some grains of Musk or Civet wrapped in Cotton-wool. The following Powder may be blown up her Nostrils. Take white Pepper, Mustard seed, Pellitory, Castoreum, of each one scruple; make it into a very fine Powder. If the Patient be very much oppressed with her fit, let her be provoked to sneeze, according to that Aphorism of Hypocrates, his 5. Section, 35. To a Woman troubled with Womb-fits, or hard Labour, if she happen to sneeze it is good. Neezing is many times provoked by the foresaid Powder; and if that alone will not do it, a little white Hellebore, or Euphorbium may be added. Also Oil of Amber or Agates, may be anointed upon her Nostrils. But laxative and wind-expelling Clysters do exceed all other Medicaments, in discussing such filthy Vapours as cause the fit: which may be made after this manner: Take Mercury Leaves, Pellitory of the wall, Mugwort, Penyroyal, Rue, Calaminth, of each one handful: Caraway seeds, Cummin seeds, and Bayberries, of each two drams: Boyl all to a pint and an half. In the straining dissolve Hiera Picra, and Benedicta laxativa, of each six drams: Oil of Rue three ounces: Camphire half a scruple. Mix all into a Clyster. If the first Clyster be not sufficient, another must be given of the same or such like Decoction, dissolving therein, Diaphoenicon ten drams: Turpentine dissolved with the white of an Egg one ounce: the aforesaid Oil, and half a scruple of Camphire dissolved in Oil of Water lilies. And in a word, The Disease continuing, a third Clyster must be given merely Hysterical and discussing, but not purging, which will be very effectual, compounded after this manner: Take Oil of Rue four ounces: Aqua vitae one ounce: Canary Sack three quarters of a pint: Galbanum two drams: Mix all, and make a Clyster, and administer the same after a Laxative Clyster. A Clyster of Vinegar, tempered with Water, does presently assuage the Mother-sit, by compressing and coagulating the vapours, which cause the same. The same does a draught of Vinegar allayed with water, being taken in at the mouth. Authors do likewise counsel that the Patient's belly above the Navel, be strongly girt with a swathband, that the womb may be thereby reduced, and the vapours hindered from ascending. Concerning letting blood, it is a great question, Whether it be convenient in the sit, or no? For seeing there is at that time a great weakness in the Patient and sometimes despair of life, and the body is cooled all over by malignant vapours which infest the Brain and Heart, which can no ways be expelled by blood-letting; no question the use thereof is very dangerous during the fits. And of this Opinion are Varandaeus and Sennertus. But Mercatus and Rodericus a Castro, do determine contrarily, That a Vein ought to be opened in the Patient's Ankle or Instep, when the Disease springs from an abundance of Menstrual blood retained; and that the Patient's strength oppressed with the burden, the passages obstructed with too much blood, and the danger of suffocation hence arising, can be remedied by no other means but bleeding; seeing in this case, neither stinking smells, nor sweet smells, nor Cupping-Glasses, can bring the Patient out of her fit. Philippus Hoechstetterus in the second part of his Observations, makes it appear by certain Histories, that bleeding in the Foot hath done much good: Insomuch, as a certain Nun, which had been speechless, and in Convulsion fits for two days together, two hours after she had bled began to speak, and to eat and drink. jam of Opinion, a Vein may be opened, if the Pulse be strong, and there be evident tokens that blood doth superabound: But if the Pulse be weak, we must forbear, and stay till the fit is over for a more convenient season, in which blood may be safely taken away. Plasters are profitably applied under the Navel of the Mass of Emplastrum Ceroneum, which mollifies and discusseth, and so is better than the vulgar Womb-Plaister, which doth somewhat bind, and therefore may retain the vapours and malignant humours. Plasters are likewise made of Galbanum and Assafoetida, or of Caranna, and Tacamahaca, either alone, or with some Spices mingled with them. As for Example: Take Gum Caranna half an ounce: Powder of Nutmegs, and Cloves, of each half a dram: Oil of Amber four drops: Turpentine two drams. Make all into a Plaster. Such Plasters are to be in fashion of a Shield or Scutcheon. and in the pointed part of the Plaster, which must be laid towards the Water-gate, some of Musk or Civet are to be put, that they may send forth a sweet smell, and thereby allure the Womb back again. Three grains of Musk may be put in a little Cotton, moistened with Oil, and thrust into the hole of the Navel: then lay on a final Plaster of dissolved Galbanum. This some Women for a Secret. Or four grains of Camphire may be dissolved in Oil of sweet Almonds, and put into the Navel, and a Diapalma Plaster laid over it. If the Disease seem to be fostered by plenty of wind and vapours, Fomentations and Baths will be good, of the Decoction of Rue, Mugwort, Time, and Calaminth, Fennel seed, Annis seed Cummin seed, Bay-berries, Chamomel Flowers, Dill flowers, etc. Also little bags may be prepared with Cummin seed, Annis seed, Carrot seed, Salt, Rue, Bran, in them, and applied very hot, and often renewed Or, Take Oil of Rue four ounces: Spirit of Turpentine half an ounce: Mingle them, and dip therein a piece of Bread hot out of the Oven, and lay it upon the Navel. Also it will be good to anoint the lower part of the belly, the Region of the womb, Share, and Loins; because such anointings do dilate the Passages, attenuate the Vapours, and discuss them. They may be made of Nard Oil, Spike Oil, Oil of Dill, Sesamine, Saffron, Lilies, and Sweet Almonds. Authors do very much commend a fume of the warts which grow upon Horses Legs; which being dried in an Oven, and beaten to Powder, they are burnt under the Noses of women in these fits as a present Remedy, whereby women are wont to be in an instant delivered of their fits, to the admiration of the bystanders. If the Disease spring from Retention of Seed, nothing is better than carnal Conjunction, as soon as the Patient is out of her fit, if she be married. Instead of carnal Conjunction, where that cannot he had, many advice that the Patient be rubbed and tickled by a Midwife in the Neck of her womb, into which the Midwife must put her fingers anointed with Oils of Spices, that so the offensive Sperm may be voided. But seeing that cannot be done without wickedness (understand by a silly superstitious Papist, that counts it a meritorious good work to burn Mother and Child in her womb alive, as at Jersey, and a wickedness to free a sick body of a little offensive humour) a Christian Physician must never prescribe the same. To Discuss those malignant Vapours which cause the womb-fit, many Medicines are wont to be given down the Throat, among which is a dram of old Venice Treacle, with water of Mugwort, Penyroyal, and Balm; Troches of myrrh, to the quantity of two scruples: or Oil of Amber to five or six drops, with the said Liquors. Pills are frequently used; the best are made after this manner. Take Castorium, Myrrh, Assa-foetida, of each one scruple: faecula Brioniae half a scruple: seeds of Rue and Saffron, of each seven grains: with Syrup of Mugwort make twelve pills. Let her take three or four; if she cannot swallow them, let them be dissolved in Water of Mugwort. These following Pills are good in a violent fit, which they are wont to remedy without fail. Take Assafaetida one scruple: Castoreum six grains: Laudanum three grains; make all into three or four Pills. Let her take them presently. Pilulae Faetidae majores, although they be purging, yet are they given to good purpose in the Fit, to half a dram. For they gently evacuate, and are not wont to work till the fit be over; so that there is no danger in their working. Also many waters are wont to be given in the fit, viz. Aqua vitae, Cinnamon water, or Treacle water. Or a specifical water may be made after this manner. Take Zedoary roots, Carrot seeds▪ Lovage roots, of each two ounces: red Myrrh, Castoreum of each half an ounce: Peony roots four ounces: Misleto of the Oak gathered at the wain of the Moon, three ounces: power upon all these being prepared, four pints and an half of Feaver-fewwater. Spirit of Wine half a pint; let them digest three days, and afterward still them. The dose is a spoonful, by itself, or with some other convenient liquor. A more easy water to make, more pleasant to taste, and no less effectual is this following. Take of the juices of Bawm, and Borrage clarified, of each two pints▪ the best Saffron one dram. Let them be infused, and distilled in Balneo. The Dose is a spoonful with Broth. This following potion is vulgarly used. Take of Cinnamon Water half an ounce: Turnip Water four ounces: Castoreum four grains. Make all into a potion, or draught. Oil of Amber given to three or four drops, in Orenge-flower-water, or some other specifical, doth quickly rid away the womb-fit. The following potion is wont to do very much good, as it is to be seen in our observations. Take Water of Mugwort, Roses, and Orenge-flowers, of each one ounce: ●●nnamon Water three drams: Conjection of Hyacinth stone one dram: Diamargaritum frigidum (that is the cooler perled powder) half a scruple: Saffron four grains. Make them all into a potion. Orange flower water doth good alone, given three or four ounces; but mingled with Musk, and Dragon's blood, it doth wonders: witness Solenander in these words. A certain Woman was vexed with knost cruel Symptoms, Headache, Belchings, contraction of the Body, pain ●●her Groin, grinding of her Teeth; sometimes falling to the ground speechless, with her mouth shut, so as she could not open it; and all this through disorder of her Womb. Many remedies being used in vain, a certain old Woman comes, and gives her thirteen grains of Musk, and as many of common Dragon's blood, in four ounces of Orenge-flower Water; she was cured, and never felt the like griefs any more. I have in the like case given the same Medicine divers times, and always with good effect. An Elks Claw is also very good in these fits, according to the experiment of Appollonius Menabeus in his Treatise of the Elk, Chap. 10▪ in these words. I confess I have both heard from others, and found by my own Experience, that an Elks Claw is a present remedy for the Suffocation of the Mother. For being called to help a Woman in those Fits, I gave her the raspings of the Elks Claw with Zedoary, with which, and with other remedies administered according to the rule of Art, I did the Cure with Honor. And when I understood, that she was wont to be troubled with those Fits oftentimes, I enjoined her to wear a piece of Elks Claw continually about her Neck: Which when she diligently observed, for the space of three months that I was in the place, she was ever free from those Fits, and gave me often times thanks for my advice. Camphire fired, and cast into the water, and there abiding till it be quenched, is an excellent Remedy, given to the quantity of a dram. The Cats-tails of the walnut, in the Epistles collected by Laurence Scholtzius, in the Letter written from Thomas Mouset to Peter Monavius, are extolled with this Commedation. In Srangulation▪ of the Womb, the Cats-tails of the Walnut tree, are a singular Medicine being dried, and powdered. You may give two scruples with two drops of Oil of Amber. I never knew any thing more excellent in that Disease. Two most excellent Remedies may be made in the form of Powders, which I have oftentimes tried. The one is of the Afterbirth of a woman that lies in of her first Child, dried in the Chimney, and beaten to powder. The Dose is a dram in some convenient liquor. It presently takes away the fit. The other is made of two parts of Brimstone, and one of Nutmeg. Powder them and give a dram. Powder of Jet given to half a dram, or one dram, will do much. The Powder of Elderberries of Quercetanus taken a dram in Wine, cures the Eplilepsie, or Falling-sickness, by consent of the Womb, and being taken the second time, makes that the fits return not. Where that Powder cannot be had, the same quantity of Soot from the Chimney, may be given in an Egg soft boiled. And because the Womb is oftentimes filled with evil, and Excrementious Humours, from whence ugly Vapours are raised up; we must be careful to purge the same, which may be most conveniently done by this following pessary. Take Diaphoenicon one dram: powder of Hiera picra half a dram: Turpentine three drams: mix all, and with Tow make a Pessary. For her ordinary drink let the Patient drink a thin weak Decoction of Cinnamon, Caraway, or Annis seeds. Touching Wine, It is a question whether it may be given a Woman in these fits. Hypocrates in his first Book of the Nature of Women seems to commend the same: and there is much reason to back his opinion. For an extreme refrigeration of the Body, and Languishment of natural strength, cannot be better helped, than by giving the Patiented a Cup of rich Canary. But Avicenna wholly forbids it. And indeed, Because this Disease depends for the most part upon Seed retained, or of Blood and foul Vapours carried up from the Womb: Wine by its thinness, and exceeding piercing faculty, doth more exagitate and vex the morbifical matter. Whence we see by common Experience, that Women troubled with this Disease, are worse if Wine be given in their fits. To Compose this Contention, we say; that Wine ordinarily is not to be given during the fit, but upon extraordinary occasion: Namely when the Patient's strength is extremely decayed, she hath Swooning fits joined with the Mother fits, or seems to be at the last gasp: all other Remedies tried in vain, we make use of Wine as our last Refuge, and present help. In this Cure we must be very careful, if the Patient be with Child, and prudent in our administration of Medicaments; neither must we use those more vehement and stinking ones, lest we cause miscarriage; and we must perform the Cure rather by outward than inward Medicaments. In the Course of the Cure, care must be taken of the Heart and Brain, and if they seem much oppressed, they must be relieved by such Medicines as are proper unto them. To the Heart, Wine, and Orange-flower-water, or Imperial water, or Treacle of Andromachus dissolved in Wine, must be applied by wetting things therein, and laying them upon the Region thereof; or hot living Creatures are to be applied thereunto. For to strengthen the Head, those Remedies must be used, which are set down in our Chapter of sleepy Diseases. When the fit is over, Care must be taken to prevent the return thereof, either wholly, or at least for a long time: which is done by a removal of the Causes, and by strengthening the Womb. In the first place therefore at a convenient season; but especially in the Spring and Fall, the Patient must be yearly evacuated, beginning with a purging Potion, or some other Medicament suitable to the nature of the Patient; always adding Hysterical things. And then, If Blood seem superfluous, it must be drawn first out of the Arm, and then out of the Foot; choosing as near as possibly the middle space between the Patients monthly purgations. Afterwards, That the redundancy of evil Humours may be sufficiently prepared and purged out, an Apozeme must be compounded, altering, opening, and purging, to be given at four or five times. If Nature seem to incline to the opening of the Hemorrhoids, they must be opened by application of Leeches. And Mercatus doth witness in his 13. and 14. Counsel, that they have much profited in these fits. After general purgation, to discuss the remainders of the morbifical matter, a sweeting Decoction will be good to give divers days together; made of Sassafras, Guajacum, with seeds of Fennel, Rue, and Agnus Castus. To the same intent Sulphurous, and Bitumenous Baths will be very good, such as we have at Baleruca, by whose use many are helped, as daily experience shows. In this Disease being of long continuance, besides the remedies aforesaid, it will be good to purge the Patient frequently, by usual Pills, Syrups or Potions. Which may be made after this manner. Take Troches of Agarick one dram and an half: Hiera of Coloquintida one dram: Carrot seed, Agnus Castus seed of each one scruple: myrrh, Costoreum, Diagrydium of each half a scruple: Turpentine, as much as shall suffice to make all into a Mass. Let her take hereof half a dram, or two scruples twice or thrice in a month. The following Syrup is mightily extolled by Mercatus, as a wonderful Syrup, and very profitable for all womb-sick women. in his 13. Counsel. Take Juice of Herb Mercury and the Cream of Carthamus' seeds of each six ounces: Scorzonera water seven ounces Sugar as much as shall suffice to make it into a Syrup. Add hereunto while it boils, Confection of the Hyacinth stone, Confection of Rermes Berries, and Powder of the Electuary de Gemmis [that is, made of precious Stones] of each two drams: Let the Dose be two or three ounces. Take Briony Roots three drams, Senna Leaves half an ounce: Agarick two scruples: Ginger one scruple: Cinnamon one dram: Let them steep all night in Fountain water. In the straining mix one ounce: of syrup of Damask Roses. Make hereof a potion to be taken twice or thrice in a month. Pilulae foetidae majores [that is strong smelling Pills made of Gums] taken twice in a month to half a dram, are very profitable. In such as easily vomit, it is good to provok to cast, once or twice in a month, after this manner: Take Agarick cakes [troches of Agarick] one dram and an half: Oxymel one ounce: Bawm water, and Mugwort water, of each three ounces: Mix all into a vomiting Potion. Chemists give salt of Vitriol in some appropriate water, from half a dram to one dram, and cry it up for a specific remedy in womb-fits. After all particular evacuations are ended (that is after each evacuation) some strengtheners are to be administered, such as this following Electuary. Take Conserve of Rosemary flowers Betony, and Bawm, of each one ounce and an half: Species of the musked Electuary, and of Electuary of Calaminth of each half a dram: With syrup of Mugwort Make all into an Electuary. Treacle by itself is very proper for this occasion, which for hotter constitutions may be tempered by the mixture of Conserve of water Lilies, Maidenhair etc. But the following powder is far more effectual, which heals old and stubborn womb-fits, if it be frequently taken one dram at a time, in Wine, in a bolus or morsel made up with syrup of Mugwort. Take Gentian Roots, white Dictamnus, tormentil, pellitory, Rhaponticum, Bistort, Aristolochia, or Birthwort the rounder, Chameleon thistle, Bay-berries, Angelica, Master-wort, Coriander seeds prepared, annis seed, juniper berries, Mastic, Bole armoniac, Terra Sigillata, of each two drams and an half: Oriental Saffron three ounces and an half. Make all into a fine powder, and keep it in a close vessel. Neither must we omit such Medicaments, which are wont to help these fits by a peculiar property thought to be in them: An Example whereof may be this that follows, made in Pills, because of the ungrateful taste of the Simples. Take Assafoetida half a scruple: Castoreum, Myrrh, Galbanum, Sagapenum, of each one scruple. With Honey of Mercury make a Mass; of which give the Patient half a scruple, or a scruple frequently. Platerus makes Pills of extremely odoriferous Ingredients, after this manner: Take of Musk six grains: Benjamin half a dram: Sugar one dram: With Cinnamon Water make them into a Mass for Pills. The Dose is half a scruple. Those Hysterical Waters before set down to be given in the fits, may likewise be profitably used out of the fits, a spoonful or two in a morning, when the Patient is free, by way of prevention. Mathiolus extremely commends the Briony Root, in these words: Briony doth wonderfully help Women subject to strangulations of the Womb, so as to free them from their choking fits, and cure them. Truly I knew a Woman, daily almost vexed with these fits for a year together, who being at last taught by an ordinary Herb-man, to drink white Wine, wherein an ounce of Briony Root had been boiled, once in a week, when she was going to bed: when she had used this Medicine for a year together, she was perfectly recovered of that Disease. The Liver of a Wolf dried, and one dram taken, may prevent the fits of the Falling-sickness proceeding from the Mother, if it be given three or four times after an ordinary Purgation. The Chemists do commend Vitriolum Martis [that is, Vitriolated Steel, or chalybeated Vitriol, or Salt of Steel] whereof they give a grain or two, with a double quantity of Sugar, many days together, in Wine or other fitting Liquor. And the Truth is, it may be given to twelve, fifteen, and twenty grains in some convenient Conserve; or it may be made into Pills, with Mucilage of Gum Tragacanth. Cream of Tartar frequently taken, is also very good in the Cure of this Disease. These two Medicines do good, not only by opening, but also by cooling; for oftentimes an hot distemper is rooted in the womb of Women subject to this Disease, arising from Blood retained within its Veins, and overheated; as Galen says in Hypochondriacal Melancholy, That there is a burning distemper in the Parts under the short Ribs, by reason of blood retained in them by obstructions, and there overheated. Those things therefore which have power to cool the Womb, are very proper in this case, such as are Baths to sit in, Vinegar and Water mingled and drunk down, or injected, and such like. Unto which we may add the History related by Dr. Harvey, touching the Childing of a woman long afflicted with womb-fits, not curable by all that could be done; who at length, after many years, was cured by means of the falling out of her womb: Because her Womb exposed to the Air was cooled, and so its Inflammation and hot distemper was repressed. Also the use of Steel itself is much commended by some Practitioners, as very convenient for all Infirmities of the Womb. Whose Preparations look for in our Cure of Obstructions of the Liver. Issues made in the Thighs, are likewise very good. For they derive and turn aside evil Humours from the womb, by reason of those Veins which are common to the womb and Thighs. Neither are Annulets to be neglected, fastened about the Patient's Neck, and hanging down upon her Navel, as we formerly mentioned touching the Elks Claw, good in this case. Some commend Peucedanum, or Hog-fennel root, hung in a string about the Neck. And our women do with good success, wear a piece of Assafoetida in a thin rag of cloth. I have known some that have worn a Fox's Pizzle and Stones dried, tied about their Neck in a string, and resting upon their Navel, and by that means preserved themselves from the womb-fits. Some wear a piece of Wolf's flesh dried, or of the Liver of a Wolf, not without profit. As for external Remedies after every Purge, or at least once in a month, eight or ten days before the monthly Purgations of blood, Fomentations or Baths to sit in will be good, that the Humour causing this Disease being resolved, may more easily find its way by the opened Passages of the Courses, and flow out with them. They may be made of the Roots of Marsh-mallows, Briony Roots, Orris Roots, Madder, Valerian, Angelica, Mugwort Leaves, Nep, Feverfew, Bawm, Bayberries, and such like. To discuss the remainders of the Matter causing the Disease, and to strengthen the Womb after Fomentation, or fitting in a Bath, as aforesaid, the following Plaster may be said on under the Navel. Take Gum Tacamahacca and Caranna, of each two drams: Alipta Moschata half an ounce: Agnus Castus seeds, one dram and an half: of each of the half a dram: Turpentine, Labdanum, Wax, of each as much as shall suffice to make a Plaster. If this Disease arise from the Seed retained, use those Remedies which we have formerly set down to quench and discuss Seed in our Cure of Womb-Fury. Chap. 7. Of Inflammation of the Womb. Inflammation of the Womb, is a Tumour or swelling of that Part, springing from blood that is shed into the substance thereof. And the said Inflammation possesses either the whole Womb, or some part thereof; and it is produced either by pure blood, and is called merely Phlegmont, an Inflammation; or it comes from blood mingled with Choler, and it is called Phlegmone erysipelatodes, a choleric Inflammation of kin to the Rose, or St. Anthony's fire; or it hath its original from blood mingled with phlegm, and is called Phlegmone oedematodes, a phlegmatic Inflammation; or it comes from blood mingled with Melancholy, and is called Phlegmone Scirrhodes, which is a Melanchollick Inflammation or Swelling. The Causes which produce or increase this Disease, may be divers; viz. A Sanguine Constitution over loaded with blood, or infected with choler; a natural looseness of the womb with wideness of the passages, air extreme hot, inflaming the humours, or very cold compacting & knitting them together, and so stopping the monthly Courses flowing, or ready to flow; vehement Exercise, immoderate carnal Conjunctions, a blow or fall lighting upon the Wombs Quarters; Perturbations of Mind more violent than ordinary, especially wrath; acrimonious or sharp vehement meats, of a hot nature, and whatever else is taken in of a fretting and vehement operation, as Authors report of Cantharideses, That they are very hurtful as well to the womb as the bladder; sharp Pessaries long time used, or purging Medicines, or strong alteratives, such as barren women are wont to take and rend from all quarters; Retention of the Courses increasing the over fullness of blood; or over great flux of Courses relaxing the Passages, and bringing the Humours from all the parts of the Body to the Womb; likewise Cupping-glasses fastened about the privy parts, may violently draw the blood and humours unto the Region of the Womb, and there detain them. Laborsom Childbirth may cause as much; Abortion, a violent handling of the parts of Generation by an unskilful Midwise; and a troublesome inconvenient bearing of a Child in the Womb. The Signs to know the Disease by, are, Swelling, Heat, and Pain in the Region of the Womb, with a continual Fever. But because the straight Gut (that is, that which is united to the Dung-gate) and the Bladder, do lodge in the same quarters with the Womb, therefore must we distinguish this Disease by other signs: such are, Suppression or diminution of the Courses, and their paleness or yellowish citrine colour, with pain in their coming forth; and in the absence of the Courses certain stinking and rotten stuff sweats through the Vessels of the Womb, and bedews the Water-gate. Whereinto if search be made, it will plainly discover the Disease; for the inner mouth of the womb will be sound to swell, to be drawn inwards, and subject to pain if touched; the neck of the womb will appear red and inflamed, the Veins dispersed therethrough, strutting with blood. If the whole Womb be inflamed, all Symptoms will be more vehement. If the Inflammation be rather in the neck of the womb, the heat and pain is spread most towards the groins and the Water-Gate. If the former side of the womb do suffer, the Bladders fellow-seeing will be the greater: If the hinder side of the Womb be inflamed, the straight Gut will be more compassionate, and the pain will stretch itself towards the Loins. If the right or left side of the womb be inflamed, the heat and pain will appear most about the one Groin; and the Thigh of the same side will be heavy, and as it were in a sort burdened. The Signs of the Causes are these. If the Inflammation spring from pure blood, all the Symptoms are milder; but if there be Choler mingled therewith, the Fever is more burning, and all the Symptoms are more vehement; but if the blood be Phlegmatic or Melanchollick, the Fever will be less acute, but the Disease more lasting, and more stubborn. And here we are to consider such Signs as may inform us what Humour is most predominant in the whole Body. If the Inflammation turn to an Imposthume and gather Matter, the pain and Fever are increased, and shaking sits come without any certain course, yet commonly they take their turn about Evening. And all the other Symptoms are heightened. When Suppression is accomplished, all the Symptoms are mitigated, and Swelling rises higher, whereby sometimes the Excrement of the Guts, or Urine is stopped. But if the Inflammation be discussed without Suppuration, the Swelling lessons, and the Symptoms becomes gentler. If it turn to a Scirrhus (that is, hard swelling) the Fever, Pain, and other Symptoms are diminished; the Swelling abides, becomes harder; likewise the weight and heaviness remain, both in the womb, and the adjacent parts, so that the Patient can hardly stir herself. A good Prognostic cannot be made of this Disease because it is very dangerous, and for the most part deadly. But more or less danger is threatened according to the greatness of the Disease, its Causes and Symptoms, as thus: If the Inflammation possess the whole Womb, it's a desperate Disease; but if only a part be inflamed, there is some hope of help. If a Woman with Child have a Choleric swelling in her womb, its deadly. Hipp. Aphor. 43. Sect. 5. For the Child dies by reason of the greatness of the Inflammation, whereupon follows Abortion, which coming upon the back of a grievous disease, kills the Mother. Galen in his Comments upon this Aphorism, doubts if this be not true of every Inflammation of the womb as well as of the Choleric, and whether it be possible that a Child in such a case can live. Inflammation of the womb easily degenerates into a Gangrene, Because the womb, as it were the Body's Close-stool, receives a mighty charge of nasty Excrements, by which the inbred heat is easily suffocated. Rave, turning of the womb, Hiccoughs, Coldness of the Hands and Feet, Diaphoretick sweat seizing on a woman in this Disease, do portend sudden death. If an Inflammation of the womb come to Suppuration, its hopeful that it may be cured; but a foul Ulcer will follow, which will make the Patient to pine away with a linger Fever, or to fall into the Dropsy. If the Inflammation turn into a Scirrhus, the evil becomes lasting, and often brings a Dropsy. To cure this Infirmity, the Course of the Blood to the Womb is to be drawn back, it is to be driven from the womb, it is to be diverted another way: that which is flown in and contained in the part, is to be resolved. And if the swelling tend to suppuration, it is to be furthered, and when it is broken, the Matter or Quittor must be voided out; Which may be done by the following Remedies. An Emollient and cooling Clyster being premised, let Blood be drawn from the Basilick Vein of the Arm, on that side on which the Womb is most affected; or from both Arms, if the swelling be in the whole Womb; and let the Blood-letting be repeated twice, thrice, or four times, according to the strength of the Patient, and the greatness of the Inflammation. After sufficient Revulsion, the Disease being come to its height, when there is no longer suspicion of any present flux into the Womb, the lower Veins are to be opened, to derive from the part affected. In which sense we must understand, Galen in his Book of Blood-letting, and in his 13. Book of the Method of Healing, where he teacheth, That in the Inflammation of the Womb, we must open the Veins about the Knees and Ankles. But so long as there remains any Indication of Revulsion, it is better to open the Veins of the Arm. Also to revel or draw back the Humours, Frictions are good, and Ligatures or bindings of the uper parts, and Cupping-Glasses set upon the Shoulders, Loins, and Back. If vicious Humours (especially Choleric) do abound in the Body, which are as it were the Coach of the other Humours to hurry them about the Body; they are to be evacuated with gentle Medicaments, as Syrup of Roses, and Syrup of Violets solutive, Manna, Rhubarb, Catholicon, or Electuary Lenitive; for stronger Medicaments by stirring the Humours over much, would excite the Flux of Humours more abundantly to the part affected. And vomiting Medicaments, though prescribed by Avicenna, seem no way convenient in this case: For if they be mild and gentle, they evacuate nothing to speak of: If they be stronger, they cause a great Agitation in the Body, by which means the Humours being in a Commotion, may flow more plentifully unto the part diseased. In regard of the greatness of the Fever, cooling Medicaments are to be used, as Juleps and Emulsions; whereunto, if very great wake, pain, and tumblings and toss do disquiet the Patient, some Narcoticks may be added, which may likewise be given by themselves. After the First Evacuations, let outward Medicines be applied to the lower part of the Belly, between the Navel and the Share, and about the Kidneys; first of all repelling and cooling things, in the form of a Lineament, an Epithem, and Cataplasm. The Lineament may be made of Oil of Roses washed in Vinegar, or of Ointment of Roses, Ceratum Santalinum, or Galens cooling Ointment, with a little Vinegar added. The Epitheme may be made of the Waters or Decoction of Plantain, Sorrel, Nightshade, the tops of white Poppies and Roses, adding a little , Dragon's Blood, and Terra Sigillata. The Cataplasm or Pultiss may be made of the Crumbs of fine Manchet boiled with Milk, to which a little Oil of Roses may be added, with Juice of Henbane. Nightshade, and the whites of Eggs; or of Barley Meal, Linseed, Fenugreek seed, with Oil of Roses; whereunto likewise the aforesaid Plants being bruised may be added. Injections must be made into the Womb, compounded after this manner: Take Plantain Leaves, Water-lilly Leaves, Nightshade, and Endive, of each one handful: red Roses two pugils. Boyl all till a third part of the Water be consumed: and add to the strainings Oil of Myrtles one ounce: Vinegar half an ounce. Make an Injection. Of the same Herbs bruised with Oil of Roses and Vinegar, Pessaries may be made, and put into the Womb. Neither must Repelling, and Refrigerating Medicaments be long used, lest the Swelling harden and degenerate into a Scirrhus. Wherefore softening and discussing things are to be mingled with the repelling Simples; with this Proviso, That the longer the Inflammation is from its Infancy, the greater must be the quantity of Digestives. So that to the foresaid Medicaments may be added, Mallows, Marsh-mallows, Mugwort, Fenugreek, Chamomel Melilot; their Doses being augmented or diminished, as the case shall require. In the mean while, if the Patient be costive, she must be helped by gentle Purgatives. Yea, and the truth is, frequent Clysters may do a great deal of good to temper the Inflammation, seeing the Womb rests upon the straight Gut, called Intestinum reotum. But let them be little in quantity, that they may be kept the longer, and that they may not compress the Womb; of which this may be an Example. Take Marsh-mallow Roots, the Leaves of Mallows, Violets, Lettuce, of each one handful: Nightshade half a handful: Violet flowers, red Roses, of each a pugil: sour Prunes, ten: boil them in Barley Water. In six ounces of the strained Broth mix three ounces of Oil of Roses, and make all into a Clyster. If the Patient be in great pain, to the aforesaid Clysters may be added, the Yolks of Eggs, the fat of an Hen, Breast-milk, Mucilage of the seeds of Fenugreek, Lin-seed, or Mallows; yea, and a little quantity of Opium, with some Saffron. In such a case, Injections into the Womb may likewise be made, of Goats or Sheep's Milk, with Opium and Saffron, of each three or four grains, and a little Rose Water. Or unto Pessaries may be added a little Opium with a little Saffron, the whites of Eggs, and Oil of Roses. Or Pessaries may be made of Philonium Romanum with Cotton. Or a Fomentation to ease pain, may be prepared on this manner: Take Marsh-mallows Branch and Root, Violet Leaves, of each a handful: Chamomel, Melilot, Roses, of each a pugil. Boyl all for a Fomentation. When the Disease gins to decline, Purgation is to be iterated with gentle Purgatives. And when the Disease tends to a Resolution or Conclusion (which is known by remission of the Symptoms, and because the part is not so oppressed with any Heaviness) Discussives must be used in greater quantity than any of the foregoing Medicaments. Or this Cataplasm may be made. Take Powder of Marsh-mallow Roots one ounce: Chamomel and Melilot flowers, of each two drams: Mugwort Leaves powdered, Barley and Bean meal, of each half an ounce: boil them a little in harsh red Wine; add new Hog's Grease, Oil of Chamomel and Lilies, of each one ounce. Make a Pultiss or Cataplasm. Fomentations and Baths to sit in, may likewise do good in this case. If the swelling cannot be discussed, but seem to tend to suppuration, it is to be furthered by the following Cataplasm: Take Marsh-mallow Roots powdered, Chamomel flowers, Melilot, Meal of Lin-seed, Fenugreek, of each one ounce: fat Figs, eight: boil all to the consistence of a Pultiss. Then add the yolks of four Eggs: Saffron half a scruple: Oil of Lilies and fresh Butter, of each an ounce. Make of all a Cataplasm. When Matter or Quittor is made, which may be known by the abatement of heat and pain, and by a certain inundation perceivable by the touch, the Matter quaking like a quagmire, endeavour must be used to break the Imposthume by moving of the Body, by coughing, by neezing, by fastening Cupping-glasses, by cleansing and attenuating Injections, or by Pessaries that will draw and break. As for Example. Take Goose-Grease half an ounce: Turpentine two drams: Rue seeds powdered, Nitre, Orice Roots, of each half a dram. Mix all, and with Wool make a Pessary. When the Imposthume is broke, we must endeavour to purge out the Quittor or Matter, and to cleanse and consolidate or close up the Ulcer, as shall be showed in the Cure of an Ulcer of the Womb, in the Chapter immediately following. Chap. 8. Of an Ulcer of the Womb. AFter a suppurated Inflammation of the Womb, follows an Ulcer, which likewise depends upon other Causes, namely, so many as may cause an Erosion, fretting, or gnawing the substance of the Womb. The Causes therefore hereof are, An Imposthume breaking, Sharp Humours flowing into the Womb, Sharp and Corrosive Medicines conveyed into the Womb, or taken at the Mouth, as was said before touching Cantharideses or Spanish Flies. The Antecedent Causes are all such things, which we have formerly showed▪ have power to cause an Inflammation, as difficult Childbirth, violent and unbridled Carnal Conjunction, a long flux of Sharp Humours from the Womb, wounds, falls, and bruises, and especially a venomous Gonorrhoea, and the Lechers Pocks, the infection whereof is soon communicated to the Womb, and its Neck. The Differences of this Disease, are taken from the place, the magnitude, the figure and complication with other Infirmities. In respect of the place, that is to say, the several parts of the Womb; the Ulcer is sometimes possessed of the Neck of the Womb, and its inner Orifice; sometimes it is in the bottom, though but seldom. Sometimes, and that most frequently, it seizes the inner surface of the Womb; sometimes, but seldom, it assaults the outer surface; whence it comes to pass, that sometimes the Quittor of these Ulcers comes out by the Bladder or Guts, or if it settle in the Cavity of the Abdomen, Imposthumes arise about the Patient's groins, of which Hypocrates speaks in his 47. Aphor. Sect. 5. In respect of Quantity, some are great, others small Ulcers, according as they take up more or less space in the Womb; which if they be little and superficial, they differ little from the Scab and Itch; but if they be great, grievous, and as it were devouring, they are called by Hypocrates, Nomae, that is, eating Ulcers. In regard of their Figure, Ulcers are called Round, Long, Hollow, or Fistulous, that is, like a Pipe. In regard of Complication with other Infirmities, they are called Phlegmonous, Cancerous, Scirrhous, Painful, Water-bloodish, Poisonous, and Infectious. The Signs of an Ulcer bred in the Womb, are, Pain and biting in the womb or its neck, voiding▪ of snotty Matter or Quittor out of the Womb, which Diagnosis will be more illustrated, if the Causes producing the Ulcer, such as we have mustered up, have preceded. If the Ulcer possess the neck of the womb, it is discerned by the sight, by help of the Womb perspective Instrument; also by the Midwife's hand or in the genial Embracement, in which the Patient feels a troublesome pain, But if the Ulcer be in the bottom of the Womb, the pain is felt about the Share, and the Excrements flow more abundantly. If the Ulcer pierce to the outward surface, the Patient's Urines or Stools appear Matterish, or a Fluctuation is perceived in the Paunch, or a Swelling towards the groins, where it threatens to Imposthumate. If the Ulcer be single and benign, the Quittor is little, white, and not stinking. But if it be malignant and eating, the Quittor will be greenish, Led coloured, and party-colored, coming away with great pain and stink. If it shall arise of the Lechers Pox, Gonorrhoea will usher it in, or attend upon it, and other tokens of the Whoremaster's Pox will appear. For the Prognostics of this Infirmity, Hypocrates in the first Book of women's Sicknesses, says, That no Ulcer in the Womb ought to be slighted, because it is in a part of exquisite feeling, which hath a fellow feeling with the principal parts of the Body, and is very much disposed to receive a flood of Excrements from them. If the Ulcers of the Womb prove Cancerous, Phagedenick, or Wolf-ish [such as we simple people call the Wolf, and tell strange tales about, how it eats flesh, etc.] hollow, or fistulous, they are for the most part incurable, and do vex the poor Patients miserably, all their life long. Ulcers in the Neck of the Womb are more easily cured, because Medicaments may be applied to them immediately. In women that are recovering of this Disease, it is a token of perfect health, if they begin to conceive, and conveniently to receive the Man's Sperm, or if they have their monthly Courses orderly and without pain. The Cure of a womb Ulcer, must tend to hinder the flowing in of such Humours as either beget or cherish the Ulcer, and to cleanse the Ulcer, and cause it to come to a coalition. To which purpose the following Remedies may be used. And first of all, If the Patient be over full of blood, or the Ulcer have an Inflammation joined therewith, a Vein in the Arm must be opened, and repeated so often as there seems danger of a new Fluxion; which is especially to be done when the Patient hath her Courses, that they may flow the less, because they are wont to supply Matter to the Ulcer, and to cause other Humours to flow unto the womb. Also Purgation is very necessary, that the Body may be freed from evil Humours; and it ought to be procured by the gentler sort of Purgatives, as Senna, Rhubarb, Tamarinds, Myrobalans, Catholicum, and such like; and Purgation is often to be repeated, that evil Humours may be diverted from the womb, and it is in this case of such moment, that Forestus witnesseth in the 48. Observation of his 28. Book, That John Tiengius, a Physician of Amsterdam, cured a Gentlewoman of Amsterdam of an Ulcer in her womb, to whom he gave every fourth day, five ounces of the Decoction of Senna, Epithimum, red Roses, and Indian Myrobalans sweetened with Sugar, using to cast cleansing Decoctions, as Injections into her womb. For to be ever in a readiness, This following Magisterial Syrup may be compounded. Take of the greater Comfry Roots, and new Polypody of the Oak, of each one ounce: Citron peels dried, six drams: Leaves of Plantain, Vinca pervinca, Lady's mantle, Sorrel, Maidenhair, of each a handful: Liquoris scraped and split, and Raisins stoned, of each one ounce: Senna cleansed six ounces: Carthamus seeds bruised two ounces: Agarick newly made into Cakes and bound in a Cloth, ten drams: Musk-melone seeds, and Annis seeds, of each three drams: the Cordial Flowers, Rosemary Flowers, and Epithimum, of each one pugil. Make of all a Decoction in Barley Water, in part whereof infuse of choice Rhubarb half an ounce: Cinnamon one dram. In a pint and half of the strained Liquor, dissolve three ounces of the Syrup of Damask Roses, and as much Sugar as shall be requisite to make it into a Syrup perfectly boiled. Of this let her take two or three ounces, twice or thrice in a month with some Decoction of Agrimony and Plantain, or the Infusion of Rhubarb in Endive Water. If the Patient be easy to vomit, a purge upwards by Vomit, is to be preferred before the other, because it draws back the Humours from the womb. In the spaces between purging, a Vulnerary Decoction is long to be used, which may be made after this manner: Take Leaves of Agrimony, Burnet, Knotgrass, Plantain, of each half a handful: China Roots three drams: Coriander seeds one dram: Currence half a dram: red one scruple. Boyl all in the Broth of a Chicken. Let the Patient take of the strained Liquor morning and evening▪ Or, Take Leaves of Mugwort, Plantain, Yarrow, of each one handful: Rhaponticum half an ounce: Agnus Castus seed one dram. Boyl all in a sufficient quantity of white Wine. Sweeten the strained Liquor with Sugar; and give her two or three ounces in a morning, If a Fever urge, and great quantity of bloodyish Quittor be voided, Whey and Milk will be very good; let her take eight ounces or more in a morning, adding a little Honey of Roses, or Sugar. If her flesh begin to fall a way, with tokens of an Hectic Fever, Milk, especially Ass' Milk, must be given with Sugar of Roses for a whole month. Sweat-provoking Medicines may likewise do good where there is no Inflammation, nor hot distemper, to dry the Ulcer, and to revel the serous humours towards the habit of the Body. Turpentine washed in some convenient water for the womb, as of Mugwort or Feaverfew; or in some water respecting the Ulcer, as of Plantain, and red Roses, taken now and then with Sugar of Roses, doth cleanse and consolidate or fill up the Ulcer. Pills of Bdellium given to a dram at a time, or every day, or once in two days one scruple, do very much good, and stop the blood in case it flow. Or new Pills may be made on purpose, to be used after the same manner, thus: Take Bdellium three drams: Myrrh, Frankincense, of each one dram: Sarcocella, Storax, Amber, Cheb-Myrobalans, of each half a dram: red Coral two scruples. With Syrup of Poppies make a Mass fit for Pills, whereunto, in case of extreme pain, a little Opium may be added. Trochisci Alkekengi [Cakes compounded with Winter-Cherries, of which consult my London Dispensatory] with Opium, are likewise (being powdered) given to drink down, where the Patient is troubled with great pain. Also to mitigate pain, the same Remedies may be used, which we prescribed for that intent, in our discourse of the Inflammation of the womb. This following Powder is very effectual to dry up the Ulcer: Take Acacia, Juice of Hypocistis, of each one dram: Dragons blood, fine Starch, Plantain Roots, Birthwort, or round Aristolochia Roots, of each half a dram: Bole Armoniac one dram: Mastich, Sarcocolla, of each half a dram. Make all into a most fine Powder, whose Doses let be one dram, with Plantain water, red Rose water, or water wherein Steel hath been often quenched. Zacutus Lusitanus in the 87. Observation, and the 88 of his second Book, propounds an Electuary and a Water, wherewith he witnesseth that he had cured Ulcers of the womb judged incurable. Any one may find the Description of them in the places above cited. To cleanse, dry, and fill up the Ulcer, divers sorts of Injections are usually made; which are nevertheless, not to be used, until the Inflammation be first taken away, which is oftentimes attendant upon these kind of Ulcers; and until the pain be assuaged, which is not only very troublesome, but also by vexing the part, it is wont to increase the flux of Humours. In regard therefore of that same Inflammation and sharpness of Humours, let Emulsions of the cooling Seeds, Whey of Goat's Milk, or Milk itself, either alone, or mingled with the Juice of Plantain and Shepheards-purse; or if need be, a Decoction of Poppy heads, and the tops of Mallows be first of all injected. Some Practitioners are of Opinion, that lukewarm water alone, doth very much good in these cases, if it be often injected. And there is reason for it, seeing by that means the heat and Inflammation of the womb is tempered, the pain is assuaged, and the filth adhering to the Ulcer is washed off. Valescus de Taranta, doth approve of cold water likewise, in these words: I have known (says he) some women, who perceiving they had Ulcers in their wombs, did wash them with cold Water, and then wipe them clean, and dry them with linen , which they did often pr●● in at the Watergate. And by these means often renewed, they came many times to be perfectly cured. The hot distemper taken away, and the pain assuaged, or for the most part diminished, we must proceed to Clensers, first using the more light and easy Clensers, and after the more strong. The gentle Clensers are, Whey taken with Sugar, Barley water sweetened with Sugar, or Honey of Roses, to make it more cleansing; or Hydromel simple (see my Dispensatory, a mixture of water and honey boiled a while together.) For a more strong cleanser, use the Decoction of Barley, Lintels, shaled Beans, and the Leaves of Smallage, Pellitory of the wall, Plantain, boiled together, a little Honey of Roses being added to the straining. When the Ulcer is very foul, the wound-decoction commonly called Aqua Catapultarum, is the best thing that can be used, whose Composition is thus: Take the Roots of Gentian, Rhapontick: Zedoary, and round Aristolochia or Birthwort, of each one ounce: white Wine six pints: boil all till a third part of the Liquor be consumed. In the straining dissolve half a pound of white Sugar. Let it be kept for use as occasion requires. Or the following Decoction may be provided: Take of whole Barley, course Bran, and red Roses, of each one pugil: Leaves of Agrimony, Wormwood, Woodbine, and Smallage, of each one handful: Beans and Lentils, of each three drams: scraped Liquoris, Orice Roots of Florence, and Zedoary, of each two ounces. Boyl all in water, adding towards the end, a little white Wine. If the Ulcers be very stinking and full of rotten Quittor, there may be added to the Decoction, a little Vnguentum Aegyptiacum, Collyrium Lanfranci, or the Powder of dulcified Mercury. When the Ulcer shall be well scoured and cleansed, we must use drying and solidating things, made after this manner. Take the greater Comfry Roots, Bistort Roots, of each one ounce: Leaves of Plantain, Horstail, Shepheards-purse, Lady's Mantle, Mousear, Yarrow, of each one handful: red Rose Leavs half a handful: Boyl all in water, and make thereof an Injection. With the which or like Injection, this following flesh-creating Powder may be mingled. Take the Roots of Orice, Birthwort, great Comfry, of each half an ounce: Myrrh one ounce: Aloes three drams. Make all into Powder, of which half an ounce may be mingled with every Injection. Turpentine washed in Plantain Water to the quantity of two drams, dissolved with Honey and the Yolk of an Egg, will do very much good, mingled with the Injection; and the more if the flesh-creating Powder be also added. The Ointment Pompholygos, de Cerusa, de Plumbo, of each six drams for a Dose, mixed together, are likewise used in Injections. But the Egg-yolk Oil, rubbed about with a Pestle in a Leaden Mortar, is better than all the rest. Fumes received through a close stool, do pierce to the deep Ulcers which are about the bottom of the Womb, and dry them: Which may be thus prepared: Take Frankincense, Myrrh, Mastic, Storax, Juniper, Gum, Labdanum, of each one ounce: Turpentine as much as shall be requisite. Make all into little Cakes for to be burnt under a close stool. In a most stubborn Ulcer, Cinnabarus or Minium being added to the Fume-Cakes, bears away the Bell from all other Medicaments. Also Baths that are drying, Sulphurous, and Allumish, are used in long Ulcers: and Physicians are wont to send their desperate Patients to those Baths, as the last Remedy. It will not likewise be unprofitable to apply convenient Plasters to the Region of the Womb, seeing their virtue can pass to the innermost parts of the womb, by the invisible pores of the Body. If an Ulcer be in the neck of the womb, it must be smeared with scouring and drying Liniments, or Ointments. The Scourers may be made after this manner: Take of the Juice of Smallage two ounces: Honey of Roses one ounce and an half: Turpentine half an ounce: Barley Meal as much as shall seem convenient. Boyl them all gently, and make them into the form of a Lineament or Ointment. Or, Take the round Birthwort half an ounce: Horehound, Centaury the smaller, Agrimony, of each half a handful. Boyl them in a sit quantity of Hydromel. To the strained Liquor add the powder Florentine Orice Root two drams: Barley meal, and clarified Honey, of each as much as shall suffice. Make all into a Lineament or Ointment. And sometimes the Ointment Pompholygos is used, adding thereto, Frankincense, Mastic, Myrrh, Aloes, as the Nature of the Ulcer shall require. When the Ulcer is sufficiently cleansed, a drying and scar-contracting Ointment is to be laid on, which may be thus made: Take Tutty Powder washed half an ounce: Litharge of Gold and Silver, Ceruse, Sareocolla, of each two drams: Oil and Wax as much as will suffice. Make all into an Ointment. It falls out sometimes, That Ulcers of the Womb do penetrate unto the straight Gut, and sometimes unto the Bladder; which is known by the Quittor issuing through the Water-Gate, or the Dung-Gate. If the Quittor or Matter come out by stool, Lenitive, Scouring, and Drying Clysters are to be used; such as we propounded in our Cure of the Bloodyflux. But if the Quittor come away by Urine, gentle Piss-drivers and cooling will be requisite, which may purge out the filth sent into the Bladder, and further the Cure of the Ulcer; such as are, Emulsions of the greater cold Seeds, after which, Turpentine must be used, and other Medicines prescribed for an Ulcer of the Bladder. If the Ulcer degenerate into a Fistula, which chiefly falls out when it opens outwardly towards the Hip, though it may likewise happen in the Womb itself, and its Neck; it is to be considered, which is better for the Patient, to leave that Passage free and open, to which Nature hath been accustomed, and by which she endeavours to disburden herself of manifold Excrements, or to stop the same. If it be judged best to keep it open, a palliative Cure must at least be made, by Purges frequently repeated, and Sweat-provokers are to be administered twice in a year,; also scouring Injections, and strengthening must be used, and Emplastrum D●apalma Divinum▪ and ●uch like Plasters, are to be laid upon it. But if there be hopes to make a perfect Cure, and heal up the Fistula, such Medicines must be applied, as are wont to be used for the cure of other Fistulaes'. If Ulcers happen in the Water-Gate, or in the Cavity of the Womb, by reason of the Lechers Pox, they cannot be Cured without the General Cure of the said Pox. In the performance of which Cure, of many ways, there is none better than Fumigations of Cinnabaris or Minium; for they do not only help to rid the whole Body of that Infection, but being received into the Cavity of the Womb, they do in a peculiar manner hasten the Cure of these kind of Ulcers. Likewise in the Cure of this Disease, by Quicksilvered Ointments, the said Ointments must be conveyed into the inner parts of the Womb. In whatsoever Ulcers of the Womb, if the Neck thereof be molested with an itch, as it often falls out, by reason of a deflux of a sharp and salted Humour into that part; to pacify the said Itch, a Pessary will be good, dipped in Vnguentum Enulatum cum Mercurio; or in Aegyptiacum dissolved in Sea-water, or in Alum water; or in new Butter wherein Quicksilver hath been killed, with some Brimstone mingled. Chap. 9 Of a Scirrhus, or a Painless hard Swelling of the Womb. THe Nature, Sorts, and Causes of a Scirrhus, or hard Swelling in the Womb, are the same which have been set down in our Chapter of the like Swelling in the Liver, and need not in this place be vainly repeated, but must be sought for in the said Chapter. Howbeit among the Antecedent Causes, this is proper to an Hard-Swelling of the Womb, and is very frequent, namely, for women when the flux of their Courses or Childbed purgations are upon them, undiscreetly to expose themselves to the cold Air, or to drink cold water; whereby the flux is stayed, and the retained blood grows thick, and is condensed, and at length produceth a Scirrhus or stony hard Swelling in the Womb. The Signs of such a Swelling bred in the Womb, are, An hardness felt in the Region of the Womb, such as resists the touch, which hardness represents the compass of the Womb; an heaviness in the same place, and a sense of some weight bearing down, especially when the sick woman stands, as though the womb would fall down into the water-Gate; but when they sit or lie, it bears upon the straight Gut with its weight. There is no Fever nor pain; wherein it differs from an Inflammation, or at most there is but very little pain in an imperfect Scirrhus, but in the Womb there is none. If it follow an Inflammation the Fever and pain ceases, the hardness and resistance abiding. If it be in the Body of the Womb, it is easily discerned by handling the parts about the Share; but if it be in the Neck of the womb, it may be perceived by one's finger. It is distinguished from a Mole by the preceding Causes; and because in a Mole, if the Courses flow, they flow disorderly, but in this Hard Swelling they keep their order; and in a Mole, the woman's Dugs strut with Milk, but in the Hard Swelling they are extenuated. As for the Prognostic Signs, Every Scirrhus or hard stony Swelling, is very exceeding hard to cure; for an extreme Hardness once contracted can hardly be softened; also Natural heat is so very weak in that part where there is such a Swelling, that it can very hardly discuss an hard and almost stony substance. A great and unvanquishable Scirrhus, or stony Swelling, doth at length bring the Dropsy to keep him company. A Scirrhus, or stony hard Swelling of the womb, if it be tampered withal with over hot and moist Medicaments, it turns into a Cancer. The Cure of this Disease aims at two things, the Antecedent Cause, and the conjoined or concomitant Cause. In respect of the Antecedent Cause▪ a Vein must be opened, first in the Arms, if the Disease be of no very long continuance; afterward in the lower parts, especially when the Patient's Courses are stopped. The opening of the Hemorrhoid Veins, is also very profitable in this case: For they do both evacuate dreggy blood, and they turn the Humour from the womb, because of the communion which the Veins have with the womb. Purging is likewise necessary, by fits repeated, procured by such Medicines as purge Melancholy, using first the gentler, and then the stronger sort by degrees. And before the Purges, such things must be given as prepare the Melancholy Humour, and open the narrow passages of the Excrements, in the form of Apozems, Juleps, or Broths, according to the disposition of the sick party. And besides the ordinary Openers, Medicines with Steel, must be likewise used, whereby those strongest Obstructions caused by thick and rebellious Humours in the Womb and other parts, may be dissolved. And that superfluous humours may be derived from the womb, Issues may profitably be made in the Thighs, which are to be kept open until the Patients monthly Courses (which are commonly stopped in this Disease) shall return unto their ordinary form, in respect of time, quantity, and quality. In respect of the conjoined Cause, Emollient and Resolving Medicaments are to be applied outwardly, compounded after this manner: Take the Roots of Marsh-mallows and Lilies, of each two ounces: the leaves of Mallows, Violets, Marsh-mallows, Bearsfoot, of each one handful: Leaves of Mugwort, Nep, of each half a handful: Seeds of Line and Fenugreek, of each one ounce: Flowers of Chamomel and Melilot, of each a pugil. Make a Decoction of all, wherewith the Region of the Share, and the Groins must be fomented, a warm sponge being first dipped therein, and then squeezed out, and so laid on, and held to the parts aforesaid. For the greater mollifying, the Decoction may be made in Water and sweet Oil, or in the Broth made of a Weathers Guts. There may also be added to the Decoction, that it may become more powerful, the Roots of Briony and wild Cucumbers; for we must begin with the milder, and proceed to the stronger by Degrees. Of the same Decoction (augmenting the quantity of the Simples) may a Bath be made for the Patient to sit in, which is very effectual in this Case, and more powerful than a Fomentation. also frequent Clysters and Injections into the Womb▪ are to be made of the same Decoction▪ whereunto the Oils of Lilies, Chamomel, or sweet Almonds may be added. Take of the Oil o● Lilies, and sweet Almonds, of each three ounces: Mucilage of Fenugreek seed extracted with white Wine one ounce: Hens, Goose's, and Ducks Fat, of each one ounce and an half: new Butter and Hog's Grease, of each two ounces: Wax and Turpentine as much a● shall suffice▪ Make all into an Ointment. This which follows, is approved in all hard Swell, being described by Rhasis in his Seventh Book, dedicated to King Almansor. Take Bdellium, Ammoniacum, Galbanum, of each equal quantities: Beat them in a Mortar with Oil of Ben, and of Lilies; then add the Mucilages of Fenugreek Seed, Lin-seed, and Figs, in equal quantities. Make all into an Ointment. Of the same Materials, adding Wax, may a most effectual Plaster be made, to be applied to the Region of the Womb, both before and behind. Or a Plaster may be applied made of Emplastrum Diachylum ireatum. A Cataplasm or Pultiss may be made of what remains after the Decoction aforesaid, being beaten and forced through an Hair Searce, adding of the meal of Lin-seed and Fenugreek seed, of each an ounce: six Figs: two drams of Orice Root: half a dram of Saffron: Hens Grease, and Oil of sweet Almonds, of each a sufficient quantity. Make of all a Pultiss. The Bitumenous clay taken out of Brimstone Baths, and such as are Bitumenous, is profitably applied as a Cataplasm. The Fume of the Stone called Pyrites [that is, the Marchasite, or Firestone] being made red hot, and quenched in Vinegar, is by Galen wonderfully extolled for dissolving all stony hard Swell, so that it works like a Charm. In the said Vinegar, Savory and Pellitory may be boiled: but care must be had, lest your Lapis Pyrites prove to be the Stone called Plumbarius, or the Leadstone, which would do very much hurt. Finally, All the Medicines, as well internal as external, which were before described in our Cure of the hard Swell of the Liver and Spleen, may also be useful in this case. Yet must the●e ●edicaments in the whole course of the Cure be moderated and accommodated with the greatest judgement and discretion imaginable, left the hard Swelling become harder; or (which is much wor●e) degenerate into a Cancer, Which all Practitioners fear, when Medicaments are unwarily administered for a long time together: so that it is better sometimes to pause, and give or apply nothing, that we may mark what good is done by the former applications. For it is vain striving, when the Swelling (having lost all sense of feeling) hath put on the Nature of a stone. Chap. 10. Of a Cancer of the Womb. A Cancer is a hard Swelling of the Body or Neck of the Womb, which resists the touch, and causeth a most vehement pain, as it were pricking and cutting the part affected. It is caused by black Choler gathered in that part, or by reason of a Scirrhus, or senseless hard tumour il cured, which easily turns into a Cancer, especially in this part of the Body, by reason of the copious afflux of blood, which being retained in those Veins which are nigh unto the Scirrhus, and not sufficiently evacuated by the monthly purgations, it becomes adust or burned, and acquires a malignant disposition. It is ordinarily reckoned to be of two sorts, Ulcerate, and not Ulcerate. So long as the Morbific matter is of lesser Acrimony and Malignity, it causeth a Cancer not ulcerated▪ but when it grows more sharp by putrefaction or adustion, it doth exulcerate the tumour, and produce an ulcerated Cancer. The Disease may easily be known by the definition propounded; for if an hard Tumour resisting the touch, be felt in the Body of the Womb, or its Neck, causing a pricking and cutting pain, we may pronounce boldly that it is a Cancer, Yet it is more evidently distinguished by the eyesight, when it may be seen as in the Neck of the Womb it may be, with help of a Womb-perspective Instrument; for we shall see an uneven and bunching swelling, Lead-colored or black, compassed about with certain branches of Veins, as it were with roots; but if it be ulcerated, it sends forth a certain blood-watry quittor or matter, which is yellow or black, and stinking, and sometimes blood, by corrosion of the Veins which pass through that part, sometimes in such quantity that the Patient incurs danger of death. Hereunto is added a small Fever, unquietness, Stomach-sickness, an heat in, and about the Water-Gate, etc. By way of Prognostication, we can only say thus much, That a Cancer is incurable, be it ulcerated or not ulcerated. Which as it is true of all Cancers, not excepting those in the outer parts of the Body, much more is it of a Cancer in the Womb, by reason of that perpetual Common-shore of Excrements which flows into the part. Seeing then a perfect Cure cannot be hoped for, we must content ourselves with such a Cure as is called Palliative. The scope whereof is, to hinder a not ulcerated Cancer from ulcerating, and an exulcerated Cancer from becoming more exulcerate: and in both to allay and temper the extremity of the pain. Which must be done, first by universal Purgations of the whole Body, and by other Medicines which may qualify and evacuate the black Choleric, and Melanchollick blood, and hinder the further generation thereof. In the number of which are, bleeding in the Arm, Ankle, and Hemorrhoid Veins; Potions, Apozems, Juleps, Broths, Milk, Whey, cold Mineral Waters, and such like Remedies as these usually prescribed by Practitioners for the Cure of all Cancers in what part of the Body soever. And especially Purgations must be frequently reiterated, that the antecedent matter of a Cancer may be abated. And then outward Remedies are to be used, such as are moderately cool and astringent, without any corrosive or biting quality; they are commonly applied in form of Liniments or Ointments. The best are made after this manner: Take Oil of Myrtles and Roses, of each two ounces: Juice of Nightshade and Housleek, of each one ounce. Stir all together in a Leaden Mortar, with a Leaden Pestle, until they grow black: then add lethargy of Silver, and Ceruse, both washed in Scabious Water, of each two drams: Camphire ten grains. Make all into an Ointment, with which let the part affected, be smeared three or four times a day. Or, Take Oil of Egg-yolks, and of Roses, of each one ounce and an half: Sugar of Lead one dram. Stir them together in a Leaden mortar till their colour change. This following puts down all the rest, wherewith Swell of the Dugs which have been accounted Cancerous, have been perfectly cured. Take Egg-yolks Oil two ounces: Juice of Nightshade and Veronica or Housleek, of each half an ounce: Quicksilver not killed two drams. Stir them lustily together in a leaden mortar, with a leaden pestle, till they become thick as an Ointment. The foresaid Ointments are to be conveyed into the womb upon long tents, or upon wax Candles, wound in Linen. But Injections may much more easily be conveyed into the Womb. They are compounded on this manner: Take Barley Water half a pint: Nightshade and Plantain Water, of each two ounces: Water of Housleek one ounce: white Troches of Rhasis two drams: Sugar of Lead one dram. Make of 〈◊〉 In section. 〈◊〉 in be very vehement, add to four ounces of the Injection, one ounce of Syrup of Poppies. Also let the part affected be fomented with the waters of Plantain and Nightshade, or their Decoctions; whereunto may be added the Leaves of Water-lilly, white Poppy, red Roses, and Camphire. Which Decoction may also frequently be injected into the womb, and it will become much more effectual, if it shall be well wrought about in a Leaden mortar, or a dram of the Sugar of Lead be added to it. Among Specific Remedies, Frogs are commended, being washed and boiled, and laid on as a Pultiss, or their Broth being used as an Injection. Also the Decoction, or juice of River Crabs, i●●ected into the womb. As also Herb Robert used inwardly or outwardly. If the Cancer be ulcerated, the Dose of Minerals must be augmented in the foresaid Liniments, and to them the ashes of River Crabs may profitably be added. And with the Injections, the white Troches of Rhasis may be mingled, and Barley Water with the Materials of the foresaid Injection. If pain be very urgent, Fomentations of Mallows, Marsh-mallows, Water-lilies, Poppy, Henbane, Green Coriander, Dil, Fleawort seeds, Milk, Saffron, and the like, are to be used at convenient seasons; or Pultisses made of them are to be applied. And of their Decoctions, Injections, and Baths to sit in, may be provided. Yet will not all these Medicaments sometimes serve turn to pacify a most cruel pain, which sometimes gives the Patient neither rest nor sleep. Which compels us many times to make use of Narcotick or stupefactive Medicines, which in this Disease, by reason of the exceeding Heat of the Humours, do less hurt. And I have seen a woman, having a Cancer in her Dug, that took every night for four months together, two or three grains of Laudanum, and had no hurt, but very great comfort thereby. If from an ulcerated Cancer much blood do proceed, as it often falls out, let Juice of Plantain with a little Frankincense be injected into the womb. Chap. 11. Of Mortification, or Gangrenation, and Sphacelation, or Blasting of the Womb. A Gangrene is the corruption or mortification of a part beginning; but when it is wholly corrupted, and dead, it is said to be Sphacelated, or blasted. In the Genital parts of Women, this Disease is easily bred, because those parts are moister and softer than ordinary, and do easily receive the Excrements of the whole Body. It often follows an Inflammation, Imposthume, Ulcer, or Cancer il cured, when the vital heat of the part, is choked or destroyed. It is choked in great Inflammations, when more blood flows in than the Natural heat of the part can digest, or turn into Matter. It is destroyed, either by a cold distemper extinguishing it, or by an hot one, dissipating and resolving the same. A beginning Gangrene is known by an unusual heat felt in the part, a horror and trembling seizes upon the Patient, with a languishing and quick-beating pulse, and with fainting away, or swooning. And seeing this Disease doth for the most part happen to the Neck of the Womb, so that the part affected may be perceived by the Eye; it is discovered to be soft, Lead-colored, black and carrion like, and may be pricked or cut, and the Patient never feel it; and it sends forth besides, a stinking and carrion-like smell. As for the Prognostic or Predictions belonging to this Disease. It is a most grievous, most dangerous Disease, and for the most part deadly: yet it hath been observed by very many Authors, That the Womb being putrefied and Gangrenated, hath either fallen away of itself, or been cut away, the women's lives being saved: which Observations of Authors, Schenkius hath collected to a great number, in the fourth Book of his Observations. The Cure is performed with the same Remedies which are wont to be applied to other parts being Gangrenated, if it be in the Neck of the Womb, or tend toward the outward parts; as namely, with Scarrifications, and washings or bathe with a Decoction of Wormwood, Myrrh, and such like, with the Ointment called Aegyptiacum, the Cataplasm called De Tribus farmis, which is thus made: Take Barley meal, Bean meal, and Orobus meal, of each two ounces: Oxymel one pound: Boyl them to the thickness of a Pultiss or Cataplasm. Whereunto if there be added, meal of Lupins, Myrrh, Aloes, and Wormwood, it will be more effectual. If any part of the Womb be wholly corrupt and dead, it must be cut off; or if the Womb fall down, it must be separated, by binding the Ligature every day faster and closer. Of which kind of Operations, there be many Examples collected by Schenkius in the fourth Book of his Observations. Wierus also relates in his Observations, That he cured a woman of twenty five years of age, who in the hottest of the Dog-days, had a certain little bunch growing in her Water-Gate. Whereunto an unskilful Chirurgeon applying Pultisses that were not proper, within a few days, all that part began to putrefy, grow black and dead, and the Disease passed on with incredible swiftness towards the Dung-Gate. And Wierus undertook the Cure after this Method: First, he squirted good store of the Juice of Nightshade and Plantain with a Syringe into both the Passages three or four times a day; between which times, he applied a bolster wet with the foresaid Juices, Vinegar being mixed therewith; which growing dry was wet again with the same Liquor. And in this course of reiterated Application he continued till the fervent heat was quenched, and the putrefaction began to cease. She took in the mean while, thrice every day a Potion, of the Decoction of Sorrel, Scabious, Burnet, Damask Prunes, the tops of borage and Bugloss, Marigold flowers, with Water, Sugar, and Vinegar, made in the manner of a long, acid, or sharp Syrup. Her Diet was spare, but cooling and tart, to prevent putrefaction. On the third day, the fury of the burning heat, and of the putrefaction, was abated. Whereupon he commanded the black and dead flesh to be drawn or plucked out with a little Forceps [Chirurgeons Instrument, like Tongues or Pincers] and separated round about from the live flesh, without any pain, and so to be cut off. Then he consumed the relics even to the live flesh with the Ointment called Aegyptiacum. And proceeded to cicatrize, or bring it to a Scar, after the same manner which is used in other Ulcers. In the whole course of the Cure, care must be had to strengthen the Heart, both by things given in, and applied outwardly: Likewise Emollient, Cleansing, and Refrigerating Clysters, are frequently to be given, which do much help the part affected, by reason of Neighbourhood. Chap. 12. Of the Wombs Wind-and-Water Swelling, or Dropsy. THe Inflation or blowing up of the Womb with Wind, and its Dropsy, are by Writers confounded or jumbled together; so that they call the Inflation, a Dropsy coming of wind; whereas the Dropsy properly so called is engendered by a watery Humour, Yet are they distinguished, and there is a certain puffing up of the Womb with wind, suddenly rushing in, and stretching the same, and causing vehement pain, as in the Colic; which because it continues not, but is soon discussed, it deserves not the name of a Dropsy; and such a puffing up is often seen in Hysterical women which have the Womb-fits. There is therefore to be reckoned a twofold Dropsy of the Womb; one from Wind, which is like that sort of Belly-dropsie which is termed Tympanitis, or the Drum-belly Dropsy: another arising from a wheyish Humour, answering to the Dropsy of the Belly, called Ascites, that is, the Bottle-belly Dropsy: Some add a third sort, answering to the third sort of Belly-Dropsies, called from its cause, Leucophlegmatia, that is, white-flegm Dropsy, which is seldom seen in the course of Practice. Yet I have seen a Gentlewoman, which in one day voided such plenty of thick phlegm out of her womb, as might weigh probably six or seven pound weight: which phlegm long retained, might doubtless have caused in her, a Dropsy of the womb. Wind and water causing a Dropsy of the Womb, are contained either within the Cavity of the Womb, or in its Membranes, or in certain Bladders. Touching the Cavity of the Womb, it is somewhat doubted how Wind and Humours can be contained therein, seeing there is so easy a Passage through the Neck and Mouth of the Womb. We answer, The inner Orifice or Mouth of the Womb, may be closed up divers ways; either by thick phlegm sticking fast thereunto, and growing hard, or by a Scirrhus, or some other cause. Mercatus conceives, That a snotty kind of phlegm is voided by the mouths of those Veins which are ordained for the monthly Purgations, and that of the said snotty phlegm a skin is framed, which covers all the inner surface of the Womb, within which thin skin, the wheyish and windy Matter is contained. But Fernelius thinks, That water may be contained in the womb, without any thing amiss in its mouth, but barely by its constriction or pursing of itself together. All these sorts are to be allowed of, and may be confirmed by divers Examples. And first of all, Examples of Winds contained in the Womb-cavity, are recited by Sennertus, in the Fourth Book of his Practice, Part 1. Sect. 2. Chap. 10. The first is taken out of Valescus de Taranta, touching a certain Jewish woman of Lisbon, who taking herself to be with Child, when she expected to be delivered, a great quantity of wind came away, and so her womb was brought down again. The Second is taken out of Mathiolus de Gradi, who relates the same thing to have befallen his own wife. And other Examples taken out of Dodonaeus, Thadaeus Dunus, and other Writers, do testify the like Cases; and we see the same often in the course of our Practice. Whereunto may be added a History, which we shall in the Cure relate out of Solenander, of a woman who by means of a Fumigation made of Nutmegs, let wind fly out of her Womb, which gave a report like a Pistol. And Examples of Water contained in the Womb are propounded by the said Sennertus, out of Rhasis, who saw a woman out of whose Womb there flowed twenty five Cotila's of water, which is a Measure not used with us, containing about half an Ale Pint. Also out of Jacobus de Partibus, and Dodonaeus, who relate such a like Story. And Vesalius Dissected or Anatomised a woman, in the hollowness of whose womb, were found above sixty Ausburg Measures of water, each Measure containing three pints, and the mouth of her womb was grown to a wonderful hardness. And that water is sometimes contained in the womb in bladders, many Authors do testify, who have seen examples thereof in some women, who voided such bladders full of water from their wombs; among the rest Aetius, Valeriola, Christopherus a Vega, Mercatus, Platerus, and Fabricius Hildanus. Sometimes also women with Child have a Dropsy at the same time in their wombs, as Fabricius Hildanus relates of his own wife, whose Belly was swelled to a monstrous greatness; and at the time of her delivery, she voided first of all, eighteen pints of water, and half an hour after, nine pints more; and at last she was delivered of a Boy, strong and healthy. The like case we find in Skenkius, but with a contrary event, concerning a woman, who being delivered of a living Child, continued still bigbellied, and her belly growing still greater and greater, she died of it, and her womb being opened, a great quantity of water was found therein. Finally, Fernelius hath an Example, in the sixth Book of Diseases, Chap. 15. of water retained in the womb, only by reason of the close shutting of the mouth of the womb, without any other fault therein. The story is of a woman that had a Dropsy in her womb, who as often as she had her monthly Purgations, voided all her watery Excrements out of her womb, filling six or eight Basins with a very hot yellowish water, till the swelling of her belly was wholly abated. The next month the like redundancy of watery Excrements being collected, was in like manner evacuated. The immediate Cause of the windy and watery Swelling of the womb, is the weakness of Natural heat, residing in the Liver or Spleen; and from those parts, wind, phlegm, or wheyish humours are transmitted into the womb; or the weakness is in the womb itself, whereby the said Excrements are therein collected and heaped together. And the Causes which weaken Natural heat, either directly, or by accident, are very many, and the chief are, of those things which are collected by Physicians, Res non Naturales, things not Natural. So, cold air, especially after Childbirth, heedlessly received into the womb, is a most effectual cause of this infirmity. Also cold Air unseasonably received when the Courses flow, and going frequently into cold water, or paddling in the same, especially during the said flux, is a cause thereof. So is much use of cold Meats, or windy, as fruits, Herbs, Beans, and Pease, and likewise of Vinegar: Cold water plentifully and unseasonably drunk down, long and deep sleep, painful childing and abortion especially if it often happen, immoderate flux of the Courses, exhausting the Natural heat, or their suppression choking the same. Add to these, the proper Diseases of the womb, as swell, ulcers, and such like, which do resolve the heat of the part; or else shut the mouth of the womb, and hinder the egress of Menstrual blood, and excrementitious humours. In the Discovery of this Disease, many things are to be considered: First, How this particular Dropsy of the womb, may be known and distinguished from that of the whole Body? Secondly, How the several sorts of this womb-dropsy may be discerned, as whether it come from wind, from wheyish Humours, or from phlegm? Thirdly, Whether it proceed primarily from some infirmity of the womb, or by fault of some other parts of the Body? Fourthly, Whether the Matter offending be contained in the Cavity of the womb, or between its Membranes, or in certain Bladders? Fifthly, How to distinguish it from other Tumours of the womb? Sixthly, How from being great with Child? Seventhly, How it may be known from a Mole? As for the First Question. It is distinguished from an Universal Dropsy of the Belly, in that the womb-dropsy swells chief the lower part of the Belly; whereas the universal Dropsy distends equally the whole Belly in all the parts thereof. Again, In the womb-dropsy, paleness and falling away of the flesh of the whole body, are not so soon discerned as in the universal Dropsy, in which also for the most part, there is evident thirst and dryness of the tongue, which are not found in the womb-dropsy, in which all other Symptoms are likewise far more gentle, than is usual in the universal Dropsy. In a word, In the womb-dropsy, some wind breaks out of the womb by fits; or a little water comes away, which evidently declare, that wind or water are contained in the womb. To the second Question we Answer thus. That the sorts of Womb-Dropsies may be known from one another after this manner. If it arise from wind, the lower part of the belly being struck gives a sound; the belly is afflicted with pricking pains, which reach sometimes as far as the Midrif, Stomach, Loins, and other parts; sometimes wind breaks evidently out of the neck of the Womb. Likewise, women often feel their Wombs rising like a Globe towards their stomaches. Sometimes their breath is short and the sick woman when she awakes out of sleep, oftentimes is much troubled to fetch her wind. After all meat and drink whatever, they are worse. They often belch, and their belchings give them ease. They are oft troubled with Womb fits or suffocation of the Mother. Sometimes they are pained below the navel, so as they cannot endure to be touched. Those Signs do also appear in the Inflation or Blowing up of the Womb with wind, which differs from this Disease (as was said before) only in this, that the Inflation is of less durance, but a Dropsy of wind continues a far longer time. But if the Wombs Dropsy arise from a wheyish Humour, the Region thereof appears soft and flaggy; whereas wind stretches it stiff: there is a greater heaviness in the part and a noise as of water flowing this way and that way: some water now and then drops from the Privity. And finally if it arise from phlegm, the softness and flagginess of the part will be yet greater, and increase daily more and more; and the bordering parts, as all under the Navel, the Privy parts, the space between the Privity & Fundament; with the Loins, will be seen to swell with a Phlematick kind of Swelling. To the Third Question we answer thus. If there be apparent tokens of the whole Bodies being misaffected, as by acute or long fevers, immoderate fluxes of blood, grievous distillations from the Head, Weaknesses of the stomach: swell of the Spleen or Liver and other stubborn Diseases of those parts, with which the Wombs Dropsy began, increasing as they increased; it will be more than an even lay, that the Womb receives the matter of its Dropsy from those parts by way of a flux of Rhewm. But if this Womb-swelling happen, when the whole Body is in good health, and do succeed particular diseases of the Womb, such as are hard Travels in Childbirth, Suppressions of the monthly courses, or over great flux thereof, Ulcers, Choleric, or Melancholic, or hard Tumours, we may conjecture, that the Wombes-Dropsie doth depend upon those particular dispositions, and that the matter causing the said Tumour, is gathered together in the Womb itself, by means of its inability perfectly to digest and assimilate its nutriments. To the fourth Question, we may Answer by saying, That the Matter which is contained in the cavity of the Womb, doth make a much larger Swelling, than when it is contained in bladders. Again, when it proceeds from a wheyish humour, a greater fluctuation of the water is perceived than when it is contained in bladders. And if so be, little bladders full of water be voided out of the Womb, it's a most certain sign, that the Humour is contained in the little bladders. To the first Question we must Answer; that the Wombs-Dropsie is Differenced from Tumours of blood or Choler, arising in the Womb: because in such Tumours or Swell there is a fever and a pain which is increased by the least touch; also the Inflammation reaching even to the parts of Generation. And it is distinguished from Scirrhous and Cancerous Swell, because in it there is no such great Hardness, which can resist the impression of the Finger, but it rather gives way, and pits. To the Sixth Quaere we say: When a woman is big with Child, the Swelling is not so even and depressed, but it is sharp, buncheth out, and seems greater about the navel than elsewhere. Secondly, In Greatness with Child, after some months, women are for the most part somewhat better than they were, because the Child grown big consumes the greater part of those humours, which in the first months were burdensome: But the Dropsy, the further it proceeds the worse it grows. Thirdly, In greatness with Child, the child is manifestly perceived. to stir, after the third or fourth month; which is not in the Womb-dropsie. Yet it falls out sometimes, that when the Dropsy is caused by wind, a certain Palpitation is preceived in the Womb; but it is easily distinguished from the moving of a Child, which is more even, and is wont to be perceived in divers parts of the Belly. Fourthly, In Greatness of Child, the woman's Duggs swell; but in the Dropsy they are extenuated and become smaller. To the seventh Quaere we Answer, that in a Mole, women find a kind of Heaviness in their Wombs, which they feel not in the Womb-dropsie; and when they lie on the one of their sides, they perceive the weight to roll like a stone to that side. Again, in the Mole, violent flux of Courses comes by fits, namely, every third or fourth month; which happens not in the Womb-dropsie. Lastly, in case of a Mole, the Duggs swell, and sometimes have milk; in the Womb-dropsie, quite Contrary. As touching the Prognostics of this Disease. A simple Inflation or puffing up of the womb with wind, because it lasts not, is without danger. Yet if not quickly cured it may grow to a true Dropsy. A womb-dropsy caused by a good conditioned Humour void of putrefaction, is wont to prove a long Disease; yet may it in process of time be cured, yea sometimes, the water flows of its own accord out of the womb, and the Patient recovers her health. But if the Humour be malignant, sharp, or putrid, which is known by the grievous Symptoms following; the Disease is dangerous, and for the most part deadly: For if the Disease depend upon some private Disease of the Womb, it betokens a perfect ruin of the natural Functions of that part; whence follows at last an universal Dropsy of the whole Body. But if the Womb suffer by consent of other parts, viz. of the Liver, Spleen, or Stomach, the Mischief will be the greater, and ruin is thereby threatened to the whole Body. Hence it was well said of Aetius, Such as is a woman's womb, such for the most part, is the rest of her body. If wind or water be contained in the Cavity of the womb, it is more easily cured than if it be shut within little skins or bladders. The Cure of this Disease is performed almost by the same Remedies which have been propounded to cure the Dropsy and Green-sickness. Whereunto some things more properly belonging to this disease must be added. And in the first place concerning Blood-letting; In the Disease, being new, proceeding from a suppression of the Courses and from some Plenitude still appearing, blood-letting may be convenient; otherwise it will hurt, seeing natural heat is exceedingly weakened and diminished; and stubborn Obstructions caused by a cold Humour, do cause fear of an Universal Dropsy. But Purging is altogether necessary, and must be often reiterated, as we ordered in the forenamed Diseases. After sufficient Purgation, Openers, Diuretics, and such things as move the Courses, are to be given, such as are described in the places aforesaid. Unto which, these following may be added. Take Roots of Smallage, and of Madder, of each half an ounce: the Leaves of Savin, Feaverfew, Penyroyal, of each one pugil: Carrots seeds one dram. Boyl all in the Broth of a young Pigeon, and let her drink the strained Liquor divers days together. Before she drink of the Broth, let her swallow one of the following Pills. Take of the best Castoreum, Myrrh, Madder, of each half a dram: Saffron twenty grains. With Juice of Lemons make all into nine Pills. After which Medicaments the Patient must exercise herself stoutly, by which means, not only the Excrements bred in the Bowels, and the whole compass of the Body, may by assistance of Heat be dissipated; but all which is contained in the womb, may be voided out, the bladders being broken by violence of the Exercise. If the woman do easily vomit, something may be profitably given her twice in a week to that end; by which means, not only the Humours which were wont to flow unto the womb, will be recalled, and brought forth; but the foresaid bladders sticking in the womb, and sometime containing a watery Humour, happily may be broken by the vehement motion and agitation, whereupon the Humour offending will be voided. To discuss the said Humour contained in the womb, the following Bolus, or Morsel, will be most effectual. Take of Mineral Borax half a dram: Saffron twenty grains: With Juice of Savin, make all into a Morsel. Let it be taken twice in a week. Sweat-drivers are likewise very profitable in this disease, for by them, wheyish and phlegmatic humours, whether in the womb, or the whole body, are discussed and evacuated. In the mean while, the inbred heat of the Stomach must be strengthened both with things given in, and outwardly applied, described in the Cures of the diseases of that Part. And outwardly, Medicines must be applied to strengthen the womb, and to discuss the Humours contained therein. And in the first place, Fomentations and Baths to sit in, may be made of a Decoction of Briony roots, wild cucumber, the leavs of Danewort or Dwarf-Elder, Mercury, Elder, Origanum, Calaminth, Wormwood, Rue, Sage, Margerum, Time, Bay, Penyroyal, Mugwort; Seeds of Broom, Carrots, Cummin, Annis, Fennel; Berries of the Bay and Juniper Tree; Flowers of Chamomel, Melilot, and Rosemary. Of which, little bags may likewise be made, boiled in white Wine. Or the foresaid Ingredients, or some of them, may be boiled in the Lie made of the ashes of Vine-boughs. And that the foresaid Fomentations may work the better, they are to be applied before and behind: and the sick woman ought to sweat, if she can, in her bed, or in a Stove conveniently prepared. Which likewise may be procured by help of a Bathing Tub. In a windy Dropsy, dry Fomentations will be more profitable, with bags of Milet, Salt, Cummin-seed, and Bran fried in a pan and besprinkled with Wine. After Fomentation let her Belly from the Navel downward, be anointed with Nard Oil, Oil of Dill, Oil of Rue, Wormwood, and Southernwood. Which Oils, if drawn out by Chemical Art, they will be much more effectual. After Unction, lay on a Plaster of Bay-berries, or a Pultiss of Cows and Sheep's Dung, with Seeds of Smallage, Parsley, and Cummin, as also Honey boiled therewith. To the same purpose the Skin of a Sheep newly killed is commended, sprinkled with warm Canary Sack, and laid warm upon the Belly. Clysters are frequently to be given, made of the Decoction of Wormwood, Origanum, Penyroyal, Rue, Centaury, and the like: Or of the Oil of Rue, Nuts and Dill, with white Wine, Hippocras, or Muskadine. In which Clysters dissolve Benedicta Laxativa, Hiera Diacolocynthidos, Terebinthinam, Confection of Bay-berries, Rosemary-flower Honey, and the like. Injections into the womb may be very profitable to evacuate the Humours contained therein, being compounded after this manner: Take Roots of Asarabacca three drams: Leaves of Penyroyal, Calaminth, of each half a handful: Savin a pugil: Mecboacan a dram: Annis seed, Cummin seed, of each half a dram. Boyl all, and in six ounces of the strained Liquor, dissolve an ounce of Oil of Orice, and as much of Elder Oil, and make thereof an Injection. To the same end may Pessaries be made, thus: Take Coloquintida and Mechoacan, of each one dram: Sal Nitre ten grains: boiled Honey as much as shall suffice. Make all into a Pessary. Or, Take Bindweed Roots, Roots of Esula, of each a dram: Seed of Gith, or Nigella Romana half a dram: Honey as much as shall suffice. Make all into a Pessary. Or, Take Elaterium half a dram: bruised Figs as much as shall be requisite. Make them into a Pessary. When the Swelling of the womb proceeds from wind, a Fumigation of Nutmegs is very helpful, being commended by Solenander, in these words: A Woman newly out of Childbed, exposing herself over soon to the wind and air, fell into insufferable pains, neither could she find any help. At last comes an old well experienced Midwife, and calls for three Nutmegs grossly powdered. Then she put an Earthen pan with hot Coals under the woman, and sprinkled the powder of Nutmegs upon the Coals, so placing the pan, that the woman might receive the smoke through a funnel into her womb by the Water-Gate. At the same time she was smoked above with the same Fume: Which when it had penetrated into her body, the woman presently cries out, I must needs go to stool: which she had hardly spoken, but a fizzing and sound was heard, such as is made when Gunpowder is fired being shut in a narrow box: which wind being expelled, the woman was perfectly well in a moment. Being advised by this Experiment, having upon like occasion used the like Remedy, I have very often found it to do much good. In the same case, Cupping-Glasses with much flame, is profitably set upon the Navel, for it excellently dispels wind. If the Disease come from Humours, Issues are to be made in the Thighs, that by those Fountains the filth of the womb may be by little and little drained out. Brimstone and Nitrous Baths are commended likewise by many, both to drink, and to be washed in; provided there be no great heat of the Liver or whole Body, conjoined with this Disease. For the pain of the womb, which is frequently troublesome in this Disease, Amatus Lusitanus commends the water or Decoction of Chamomel flowers, given to the quantity of four or five ounces. And finally, If the Inflation or puffing up of the womb happen after Childbirth, there will need no other Purgation than that by the womb: Which if it find any hindrance, it must be helped forwards by drawing Pessaries, and by Cupping-Glasses fastened to the Thighs, and by other Medicines described in our Chapter of Suppression of Courses. And if there be wind, the Fumigation made of Nutmegaforesaid, will be most seasonable. Chap. 11. Of the falling down of the Womb. WHen the womb loseth its Natural Situation, and falls towards the Water-Gate, the Disease is termed, the falling down, or slipping forward of the womb. Many Differences there are of this Disease, differing only in degrees: For sometimes only the inner neck falls down into the Water-gate: sometimes the whole body of the womb falls downwards, but does not appear without the Water-Gate, in the threshold whereof appears the inner mouth of the womb, in likeness of a man's Yard, or a Goose Egg with an hole in it. Other whiles with the bottom turned out, it hangs without the Water-gate like a man's Cod, or an Ostriches Egg, save that it is rugged, and hath an uneven surface: and it is in a word, sometimes so reluxed, that it falls so far out as to reach the Patient's Thighs. The immediate Cause of the falling down of the womb, is the Rupture, or Relaxation of those Ligaments, which are wont to retain it, and its Neck in their proper place. A Rupture of the foresaid Ligaments may proceed from all violent Causes, as a blow, a fall, dancing and leaping, lifting some heavy burden, or carrying the same, violent compression of the Abdomen, vehement Coughing which dures long, violent neezing, especially in Childbed, hard straining to stool, difficult Travel, violent extraction of the Child out of the womb, or of the Afterbirth; vehement endeavour of the womb to cast out somewhat offensive thereunto, as a dead Child, a Mole, or an Afterbirth: for then, according to Galen, in his Third Book of Natural Faculties, the same thing betides the womb, which is wont to happen to two wrestlers who endeavour to throw one the other upon the ground, till both fall together. Hereunto add, frequent setting of Cupping-Glasses upon the Thighs, and very vehement agitation of Body, or of Mind. Relaxation or slackening of the Ligaments is caused likewise by divers causes, as by a long-lasting Catarth, divers Crudities, which are cast out into the womb, as the sink of the whole Body. Whence it is that women long troubled with the Whites, can scarce avoid this Disease, especially elderly women which are most of all troubled therewith. Add hereunto external causes, as over-frequent bathing, especially in cold water; Southern and moist Air, especially being received into the womb after Child birth; moist Diet, much drinking; Idleness, long sleep, and all other causes, which may decrease phlegm, and cause its flux into the womb. The Signs whereby to know this Disease are evident to the sense. For the womb is found sticking in the Water-gate like an Hens or Goose's Egg, or like a Clew of third, with the perceivance of a weight pressing upon the Water-Gate, when the Patient stands upright. And while they sit or go to stool, a vehement pain is felt about the privy Parts, and the Region of O sacrum, or the Hanch-bone. If it hang far out, the greater pain and heat is felt, the urine comes away by little and little, and makes the womb smart as it passeth. The Causes procuring this Falling-down of the womb, may be thus distinguished. If it proceed from looseness or slackness of the Ligaments, it comes by little and little, hath the less pain, and white Purgations have preceded, or other Causes moistening the womb, and relaxing the Ligaments thereof. But if it proceed from a breaking of the Ligaments, the pain is more vehement, and blood sometimes breaks forth; and such Causes have preceded which have been able to break with violence the Ligaments. As for the Prognostics belonging to this Disease. The Disease of itself is not dangerous; yet is it very unhandsome and troublesome, hindering the Patient from freedom to go and walk at will; also from Conception and convenient expurgation of her Courses. Yet may it sometimes occasion death, if pains, Fevers, convulsions, or other grievous Symptoms be joined therewith. Also the womb in this Case is sometimes corrupted through distemper of the Air, or by violent impulsion, and becomes Gangraenated, which necessitates it to be cut off. The Disease being fresh, and the womb coming not far out, is more easily cured than when it is an old Infirmity, and the womb comes far out. In younger women, the womb is more easily restored to its place than in Elderly women. Falling down of the womb, by reason of the Ligaments being broken, is incurable. To come to the Cure. The womb is to be thrust back into its Natural place, and to be detained there; and the fault of its Bands or Ligaments must be corrected; If they be broken, by things that do glue and sodder together; if they be relaxed or slackened, with things drying, aftringent, and strengthening. All which may be done by the following Medicaments. In the first place therefore, That the womb may more easily be restored to its place, the Guts and Bladder must be disburdened, left pressing the Neck of the womb, they should hinder its reduction; forasmuch as the neck of the womb rests upon the straight Gut, and the bladder rests upon the neck of the womb. When the Guts and Bladder are discharged of their Excrements, let the woman lie along upon her Back, with her thighs wide asunder, and her knees drawn upwards, and let her with her hands thrust her womb inwards; and force it still upwards into the neck, so as to turn it inwards as it goes, till all is returned within the cavity of the Belly which should contain the womb. Or if she is not able to do it herself, let her do it by help of the midwife; or use a thick blunt ended stick with wrapped about it, by which it may be forced further into the Cavity of the Belly, than is possible by the hands to drive it. Or, for fear of hurting her Body, a Pessary may be made of Linen Cloth often doubled and rolled together with a string tied fast thereunto, and accommodated to this service of thrusting up of the womb. But if the womb fallen from its place shall, swell, so that it cannot enter into the cavity of the Belly, the swelling must in the first place be removed. And if there be an inflammation, such things must be applied as are sit to heal the same. If otherwise it be blown up, such things must be used as will discuss the inflation. Rodericus a Castro washes the swollen womb with a Decoction of Beets, and then sprinkles it with vinegar and salt, and so when the swelling is aborted, he reduceth the same. The same Rodericus a Castro writes, that it is very good towards restoring the fallen womb, for a Physician or a Chirurgeon to come with burning red hot Iron in his hand and to make as if he would thrust it into the womb. by that means nature contracts herself, and the womb with her, and any other part that sticks out of the Body. For he relates that a certain very expert Chirurgeon did by this stratagem force Back a man's Guts, that were ready to come out at a wound in his belly, when other remedies did no good. For holding a great red hot Iron in his hand, the Patient looking on, he made as if he would Clap it upon the wound. With the sudden fright whereof the Guts were presently drawn back into their place. Avenzoar in his Second Theizir, Tract 5 Chap. 4. Propounds some such thing as this. When this disease (saith he) gins first to appear, the Physician may gently cure the same. And it is reduced all these ways, viz. by your hand If you please; and if not make her he on her Back and let some Body sit upon her breast, and another upon her thighs; and then cause her to be frighted putting some creeping Vermin upon her Legs, such as Mice, Efts, frogs and such like; by which let her be so frighred as to endeavour to get away by drawing her Legs and thighs up to her; whereby all her Members and her whole Body may at once be contracted: by which means the Womb will return unto its own place. Zacutus Lusitanus following Avenzoar relates the following story in the 66 observation of his Second Book. Coming to a woman (says he) Which had her Womb fallen down the space of a year & an half, with extreme hardness; it seemed very hard by reason of its stretching out to be reduced to its place; especially seeing Avenzoar says, that this work must be done before the Womb be grown hard. I devised many remedies for this disease; astringent Insessions, Pessaries, Plasters, Confections. At last, having wrestled stoutly with the disease, I could do no good. I betook myself to this stratagem. I put Mice tied by the tails, between the woman's Legs. Which running up her Thighs, the woman is mightly frighted, and forthwith (a strange thing to see) her Womb is reduced into its proper place. This done, The Plaster against Ruptures being laid upon the Region of the Womb and to the Groynes, she remained for the time to come free from that Disease. Before the Womb be reposed in its place, it must be anointed with the Mucilage of comfrey Roots, or with an infusion of Gum Tragacanth. Then are powders to be sprinkled thereupon, which have no asperity or sharpness, lest they hurt the Womb or its neck; but of quality rather gluing than astringent or binding. Such an one may be thus made. Take Frankincense, Mastic and Sarcocolla nourished (that is, well steeped so as to drink up as much of the Milk as it can hold) with Brest-Milk, of each one dram. Mummy, , Acacia, Hypocistis, of each half a dram. Make all into a most fine Powder, to be sprinkled as aforesaid. The same Powder may be applied in form of an Ointment, if it be mixed with the aforesaid mucilages, or Oil of Saint John's wort, or some other consolidating thing. After the Womb is conveniently replaced, all art must be used to retain the same in its place, the woman lying in her bed, a little bending, with her thighs gently stretched out and the one resting upon the other. And let her abide some days in this posture, and put in at the Water-gate a little wool, cotton, or sponge wet in harsh red Wine, or in Rosewater wherein Acacia or Hypocistis hath been dissolved. To further this Retention of the Womb in its place, Cupping-Glasses with much flame are frequently to be fastened under her Duggs and upon her Navel. Likewise sweet savours are be presented to her Nose, and stinking things to be applied to her Genitals, unless she be subject to sits of the Mother. Let the said Parts be fomented with a Decoction of astringent things made in red Wine and the Water of a Smyths Forge. Also Practitioners use a Bath to sit in, made of the Same Decoction. In which there needs caution. For it is to be feared, least in that posture, the Womb should again fall from its place, especially at the beginning, while the Disease is yet fresh. But when it hath held the Patient long, and she is provided of a convenient kind of Truss, such a bath will do much good. After the said Bath a Fumigation will likewise be very good, of Frankincense, Mastic, Sandarach, red Roses. Others indeed do commend a Fumigation on made of a salted Eel-skin. Injections into the Womb will work much more effectually than those remedies which are outwardly applied: they may be compounded of the Decoction for the Fomentation or Sitting Bath aforesaid, Ointments and plasters will likewise be good in this case such as were described in the Immoderate flux of Courses and in the Whites; and as shall hereafter he propounded to prevent Abortion. The Retention of the Womb in its place may likewise be helped, by astringent and strenghening Medicaments taken in at the Mouth. And among the rest, the following Powder frequently taken is very proper for this Disease. Take Mullein two drams: Myrtle Leaves, Garden Parsnep Seeds of each one dram: Shave of Hartshorn, half a dram: Ashes of Cockle-shells one dram: red Coral two drams: Make all into a Powder. The Dose is one dram with harsh red Wine. Touching these astringent Medicaments both internal and external it is to be observed: that they must be warily used, it the woman's courses do still flow at their seasons, lest they being suppressed may cause more grievous Diseases to follow. The best season for these Medicaments, is when the Patient's courses are past. These Remedies are to be contained twelve or Fifteen days together. Also care is at the same time to be taken, that the Patient be neither costive nor lose. For if the Excrements be hard, the Womb is easily thrust out by the Patients straining at stool; and a lose Belly doth relax or slacken the bands or Ligaments of the Womb. While the foresaid Remedies are used, we must resist the Antecedent Cause, by such things as shall purge out and discuss those phlegmatic humours which relax and slacken the Ligaments of the Womb. And first convenient Purgations must be ordered; which must not be violent in their operation and disturbing, lest the Womb out of its place again, bringing abundance of humours into those parts. Some allow of vomiting, because it draws the humours into the upper parts of the Body: and in that respect it would be profitable, if it were not to be feared in another regard: Namely because it is performed with great straining, and drives the Womb downward, as much as neezing. Yea and experience hath taught that nothing doth more effectually facilitate hard travel, and bring the Child sooner into the light, than a Vomit given to the Childing woman. After sufficient Purgation, a Decoction of Guajacum is to be given three weeks together that every day the Patient may sweat in the morning. And in the Evening let her Belly beneath the Navel be fomented with a Decoction of Sage, Origanum, Marjaram, Time, Feaverfew, tansy, Wormwood, Rue, red Roses, Cyperus Roots, Calamint, Cypress Nuts, and the like simples boiled in Smiths' Forge-water and red Wine. After the Fomentation, the Fumigation and Lineament may be used which were before described. Instead of a Sweat-driver, or after the use thereof, Baths arising from Sulphurous Mines, will be singularly profitable, such as our Balerucan Baths; and experience hath shown that many have been cured by such Baths. And that a woman may be secure that her Womb fall not down again, which it is very apt to do; or if there be no hope of a perfect cure let her wear such a kind of truss as is called Hippocrates his Girdle. Whereby women are so guarded and defended, that without fear of the falling down of their Wombs they may go about and do their daily businesses; also their Womb is thereby defended from the cold. They are made almost after the same manner, as trusses that are used against Ruptures or Burstennes. Pessaries are likewise very profitable in desperate Fall down of the Womb, which some do make of a good long piece of cork covered over with Wax. Others make of Wax alone, some round, others square, triangular, oval or any other fashion; which are conveyed into the Cavity of the Womb, and are never taken out, but keep the Womb in its place: so as the women notwithstanding do all their usual enployments, conveniently are enjoyed by Men in carnal conjunctions, do conceive, carry their big Bellies, and bring forth. Which is confirmed with many Examples by Franciscus Rossetus in his Book entitled De Partu Coesareo, Sect. 6. Chap. 5. and by Bauhine in his Appendix to Rossetus. All which are transcribed word for word by Schenkius and Sennertus, in their proper Chapters, where they are to be seen. Chap. 14. Of the Womb shut up, or Imperforated. Virgin's that have their Wombs closed up, are said to be imperforated, or unboared, like a Barrel of Beer that hath no hole to put in a Spigot. Now this Closure of the Womb is wont to be in three places; viz. In the inner Mouth of the Womb, in its Neck, and in the outward mouth of the Womb next the Water-Gate. And it is caused, either in the first formation of the Infant, when some Membrane is drawn before the mouth of the Womb, or its neck; or by some precedent wound or ulcer, which growing whole again, the parts of the neck of the womb, or its lips come to be closed together; or by tumours shutting or stopping up the inner Orifice; or by some compression, straightness, or distortion, which hinders the man's Yard and Seed from going in, and the Monthly Purgations from coming out. This Disease is in part easy, and in part hard to be known. If the closure or stoppage be in the outward Orifice of the Privity▪ it is discerned by seeing & feeling. But if it be in the Neck or Mouth of the Womb, it is not discerned till the courses begin to break out, or till the parties begin to addict themselves to generation. For when the time of their monthly Purgations is come, pains and gripe ar● felt in the Region of the Womb at certain periods of times, with a sense of weight, yet no flux of Courses follows; the Conjecture will be more probable, if the Virgin be of a good habit of Body, not troubled with any Obstructions, or Cachectick dispositions. The Disease persevering, their wombs swell, so that Maidens seem to be with Child; and sometime their whole Body swells, which likewise seems as it were black and blue through the abundance of blood. But if the closure do possess the neck of the womb, it is perceived in the first Carnal Conjunctions, because it doth not admit the Man's Yard. Lastly, I● the Closure be in the Orifice or Mouth of the Womb, it is hardly discerned; yet may it be in some measure perceived by the hand of a skilful Midwife; and it gives some suspicion thereof when the man's seed doth presently slip away, as soon as it is castin. As for the Proguostick. If the Closure be in the Orifice of the Privity, it is easily cured, being opened by a slight Section. But if it be in the inner parts, it is much harder to cure. When the Passage is stopped with a Membrane, it's more easily cured; but when the closure is caused by a fleshy matter, as it happens after Ulcers, the Cure is more difficult. The Closure of the inner Orifice of the Womb is incurable, because the Instruments of Chyrurgiry cannot be applied to open the same. The Cure of this Disease, because it belongs chief to Chyrurgiry, we shall dispatch in few words. If the Closure of the Womb have been caused in the first formation, it is to be opened by cutting only. The manner of which cutting is largely described by Sennertus, in its proper Chapter. But if the Closure have been occasioned by reason of an Ulcer, as it happens in the Whore's Pox; it is to be considered, whether it be only an excrescence of flesh not wholly stopping the passage, or a perfect and entire growing together of the sides of the neck, or of the lips. For, if flesh only be grown up, endeavour must be used, convenient Evacuations being premised, first to prohibit the increase of that flesh by drying and discussing Medicaments, then to diminish the said flesh by Medicines of Frankincense, Birthwort, Bark of Frankincense, Roses, Balaustines, Mastich, Myrrh, Aloes, and such like. Which not doing the deed, we must come unto such flesh-consumers as are least painful, as burnt Alum, Vnguentum Aegyptiacum, and such like. And at last, if this will not consume the flesh, it must be cut off round about, with the same Instrument where with the superfluous flesh breeding in the Nose, called Polypus, is wont to be cut off. But if the neck of the womb be wholly grown together, we must try to renew the Ulcer, and with the foresaid Medicaments to remove the superfluous flesh. And if that cannot be, we must undertake to cut it, in the very self same manner, as we are wont to cure the natural coalition of the neck of the womb. If the passage of the womb be shut up by some tumour, proper Remedies are to be appointed thereunto; such as have been propounded in the Inflammation, Scirrhus, and Cancer of the womb. If it be caused by compression of the neck of the womb, or of the inner mouth thereof, the compressing cause is to be taken away, which may be divers, viz. A Stone in the Bladder, a Swelling in the straight Gut, Fatness of the Caul, the Legs or Thighs distorted, and going asplay; the Cure of which accidents see in their proper place. In straightness of the Pa●●age, which is chief caused by hardness or dryness, we must work with things moistening, emollient, and laxative; with Baths to sit in, Fomentations, Liniments, and Pessaries: and so when the part is relaxed, a little pipe of Lead may be put in, or of white wax artificially contrived, and meared with Butter, or some emollient Oil, which let her always carry, or at le●●t in the night when she goes to bed, and in the day time▪ let a Pessary conveniently made of Cotton be put in the place, being smeared with Ointment of Marsh-mallows, or such like. In Distortion, the same Method of Cure, very near, is to be observed; and let the pipe be so framed, that it may gently bow the contrary way to the distortion; and so the neck of the womb may by little and little be reduced to its due place. Chap. 15. Of Barrenness. THis word Barrenness or Sterility, is not in this place taken in so strict a sense, as to signify only a total defect, and perfect abolition of Conception; but in a large and ample signification, so as to comprehend all kind of impotency, and every impediment of Conception: namely, When a woman at such a● age in which she ought naturally to be capable of Conception, and using the company of a man, doth not conceive. And this defect is termed Agonia, or Atecnia, that is, Inability to conceive or bear children. And this Barrenness or Impotency of Conception, is caused divers ways; all which for cleverness sake, we may reduce to four Heads, according to those four Natural Operations which are required to perfect Conception. The First of which is, That the Woman in her Genial Embracements, do conveniently receive the Man's Sperm into her Womb. The Second, That she retain the same a convenient season. The Third, That she cherish and preserve the same in her Womb▪ The Fourth, That she afford fitting Materials to form the Embryo, or first Conception, and duly to augment the same, as need shall require. Hence Four Impediments of Conception do arise; viz. If the woman receive not the Seed; If she retain it not; If she preserve and cherish it not; If she nourish it not so as it increase and grow. Reception of the Seed is hindered by many Causes; by things Natural, things not Natural, and by things Preternatural. Among things Natural hindering the Reception of the Sperm, in the first place is reckoned, yongness of Age, in which, by reason of the smallness and straitness of the Genital Parts, the woman cannot receive the man's yard, or not without very great pain, which makes her worse for Genial Embracements. The same effect is caused by over great Age, seeing that in elderly Virgins, the Genital Parts, through want of being exercised in actions tending to Generation, do become withered, flap, and flaggy, and so straight, that they cannot afterwards easily admit a man's Yard. Likewise, all such as are naturally lame, with distorted Legs, and their Crupper-bone depressed, can hardly put themselves into such a convenient posture during the genial Embracement, as a necessary that the Seed may be duly and rightly received. Hereunto add over great fatness, which straitens the Passages of the womb, and by greatness of the Belly, hinders the right and fit Conjunction of the man with the woman. And lastly, a cold distemper of the womb, makes women dull and listless, so that they enjoy no pleasure (to speak of) in the Genial Embracement, or it is long before they are provoked with desire; so that the inner Orifice of the Womb is not timely enough opened to receive the Man's Sperm. Among things not Natural, Passions of the Mind hold the first rank, and especially hatred between Man and Wife; by means whereof, the Woman being averse from this kind of pleasure, gives not flown sufficient quantity of Spirits, wherewith her Genitals ought to swell at the instant of Generation, that her womb skipping as it were for joy, may meet her Husband's Sperm, graciously and freely receive the same, and draw it into its innermost Cavity or Closet, and withal bedew and sprinkle it with her own Sperm, poured forth in that pang of Pleasure, that so by the commixture of both, Conception may arise. The things Preternatural which can hinder the Reception of Seed, are certain Diseases incident to the Genital Parts, or to such as border near upon them; as Tumours, Ulcers, Obstructions, Astrictions, Shutting up, Distorsions, Stone in the Bladder, and other such like. The Second fault in Women, which hinders Conception, viz. When the Seed is not retained, depends either upon the over great moisture of the Womb, namely, when the womb is filled with many excrementitious Humours, by which becoming loser and more flaggy than is fit, it doth not rightly purse and contract itself together, so as to retain the Sperm; or the Orifice of the Womb is so slack that it cannot rightly contract itself to keep in the Seed; which chief is caused by Abortion, or hard Labour in Childbirth, whereby the fibres of the Womb are broken in pieces one from another, and they, and the inner Orifice of the Womb over much slackened. And that same immoderate moisture may arise both from the proper Constitution of the woman, and from external causes of moisture, such as Baths, Idleness, moist Diet, and especially from the Whites; which flux of Whites happens very frequently, since the Womb is as it were the Common-shore, whereinto all the parts of the Body do discharge their Superfluities, so that this is wont to be the most frequent and ordinary Cause of Barrenness. The Third Cause hindering Conception, viz. When the Sperm is not sufficiently nourished in the Womb, depends upon such things as are apt to corrupt the Seed, as every distemper of the womb; namely, a cold distemper, which extinguisheth the Seed; an hot distemper, which dissipates the Spirits; a moist distemper, which robs the Seed of its due thickness; and a dry distemper consumes and drinks up the Seed: and thus the Seed being by these distempers corrupted and degraded from its natural Constitution, becomes unfit for Conception. To these Causes, Authors do add Witchcrafts, and Charms, by which all confess that Conception may be hindered. Likewise external things, as Meats and Poisons may do as much, such as are reckoned up by Authors, viz. Among Meats, Vinegar, Mint, Water-Cresses, Beans, and such like: and among Poisons, or at least such things as have a certain venomous property causing Barrenness, The Agate or Jet, ●he Matrix of a Goat or Mule, Glow-worm's, Saphires, Smaragds, and the like. And lastly, Malignant and venomous Diseases, may exceedingly corrupt the Seed, and render it unfit for Generation, as the Consumption, Leprous Infections, Whores-Pox, stinking and cancerated Ulcers. The Fourth and last Cause of Barrenness, viz. When the woman doth not yield convenient matter to form the Conception, and to augment the same, depends upon a want of Seed and Menstrual blood; so over young women and over old, do not conceive, through want of both those Materials. The Age of a woman fit for to conceive, is commonly determined to be from the fourteenth to the fiftieth year of her Age. Yea, and though those foresaid Materials are not wanting, if yet they are ill disposed, they are not fit for Generation. And they may be ill disposed through divers distempers, and other Diseases; likewise by reason of bad Diet, producing none of the best blood. So women which gorge themselves with much raw fruit, and cold small drink, breed wheyish blood unfit for Generation. Yet we must needs confess, that some women have conceived who never had their Courses, as may be collected out of the Observations of divers Authors; yet so much Menstrual blood was collected in those women, as useth to remain over and above in such as have their Courses, though they had not so much as to cause their monthly Courses. To the Causes hitherto mustered up, must be added a certain disproportion or unsutableness between the Man's Sperm, and the Woman's, which makes they cannot be rightly mingled, nor conspire to the Joynt-making up of an Embryo or Rudimental Infant; though there be in the mean while, no sensible defect, either in the Man or Wife. And it sometimes happens, that the same man can have a child by another woman, and the same woman by another man; whereas they have lived together in the married estate barren. It comes likewise to pass, That a woman shall live with a man for ten or more years together, and not conceive child, and afterward shall begin to conceive and bring forth: the Cause of which accident is, The change of Temperature caused by years, whereby the Seed comes to have another temper, so that being before disproportioned to the man's Seed, it comes by change of Age to be fitly proportioned thereunto. Now this disproportion of Seeds, consists chief herein; When men much exceeding in some quality belonging to their temper▪ are joined with women which partake of the self same excess, viz. When over hot men are joined with over hot women, over cold men with over cold women; for those distemperatures can procure no mediocrity in the Seeds, and other causes necessary to Generation. Some fly likewise to occult or hidden qualities, which make the Sperms to agree, or disagree, though no excess of the first qualities can be discerned. To these Authors add an hidden kind of Disposition, which makes some women barren, though no manifest cause of such Barrenness appear in them. The Signs of Barrenness, we will run over according to these four sorts of Causes propounded. And in the first place, Causes hindering Reception of Seed are not hard to be discovered, being evident to our very Senses. For tenderness of Age is easily observed, and so is an over elderly state of years; and the evil constitution of those parts which border upon the womb, as when women halt, have crooked Legs, have their Crupper-bone depressed, or are over fat; as for the cold distemper of the womb, we shall treat of that in our third Rank of Causes. Hatred between Man and Wife is known by relation of themselves, or of those that live with them. Also the particular Diseases hindering the reception of Seed, as Tumours, Ulcers, Obstructions, Astrictions, shutting up, Distorsions, may be known through search of the Genital Parts made by a Midwife or Chirurgeon. Of the Causes hindering the retention of Seed, which make the second Rank, we shall treat of over great moisture among those of the third Rank; as for Abortion and hard Travel, they are known by the woman's relation. The Causes of the third Rank, viz. Which have power to corrupt the Seed to require more exquisite signs to know them by, which we shall prosecute as followeth. A Cold Distemper of the Womb, is hereby known, In that the Woman longs not after Carnal Embracements, and feels little pleasure therein; her Face is soft, whitish, and cloudy; her feeling is dull about her Share, Loins, and Thighs; she voids thin and crude Sperm, and with little pleasure; her Courses are suppressed, or they come every sparingly, and keep no constant orderly time, and they are pale and discolored. Add hereunto, Diet preceding of a cooling Nature, consisting of a long use of Fruits and Herbs, with much drinking of cold small Drink. A moist distemper of the womb is known by the lax, and slap, flaggy, soft habit of the woman's body, her much sitting, frequent and almost continual flux of Whites; plenty of Courses, thin and watery, no appetite to fleshly Conjunctions, heaviness of her Loins, aptness to miscarry, plenty of Urine, and a moist Diet. An hot Distemper is known, by the manly and strong habit of the woman's Body, such as is seen in Viragoes and Amazons; by a ruddy countenance, black hair of the Head and Eyebrows; a strong and manly voice; she is frequently disposed to be angry, over prompt to all kind of actions, he● thirst cannot be satisfied, her Urine is yellow, her Courses few, their colour is a dark red, their heat and acrimony so great, that oftentimes they exulcerate the secret Passages; their Privities itch, and they are prone to carnal Embracements; they are quick and sudden in the voiding of their Seed; they have frequent Pollutions, and lustful Dreams. A dry distemper of the womb is known by the small quantity of Courses; dryness, itching, and chopings of the Mouth of the Womb; little excretion of Sperm in the Genial Embracement; trouble arising from over much carnal Conjunction, and Leanness. If the Seed be corrupted, and Barrenness caused by Witchcraft, all other signs will be absent, which are wont to declare the Natural and manifest causes of Barrenness. There will be likewise some alienation of minds between the married Couple, of which neither of them can give any handsome account; yea, and sometimes they can both of them, but seldom shoot forth their Seed, and that with Labour and Difficulty. Diet or poisons that extinguish Seed, if they have been taken in, we shall come to knowledge thereof, by diligent questioning of the woman, and those that are about her. And lastly, Malignant Diseases, such as are of power to extinguish the Sperm, as Leprous Manginess, the Whores-Pox, and such like, are known by their proper signs. The fourth Cause of Barrenness, which consists in defect or badness of the Menstrual blood, is known, first by the over great fatness of the whole Body, to the nutriment whereof the blood is carried away▪ and consumed, and is not allowed for the nutriment of the child in the womb. The same is likewise known by great Leanness of the Body, and extreme slenderness; ●●r when there is not blood enough to nourish the Body, it can hardly superabound to nourish the Conception. And in a word, All such things as consume, and much diminish the blood, if they have preceded, or be at present in the Patient, they signify want of blood in her body; such as are, extreme labours and painstaking, immoderate sitting up, and watching, austere fastings, large bleedings at nose or elsewhere, 〈◊〉 or chronical Fevers Fistulous Ulcers, and Issues that run much. 〈◊〉 〈◊〉, over great quantity of blood, doth hinder the nourishment of the Seed, and of the 〈◊〉; for the Seed is oppressed with so great plenty, and cannot exerci●e its formative faculty: which is 〈◊〉 to happen in full bodied, and ruddy women, such as live a 〈◊〉 〈◊〉, and delight ●n Feasting, 〈◊〉 wombs are always bedabled with a continual moisture. Now the 〈…〉 on of the woman's blood, may be known by the ill habit of her Body, the colour of her 〈…〉 her strange dispositions, together with an ill diet foregoing. The 〈…〉 and the Wi●es Seed is hardly known; but if both of them be of a very hot, or a very hot 〈◊〉 Constitution, we may conjecture, That the disproportion 〈◊〉 from those distempers; 〈◊〉 more manifest causes of Barrenness, do not appear. It is yet harder 〈…〉 hat kind of Barrenness which depends of a certain hidden disposition, no manifest 〈◊〉 thereof appearing. Yet many Experiments are related by Authors, whereby to know whether a Woman be ●●turally Barren, which though they carry no great certainty with them, yet are Physicians 〈…〉 sometimes to make use of them, in favour of Princes and Nobles, who are permitted to divorce their Wives, in case of Barrenness. Hypocrates in ephor. 59 Sect. 5. saith, If a Woman conceive not, and thou wouldst know whether she shall conceive or not cover her with blankets, and burn some perfume under her, and if the smell proceed through her Body, up to her Nostrils and Mouth, know that she of herself is not Barren. The same Hypocrates supposeth that it may be known whether a woman be fruitful or not, by putting a head of scraped and peeled Garlic into her Womb; for if the next day the smell shall come into her mouth, she is apt to conceive; if not, she is barren. Or put Galbanum softened at the fire, and enclosed in Silk, into the woman's womb at night, and bind her whole head in perfumed Linen; if in the morning the crown of her head shall smell of Galbanum, the woman is well purged, and will be fruitful. You may try the same, if you put a little Balsam mingled with Water, and received in Cotton, into the Womb, binding it with a string to her Thigh; for if the womb do draw it inwards, it is a most approved sign of fruitfulness. Amatus Lusitanus commends this following as a most true sign: He takes a dram of a Hare's Runnet, which dissolved in warm water, he gives the woman to drink, being in a bath of hot water, and fasting. If the Woman do then feel pains in her Belly, he pronounceth her fruitful; if not, barren. Many seek to know the Barrenness of a woman by her Urine, wherein they steep Barley: which Barley, if it grow within ten days, they count it a sign of Fruitfulness; if not, they account it a certain token of Barrenness. And others, Finally, do power the Woman's water upon Bran or Fenugreek, and take it for a note of barrenness, if Worms breed there. For a Conclution to these Discoveries, We shall diligently consider and inquire, whether Conception and Generasion be not hindered by fault of the Man, or any defficiency in him. For in such a Case, it were vainly done to torment the Woman with a multitude of Medicines. Barrenness proceeding from the Man, may be known by the diseases of his Genital parts, as inability to raise his Yard, want of Sperm, Swelling of his Stones, Gonorrhoea, and the rest. And it gives some token hereof, if the Man be faint hearted and Womanish by Nature, if he want a Beard, be slow in casting forth his Sperm, and his Sperm be cold, so that his Wife feel it cold in her Womb; if he have little or no Lust to Carnal Embracements, and perceive very little pleasure therein. And lastly, If such Causes have preceded which are of power to make the Seed unfruitful. The Prognostic must be regulated according to the Method of the Causes, as we have ranked them. And in the first place, Tenderness of Age hinders conception only for a time, which cannot be expected till the Woman is more grown. But Elderly years cause a Total despair of Conception. But if the Parties Courses do as yet proceed, in due season, there may be yet some hope of Conception; howbeit very small, especially in such Women as are at the fortieth year of their Age; for although Women that have had Children younger, are likewise wont to Conceive at that Age; yet such as have never been with Child, have little reason to hope that they shall Conceive at that Age, because the Womb having been so long unemployed, is become withered, shrunken up and unfit to Conceive Child. Barrenness which is caused by an evil shape of the Members, as in such as are Lame, have distorted Thighs, or their Crupper-Bone depressed; is incurable. But if Barrenness proceed from over Fatness, or some distemper of the womb not over old, the cure is to be hoped, by procuring leanness and by correcting the Distempers. That Barrenness which is caused by other diseases, as by a Swelling, an Ulcer, Obstruction, whites, want of Courses, falling of the Womb, Consumption, Leprous Mangyness, Whores-Pox, and such like; is easier or harder to cure, according as the said diseases are either easy to be cured or hard. For the Cure of this disease, whichsoever of the causes aforesaid hath produced the same; we must seek the removal thereof. And in the first place, the straitness of the Genital Parts in regard of youngness of Age, needs no cure; for as Age increases, they attain to a convenient wideness. But in the mean time, it is necessary that the Party abstain from Carnal Conjunction; because the oversoon use thereof, doth spoil the natural constitution of those parts. Barrenness which is caused by lowness of stature, or Elderliness of years, is incurable, yet endeavour may be used to help the same, by Emollient and Relaxing Medicaments, provided the Courses do still slow. Over great Corpulency, must be corrected by an extenuating Diet and convenient Evacuations. If Barrenness seem to arise from a bad Course of Diet, as in persons given over much to Belly-cheer, to Wine, or small Drink, such women are to be reduced to an exact Course of Life; and all excess of eating and drinking must be avoided. Viragoes and strong constitutioned women, such as come near to the Nature of Men, that they may be 〈◊〉 fit for conception, must by all the art possible be effeminated, and reduced to such manners as become their sex; all meats of grosser nourishment being forbidden them, and all labours and exercises; their Courses being made conveniently to flow, by plenty whereof they may be abated of their manly courage, and grow soft and gentle. And if their monthly courses shall not suffice to that end, their humours must be diminished, by frequent Blood-letting, and purging; and by frequent bathing and other alterative remedies, the whole habit of their bodies must be moistened and cooled. If Barrenness be caused by Closure of the Womb, by distorsion, by obstructions, by Tumours or Ulcers; all these must be remedied by such Medicaments as are propounded in those Chapters which treat of their Respective cures. Barrenness depending upon an hidden property in the woman which is natural to her, is incurable, and therefore it ought diligently to be enquired after, least remedies be applied in Vain. If Barrenness come by witchcraft, Charming, or hidden power of Medicaments, there is little place for Physic; but the party must have recourse to prayers and supplications, which being Zealously poured forth, by men eminent in piety, do procure Help from the Almighty. Howbeit against Medicines which by a secret power do cause barrenness, certain Annulets are propounded by Authors, which have a peculiar virtue to resist the malignity of such Medicaments. Cardan will have it, that the Pizzle of a Wolf worn about the woman, will frustrate all such Incantations and fascinations. Others do much commend the Adamant and the Hyacinth Stone. The Ancients called Saint Johnwort, the Divel-driver. The same virtue is likewise attributed to the Squil or Sea-Onion, to Eryngus, ●agapenum, Rue, & other things, being worn by Man & Wife. Also certain it is, that for the parties concerned, to endeavour confidently to despise and slight all Charms and Witchcrafts, is very profitable in this case. Also (if the Author of the Witchcraft be not known) it is good for them to Change their Habitation, and to forsake their Houses, Beds, wearing , and other Household stuff, wherein the Charms are oftentimes concealed. If an hot Distemper be the cause of Barrenness, the same Cure is to be used, which was described in the hot distemper of the Liver. But if the Excess of Heat be yet more violent, recourse must be had to those things which have been described in our Chapter of Womb-fury. But the camphire must be let out of those Medicines, Because it is held to be a very great Enemy to fruitfulness. Extreme Dryness, hindering Conception, must be cured by a restorative Diet; and if the Consumption of the flesh be much, we must have recourse to the Cure of an Hectic fever viz. Use of Milk, frequent Bathing, and such like. But the most frequent Cause of Barrenness is a cold and moist distemper of the whole Body and of the Womb, which is often accompanied with the Whites, whose particular Cure must be 〈◊〉 from its proper Chapter. But the following Medicaments may be peculiarly applied to these distempers, which by a discreet Physician may be varied; so as to make them more heating or drying, according as Moisture shall the more offend. And in the first place phlegmatic humours abounding in the Body are to be evacuated by purging, diuretic and sudorisick Medicaments. And certain Revulsions are to be made, by ●ssues in the Arms, Neck, or thighs. Also the principal parts are to be strengthened with Treacle, Mithridate, Tablets or Lozenges of Aromaticum Rosatum, Confection of Alkemies and such like. Also Purgations must be repeated at certain distances of time, if Evil humours do s●em to abound. Afterward we must proceed to such things, which do by a peculiar virtue or spec●●ck property strengthen the Womb, help Conception, and procure desire of fleshly Embracements, of which kind of Medicaments there are innumerable forms described by Authors. We shall in this place choose out the principal and set before you, And in the first place, An Electuary may thus be made. Take Roots of Eryngus and Satyrion candied or preserved, of each one ounce. Green Ginger candied, half an ounce. ●i●bert Kernels, Pine-kernels, and Pistachio● of each six drams: one preserved Nutmeg. Seeds of Rocket and Water-Cresses of each two drams. ashes of a Bull's Pizzle, the Reins of the Sea-Scinkos and shave of Ivory, of each one dram. Confection of Alkermes three drams. The Powders D●amb●a and D●amoschum Dulce, of each one ounce and a half. Amber Greece half a dram. With Syrup of Preserved Citrons, make an Electuary. of which let her take the quantity of a Chessnut, a● her lying down to sleep, twice or thrice in a week, drinking a small draught of Canary Sack or Hyppocras, after it. In the form of a Powder, the following Medicaments may be administered. Take Seeds of Rocket, Siler Montanum, of each half a dram, shave of Ivory, Cinnamon, Nutmeg, of each a dram, Musk (in such as can away with it) three grains. White Sanders three drams. Mix them and make of all a Powder. The Dose is one dram in Canary. Or Take Seeds of Rocket, wild Parsnep, Cinnamon, Powder of the Nutmeg, Electuary Diambrae and Diamoschus, of each one dram: the Matrix of an Hare, a Bores-stones, a stags Pizzle, Cloves, of each half a dram: Musk and Ambergris, of each six grains, Sugar the weight of all the rest. Mingle them, make them into Powder, whose Doses is two drams with rich Canary. The Afterbirth of a woman is believed to be of great efficacy, being dried and Powdered and taken to the quantity of a dram. Some Reckon as a secret the Powder of the Liver and Stones of a Boare-Pig which the Sow his Mother farrowed alone without any Brothers or Sisters by him. This Powder they say cures Barrenness both in men and women. Matthiolus in his Comments upon Dioscorides cries up the Seed of the Herb Amy, in these words: The Seed of the true Amy, which is brought from Alexandria, does exceedingly help the Barrenness of women. For experience hath shown, that many have been made fruitful only by the use of this Seed. For if it be drunk a drams weight in a morning in strong Wine, or in broth of flesh, being finely Powdered, every other day three hours before Meat, it gives great hopes of Children. But the Man must have to do with his Wife only on those days in which she does not take the Seed. In such women whose bowels are apt to be Inflamed, the shave of Ivory will be very good, taken to the quantity of a dram in White Wine, for four or five days together, after the monthly Purgation. The Essence of Satyrion, described by Crollius, is most excellent in this case, if it be given from a scruple and two scruples, to a dram, in a Cup of Muscadine. Salt of the said Satyrion is also very effectual, given to the quantity of ten grains in Muscadine, after the Courses. Divers Decoctions are wont to be made to the same intent. The most effectual, are these which follow: Take Eryngo Roots one ounce: Mugwort, Nep, of each a handful: Boyl them in white Wine. Give a Cu● of the Decoction morning and evening, with a dram of Tryphera Magna, made without Opium, nine days together. Quercetanus highly commends this which followeth: Take of the Stones of a Ram prepared with Wine and dried, the Matrix of an Hare prepared after the same manner and dried, Mace, Cinnamon, Cloves, white Ginger, Seeds of Ammeos, of each two drams: Saffron a dram and an half: Hazelnut Kernels, and Pistachios, of each three drams. Beat such of these as require beating, and boil all in a quart of Muscadine till a third part be consumed. Let her take three or four ounces of this Decoction in a morning three hours before meat, and that three days together; and upon the fourth let her lie with her Husband. The distilled Water following, is likewise very effectual. Take of Cinnamon, Cloves, Nutmeg, Mace, of each an ounce: Cubebs, long Pepper, Galangal Zedoary, Seeds of Ameos, Seseleos, of each half an ounce: Juniper Berry's one dram: rich white Wine, Rosemary Water, Margerum water, Balm water, of each as much as shall suffice. Let them digest together six days, and then distil them, and give of the stilled Water morning and evening two or three spoonfuls. Pena and Lobellius propound as a Secret not to be communicated to any living Creature, the distilled Oil of the smaller, and more delicate sort of sweet Marjoram, mingled with the Runnet of an Hare, and a little Musk, to facilitate Conception. If a woman upon the fourth day of her monthly Purgations, shall drink about half a pint of the Juice of Sage with a little Salt, and a quarter of an hour after submit herself to the Genial Embracements of her Husband, many grave men affirm, she will undoubtedly conceive. With which Medicine, Aetius testifies that the Egyptian Women after a great mortality by Pestilence, had abundance of Children. To the foresaid internal Medicaments, external Medicaments must be joined. In the use whereof, it is diligently to be observed, that before we go about to dry, bind, and corroborate the womb, that the filth contained in the Cavity thereof be first drawn away and purged, lest it either flow back into the noble parts of the Body, or be more affixed to the substance of the Womb. First therefore such things must be given as purge the womb, after this manner compounded: Take Diaphoenicon and Hiera Picra, of each half an ounce: Turpentine and Honey of Mercury, of each one ounce: Castoreum a dram. Mix all, and according to art bring them to such a constitution as shall be fit to make Pessaries, to put in●o the Womb. Or, Take of Hiera Picra half an ounce: Agaricktrochiscated and powdered, Orice Roots of Florence, of each one dram: old Mithridate, and Diaphoenicon, of each two drams. With Juice of Mercury, make a Pessary. Roul it in a cloth, put it up when she goes to bed, and let her keep it two or three hours. If the Womb be very full of Excrements, a more strong Pessary must be put in, after this following Injection. Take Leaves of Wormwood, Mugwort, Mercury, and Rue, of each one handful and an half: Pulp of Coloquintidaten grains: Agarick trochiscated half a dram: Ginger and Myrrh, of each a scruple, Boyl all in water and white wine to a pint, wherein dissolve two ounces of Honey of Roses. Let three ounces of this Liquor be injected into the Womb for three days together, in the morning, and when she goes to bed, after her Courses have done. Then put up this following Pessary. Take Hiera Picra, and Benedict a Laxativa, of each an ounce: the pulp of Coloquintida, and Agarick trochiscated, of each half a dram: Spicknard, Seeds of the Roman Nigella, Savin Leaves powdered, of each a dram: Incorporate them with Honey of Rosemary flowers, and include them in a piece of Silk. Make Pessaries hereof, and put one into her womb, when she is going to bed, and let it bide there two hours, and afterward wash the part with white Wine. To strengthen, fasten, and dry the womb, these following Medicaments may be used: Take Roots of round Birthwort half an ounce: Lignum Aloes three drams: Cypress Nuts and Roots, of each two drams: Calamus Aromaticus a dram: Dictamnus Creticus, Winter Savory, and Myrrh Leaves, of each one handful: choice Myrrh, Storax, and Benjamin, of each two drams and an half: Stoechados, Rosemary flowers, and Marjoram, of each one pugil: Boyl all in a sufficient quantity of strong white Wine. In a pint and an half of the strained Liquor dissolve two drams of Troches of Alipta Moschata, Ambergris, and Musk, of each seven grains: Civet five grains. Make hereof an Injection into the Womb warm, morning and night for certain days together. Before or after the Injection, this following Fumigation may be used: Take Troches of Gallia and Alipta Moschata, of each two drams: Storax, Benjamin, and pure Laudanum, of each half an ounce: Lignum Aloes, and Lignum Rhodium, of each one dram: Nigella Seeds, Cubebs, and Cloves, of each four scruples: Amber, and Tacamahacca, of each one dram and an half: Mace half a dram. Make of all a Powder, of which with Orange-flower water, wherein Gum Tragacanth is dissolved, make little Cakes or Troches: of which, let one or two be laid upon burning coals, and let the smoke be received by a Funnel into the Patients Womb. The poorer sort may be smoked with Myrrh, Frankincense▪ Lignum Aloes, Storax, Benjamin, Cinnamon, and Cloves, of each a like quantity. After the Injection and Fumigation, let the following Pessary be put up. Take Frankincense, Mastic, of each two drams: Troches of Gallia and Alipta Moschata, of each four scruples: Bistort Roots, Cypress nuts, Shave of Ivory, and red Roses, of each one dram: Styrax, Benjamin, and Laudanum, of each two scruples: Calamus Aromaticus, and Cypress Roots, of each half a dram. Make them into a Paste with Orange-flower Water: then with thin linen cloth, make two Pessaries of sufficient greatness; one of which put up when she goes to bed, anointing the top thereof with a little Oil of Nutmegs and Civet mingled together. It is furthermore related of Garden Garlic, That if it be beaten with Oil of Spike, and thrust into a piece of Linen made like a Pudding bag, and so put up far within the Womb, that it powerfully brings down the Courses being stopped, and wonderfully delights the womb, and purgeth it: so that hereby, many have been brought to conceive Children, who for a long time had been past all hope of ever having any. Before the strengthening Injections and Fumigation, a Bath to sit in may be used for an hour together, before the Patient goes to bed; and it may be thus prepared. Take Roots of Briony, Master-wort, valerian, Orice, Enula Campana, of each three ounces: Leaves of Marjoram, Mugwort, Nep, Penyroyal, Mercury, Sage, Bay, of each four handfuls: Bay-berries, and Juniper Berries, of each an ounce: Boyl all, and make thereof a Bath for the Patient to sit in. As for total Baths, such as arise from Brimstony and Bituminous Mines, are most excellent; and very many women in this Condition, do flock unto such Baths, as to a Sanctuary. After Bathing and Fumigation, the Share, and the space between the Privities and Fundament, must be anointed with this following Ointment: Take Oleum Nardinum, & Moschatellinum, of each an ounce and an half: Oleum Cheirinum half an ounce: Powders Diambrae, and Diamoschi, of each one dram an half: Liquid Storax one dram: Civet ten grains: Musk, Ambergris, of each six grains: a little white Wax. Mix all, and make them into an Ointment: Wherewith let the parts aforesaid be anointed. Within let her be anointed with Civet, or Indian natural Balsam. Or let the Man smear his Yard with Civet immediately before he join himself. Finally, Let Plasters be applied to the Share, and to the Loins, which let her wear continually, or at least every night, until the last week, in which her Courses are wont to flow. Let them be made after this manner: Take of the Rowl of Emplastrum pro Matrice four ounces: Of the Rowl of Emplastrum de Mastiche two ounces: Tacamahacca, and Caranna, of each one ounce: Powder of Tormentil and Bistort Roots, of each three ounces: Powder of Myrtle two drams: Powder of Aromaticum Rosatum four scruples: Soften them with Oil of Quinces, adding thereto a dram of Oil of Nutmegs. Spread it upon Leather, and shape two Plasters, the one round to be applied to the Share; the other square for the Loins of the Patient. Chap. 16. Of Acute and Chronical Diseases of Women with Child. THe Acute and Chronical Diseases of women with Child are the same in Essence or Nature, and have the same signs, with the like Diseases in women not with Child, or in men; wherefore it is needless in this place, to speculate thereupon, let the Reader please to look for them in their proper Chapters. But the Prognostic of these Diseases is not the same; because in women with Child they are far more dangerous, and very often times mortal. So saith Hypocrates in Aphor. 31. Sect. 5. For a Woman with Child to be feized by an acute disease, is deadly. For it the Disease have a Fever joined with it, there is a twofold danger attending the same (as Galen shows in his Commentary upon this Aphorism) one from the Fever, which will kill the Child; another from the slender diet which is requisite to the Cure of the Fever, but is not sufficient to nourish the Infant in the Womb. Or if it be an acute Disease without a Fever, as the Falling-sickness, Apoplexy, Universal Convulsion of the whole Body, the Mother and Infant cannot withstand the violence of the Disease, neither can they bear such strong Medicines as are requisite to the Cure of those Diseases. Yet we must know that this Prognostic is not perpetually true. For we know by the Testimonies and Examples in Authors, and by daily Experience, that many women with Child having acute Diseases, escape with their lives. But Chronical or linger Diseases, as Intermitting Agues, Catarrhs, Tenesmus, etc. do threaten Abortion, and if they cause it not, they can hardly be cured before the woman be brought to bed, but do keep her company till she lie down. Diseases Acute and Chronical in the first and last months, are more dangerous, than in the intermediate months. For in the first months, the bands wherewith the Infant is fastened to the Womb are weak, so as they may easily be broken, and the tender Infant is more easily over pressed with those preternatural Causes. But in the last months, namely, the sixth, seventh, and eighth, the Child being grown greater, requires much nourishment, which in these Diseases it is deprived of. Also the foresaid bands do not stick so fast as in the third, fourth, and fifth months, in which there is less danger of Abortion. Therefore Galen doth excellently compare the Child in the Womb to Fruits hanging on a Tree, which upon their first growing out have very tender stalks, so that they may be easily shaken off with the wind, or any other violent commotion; and when they are near ripe, they hang not so fast upon the bough, as in the intermediate spaces they did. Likewise the Cure of the foresaid Diseases in women with child doth remarkably differ, as touching their Diet, and those two grand Remedies, Blood-letting and purging; whereunto we may add Medicaments which evacuate by other ways, viz. Such as move the Courie, Piss-drivers, and Sweat-drivers, because it is feared lest by these evacuations, abortion may be caused: of these therefore we shall only treat at present, referring what else belongs to the Cure of these Diseases to the proper Chapters, where such respective Diseases are handled. As for Matter of Diet it is not to women with Child in Acute Diseases to be enjoined so spare, lest the little Infant be famished; neither is it to be allowed so liberal, that the Fever should be thereby strengthened; but we must steer a middle course, with this Caution, That in the first months of their Belly-burden, a thin Diet be enjoined, and in the latter somewhat more solid and plentiful, because the Child doth then stand in need of more nourishment. Yet if there must needs be some error in Diet, it is better to err in keeping too full, than too slender diet; for recovery is chief to be expected from the strength of the Mother, and the Child. Touching bleeding, that Aphorism of Hypocrates, viz. the 31. of Sect. 5. is presently brought in opposition, where he says, If a woman with child be let blood, she miscarries, especially if the child be grown. And Galen renders the Reason in his Comment, Because the Blood being let out, the Infant wants its nourishment, whence follows Abortion. On the other side, daily Experience shows, That in very many Diseases of big-bellyed women, especially acute diseases, as the Pleurisy, Inflammation of the Lungs, continual Fevers, and such like, blood-letting is necessary, and may be administered, not only in the first but also in the middle months, and sometimes in the last months of a woman's Belly-bearing. Which if it be omitted, both Mother and Child are in great danger of death. And to this latter Opinion the elder Physicians assent, not dissenting from the Mind of Galen and Hypocrates, by so doing. For therefore it is they held a woman would miscarry, if being with Child, she were let blood, because blood being taken away, the Child would want its Nourishment. So that if blood may so be taken away, as that the Infant shall not want its nourishment, there will be no danger of Abortion thereby. Now so the case may stand: As first, In the first Months of a Woman's Belly-bearing, while the Infant in the womb is little, and wants but little Nourishment, for then its Nourishment by bleeding will not be drawn away, especially if certain signs of superfluity of blood be apparent in the Mother. So that from the first month to the fift blood-letting, may be safely practised. But in the middle and last Months, greater circumspection is to be used, because the Child being greater, and wanting more Nourishment, cannot so safely admit of Phlebotomy. Howbeit, if the Woman abound with blood, and a small quantity be taken away, she may safely be let blood, because hereby the Disease will be allayed; neither will so much Nutriment be there by withdrawn from the Child, as to cause Abortion. But if it seem that Hypocrates thought otherwise, let us consider that we let blood after a far other fashion than the Ancients did, they let blood by pounds, and we by ounces. The very truth is, there is no better way to preserve women from Abortion, than by blood-letting, when it springs from overmuch blood strangling the Infant, and overwhelming the same, in such women as have been accustomed out of their time of being with child to have a plentiful flux of Courses for divers days together. Thus Petrus Salius Diversus in the 22. Chapter of his Book of particular Diseases: I for my part protest (quoth he) that I have preserved many women from Abortion, which they had often suffered, only by letting them blood in the first months of their being big. Neither would I have it thought, that no other kind of blood-letting may be practised in childing women, save that which is sparing or moderate. For sometimes plentiful bleeding in the last month hath done very much good. And I have sometimes experienced this plentiful Blood-letting in the last month, when the women with Child were afflicted with a burning Fever, and were full of Blood hoping thereby an abatement of the Fever, and an hastening of the Birth, both which I obtained by blood-letting, and saved both child and mother in danger of death, by this only Remedy. Which being in some Patients omitted, and neglected by Physicians, minding more the words of Hypocrates, than the matter itself, hath been the cause that both child and mother hath miserably perished, being strangled by the plenty and fer vency of blood. So far Salius. Amatus Lusitanus, in the 57 Cure of his I. Section, let a woman with child of eighteen years of age, blood, in the sixth month, four times with happy succe, she being in a burning Fever. And Rodericus a Castro in his third Book of women's Diseaeases, Chap. 21. writes, that he let a woman of Lisbon blood, who had a Pleurisy in the eight month, and was given over for desperate by other Physicians, four times and no less one after another, and she recovered, and had a healthy Boy. And to conclude, If I may freely relate somewhat from mine own Experience, I will set down the following History, which is a rare one, and worthy to be regarded. The Wife of John Vicules, Citizen of Montpelier, had three miscarriages one after another at several times of her being with child: When she was the fourth time with Child, about the end of the second month, she was taken with the same pains of her Belly and Loins, which had been the usual forerunners of her former miscarriages. I being called to her, and considering she was a Sanguine Woman, and full of Blood, presently caused four ounces of blood to be taken from her; and within half an hour the foresaid pains quite ceased, and the Woman was so well that she would not use those other Medicines which I prescribed for her to prevent Abortion. Now those Symptoms appeared in the self same time, wherein she was wont to have her Courses, when she was not with Child. Again in the third month of her being with Child, at the same period of time, the same Symptoms return upon her: She sending for me, desires I would order her to be let blood, seeing the month preceding she had found so sudden help thereby. I consent, and she is again let Blood, with like good success as before. In like manner in her fourth, fifth, sixth, seventh, and eighth months the same Symptoms returning, in their just distances of time, she was again let Blood and presently recovered. The last of h●r ●leedings was but eight days before the beginning of her ninth month, with like profit 〈◊〉 before; and about the end of the ninth month the said woman brought forth a living 〈◊〉 and Lusty. Yet I would not have a young Physician moved with these examples be too bold in letting women Blood in their last months of being with Child. But the Nature of the Diseases and of the women raust be diligently considered, that Medicaments may be conveniencly suited thereunto. Always remembering that sins of omission are lighter than sins of commission, and that it is better in a doubtful case to fall short, than to outpass the due and fitting bounds. Yet when he finds the evident indications of Blood-letting, let him boldly draw Blood, first informing the bystanders or friends of the sick, that there is more danger of abortion, and of the death of Infant and Mother from the Cruellty of the disease, than from Blood-letting: and always remembering that but little Blood be taken away, that the Child may not miss of its nourishment. And if plenty of Blood require a larget quantity to be taken away, let it be done at divers times and not all at once. Wherefore the foresaid Aphorism of Hypocrates does not absolutely forbid the opening of a vein, but only warns that Physicians be wary what they do in that kind. Which is elegantly delivered by Cornelius Celsus in the 10. Chapter of his 2 Book, in these words. The Ancients did judge that young and old people could not bear Blood-letting. And they persuaded themselves that a woman with Child, let Blood would miscarry. But experience hath since taught us, that these are no general Rules, and there are other considerations of more weight, which the Practitioner is to regard. For it matters not of what Age the Patient is, nor what she hath in her Body, but what her strength is. So that if a young man be weak, or a woman not with Child be weak, Blood is ill taken from them, for the remaining strength dies, and they perish. But a strong Child, and a strong old man, and a woman with Child that is lustily, are safely cured by bleading. So for Celsus. Some latter Physicians have dared to open the lower veins in women with Child, to Cure the Falling-sickness by consent of the Womb, the venerial and pestilential Bubo, yea, and to prevent abortion, as we may see in Zacutus Lusitanus in his Book of Wonderful Cures Obs. 23. Book, 1. and Obs. 130 and 151 of Book 2. Who by his own and other men's experiments endeavours to prove, that such Blood-letting may be safely practised. Which I leave to prudent Physicians to consider of. We said about the beginning of this Chapter, that there is no difference in Curing the diseases of women with Child, saving with respect to the greater remedies; which difference must be in them thus determined, viz. That the diseases which hold women not with Child, as vomiting, want of appetite and the like; in them being not with Child, they are to be Cured rather by vomiting than by Blood-letting, because they come from evil humours abounding in the stomach and the whole Body; but in women with Child, they need rather Blood-letting, because they Spring from Blood retained in in the very beginning of their being with Child. And experience hath taught that the vomiting, which is wont often to trouble women with Child, is in the first months of Childing exasperated by purges; but by bleeding much abated, yea and wholly taken away, if the Blood-letting be iterated every month till the symptom cease. The use of Purging in women with Child Hypocrates hath defined in Aphor. 1. Sect. 4. Women with Child (saith he) are to be purged if the humour offending do work in the fourth month and to the seventh, But these about the seventh less. And we must take heed what we do when the Child is very young, or old. Galen in his Comment says that there is the same proportion between a Child in the Womb and fruit upon the true. For fruit when it first grows upon the bough, it is held by a very tender stalk, and therefore quickly falls, being shaken by a vehement wind. afterwards when they are grown greater, they are not easily separated from the boughs. And yet when they are fully ripe they fall off of their own accord. In the same manner women suffer abortion in the first and last months, because in them the Child is not so fast tied to the Womb. But in this Age of ours, purges are wont to be given to women with Child in all the months (very near) of their being with Child in diseases springing from the tyranny of humours & excrements vitiated, when the matter is in motion and works, or when it is concocted: so often as there is more danger seared from the evil humour causing the disease, than from the commotion raised by the purging Medicaments. Gentle and harmless Medicaments have made Physicians bolder in this kind, such I mean as we use at this day, as Rhubarb, Myrobalans, Cassia, Manna, Senna, Agarick and the like. But we must always remember that saying of Hypocrates; and we must more freely give purges in the middle months and more warily in the first and last. Also the use of Pills is ever more suspected in women with Child; both because they make a greater commotion in the Body, and also by reason of the Aloes, which by reason of the extreme bitterness is an enemy to the Child, and is thought to open the mouths of the veins. But if sometimes the use thereof seems necessary, in some grievous infirmities of the stomach, which are wont frequently to infest women with Child the first months of their being with Child bearing, let it be carefully washed with Rose-water, that the acrimony thereof may be taken away; or let it be mixed with strengthening and astringent things, as Rhubarb, Mastic and such like. Clysters are not very safe, because by compressing the Womb they may cause abortion. So that when there is need of them, and in women accustomed to that kind of evacuation, they must be made in less quantity, and of such things as are rather mollfying and lenefying than much purging. In a word, touching Sweat-drivers, Piss-drivers, and such things as move the Courses, our Opinion is, That Movers of the Courses properly so called are never to be used in women with Child. And Piss-drivers because they likewise are apt to bring down the Courses, aught to be suspected; and if the necessity of some disease require the use of them, the gentler must be made choice of. And finally, Sweat-drivers may be safely given, because they drive the humours out, by the habit of the Body, whereby no danger of abortion is incurred, in so much that some women in the middle of their being with Child, have been Cured of the whore's Pox, without harm to their Child. Chap. 17. Of Abortion or Miscarriage. ABortion or Miscarriage is the bringing forth of an imperfect or unripe Child. And consequently a child dead in the Womb, is not counted an Abortion, till it be excluded. So that whether alive or dead Child be brought fourth, not being ripe, nor having attained to the just term of growth which it ought to have had in the Womb, it is to be termed an Abortion, or Miscarried Child. The Causes of Abortion are some internal some external. The internal may be reduced to four heads, viz. to the Humours, to the Child, to the Womb, and to the Mother's diseases. The humours may cause Abortion while they offend in quantity or in quality. They offend in Quantity either by way of excess or of Defect. Humours offending by way of excess are seen in a Plethoric or over-full Constitution of Body; for Blood being more plentiful than is requisite to Nourish the Infant in the Womb, flows into the veins of the Womb, and is excluded by way of the monthly Courses, and brings away the Child with it. Defect of Humour fitting to Nourish, springs from such Causes, which are able to draw the Nourishment from the Child, as fasting, whether voluntary or forced; as when women with Child loath all kind of Meat, or vomit it up again; a thin diet in acute diseases; immoderate bleeding by the Nose, Haemorrhoides, Womb, or by immoderate Phlebotomy. Whereupon Hypocrates in Aphor. 34. Sect. 5. If a woman with Child go very much to stool, it is to be feared that she will Miscarry. Hereunto may be referred extreme leanness of the whole body, wherein there is not Blood enough to nourish the Infant. Of which, Hypocrates in Aphor. 44. Sect. 5. Speaks thus. Women with Child being very lean, not by nature, but accident, as famine, long-sicknes etc. they Miscarry, until they get their flesh again. In respect of the Child, Abortion may happen, if it be over great, so that it cannot by reason of its bulk be contained in the Womb; hence it falls often out that little Women miscarry especially if they be married to Men Bigger than ordinary whose Children grow very great, and find not in the Womb place large enough to contain them, till they come to their perfect growth. Which made Hippocartes say In his Book of superfoetation. If any Woman conceive frequently, and do duly and at a certain period of time Miscarry, as in her second, third, or fourth month, or later: the narrowness of her Womb is in fault, which is not able to contain the Child as it grows great. Also plurality of Children may cause abortion, as when two or three or more are contained in the Womb at one time; for then the Womb overloaden excludes the Children before the fit time: which is the cause that Women often Miscarry of twins. Also the dead Child is to be reckoned among the causes of Abortion: for as soon as the Child is dead; Nature doth forthwith set herself to cast it forth. Abortion happens in respect of the Womb itself, if it be not of largeness and capacity enough, sufficiently to widen itself according as the child grows, as was showed above out of Hypocrates. As also if there be any thing preternatural in the Womb, as an Inflammation, a Scirrhous Tumour, an Impostume and very many diseases besides. And finally if the Womb be overmoist and slack, that it cannot contain the Child so well as it ought to do. In respect of the Mother's diseases, Abortion comes two ways. First of all, when as her diseases are communicated to the Child, whereby it is killed, or so weakened that it cannot receive due nourishment nor growth; such as are continual and intermitting fevers, the Whores-Pocks and many such like. Secondly, when the said diseases of the Mother, do cause great evacuations or great commotions or the Body, as ●●rge Bleedings, from what part of the Body soever, fluxes of the Belly, grievous swoonings, Falling-sickness, Vomiting, and Tenesmus [that is perpetual going to the stool and voiding nothing but a little slime▪ which above all other diseases is wont to cause Abortion, because by that frequent and almost continual endeavour of going to stool, which perpetually attends this disease, the Muscles of the Belly are perpetually contracted, and do more compress the Womb than the straight Gut upon which the Womb rests; which continual compression or squeezing of the Womb, doth at last cause Abortion. External causes which further Abortion, do some of them kill the Child, others draw away its nourishment, and others dissolve those bands wherewith the Child is fastened to the Womb. The Child is killed by grievous commotions of mind, as Anger, sadness, Terror etc. meats earnestly longed for and not obtained, strong purging Medicaments, such things as provoke the Courses, such things as drive forth the Child; such things as are reckoned by a secret property to destroy the Child in the Womb; abominable smells, especially the stink of a Candle ill put out. The Child is deprived of its nourishment, by the Mother's being famished, and by immoderate loss of her Blood, especially when the Child is big. As Hypocrates teaches in the Aphor. 60 Sect. 5. The bands which fasten the Child to the Womb are loosed by vehement exercise, Danceing, Running, riding, or Jolting in a Coach or Cart; carrying of an heavy weight, or lifting it from the ground, a violent fall and squelch, a Blow upon the Belly that mauls the Child, vehement motion of the Belly by coughing, vomiting, looseness, neezing, convulsions, crying out, immoderate or over wanton venereal embraces. And in a word, vehement motions of the Arms, by drawing somewhat violently to a Body, by turning a wheel, or doing some such work, may exceedingly further Abortion or Miscarriage. The Signs of present Abortion are manifest of themselves. But such as go before Abortion, and prognosticate the same, are these; An unusual heaviness of the Loins and Hips, a loathness to stir, Appetite gone, shivering and shaking coming by fits, pain of the head, especially about the Roots of the Eyes; a straitening of the sides, and of the Belly above the Navel; the flagging or falling, and extenuation of the Dugs, which made Hypocrates to say in Aphor. 37. Sect. 5. If the Dugs of a woman with child do suddenly grow small, that woman will miscarry. For the extenuation of a woman's Dugs in such a case, doth signify want of blood in those Veins which are common to the womb, and to the Dugs, by means of which defect, the child is in danger to miscarry. But if Abortion shall be caused by some external essicient, causing violent agitation of the Child in the Womb, and a bursting of the Vessels, with a pain raised in those parts; the Spirits and Blood run speedily to the genital parts, of which the Dugs being destitute, grow smaller than they were. Furthermore, Plenty of Milk dropping from the Dugs, doth argue weak Child, and consequently portends Abortion; according to Hypocrates in Aphor. 52. Sect. 5. But if frequent pains, a●d almost continual, do torment the Reins and Loins, reaching towards the Share as far as Os sacrum, with a certain endeavour of going out of the Womb, it is a certain sign of a woman that will shortly mscarry. For those parts do signify that the Membranes and Ligaments wherewith the child is fastened to the womb are stretched and torn in ●under. And if so be that pure Blood, or such as is wheyish, or water flowing from the Womb, do ●ollow the foresaid pains and endeavours of coming out; it shows that Abortion is hard at hand, and that the Vessels and Membranes of the Womb are broken, and the mouth of the Womb open. At the same time, the situation or posture of the Child is changed; for whereas it lay high and possessed the middle of the Woman's Belly like a Sugar-loof bearing out; it is now gathered, round like a Football, and roiled down towards the Water gate. Also oftentimes there follow grievous Symptoms, as shiverings, tremble, Palpitations of the Heart, Swoonings, and abundant Bleeding. Hereunto may be added what Hip●oc●a●es teacheth us in the second Book of Popular Sicknesses, Text 17. That if after violent external c●uses, such as are blow, a fall, and such like, vehement pain, and perturbation arise in a Woman with Child, she suddenly (or at most the same day) miscarries; but if the external cause were weak, the Abortion may be differred till the third day, which being once over, there is no longer danger of Abortion, because such wounds and hurts, are wont to grow well again upon the third, or at most, the fourth day, or very much to be mitigated and assuaged; whereupon the Child is again confirmed in the Womb and retained. Which Precept is of great moment in the Practice o● Physic, that women with child being hurt by some external accident, should keep their bed for ●nree days or longer, and use such Remedies as prevent Abortion. The Prognostics o● Abortion may be divers, after this manner: Women are more endangered by Abortion, than by due and timely Childbirth, because it is more violent, and unseasonable, for as in ripe Fruit, the Stalks are loosened from the Boughs, and the Fruit falls of itself; so in a Natural Birth, the Vessels and Ligaments wherewith the Child is tied to the Womb, are loosened and untied as it were of their own accord, which in case of Abortion must needs be violently broken asunder. Very many women become Barren by their Miscarriages by reason of those exceeding rendings & tearing which do wholly overthrow the dispositions of the Womb. Much bleeding accompanied with fainting, raving, and convulsions, is wont to cause death; and Aresaeus testifies he never saw any escape, who in the time of their Abortion, or aiterwards, had Convulsion fits. Inclamation of the Womb caused by Abortion, is for the most part deadly; for Blood flowing to the Womb in great quantity, is not purged out, but putrefies therein, and regurgitat●s or slows back into the upper parts; whence arise burning Fevers, pant of the Heart, Heartburning, and other Symptoms enumerated before. Abortion is more dangerous in a woman that never bore Child before, because being unaccustomed to Pains, and having those Passages more straight, she is longer and more vehemently tormented. Women very lean or very fat, are more endangered by Miscarriage; the former, because of their weakness; the latter, because of the narrowness of those Passages by which the Child must come forth. Abortion is more dangerous in the sixth, seventh, and eight months, because the Child being the greater, is excluded with the more pain and difficulty. Women which have a more lose and moist womb than ordinary, domiscarry commonly without danger, especially in the first month; because those parts in such women, do easily give way, whence their pain and trouble is the less. Hypocrates in the second Book of Popular Sicknesses, affirms, That to miscarry of a male Conception of threescore days old, helps a Woman whose Courses are stopped, By stopping of Courses, he understands only their imminution, when women are not sufficiently, or conveniently purged, at their monthly seasons; for by such an Abortion or Miscarriage as aforesaid, those stopped passages are opened, and the Blood is drawn towards the womb, which came thither but slowly in former times. Our ordinary women seem to have taken notice, of the truth of this saying of Hypocrates. who touching an Abortion of a few months, are wont to say by way of proverb, Amiscarrying woman is half with child again. The Cure of Abortion consists in Preservation, for that which is passed cannot be helped. But all the Symptoms which follow Abortion, are the same which accompany women duly brought to bed. The Preservation from Abortion hath two principal Points or Heads: The one concerns the woman before she is with child: The other when she is with child. Before the woman is with child, all evil dispositions of body which are wont to cause Abortion, must be removed: as fullness of blood, badness of Humours, and peculiar Diseases of the womb, viz. Distempers, Swell, Ulcers, and such like. Fullness of Blood opens the Veins of the womb, or strangles the Infant while it is in the womb. This if it be a pure and simple Plenitude, may be cured by Blood-letting, such as shall answer the quantity of blood superabounding. But badness of Humours, is either choleric and sharp, so as to open the Orisices of the Veins, or by provoking Nature, to stir up the expulsive faculty, whereby the child comes to be expelled with those evil humours; or by reason of plenty of excrements heaped together in the first Region, and distending the Belly, it suffocates the child; or it vitiates the blood in the whole habit of the Body, rendering it unfit to nourish the child, or it fills the Vessels of the womb which retain the child, full of slime and snot. This Badness of Humours may likewise be helped by blood-letting, but it must be in a lesser quantity, seeing the principla scope of the Cure, is by frequent Purgations, to take away the supper fluous Excrements of the Body. And in the spaces between Purge and Purge, such things must be used, as help the distemper of the Bowels, mitigate the sharpness of Humours if there be any, or thicken the said Humours, in case they be too thin. Or if slegmatick Humours are too rife, they must be discussed by Sweat-drivers, Piss-drivers, and other Remedies. Howbeit we must diligently observe, that whatever ill humour abounds, Issues are wonderful profitable to prevent Abortion: of which Zacutus Lusitanus gives a special note, in these words: By most happy Experiments I have observed, That frequent Abortion caused by corrupted Humours which slow from the whole Body to the Womb, and by their evil disposition or abundance do kill the child, is hereby as by a most present help prevented. Many women did miscarry upon this very account, among which some having often times brought forth a Child of seven months or four months' growth, but torn and putrefied, could by no other means be freed from so great a Calamity, save by Issues made in their Arms and Thighs, which were always made at the beginning of the fluxion; by which means they went out their time, and brought forth Children healthy, and not defiled with any Infection. The peculiar Diseases of the Womb, as over great Moisture, Swell, Ulvers, and such like must be cured by their proper Remedies described in the Chapters which treat of them. In women with Child, if the same Causes be present as in other women, the difficulty is yet greater, because bigbellied women cannot so easily bear all kind of Remedies. Yet, lest being destitute of all help, they should remain in extreme danger of Miscarriage and Death, some kind of Remedies are to be used. In case therefore the Patient be too full of blood, she must have a Vein opened, though with child, especially in the first months; and that the second and third time, if need be. Always remembering that there never be much blood taken away at a time. Of which kind of bleeding we have discoursed more at large, in the foregoing Cure. And when there is an abundance of some very bad Humours, gentle Purgations must be reiterated, especially in the middle months of a woman's being with Child. And if a moist, rheumatic, snotty, or windy distemper do annoy the Patient, we may sometimes proceed to a Sudorific Di●t, at least a gentle one, in the stronger sort of women. Mean while, in the whole course of being with child, astringent and strengthening Medicaments are to be used, such as have a virtue to hinder Abortion. Many of which have been described in our Chapter of immoderate flux of Courses; whereunto these following may profitably be added. Take of Kermes, and Tormentil Roots, of each three drams: Mastich one dram and an half. Make all into a Powder, of which give the Patient half a dram at certain distances of time, or as much as may be taken up upon the point of a knife. Or, Take red Coral two drams: Kermes berries, Date Stones, of each one dram: Shave of Ivory half a dram: Pearls not bored through, ascruple. Make of all a Powder. Or ler her swallow every day certain grains of Mastic in the morning. Our ordinary women do frequently use Plantain Seed, which they take in the morning about the quantity of half a dram, with Wine and Water or in an Egg, or Broth, or by itself, almost every day, the whole time of their being with Child, and that not in vain. To the same purpose very effectual Electuaries are compounded, according to this following Example: Take Conserve of Roses two ounces: Citron peels candied six drams: Myrobalans candied, Pulp of Dates, of each half an ounce: Coral prepared, Pearls prepared, and Shave of Ivory, of each a dram. With Syrup of quinces, make all into an Opiate, of which let the Patient take often the quantity of a Chestnut. If a Liquid form shall be more desired, a Decoction of Tormentil Roots, sweetened with Conserve of Roses, may profitably be given. The following Lozenges are very good; for they strengthen, and do by little and little free the Body from Excrements, though sometimes they do not visibly purge. Take Mace, the three sorts of , Rhubarb, Senna, Carals, Pearls, of each a scruple: Sugar dissolved in Rose-water, four ounces. Make all into Lozenges, weighing three drams apiece. Let her take one twice a week by itself, or dissolved in a little Broth. Outwardly Ointments and Plasters are to be applied, made after this manner: Take Ship-pitch half an ounce: Frankincense an ounce: Mastich half an ounce: Dragons Blood and red Roses, of each two drams. Make all into a Cerate or Plaster. Or, Take Oil of Myrtles, and Mastic, of each an ounce: red and yellow, Hypocistis, Acacia, of each half an ounce: Spodium, red Roses, of each two drams: Bole Armoniac, Terra Sigillata, Shave of Ivory, of each two scruples: Turpentine washed in Plantain Water an ounce: Wax as much as shall suffice. Make all into a Cerate or Plaster; spread it upon a Cloth, and apply it to the Reins. Plasters are compounded of the Mass of Emplastrum pro Matrice, and Emplastrum contra Rupturam, to be applied to the Region of the Share, and of the Loins. Or after this manner following: Take of the Mass or Rowl of Emplastrum pro Matrice three ounces: Bistort Roots, Acacia, Hypocistis, Pomegranate peels, of each half an ounce: Laudanum six drams. Moisten and soften them with Juice of Quinces, and make a Rowl of Plaster for the use aforesaid. Concerning Plasters it is to be observed, That they must not be worn long together, but taken off ever and anon; otherwise, if they stick too long upon the Back, they do so heat the Kidneys, that the poor women are sometimes troubled with sharpness of Urine, or do sometimes piss Sand, Stones, yea and Blood itself. Neither must we omit such things which are accounted by a secret property of their Nature to retain a Child in the womb; as an Aegle-stone worn about the Neck, a Loadstone applied to the Navel, Corals, jasper's, Smaragds, Bones found in the Hearts of Stags, and such like, worn under the Armpits, or hanged about the Neck. Zacutus Lusitanus in Obs. 152. of the Second Book of wonderful Cures, commends a Girdle made of the Hide of a Sea-horse; and if that be not to be had, he saith a Wolf's Skin may profitably be used instead thereof. And that the success of these Medicaments may be happy, the Patient must be enjoined to rest and keep herself as quiet as possibly she can, both in her Body and Mind; also to abstain from Genial Embracements, which do vehemently touse and disquiet the Womb. For while the Womb opens itself to comprehend the Man's Sperm, with which it is exceedingly delighted, it drives forwards the lately conceived Child, not yet throughly fastened in the womb. But if notwithstanding the Medicines aforesaid, by reason of the vehemency of the Cause, whether it be internal or external, the Patient be ready to Miscarry, we must apply ourselves to do the best we can, with these following Remedies. And in the first place, so soon as pains and throws shall be perceived in the lower part of the Patient's Belly towards her Share, in her Loins, and about the Ossacrum, we must seek to allay and stop them, both by things given in, and outwardly applied, according to the variety of Causes. For if Abortion be provoked by Crudities and Winds (which is most usual when it gins from an Internal Cause) a Powder must be given, compounded of Aromaticum Rosatum, and Coriander Seeds: Yea, we may give of the Aqua Imperialis, if the quantity of phlegm and wind be very great. At the same time let Carminative, or Fart-forcing Medicaments be applied below the Patient's Navel: such are, bags of Annis seed, Fennel seed, Foenugreek seed, Flowers of Chamomel, Elder, Rosemary, and Stoechadoes mingled together; Or a Rose Cake fried in a Pan with rich Canary, and sprinkled with Powder of Nutmeg and Coriander, or the Caul of a Weather newly killed, or his Lungs laid on warm. If with these means the pains cease not, let a Clyster be cast in, made of Wine and Oil, wherein two drams of Philonium Romanum may be dissolved, or Narcoticks may be given inwardly in a smaller Doses, to allay the violence of Humours and Winds, as we are wont to do in pains of the Colic. But if by reason of contumacious pains that will not be assuaged, or of the violence of some external cause, blood begin to come away, Revelling Medicines are to be applied, to withdraw the course of the blood from the Womb: such are, Rubbing of the uper parts and painful bindings; also Cupping-Glasses fastened to the Shoulderblades, under the Dugs, and under the short Ribs on both sides. Yea, and if the Woman be full of Blood, it will not be amiss to take some blood from her, both when she gins to void blood, and especially before it gins to come; and the blood must be taken away at several times, a little at once. And if all this will not suffice, but the Flux of blood continues, we must proceed to astringent and thickening Diet, and Medicaments; and so the Powders and Electuaries formerly described, may be administered. Also Juice of Plantain new drawn, and Syrup of Poppies to the quantity of an ounce, with Powder of , or Dragons-blood. Also outwardly may be used fomentations binding and strengthening, made of Pomegranate peels, Cyprèss Nuts, Acorn Cups, Balaustians, Grape-stones, and such like things boiled in Smith's water, and red Wine. Or a little Bag full of red Rose Leaves and Balaustians, may be boiled and applied hot to the Patient's Belly. Hereunto may be added the foresaid Plasters and Cerecloaths: Or for to cause the more astriction, make a Cataplasm of astringent Powders, with Turpentine, and the whites of Eggs, which must be spread upon Tow, or course Flax, and applied to the Navel and the Reins warm. The Tow which shall be applied to the Navel, must be moistened with Wine; that which is to be applied to the Kidneys, in Vinegar. The two following Medicaments are accounted for Secrets, and it is believed they will certainly hold the Child in the Womb, if they be used before it be loosened from the Wombs Vessels. Take twelve Leaves of Gold: Spodium a dram: the Cocks Treading of three Eggs that are not addle. Mix all very well, till the Gold be broken into small Atoms. Afterwards dissolve them in a draught of white Wine, and give it to drink three mornings together. At the same time let the following Cataplasm be laid on. Take male Frankincense powdered two ounces: five whites of Eggs: Let them be stirred about together over hot coals, always stirring them that they may not clodder together: add Turpentine to make them stick, Then spread it upon Parcels of Tow, which lay upon her Navel as hot as she can possibly endure them, twice a day, morning and evening, on the three days aforesaid. Chap. 18. Of Hard Childbirth. Heard Travel in Childbearing, is such as keeps not the due and ordinary Laws of Nature, taking up longer time than ordinary, and accompanied with more vehement pains than are usual, and other more grievous Symptoms. Divers causes here of may be assigned both internal and external. The internal depend either of the Mother, of the Womb, or of the Child. In respect of the Mother, Travel with child may become sore and hard, by the weakness of her Body, either Natural, or in regard of Age, as in very young and very ancient women, or in regard of Diseases wherewith the woman was troubled during the time of her going with Child, or is still troubled. Hereunto also Leanness, and over great dryness of the whole body, may be added; as also over fatness, and grossness compressing and straitening the passages of the womb; ill shape of such bones as border upon, and embrace the womb▪ as in such as limp, wind stretching the Guts; stone or preternatural tumour possessing the bladder, and pressing the Womb; and the ill constitution of the Lungs, and other parts serving for Respiration, because holding the Breath is very necessary to exclude the Child. In respect of the Womb, divers Diseases thereof may cause a sore Labour, as Swell, Ulcers, Obstructions, Astrictions, Stoppages arising from preternatural Causes. In respect of the Child, Hard Travel is caused, when there is some fault therein, in respect of its substance, its quantity, its figure, and certain things thereunto belonging. The Child is faulty in regard of Substance, when it is dead or putrefied, or some ways infected, or weakened with some Disease, so that it hath no ability to contribute to its own exclusion. In regard of Quantity likewise, the Child doth not further it's own Birth, which is either discrete or severed quantity, or concrete and joined; the former is called Number, the latter Magnitude. In regard therefore of continued quantity, the child is faulty, if the Body or Head of it be over great; which makes the Birth thereof become difficult and laborsom; in regard of the disjoined quantity of the child or burden, Labour becomes difficult, as when there are more than one in the womb; so the Birth of Twins is more painful than of a single Child, for the most part. In respect of the Figure, or Situation of the Child in the Womb difficult Travel happens many ways; as when the Child endeavours to come forth with its feet or its hands foremost, or puts out one hand only, or one foot; or when it endeavours to come forth doubled, with its breech, or its belly foremost. In regard of the Child's Adjuncts or certain things belonging to the Child, difficulty of Travail happens, when those membranes which enclose the Child are more thin than ordinary so that they come to break, sooner than they should; whence followed an over quick effusion of the waters contained therein, whereupon the mouth of the Womb remains dry at the time of the exclusion of the Infant; or where the foresaid Membranes, are more thick and compact than ordinary, by which means, the Child is hardly able to break them. External Causes depend upon things necessary and things contingent, the things necessary are such as Physicians commonly call res non naturales, things not natural. So a cold and dry air, and the Northern-wind are very hurtful to women in travail, because they straiten the whole Body, drive the Blood and spirits inwards, and prove very destructive to the Infant coming forth of so warm a place as the Womb. Also air more hot than ordinary dissipates the spirits and exhausts the strength both of Mother and Child, easily introduceing a feverish Inflammation into a Body replenished with ill humours, and exagitated. Meats raw and hard to digest, or of an astringent quality, taken in a large Quantity before the time of travail, may render the same laborious, the stomach being weakened and the common passages stopped, which in this case ought to be very free and open. Sleepyness and Sottishess do slacken the endeavours both of the Mother and the Child, and show nature to be weak. Unseasonable stirring of the woman doth much delay the Birth of the Child, whenas she refuses to stand, to walk, lie down, or to sit upon the Midwife's stool, as need shall require; or when she is unduly agitated to and fro; whence it comes to pass that the Child cannot l●●ue in a sitting posture, or loses the good posture it had, by reason of the Mother's undue and disorderly moving herself. The retention of Excrements at the time of Travail, as of Urinal distending the Bladder of hard excrements in the straight Gutt; and hemorrhoids much Swelled, do straiten the neck of the Womb, and divert nature from her endeavour of expelling the Child. And in a word, vehement Passions of mind, as Fear, Sadness, Anger, may very much increase the difficulty of Child birth. To things contingent are referred Blows, Falls, wounds, which may very much hinder the Birth: hereunto likewise appertain the party's assistant in time of travail to help the labouring woman, viz. strong women and maid servants, which may lift her up and support her when she is in her labours, and especially an expert Midwife, which ought to manage the whole Business. For if the Midwife err in her office, it is wont to cause difficulty of Birth. For sometimes the Midwises do over soon exhort the Childing woman, to hold their breath and to strain themselves to exclude their Child, while the bands which fasten the Child to the Womb, are as yet unloosed; by which means, the strength of the woman is wasted before hand, which should have been reserved to the just time of her travail. Yea and the truth is, while the Midwives do oversoon persuade the Childing women, that the time of their travail is at hand, they bend all their strength to exclude the Child, and oftentimes violently break those bands with which the Child is fastened, and cast themselves into no small Jeopardy. Hard Travail is known both by the Childing woman, and by the Assistants, but especially by the Midwife. And in the first place, if the woman continue a longer time than ordinary in her Labours, as two, three, four or more days whereas a truly natural Childbirth ought to be accomplished within the space of 24. Hours. Again, it is a Sign of an hard Labour, if the woman's pains be weak, and are long before they return, and if her pains are more about her Back than Privities. And the Causes of hard travail, are known by relation of the Childing woman, and are for the most part evidently to be seen. So the weakness of the woman, her over leanness, or over fatness, is perceived by the habit of her Body. Diseases of the Womb are known by their proper Signs. The Child's weakness is known by its weak and slow moving itself. But the Signs of a dead Child shall be declared in the next Chapter. The greatness of the Child may be gathered from the stature of the Parents, especially when a big-Bodyed man is matched with a little woman. But when there are none of these Signs, and the woman labours stoutly, and the Child stirs and makes its way sufficiently, and yet the travail is hard and painful; it is a token that the secundine or Afterbirth is stronger than ordinary, and can hardly be broken, which conjecture is more probable, if no water or moisture come from the woman dureing her Labours. The disorderly posture of the Child is perceived by the Midwife, and the other Causes are visible to the Eye, as we said before. As for the Prognostic. Hard-Travail, is of itself dangerous in which sometimes the Mother, sometimes the Child and sometimes both do lose their lives. If a woman be four days in Labour, it's hardly possible the Child should live. Sleepy diseases and convulsions which befall a woman in Travail are for the most part deadly. Sneezing which befalls a woman in sore Travail is good. Out of Hypocrates in his Aphorisms. To cure difficulty in Childbirth first all causes which may delay the birth, are as much as may be, to be removed. And afterwards, such Medicines as further the Birth are Methodically to be administered. And in the first place it is common among the women to give a groaning wife a spoonful or two of Cinnamon Water. Or Cinnamon itself in Powder with a little Saffron may be given, or half a dram of Consectio Alkermes may be drunk in a little Broth. Also Saffron alone being given ten grains in every Mess of Broth the woman takes, or every hour being taken in a little Wine is very good Or. Take Oil of sweet Almonds and White Wine of each two ounces. Saffron and Cinnamon of each twelve grains Confectio Alkermes half a dram. Syrup of Maiden Hair one ounce and an half. Mix all and make thereof a potion. If this shall not suffice, but that stronger things, must be used, the following potion will be most effectual, which I have had frequent experience of. Take Dictamnus Cretensis, both the Birthworts, and Trochiscs or Cakes of Myrrh of each half asc uple. Saffron and Cinnamon of each twelve grains. Confectio Alkermes half a dram: Cinnamon Water half an ounce, Orange-flower and Mugwort Water of each an ounce and an half: Make all into a potion. Among the more effectual sort of Medicaments are numbered Oil of Amber Oil of Cinnamon and extract of Saffron, which do in a little quantity work ●●ch viz. Extract of Saffron to five or six grains, Oil of Cinnamon to four or five Drops; Oil of Amber to twelve or fifteen Drops, in Wine, Broth or other Liquor. Sneezing hastens the Birth, or Hypocrates in the Aphor. 35. Sect. 5. Sneezing which happens to a woman in sore Travail is good. Sneezing may be provoked by the following Powder. Take White Hellebore half a dram. Long Pepper one scurple. Castoreum five grains. Make all into a Powder, and blow thereof into her ●st●●lls the quantity of a Pease. The same Hypocrates prescribes another Remedy in the first Book of women's diseases, which is omitted by all authors almost. And that is the opening of one of the lower veins of the Body, which he propounds in these words. But if (saith he) a woman be so stopped that she cannot bring forth, but continues divers days in her ●ains: if she be a young woman, vigorous and full of Blood, her Anckleveines must be opened, and Blood taken away, according as her strength will bear, Although this remedy be never used by our Practitioners, and it seems much to be feared, because in Travail nothing is so needful as strength, which may be weakened by Blood-letting: Yet if difficult Travail do arise from fullness of blood, which Hypocrates doth insinuate in those words, where he says If the woman be young and in the prime of her strength, and very full of Blood; there is no question, but bleeding may be very profitable, because the Veins being very full of Blood, are wont to make all other inward passages of the Body more straight. Whence it comes to pass, that in pains of the Stone in the kidneys, the like Blood-letting doth often work wonders, and facilitate the expulsion of Stones contained both in the kidneys and Ureters. Also hard Travail may be helped not only by those inward Medicines prescribed, but likewise by outward Let the Midwife therefore frequently anoint the Womb of the Childing woman with Oils of Lilies, sweet Almonds, Lin-Seed, and such like. Also let her belly be fomented on the nether parts with an emollient Decoction of Marsh-mallow and Lily Roots, Leaves of Mallows, Violets, Mugwort, Seeds of Line and Fenugreek, with the flowers, of Chamomel and Melilot. Let sharp Clysters be administered, by the provokeing virtue of which the expulsive faculty of the womb may be likewise ●oused up; and the Guts being emptied will afford larger space for the womb. Let her Navel be anointed with Oil of Amber. Some commend the Gaul of an Hen applied to the same part. Also such things may be used which are thought by a peculiar property to help the Birth: as Aegle-Stone, Loadstone, Storax, and the rest being fastened to the Hips. Hartmannus Commends the Eyes of an Hare taken in the month of March: which are carefully to be taken out and dried entire with Pepper. Let one of these with Pepper be so tied to her Belly, that the Sight of the Eye may touch her belly: and it will bring forth the Child, be it alive or dead. Which being done take away the Eye lest it bring forth the Womb itself. He says likewise that it is good to bring out the Mole. Heed is likewise to be taken that the woman carry no Precious Stones about her, either in rings or otherwise, but let her lay them all away: for many of them are conceived by a peculiar property to retain the Child in the womb. If the Child seem to be weak, it must be refreshed, both with strengthening things given to the Mother, as warm wine, Confectio Alkermes, Cinnamon Water; and also with things outwardly applied, as with a Crust of Bread, or a Rose Cake strewed with Powder of Nutmegs, Cinnamon, Cloves, Kermes Berries, and sprinkled with Aqua Imperialis or with warm Wine. Or with a piece of Wether-Mutton a little broiled upon a Gridiron, and sprinkled with Water of Roses or of Orange-flowers; with the call of a wether newly killed, not yet cold, and such like. If the Child begin to come forth in a disorderly manner, as by putting out one Foot, one Hand, or any other way; the Midwife must no ways receive it on that manner, but thrust it into the Womb again, and compose it to a right and natural posture or form of egress. Which must be done by laying the Childing woman on her Back in the Bed, with her Head somewhat low and her Buttocks high: and then gently pressing her Belly towards the short Ribs, and thrusting the Child into the Womb. Afterward let the Midwife endeavour to put the Child into a right posture for coming out, by an artificial Hand procuring that the Child turn its face towards the Mother's Back, and its Buttocks and shighes let her lift up towards the Mother's navel, and so hasten the same unto a natural manner of coming for●h. When all Hope of the Child's coming forth is past, or when the Mether is almost dead, some Authors proceed to the Caesarean Section [that is to cut the Child out of the Womb, as Caesar was cut out] of which Francilcus Rossetus hath Printed a most elegant Treatise; in which by many reasons and examples he endeavours to show, that such a thing may be sometimes done with good success. Howbeit, seeing this Operation is very dangerous and terrible, it ought seldom or never to be practised by a discreet Physician, that would preserve his own reputation. Chap. 19 Of A Dead Child. IN sore Travel of Childbirth by reason of great and long Labour, the Child is oftentimes killed; and sometimes before a woman's pains come upon her, the Child happens to die through some preternatural accidents, such as those which are wont to cause Abortion; and if it hath not attained to the due time of natural Birth it causes Abortion, but if it have, it causes an hard and sore Travel, Because in a due and natural Birth, both the Mother and the Child ought to join their Forces, to bring it from the Dark Dungeon to the Liberty of Day. All such things therefore which cause difficult Childbirth being in a greater and more grievous degree, are of power to kill the Child. But especially the Child is wont to be killed, if it come in so untoward and preposterous a figure, that it can by no means be brought forth in that manner neither can the Midwife or Chirurgeon draw it forth, or reduce it to a better Posture. For while sticking thus in the mouth of the Womb, it frustrates all the endeavours of the Mother straining herself to exclude it: it comes to pass, that in those s●●ainings, various motions and compressions, sometimes both Mother and Child, sometimes the Mother alone and sometimes the Child alone doth die. It is to be admired which Fabricius Hildanus writes, touching two women which died through hard Labour, in whom their Wombs were found broken a sunder and the Heads of the Infants in their Mother's Bellies By which we may gather, how strongly a lusty Child doth labour to work itself out of the Mother's Womb. A Dead Child is known, when the motion thereof ceaseth, which either the Mother did feel, or the Midwife perceive by h●r hand laid on, or other warm and strengthening things which were wont to awaken and rouse up the powers thereof when they were in a slumber or stupefied. Also the Mothers find a greater sense of weight, with which and pain of the Belly they are troubled: when they turn from one side to another they perceive the Child to roll from one side to another like a Stone. The lower part of their Belly feels very cold, the native heat being extinguished and those spirits dissipated, which were formerly in the Child; their Eyes become hollow and troubled: their face and Lips are pale; their extreme parts appear cold and of a Leaden-colour: their Duggs become slap and flaggy, and at length, when the Child rots, stinking moistures flow from the Womb, like water and blood: their belly is blown up with vapours ascending thereunto: a filthy smell, and a stinking Breath comes both out of the Mouths of such women and from their whole bodies. If the Afterbirth be excluded before the Child, it is a certain token that the Child is dead in the Womb. As to the Prognostic. A Child dead in the Womb is a very exceeding dangerous thing, and if it be not timely voided forth it is wont to cause Fevers, Faintings, Dead-sleeps, Convulsions and death itself. Yet sometimes a Child dead in the Womb may be kept a long time, as appears by many stories related by divers Authors, which Schenkius hath collected in great number as rare Cases, and Sennertus hath transcribed out of him, touching many Women which have voided the Bones of Children dead and putrefied in the womb, by their Water-gate, their Dung-gate, and by a Swelling that broke in their Belly. I have seen one Woman which voided all the bones of her child by her Navel, and her Navel growing afterwards whole again. she recovered her perfect health. The Cute consists wholly in the Exclusion or Extraction of the Child; for seeing great danger of life at ends the Mother so long as the dead Child is in her Womb, as soon as ever by the foregoing signs, we certainly collect the Child is dead, we must make haste, to force it out. Which is done by the same Remedies which were formerly propounded to hasten the Birth. But among them we must choose out the most strong and effectual, whereunto some other things may be added which are yet stronger, after this manner: Take Leaves of Savin dried, round Birth-wort Roots, Troches of Myrrh, and Castoreum, of each one dram: Cinnamon half a dram: Saffron a scruple. Mix all into a Powder. The Dose is a dram in Savin Water. Or, Take Dictamnus Creticus, Savin, Borax, of each a dram: Myrrh, Asarum Roots, Cinnamon, Saffron, of each half a dram. Mix and make all into a Powder. The Dose is a dram in the foresaid, or such like Liquor. In the mean time, let the Fomentations aforesaid be applied to the Privities, the Share, and space between the Water and the Dung-Gate; adding Briony Roots, Roots of wild cucumber, Florentine Orice, round Birthwort, called Aristolochia rotunda, and Broom-flowers. After Fomentation, anoint the said Parts with Vnguentum de Arthanita, or with this following: Take Aristolochia rotunda, or round Birthwort, Coloquintida, and Agarick, of each one dram: Gum Ammoniack dissolved in Wine and Bulls Gall, of each two drams: With Oleum Cherinum, as much as shall suffice. Make all into an Ointment. Also let this Pessary be put up into the Womb: Take Aristolochia rotunda, Orice Root, Black Hellebore, Coloquintida, Myrrh, of each one dram: Galbanum, Opopanax, of each half a dram: With Ox Gall, make all into a Pessary. Or this: Take Ammoniacum, Opopanax, Castorium, Sagapenum, black Hellebore, wild Vine, round Birthwort, Pulp of Coloquintida, Scammony, of each one scruple: Euphorbium one dram: With Juice of Rue, Bindweed, wild cucumber, and an Ox's Gaul, make all into a Pessary. Zacutus Lusitanus in Obs. ●54. of the Second Book of his strange and Admirable Cures, doth testify, that a dead Child in the ninth month's growth, producing many Symptoms in the Mother, was driven out by this Pessary, and by help of an Oily Bath, wherein was mixed the Decoction of such Herbs as do open and widen the Passages of the Body. A Fumigation of Galbanum, or an Ass' Hoof, may be received by a Funnel into the Womb. If the Matter hang long, it will be good, the woman being sufficiently strong, to give her a purging Medicine; whereby evil Humours, which in this case are easily collected, may be evacuated, and the dead Child comequently cast forth. Angelus Sala, in his Book which he calls Triumphus Emeticorum (that is, the Triumph of Vomits) doth witness, That in this case he had often with happy success given four or five grains of Mercurius vitae, which doth most powerfully expel the dead Child, and excel all other Medicines in that point. Which notwithstanding, in regard of its vehement working, requires great Caution and Discretion in the Physician that would use it. If after Medicines long tried, the dead Child cannot be ejected, we must implore the Chirurgeons aid. Who may pull it out, either by Instruments, as Paulus Aegineta describes the manner, or only help of the hand, as is taught by Carolus Stephanus, Bauthine, and others; all which are diligently transcribed by Schenkius and Sennertus. Chap. 20. Of the Afterbirth retained. IN a Natural Birth, commonly the Secundine is excluded presently after the Child, yet sometimes it is retained in the Womb, by which means the Mother is in great Danger of her life. The internal Causes of this retention are, the over thickness of those coats, and their too great compactness, by which means they cling more fast to the sides of the Womb: their being swelled through confluence of humours, which is stirred up in a laborious Travel, weakness of the Mother caused by hard Labour, so that she wants strength to exclude the Afterbirth; and the shutting up of the Mouth of the womb, after the Child is come away. But the external causes are, the Cold Air, by force whereof the Secundine is repelled and the Wombs mouth stopped; Certain smells by which the Womb may be enticed upwards or agitated; some grievous passion of mind, as fear, or sudden terror or frowardness of the Childing woman, which will not abide in such a posture nor use such endeavours as are necessary to this work; the over great weight of the Infant, by which the Navil-string is broke unawards and the secundine is left within; and the Error of an unexperienced Midwife, which cuts the Navil-strings too soon, or holds them not fast in her le●t Hand; as she ought to do, for if she let them go, they are drawn back into the Womb, and there lie hid with the Afterbirth, which they ought to have helped to pull out. The Tokens of a Secundine retained are needless, its apparent of itself; yet sometimes a bit thereof is severed from the whole and retained, which is not so easy to be known; yet it may be known, because the Womb after the Birth, doth yet labour to cast somewhat forth, although those endeavours are not so great as formerly; there is perceived in the womb, a sense of pain and heat, and after certain days, a filthy and carrion-like smell exhales from the Womb. The Retention of the Secundine is a very dangerous thing, and if it continue some days in the womb, it acquires a silthy putrefaction, whence ariseth an acute Fever, aptness to vomit, fainting, difficulty or breathing, a Diaphoretick Sweat, Coldness of the extreme parts, Hysterical Fits, Fits of Falling-sickness, and at last death itself. Hypocrates in the Second Book of Popular Sicknesses, by the example of a certain Carrier's Wife, doth hint unto us, That it is good in this case, when corrupt blood doth suddenly come from the womb in large quantities, for it is hopeful, that those Membranes being rotten and wasted, will flow forth upon the sixth or seventh day. The Afterbirth retained, is expelled by the same Remedies which were propounded to drive out the dead Child, whereunto we may add some appropriated or specific Medicaments, mentioned by Authors. Gesnerus and Augenius, do very much commend the stones of a gelded Horse, cut in pieces and dried in an Oven. The Powder whereof is given, as much as can be taken up between three fingers, with the Broth of a Pullet: which Medicine, if need be, must be twice or thrice reiterated. Rulandus gave thirty drops of Oil of Juniper with happy success. Some advise the Childing Woman to hold an Onion hard between her Teeth, and squeeze it there, swallowing down the Juice; and she is to by't it so three or four times, still sucking out the Juice, and swallowing the same; and at last to drink a draught of warm Wine upon it, which presently helps her. Forestus makes relation of a certain Midwife, which received this following Secret from a ●ewish Physician. She took the green Tops of Lovage, she stamped them, and strained out the Juice with the best Rhenish Wine, and gave a draught of it to the Patient. Angelus Sala commends Mercur●us vitae in this Case, as well as in the Expulsion of a dead Child. Hereunto add, Sneezing, Fumigations, Fomentations, Liniments, and other Medicines both inward and outward so●●er●y described in the case of a dead Child. The following Decoction used by a Country woman of ours, hath done wonders. Take Vinegar of Roses eight or ten pints: Bay Leaves, and Bay Berries, of each three handfuls: one Rose Caze cut in bits. Boyl all together, and let her Hips and Legs be a long time together bathed, from her g●oyns down to her feet. Upon the use hereof, the Womb hath opened of its own accord, and the Afterbirth fallen away. To this Decoction may fi●●y be added, of Myrrh, and of the two Birthworts, of each one ounce. And among other helps, the hand of a skilful Chirurgeon can do much, being put into the womb, before the Inflammation or Inflation be augmented. For he laying hold of the After-births, and gently turning them this way and that way, may draw them out, and free the woman from so many Symptoms, and tiresome Medicines. If the Secundine can by no means be persuaded forth, but stick strongly to the womb, and there putrefy, suppurating things are to be put into the womb, cleansing things being mingled with them, that as much as is putrefied, may be by little and little brought forth. To which intent Rondeletius commends Vnguentum Basilicum, especially if it be dissolved in the following Decoction. Take Leaves of Mallows with their Roots, three handfuls: Roots of the two Aristolochia's, or Birthworts, of each six drams: Lin-seed, and Foenugreek seed, of each half an ounce: Violet Leaves one handful: Flowers of Chamomel, and the smaller Centaury, of each half a handful▪ Boyl all in Water, mixing therewith (if there need great suppuration, or reduction to Matter) a little Oil; but if there be more need of detersion, or cleansing, add a little Unguentum Aegyptiacum. Chap. 21. Of Immoderate Flux of the Loches, or Childbed Purgations. THe Immoderate Flux of Childbed Purgations called from the Greek, Loches, is not to be estimated from the quantity, or the time of continuance; because that in divers Natures, Ages, and Courses of Life, it is very different; but from the ill-bearing of the woman and her weakness therefrom arising. The Causes of this immoderate Flux, are the over wide opening of the Vessels, or their rending in hard Travel, or the violent drawing forth of the Afterbirth; or a more than ordinary quantity of blood, which hath been collected in the Veins of the Womb, during the whole course of the Woman's being with Child; or the thinness and sharpness of the said Blood, which doth too much open the Mouths of the Veins, and provoke Nature to Excretion. Immoderate flux of the Childbed Purgations is known, as hath been said, from the strength of the woman which is dejected through the exhaustion of her spirits that issue with the blood; also the blood is clotted, and the Patient loathes all meat, is pained under her short Ribs, feels a distension of her Belly; her Pulse is weak and frequent, her sight is dimmed, she hath noise in her Ears, is subject to Swooning and Convulsions. As all great Fluxes of Blood are dangerous, because blood is the Treasure of our Life, so immoderate flux of the Childbed Purgations is more dangerous than the rest, because of the Travel which goes before, and weakens the Patient. But the danger is more or less, according to the greater or less quantity of the Blood which comes away, and as the Symptoms are more light or grievous which attend the same; which made Hypocrates to say, in the 55. Aphorism of the fift Section. If Convulsion or Swooning betides a Woman upon her Feminine Purgations, it's a shrewd sign. The Cure of an Immoderate flux of Blood, consists in one only Point, viz. The stoppage of the said flux. Yet extraordinary care is to be taken, lest that be kept within, which by these Purgations was wont to be carried away, and so prove the cause of grievous Infirmities. And therefore if the flux do not extremely urge, we must begin with lighter Medicaments, proceeding by little and little if need shall require, to such as are stronger. And in the first place, The violent Motion of the Blood is to be bridled by an incrassating of thickening Diet, as by Panadaes', Jellies, Rice, Starch, with Calves-foot Broths, Pears, and Quinces boiled, Roasted Flesh sprinkled with juice of Pome-granates. Let her have pretty plenty of Meat, but not at once, but divers times one after another. For by this means the Heat and Spirit which in the Womb do aslist to the Expulsion, are called away to the Stomach, and by that means the Patient's strength is restored. Let her Drink be Water that hath had Iron quenched in it, or Gold, or in which a little Mastic hath been boiled. Then such things are to be used as do revel the Blood into the superior parts, as rubbings and bindings of the upper parts, Cupping-glasses fastened under the short Ribs on either side. It is good likewise to bathe the Patient's hands in hot Wine, in which Confectio Alkermes, or Venice Treacle hath been dissolved. Also let her Belly be moderately swathed with a Rowler or Swathband; because hereby the Vessels of Blood will be pressed together, and the immoderate flux hindered. Let Linen be applied to her Loins moistened with a mixture of Water and Vinegar, by which the blood contained in the Vena Cava, is tempered, and the motion thereof hindered. If the flux be very immoderate, and weaken the Patient, so that there is danger of Death, we must have speedy recourse to stronger Remedies: Among the rest, this following Potion hath commonly good success. Take Waters of Plantain, Orange flowers, and Roses, of each one ounce: Syrup of Corals, or where it is wanting of red Roses, one ounce: Sal Prunella one dram: Dragons blood ten grains. Make all into a Potion. If the flux do yet continue, a Powder, or an Electuary for divers Doses, may be prescribed after this manner: Take Bloodstone four scruples: Powder of , red Coral, prepared Pearls, of each one dram: Seeds of Plantain, Coriander prepared, and grains of Sumach, of each two scruples, Mix all, and make them into a most fine Powder, of which let her take one dram with the Decoction of Knotgrass and Syrup of Quinces. Take Conserves of Roses and of Comfrey Roots of each one ounce: , Troches de Carabe and prepared coral of each one dram: with syrup of coral or of dried red Roses make all into an Electuary, of which let her take the Quantity of a Chestnut, drinking a little of her ordinary drink after it. Also a fomentation and an Ointment will profitably be applied outwardly, made after this manner. Take Topps of the red Mastic or Lentisch, Plantain, Cypress, Olive, and Solomon's Seal of each one handful: Red Rose Leaves two pugils: Myrtle Berry's one ounce and an half: Cypress-Nuts, six: Peels of Pomegranates two pugils: Boyl all in Steel-quenched Water and astringent harsh red Wine, and with the strained Liquor bathe the Privy Parts, very lukewarm, and almost coldish. Take of the Countess' Ointment or Uuguentum Comitissae two ounces: J●yce of Plantain one ounce: work them together into one Ointment, to be used after the fomentation. Also an Injection may be made of the Juice of Plantain into the Womb, commended by Galen in the fifth Book of his Method, or of the Decoction of the foresaid fomentation. Other remedies not helping, to open a vein in the Arm is a present Cure, if the Blood be drown out in distant spaces of time; for experience hath taught, that many women given over as it curable have by this means recovered. And finally, the disease still remaining, all Medicines prescribed for the immoderate flux of the monthly courses, may be used in this Case likewise. And among the Medicines for immoderate Courses, Cataplasms were propounded to be applied to the share, and Loins; unto which the following Cataplasm or pultis may be added, very good for all immoderate fluxes of Blood, but especial for these Childbed Purgations. Take Pure Soot from the Chimney not mixed with Dart eight ounces: work it lustily with the strongest Vinegar, and make a pultis to be applied to the Reins of the Back. And it is here specially to be noted touching sleep; that while the Blood flows plentifully, the woman must not be suffered to sleep, for many by that means are taken away, because the natural heat retiring inward, causes the flux to be greater. And if sleep in such a case cannot be avoided, some must be always by of the servants to feel her pulse and mark how she fetches her Breath. In a word, if clotters of Blood do settle in the Womb, and cause a pain and stretching therein; endeavour must be used speedily to bring it out, least coming to putrefy, they transmit filthy vapours to the Brain and Heart and cause a fever. Therefore the Childing woman, if strong enough, aught to walk gently, or stand bolt upright for some time together, or to sit upon the groaning Chair, as if she had list to stool. And if this suffice not, the clotters are to be dissolved with a warm Decoction of French Barley and a little Oxymel or honey of Roses injected into the Womb. But here we must go warily to work least while we bring out the clotters, the flux of Blood be afresh provoked. Chap. 22. Of Suppression of Childbed Purgations. THe good and happy success of Childbearing doth especially depend upon the convenient and orderly flux of the Loches or Childbed Purgations; seeing the Impurities which have been collected in the veins of the Womb, during the nine months' time of the woman's Belly-bearing, are wont to be avoided by these evacuations; but if they be suppressed wholly or diminished, infinite Dangers and Calamities arise thereby viz. acute Fevers, Frenzies, Madness, Melancholies, Squinz●es, Pleurisies, Inflammations of the Lungs and other swell, which are for the most part malignant. The Cause of this supression or imminution are, the thickness of the Blood, narrowness or obstruction of the vessels, which hinders the free egress of the Blood; cold air heedlessly received into the Womb, which closes the Orifice of the vessels, taking cold at the feet, drinking of small cold Drink, fear, Affrightment, sadness and other Passions of the mind, which withdraw the Course of the Blood from the Womb. This Suppression is manifest of itself, and the diminution thereof is not to be judged by the Quantity which comes away, because some women have more superfluous blood and some less. But the perfect knowledge thereof is gathered from the supervenient Symptoms such as are a swelling of the Belly, a pain possessing the nethermost part of the Belly the Loins and Groins; redness of face, difficulty or breathing, perturbation of the Eyes, shivering fits, Fevers, Fainting fits, and other Symptoms related before. The Prognostic is drawn out of the Symptoms propounded as supervenient to this Disease, for they being for the most part dangerous, the cause from which they spring must needs be very dangerous likewise. Childing women are freed from the foresaid danger, if some other evacuation happen which may at least in some measure supply the defect of these purgations, as Bleeding at the Nose or by the hemorrhoid veins: plenty of Urine with a sooty settling, or plentiful sweeting. Or if after some day's Lead-colored, black, and stinking matter begin to flow forth. But it is to be feared, lest by the corrupt blood, ulcers should be bred in the womb. The whole Cure of this Malady, consists in the provocation of these Purgations, which must be endeavoured by such Medicines as provoke the Course of the Blood downwards, and open the Vessels of the Womb. And in the first place, Emollient, Purging, and Opening Clysters are to be administered, made after this manner: Take Roots of Marsh-mallows, and Water-lillies, of each one ounce: the long and round Birthwort, of each three drams: Leaves of Mallows, Marsh-mallows, Pellitory, Mercury, of each one handful: Line seed and Fenugreek seed, of each half an ounce: Flowers of Chamomel and Elder, of each two pugils: Boyl all to a pint. In the strained Liquor dissolve, Oil of Dill, and Lilies, of each one ounce: Hiera simplex, half an ounce: Unguentum de Arthanita one dram. Mix all into a Clyster. Let her Thighs be rubbed downwards; let the Toes of her Feet be tied till they ache again; let divers Cupping-Glasses be fixed to her groins and Hips, and let some of them be scarified. If these means suffice not, open the Veins about the Knees, or of both the Thighs; or the Hemorrhoid Veins, if Nature seem to incline that way. If a Fever be caused by suppression of these Purgations, a Vein must be opened in the Arm, as shall be said in the Diseases of Women in Childbed. This following Fomentation may be applied to her Belly beneath the Navel, and to the Privy Parts. Take Roots of Marsh-mallows, Lilies, Briony, Angelica, and Birthwort, round and long, of each an ounce: Leaves of Mercury, Mugwort, Penyroyal, Savine, Calaminth, of each one handful: Lin-seeds, and Fenugreek seeds, of each an ounce: Flowers of Chamomel, Melilot, Elder, tansy, of each a pugil. Beat them and cut them according to art, and put them into two bags, which boil in Fountain Water, and apply by course one after another. After Fomentation anoint the foresaid Parts with Oil of Lilies, Sweet Almonds, and Sesamum, adding thereto a little Saffron. Hereunto may be added such Pessaries and Fumigations as have been set down in our Chapter of Suppression of the Courses, beginning with the most gentle. Let her drunk a Decoction of opening Roots, Cinnamon, and red Vetches with a little Saffron. Or, Take Opening Roots, of each two drams: Leaves of Bettony, Endive, Maidenhair, of each a handful: Schaenanth one pugil: Annis seed, and Fennel seed, of each one scruple: red Vetches a spoonful: Boyl all to a pint and an half. To the strained Liquor ad Cinnamon Water two drams: Syrup of the five opening Roots three ounces. Let her take four ounces twice a day. Before the Fever be increased, we may sometimes give Troches of Myrrh one dram; with white Wine or Fennel water. Forestus useth the following Decoction though there be a Fever. Take French Barley one handful: Liquoris scraped half an ounce: Schaenanth one dram and an half. Boyl all to a pint, for three Doses. For the weaker he causeth one dram of Schaenanth to be boiled in Chicken Broth, which he gives the Patient to drink. Also a Purgation may be convenient, seven or nine days after she is delivered, of the Infusion of Rhubarb, Agarick, or Senna, or with a Laxative Broth made of opening Herbs and Roots with Senna; or with an ounce and an half of Manna dissolved in Broth. Chap. 23. Of Gripe after Childbearing. Gripe do so frequently betid Women in Childbed, that very few Women are free from them. But they are not wont to seek to the Physician for these Pains, because within two or three days they go away. But if they happen more sharp, and of longer durance than ordinary, they are forced to send for the Physician, who before he prescribe any thing, must consider the Causes. The chief Causes of Gripe and Pains after Childbirth, are the plenty of Blood, its thickness, sharpness, and narrowness of the Vessels. For the Veins of the Womb, having for nine months forborn their usual evacuation of blood, and the blood being gathered in great quantity, and by its retention becoming thick and sharp; while it goes through the narrow passages, it causeth pains, which return by fits, as often as the womb endeavours a new expulsion of blood; which being over, they cease till such time as other blood doth seek its way forth. Sometimes these gripe are caused by Winds, or by Cold received into the Womb, but not so often. These Pains are differenced from others which are wont to afflict the Belly, by their continuance, and by the distances of holding up, which they observe according to distant fits of the bloods issuing forth: and the women themselves can easily distinguish these pains from all others. Thick blood is known by clottering, but the thin blood by its tenuity, fresh colour, or yellowish. If the Pain spring from wind, it is more wand'ring, being sometime in one part of the Belly, and sometimes in another; neither doth it observe the distances in which the Blood issues. If cold Air have entered the Womb, it may be known by a relation of what hath been acted about the sick woman. These pains are not dangerous, but for the most part exceeding troublesome: therefore must be removed or mitigated as soon as may be. The Cure of these Gripe ought to be directed to these ends; viz. That the Vessels of the Womb be made wider, the Blood thinner, and its sharpness mitigated. All which may be accomplished by these following Medicaments. And first of all, let the Patient's Belly be gently swathed that her womb may settle, and not be moved this way and that way, as often falls out after Childbirth, by reason of the sudden evacuation. Then give her three ounces of Oil of sweet Almonds new drawn, with an ounce and an half of Syrup of Violets, and two ounces of Hippocras. Let Clysters be cast in of Milk and Sugar, with the Yolks of Eggs. Or they may be made of a Decoction of Chamomel flowers, and Mugwort in Pullet Broth, adding Oil of Lilies, and the Yolks of Egs. Anoint her Belly with Carminating or Wind-expelling, and opening Oils, as Oil of Dill, Rue, Jasmine, or with this following, which being of great efficacy, aught to be made in time convenient, and kept in the Apothecary's Shop for such occasions. Take Roots of round Birthwort, Orice, and Peony, of each one ounce: Cypress Roots half an ounce: dried Leaves of Mugwort, Feaverfew, Origanum, Calaminth, Penyroyal, Dictamnus Cretensis, Wormwood, Savin, Rue, Bettony, and Sage, of each one handful: Flowers of Rosemary, Stoechados, Lavender, Chamomel, Dill, St. John's wort, and Elder, of each half a handful: Bay-berries, and Juniper berries, of each half an ounce: Seeds of Cummin, Rue, Peony, Carrots, and Agnus Castus, of each three drams: Cloves, Nutmeg, Cinnamon, Ginger, of each two drams: Storax, and Myrrh, of each one ounce. Let all being beaten and cut, be steeped in six pints of old Oil, adding a little white Wine. And put them in an Earthen Vessel close stopped, the space of a week; and then boil them over hot Embers the space of four o● five hours; then let the Oil be strained out, and reserved for use. If the foresaid Oil be wansing upon occasion, let the foresaid simples boil in equal portions of Oil and white Wine, till the white Wine be consumed; then let the Oil be strained out. Also a Fomentation may be made of the Decoction of Mugwort, Bawm, Bay-leaves, Calaminth, Carret seed, Cummin, and Caraway Seeds, Flowers of Cheiri and Chamomel in Water, white Wine or Milk. Or the following Cataplasm may be applied. Take three or four Onions well boiled in Water; beat them in a Mortar, and put thereto Seeds of Line and Cummin beaten, of each one handful: As much Chamomel flowers: Barley Meal as much as shall suffice to make all into a Pultiss. And if need be, add a little of the Water wherein the Onions were boiled. Spread it upon a Cloth, and apply it warm to her Navel. It is likewise profitable to apply the Skin of a weather newly flayed off while it is warm, to her Belly. For this kind of warmth is very near of kin to our Natural heat, concocts and mitigates the cause of the pain; also it hinders the Skin of the Belly from gathering into wrinkles. These following Medicines may be given inwardly: Take Carrot Seeds powdered one dram: white Wine three ounces: Mix them. Give it warm twice a day. Or, Take Nutmeg, Annis seed, Cinnamon, of each one scruple: mix them into a Powder to be taken in white Wine; or give one scruple of Oil of Nutmegs in Broth. Or, Take Date and Peach Kernels, of each half a dram: Nutmegs four scruples: Powder of Diamargaritum Calidum two drams: Annis seed one dram: Cinnamon two scruples: Saffron ten grains: Sugar the weight of all the rest. Make all into a most fine Powder, whereof give two drams in Wine twice or thrice a day, if the pains are much. Forestus gave a Decoction of Chamomel flowers in Beer, or a Decoction of Mugwort and Chamomel in Puller Broth with good ●ucce●s. It's good presently after the is brought to bed, to give her the Broth of an old Cock, three days together ear●y in a morning while she is fasting, with a little Cinnamon and Saffron. The following Powder taked presently after the delivery of a woman, doth wonderfully preserve her from Gripe; insomuch that it is thought, If it be given a woman after her first Childing, she will never after in her following Lyings-In, be troubled with these Gripes. Take the greater Comfry Root dried one dram: Peach Kernels and Nutmeg, of each two scruples: Amber half a dram: Ambergris half a scruple. Make all into a Powder; of which let her take one dram in white Wine, or if she be Feverish, in Broth. For her ordinary Drink, let her use a Decoction of Mugwort with Cinnamon. If the Gripe be caused by Choleric and sharp humours, they are cured much after the same manner that the Colic is cured, when it proceeds from Choler. As for Example: Take Syrup of Violets and borage, of each one ounce: Mucilage of Quince seeds drawn out with Violet Water, half an ounce: Water of borage and Scorzonera, of each three ounces. Mix all, make thereof a Julep for two Doses. Or, Take Oil of sweet Almonds two ounces: Syrup of Violets an ounce: Borrage Water half an ounce. Mix all for a draught. External Medicines must likewise be used, such as are laxative and emollient, which do likewise by one and the same labour, ease pain. Oftentimes, after they are brought to bed, women are pained in their Groin, by reason of their wombs being gathered together like a ball in their Groin. It is cured by applying to their Navel a Plaster of Galbanum and Anafoetida, in the midst whereof, some grains of Musk must be put. Chap. 24. Of Acute Diseases of Women in Childbed. WHat we said before touching the Acute Diseases of women with Child, we may now repeat touching the Acute Diseases of women in Childbed; viz. That they have the same Essence, and the same Signs, with the like Diseases in women which are not with Child, and in men. So that we shall refer the Reader for the Theory of these Diseases to their proper Chapters. Now these Acute Diseases are for the most part, continual Fevers, both Essential, as Synchus putrida, a continual Tertian, and the rest; and also Symptomatical, which accompany inward Inflammations, as the Pleurisy, Inflammation of the Lungs, Inflammation of the Liver, Frenzy, and such like. Yet there is a peculiar sort of Fever, which besals almost all women in Childbed, which is called by them the Fever of their Milk, which is wont to befall them about the third or fourth day after they are brought to bed, when their Milk gins to increase in their Breasts; and it ariseth from the reflux of the blood from the womb to the Dugs, and the motion and agitation thereof. Which kind of Fever is reckoned among the Diary Fevers of the longest durance; neither needs it any Medicines, because within three or four days, viz. about the ninth after her delivery, it is finished by sweat. It is distinguished from putrid Fevers, because commonly it seizes the woman about the fourth day, after her being delivered, and her Dugs begin to be filled with Milk, and to be troubled with hardness, pain, and heat; with heat and heaviness in her Back and Shoulders; also her Childbed Purgations slow duly, which seldom is seen in putrid Fevers. Now putrid Fevers do befall women in Childbed from three causes, viz. Suppression of their Childbed Purgations or diminishing, by the heaping together of bad Humours during the time of their Belly-bearing, which were agitated by her Labours, or by Errors in their Diet. Some add immoderate flux of the Childbed Purgations, which is rather a sign of the secret badness of Humours causing the Fever, but cannot be itself any cause thereof. In suppression of the Childbed Purgations, the blood and vicious humours which are collected during the whole time of her going with child, do flow back again into the greater Veins, and there putrefy, and sometimes are c●rr●ed to the Liver, Spleen, and other parts, in which they raise Inflammations; or if they abide in the Veins of the womb, they putrefy, and so cause a Fever, in those women which were before in perfect health. But if (the Childbed Purgations duly flowing) a fever arise, it comes either from superfluity of Choler, or from errors in Diet. Evil Humours agitated by the Labours and Pains of Travel, do easily inflame and putrefy, and stir up a fever. Errors of Diet may happen divers ways: And first in point of eating in which women that he In, are wont to be very faulty, stopping themselves with plenty and variety of Dishes, which cannot be by them digested, but causeth putrefaction in their Bodies. Another error is committed when Childing women do unadvisedly expose themselves unto the cold Air, especially while their Milk-feaver is in its vigour, which is wont to be terminated by sweeting and transpiration, which is hindered by heedless admission of the cold Air, whence it comes to pass that the Fever which of itself was void of danger, and would in a few days have ceased, is changed into a dangerous putrid Fever. There is yet another frequent Cause of the Fevers of Childing Women, viz. When the After-births are not wholly cast forth, but some portion remains behind. This happens principally in the Womb-Liver, a part whereof is sometimes annexed to the Womb, and left there, doth putrefy; which makes the Childbed fluxes to come forth greenish, stinking, and Carrion like; and if within few days it be not separated from the womb, and excluded, it casts the sick woman into great danger of death, seeing it may mortify the Womb. If Clotters of Blood, or any other preternatural thing, shall remain in the Cavity of the womb after Childbearing, it may thereby be known, because the neck of the womb remains soft and open, neither is the inner Orisice thereof shut, neither is the womb drawn upwards; and whereas, when all goes well after Childbirth, the womb is drawn upwards, and its neck and orifice are quickly shut. An Example here of is propounded by Dr. Havey, in his Treatise de Partu, concerning a woman, who having a malignant Fever, and being very weak, miscarried; and after exclusion of a perfect Child, and uncorrupted, yet being very weak, with a creeping Pulse and cold Sweats, she was ready to give up the Ghost. He feeling her womb, perceived the Orifice thereof lax, soft, and very wide; and putting in his fingers, he drew forth a Mole as big as a Goose's Egg, having certain holes in it containing a clammy, black, and stinking putrefied matter, and the woman was soon freed from the foresaid Symptoms, and quickly recovered her health. It happens likewise in some women that the Orifice of the womb presently after their delivery, is so shut up, that the blood contained within the womb, suddenly clottering and putrefying, causeth most sad Symptoms, and when no Art can bring it forth, present death follows. Yet Dr. Harvey relates in the place aforesaid, the History of a woman cured by him of this Disease. The Lips of the Water-gate were swelled, and very hot; the mouth of the womb was hard and close shut: He opened it a little with an Iron Instrument which he forcibly put in, so as it would admit an Injection made by a Syringe; and thereupon, clotted, black, and stinking blood, some pounds in quantity came away, by which means the sick woman had present ease. The Prognostic of these Fevers herein only differs from the Prognostic of such like Fevers which happen to those that are not in a childing condition; because through the Labours of Childbirth, the strength of the patiented is more dejected; and by reason of the Childbed Purgations suppressed there is a greater redundancy of Humours in the Veins; and in both respects the Party is in greater danger. The Decision of that famous Question, Whether the computation of the days of the woman's sickness, aught to be made from the beginning of her Disease, or from the day in which she is delivered of her Child, makes much to clear the Prognostic of this Disease, especially to foretell the Crisis. Which Question we shall therefore thus briefly determine: If the Birth of the Child were natural, attended with no grievous symptoms, and the Childbed Purgations were as they should be, and the Fever come some days after, the account ought not to be made from the day of the Child's birth, but from the day the Fever began, which was provoked by some other preternatural Cause, viz. Evil Humours lurking within the Body, or from some external Cause. But if the Childbirth were hard and beside the Course of Nature, and the Fever arose after three or four days; we must reckon from the day of the Child's birth; because then the whole order of the Body began to be overthrown, and the Humours to be disturbed, which was followed by the Fever. So in grievous wounds of the wont of the Head especially, though the Fever come not till after the fourth of fifth day, yet the account is wont to be made from the day of the wound received, because the Humours began then to be in a commotion, and to be disposed to cause a Fever. The Cure of these Fevers, differs not from the Cure of other Fevers, unless in point of those great Remedies, Blood-letting, and Purging,; in the administration whereof, there is no small scruple, which we shall briefly endeavour to remove. As for letting of Blood in acute Diseases of women in Childbed, the disagreement of Authors is so great, by reason of the contrary Indications on the one side, and on the other, that we can scarcely find two of the same mind. We shall briefly in these following Theorems or Maxims, propound that Opinion which cometh nearest the Mind of the wisest Authors, and is in the course of Practice most successful. An Acute Disease befalls a Childbed woman, either in the beginning, or in the middle, or in the end of her Lying in. If it happen in the beginning, and the woman be plentifully purged, there must be no other evacuation of blood, than that which is directed by Nature when she rightly and conveniently performs her Operations. But if the Childbed Purgations are suppressed, or flow sparingly, let the interiot Veins be opened, and take a good quantity of blood away: because at that time the Childbed Purgations of blood, ought by the appointment of Nature to be plentiful. If an Acute Disease happen in the middle time of her Lying In, two things are to be considered. The one is, Whether the Morbific matter be contained in one particular place, or if it be dispersed through the Veins? The second, Whether the Woman hath been conveniently purged or not, in regard of quantity? If the Disease proceed from matter scattered abroad, as in Fevers, and the woman hath not been fully purged, the lower Veins ought to be opened: because both the Morbific Matter will be diminished, and her Natural flux will be provoked. But if the woman have been sufficiently purged, and the Disease get ground, and the Natural Evacuation have not been sufficient for the Disease, the inferior Veins must be opened notwithstanding; and so much blood must be taken away, that by two Evacuations that may be accomplished, which the Disease requires, according to the Doctrine of Galen, in the ninth Book of his Method, Chap. ●. If the Fever be very high, and great heat vex the Patient, let that be done which we shall presently declare; which ought to be performed when the Disease ariseth of Matter driven into some corner, and there putrefying. In a particular Acute Disease, as the Pleurisy, Inflammation of the Lungs, Squinzy, and the like; we must mark whether the Fluxion be only beginning, so that the Disease is only ready to seize upon the Patient, or is in its beginning, and very little blood be collected in the part. For then the inserior Veins are to be opened, that revulsion may be made to such opposite part. For then the inserior Veins are to be opened, that revulsion may be made to such opposite parts as are at greatest distance from the part affected, and by that means that preposterous motion of Humours may be stopped. But if the fluxion be already in good measure begun, and an Inflammation bred which proves very troublesome, whether the woman be sufficiently purged, or not, the superior Veins are presently to be opened right against the Part affected, because such an Evacuation draws Blood out of the Part Affected. But if the inferior Veins should be opened, which are neither next the part affected, neither can evacuate therefrom, both the strength of the Patient will be weakened by the evacuation, and that matter which is by Nature driven into a corner, and subdued, will not be thereby diminished. And so you must either draw all her blood in a manner out of her Veins, to revel the matter of the Disease from the part affected; or the woman will be killed by the Disease before sufficient Revulsion be made. Neither need we fear, lest by taking blood from the upper Veins, we should draw the Course thereof from the womb, because in such Cases the superior parts of the Body do abound with blood. And although much blood be taken away, yet are not the Veins so emptied, that they should be forced to draw new blood from other parts. Yet for the greater Caution, it will not be unprofitable before blood be taken from the superior Veins, to cause the Thighs to be lustily rubbed, and presently after to tie them with bands so hard as to pain the woman, which must abide so bound till the bleeding be over, and a little after they may be loosened; and now and then Cupping-Glasses must be fastened to the same parts, or at least they must be again well rubbed. So we may procure an evacuation of the Matter offending, and yet preserve the Natural course of the blood towards the Womb. The same course is to be taken in vehement and burning Fevers: For although the matter offending be dispersed through the Body, yet is the burning heat so great about the Heart and Bowels, that it cannot be so well extinguished by the opening of a small, and far distant Vein, as by the opening of a nearer and greater, such as is the Vein called Basilica. This Method of Curing may be observed not only in Childbed women, but in other women who are taken with Acute Diseases, and have their monthly Courses upon them. If in the end of a Woman's Lying-In, an acute Disease befall her, the same Course must be followed as in the middle, the same conditions being observed; observing this for a Rule, That by how much a woman is further from the beginning of her Lying-In, by so much more safely may the uper Veins be opened; but the nearer she is to the beginning, yea, even in the middle, we are to open those Veins with the greater premeditation. And if the Disease be not importunate, nor the sharpness thereof require such a thing, and the Natural Purgation be copious, we must wholly abstain. But if the Purgation be scanty, we must open the inferior Veins to supply that which is wanting in the Evacuation. But if the contrary shall happen, let us follow that Rule which we presceibed to be followed, in followed, in the urgency of an acute Disease. The use of Purging in Childing Women that are held with acute Diseases, shall be comprehended in these following Maxims. While the Childbed Purgations do Naturally flow, a Purge is never to be administered; for it is to be feared lest Nature be diverted from her business. But if the Childbed Purgations are not kindly, we must consider whether their consist its Quantity, or in Quality. If they offend in Quantity, so as to be too little, so that the woman be purged either not at all, or not sufficiently: After all Remedies fit to procure these Purgations have been given in vain, and the Morbific matter appears digested, eight, ten, or twelve days being past since she was brought to Bed, according to the more or less urgency of the Disease, she may be purged gently, wholly abstaining from all stronger Purgatives. If other Purgations offend only in Quality, so that a white flux, or some other unnatural colour do proceed from her, the Matter being ripe, she may in the last part of her Lying-In, be safely purged. But this must evermore be generally observed, That by how much the longer a Childing Woman is distant from the day of her bringing to bed, by so much the more safely she may be purged, and contrariwise: For Experience hath taught us, That women wanting their Childbed Purgations, if after the seventh or ninth day they are taken with a looseness, they commonly scape. But if the Looseness seize upon them upon the first days, viz. on the secoed, third, or fourth, for the most part they die. And so have we finished the Cures of women's Sicknesses; all Praise and Honour be given to God therefore. The End of the Fifteenth Book. THE SIXTEENTH BOOK OF THE PRACTICE OF PHYSIC. Of Diseases of the Joints, and Rhewmatick Pain of the whole Body. The PREFACE. THough all Diseases of the Joints depend upon the same Causes, differing only in respect of the place affected, and are wont to be cured with the same Medicines; yet is there some difference between the Sciatica, or Hip-Gout, and the pains of other Joints, by reason of the structure and largeness of those parts, of which the Huckle or Hipbone, is articulated, and made up; in respect of which, it requires some diversity in certain Medicines: therefore it is that I have resolved to treat of the Sciatica by itself. And because the Rhewmatick pain incident to the whole Body hath great Affinity with the running Gout which afflicts only the Joints, I have thought good to annex the Explication thereof in this place; so that this Book will consist only of three Chapters: Of which, The First will treat of the Pains of the Joints in General: The Second, of the Pains of the Hucklebone, called Sciatica: The Third, of those Rhewmatick Pains which seize all Parts of the Body. Chap. 1. Of Pain in the Joints, called Arthritis, or the Gout. ARthritis, or the Gout, is a pain in the Joints which comes for the most part by fits, stirred up by an Influx of Humours into the said Joints. The parts pained are, Membranes, Tendons, Nerves, and all the Nervous parts that are near the Joints, which are stretched by the Humour which flows into them, or by their sharpness are pricked and twitched: but the Ligaments which spring out of the Bones, are void of sense. Now the Humours which cause the Gout, do seldom flow into the very Cavities of the Joints, and that only in an old Gout, and where the Cavities are wider than ordinary, as it happens in an old Sciatica, in which sometimes the Thighbone falls out of its place, the Ligaments and other parts binding the Joints together, being loosened, and then the Cavity of the Joint is filled with a snotty kind of phlegm, as we see in Hypocrates, Apor. 59 Sect. 6. It is wont here to be demanded, why the Humours flowing into Nervous and Membranous Parts, and distending and twitching then, they should not cause a Convulsion. We answer, that the Parts affected in the Gout are chiefly Membranes, which being no instruments of motion, they cannot cause a Convulsion, though never so much stretched or twitched. And although the Tendons and Nerves ordained for motion should be likewise pained, yet do they not cause a Convulsion; because to make a Convulsion the Muscles must be drawn back to their Head, and that retraction ought to be made by a contraction of the nerves which are inserted into them; but when they are gone out from the muscles, or are come unto their extremity, though they be distended, yet can they not contract the Muscles. Authors do commonly make four forts of Gouts, according to the diversity of the Joints affected; Chiragra, or the Hand-Gout, when the Pain is in the Hands; Sciatica and Ischias when it is in the Hip. Gonagra when it is in the knees; and Podagra or the Foot-Gout when it is in the Feet. And the Pains of the other Joints go under the common name of Arthritis: though Pareus have imposed proper names upon every one of them drawn from the Parts affected; calling the Pain in the Joints of the Jawbone Syagonagram; in the Neck Trachelagram, in the Backbone Rachysagram; in the Shoulder Homagram; in the Elbow Pechyagram. But these names have not been entertained by Practitioners. Therefore its sufficient to refer the Pains of those Parts to the general name of Arthritis. There are besides, other differences of the Gout; as that some Gouts are General, occupying all or most of the Joints of the Body; others particular, residing only in some one Joint: some are engrafted and Hoeredetary from the Parents, others are adventitious caused by external Causes and Errors in Diet, Now the Humours which breed the Gout, may have their Course not only into the Joints but sometimes also into other Parts of the Body as the head, Teeth, sides, yea and the internal Parts as the Liver and Spleen and stir up divers Pains in these parts, which Pains are not to be termed the Gout, though they are Caused by the same matter which Causes the Gout. Again all Pains seated in the Joints merit not the name of Gouts for sometimes there are Swell in the Joints especially in the knees, from which Pains arise, occasioned by thick, phlegmatic, and Melanchollick humours, which Pains continue very long, but are not to be reckoned among the Gouts, but have a distinct nature of their own. Which difference will more clearly appear by the different Characters of the Gout, which we shall describe in our Diagnosis thereof, that is in the Art of discerning the Gout from other Diseases by certain signs and tokens. The next and immediate Cause of the Gout is a serous or wheyish Humour, either by its quantity stretching those sensible Parts which are about the Joints, or by its sharpness twitching the same. That this matter is wheyish is hereby known, because thick Humours could not so easily flow into the Joints, and they would make a more Visible swelling in the Joints, which is wont to be very little, yea in the begnning there appears no Swelling at all though there be a most bitrer Pain; add that the Tumour which is in the Gout, never comes to suppuration or ripens of matter, which often happens in other thicker Humours, if they have never so little Blood mingled with them, But in the Gout the Blood is drawn to the Joints, as appears by the Inflammation of the Parts; yet there never happens any suppuration or growing to a mattery Head, because Serosities or wheyish Humours rule the roast, and they hinder Suppuration. But this wheyish Humour is seldom pure and sincere, but hath other Humours or their serosities and thinner Parts Joined with it; whereupon great variety ari●es, according to the greater or lesser acrimony of the Humours mixed with the wheyish Humour, according to which the Pain is more or less; the Tumours is sometimes notably great and sometimes not visible; some are of a red colour, others yellow or white; in some the malady is soon ended, in others it continues long; sometimes a mighty and fervent heat possesses the Parts, otherwhiles little or none is discerned; sometimes hot things laid on do good, other whiles they do hurt and cold things help. Howbeit, it cannot be denied but that the wheyish Humour may of itself have more or less acrimony, according as it hath more or less Salt mixed with it: for seeing the serous or wheyish Humour, is wont to dissolve and drink up those heterogeneous salts, which are multiplied in the Body by reason of the multiplicity of meats we use (whence it is that all the serum or wheyish Humour in us is salt) according as this Humour is more or less salt, and according as the salts mixed there with have more or less sharpness, more or less Pain is wont to be caused. And because in the Gout, as in every Fluxion, for things are considered, the matter flowing, the Part sending that matter, the Part receiving the same, and the ways by which the Fluxion is made; seeing we have spoke of the matter flowing, we are now to speak of the other four. Touching the Part sending the Humour there is disagreement among Physicians. Fernelius would have all the material cause of the Gout (which he takes to be thin and phlegmatic) to flow from the Head; not from the brain itself, (whose excrements are either voided by the nostrils, or flowing through the palate, are driven to the mouth, throat, weasand or stomach) but from the external Parts of the Head, situate without the scull. For seeing very many veins derived from the external Jugulars do run thither, he says they do there lay down their thin and wheyish excrements, and seeing the Skin of the Head is thick and compact, and the Humours cannot easily breathe through the same, in process of time they grow there to a quantity, and as he conceives from thence they flow through the surface of the Body, under the Skin, into the Joints. But others do conceive, that the Head is the fountain of the flood of Gouty Humours, but they conceive those Humours flow from the inner Parts of the Head viz. From the Brain. Finally others there be that give sentence, that these faulty Humours do flow from the bowels contained in the lower ●elly, namely from the Liver, Splen, Womb and others, and also from the whole Body, through the Veins and Arteries into the Joints. All which Opinions in my Judgement are Partly true and Partly falls. We Judge they are true in that, they say the Humours which cause the Gout do flow from the Head by the inward and outward Parts, and from the Bowels and the whole Body by the Veins and Arteries: and falls we say they are, because they say that only the internal Parts of the Head, or only the external, or only the inferior Bowels do furnish the Gouty Humour. For seeing the whole Body is passable to and fro by Humours, all Parts of the Body may send their superfluities to the Joints, if they be disposed to receive them. Now that disposition of the Joints which makes them fit to receive a Fluxion of Humours (that I may take this occasion to open the condition of a receiving Part) is their weakness, either native from the Parents, or arising from other Preternatural Causes, which we shall speak of by and by. Seeing therefore it is established by Physicians as a most sure maxim, that the stronger Parts of the Body empty their excrements into the weaker, we may avouch that all the Parts aforesaid may discharge their excrements upon the Joints, if they being weakened, cannot sufficiently resist the same. And that the Opinions aforesaid may be severally refuted: Fernelius indeed doth clearly enough demonstrate, that Humours collected without the Soul, do flow upon the surface of the body, and under the Skin creep into the Joints, seeing sometimes the Pain gins in the Head, goes thence into the Neck, thence to the shoulders, and at length into the Joints. But that Humours do never flow from other places and Parts into the Joints, he no ways proves, neither is any man able to prove after him. In like manner, they which say that such Fluxions come only from the brain, seem to contend against sense; Forasmuch as those Parts which compass the Joints about, do receive Veins and arteries, by which blood is brought unto them to nourish them withal, why may not also the wheyish Humour collected in the greater vessels be carried unto the same Parts by the same ways? Galen hath taught this precisely, in his Comments upon the Aphor. 10. Sect. 3 where he shows, that in the knobbs and Pains of the Joints the profound Parts of the body are purged, the vicious Humours being driven from the principal Parts of the body into the Circumference. This is seen by the Fever which is oftentimes raised in the beginning of the Gout; for it is caused by wheyish excrements contained in the Veins, put into a commotion and working, when nature sees herself to expel the same, and seeing she cannot drive it all forth, she discharges the same into the weaker and ignobler Parts. Also the third Opinion, which Sennertus defends, is Void of reason, and is herein faulty, because it denies that Gouty defluxions do ever come from the brain. For seeing all Parts of the Body both inward and outward, do receive Fluxions from the Brain, how can the Joints be free from them? And if Humours causing a Catarrh do often flow by the Veins and arteries, whence Rhewmatick Fevers daily arise; and the Humours contained in the Veins and Arteries (as Sennertus himself affirms) do easily flow unto the Joints, it is a clear demonstration, that a Fluxion is made from the brain into the Joints. Also plentiful Pissing declares that Humours flow from the brain through the Veins, when the said Pissing is caused by some commotion of the brain by reason of long abiding in the Sun, or in a very cold air; for then the wheyish Humours contained in the brain are agitated by those Procatarctick Causes, and driven into the Veins and Arteries, through which they flow unto the Kidney's and the Bladder, and thence comes so plentiful making of water. The next and immediate Internal Cause of the Gout hath hitherto been sufficiently expounded; now let us proceed to the external and Procatarctick Causes or occasions thereof: which we may for clearness sake distinguish into three Tribes or Ranks, The first Tribe is of them which afford matter convenient to breed the Gout. The second is of those which do weaken and loosen the Joints. The third is of them which promote the flux of the Morbific Humour into the Joints. To the first Tribe are referred all things which increase raw and wheyish Humours, or any bad Humours whatsoever: as meats of gross substance hard to be digested, and such as afford many excrements, frequent Gluttony and Drunkenness; immoderate Carnal Embracements; which is the reason that Gout is called the Daughter of Bacchus and Venus; Idleness and a sedentary life, and intermission of such exercises as men have been formerly accustomed unto; long sleep and unseasonable watching; intermission of such natural and artificial Evacuations as men have been accustomed unto; fear, Sadness and continual Care. To the second Tribe are referred vehement motion and Labour; frequent use of carnal conjunction, especially of that which is celebrated standing; refrigeration and humectation of the Joints; frequent Bathing; Contusion, Luxation and Fracture of the Joints. To the third Tribe are referred, Cold air squeezing out the Humours, and Heat melting, dissolving and agitating the said Humours and opening the secret Passages; meats of a servant and salt nature which attenuate the Humours; thin and strong Wine; Immoderate exercise, unbridled Lechery, vehement anger and other immoderate passions of the Mind. The Signs do either foretell the Gout at Hand, or declare the same to be present. Signs of the Gout at Hand: a Sense in the Joints more exquisite and quick than ordinary so that the lightest thing will hurt them; as for example the hard sitting of a new Shoe, Long walking, a small blow, or a light hitting against a stone, or some other hard thing. A Fever commonly ushers in the Gout, which is caused by wheyish Humours and others contained in the Veins and arteries, being disturbed and agitated, whiles nature endeavours to expel them to those less noble Parts. But the nearer approach of the Gout, and its beginning as it were, is signified by a stupidity, and sense of crawling Pismires in the Joints, and a kind of unusual Heat felt in them. The Gout is known to be present by an actual pain tormenting the Joints, which commonly is attended with redness and swelling; which if it appear not at the very first; yet is it seen presently after. The pain doth usually seize upon the great Toe, especially on the left foot, and oftentimes it spreads itself from thence into other Joints. The Fever which comes before the pain, doth sometimes continue; and sometimes it goes not before, but comes together with the pain. The Signs of the Causes are likewise to be considered: For although the Humour causing the Gout be principally wheyish, yet is it needful to know what other Humours are mixed therewith, that we may fit out Medicines thereunto. And in the first place, Choler abounding with the wheyish Humour, is known by a vehement and cutting pain, a small swelling, a reddish or palish colour, great heat, and the Fever intense and persevering in its state or height; thin Urine, yellow and riddish; cold things help, and hot things hurt. Signs of phlegm abounding with the Whey, are, a softish and somewhat lose swelling of the parts affected, which if a man press with his finger, there remains a pit; the pain is not so great, Urines are thick and troubled; Cold things hurt and hot things help; little or no heat is felt: the colour is white, little differing from the Natural colour of the part. Signs of Melancholy abounding are, an obscure colour of the part like Lead, deep pain, a thin and watery Urine, a weariness of the whole Body, and the temper thereof inclining to Melancholy. As for the Prognostic. The Gout is no dangerous Disease, but very troublesome by the vehemency of pain, and of a very long continuance; so that for the most part it accompanies a Man during his life, to his old Age; yea, and it doth cause some to live long, because Nature at certain seasons drives unto the Joints vicious Humours, which might cause other Diseases; and by so doing frees the nobler parts of the Body from bad Humours. Yet doth it often fall out in weak bodies, or such as are decayed with Age, that when Nature can no longer expel such Humours as are collected in the inner parts of the Body, deadly Diseases do thereupon arise; as most sharp Fevers, Inflammations of the Bowels, Apoplexies, Convulsion, Frenzies, Difficulty of Breathing, and inability to breath, unless sitting upright, Pant of the Heart, and other most grievous Infirmities. Although a Disposition rooted in the Bowels tending to breed Goutish Humours, and Natural weakness of the Joints cannot be perfectly taken away; yet may the Invasions of the Gout be very much retarded, and kept off; so that some only by abstaining from Wine, others by usual Purges frequently repeated, have kept themselves for many years free from the Assaults of this Disease. Hypocrates in the Second Book of Predictions, affirms, That many Gouty persons may be cured, distinguishing them from such as cannot be cured, in these words: Touching the Gout, this I say; All that are aged, or have stony knots about their Joints, or live miserably, being costive, cannot be cured by Art of Man that I know of. Such are well cured by a Dysentery, when it seizes upon them; and by other fluxions of Humours to the inferior parts. But he that is young, and hath no stony know about his Joints, and lives accurately, being inclined to labour, and having a belly well inclined to stool; this man having a skilful Physician may be cured. An hereditary Gout may well be accounted incurable. If the Veins of Gouty persons do swell with black blood, their Gout leaves them; out of Avicenna. Because the Humours which were wont to flow into the Joints, are derived to the external parts of the Skin. If the Gout, being accustomed to return at certain seasons, shall not return, it portends grievous, and oftentimes deadly Diseases, unless the Morbific matter by a diligent prevention shall be taken away. For if through weakness of Nature, the matter which is gathered together within, shall not be expelled, it breeds the greatest and most dangerous Diseases imaginable. Whosoever they be that have the Gout within the space of forty days the Inflammation is allayed, and they are freed. Hypocrates in the 49. Aphorism of the fifth Book or Section. For in such Parts as have little Natural heat, the matter offending requires a long time before it can be discussed. Howbeit this period of Hypocrates is not certain and perpetual; for some are healed sooner, and some later; which depends upon the quantity, thickness, or rebellion of the Morbific causes; the strength or weakness of the Parts affected and the obedience of the Patients in Point of keeping the Diet, and using the Medicaments appointed for them. The Cure of all Gouts consists herein, viz. That the flux of Humours into the Joints may be stayed, that which already is come in and abides in the Joints may be removed, and that the Pain may in the mean while (if it be sharp) be abated; all which may be performed by the following Medicaments. And in the first place, Letting of Blood will be very convenient, if there be no want of Blood in the Patient, and if phlegm do not abound; because the Blood is agitated by the motion of the Humours flowing into the Joints, and does as it were boil, and is by Pain drawn into the Part affected: wherefore it is necessary to draw the same back, into that Part of the Body which is opposite to the Part affected: and therefore if the right Arm be Diseased, a Vein must be opened in the left; if the right Foot be Pained a Vein must be opened in the right Arm; and if the left Foot in the left Arm. And Blood is to be taken away at the first beginning of the Disease, and as much as needs must be taken at one time, if the Patient's strength will bear it: if not, it must be done at several times, till the plenitude of Blood be sufficiently diminished. One thing we must always remember, that copious Blood-letting in such as can bear it easily, does exceedingly shorten the Disease, if it be done at the beginning of the Disease, at least by Piece-meal, drawing now a little and then a little. Also Purging must be used at the beginning of the Disease, as soon as may be: for so both that Humour which is influx and is ready to flow, will be drawn from the way to the Joints and be brought unto the Guts. But in this purgation two things are worthy of observation, being frequently noted by Solenander a famous practitioner. The first is, that this Purgation be not made by some mild lenitive Medicaments, whereby the Humours are rather stirred than Evacuated, and are precipitated into the Joints, whereupon a more grievous Pain and swelling is wont to follow such purges; but with some strong purgative, which may force out the stirred Humour and turn the cause there of from the Joints. The other is, that the Medicaments being given, the Joints above the Knees and elbows, be Plastered with some defensative, by which the Humour which is put in motion by the Medicine may be intercepted, so that it may not so much nor so forcibly fall down into the Joints. To which intent let an Ointment be made of Bole, Pome-Granate Rinds, Balaustians, Roots of Bistort and tormentil, red Roses with the white of an Egg, and Vinegar; which being spread upon snipps of cloth as broad as one's Hand and indifferent long, let them be wrapped about the Parts aforesaid. If these simples be not to be had at present, wet them only with Vinegar and water and let them lie on at least an whole day. If the Fluxion be vehement, use a lineament of Bole, Dragon's Blood, the white of an Egg and Oil of Roses made with Oil of unripe olives: or at first use it without Oil adding a small quantity of the Oil aforesaid or of Vnguentum Comitissae, lest growing dry and hard it cause Pain. And for to procure such a purgation as we have spoken of, let the skilful Physician prescribe a Medicament fitted to the Nature of the Patient and such Humours as are redundant in his Body: or some of those Specific Purgations which we shall propound in our Doctrine of Preservation from the Gout. Vomiting is likewise profitable in this Case, for such as are easy to vomit; because it brings out the evil Humours by a shorter way, and so there is no such fear lest they should rush into the Part affected. But gentle Vomits are to be used, which do only evacuate those Parts which are near the stomach. For if they be vehement, and draw Humours out of the Veins, they may precipitate the said Humours unto the Joints. Then after vomitings, purgation must be procured downwards; yea and if one purgation will not serve turn, it must be repeated. After sufficient Purgation, it will be very good to procure sweat; for so the wheyish matter will be discussed by the habit of the Body. But, seeing when the Gout gives its first Onset, there happens a kind of boiling and working of the Blood, and commonly there is a Fever, hot sudoroficks will not be convenient, but only such as are temperate; amongst which Sennertus commends Hartshorn, either crude, or prepared without burning, either alone, or with Carduus Water; as likewise Antimonium Diaphoreticum. In an old Gout without a Fever, a Decoction of China Salsa Parilla are Sassafras may be given, qualified with coolling Herbs, as Cichory, Endive, Sorrel and Or after the Sweat is wiped off, it may suffice to give the Patiented Chicken-Broth, altered with the Herbs aforesaid. Martinus Rulandus did use this following Sweeting Medicine with happy success: Take Tops of Centaury two handfuls: Asarum Roots two ounces: Boyl them in ten pints of Water to five pints, and strain the Liquor. Give the Patient eight ounces of this Liquor hot, in the morning some days together; and let him sweat upon it. But Forestus commends the Roots of the greater Burdock; because it cuts, discusseth, and provokes both Sweat and Urine. And he reports that a certain Gouty person that kept his bed, and could not stir a Limb, drank hot Beer in which the great Burdock Root had been boiled; after the drinking whereof, when the Physicians could do him no good with all their Medicines, he pissed a great deal of white Matter like Milk, and was freed from his pains. Hercules Saxonia puts a great many Loaves hot out of the Oven round about the Patient's Body, by which means Sweat is plentifully procured, and the pains removed. Also a Decoction of Elder, Bay-leaves, Sage, Rosemary, and such like Herbs will do much good, the Patient receiving the vapour of this Decoction in a sweeting Tub, which will make the sweat to come lustily. Also the Waters of Natural hot Baths do provoke sweat, and do readily discuss the Matter contained in the Joints. And therefore when the sick are not able to go unto them, their Water is wont to be brought unto them and heated in a Cauldron for them to bathe in. Erastus in his 15. Counsel, prefers this above all others, for easing the pains, but he boils so much Salt in the Water, as gives it an evidently brackish taste. In the beginning of the Fluxion of Gouty Humours, in the spaces free from Purgations, such things must be given as stop the Flux, which have been propounded by me in the Cure of an hot Catarrh; especially Juleps of Waters, or Decoctions and Syrups which do cool and thicken. Yea, and the truth is, We are sometimes compelled to use Narcotick or Stupefactive Medicaments; for they both stop the flux of Humours, and they mitigate the rage of the pains. Of these sort of Medicines new Venice Treacle is most convenient, which may often be repeated without danger from half a dram to a dram. Unto which may profitably be added, a little to stop the flux of Humours. Howbeit, instead of Treacle, Laudanum Opiatum, and other Narcoticks, may conveniently be substituted. After due Evacuations have been celebrated, and other things given inwardly which respect the antecedent Cause, we must proceed unto local Applications, such as mitigate the pain, and discuss the contingent Cause: Which are not presently to be used before the universal Remedies aforesaid have been first applied; for otherwise they are wont to do more hurt than good. For either the Matter which Nature intended to drive into the Joints, is driven back into the inner parts of the Body, whereby grievous Symptoms are raised; or it is forced into the Joints, and the pain is exasperated; or the part is effeminated, and made lax, and so the fluxion is increased. Which Cautions being commonly neglected, and external things untimely and heedlessly applied; the Patients receive commonly more hurt than good thereby. And those external Medicines do either respect the pain alone, or the Cause likewise of the pain, viz. The Humour which hath took its course into the part, and caused both the pain and Swelling. Such things as mitigate pain, are very necessary in this case, because the extremity thereof weakens the Patient, and draws the Humours to the parts affected. Furthermore, by the use of anodynes, the parts are relaxed, and the Humour which before did flow into the more deep parts about the Joint, is diffused to the more ambient parts and external. Whence it is that the pains of the Gout are most vehement before the part swells; but after it is swollen they are mitigated. Now there are many Anodine, or Pain-charming Medicaments propounded by Authors to be applied to those parts which are troubled with the Gout. But the chief are these which follow: Lukewarm Milk applied to the part affected, by wetting Linen therein, and laying them on, doth assuage the pain; as also if the part be sprinkled and bedewed therewith, especially when it comes fresh from the Dug; which Amatus Lusitanus doth very much commend, in the 41. Cure of his sixth Century, in these words: One mightily tormented with the Gout, caused a she Goat to be brought into his Chamber, and her Milk to be milked out upon his pained Joint; by which he perceived the pains evidently lessened. And there is good reason for it: For Milk newly milked, doth assuage, mitigate, and lessen pains. It is a Medicine commonly used by the Great Turk: by you who seek Profit and Honour, highly to be prized. Of Milk likewise is made the Cataplasm of white Bread Crumbs boiled therein, adding the Yolks of Eggs, and a little Saffron. Also the Leaves of Henbane, or Violets, are boiled in Milk, or in Vinegar and Water, and profitably laid upon the part affected. Also a Cataplasm is made of the Pap of Marsh-mallow Roots mingled with Milk. Also a Cataplasm is made of the Pulp of Cassia alone, or mingled with Oil of Roses, or the following Ingredients: Take Crumbs of white Bread boiled in Milk, half a pound: Pulp of Cassia three ounces. Make them into a Pultiss. Or, Take the Pulp of Cassia four ounces: new Venice Treacle half an ounce: Barley and Oaten meal, of each three ounces: the Crum of white Bread four ounces: Cows Milk two or three pints▪ Boyl all into the form of a Pultiss, which apply warm to the parts pained. If you shall add half an ounce, or an ounce of Vitriol calcined and finely powdered, you will make it far more excellent. In the beginning of the Gout, which seizes only the great Toe, lay on this following: Take two whites of Eggs: a little Salt beaten to Powder: a few drops of Vinegar of Roses. Mix all, and apply it upon Tow, or course Flax to the part affected. Other Cataplasms are likewise made of greatest efficacy, compounded on this manner: Take Water of white Mullein, and of Fern Root and Branch, of each half a pint: calcined Vitriol tightly powdered, one ounce and an half: Meal four ounces: Saffron two drams. Make all into a Pultiss. Take Mallows, leaves and Roots, as much as you please, Boyl them in a new Earthen Vessel, with equal parts of Wine and Vinegar, till a third part be consumed; then add as much course Rye Bran as will make it into a Pultiss; which being well wrought together and spread upon a Linen Cloth, let it be applied to the parts pained, as hot as the Patient can endure it. Solenander doth exceedingly commend this Pultiss. Forestus relates that a Cataplasm made of Duck-weed and Chamomel Flowers boiled in Milk, adding a little Barley Meal, will do miracles. Montagnana affirms this following to be most excellent in extreme pains. Take the Yolks of ten Eggs; beat them in a Frying Pan with half a pound of Oil of Roses. Let them boil gently till they grow thick, adding two drams of Saffron; and lay it on hot. In the beginning of the Flux, many lay on a Cataplasm of Salt and Soot, wrought into a Body with whites of Eggs. Or of two ounces of Chamomel Flowers: red Rose Leaves one ounce and an half: Mullein flowers half an ounce: Powder them, and boil them in sweet Milk to the stiffness of a Pultiss, adding three or four Yolks of Egs. Or of Barley Meal, and Bean Meal, of each one handful: Flowers of Chamomel and Roses, of each half a handful: Mullein Water, and Willow Water, or Plantain Water and Wine, of each as much as shall suffice. Incorporate all together in form of a Pultiss. Also divers Fomentations may be made to be applied to the place affected, after this manner: Take of the Leaves of Mullein six pounds: red Wine a Quart. Beat the Leaves and st●ep them in the Wine for three days. Distil them, and bathe and foment the parts affected therewith warm, with Linen dipped therein. Or, Take Flowers of Mullein as much as you please; fill a glass Bottle therewith, and stop the mouth, and set it in the Sun; for so they will turn to Liquor, which being applied to the part affected, with Linen, mitigates the pain. Salsaturni, that is, Salt of Lead dissolved in subtle Spirit of Wine, easeth pains wonderfully. Frog-spawn-Water stilled in May, applied to the parts pained, doth wonderfully assuage the pains, and tempers the Inflammation and redness of the part. These following Simples may profitably be mingled therewith. Take Frog-spawn-Water, Water of Tapsus Barbatus, or of Mullein, and of Fern, of each one pound and an half. Infuse therein Lapis tutiae, and Litharge of Gold, of each two ounces: Vitriol calcined, and Alum, of each one ounce. Foment the pained Parts herewith warm. An Infusion of lethargy made in Vinegar, the Vinegar being a little evaporated, till it grow sweetish, doth much good to an hot Gout. Oil of Calf's Feet is excellent to allay the pains of the Gout, and it is thus prepared: Let the Calf's Feet be beaten, and the Bones broken, then boil them all to a Pap. Take the Oil which swims on the top of the Water, mingle it with Aqua vitae, and Salt, and therewith bathe or anoint the parts pained. Also Oils and Fats are by many used. But seeing the Inflammation which befalls those Members which are troubled with the Gout, doth draw very near the Nature of an Erysipelas, or red fiery swelling, oftentimes those fat things may do more hurt than good; for by stopping the pores, they may keep in the Humour, and so increase the pain. According as Sennertus makes relation of a man troubled with the Gout, who found great good by very new Sheeps-milk Cheese laid upon the pained part: for as soon as the Cheese being heated by the pained part, began to melt and shed its Butter, the pains were increased. Yet in some Bodies, Oil of Roses, and such like, may do good, especially mixed with other Medicaments; because according to the different Natures of men's Bodies, several things do good to several persons. And therefore we must be furnished with a mighty company of Medicaments, that upon all occasions we may have change; because there is scarce any one so effectual, as to do good to all that are troubled. Take these following for an Example or Pattern. Take Crum of the whitest Manchet half a pound: Boyl it in new Milk to the consistence of a Pultiss; then add of the Mucilage of Marsh-mallow seeds two ounces: Meal of Line seed and Fenugreek seed, of each two drams: Flowers of Chamomel, and of Melilot powdered, of each one ounce: Saffron one dram: Oil of Roses one ounce: Mix all into a Cataplasm. Or to the Cataplasm of white Bread Crum before described, Oil of Roses may be added. Also Liniments and Ointments are wont to be made to mitigate pain. Take Yolks of Eggs two or three: dissolve them with Oil of Roses, or Violets, or Wine, and apply them lukewarm. Balsamum Saturni prepared with Oil of Roses or Violets, alleys pain most effectually. Take Ceruse two ounces; dissolve it in Endive Water and a little Vinegar make thereof a Liquid Ointment. Of the said Ceruse is made a Plaster of great efficacy which may be laid on in the beginning of the Disease, even whiles the Tumour and Inflammation is present. It's composition is thus. Take Common Oil one pound, Wine a pint and an half: Boyl them till half the Wine be consumed. Then add a pound of Ceruse finely Powdered and two drams of Camphire. Boyl them to the Consistence of an Emplaster. When there is great Inflammation, Vinegar must be used instead of Wine. Spread this plaster upon Linen that it may the more commodiously be wrapped about the Parts affected. A Living whelp laid to the pained Part, doth very much assuage the pain. When the pain rages extremely we may have recourse to Narcoticks; howbeit they must not lie long upon the Part, because they are adverse unto the natural heat and to the nerves. Take Henbane Leaves two Handfuls: Nightshade and Housleek of each one Handful. Garden Poppy-Head one pugil, Mandrak Roots one ounce. Chamomel Flowers and violet Flowers of each one pugil, make a Decoction in Water or Milk with which let the Part be bathed. Beat the residue after the Liquor is strained out, and add of the Flower of Lin-Seed one ounce and an half. Wheat meal two ounces: Oil of chamomel three ounces: and make a Pultis. Or, Take Spirit of Wine somewhat Yellow by infusion of Saffron four ounces: camphire one scruple: Boyl them a little, then dissolve therein, one dram of Opium: With that Liquor let the pained Part be bathed: It is a safe and most effectual Medicine. Green Tobacco Leaves beaten and laid on do ease the Gout, and are said to be of a stupefactive Nature. As for the Efficient Cause of the pain, to the Humour flowing into the Part repelling Medicaments must be opposed; and to that which is already in, deriving and resolving Medicaments must be applied. Howbeit repelling Medicines are disallowed in this Case, especially alone and without the commixture of other things. For if they shall wholly stop the influx of the matter into the Parts affected, it is to be Feared lest they retiring to the inward Parts, should cause dangerous diseases, unless they happen to be translated to some other Joint. Again the Humour which hath already flowed into the Part, is the more driven inward, by which means, the Pains become more violent. But yet, if in the beginning of the Gout there be a great afflux of Humours especially hot ones, which threatens sharp Pains to follow, it will be convenient in some measure to repress the same, by applying repellers, not alone, but mixed with such things as mitigate Pain, after universal and sufficient Evacuations. For then such things as do overmuch relax, do help forward the afflux of Humours. And therefore, we may add unto the foresaid cataplasms and other remedies Plantain, Lettuce, Purslane, Housleek and such like as also a little Vinegar. As for example. Take Barley Meal three ounces: Boyl it in Water and Vinegar, add two Yolks of Eggs, Saffron twenty grains: Make all into a Pultis. Or, Take Red Roses an Handful: Barley and Fenugreek Meal of each one ounce: Red Sanders one dram and an half: Chamomel Flowers one pugil: when they are Boiled and beaten, add two Yolks of Eggs, Vinegar four ounces: Oil of Roses as much as shall suffice; make all into a Pultis. Among remedies which derive the Humour from the Part affected are Horseleeches, after sufficient Evacuation applied thereunto: for than they do much good, especially when the Veins in the Part affected, do seem distended and swelling with Blood. Now resolving Medicaments are wont to be used in divers forms as of Waters, Oils, Unguents, Balsams, Fomentations, Fumigations, Cataplasms, Plasters and the like, compounded after this manner. Take Vitriol white and green, of each one ounce: camphire two drams: aqua vitae and white Wine, of each one pint: Mix them and apply them with dipped in them. Or, Slake Lime in Urine, purify the Liquor and foment the Pained place therewith It is likewise good if it be done with Vinegar and Lime. Martinus Rulandus in the Centuries of his Cures, doth mightily cry up his Gout-quelling Water, but never describes the same. But Libavius, Petreus and others suppose it was thus made. Take Fountain Water a Pint, Aqua fortis half an ounce: Sublimate one dram: Boyl them a quarter of an hour. Wet linen in this Liquor and apply them lukewarm to the Part affected. Quercetanus in his Pharmacopoeia propounds these following. Take Pickle of salt, and the Urinal of a Boy of each Equal Parts. Still them and Wet Linen in the Water and apply to the place affected, often changing the for fresh ones. Take Green Elder Leaves and flowers of each one pound: beat them and steep them in Aqua vitae for two or three days: still them in a Glass or Copper vessel, till they be dry. Take Spirit of Wine rectified two pounds: of the finest honey one pound. Distil them in Balneo Vaporoso: So you shall still two Liquors; The first is waterish; The second much stronger, and Sulphureous, which you shall keep by itself. To the remaining materials add an ounce and an half of whole Oriental saffron: Venice turpentine two ounces: Castoreum six drams: Tartar calcined till it be white, half a pound; dissolved salt an ounce: Phlegm of vitriol not separate from its spirit four ounces, Lie made of Vinetree-Ashes two pound: steep them together twenty four hours. Then still them till they become dry: keep the Liquor which comes likewise by itself. To the dregs remaining pour on the former Water which you kept: Steep them and still them. Lastly put all the distilled Waters together and distil them in Balneo Vaporoso. Quercetanus says, That this Water is of wondrous efficacy, and that it was communicated unto him by a certain most famous Germane, as a special gift, affirming, that this was the very Water of Rulandus. And he averred that he had seen the rare effects thereof in easing the Pains of the Gout, if Linen being moderately warmed and dipped therein, be applied to the Part affected, The same Quercetanus in his Council touching the Gout, doth brag that he reserves to himself his Gout-quelling Water, as a Masterpiece for such an old soldier as himself to boast of which he says is made of plain Fountain Water, wherein he doth divers times quench certain Metallick substances, which are wont to be taken inwardly when rightly prepared: whose spirits being impressed into the foresaid Water, do contribute thereunto the power of penetrating unto the Roots of the Disease, and of truly resolving the Tartarous, stony matters, with the salts, which are combined in the Joints, from whence such intolerable Pains do arise. Peradventure this that follows it not unlike it, nor a whit inferior in Virtue. Take Vnslaked Lime four pound: Slak it in Riverwater as much as you please, and let it stand in a Wine Cellar three days, that the Salt may be better extracted out of the Chalk or Lime. Afterward let them Boyl a little and strain the Liquor through an Hippocras Bag. In twenty pints: of the strained Liquor, quench seven or nine times; first Plates of steel red hot; & then Plates of Copper red hot; and thirdly to the quantity of ten ounces of Vitriol calcined till it be white; fourthly Antimony melted in a Crucible to half a pound; fifthly lethargy or Ceruse heated in a Crucible, half a pound; white Precipitate once washed and no more one ounce and an half. Brassburnt and finely Powdered, half an ounce: After the quenching of these minerals, let the water stand still in a Wine Cellar, the space of ten days. Afterward, Boyl it a little, and strain it through an Hippocras Bag. In this Water being hot, doubled must the dipped and frequently applied to the Gouty Part. Among Fomentations easy to make, that is commended, which is made of Salt Ammoniack seven times sublimed, and fitly dissolved in Wine or Water. or of the Urinal of a young man in good health, Boiled till half be consumed and laid on with Rags; Solenander Writes in his 24. Counsel, Section the 4. That a certain Gouty old man was wont to make himself this Medicine. When the swelling and Pain was great and the place red, he took Salt, the Urinal of a Boy and Vinegar. In these being mingled together, he Wet a Linen cloth and squeezed it and laid it on, this he did divers times and so the Pain was much abated, As we said before, that Anodine or Pain-quelling Oils did little good in the Gout, the same must here be said of resolving Oils, because they close the pores of the skin and so hinder the freedom of transpiration and increase the heat, neither can they by reason of their clammy substance pierce into the innermost Parts of the Joint, so to temper and resolve the Salt, sharp and Tartarous Humours which lurk in them, Yet if the foresaid Oils shall be Distilled in a Retort, they will become very fit for this use, because they will be very searching and no ways clammy. Among these the most excellent are Oil of Cheiry, Saint john's Wort and of the Yolks of Eggs, which being mixed together▪ and stilled by a retort, are very profitable to ease Pain and to discuss the Cause thereof. Also Mathiolus his Oil of Scorpions stilled after the manner aforesaid, is most excellent. Oil of Wax is likewise effectual to the same purpose. But Oil of Man's Bones made after the same manner that Oil of Tiles is made, is preferred before all others, and commended not only by the Chemists, but also by the Dogmatical Doctors, as Crato, Platerus, and others. The manner of making it is this: Man's Bones fresh and unburied, are broken and burnt, and cast into old Oil: afterward, they being full of the Oil, are beaten and cast into a Retort, and so by the force of the fire, an Oil is drawn out. Where Man's Bones are not to be had, the Bones of other Animals may serve the turn. This following will also be very good: Take Mastich, Frankincense, Myrrh, Ammoniacum, Opopanax, Bdellium, Mummy, of each two ounces: Vitriol one pound: Honey two pound: Tartar one ounce and an half: Spirit of Wine four pound. Distil out of all an Oil, with which let the pained part be anointed with a feather. To ease the pain, and to resolve the Matter of the Gout, a Liquor made of Snails is likewise commended, which is thus compounded: Put an handful of Snails into an Hippocras Bag, and cast upon them an handful of common Salt; upon the Salt, a handful of Dwarf-Elder, or Danewort seeds very finely powdered: And so one Lay after another of Snails, Salt, and Seeds, until you have made four or five Lays of every one in particular. Let the Bag hang in a moist Cellar; and after a few days there will drop a slippery Liquor and fat; which set in the Sun for four days, and then smear the place affected therewith. A resolving Unguent may be made after this manner: Take Chamepitys, common Wormwood, and Rosemary tops, of each a handful: Chamomel flowers, Melilot flowers, and Rose Leaves, of each one pugil: Oil and Wine, of each half a pound: Let them boil till the Wine be consumed: the Liquor being strained, add thereto as much Wax as shall suffice to make it into an Ointment. Let the Part affected be anointed herewith warm; within twenty four hours the Part doth swell, and the pain ceaseth. Also divers Pultisses resolving and easing pain, may be made. The principal are these: Take Wheaten Bran a pound: Salt one ounce: Soap as much as shall suffice. Boyl all into a Cataplasm, or Pultiss. Or, Take Bean Meal half a pound: Boyl it in a sufficient quantity of Wine, adding thereto a little Aqua vitae and Butter. Make it into a Pultiss. Or The Leaves of Dwarf-Elder, or Tree-Elder being beaten, may be applied; or they may be fried with Butter in a Frying-Pan like a Pan-cake. Briony Root bruised with Aqua vitae, is also very effectual. Also some commend Aron, Cuckoo-pintle, or Priests-pintle Roots, being mingled with Cowdung. This following is commended by Solenander, because it resolves without any great heating, easeth the pain, and strengthens the Joints. And it may be safely applied after the beginning of the fit, about the fift day of the Disease. Take Powder of red Roses two ounces: Mastich one ounce: Camphire half a dram: Barley meal half a pound. Boyl all in white Wine, evermore stirring the same, till it come to be thick, and lay it on warm. Emplasters are likewise wont to be of great use in this Case. The chief are these which follow. Take Frankincese, Mummy, Colophony, of each one ounce: Mastich, Myrrh, white Coral, of each half an ounce: Man's Fat six drams: Gum Ammoniacum, and Bdellium dissolved in Vinegar, of each three Drams: Turpentine half an ounce: Oil of Foxes, and of Roses, of each as much as shall suffice to make all into a Plaster. Take Florentine Orice Roots, and Hermodactils powdered, of each six drams: Emplastrum Oxycroceum, & de Mucilaginibus, of each two ounces: Rozin of Pine one ounce. Melt them together, adding Oil of worms as much as shall suffice, and make thereof a Plaster. Emplastrum Diapalma, or Diacalciteos, is very much used, both alone, or with Camphire added thereunto, after this manner: Take of the Rowl of Diapalma Plaster half a pound: Camphire two drams. Mix them together, and apply them to the parts affected. Or in Form of a Cerecloth. Take of the Rowl of Diacalciteos Plaster half a pound: Plaster of Sulphur an ounce: Storax and Benzoin, of each half an ounce: Tacamahacca two ounces: Oil of St. John's wort, and Worms, of each an ounce: Liquid Storax an ounce and an half: New Wax, as much as shall suffice. Melt all together, and dip your cloth therein, twice or thrice, make it smooth and dry, and keep it for your use. But yet the same Plaster mingled with these things following, aught to be reckoned amongst the most excellent Medicines for the Gout. Take Diacalciteos Plaster dissolved in harsh red Wine, and boiled till the Wine be consumed, one pound: Myrtles, red Roses, Mastich, Tartar of red Wine powdered, of each two drams: Chamepitys, or Ground-pine, and right sweet Chamomel powdered, of each half a dram. Make of all a Plaster, to be applied after the swelling is much abated. And at last, in a very old and settled pain, especially from a cold Cause, some lay Vesicatories to raise Blisters upon the parts affected. Sennertus makes mention of them, but so as that anodynes be mixed with them. But the most wise Varandaeus, my Master, did with happy success use the common Vesicatory Plaster, which is kept in our Shops, simply, and by itself without any mixture; wherewith he cured a great and rebellious Swelling upon the Knee, when other Physicians had in vain used many Purgations, a Sudorofick Diet-Drink, and many External Medicines. In the use of all the forerecited Medicaments, this one thing is diligently to be noted, That we must take our hints from such things as we find do help or harm the Patient: forasmuch as the Natures of Men are divers, their Complexions divers, and divers kinds of Excrements are bred in several Men, whence it is that the same Diseases do extremely differ in several persons: therefore what profits one man, doth another no good at all; which often comes to pass in curing the Gout. And for this Cause, every Practitioner must have an abundance of Medicines, that when one hath been applied in vain, he may use another and another, making always choice of such as a rational Method shall most approve of. When the Gout becomes stony and knotty, it is extremely hard to cure, especially if it be of long standing. But new knobs may with Emollient and Resolving Foments, Unguents, and Plasters, be dissolved. The most Specific or Appropriate, are these which follow. Galen exceedingly commends a Plaster compounded of old strong Cheese, made into a Plaster with the Decoction of a powdered Sow's pestle or Leg. Others boil powdered Sows Legs, till they come to a slimy substance or Jelly. Afterwards they mingle therewith two parts of old Cheese, powder of Water-cresses one part, and so make a Plaster thereof. Or, Take Juice of Tobacco three ounces: yellow Wax two ounces: Rozin of the Line-tree an ounce and an half: Turpentine one ounce: Oil of Chamomel as much as shall suffice. Make all into a soft Cerate or Plaster. Or, Take of those Eastern Berries, which the French call Coques de Levant, and Myrrh, of each half a pound. Powder them, and mix them together with strong Vinegar into the form of a Cataplasm. Gum Ammoniacum dissolved in Vinegar, doth powerfully soften. Rulandus anoints those hard Swell in the morning, at noon, and in the Evening with Oil or Balsam of Sulphur hot, and then he lays on a Plaster hot, of Emplastrum Diasulphuris. But this Plaster following, is your rare Plaster, because besides easing the pain, it draws the gritty, stnoy substance out of the Joints likewise. Take Roman Vitriol one pound: Roch Alum half a pound: Salt four ounces. Calcine all these together in a Crucible or Earthen pot, letting it to steem so long till the spirits shall begin to go away. Which when you perceive by their smell to rise, leave presently your calcining, and let all cool, and then powder them. Take of this Powder, and Barley Meal, of each a like quantity; mingle them with Wine Lees to the form of a Pultiss, which spread upon a rag as thick as a knife, and apply to the place affected. When it is dried, dissolve it again with Lees of Wine, and apply it again, until in the first place the pain be discussed; and in the next place, until all the stony substances be consumed out of the knobbed and knotted Joints. In the mean while it falls out often that the Skin will break, which need not affright us; for either afterwards the Ulcers close of their own accord, or at least by laying Wax upon them in manner of a Plaster, they are closed up, the Joints having regained their motion with activity. Finally, If the Gout be very exceeding old, and perfectly knotted, by the preceding Cure a mitigation of pain is to be hoped, but the stony substances will hardly give way; therefore with a gentle Caustick the Skin is to be opened, and then the stones are to be taken away with a drawing Plaster of Gums. The Cure of the Gout when present, is performed by the Remedies aforesaid. But because this Disease is wont to return by fits, especially in the Spring and Fall, we must now show the way to prevent the same. Which Prevention ought to aim at the hindering of any Gouty Matter, like to fall into the Joints, from gathering in the Body; or if any be collected, that it may be carried away. And finally that the Joints may not be so disposed to receive the Humour which flows unto them. The collection of Matter will be hindered, by an excellent Diet, and by Medicines rectifying the distempers of the Bowels. The Matter collected will be carried away by Evacuating Medicaments. And the Joints will not so easily receive if they be fortified with corroborating Medicaments. As for the Matter of Diet, although in this Case it be of very great, yea greatest moment, yet the Nature of this work will not give me leave to describe the same. I shall only speak of the Patients Drink so as to say, that Wine is extreme hurtful to all Gouty Persons, and many have recovered only by abstaining therefrom. Yet if the Patient in regard of some other Infirmity cannot wholly abstain from Wine, let him drink weak Wine, or well allayed with Water. Hollerius instead of Wine commends thin Metheglin viz. Of forty or forty eight Parts of Water to one of Honey. Yet this suits not with such as abound with bitter-choller and those that are dry and thirsty. This following Diet drink suits all Natures, and hath done much good to very many persons. Take Salsa parilla Roots two ounces: Liquorish one ounce: Cinnamon and anise Seeds half an ounce: Make all into a very sine Powder. Of this Powder mix one spoonful with so much small Beer or ale as the Patient is wont to drink at a Meal. Brew them together out of one Pot into another three or four times. Then strain the Liquor for the Patients ordinary drink. Doing the like for every Meal. And as for Evacuations, Bleeding must be first practised especially in the spring and fall, in such as abound with Blood and whose Blood is wont to work and ferment or be very hot. But Purgation is not only to be used spring and fall, but four times in a year, yea and every month in every Cacochimical Body that is which abounds much with evil Humours. To which purpose many forms of Purgations are handed to and fro, of a special property for this Disease. These that follow are the chief, which are so to be used by the discreet Physician, as that he must make many changes, both in respect of the materials and the Dose, according to the various Constitutions of the Patients, Take Senna cleansed, Turbith, Hermodactiles and Powder of a Man's Skull that hath never been in the Earth of each one dram: Diagridium half a dram: Make all into a Powder of which give one dram: at a time, in Groundpine Water, or in Broth. Or, Take Salsa parilla one ounce: Senna six drams: Turbith, Hermodactiles, Jalap, Mechoacan of each half an ounce: Agarick Trochiscated two drams: Diagridium and Cinnamon of each half a dram: Make all into a Powder. Steep a dram thereof in white Wine all night, in the Morning let the Patiented drink Powder and Wine. Electuarium Caryocostinum is by Petrus Bagerus exceedingly commended, and is approved by all Practitioners, and it is described in the London Dispensatory in Folio 111. and in that of Bauderon. It is given to half an ounce: But in hot Constitutions it may do harm. Rhasis Commends his Pills so far as to say, that they can make such as are fain to Ride, to go on Foot again. Thus they are made. Take Aloes of the best half an ounce: Red Roses two scruples: Hermodactiles white and purged from their outmost Skin or shell, one dram and an half: Diagridium one dram: With Water of Ground-Pine and honey of Roses make all into a Mass of Pills. the dose one dram. These also are good which follow. Take Aloes, Hermodactiles of each half an ounce: Groundpine, or Chamepitys two drams: Chamaedris or Germander, Stcoehados of each one dram: Saint john's Wort Seeds, half a dram: With Venice Turpentine make a Mass of Pills, which because they Purge little may be given the oftener. Also Evacuation by Vomit is very good for Prevention if the Patient can bear it well; which is declared by Alsaharavius a famous Physician in these words. A Vomit is better than a purge to Root out such ill Humours of a gross Nature as are below the Knee even to the Foot; as in the Knee-Gout, Sciatica and such like. Now Vomiting may be procured every Month two days together because the second day drives out the Relics of the first. And some have observed that vomiting is more successful than ordinary when is in a Sign that chews the Cud, such as the Bull & the Goat or Capricorn. It is good to Vomit the Moon after Supper the Patient having eaten divers Meats, Fat, sharp of Salt or Spice etc. and others in great Quantity, and afterward rubbing his stomach and putting his finger into his throat. And if that will not do, he must take a Vomit, especially of Asarum and Broom Boiled together and the Decoction drunk, which are otherwise good in the Cure of the Gout, That Evacuation likewise which is made by sweat, Purges the Blood from wheyish excrements, and draws out the antecedent Cause of the Gout. To this Purpose a Sudorofick Diet drink may be ordered for the Patiented Spring and Fall, of a Decoction of Salsaparilla, China, Sassasras, or of Guaiacum, as the temper of the Patient shall advise, But some late Physicians have brought into use, a Decoction which carrieth away the Matter merely by invisible Transpiration through the Pores of the Skin, without any sweat at all, which hath done a world of good. It's Composition and use is thus: Take Sarsaparilla, Crude Antimony, Nutshells, of each six ounces: China Root one ounce: A little Brasil Wood: Water nine pints: Boyl them to four pints and an half. Let the Antimony and Nutshells be powdered and tied in a cloth, which must be so hanged in the pot that it touch not the bottom. Let him take a good draught of the strained Liquor, on mornings three hours before dinner; in the afternoon four hours after dinner, and three hours after supper, for fifteen days together. Bleeding and universal Purgation being premised. Of the Grounds remaining in the Strainer with like quantity of Water, may be made a Diet-Drink for ordinary use instead of Beer. Boyl the Water half away, and ad Coriander and Liquoris as much as shall suffice to give it a good smack. To prevent the Gout, and to root the same out of the Bowels, some Practitioners commend the use of Gout-quellers given an whole year together, whereby they avouch many have been perfectly cured. Among many of their Receipts, this is the Principal. Take Salsaparilla four ounces: St. Johns-wort seeds, Groundpine, and Germander Leaves, of each three ounces: round Birthwort six drams: Angelica three drams: Cinnamon three drams: Cloves four scruples: Saffron two scruples. Let all be finely powdered and incorporated with Spanish Honey clarified as much as shall suffice. Make all into an Electuary, which let the Patient use a year together, taking every day in the Spring, Fall, and Winter, one dram and an half; in the Summer only one dram. Let the Patient forbear to take it in the Dog-days. Let him wholly abstain from Wine and Lechery. Peradventure the Decoction of Germander may be of the Nature of the Gout-quelling Medicaments our Practitioners talk of; which was therefore commended to the Emperor Charles the Fifth exceedingly by the Physicians of Genoa; and Solenander doth testify, That very many who drank this Medicine threescore days together, were perfectly cured. The Composition of this Decoction is thus: Take Germander gathered when it flowers, and well preserved, one handful: Ripe Wine not very strong, nor very small, three pints: Boyl them in a double vessel five hours. Let the Patient take a draught of the strained Wine, and compose himself to sweat. This is to be done after the Patient hath been purged. And it is here to be noted touching those hot Medicines, that they are not only unprofitable for hot Constitutions, but they cause such Resolutions of Humours or Joints, or other inconveniences, as can never be cured, and therefore they must be given with great Caution. Peradventure this following Electuary may be used with more safety and success, which doth purge the Body by little and little from all superfluities without heating the same. Take Senna half an ounce: Turbith, Hermodactils, of each six drams: Lignum Guajacum, Sassapbras, and Salsaparilla, of each half an ounce: China Roots one ounce and an half: Nephritick Wood two ounces: the three , of each one ounce: Annis Seed two drams: Honey very well clarified fourteen ounces: make all into an Electuary. The Dose is one dram every day in the whole year, except the Dog-days. Among the common People, some hold it for a great Preservative from the Gout, to swallow three Cloves of Garlic whole every morning for a month together. For they heat and strengthen the Stomach, without heating the Liver, or other Bowels; for they are voided forth with the Excrements whole, but boiled and wrapped in clammy Phlegm, which they bring from the Stomach and Guts. In the Gout proceeding of Choleric Humours, Waters of Medicinal Wells, which are Acid, Vitriolate, and cooling, such as that of Tunbridg in Kent, Blackbois not far from Lewes in Sussex, one in the Parish of Sandherst in Kent, do very much good. So that by the use of such Waters, some persons have been for a long time freed from the Gout. To the same purpose Hypocrates commends in his Book of Diseases, the use of Ass' Milk, which Experience shows hath done good to many Gouty persons. And in a word, All things which are good against an hot distemper of the Liver, and to strengthen that Bowel, will be good in this Case, as they are described before in the Cure of the hot distemper of the Liver. But if a wheyish Humour flowing from the Brain be Cause of this Disease, as most commonly falls out, the greatest care must be had of the Brain; viz. That its distemper may be corrected, and that the Humours bred therein may be derived and discussed. To which intents; Issues, Vesicatories, Medicines to be drawn up into the Nose, Masticatories, Powders, Spiced Caps, will be very serviceable; and other Remedies propounded in the Cure of Diseases of the Brain. The last Point of Prevention, is to strengthen the Joints that they may not so easily receive the the Humour flowing in. Yet it is to be noted, that strengthening Medicaments, are not only Vain but hurtful also, unless the antecedent Cause, and the Humour ready to flow into the Part, be carefully removed by the foresaid Medicaments. Otherwise those strengtheners, either are not able to hinder the influx of the Humours into the Joint: or if they do hinder the same, the Humours retire to the more noble Parts of the Body and raise much worse Diseases. Among the principal strengtheners the press of Grapes viz. their Seeds etc. are reckoned, which discuss the relics of the Morbific Matter by their actual heat, and by their astringency, do very much strengthen the Parts. Duretus' upon Hollerius doth thus commend them. But the use of Vine-Grape Kernels doth exceedingly profit in the time of Vintage. If the press of the Grapes be brought out of the Wine Press into a Barn and being covered with Blankets do there grow hot. In them let the Patient thrust his Feet, Legs, Thighs, Arms, or his whole Body. I have tried it (saith he) an hundred times, there is no better thing under the Cope of Heaven. And Solenander in his Counsel 21. Sect. 4. Doth give the foresaid Medicine this commendation. But among the best and safest remedies, (which do also strengthen the Parts affected, and do cherish the innate heat,) is this to be reckoned, and diligently once every year (for oftener it cannot) to be practised, viz. That in Vintage time, the Feet and hands affected, be whelmed in press of Grapes hot from the press, or made hot with warm Wine, every Morning for fifteen days. And I could name a worthy Personage, to whom I have communicated this Medicament, and received from him a very considerable Gratuity; therefore who could not go at all, and by this Medicine and God's Blessing, he was restored. And by how much the Grapes are riper, by so much the more good, will the press do in this Case. Sulphureous and Nitrous baths such as the Balerucane in France, do not only discuss the Matter of the Gout, by provoking sweat, as was said before; but also by strengthening the Joints, they do much conduce to the Prevention thereof; as also being used by way of Embrocation, that is the Head being wet therewith or it being pumped upon the Heat, Cotton wet therein be at last laid on and made fast. The mire of the said Baths applied to the weak Parts, doth likewise strengthen them. Where the benefit of Natural baths cannot be had, the Feet may be washed and other Parts Fomented, with a Decoction of nerve Herbs, some astringents being added thereto, as Balaustians, Mirtill. Cypress Nuts, Alum, and Salt, with Iron-quenched Water and red Wine. Also Ointments are commended, being frequently used, made after this manner. Take Oil of Myrtles or Roses two ounces: Salt two drams: Mix them and make a Lineament. Or, Take Oil of unripe Olives Oil of Mastic one ounce: Salt fried in a pan two drams: Bole Armoniac three drams: Dragons Blood, Hipocistis, Frankincense, Mastic, of each one dram and an half: Let each Particular be first finely Powdered by itself, then with the Oils mix them into the form of an Ointment. The Plaster called Emplastrum Diapalma is very good to strengthen the Joints: and its useful in all Gouts whatever the Humour be which offends. and Solenander writes in Counsel 25. Sect. 4. that he hath known some, who had wont to be often troubled with the Gout, and by the continual use of this Plaster, with frequent purges taken at certain distances of time, they were freed from those Pains for five years together. And this Plaster doth not daub and foul, doth not raise Itch or Pimples, nor is it troublesome by its smell or any other evil quality. And it is fitted to the shape of the member. When the Feet are troubled shoes are made of thin Leather which being smeared with this plaster are put upon the Feet. The like spread with this Plaster may be applied to the Wrists and other Parts. But the truth is the same Plaster boy led in Wine and mingled with Powder of Myrtles, Roses, Tartar, Chamepitis or Groundpine and Chamomel, so as we described before in the Curation, is much better for the same uses. And we have seen Gouty persons, who contivally wore such a Plaster upon their Feet and Wrists, with most happy success. Chap. 2. Of the Hip-Gout, or Sciatica. THe Pain of the Sciatica or Hip-Gout, doth herein chiefly differ from other sorts of the Gout, because in those the Pain possesses only the Joints; but this, it is not only in the Hip, but it holds the top of the Buttock also, the Loins and the Os sacrum, and reaches into the Thigh and Leg even to the very Foot. Which comes to pass by reason of Nerves arising out of the Loins and Os sacrum, which are carried unto the Hip, and are from thence derived and spread unto the Thigh, the Leg and Feet. The Cause of this Pain is the same which was propounded in other sorts of the Gout. The knowledge of this Disease is taken from the Part affected: from whence it also took its name, for the Pain doth especially affect the Region or Part of the Hucklebone, for it hath this property, that no Humour, nor Inflammation or change of the colour appears as is wont to be in other signs of the Gout: because the flowing Humours do insinuate themselves into more profound or deep Parts, & into such as are larger, and covered with much flesh, and they are not diffused into the surface of the body nor the very Skin as in other Gouts. This peculiar Prediction belongs to the Hip-Gout, that if it continue long it puts the Hip out of Joint: for a wheyish and phlegmatic Humour doth insinuate itself into the Hollow of the Joint which is very large, and if it bide there long, it's thinner Part is discussed, the thick or remaining, which becomes snotty and softens and looseus the bands which knit together the bones which belong unto that Joint; so that the Bone of the Hip falls from its Socket, whence follows Luxation, and thereupon limping or halting, and a Consumption of the whole Thigh; because the Bone being slipped out of its seat, doth press upon the Muscles, Veins and Arteries, by which means motion is hindered and Blood and spirits cannot conveniently flow into the inferior Parts. The foresaid Doctrine is confirmed by two Aphorisms of Hypocrates, viz. The 59 of the 6. Section. Such whose Hippolito after long pains, slips out of Joint and in again, they have Snotty excrements in that Part. and the 60. Aphorism of the same Section; Such as being troubled with long Pains of the Sciatica, come to have their Hip disjointed, their Thigh Consumes and they halt, except they be burnt. The Cure of the Hip-Pain hath many things common with the other sorts of Gouts; yet in many things it differs because of the structure and Largeness of the Joint; therefore it is to be distinguished from the former Gouts, and to be handled in this Chapter by itself. And in the first place a Clyster or Gentle Purgative being premised, the Vein of the Arm on the same side must be opened for revulsion sake: afterward for derivation sake, the Vena poplitis must be opened about the Knee, or that Vein near the outward Anckle-bone, which is called the Sciatica Vein, because of the great good which the opening therefore is wont to do in this Disease; which alone being opened doth often heal this Disease. It is wont to be opened on the Leg of the same side the Gout is on, yet hath it done much good being opened on the contrary side, and hath been seen suddenly to take the Pain quite away. Galen in his Book of Blood-letting, Section 18. I remember (saith he) that I have Cured divers troubled with the Sciatica in one day, opening a Vein in their Thighs; viz. the Cause being, not from cold, but fullness of those Veins which are in the Hip; so that a Vein opened about the Ham or Knee, is more Proper and commodious in such cases, than in the Ankles. Also Blood drawn out of the Hemorrhoids by Leeches, doth wonderfully help those that are Hip-Gouty, because the Blood contained in the Veins of the Hip is thereby drawn out: for there is the greatest Consent & fellow-feeling that can be between these Parts by means of their Veins. Strong Purgations are proper in this case; for lighter purges do rather precipitate the Humours into the Parts affected. And therefore the Arthritical Powders are most convenient, Carpocostinum, Pills of Hermodactils and such like. The Chemists do sometimes successfully use Mercurial and Antimonial purges in strong Bodies. Mercurius dulcis which Scammony or other purgatives given frequently, doth powerfully eradicate the Humour causing this Hip-Gout. Many prefer Vomiting Medicaments before purgatives, because they Evacuate the Humours by a place more remote from the Part affected. Rondeletius prefers Alarm before other Vomitories. After sufficient Purgation, we must proceed to local Medicaments. And as for repelling Medicines, they are no ways convenient, because it is to be feared lest the Humours be so much the more fixed into the Part affected; but at the beginning Resolving things must be applied; first milder and less hot, lest they should attract the Humours more into the Part affected; after such as are more vehement, in this manner. Take Briony Roots two pounds: Dwarf-Elder Roots one pound: Juniper Berry's half a pound: Leaves of Groundpine, Mint, Marjarom, Sage, Rosemary, flowers of Chamomel and Melilot of each four handfuls: Make a Decoction for a bath to sit in, which let the Patient sit in twice a day for two or three days together. At the beginning the Decoction may be made of Water alone afterward in Water and White Wine. With the same or like Decoction hot, may the Part Pained be fomented frequently. Also Bags may be prepared of Salt, Millet and Bran fried with rich Canary in a frying Pan and laid on Warm. Or, Bags very effectual may be made only of Juniper Berries beaten and fried in a Pan as aforesaid. Also anointings will be convenient of Oil of Chamomel, Oil of Dill, Orice, Nard and Rue; which by relaxing the exterior Parts, will draw the motion of the Humours to themwards, by which means the inner parts will be less affected. Oil of Scorpions of Mathiolus anointed on, will be very effectual. To resolve more powerfully, The Aqua Balsami Guidonis, being anointed on, will be exceeding good. Ointment of Marsh-mallows doth loosen the external parts, and doth gently discuss the Morbific Matter; therefore towards the beginning, the whole Thigh may be anointed therewith, and the Leg to the Foot by a flaming fire. In the Progress of the Disease, this following being hotter and stronger, may be used. Take Oil of Worms, Tiles, Turpentine, of each two ounces: Oil of Foxes one ounce: Gum Ammoniack, and Sagapenum dissolved in Aqua vitae, of each six drams: Fat Castoreum three drams: Euphorbium two drams: Wax as much as shall suffice. Make all into an Ointment. Spanish Soap, or Castle Soap dissolved in Spirit of Wine, is most excellent, smeared on by the fires side. Oil of Tiles or Bricks alone, being anointed hot, after six Cupping-Glasses have been fastened upon the pained place, and about the same; and after the anointing, the place being covered with very hot Linen , hath in one day cured a very stubborn Sciatica. Lacuna in his Comments upon Dioscorides, doth commend the following Ointment as wonderful: Take the Juice of the Roots and Leaves of Dwarf-Elder, or Danewort, of each one ounce: Oil of Chamomel six ounces: Boyl them to the consumption of the Juices. Then add Wax as much as shall suffice, and a few drops of Vinegar to make the virtue pierce. Make of all an Ointment. A Cataplasm of the Herb Iberis, wild Cresses, or Sciatica Cresses, is much commended by Authors, because this Herb is very effectual in the Cure of this Disease. It may be made after this manner: Take of wild Cresses four handfuls: boil them in Wine, and beat them, adding thereto Meal of Lupins, Vetches, and of Beans, of each three drams: Powder of dried Rue, Chamomel flowers, and Costus Root, of each one dram: Oil of Turpentine half an ounce: Oil of Earthworms as much as shall suffice. Make all into a Cataplasm. Platerus witnesseth that it hath done much good, when green Sage hath been put on an hollow hot Tile, and often stirred lest it burn; and thus being half boiled and sprinkled with Vinegar, and a Cl●th put about the Tile. and the same put under the Hips, the vapour thereof hath been received into the part affected. Also a Loaf very hot out of the Oven, cut in the middle, sprinkled with Aqua vitae, and laid on, will be very helpful. To draw the Morbific Matter outwards, a Cupping-Glass is good, four times fastened upon the highest part of the pained place, which appertains to Os sacrum, without Scarification. To the same intent, eight or ten Leeches fastened to the part affected do much help, which are allowed and approved of by Paulus and Aurelianus. And Zacutus Lusitanus says that in ten hours' space he therewith took away the pain of the Sciatica, which no other Remedies could help. Plasters are likewise frequently used, and in this Case may do much. But in the use of them, this is always to be observed, as it hath been said generally of the rest; that at the first mild ones be applied, which if they do little good, we may arise to more vehement. Which order we will likewise observe in our setting down the making of such Plasters. Take Pitch used in Ships, two ounces: Brimstone powdered very fine three drams: Mastich two drams: Turpentine half an ounce. Mix them, and make of all a Plaster, adding as much Wax as shall be requisite. Take Ship-Pitch two ounces: Gum-Ammoniack, Bdellium dissolved in Vinegar, of each one ounce: Live Brimstone, Turbith, Hermodactils, of each half an ounce: Castoreum one dram: Turpentine a little: Wax as much as shall suffice. Make of all a Plaster. Take Gum Ammoniack, and Sagapenum dissolved in Vinegar, and then thickened again, of each two ounces: Emplastrum Diachylon cum Gummis, one ounce and an half. Melt all together. Then add Cinnabaris, Cinoper or Minium, and burned Brass, of each one ounce: Orpment and Verdegreece, of each two drams. Make all into a Mass or Plaster. If it raise Bladders, lay a Linen Cloth between the Plaster, and the part affected. If the Disease do pertinaciously continue, we must proceed to a Vesicatory, which doth draw out the Morbific Matter, being applied to the part affected. Wherefore a Blistering Plaster must be laid on, either alone, or that it may work more gently, with some of the foresaid, mingled in equal proportions, for so it may be endured upon the part a longer time. Or this following may be made fresh. Take Ship-Pitch, Wax, white Pitch, of each one ounce and an half: Colophonia, Frankincense, Mastic, of each two drams: Euphorbium, Laudanum, Quick Sulphur, Opopanax, Ammoniacum, Bdellium, Galbanum, Sagapenum, of each half an ounce: Storax, and Benjamin, of each two drams: Cantharideses three drams: Galangal, Cloves, of each two drams: Liquid Storax, as much as shall suffice. Make all into a Plaster. In an old Disease, an Issue in the Leg on the pained side, doth derive the Matter away, and sometimes cures the Disease. Zechius will have it made in the outside of the Leg. And if there be suspicion of a Catarrh from the Brain, another must be made in the hinder part of the Head. For that hath sometimes cured an old Sciatica when nothing else would do it. And then likewise other Remedies, correcting the Brains distemper, must not be neglected. Zacutus Lusitanus tells of his making an Issue behind the Ears with wonderful success, when the Humour came from the Head. Of this he makes a peculiar story, Observat. 160. Book 2. During the whole Course of the Cure, frequent Clysters are to be injected, that part of the Morbific Matter may be derived unto the Guts. Also to discuss the next and immediate Cause of the pain, this following hath sometimes been useful. Take Rich Canary half a pint: Walnut Oil, and Oil of Rue, of each three ounces: Oil of Turpentine half an ounce. Mix all, and make thereof a Clyster, to be cast in so often as the pain shall require. And this following Clyster doth wonderfully draw the Humours from the part affected, in regard of its Neighbourhood to the Guts. Take Pulp of Coloquintida one dram: Lean Bran an handful: white Wine a pint and an half: Boyl all to a pint. Of the strained Liquor make a Clyster, and let the Patient keep it an hour. The Hip-Gout is sometimes bred of Choler, and hot Humours, which is known when the pain is very sharp, and pricks the pains are greater every other day, the party is lean, the Constitution of Body Choleric. Age youthful, Country and Season hot, the pain is increased by heating things, Choleric Diseases have preceded, an hot Diet, and vehement Exercise; and then the Medicines must be fitted for Choler, and an hot distemper. Wherefore, Bleeding is good, Purgations of Choler, sometimes Lenitive, sometimes strongly purging with Diagridium, that the Morbific Matter may be brought forth; cooling Juleps, emollient Clysters cooling, Milk, Bathing, and other Remedies propounded in an hot distemper of the Liver. Always being careful to avoid things Opening, and to choose rather such as do incrassate or thicken, such as we propounded for a thin and hot Rhewm. The Pain being extreme, some Narcoticks may be given, especially Syrup of Poppies, whereby the pain is allayed, and the flux of Humours stopped, by the Humours being thickened. But Laudanum Opiatum is far more powerful, given to the quantity of three or four grains; which also dissolved in a Clyster of Broth or Milk, using a Purging Clyster before it, doth often take away the pain in a moment. The external Medicaments must be gentler, as Oil of Lilies, Violets, Chamomel, and sweet Almonds: Pultisses, of Lettuce, Nightshade, Endive, Barley Meal, with the foresaid Oils; and towards the declining of the Disease, Fomentations, Liniments, Milder Plasters, and less Heating. The Matter Causing the Sciatica, comes sometimes to maturity, so as to make an Imposthume. Which Hypocrates shows in the third Book of his epidemics in the History of Eupolemus, who had such an Imposthume, which killed him with a Consumption. If the Imposthume be opened, there remains a filthy i'll conditioned Ulcer, which likewise pines the Patient away. Yet Zacutus Lusitanus glories, that he had often cured the Sciatica with an Ulcer, in Obs. 126. Book 1. Which Observation ought to be read and diligently meditated upon. Chap. 3. Of Rheumatic Pains of the whole Body. AFter Gouty Diseases properly so called, it is worth our while to treat of the Rhewmatick Disease, because of the likeness between these Diseases, which verily is so great, that the generality of Physicians, which know not the Nature of this Rhewmatisin, are wont to call it the universal Gout. For in both Diseases the Joints are pained: but therein is the difference; In that in the Gout, only the Joints are pained; But in this Rheumatismus, or Rheumatic Malady, not only the Joints, but also the whole Body, viz. The middle spaces between the Joints, namely, the Muscles and their Membranes, and especially the Skins which cover the Bones, and the whole habit of the Body; yea verily, and sometimes the inward parts of the Body, as the Stomach, Womb, Lungs, are troubled with this Rheumatic Disease. And although the Greeks call a Catarrh by the name of Rheuma; yet this Rheumatism we speak of, differs from a Catarrh, being indeed contained under the general term of Flux of Rheum, yet of a different Nature from that kind of Flux which is commonly called a Catarrh, which comes only from the Brain, and trouble no more than one or two parts; whereas this Disease we treat of, comes from the internal Bowels by the Veins and Arteries, and is shed into the whole Body. This is no new Disease, yet is it not sufficiently described by the Ancients. We have a rude ●raught thereof in Hypocrates, in his Book, de locis in Homine: and in Galen, Book 1. of the dif●●●ence of Fevers; and the first de compositione Med. secundum Genera. But the most notable 〈◊〉 ●leer place of all, explaining this Disease, is in the first Book of the Differences of Fevers, in 〈…〉 the words are these: Understand thou, That the Rheumatic Disease so called, is caused 〈…〉 such way as this; viz. The whole Body being weak, and the principal Parts thereof, though 〈…〉 but little blood, yet finding themselves burdened, they thrust the same and expel it to the 〈…〉 parts of the Skin. Whereby it appears that the true Nature of this Rheumatic Disease, 〈◊〉 to Galens Doctrine, consists herein; That the whole Body is so weak, that when any princi●●● 〈◊〉 is burdened with blood, although it be in no very great quantity, it transmits' the same to the 〈◊〉 parts and habit of the Body. 〈◊〉 that is not simply to be understood which is said by Galen, That the principal Parts being 〈◊〉 with blood, do thrust the same unto the fleshy Parts of the Body. For so Inflammations 〈◊〉 ●●ellings would arise in those parts. Whereas Experience shows, that in this Disease called 〈…〉, for the most part there appears no Swelling, no Inflammation, no change of colour in 〈…〉 pained. 〈◊〉 and immediate Cause therefore of this Disease, is a wheyish Humour, which by reason of 〈…〉 doth not swell the parts, and because of the substance thereof, not apt to turn into Matter 〈…〉, it never makes any Imposthume, but only a certain Inflamatory disposition, arising from 〈…〉 of the wheyish Humour. 〈◊〉 the Primary Original of this Disease ought to be ascribed to the Liver, which being affected 〈◊〉 an hot distemper, and being weakened, breeds not blood convenient for to nourish, and affects 〈◊〉 whole Body with the like weakness, whereby it becomes exceedingly disposed to receive all superfluities. And from the same Distemper and weakness of the Liver, great quantities of evil Humours do arise, which being long detained in the Veins and Arteties, they become viciously corrupted, ●●d are there dissolved and turned into the Nature of Whey, and Blood-watry Liquors, and as an 〈◊〉 burden, are by Nature cast off into the ignoble Parts, she being not strong enough to drive ●●em out of the whole Body. Now these wheyish and blood-watry Humours being very sharp, do 〈◊〉 and cut (as it were) those parts unto which they are carried, from whence pains and torments 〈◊〉. And although we conceive the Liver to be the primary Cause, and Original of this Disease, 〈◊〉 is apparent that these Humours do sometimes flow immediately from the Brain, because the 〈◊〉 do often begin in the Neck, and afterwards do descend unto the Shoulders and Arms. But the 〈◊〉 ●eneration of these sharp Humours was in the overheated Liver, which being translated from 〈◊〉 into the Brain, do from thence afterward fall down into the inferior parts. 〈◊〉 although these Humours are expelled by the Veins in manner of a Crisis, yet is not their motion 〈◊〉, but is performed by little and little; viz. When those evil Humours and corrupted, 〈◊〉 for work in the Veins, and are afterward leisurely by the Veins expelled and vomited as it 〈◊〉 for which cause this motion is wont fitly to be called, the Vomiting of the Veins. 〈◊〉 a ferous or wheyish Humour is the principal Cause of these pains, many Reasons do convince. 〈◊〉, because ordinarily they cause no swelling nor change of colour in the part affected; howbeit, 〈◊〉 when the Humour doth much abound, it raiseth the part into a little, and very red Swelling, which nevertheless is easily discussed. Secondly, Because these pains are exceeding movable, and ●● seize now this, now that part of the Body, and are suddenly gone from one part into another, the former part being quickly well, and free from all pain; which sudden mutations cannot come but from an Humour very apt to move, and exceeding thin. Thirdly, Because this Disease is often terminated by Sweeting. Fourthly, Because there appear many tokens of abundant Serosities in such as are troubled with this Disease; Thin and abundant Urines beyond the Quantity of what they drink, and abundance of Wheyish Humours appearing in the Blood that is taken from them. And although a wheyish Humour be the principal, and most frequent Cause of these Rheumatic 〈◊〉, yet probable it is, that wind doth sometimes concur in the production of these pains. Which we may conjecture by the quick Passage of the pain from one place to another, and because there is ●● weight or heaviness felt in the parts pained. This is the Opinion of Avicenna, who seems to describe this Disease, and to assign windy Vapours for the Cause thereof: Fen. 1. Book, 3. Tract. 2. Chap. 7. in these words. In pain Caused by winds, the extension of the part is increased & the heaviness diminished sometimes it is with pricking, & sometimes with Corrosion; and in a flatuous Pain there is no Heaviness. And sometimes there is a Change of the Pain from one place to another. These are the words of Avicenna: unto which he Joyns these following, which seem to come nearer the description of this Disease we treat of. And the wind is sometimes in the Coats and fibres of the Members, as in the Colic from wind; or in the Coats of the Muscles and under the membranes, and upon the Bones, or in the Circumference of the Muscles, between the soft flesh and the Skin, or lurking in the Member itself, And if any shall object, that Diseases arising from wind, do not endure so long, because windy Vapours are soon discussed. We shall answer, that a wind contained in the Parts Pained is easily discussed, whence comes often change of Pains from one Part to another; but there is a seminary in the Veins from whence winds may perpetually arise, & afterwards be carried to the Parts aforesaid. Now this Seminary of winds is a thick, viscid Humour and phlegmatic, which the Blood taken from them doth often testify to be redundant in such as are troubled with these Pains; it being frequently thick and clammy like Glue, in appearance like crude and putrid phlegm. The knowledge of this Disease may easily be learned out of what hath been said: yet shall we discourse thereof a little more fully. First therefore, the Parts affected with these Pains viz. the Muscles and their Membrans, and the Membranes which enfold the bones, do distinguish this Disease from all other. For although the Pains of the Lechers Pocks, do possess both the Joints and the spaces between the Joints, and specially the membranes covering the bones; yet they differ herein, because they do not so universally infest the whole Body, neither are so continual night and day, for they vex the Party only in the nights and very little in the day time; neither do they hinder the Patients from their business commonly; whereas this Rheumatic Pain, doth Nail them to their Beds, so as they can hardly stir themselves; neither can those that look to them, once so much as move without great trouble and increase of their Torments. And finally other signs of the Whore's Pox have preceded or are present, as Gonorrhoea, the Whores Boil, Putrefaction of the Privities and such like. Other symptoms also there are accompanying this Disease, which help much to the knowledge thereof. For if you lay your hand upon the Part pained, you feel a kind of sharpness with Heat; commonly there is a Fever Joined therewith, but it is very small; and some times there is none at all. The Blood which is taken away is evidently corrupted, thick and clammy like glue, and after many times bleeding, it is full of wheyish moisture, and so changed, that it hath not the appearance of Blood. When the Pain is quite gone or intermits there remains no weakness in the Part, as is usual in the Gout. Purging Medicaments at the beginning do no good, nor things outwardly applied to the Part affected; they do rather augment the Disease and the Pain: but when the Disease gins to decline, both are profitable. As for the Prognostic, this Disease is seldom or never deadly, but is very troublesome to the Patient by its length: for it continues two or three months, if it be without a Fever; nay verily; sometimes if it be not rightly cured, it continues for a year or years. Franciscus Portus who in an elegant verse writ ten Poems of Physic speaking of this Disease relates that he was troubled with this Disease about two year's space, which at length he overcame by the earnest Endeavous of six Physicians of Paris, the most famous in their times, viz. Basinus, Belly-Quercus, Sanjacoboeus, Seguinus and Hollerius. If this Rheumatisus do begin with a Fever, it is wont to be the shorter, but it torments the Patient with more direful and cruel Pains: and then it finisheth within twenty or forty days, or at least, it is much lessened. This Rheumatic Pain coming upon the Neck of other Diseases as an Apoplexy or convulsion, doth make the Case less Dangerous, the morbific matter being translated from the internal Parts to the habit of the Body. Sweats happening in the Declination of the Disease are good. Thick and abundant Urins in the Declination, do bring an end to the Disease. For the Cure of this Disease the Morbific matter must be reveled, mitigated and Evacuated, the distemper of the Bowels must be corrected, and the strength of all the Parts both the sending and receiving must be maintained. All which may be done by these following Remedies Take Leaves of Mallows, Violets, Betes, Lettuce, borage, of each one Handful. Anis-Seeds two drams: Boil all to twelve ounces, in the strained Liquor dissolve Honey of Violets and Sweet Butter of each two ounces: Make thereof a Clyster. Give it at a convenient Hour, and repeat every day, or every other day during the whole Course of the Disease. When the Clyster is come away open a Vein in either Arm and take away eight or nine ounces of Blood. It Matters not on which Arm the Vein be at first opened, because Blood-letting must be often repeated and the Veins of both Arms divers times opened. Blood must therefore be drawn every day from the beginning of the Disease till the Disease come to remit & the Pains to lessen neither matters it though the Patient be let blood ten or twelve times one after another in so many days, because it is a peculiar property of this disease, that the Patient's strength is not diminished by frequent bleeding, as in other Diseases it is wont to fall out. My manner therefore is in these Diseases when I appoint Bleeding so often, lest the friends and attendants or the Patient should be affrighted with so frequent Blood-letting, to add this restriction, that Blood-letting be continued every day, till either the Pains be diminished or the Patient much weakened. And seeing no weakness follows the continual use of this Evacuation the patients do willingly undergo the same, and are easily persuaded to repeat the same. Now the condition of the Blood it is which makes this easy bearance, which in this Disease comes always away very much corrupted. Experience shows how profitable this frequent Blood-letting is; for by the constant continuance thereof, the Disease which is wont (as was said in the Prognostic) to be long, is often mastered in a short time. And experience shows that large Bleeding at the Nose, if it happen to one that hath this Disease, it perfectly Cures that party, Hypocrates seems to hint at this in Aphor 74. Sect. 4. Those who are likely to have an Impostume about their Joints, are freed from that danger, danger, if they void much thick and white Urinal, such as in painful Fevers, some begin to make upon the fourth day: and if with all their Nose Bleeds, the Disease will very soon break. For the falling down of Humours into the Joints tending to an Impostume, hath some Analagy with this Rheumatic Disease we treat of. Also the same Hypocrates seems to propound a certain adumbration of this Disease in the second of his Predictories, and ascribes the cause thereof to the suppression of some usual Hemorrhage or Bleeding, in these words. They who have Pains and swell about their Joints, which are all aid not as the Gout uses to be, in such you shall sinned their Bowels large, and a white settling in their Urinal etc. afterward he adds; now this Disease betides those who in their Childhood and in their youth have been accustomed to Bleed at Nose, which custom hath left them. Whiles these bleedings are Practised, Clysters (as was before said) must be given every day or every other day; also Juleps must be given, which have power to correct the distemper of the Bowels, and to mitigate the Acrimony and agitation of the Humours. To this intent Red poppy water is very profitable in this Disease it is to be given alone morning and Evening six ounces at a time, with Syrup of Lemons and Pomegranates in form of a Julep; howbeit it is no less effectual alone without the Syrups. For ordinary Drink let the Patient use a Ptisan Drink of Barley, Grass and Liquoris; or of the Decoction of Sorrel Roots, or of the tincture of Roses: abstaining from Wine which is the great Vehiculum or Spreader of all Flowing Humours. Purgation in the Beginning, Augment, and state of this Disease doth no good at all; nay verily it doth hurt, for it sets the Humours on running, and increases the Pains; as it is wont to fall out in all inflammatory dispositions. But in the Declination it is necessary and frequently to be Celebrated, and that with gentle Medicaments, that the evil Humours abounding in the whole body may be Evacuated by Degrees. To which purpose this following potion may be prescribed. Take Senna and Tamarinds of each half an ounce: Annis Seed and Cream of Tartar, of each one dram: Sorrell Leaves half a Handful. Boyl all to three ounces: In the strained Liquor dissolve Manna and Syrup of Roses of each one ounce: Make a potion, to be iterated divers times, as the Physician shall think sit. If the form of a Bowl be more , it may thus be made; Take Cassia new drawn six drams: Catholicum doubled three drams: Rhubarb in Powder and Cream of Tartar of each one dram: with Sugar make a Bolus. If you would purge more effectually add to the potion or the Bowl a scruple of jalap. If these Purgations shall not suffice to eradicate this Disease (which is often very rebellious) we must proceed to stronger Purgatives, as Electuarium Diephoenicon, Diaprunum Solutivum, and such like provided there be no Fever. I have all ways cured this Disease (when the foresaid Medicaments could not do it) which Mercurius Dulcis six times sublimed, being given divers times to the Quantiry of a scruple with ten grains of Scammony or Rosin of jalap. An example of which kind of Cure is to be seen in my observations, viz. in Obs. 41. Cent. 3. One only Clyster of Vomiting Wine Cured this Disease in a certain Gentle Woman, as you have it in Obs. 22. of the same Century. Touching Sweat-Drivers, the same is to be said which was said of Purges; viz. that they in the Beginning, Augment and state, do no good; nay do very much harm; which the common sort of Practitioners find by experience, who being deluded with the likeness of a true Cararrh, and wearied with the stubbornness of the Disease, do fly to Sudorosicks, by which the Disease is doubled and the Pains increased. But in the Declination, after due Purgations, no Fevers being present, they may do much good, and they may be made of a Decoction of China, or Salsaparilla; or sweat may be procured in a Laconic Bath with spirit of Wine or some appropriate Decoction. After sufficient Evacuations; yea rather while they are celebrated, we must be careful to strengthen the whole body and the principal Parts thereof; which Indication Galen in 1. of the Difference of Fevers Chap. 6. where he expounds the Nature of this Disease, says, is to be preferred before all others, in these words. Justly therefore the aim of a Physician in cureing these kind of Patients, is not Evacuation, but Roboration of the whole Body. Which is not so to be understood, as if no Evacuation were fit in these Cases (for the same Galen gins the Cure of this Disease by Blood-letting) but that we must make more and more often use of strengthened, and less and seldomer use of Evacuations. Yet sure enough it is, that the Parts cannot be strengthened, unless the superfluity of Excrements, by which they are burdened be purged out. Now these strengtheners we speak of, must be of a cooling Virtue; seeing (as was said) the over hot distemper of the Liver gives beginning to this Disease. There is great plenty of such Medicaments in Authors: Of these I shall propound four, which I account most effectual and least ingrateful to the Patient. The first is the Tincture of Corals, two ounces of which the sick may take in a morning, two hours before Meat, every day on which no other Medicaments are administered. But because the Tincture of Corals cannot long be kept, it is reduced into a Syrup for longer keeping, with Sugar, of which two spoonfuls may be taken in the morning: but the Efficacy thereof is much less, than of the simple Tincture. The second, is the Conserve of the fruit which grows upon the Rose-b●●ar or the Eglantine Briar, which is most pleasing to the taste, cools the Liver, and by a gentle a friction corroborates the same. The Patient may take thereof the Quantity of a Chestnut, morning and evening. The third is the Electuary of Triasantalon with a proportion of Rhubarb, made into Lozenges; two drams whereof the Patient may take every day and drink a little ordinary drink thereupon. The fourth is A Tincture of Roses, a Cup whereof the Patient must drink, once, twice, thrice a day far form Meals. It is thus made. Take Red Rose Leaves dried one ounce: Water, Blood Warm three Pints: spirit of Sulphur or Vitriol one dram and an half: infuse them six hours: To the stramed Liquor add white Sugar half a pound: keep it in a Glass for Use The foresaid Remedies or some of them must be used in Course one after another, least Nature be too much accustomed to one, and so the less altered thereby, When the Disease is Cured, the Patient must be cautious for a time least new matter being collected a Relapse should happen. The Prevention therefore hereof, will chiefly consist in a state or periodical Purgation, to be iterated once or twice every month; which may fitly be done by this Magisterial Syrup following, which will do more good by altering and strengthening the Liver than by purging. Take Juices newly pressed and cleared by settling, out of Endive, Cichory, Egrimony, Fumitory, Hopps, and Bugloss three pints: Juice of Apples that are Odoriferous, as Permaines and Pipins, two pints, Senna six drams: Epithimum two ounces: Rhubarb elect, and Agarick newly trochiscated of each one ounce: Mace and Cloves of each half a dram: Infuse and Boyl all according to Art, till there remain fifteen ounces of the Liquor, wherein dissolve of white Sugar the same Quantity and make a Syrap perfectly boiled. Of with let the Patient take two ounces once or twice in a month, with Chick or Veal Broth, qualified with the Leaves of borage and Cetrach and Agrimony. Allo spring and fal'twil be good to open a Vein. Furthermore, to temper the fervency of the Liver, a Bath of Lukewarm Water will be good, which must be frequently repeated, the whole Summer through: or for more Conveniency a Tub to sit in may suffice. To the same intent Conserve of Bramble-Rose or Eglantine Rose-Berries will be good, or an Electuary of the same virtue, and Lozenges made of the Species Diatrion Santalon, being frequently used. Hereunto must be added a good Diet of Meats affording good Juice and easily digested, as Partridges, Capons, Chickens and Pullet's; especially broths and the Juices of flesh pressed forth, and such like, all which must be taken in no great Quantity, that they may be more easily digested. The End of the Sixteenth Book. THE SEVENTEENTH BOOK OF THE PRACTICE OF PHYSIC. Of FEVERS. The PREFACE. WE find by many Author's great Volumes written touching the Theory and Cure of Fevers; in which, innumerable Controversies, and difficult Disputations are handled. Which as they are in the Schools very useful, yea, and necessary; so are they tedious to most Physicians, who having left the Universities, do give themselves unto the Practice of Physic: For they desire a short and clear Explication of the Theory of Diseases, which may suffice to declare their Nature, Causes, and Signs, both Diagnostic and Prognostic, with their right Method of Curing, which is the only thing they regard. It being my endeavour in this whole Work to satisfy their Desires, I have banished all Controversies, briefly expounding the decision of Questions only which seem most nicessary for a Practitioner. This we have likewise done in our Doctrine of Fevers; and letting pass all tedious Controversies, which are continually handled in the Schools, usque ad Nauseam; we have declared only such things as principally regard Practice. And this Book for better Methods sake, I have distributed into three Sections, following that General Division of Fevers, into Simple, Putrid, and Pestilential. So that the first Section of this Book shall treat of Simple Fevers: The second of Putrid: And the third of Pestilential. SECT. I. Of Simple Fevers. The PREFACE. THat which we call a Simple Fever, is subdivided into three sorts; of which, one is called Ephemera; another Synochus simplex, or Imputris; and another Hectica. And therefore we shall divide this Section into three Chapters: The first of Febris Ephemera: The second of Synochus simplex: The third of Febris Hectica. Wherein we shall declare their Nature and Cure. Chap. 1. Of the Fever Ephemera. THis Fever is commonly bred of external Causes, and of vehement Motions of Body and Mind, as Anger, Cares, Labour Pain, Watching, and Fasting, by which the Spirits are inflamed; also by Sleep and Sorrow, by which the hot Humours and Vapours are kept within the Body. Also by being heated with the Sun, Fire, or Stove, by which means, hot air being drawn in with the Breath, and received by the Pores of the Body, it doth inflame the Spirits. Also by Surfeiting, Drunkenness, and especially by over large taking in of Meats and Drinks, that are of an hot Nature, as Peppered Meats, and stroog Wines, by which more Vapours are raised than can exhale. Also by Retention of hot Excrements, and that not only of the Dung and Urine, but especially of those Sooty Vapours which are wont to pass through the Pores of the Skin, if those Pores be shut up with cold, an aluminous Bath, and such like Causes. Also this Ephemera Fever is bred of internal Causes, as from a Bubo, and other Swell of the Thighs or Arms, especially whiles they break; from an hot fiery Swelling of the Extremities of the Body, when hot Matter shut up together in one certain place, doth offend the Heart, not by its putrefaction, but heat alone. Also by some small Obstruction of the Vessels, by which means the sooty exhalations being retained do cause a Fever; as is wont to happen in Distillations, when they arise in hot Natures, and a thick habit of Body. This Fever is known, both when some of the Causes specified hath gone before; and also by a swift, frequent, and great Pulse; breathing frequent and great, Headache and Heat; there is neither cold nor shaking, no sense of weariness, nor want of Appetite. Yet may there be sometimes a shivering or shaking fit, namely, when the Fever is occasioned by the heat of the Sun, or by cold. Feeling the Patient's Hand we find a mild and gentle heat; the Urine is concoct, like that of one in health, unless by some Obstruction or Crudity it be changed. It is commonly terminated in the space of twenty four hours, with an easy gentle Sweat; yet it reacheth sometimes unto the third day, which if it pass it degenerates into a simple Synochus, a Putrid, or an Hectic Fever. For the Cure of this Fever, the Ancients did chief use a bath of lukewarm Water, which they did also frequently use in their Health. But seeing it is in these times out of use, neither is it in practice in the Cure of these Fevers. Neither is it counted safe, in regard of a Plethoric or Cacochymical Constitution of Body, Putrefaction, or flux of Rheum, which may be in such bodies, or may be feared will happen. But this Fever is better cured by a Cooling and Moistening Diet; as Barley Cream, Cooling Broths, Small Drink and Sugar, common Ptisan Drink, or Fountain Water with Syrup of Lemons, Maidenhair mixed there with. But the Cure admits some variation, according to the Nature of the Cause. So if it spring from the Heat of the Sun or Air, a cooling Diet is good, and the Patient must be conveyed into a cool lodging; and Vinegar of Roses must be applied to his Forehead, to the Temples and former part of the Head itself, if there be pain, as commonly there is when the Fever comes from the heat of the Sun. If it come from being in the Cold, especially if the Patient being hot with Exercise went presently into the Cold, Sweat must be provoked, especially towards the end of the Fit. If it come from the Skins thickness and closing up of the pores, the same Cure must be used; and to both these Causes, small Wine very well allayed with Water may be convenient, because it opens the pores, and helps to sweat. If the Disease was caused by Labour, the Patient must rest and be nourished more liberally with Meat of easy Digestion. If from weariness, the Patient must be artificially rubbed. Tranquillity of mind, and cheerfulness, must be opposed to Anger; and Choler must be tempered with Meat and Drink of a cooling Nature. To Sadness, Recreation of the Mind is a Remedy, and the use of thin small Wine. If the Fever was caused by watching, let the Patiented sleep by application of things convenient: If by fasting, let the Patient eat cooling Meats of good Juice: If by over eating or drinking, let the Patient abstain from Meat and Drink, not omitting such things as strengthen the Stomach, both inwardly given, and outwardly applied: also with an Emollient and Laxative Clyster, part of the Crudities is to be taken away. If Putrefaction be feared, Vomit may be procured, or a Purge given. If the Fever arise of Obstructions, we must consider whether the Patient be Plethoric or Cacochymical, viz. Whether the whole Mass of blood be over great, or only some bad Humours abound in the blood. If the Patient be too full of blood, blood-letting must be advised; if evil Humours only abound, a Purge must be prescribed. And if the Obstruction will not easily be removed, this Fever changeth into some of the other sorts of Fevers, whose Cures shall be described in their proper places. Chap. 2. Of the Fever Synochus Simplex. THe Causes of the Fever Ephemera aforesaid, if they light upon a Plethoric Body, and thick skinned, they cause the Fever Synochus Simplex. Yet may this Fever arise only from abundance of Blood stuffing the Veins, and yielding many Vapours more than can breathe through the pores of the Skin. This Fever is known by a thick and swelling habit of Body, the colour of the Body and Face is ruddy; the Head is pained with a stretching or distending kind of pain; the Patient is sleepy, hath a beating in the Temples, is unquiet, hath a straitness in the Chest with difficulty of breathing; the Pulse is great, even, frequent, full; the Veins strut with blood, whence a stretching kind of weariness doth proceed; the Urine is thick, little differing in colour from a Natural Urine, only somewhat redder; the heat is to one's hand mild, tempered with a steamy Vapour; the Fever holds an even progress, for either it holds one and the same tenor, or it lessens by degrees, or it increaseth equally, never remitting or ceasing. Whence there are reckoned three Differences of this Fever: For that which continually increaseth, is called Epacmastica; That which continually decreaseth, is called Paracmastica; That which keeps one and the same tenor, is called Homotonos, or Acmastica. It lasts till the fourth day, and sometimes till the seventh; and than it is terminated by bleeding, or sweeting; and if it be further prolonged, it degenerates into Synochus Putrida. The Cure of this Fever is performed, by blood-letting, by cooling, and by opening the pores of the Skin. Galen in the ninth Book of his Method, Chap. 4. cures this Fever by two Remedies only; viz. Letting of Blood till the Patient faint away; and by giving a great quantity of Water to the Patient to drink. Blood-letting is absolutely necessary in this Disease, because it is bred by fullness of blood; and a Vein must presently be opened at what hour soever the Physician is called, unless the Patient's Stomach be full of Meat, the digestion whereof must be expected for certain hours. And although Blood must be plentifully drawn, and Galen reports in the forecited place, That he cured the most of such as had this Fever, suddenly, by letting them bleed till they fainted away; which bleeding was attended by a looseness, vomiting of Choler, and plentiful Sweat. Yet in these days of ours, that same large blood-letting is out of date; which is not without danger, seeing Galen himself relates in his Book of Curing by Phlebotomy, Chap. 12. That it besel three Physicians, while they were practising this large Blood-letting▪ that instead of fainting away, their Patients died outright. It is better therefore at several times to take away so much blood, as the Nature of the Disease doth necessarily require. Before Blood-letting, if the Patient be Costive, or the Guts abound with Crudities, an Emollient and Laxative Clyster must be given. As for the point of cold Water, Galen order it to be given in so great quantity, that the Patient grow pale, tremble, and be cold all over; and so he says, it extinguisheth the fiery heat, it strengthens the solid parts, and drives out unprofitable Humours by stool, by urine, and by sweat. But he says there must be many Cautions in the use thereof; viz. That it be given in the Vigour of the Fever, the signs of Concoction appearing; that the Patient have been used to drink cold Water in time of health, have strong bowels, and full of juice, a fleshy and wel-set Body; have a constant and vigorous strength; be not full of thick and clammy Humours, have no tumour in any bowel, nor stomach, throat, or sinews weak. Otherwise, if these conditions be wanting, it is to be feared lest the Patiented fall into shortness of breath, Dropsy, Trembling, Convulsion, Lethargy, or some other grievous Disease. This kind of Medicine is likewise grown out of date in our times, seeing it is hard to observe all those conditions, and so many dangers attend the undue use thereof. For it is better to use other more safe Medicines which cool the whole Body, and the Blood; as Juleps, and opening Emulsions, Epithems, Liniments, and a Diet altogether cooling. Juleps are made of the Decoction of Barley, or Sorrel, or Cichory; or with Water of Cichory, Endive, Sorrel, Lettuce, adding Syrup of Juice of Cichory, Lemmons, Pomegranates, Vinegar, etc. Whereunto also for the greater cooling and opening, may be added some drops of Spirit of Vitriol, or Sulphur. If the distilled Waters seem too crude or raw, let them boil with a little Species Triasantalon, or Diamargaritum frigidum. Emulsions may be made after this manner: Take sweet Almonds blanched and steeped in Rose Water, one ounce: the four greater cool Seeds, and Seeds of white Poppy, of each two drams. Beat them in a Marble Mortar, pouring on by little and little, a pint and an half of Barley Water. In the strained Liquor dissolve Sugar of Roses three ounces. Make an Emulsion of Almond Milk for three Doses. Which will be convement, and is to be preferred before Juleps, if there be want of Rest. Epithems to be laid upon the Region of the Heart and Liver may be thus made: Take Water of Roses, Bugloss, and Lettuce, of each three ounces: Vinegar of Roses one ounce: Powder of the Electuary Diamargaritum frigidum one dram and an half: Camphire six grains. Make an Epithem, lay it upon the Region of the Heart. Take Water of Endive, Cichory, Sorrel, of each four ounces: Vinegar of Roses an ounce and an half: the three two drams and an half. Make an Epithem for the Region of the Liver. A cooling Ointment may be anointed upon the Liver and Loins, of Vinegar of Roses, Vnguentum Rosatum, Vnguentum Refrigerans Galeni, or Ceratum Santalinum, washed in Vinegar, tempered with Water. If the Disease seem to lengthen, after bleeding we must purge, lest the wheyish and Choleric Excrements putrefy, and thereby a putrid Fever arise. But we must use such Medicines as purge without heating and agitation of Humours, as Cassia, Manna, Syrup of Roses, Tamarinds, Catholicon, and such like. Ad hereunto a convenient Diet, viz. Cooling, moistening, and thin, of Broths made with cooling Herbs, Prunes, and sharp Apples boiled, and Panadaes'. Let the Patients Drink be, a Decoction of Barley, Water boiled, and Water with Bread boiled in it, or mixed with Syrups of Maidenhair, or of Pomegranates. Chap. 3. Of an Hectic Fever. AN Hectic Fever occupies the solid Parts of the Body, which constitute the Habit thereof, and are commonly called Spermatical, or fleshy; in regard of which parts it is more fixed and rooted than other Fevers which are in the Spirits, or Humours. For which cause it is also termed Habitual, because it is become Habitual, and can hardly be removed from its subject. There are many Divisions of this Fever. For first of all, there is a Primary Hectic, which gins of itself; and another Secondary, which follows other Fevers. Secondly, an Hectic Fever is simple and solitary, or joined with a putrid Fever. Thirdly, some Hectics begin at the Heart; others from other Parts, as the Lungs, Liver, Spleen, Kidneys, Womb, and other Parts inflamed, ulcerated, corrupted, or possessed with some other grievous Disease. And this Fever though it have its habitual seat in the Heart, and the whole Body; yet is it commonly termed Symptomatical, because of its first Original which it hath from other parts. Galen makes three Degrees of an Hectic Fever. The first is the very beginning of an Hectic; in which the Body is hardly extenuated; yet the moist Humidity of the Body is inflamed, consumes, and dries. The second comprehends the Augment, and therein is an evident extenuation of the Body, the fleshy and fat substance of the Body perishing. The third contains the state of the Disease, and its last age; for it never comes to a declination, because therein, viz. in that degree it is incurable: for then the fibrous and membranous substance of the Body is consumed, and the whole Body is so extenuated, that the Face of the Patient is like that described by Hypocrates, nothing but skin and bone. This last Degree is called Marasmus, or rather Hectica Marasmodes; because in a true Marasmus, cold is joined with dryness. The Causes of an Hectic Fever are divided into an Internal, and External. To the External are referred, what ever Causes may occasion any of the other Fevers, if the Action of Heating be continual and vehement, or the Patient's Body be apt to entertain this kind of Fever. Such are, the heat of the Sun, or of the Fire, vehement Exercise, Meats and Drinks that are heating, immoderate Evacuations, as in a Looseness and bloodyflux, vehement passions of Mind; and finally, fasting in a Choleric Body that is hot and dry of Constitution; seeing Galen affirms, that those Physicians that were wont to enjoin their Patients to fast three days together, did bring Choleric Constitutions by that means into burning and hectic Fevers. The Internal Causes are, burning and pestilential Fevers, which do speedily consume the moisture of the Heart; also a long slack Fever. Also some peculiar Disease of any of the bowels, as an Inflammation or Ulcer; or putrefaction of some Humour contained therein; or finally, the corruption of the Member itself, which are wont to cause a lingering Fever, and an hectic. Of these Infirmities peculiarly possessing some certain Members of the Body, and causing an Hectic, we have Examples manifest enough. For, as for what concerns Inslamations, Galen saith he saw a woman that by reason of an Inflammation in her Midrif, fell into an Hectic Fever. And we daily observe in the Consumption of the Lungs, or Phthisis, a complicated Hectic Fever. The putrefaction of Humours contained in some bowel, falls out in great obstructions, or cold swell. The corruption of some Member is often seen in the Lungs; sometimes in the Liver, in such men as are given to Wine, and who use much hot Spices; for a certain filthy corrupt blood is bred in their Liver, by which the substance thereof is corrupted. Fernelius says, he sometimes met with this kind of Fever, and that it is a sign thereof, when the Patients extremely covet Wine; but abominate all kind of Flesh. A Simple Hectic Fever is known, because it is continual, without any ●its, always alike, neither increasing nor decreasing, save that it is somewhat augmented, an hour two or three after Meat. The heat under the short Ribs, is at first laying on the hand mild, afterward sharp, biting and dry. The Pulse, is little, frequent and quick; the sick perceive not any Fever, they are lazy, and loath to stir, and when they stir it is with Pain, because their strength is in a languishing condition. Their arteries are hotter than the Parts circumjacent, which may be preceived by the touch after the Patient hath washed in cold Water. The Urinal is like that of one in health both in point of colour and sediment. In the progress of the Disease Oily substance Swims on the top, and the sediment is like to Meal, which is sign that the substance of the Body doth melt, More particularly, we may know not only the several degrees of an hectic, but foresee it before it comes after this manner. An hectic Fever at hand, is known, if the causes have preceded; viz. if there have been a burning Fever, in a body naturally hot, dry, and of a thin contexture, in an hot season of weather, it is to be Feared, the Patient will fall into an hectic, and such remedies as may prevent the same are to be used. The first degree of an Hectic Fever if it be Joined with a putrid Fever, is very hardly known: if it be alone, not very easily. In the first day, there are all the signs of Febris Ephemera. In the second, the dryness is augmented, not the heat. On the third day it repeats not, it is not evidently augmented nor diminished. And at length one hour or two after Meat, the Heat seems somewhat increased. In the second degree, the Patient perceives no Feaverishness, only some alterations after Meals. There is a manifest dryness, a smaller and swifter Pulse, with a certain hardness. The signs of the third degree are most manifest; the Eyes are hollow, dry and have dry excrements in them, the bones evidently stick out, the lively colour of the Face is extinguished: the whole Skin is dry, the Midrif vehemently contracted, so that the Patients seem to have no Guts. Their Pulse is perceived under the stomach, in all extenuated persons. And because a putrid Fever is many times coupled with an Hectic, they are both exactly to be distinguished, because it is of great moment in regard of the Cure, which in this case is very much differing. Now this coupling may be known by Comparing the signs of an Hectic propounded, with the signs of a putrid Fever, which shall be hereafter described in their proper place. The first degree of an Hectic Fever is easily Cured, the third is incurable; the second is of a middle Nature, and look how much the nearer it approaches to the first or third by so much is it easier or harder to be Cured. An Hectic Fever happens most commonly from the eighteenth year to the thirty five, for in that Age the Heat is most intense, and soon consumes the Body. But they who before this Age or a little after are taken with an Hectic Fever, do more easily escape and are sometimes Cured perfectly; or by a palliative Cure their life is protracted a long time, especially if they be Women. For the Cure of this Disease, we must first consider whether it depend upon any Diseaseof some particular Part or not: for then the Cure must be directed to that Disease: as also if it be single or combined or complicated with a putrid Fever. And in this case the putrid Fever is first to be Cured by Bleeding, Purging, and by Opening Medicaments and such as hinder putrefaction: the Hectic Fever in the mean while not being neglected. But if the Hectic Fever be single and alone the Cure must be effected only with cooling, moistening and restaurative things; the matter of must be taken from Diet and Medicine. Diet, here, as in all Chronic Diseases, can do much; nay in this Disease it can do more than all Medicines. Therefore the Patient's Diet must be by the Physician exactly ordered, viz. That it may be directed so as to cool and moisten the whole Body. If therefore the Air where the Patient is, be moderately cold or temperate, let him use the same; if not, let it be corrected, so as that it may cline to cold and moist. For this Reason Galen in the 10. of his Method Chap. 8. in the Summer when the Air is hot, order the sick to abide in a Room under the Ground, that is very cold and blown through with the Wind, open towards the North. By which Remedy alone, we have seen a man extremely consumed, restored within a month. Again the heat of the Air in the Patient's Chamber must be altered, by cold Water being poured out of one vessel into another, by the very noise whereof Sleepis caused; also by moistening the Pavement often with cold Water Sprinkled thereupon, or by cooling Herbs, oftentimes fresh strewed therein: and by forbidding any number of people to come in, which among other things, doth likewise heat the Chamber. And Galen gives order that when the Air is coldest it should be received by the sick namely by drawing it in by the mouth, because it exceedingly cools the heat of the heart; but it is not good for the Body of the sick, lest it stop the pores of the Skin and hinder the breathing forth of excrements. But Galen affirms that the breathing in of the cool Air doth the Patients more good, than they can receive hurt, by the stopping of their pores, if that should happen: but that may be hindered by warm clothing of the Body. Yet it is to be observed, that if the Hectic Fever ari●e from an Ulcer in the Lungs; that the cold Air is not good in that respect, but rather temperate, a little inclining to heat, and dry. For which Cause Galen sent those that had consumptions of their Lungs to the Mount Tabias' where the Air was more dry than ordinary. The Meats of the Patient must be cooling and moistening and quickly nourishing, as Chicken-Broaths and Broths of Hens, Capons, Veal, Kid, Weather Mutton; Yolks of Eggs, with French Barley, Lettuce, Purslane, Endive, borage, Sorrel; The flesh of Calves, Kids, Pigs, Pheasants, Partridges, Young Hares and such like. Panadaes', Barley Cream, Water-Gruel, Rice-Pottage, with Sugar and a few Almonds or rather with the greater cooling Seeds. Boiled Meats are fit than Roasted which are sooner Inflamed and turned to Choler; the boiled do more moisten. But if the Patient be more delighted with Roastmeats; they must be very moderately Roasted, and tempered afterwards with Juice of Lemons, Citrons, Oranges, or of unripe Grapes, without Salt. Fish's may be eaten, because they cool and moisten but such as are taken out of stony places are to be preferred, and such as have a tender friable flesh, haunting the Sea or Pure Waters. Among fruits, Apples are commended because they breed cold Blood. also Pears are convenient, Damask Prunes, and French Prunes boiled in Sugar; also Raisins cleansed, which being prepared after this following manner, do nourish the body without heating. Take Raisins of the Sun cleansed one Pound: Let them be tempered in endive, bugloss and Rose-Water and very diligently washed, that the Laxative power may be taken away. Afterward let them be lightly boiled in the same Waters, adding a little Sugar, wherewith let them be preserved for use: let the Patients take of them in the mornings and always after Meat. And because Persons that are Hectical, have the Feverish heat fixed in the solid Parts of their bodies, by which the Nutriment is easily and suddenly consumed and dissipated: therefore Practitioners are wont to prescribe unto them, Meats solid and of a clammy substance, as the Feet of Living Creatures, The flesh of Snails, Crabs, Tortoises, and of Frogs. For seeing these sorts, of flesh are moist and clammy they easily adhere unto such Parts of the body as want nourishments neither are they easily consumed by the Feverish heat: and so they hinder the drying up of the solid Parts of the body. Yet some do reject these Meats, because hard of digestion and trouble●om to the stomach. But this difference is thus reconciled. In the beginning of an Hectic, while the digestive faculty is yet strong, these thick and clammy nutriments are convenient: but in a confirmed Hectic they are not to be given because hard to digest. Add hereunto, that they may be so prepared and qualified, as that they may easily be digested; as by being boiled to a jelly, or giving only what is strained out of them being beaten into a mash. Among other things the land Tortoises are mightily praised for an Hectic, not only for a single Hectic, but when Joined with a Consumption; and they are prepared divers ways. For either they are boiled in Water till they are dissolved then casting away the shells, the flesh is separated from the bones and boiled again with Cichory, Sorrel, borage, French barley, and prunes in a single Hectic: but in an Hectic of the Lungs it is Boiled with Bramble Leaves, Purslain, and Plantain. Let the Patient drink the broth and eat the Flesh twenty days together. Or the Juice is pressed out of the Flesh being beaten. Or little Loaves are made of the Flesh of the Tortoises boiled in Barley Water, with sweet Almonds, pine kernels, the cooling Seeds and Sugar. Which are lightly baked in an Oven and are given the Patient at Dinner and Supper. They may be thus made. Take of the Flesh of Land-Tortoise Boiled in Barleywater four ounces: sweet Almonds steeped in Rose-water six ounces: Pine-kernels so steeped two ounces, of the four greater cool Seeds, of each one ounce: Annis Seed not Powdered, but lightly baked in an Oven one dram and an half: Cinnamon two drams: Sugar dissolved in Rose-Water, to the Quantity of all the rest. Make thereof little Morsels. Instead of Tortorises the Flesh of a Capon is used and of a Partridge, and Marchpane is made thereof, good to restore Hectic Persons, after this Manner. Take Pulp of a Capon and Boiled Partridge of each three ounces, sweet Almonds steaped in Rose-Water four ounces: Pine-kernels one ounce and an half: Seeds of white Poppy two drams: Gum Arabickand Traganth of each one dram and an half: Pearled Sugar Cakes two ounces: with a little Rose-Water make a Marchpane, and gild it with Gold. To such as have weak stomaches, Jellies, broths, and Restorative stilled Waters are given. A Jelly may be made after this Manner. Take a choice Capon, a Knuckle of Veal, or a Weathers Thigh, two Calves Feet, or six Weathers Feet. Boyl all in fountan Water, till it be sufficiently wasted. Strain and squeeze out the Juice and Broth and take off the Fat. In the strained Liquor dissolve a pound of white Sugar, six whites of Eggs, a little saffron or Cinnamon. Stir them together let them Boyl lightly, and strain them through an Hippocras bag twice or thrice. At length put it into Porringers, or other Vessels in which it will become a Jelly. If the taste of Saffron or Cinnamon be displeasing, or you desire to have your Jelly more cooling, add instead thereof the Juice of a Lemon, or of one Citron. Restorative Broths may be made divers ways; this is far the best of all, which follows: Take a well fleshed Capon; pull, draw, and cut him in pieces, and take away the fat and skin: add, if you please, some Veal, or Wether Mutton cut into bits, and freed from the Fat. Put them into a stone Vessel well glazed; in which, about the middle, there must be a grate of Wood, or other materials, on which the pieces aforesaid must be so laid that they may not come at the bottom. Then cover the Pipkin with its cover, and close it up well with paste, and let it stand in boiling Balneo Mariae five hours. There will drop into the bottom a clear transparent Liquor; of which three of four spoonfuls, may be given in Broth, or by itself, three or four times in a day. Such Distillations of Flesh by Descent, are very convenient for Hectical Persons; but those that are made by Ascent, although they refresh the Spirits, yet do they very little nourish; neither do they restore the solid substance of the Body. Let the Patients Drink be, Barley Water, either by itself, or with Syrup of Vinegar, or Pomegranates mingled therewith, or Water in which a piece of Bread hath been boiled, sweetened with a little Sugar. But if the Patient's Stomach be very weak, weak Wine well allayed with Water may be allowed, which helps the concoction and distribution of Nourishment. Galen, Meth. 10. Chap. 5, 6. gives cold Water, with which he boasts he had saved many from the Marasmus. Howbeit, great Caution is to be used in the giving thereof; for when the Body is very much pined away, it is to be seared lest the small heat of the Patient should be wholly extinguished. And therefore it is only good when an Hectic is feared, or in the beginning thereof, and to such as are accustomed thereunto, and while the Body is yet sufficiently full of blood. Motion of the Body is not good, but the Patient must be enjoined to rest; howbeit before Meat, if strength will bear it, some light exercise will be good; or instead thereof, a few light frictions or rubbings may serve turn, especially presently after sleep, beginning at the inferior parts of the Body; for they provoke the Humours outward. And the Patient must be rubbed no longer than till a light redness begin to appear upon the Skin; for to rub longer would dry the Body. Carnal Embracements must be above all things avoided, which do very much consume the substance of the Body. Let the Patiented sleep, neither very long, nor very little. For long sleep increaseth the heat of the Bowels, by the retiring of the Natural warmth inwards: too short sleep dries the body more. But there is less inconvenience from sleeping a little over largely, than too scantily, because sleep doth exceedingly moisten, which in this Fever is very much to be desired. Let the Patiented sleep in a soft bed, and that a Flock-bed, not a Featherbed, and large enough. Let the Patient's Linen be often changed, which must be sprinkled with Rose-Water before they be put on. If there be Costiveness, the Belly must be provoked with a Suppository, or a Clyster of Chicken Broth, with Barley, Mallows, and Violet Leaves boiled in it; adding Cassia, Honey of Roses, Butter, and the Yolks of Eggs. Finally, The Mind must be preserved in peace and cheerfulness, avoiding vehement Perturbations, as Anger, Sadness, Fear. As for point of Medicaments fit for Hectic Persons, they are Internal or External. Among Internal, in the first place Purgers must be considered; and because addition is more necessary than detraction in this Disease, Purgers can hardly be convenient, unless a putrid Fever be joined with the Hectic. Yet if the first Region of the Body seem filled with Excrements, because of Crudities arising from a weak Stomach, Purgation may safely be used with Cassia, Manna, or Syrup of Roses. Nay verily, if strength be not deficient, the Infusion of Rhubarb may be given, with a Decoction of Prunes, Tamarinds, Myrobalans, Bugloss, and Violets. But Altering Medicines may be reduced into the form of Juleps, Broths, and Emulsions, after this manner: Take Waters of Endive, Lettuce, Sorrel, of each four ounces: Syrup of Violets, Water Lilies, Apples, of each one ounce. Mix all into a Julep for three Doses, to be taken at several times in one day, and to be continued for divers days together. Or, Take Whole Barley one pugil: Leaves of Endive, Cichory, Lettuce, Pimpernel, of each one handful: Flowers of borage, Bugloss, Violets, and Water-lillies, of each one Pugil: Damask Prunes three pair: Boyl all to a pint and an half. In the strained Liquor, dissolve simple Syrup of Cichory, and of Water-lillies, of each two ounces. Make of all a Julep for four Doses. Of the same Simples with a Chicken or a Pullet, may be made a Broth for the same use. Or, Take Roots of China one dram and an half: Entire Barley two pugils: the four greater cool Seeds half an ounce. Beat all together, and therewith fill the Belly of a Capon, or young Pullet, and make Broth; to which add Sugar of Roses half an ounce. Let the Patient take of this broth a long time together. It restores flesh and fatness. Take sweet Almonds blanched and infused in cold Water one ounce: the four greater cool Seeds, and of white Poppy seeds, of each one dram. Beat all together in a marble mortar, pouring on by little and little a pint of barley Water. In the strained Liquor dissolve Sugar Cakes made 〈◊〉 Pearl four ounces. Make hereof an Almond Milk for three Doses. If we be minded more powerfully to cool, we must add to every Dose of the Julep or Emul●●●● two scruples or one dram of Sal prunella. In the use of Refrigerating things, this is to be observed, That we use not the more 〈…〉 of a sudden, or frequently; for they might extinguish a weak heat. But it is better to 〈…〉 and little, than suddenly. And Moisteners are always safer than Coolers, because they exerc●●● 〈◊〉 Operations slowly. While the foresaid Remedies are using, we must be careful to strengthen the Bowels, by a convenient Opiate, which may be made after this manner: Take Conserve of the flowers of borage, Bugloss, and Violets, of each one ounce: Conserve of the flowers of Water-lilly half an ounce: Powder of the Electuary Diamargaritum frigidum four scruples: Shave of Ivory, Bones found in hearts of Stags, of each half a dram: Pearls prepared, and Coral prepared, of each one scruple: three Leaves of Beaten Gold: With Syrup of Apples, make of all an Electuary. In extreme consumption of the Flesh, nourishing Clysters are frequently to be injected, of the Broth of a Chicken, or Wether's Head, with Sugar and the Yolks of Eggs. But their Quantity must be small, or else compressing the Guts, they will provoke the Expulsive Faculty to drive them out. But among other Medicines most convenient for Hectical Persons, Milk is a principal one, it being endued with all the qualities which can desired in this Disease, namely, of cooling and mostening; it nourisheth much, and is easily distributed into all parts of the Body. In the use whereof, the same Cautions must be observed, which were set down in the Cure of a Consumption. Among External Remedies, a Bath of fresh Water is principal; for it powerfully cools and moistens, and relaxeth the external Parts that they may more readily receive Nourishment. Among the Ancients the use of Baths was most frequent, and there were four parts of the bathing place: In the first somewhat warm, they put off their : In the second there was a bathing Vessel of hot Water: In the third a bathing Vessel of cold Water: In the fourth the Sweatiness and Moisture was dried off. Galen in 10. Meth. Chap. 19 doth thus moderate the use of these parts of the Bath; That the Patients should be brought into the first part of the Bath, which was heated with the vapour of the bath, that the pores of their bodies might be opened; then being anointed with fresh sweet Oil, they were to be plunged in the hot Water to moisten their bodies; and then they were of a sudden to be thrown into the cold Water, quickly to be taken out again, and to be dried and anointed with Oil, that the pores being closed, the moisture may be received from the hot bath, might be retained. But inasmuch as the Industrious Diligence of the Ancients in the use of bathing, is long since out of use; and our Practitioners have likewise left this Method of bathing Hectical persons, which they judge unsafe, seeing it is to be feared, lest by the sudden receiving of the cold Water, the Patient's Body should be hurt, and the Patient not be able to endure the sudden sense of contrary qualities. So that our Practitioners do more advisedly, and more compendiously, whiles they convey the Patients into a bath of Water moderately hot, in the morning, after a stool procured by Nature, or by Art, and two or three hours after they have eaten some broth, or milk, or the Yolks of Eggs; wherein they abide solong, till it grow lukewarm of itself, and at last cold. For seeing Galen conceives the use of a cold hath after an hot to be so necessary, that without it the hot bath doth no good: the use of a cold bath is supplied, if the Patients stay so long in the bath till of itself it grow lukewarm, and cold. But this Caution is to be observed, That whereas a threefold quality may be had in the same bath, the Patient must abide in the hot a little while, in the lukewarm longer, in the cold lest of al. And although the Ancients were wont to make their baths of simple Water; yet is it good to make them more moistening by boiling therein Emollient and moistening Herbs, as Mallows, Marth-mal-lows, Violet Leaves, etc. or with barley and beaten Almonds, especially in the Summer, because a bath of Decoction of Herbs is sooner corrupted. After bathing, the sick is softly to be wiped with hot : then to be anointed with Oil of Violets, sweet Almonds, with fresh Butter; and after some time of rest, let the Patient eat some broth, or other food. A bath of Water and Oil, is exceedingly cried up by Zacutus Lusitanus, in the 35. Observation of his third Book of wonderful Cures; where with he says a young woman was cured, when a bath of simple Water and Goat's Milk could not help. The reason of which great good, he renders to be this; Because bathe made of fresh Water, with store of Oil in it, doth soften the distended stiff parts, doth moisten the dry and withered: and by opening the pores obstructed, and through dryness contracted, it draws the Nourishment to the outmost, and most distant parts of the body. When the Patient cannot use baths, apply an Epithem to the Heart and Liver, in this manner compounded. Take Waters of Roses, Water-lillies, and Purslain, of each three ounces: Juice of Pome-Granates an ounce: Powder of Diamargaritum frigidum two drams: Bones out of the Stag's Heart one scruple: Camphire four grains: Make an Epithem for the Heart. Take Waters of Endive, Lettuce, Cichory, of each three ounces: Vinegar of Roses one ounce: the three , of each two scruples: Ivory one scruple. Make an Epithem to be applied to the Liver. Also the Region of the Liver may be anointed with Ointment of Roses, or Ceratum Santalinum. But Oils and Unguents must be sparingly used, because they may sometimes increase the Fever. Among the Symptoms which are wont to come upon this Disease, the chief is a Looseness, which is wont to bring the Patients to their death. This is to be bridled with a Decoction of French-barley toasted, for their ordinary drink, Syrup of Quinces, dried Roses, Chalybeate Milk, Rice boiled in Milk, and such like. SECT. II. Of Putrid Fevers. The PREFACE. PVtrid Fevers are divided, into Continual, or intermitting. The continual Putrid Fevers are generated when a putrid Vapour, or a preternatural Heat, which ariseth from putrefied Humours, doth perpetually afflict the Heart, and stirs up therein a continual Heat; from whence likewise is perpetually diffused a Feverish Heat into the whole body. But the intermitting Fevers are caused, when the said Vapours are carried unto the Heart, only at certain distances of time. Continual Fevers are again divided into Essential, and Primary, or Symptomatical. Those are called Essential and Primary, which spring from a putrefaction inflamed in the common Veins, and not in any particular part of the Body. Those are Symptomatical that arise from the putrefaction or suppuration of some particular part inflamed; out of which part by communion of the Vessels, a putrid vapour may continually be carried unto the Heart: Such fevers are seen in the Pleurisy, Inflammation of the Lungs, Inflammation of the Liver, and in the Inflammation of other Internal Parts. Again, the Primary continual Fevers are twofold; for some are without any Exacerbation or Fits, and remission, but continue alike from the beginning to the end, and are called Sunochi, or Continentes. But others have manifest Exacerbations or fits, and remissions, and are called Sunecheis, or Continuae, by the name of the kind. And these again from the difference of their Exacerbations or fits, and remissions, are divided into three sorts. For some are called continual Tertians, which have their Exacerbations or fits every third day; others continual Quotidians that are exasperated every day; others continual Quartans, that are exasperated every fourth day. The intermitting Fevers or Agues, are likewise divided into Tertians, Quotidians, and Quartans, according as their Fits are wont to return every third, every fourth, or every day. There are other Differences of Fevers likewise, which are either Accidental, or arise from the Composition of those aforesaid; all which we shall Particularly and briefly Explain. Chap. 1. Of Continual Putrid Fevers. ALthough there are divers sorts of a continual putrid Fever, yet have I determined to describe the Cure of them all together, because in a manner the same Remedies are suitable to all, of which some differ only in more or less, and are accordingly to be varied; which depends more upon the Judgement of a Physician, and his Dexterity attained by Practice, than upon particular Precepts, Yet shall I as near as I can, observe what is peculiar to every sort of Fever, in its peculiar place. Fever's Putrid, Continual, and Primary, or Essential, are wont to be bred of the putrefaction of Humours, which are contained in the Veins and greater Arteries: And according to the various Nature of putrefying Humours, several Species do arise. Synochus Putrida is distinguished with no fits or exacerbations, but its whole time is taken up as it were with one fit, which reaches from the beginning to the end of the Disease and of this as of a simple Fever there are made three differences. The first whereof is, that which continues all alike during from the beginning to the end. The second is that which increases by degrees. The third is that which decreases by little and little. The first is named Acmastica or Homotonos, and it happens when the whole course of the Disease the manner of putrefaction is one and the same. The second is called Epacmastica, when more putrefies than is dissipated. The third is called Paracmastica when less putrefies than is dissipated. Yet although these kind of Fevers do perpetually increase or decrease, or keep the same Tenor: yet doth not this hinder but that they have four times, if they terminate in health; but some have them longer, others shorter, if they be considered according to the vehemency of the Symptoms. So that which is called Homotonos, hath a very brief beginning and Augmentation, but a long state. The Epacmastick hath a long augment: the paracmastick a long declination, but the other times do quickly pass away. Yet we must know, that the times of Putrid Fevers are two ways considered; either with respect to the Symptoms, or with respect of coction and crudity; which two in other Fevers do commonly comcide or happen at one and the same time: But in these continent Fevers called Sunochoi it is not so. For their times ought not so much to be defined by the increase and decrease of the Symptoms, as by the signs of Concoction or non Concoctions, which appear chiefly in the Urines. Now Galen propounds two sorts of this continent Fever called Synochus: one springing from Blood putrefying, of which he treats in the second of this Method Chap. 7. and 9 as also in the 9 of his Method Chap. 3. and 5. another arising of choler putrefying in the greater vessels, of the kind of burning Fevers, which he explains in his second of the Differences of Fevers and the second of Crises Chap. 6. The first is called Synochus Sanguinea; and the other Synochus Biliosa. For although the whole Ma●s of Humours contained in the Veins do go under the name of Blood, yet do we acknowledge four Parts thereof, of which the more temperate is specially called Blood; the hotter Part Choler; the rawer and colder, phlegm; and the thicker and more dreggy Melancholy. So then; if that more temperate Part, which is more especially called Blood, do surmount the rest in quantity, and the whole Mass putrefy, that Fever is caused which we term Synochus Sanguinea. But if the thinner and hotter Part of the Blood, which is of th● nature of Yellow Choler, do exceed the rest, and putrefy, that Fever is caused, which we term Synochus Biliosa. Synochus Putrida is engendered by the same causes which are wont to produce the simple Synochus, And so not only the shutting the pores of the Skin, but the obstruction of the vessels also, by reason of much Blood and thick and cla●my Humours, is wont to cause this Fever. For seeing by such like obstructions the Transpiration of Fuliginous Vapours is hindered, putrefaction is bred in the ●lood redounding within the Veins. A continual tertian, which every third day doth more afflict the Patient than ordinary, takes its Rise from bad and Choleric Blood putrefying in the Vena Cava. And the Causes thereof are all such things as multiply this Humour in the Body, as an hot and dry distemper of the Liver, Meats hot and dry, Youthful Age; fasting or very spare Diet; vehement and frequent exercise; hot and dry constitution of the Air; over great watch and such like. A continual Quotidian (which the Barbarous writers term Latica or lurking, because it hath a certain, hidden and concealed heat) is produced by phlegmatic Blood putrefying within the Veins; & therefore it hath its exacerbations or fits every day. It is wont to assail phlegmatic bodies, as of Infants and Children and old men, as also of such as are of a fat and corpulent constitution given to idleness and cramming of belluchear, and inhabiting moist places. This kind of Fever happens but seldom because phlegm is hardly putrefied. A continual Quartan, is that which is exasperated every fourth day, being Caused of Melancholy Blood putrefying in the branches of Vena Cava. And all things may Cause this Fever, which are apt to breed Melancholy Blood and to Cause the same to putrefy. Howbeit this kind of Fever is most rarely observed. The accidental differences of Fevers are taken from their evil Symptoms, which are wont to be complicated with the Essential, and from them they are named. Among these are wont to be reckoned Febris Arden's that is the Burning Fever, Colliquans the ●elter or dissolving Fever; the shivering Fever Horrisica, Assodes the tumbling, tossing and vomiting Fever; ●lodes the sweeting Fever; Syncopalis the swooning Fever Epiala the Fever which makes the Patiented hot and cold at one and the same time. Causus or Febris Arden's the burning Fever, is properly that, which is perpetually accompanied with these two symptoms viz. an ardent burning heat, and an unquenchable thirst though the Patient drink never so much. Galen. 3. Epidem. Com. 3. text 34. It is divided by the same Galen in Com. 4. de Vict: Rat: in acutis text. 13. into a Legitimate or bastard burning Fever. The Legitimate or exquisite burning Fever is that, which hath the two symptoms aforesaid, always, and evidently conjoined therewith. The bastard, in which those symptoms are less vehement, the thirst less Urgent, and the body not so burning. The Lightimate is Caused by a Choleric Humour putrefying within the large Vessels near the heart; the bastard is caused by Choler mingled with Phlegm or Salt Phlegm putrefying in the Vessels aforesaid. Whence it appears that a Legitimate burning Fever is no other, but a continual Tertian Fever, whose Matter is more sharp and plentiful than ordinary and contained in the larger Vessels which are near the Heart; whereas the Matter causing a simple continual Tertian is in Vessels Remoter from the Heart. Again there are two sorts of an exquisite burning Fever the one from the beginning to the end hath one only accession or fit, which we before named Synochus Biliosa, and it is likewise called Synochus Arden's; which is caused when the Humour putrefying doth occupy all the Vessels which are most neert the Heart: the other is named Arden's Periodica and contains in itself divers fits or accessions; it is caused by the same Choler contained in the Vessels near the Heart, but not in all or not so near as in Synochus Arden's. So that a Continual Tertian, Synochus Arden's, and Arden's Periodica, do differ one from another, only as the Choler causing them is more or less sharp, plentiful, and near the Heart. Febris Colliquans, the Melting Fever is of the kind of burning Fevers, which in regard of the exceeding heat, do●h suddenly melt the Fat, Flesh, and substance of the solid Parts, and sometimes the Blood contained in the Veins, and dissolve the same, by insensible Transpiration, Sweats, Urines or Stools. It is wont to be caused by a thin, sharp and Choleric Matter, which is vehemently inflamed, and Galen teaches that often times there is adjoined thereunto a malignant and pestilential Quality. Comment in 3. Epid. Sect. 3. Sent. 57 Horrifica Febris, in Greek Phricodes, is that Fever in which the Patient doth often undergo shaking fits, it is caused by a mingled Matter, viz. Partly Choleric and Partly Phlegmatic o● wheyish, which being unequally moved is wont to excite those Horrors or Shakes; either because the thin sharp and wheyish Matter, doth twitch and nip as it were the sensible and menbranous Parts; or the inflamed Choler doth putrefy and put in motion the crude Humours; or because Nature doth in Vain seek to shake of the crude undigested Humour whereupon the Heat being driven Back to the Centre the Extreme Parts of the Body are cold; and afterwards, when the same blazes out again, they grow hot. Assades Febris, the Fever so called, is a kind of burning Fever, in which the sick do tumble and toss and are exceeding unquiet, much oppressed with the disease, being for the most Part subject to stomach sickness and vomiting. Because it is wont to arise from the vexation of the Stomach by sharp and Choleric Humours, biting the orifice or Coats thereof. The Fever Elodes, is that in which the Patient prepetually Sweats: and it is caused by a mighty Putrefaction or Maliginty of Humours, dissolving the Substance of the Body. The Fever Syncopalis, is that in which the Patient often Swoons and Faints away. Avicenna makes two sorts hereof, one of thin sharp and Venomous Choler: another of much Phlegm, or abundance of crude Humours. The former is called Syncopalis Minuta, because it arises from a little Quantity of Humour, but thin and malignant. The latter Avicenna doth call Syncopalis Humorosa vel Repletionalis, because of a great Quantity of crude and Phlegmatic Humours abounding therein and there is also Joined a weakness of the mouth of the stomach, by which means especially the sick persons come to Swoon so often. That Fever is by Galen termed Epiala 2. de diff. Feb. cap. 2. & Lib. de inaequali intemperie cap. 8. in which at the same time, through the whole Body in the smallest particles thereof there is felt both cold and heat. For, albeit one and the same Part cannot be the subject of contrary qualities: yet is that which hath been said of this Fever to be understood of the smallest particles in respect of sense, but not indeed and in truth. Galen shows that this Fever is caused two ways; the one is by means or Glassy Phlegm mingled with bitter Choler and ●o diffused into the whole body. For Choler causes a sense of heat and the Phlegm a sense of cold. The other is by means of Glassy Phlegm alone, but partly putrefied and partly void of putrefaction. For, inasmuch as Glassy Phlegm is extreme cold and clammy, it doth not readily putrefy, nor all at once, but only by piecemeal; so that one portion thereof being putrefied the other remains unputrefied. That Part of the said phlegm therefore, which is not putrefied being shed among the sensitive Parts, causes a sense of cold, by reason of the extreme coldness thereof; and that which is putrefied causes a sense of heat. And so the whole body at one and the same time feels both cold and heat. Platerus also hath invented a way how this Fever may be bred, viz. when intermitting Fevers, or Agues, do one fall upon the Neck of another the same day in the same Patient, so that the cold fit of the latter Ague gins, ere the hot sit of the former be ended; or else when intermitting Fevers co●cide with those which are continual, so that the heat of the continual Fever and the cold of the Intermitting, happen at one and the same time. There are likewise other accidental differences of continual Fevers, which because they are wont to be reckoned among the Symptomatick Fevers, they shall be discussed forthwith in the Description of the said Symptomatick Fevers. Now although the Cure of Symptomatick Fevers depend upon the Cure of those Diseases in particular, from whence they arise, yet must we declare their Nature, lest they come to be confounded with Essential or Primary Fevers. Those therefore are called Symptomatical Fevers, which arise from the Inflammation and putrefaction of Humours contained in some of the Bowels. Of which kind are those Fevers which accompany the Pleurisy, Inflammation of the Lungs, Frenzy, Squinzy, Inflammation of the Liver, and other Inflammations, Ulcers or Impostumes of the internal Parts. And it is diligently to be observed, as a thing of great moment in Practice and by few taken notice of, that all Fevers perpetually which are Joined with Inflammations of the Parts of the Body, are not Symptomatical; But that some of them are essential & the foresaid Inflammations, do follow upon them. For it often falls out that Blood corrupted or filled with evil Humours, after it hath raised a Fever, comes to be agitated by Nature and her as hurtful to her expelled to the weaker Parts, or to such as are most convenient to receive them: whereupon an Inflammation is caused in those Parts, which doth not cause the Fever, but is rather a Consequent thereof. So we may often see in the Course of our Practice, the Patients sick of a continual Fever, for a day or two before Pain in the side and other Signs of a Pleurisy appears So many on the third or fourth day fall into a Frenzy; so, all Gouty persons in a manner, before they are troubled with Pain, swelling and Inflammation of their Joints, are wont to have a continual Fever for a day or two. So they which have the Rose or Saint Anthony's Fire, have a Fever sometime, before the swelling break forth. The same thing appears by the Urine, which in such Inflammations as these, do show manifest signs of putrefaction in the Veins. For in the beginning they appear crude and undigested, and in the progress, they show tokens of concoction daily increasing. Also Blood is often taken away very corrupt. Which things would not happen if such Fevers were only Symptomatical, simply depending upon those Inflammations. And these Fevers whether they be Symptomatical or primary and attended by Inflammations of the Parts, have their accidental differences. For if the Inflammation be of Blood, the Fever is called Phlegmonodes: if it be of Choler, Typhodes. And peculiarly an Erysipelas or Choleric Inflammation of the stomach and Guts brings the Fevers called Zipyria, in which the outward Parts are very cold and the inward Parts burn. For the inward burning doth draw the Blood and spirits co the Part inflamed; whereby the heat is so increased, that the inward Parts seem to be burned with unquenchable thirst, but the outward are cold, being destitute of heat and spirit. Lenta Febris, the flow or Lingering Fevers, is wont also to be reckoned amongst Symptomatical Fevers, which arises from some hidden obstruction and putrefaction, sticking so close to some Bowel and so impacted, that the substance of the Bowel is for the most Part Vitiated. And when a portion of the putrid Humour is shed into the Veins and mixed with the Blood, it stirs up a slow Fever, and so mild, that it troubles the Patient with no grievous symptom, yea and the Patient is scarce sensible of any Fever. Yet some notes of putrefaction appear in the Pulse and Urin. And sometimes this Febris Lenta is bred of the putrefaction and corruption of some of the bowels; because by the Veins inserted into that Bowel, putrid and hot Vapours do breath unto the Heart. Such a kind of Fever is often bred in the Consumption of the Lungs, which degenerates into an Hectic. It is also sometimes caused when the substance of the Liver or spleen corrupts: or when putrefaction settles upon the Mesentery, the Caul or the Pancrea, or other Parts; or also sometimes when the Child or Afterbirth are corrupted in the Womb. And hence not only slow Fevers, but sometimes also acute ones do arise, according to the different Nature of the putrefactions. And finally, to this kind of slow Fevers, those are to be referred, which are found in Cachectical persons, and in Maids which have the Green-Sickness; which Fernelius conceives do arise from a light putrefaction of wheyish phlegm shed abroad in the Body. Besides these forenamed differences of continual Fevers, which are most frequent, and are commonly set down by Authors; there are also some other, arising from peculiar and extraordinary Causes, which sometimes we meet with in our Practice. The Case of a certain Infant may serve for example, propounded by Zechius in his 46. Counsel. The Infant was scarce two years old, and had a continual Fever, with most grievous Symptoms viz. Unquietness, convulsions, and continual stomach Sickness inclining to Vomit; and it was conjectured that there was some Malignity adjoined, because such grievous symptoms did not answer to that Fever. For all the external Parts were cold, though the inner Parts were burned with heat, as appeared by the heat about the breast and under the short Ribs, and also from the dryness and blackness of the Tongue. The Cause of which was blood putrifying contained in the stomach. For this Infant being tonguetied, was lately cut by a Chirurgeon, in which work some Veins or other was opened which shed some blood into the stomach, which putrefying there, by sending forth hot, putrid, and as it were poisonous Vapours into the heart and Brain, was the Cause of all the symptoms aforesaid. But how this cause was found out and removed, it is worth the while here to recite, out of the Story of Zechius. So often (quoth he) as I diligently consider with myself, how hard a thing it is to understand internal Diseases, and their causes, I come easily to be of the mind that Hypocrates in his second Book of vulgar Diseases, Sect. 4. did not without greatest premeditation leave in writing; then in the Curing of all hidden Diseases, the Physician must diligently inquire the first assault of the Disease, that is to say, the first occasion of the Patient's illness. For of that for the most part depends the knowledge both of the Cause and Cure. See an Example hereof: This Disease of the Gentleman's Child was very acute, and the Cause very hard to find, had not I diligently asked of the Parents touching the conditions of the Child and the Nurse; who told me that two days before its being first ill, a certain Chirurgeon had cut the Membrane, whereby the Tongue of it was fastened to the parts beneath it. And when I again asked them, if presently after this was done, they had caused the Child to be held forward, or if any blood had come out of its mouth; they said no, it was neither so held, neither came any blood from the mouth of it. Whereupon I presently conjectured, that blood was fallen from the place cut into the Stomach, and there putresied, and was the cause of the Disease, and symptoms aforesaid. Neither did my Opinion deceive me; for having given it Oil of sweet Almonds to make it vomit, it uttered a considerable quantity of clotted blood, and matterish. Also it voided with a Clyster many clodders of blood. And presently, by the blessing of God Almighty, the Fever was abated, and all Symptoms began to cease. Whereupon it fell greedily and lustily on sucking its Nurse, and all the following night it slept quietly, and was afterward perfectly well. The Diagnostic Signs of putrid continual Fevers, do some of them show the continu'ty, others the putrefaction, and the rest the peculiar differences of them. The continuity is easily known, in that the Fevers is continual, and hath no intermision. The putrefaction is signified by a sharper heat than ordinary, and more biting, and by a sharp and biting Sooty vapour, produced by the exhalation of putrid Humours. The pulse is not only great and frequent, and oftentimes unequal; but it hath this peculiar property, That the Systole is quicker than the Diastole; because the Expulsion of Sooty Excrements is more necessary than refrigeration. The Urins are in the beginning crude, or very little digested The Exacerbations or fits keep their certain times, which yet is not to be understood of the Fever Synochus. A cold shaking fit at the beginning of the Disease. Hereunto are added various Symptoms, commonly accompanying putrid Fevers, as Illness of stomach, vomiting, heaviness of the body, pain of the head, raving, giddiness of the head, hiccoughs, anxiety, heartburning, thirst, roughness and blackness of the tongue, stretching of the parts under the short ribs, and the rest. Before which preceded, weariness without labour, pursiness, troubled sleeps, watch, tension of the parts under the short ribs, difficult breathing, pain and pulsation of the head, stomach-sickness, want of Appetite, plenty of stinking Excrements, frequent yawnings and reachings, or some of these. But the peculiar Differences of continual putrid Fevers, may be discerned by these Signs following: A continual putrid Fever, called Synochus putrida, hath the same signs which were propounded in Synocha simplici, but more vehement; for the heat is more sharp, the watch, headache, thirst, disquiet, and other Symptoms are more vehement; also the pulse is unequal, so that the Systole appears greater than the Diastole, the Urines are crude, red, and thick. The Signs of a Fever from Choler, are burning pain, a pulse mighty frequent and swift, a sharp Urine, fiery, in the beginning always crude, without Sediment; Stomach-sickness, Choleric vomitings and Stools Choleric, much anxiety, mighty thirst, bitterness of the mouth, dryness and blackness of the tongue, watch, raving, and an ulcerous kind of weariness, soregoing, paleness of Face, or a citrine Color, youthful Age, temperature hot and dry, Summer season, hot and dry Diet, Choleric Evacuations suppressed. And a continual Tertian is distinguished from a Synochus biliosa, or continent Fever springing of Choler, because it hath Exacerbations or fits every third day, but the Synochus biliosa, keeps still one and the same tenor. The Signs of a continual Quotidian are, Heat at first rather vaporous than biting, afterwards somewhat sharp, but unequal, because of the thickness of the Humour which is difficultly dissolved; the Urines are at first white, watery, troubled; afterward somewhat red and thick; the Pulse is seldomer, slower, and less than in the rest of these Fevers; thirst little or none; seldom sweat, unless there be salt phlegm; the Face of the Patient is somewhat bloat or blown up, lax, flaggy, and as it were Led coloured; Drowziness, want of Appetite, phlegmatic Excretions, a cold and moist Temperament, old Age, Winter Season, Cold and Moist Diet, Evacuations suppressed, and a daily Excretion of the Disease. A continual Quartan is known by these Signs. The Heat is less sharp than in Fevers of Choler, yet sharper than in Fevers of Phlegm; likewise Thirst greater than in a Quotidian, and lesser than in a Tertian; a Pulse in the beginning slow, rare, languishing; afterward stronger, frequenter, and very unequal. The Urine in the beginning thin, afterwards various; the body dry and lean, of a tawny or swarthy colour; Temperament cold and dry; Age inclining; Autumn of the Year, or very changeable weather; a life entangled with many Cares and Studies; suppression of the Hemorrholds, Swelling of the Spleen, and Exacerbation or vehemency more than ordinary of the Fever every fourth day. The Signs of a Causus or burning proper to that Disease, were propounded before, viz. a burning heat of the Body, and an unquenchable Thirst. Yet it is to be marked, if any Cough arise, that the Patients Thirst is thereby diminished, viz. by such moisture as is drawn by the Cough out of adjacent parts; howbeit, the Cough is never wholly taken away while the Fever lasts. The other Signs are all such as we have before shown, do signify a Fever from Choler. Yet the signs which signify a bastard burning Fever, are much more remiss than the foresaid. A melting Fever is known by a sudden Consumption of the Body, and growing lean; the Eyes are hollow, the Temples fallen, Nose sharp, Stools red, fat, stinking, clammy, corpulent, sincere, choleric, and frothy; the Urines, fat and Oily. The Shivering Fever, and the tumbling and tossing Fevers are to be known, by what is said of them in their Descriptions. In the Fever called Elodes, the Skin is ever moist with a clammy moisture, and the heat to feel to, is not very sharp. Malignity is distinguished from the largeness of putrefaction; because in Case of malignity, the Urines are in a manner Natural, or appear not much different from the Natural; or somewhat swins in the Urines like a Spider's Web, when the Fat melts; or if with the Urine there comes away somewhat like Vetches or Barley, which signify a melting of the flesh; or finally, abundance of Urine coming divers days together, when the blood and humours are melted. Add hereunto an extreme decay of strength; a small contracted Pulse, not very frequent. In great putrefaction the Urines are thick and troubled, the Pulse great, soft, and frequent. Syncopalis Febris, viz. the Swooning Fever, is known by fainting sits, and swoonings frequently befalling the sick. And that sort called Minuta, is distinguished from that Humorosa, because in the former are seen the signs of a Choleric, in the latter of a Phlegmatic Fever, as they were lately set down. The Fever Epiala is known only hereby, That at the same time, heat and cold is felt in the whole Body. Finally, Symptomatick Fevers, and such as are called Comitatae, are known by what hath been said of them in their Histories, or Descriptions. Now in every of these sorts of continual putrid Fevers, the Prognostic Signs are to be described, by which their events may be presaged. And first for Synochus Putrida, seeing it is of the kind of acute Fevers, it is not without danger. Yet if signs-of Concoction do evidently appear upon the fourth day, and no error be committed, it will terminate towards health the seventh day. But if the Signs of Concoction appear later, it may reach unto the eleventh or fourteenth day. But if no signs of Concoction appear, and the sick have a round swollen Face like a Globe, it signifies the Disease will be long. By how much the Urine is redder at the beginning, other signs corresponding, by so much safer it is, and signifies the Disease will soon come to an end, if there appear therein signs of Concoction; but with signs of Crudity it threatens death, especially if the party be weak. White Urine is the worst of all, and commonly portends death. Among the Differences of Synochus, Paracmastica is more secure, Acmastica more dangerous, Epacinastica most dangerous of all. Furthermore, an exquisite Synochus, and benign rightly Cured, is safe; a bastard one that hath malignity in it, with cruel Symptoms, and strength decayed, is dangerous. Choleric Fevers inasmuch as they are acute, are also dangerous; and that more or less, according to the more or less distemper, vehemence of the Symptoms, and validity of the Patient's strength. The distemper is measured not only absolutely by the degree of Heat itself; but also comparatively, with reference to the Natural Constitution of the sick party; so that look how much the heat is increased above the Natural temper of the Patient, so much the greater is the danger. So a burning Fever in an old Man, or in Winter, is for the most part deadly. The vehemence of Symptoms, is considered in actions Animal, Vital, and Natural; in Excrements, qualities changed, and proper adjuncts; whose enumeration requires a work by itself, according as we have expounded them, in the third Section of our Semiotica, or Doctrine of Signs, out of Hypocrates his Aphorisms, Prognostics, Predictions, and his Coic Praenotions, which may easily be transferred to this place. And finally, the strength of the Patient must be compared with the vehemence of the Symptoms; For if the strength be lusty, and likely to hold out against the Cruelty of the Adversaries, there is good hope; if not, we may justly fear the Patient's death. A continual Quotidian, is wont to be long by reason of the thickness and contumacy of the Humour: but if divers Evacuations happen in its course, it is wont to be the shorter. We must measure the danger thereof, by comparing the vehemence of the Symptoms, with the Patient's strength. And the chief care ought to be least it degenerate into a Cachexy or dropsy, by reason of the obstructions of the Liver and spleen, which happen in these long Fevers. A Primary continual Quartan is most rare, yet sometimes an intermittent Fever or Ague degenerates thereinto, and then for the most Part deadly. The melting, shaking, Tumbling, Sweeting and Swooning Fevers, seeing they borrow their Names from such bad symptoms as they are attended with; they are in regard of such symptoms extreme dangerous, and for the most Part is deadly. Finally, the Prognostic of Symptomatick Fevers, is to be gathered from the Excellency of the Parts affected, vehemence of the Symptoms and Validity of the Patient's strength. Now in the Cure of all putrid Fevers, we must take our Hints or Indications from the Fever, from its Cause and from the Patient's strength. The two former indicate their own ablation or removal; the third, it's own Preservation. Which must be done by assistance of those ordinary Medicinal Utensils viz. Diet, Manual Operation, and Medicaments. The Diet in all Choleric Fevers ought to be cooling and Moistening, in phlegmatic and Melancholic more warming and attenuating. Let therefore the Air be cold and moist, which being drawn in by the Lungs unto the heart, doth exceedingly temper the burning heat thereof. Yet must not the Patient be laid bare to the cold Air, because transpiration, which is exceeding needful, would by that means be hindered; and the sooty Vapours and sweats would be driven back again into the Body. Howbeit the sick must be covered only with light and soft Cover, and not loaded with over many blankers or Rugs. also the Featherbed must be taken away and a flock-bed put in place, upon which also in the extremity of Summer a covering of Leather will conveniently be laid on. Let the bed be wide, that the sick may change place therein. Let the Patient's Linen Shifts be often changed contrary to the vulgar opinion; provided they be not newly washed, nor smell of Soap, and that the Time of the Crisis be not at hand, in which nothing is to be stirred, lest the motion of Nature be hindered and disturbed. The Sunbeams are to be kept out of the Patient's Chamber, and store of Company is to be avoided. Water is often to be poured out of one Vessel into another, in the sick Persons chamber. The Pavement of the Chamber is to be sprinkled with Water, Vinegar and Rose-Water mingled; or with cooling Herbs and flowers; as Vine Leaves, Willow Leaves, Leaves of Water Lilies, Flags; Roses, and flowers of Violets and of Water Lily; which must be kept at hand in good Quantities in a cool place, and be often fresh sprinkled and strewed about the Patient's Chamber; for when these Herbs and flowers are dried, they heat the Chamber. If the Chamber be cold, as in winter, it must be a little tempered with a fire avoiding Smoke. Howbeit in phlegmatic Fevers the Air must be Moderately hot and dry. As for Point of Nourishment, the Diet ought to be thin and spare in acute Fevers. And therein the Ancients were so severely diligent, as to place the greatest Part of the Cure in ordering the Diet, enjoining such as were sick of a most acute Fever, to keep a most thin and slender Diet; and giving them nothing but a ptisan drink of Barley Water, as most convenient for persons in a Fever; seeing it cools, and Moistens; withal extenuating and opening and hindering not Evacuation. And they had two kinds of Ptisans. One simply so called, or whole Ptisan not strained; the other was strained, which we call Barley Cream. Barley cleansed of the Husks boiled in fair Water, to a Consistency or Pottage, is the whole Ptisan; this being strained with pressing, is called Cream or Juice of Barley. But in our Times, at least in our Country, by the refractoryness of Women [who fear nothing but that the sick person shall be starved, as all their care in a manner is to cram their Children with meat like Pudding Bags, how empty their Brains be of wit, or their Hearts of Grace and wisdom, matters not] and the Indulgence of Physicians [who the best of them smell too strong of the Mountebank] it is grown into a fashion in all Fevers, yea the most acute and violent, to allow the sick at all times broths of the flesh and Hen's Chicken, Capon's mutton; and that for the most Part they give every third or at most every fourth hour. And in the Summer the flesh of a pullet, kid or Lamb is added to the former Diet. And sometimes again broths are made of nothing but a chick with cooling Herbs, as Lettuce, Endive, Sorrel and Purslan. Or to ordinary broths is added Juice of Oranges, Lemons, or Pomegranates, when the heat of the Fever is very great, or the putrefaction very intense. Moreover in Fevers not so very acute Panadaes are given twice or thrice in a day made of washed bread and broth. Also Barley broths are sometimes used of the Ptisan of the Ancients being strained, with the broth of the flesh aforesaid, and Sugar; or without broth, adding sweet Almonds. But these for the most Part do oppress the stomach, and therefore the use of simple broths and Panadaes seems more convenient. Howbeit very profitable it it to boil a little Barley with flesh and thereof to make broths. In long Fevers, a fuller Diet is fitting, of the flesh of Chickens, Veal Hens and Pullet's, Capons, Partridges, Mutton, or of the Juice pressed out of them, Jellies made with them, and such like. Concerning the time of giving the Patient's meat, this is principally to be observed, that they never eat in the time of the Exacerbation or fit but in the time of the Fever. But if the Exacerbation be very long, let the Patient eat in the declination thereof. For drink, the Ptisan of the later Physicians, made of the Decoction of Barley with Liquoris, is usually given in all Fevers. To which if the Fevers be very burning may be added a little Lettuce, Sorrel, Tamarinds. But more ordinarily are added the Roots of Grass or Sorrel which makes the Water look of an Elegant Colour like Wine. But in long Fevers may be added sweet fennel Roots, Parsley Roots, Annis Seed, Coriander Seed, or Cinnamon, as oft as the stomach through weakness is offended with drinking. Take of the ordinary Ptisan-drink of Barley and Liquoris two pints: spirit of sulphur as much as shall suffice for to make it pleasantly tart. Hartshorn burnt till it be white one ounce: Let the Patient use it for ordinary drink, shaking the Vessel before it be poured forth. Also Water that hath had a piece of bread boiled in it either by itself or sweetened with Sugar is good; or mingled with a little Vinegar; or Water alone, boiled to take away the Crudity; wherewith sometimes a little Sugar is mixed, and sometimes a little of the Juice of Lemons, Pomgranats, Barberries, Cherries, or of their Syrups; or as much spirit of sulphur or Vitriol as may serve for a great full Acidity; or a little Sal Prunellae, if need be of potent refrigeration. Water is commended wherein are steeped Tamarinds, Berberies, or Prunes. A Decoction of french Prunes is very pleasing to the taste. Or Barley is boiled with Tamarinds, and towards the End, the broth is Aromatized with yellow and Cinnamon. Which drink doth not only Quench thirst, but loosens the belly, and cools and strengthens the Liver. Take Sugar eight ounces: Sal Prunellae one ounce: Make it into a Powder, to be taken with the Patients ordinary drink. Whereunto if thirst be extreme, the spirit of vitriol may be added. Touching spirit of Vitroil and of Sulphur, this is diligently to be observed, that in putrid Fevers the use thereof is great, because they have a mighty cooling, opening, and putrefaction quelling faculty; prohibit the Inflammation of the Humours, and quench thirst. Howbeit in the Pleurisy, Inflammation of the Lungs, Spitting of blood, Consumption of the Lungs and other Diseases thereof (unless they spring from thick phlegm stopping the Vessels thereof) Inflammation of the stomach, Dysentery or bloody flux, Pissing of blood, Ulcers of the Kidneys and Bladder, they do very much hurt and therefore we must abstain form them. In Fever's arising from very thin and hot Choler, or Joined with a sharp thin distillation, sharp things are not convenient; but rather such as gently thicken, as Syrup of Violets, of dried red Roses, with Barley Water, or Bread boyld-Water, or simple Water boiled, or small beer, mixed therewith. Where thick and clammy humours abound, the Syrup of Vinegar will be very profitable. in stead of those last named. Also sometimes Conserve of Roses, Violets, or borage is wont to be mingled with clear Water boiled, with Barley Water, and to be strained through an Hippocras bag for ordinary drink, unto which some drops of spirit of Vitriol may profitably be added. Or a Tincture of Roses is made after this manner, most delightful in colour and in taste. Take Red Roses one ounce: Bloodwarm Water three pints: spirit of sulphur or Vitriol one dram and an half: Let them stand infusing cold for three or four hours. To the strainings add, white Sugar, four ounces: Rose-Water half a pint: Make thereof a clear Julep for ordinary drink. Also Julepus Alexandrinus, is very good, and extreme pleasant. It is thus made. Take Fountain Water one pint: Rosewater, Juice of Lemons, and white Sugar, of each four ounces: Boyl them over a light fire till you have taken away the Scum. As for other things pertaining to Diet, Sleep is extreme good and watch bad. Yet over much Sleep doth overwhelm the natural heat and hinder the Evacuation of excrements. Rest is necessary in acute Fevers; but in long Fevers, light and gentle exercise is good. Also we must endeavour, that nothing be retained which ought naturally to be expelled; howbeit all immoderate Evacuations, which exhaust the strength, are to be stopped; and all vehement Perturbations of mind, must be turned out of Doors. Among manual Operations, Blood-letting holds the chiefest place. for it doth not only diminish plenitude, whether it be a simple fullness so as to stretch the Vessels, or only a fullness with reference to the strength of the Patient; whether it be in the whole body or in some Part; but also revels the influx of Humours Causing obstructions; cools the whole body and makes it perspicable; keeps back putrefaction, and furthers the concoction of putrefying Humours. Presently therefore, and at the beginning of the Disease, blood must be drawn (unless weakness hinder, as in the Swooning Fever, and other like Cases) and that after the Belly hath been loosened with a Clyster, or a Suppository. How much blood should be taken, it gathered from the Patient's strength, from the greatness of the Ple●hora, Custom of the Patient to bleed or not to bleed, and other circumstances. The Ancients in the Synochus Putrida, and the burning Fever, did let blood till the Patient fainted away. But it is much more safe (as we have said in the Cure of a simple Synochus) to take away at several times so much as shall be sufficient; then suddenly to put the Patient in danger of death. Avicenna in a burning Fever, and in a continual Tertian, doth forbid letting blood, unless the Urine be thick and red. For he fears lest Choler should be the more inflamed, which he saith is bridled by Blood. But the wiser Physicians do explode this Opinion of his, seeing these kind of Fevers are often terminated even by Nature herself, by bleeding at the Nose; and they do sometimes cause Frenzies, and other Inflammations: and finally, because Blood-letting doth potently refrigerate, doth rather stop than further the Ebulition, or boiling and working of the Blood, and Choler comes away as well as Blood when a Vein is opened; so that in that Mass of Blood, which is in the greater Veins remaining, there is the same proportion of blood to Choler which there was before. Nay verily, when a Vein is opened, if the sick party be any thing lusty, and the blood flow amain, only the putrid Blood which is offensive to Nature is voided, the purer remaining in the Veins; which few Authors have taken notice of, although it be in the course of Practice every where observable. For if the Blood flow out of the Vein drop by drop, it is the purest Blood, because it comes out of the Vein by its own proper motion. But if it spring out with a forceable stream, it appears foul and corrupted, Nature expelling the worse part of the Mass of Blood. Howbeit Blood is more sparingly to be taken from such as are of a very Choleric Constitution, in the middle of Summer's Heat, and the Dog-days, than in other Natures and times. But in Phlegmatic and Melanchollick Fevers, Blood must be taken away in lesser quantity: and evermore great regard is to be had to Coindicants, and Contraindicants; forasmuch as Quotidian Fevers do for the most part happen unto Children, or old Persons in cold Countries and cold Seasons of the year; which considerations do lessen the Quantity of Blood, which otherwise the Disease, or its Cause require, should be taken away. When the Fever is caused by over much labour, blood must be taken away more sparingly. If a Fever happen by over great use of Carnal Embracements, Blood-letting is pernicious. Concerning the time of Blood-letting, it is to be noted, That a Vein must not be opened presently after the Patient hath eaten; but after Digestion is past, and after the Patient hath been at stool. Again, Blood is to be let when the Fever is most remiss, and not in the vigour thereof, for then Nature is not able to bear both the violence of the Disease, and the loss of Blood. As for the repletion of Blood-letting, if the same be necessary, to cause Evacuation, it must be repeated the same day; if for Revulsions sake, on another day. For where Evacuation is necessary, especially in acute Diseases, the Body must be suddenly changed into another condition; also it often happens, that a Disease is quickly past its first time or beginning, so that afterward we cannot so conveniently open a Vein. But in Revulsion we have respect to the motion of the Humours, which is then best ordered, when it is done at divers times, some space being interposed, whereby Nature becomes accustomed to a contrary motion. For in the space between Bleedings, the Blood which was shed into the parts regurgitates into the Veins, and by another Blood-letting is profitably drawn forth. We understand that Blood-letting must be iterated, if that blood which was first drawn forth, were very much corrupted; and there is reason to think, that there is yet a great quantity thereof abiding in the Veins. Yea verily, Although the Blood at first seem pure, and uncorrupted, yet must we not desist from taking the same away, but continue so doing until it appear more impure and corrupted. And truly that Precept delivered by Hypocrates, in his 4. de Victus Rat. in Morbis acutis, in the Cure of a Pleutisie, may very profitably be observed in acute Fevers, viz. That Blood-lettings be so long continued, till the blood change colour; so that if at first corrupt blood come away, we must let it run till it appear more pure; and on the other side, if at the first the blood appear laudable, we must suffer to flow, till that which is impure and corrupted be come away. Yet is there some diversity to be observed in both Cases. For if at first good Blood come away; blood ought to be again taken from the same Vein; that putrid blood residing in the innermost parts of the Body, may the sooner be drawn forth. But if at first corrupt blood be taken away, blood is next time to be taken out of the other Arm, and afterwards out of the former again, and so in course as oft as need shall require. But if the Symptoms declare, that the Putrefaction is in the inner branch of the Vena Cava descendent; as heat and pain in the Loins, redness and thickness of the Urine: after two or three Blood-lettings in the Arms, it will be convenient to draw Blood out of the Vena Saphena, two or three several times. If in the latter Blood-lettings, some part of the Blood seem laudable, and not so putrid as before; it's a sign that Nature doth repair and restore new good blood instead of the corrupt blood which hath been taken away. Contrarily, If the more is taken away, the worse it comes, it's a sign the Disease grows worse, and that Putrefaction is increased; whence there is reason to fear a stupefaction of the Internal Parts. The Vein in the bending of the Arm, or the Basilica, of the Mediana, is for the most part to be opened, in the right Arm most commonly, sometimes in the left, viz. when more distension is felt under the short Ribs on the left, than on the right side. Yet sometimes a Vein is profitably opened in the Foot, if Revulsion be necessary and the Patiented weak, the Matter of the Disease being in the Head, and the sick person molested with Headache, and want of rest. Frictions are seldom used in putrid Fevers, unless it be in the Swooning Fevers; the Cure of which we shall set down in the Cure of the Symptoms of Putrid Fevers, towards the end of the next Chapter. But Cupping-Glasses are more frequently used, as being the Substitutes of Blood-letting, in whose stead they serve, when Weakness or Age of the Patient will not permit a Vein to be opened. Medicinal Remedies are comprehended under a double kind; whereof some are Evacuative, others Alterative. Under the Evacuative, we comprehend Purgatives, Vomitories, Sudoroficks, and Diuretics. Under the Alterative, we comprehend Coolers, Attenuaters, Cutters, Openers, and Strengtheners. Of all which we shall set down the Composition and use in order, according to the usual Method of Practice. And that we may begin with Purgatives, it's a great Question among Authors, Whether or no they ought to be used in the beginning of Fevers? Which Controversy, omitting all Circumlocutions, is thus determined. In respect of the Matter immediately producing a continual putrid Fever, which is contained in the greater Veins, Purgation is not convenient in the beginning; unless the said Matter do heave and work, being so stirred by Nature, provoked by the ill quality thereof, and endeavouring to expel it, that thereby it becomes more disposed for expulsion, and there be danger by the foresaid working thereof, lest it rush into some noble part; howbeit this seldom happening, for the most part the Concoction thereof is to be expected, before we undertake to evacuate the same by Purging Medicines. But in respect of the Matter contained in the first Region, if it be very much, and do increase the Fever, oppress Nature, and divert her from concocting of that which is in the Veins; Purgatives may be given the next day after Blood-letting, but they must be gentle, such as evacuate only the first Region. Now that naughty Humours and Excrementitious do abound in the first Region, that is to say, in the Stomach, Guts, Mesentery, or about the Midrif, may be known by Stomach-sickness, Bitterness of the Mouth, Thirst, Pain of the Stomach, or some other part contained in the lower Belly, Looseness of the belly, and other Symptoms; in regard of which Purgation is sometimes to be practised before Blood-letting. Now the Medicines for this intent, must be Cassia, Manna, Tamarinds, Catholicum, Electuarium lenitivum Diaprunum simplex, Syrupus Rosaceus, de Cichorio cum Rhabarbaro; which may divers ways be compounded after this manner: Take Cassia newly drawn one ounce: Tamarinds half an ounce. With Sugar make it into a Bolus. Or, Take Catholicum six drams: Elect. lenitive, or Diaprunes simple, half an ounce: Cream of Tartar one dram. Make all into a Bolus. Or, Take Leaves of Endive, Cichory, Sorrel, of each half a handful: Tamarinds half an ounce: Boyl all to three ounces. In the strained Liquor dissolve Catholicum half an ounce: Manna and Syrup of Roses, of each an ounce. Mix all into a Potion. If you desire your Medicine a little stronger, you may add a dram or four scruples of Rhubarb infused in Endive or Cichory Water with yellow . Yea, and sometimes if the Fever be not very strong, two or three drams of Senna may be added to the Decoction. Some reject Rhubarb, because it heats; also Manna, and Syrup of Roses, because being sweet, they are soon turned into Choler. But with cooling Waters or Decoctions Rhubarb being infused, or Manna and such like dissolved, can do no hurt; especially if to the said Decoctions, Tamarinds be added, which are much commended to this intent, or if the Pulp thereof be given dissolved in the Potion. Some in Choleric Fevers do use the Whey of Goat's Milk, and that very pertinently; for it tempers the heat of the Fever, evacuates Choler, and strengthens the Bowels. In a Cup of Whey they steep all night one dram, or one dram and an half of Rhubarb, or they add two or three ounces of Syrup of Roses, and so give it in the morning; and afterward they give the Patiented a quart of Whey more to drink, that all the Whey may not be infected with the taste of the Medicament. That kind of Purgation which is practised in the beginning of putrid Fevers, the Vulgar Physicians call Minorative purgation; and that which is practised when the morbific matter is concocted, they call eradicative purgation: which is also convenient in the beginning (as was said) in the Judgement of Hypocrates, if the matter be turgent. Now this same turgescence▪ and boiling as it were of the matter is known hereby, because the Patient perceives in divers Parts light Pains which soon go away and shift suddenly from place to place; and hath divers colours of the Face and other Parts, so that sometimes there is a redness and then again a paleness in some Part of the Face. And in a word the Patient is exceedingly tormented with anxiety and unquietness, continually tumbling and tossing. Howbeit that Rule of Hypocrates touching the use of Purgation, when the morbific matter doth ferment and work in the Patient's body, is not observed in ordinary Practice: but when the Humours appear in their fermentation and Motion, we do more safely apply ourselves to Blood-letting; and by that means we do more readily present the rushing of the stirred Humours into any noble Part, which being agitated by the Purgation may more easily flow into the said Parts. Sometime also in the beginning of these Fever's Vomit is to be procured, viz. when the Patient is much vexed with illness of stomach and with vomiting for then Nature endeavours to evacuate the morbific matter upwards, and the Physician ought to assist her endeavours. And many times it falls out, that great Quantity of matter is contained in the stomach and Parts thereabout, which must be Evacuated as soon as possible may be, by Vomit; seeing no concoction can be expected of such excrementitious matter in so great a Quantity; and what ever the Patient eats or drinks is changed into such a like Humour and increases the Matter which is cause of the Disease. For Fernelius hath well observed in his third Book of the Method of Healing, Chap. 3. that all superfluity of Humours in the stomach, spleen, Pancreas, Mesentery, and the Cavity of the liver; is conveniently emptied out by a Vomit, which sometimes will not be removed with Medicines that work downwards, though divers times administered. And it comes often to pass, that the Matter being Vomited up, the Fever is taken away at the first, which otherwise would have proved long, in case that matter had been transmitted into the more inner Parts of the body, and very well mixed with the blood. Now of the three degrees which we reckon of Vomitories, the mildest is to be Chosen, as Barley Water Lukewarm with Oil of Almonds or common Oil, or with a little Quantity of white Vinegar. Also Syrup of Vinegar, or Oxymel simple which Chicken broth or a Decoction of Dil Seed, Radish or Orach, whereunto also Oil may be added. All which are to be given to the Quantity of a pint or more; for in a less Quantity they abide in the stomach. And seeing these weaker sorts of Vomits are of little efficacy, we may sometimes apply ourselves to those of the middle Rank; which shall be propounded hereafter, in the Cure of a Tertian Ague And not only in the beginning of the Disease before Blood-letting, but also the whole Course thereof, Clysters must be given every day or every other day, if the Belly be not of itself very free, made of a Decoction of Emollient and refrigerating things, such as French Barley, Prunes, Mallows, Violet Leaves, Mercury Leaves, Bearesfoot, Orach, Lettuce, Endive, Houseleek, Water-lilies: dissolving therein Catholicum, Cassia, Diaprunum simple, Red-Sugar, Honey of Violets, and Honey of Mercury; Oil of Water-lilies, Violets etc. But in a violent hot Fever, it is better not to add the Oils, because they are easily inflamed. Observe in the first place, that not above three or four blades of Houseleek must go into one Clyster, because it cools most potently, and being taken in greater Quantity, may hurt the Guts. Observe secondly, that in all Fevers of Choler, Clysters are not to be injected actually hot, but only Bloodwarm. In Fevers that spring from phlegm, Decoctions for Clysters are made of the Emollient Herbs with Annis Seed, Seeds of Fennel and of Carthamus; flowers of Chamomel and Melilote; dissolving therein Hiera Picra, Diaphoenicum, Honey of Roses, Honey of Mercury, Oil of Chamomel, Dil, or common Oil. And because, as we noted before, absolute and perfect Purgation, which they call Eradicative, is not to be attempted till the Morbific Cause be ripened and digested; the Physician from the beginning of the Disease, after the first Blood-letting, and when the passages nearest the stomach are cleansed, aught to use such Medicaments as prepare crude Humours for digestion and Evacuation, and withal temper the Feverish Heat, hinder Putrefaction, and open obstructions; such as are Juleps, broths, Emulsions and other things which shall be hereafter described. Juleps are compounded in a Choleric matter offending, of Syrups of Lemons, Pomegranates, Sowr-Grapes, Vinegar simple, of the Juice of Sorrel of Cichory simple, with Waters of Endive, Sorrel, Grass and Cichory. Or better, of the Decoction of the Roots of Sorrel and Cichory, of the Leaves of Sorrel, Maidenhair, Garden Endive, Dandelion, the four cool Seeds, Tamarinds, with the Syrups aforesaid. And sometimes that we may cool more effectually, a dram of Sal Prunella is added, for every Dose of the Julep, or so much spirit of Vitriol or Sulphur, as shall suffice for a moderate sharpness. Sour things are never to be omitted in Fevers springing from Choler; because bitter things are sweetened by Sour and acid things: which if they are Sour in an high degree, as spirit of Vitriol and of Sulphur, they deface the bitterness even of Aloes and Coloquintida. Now yellow Choler being plundered of its bitterness, i● dead. And Harmless. Juleps also of great Virtue, may be made of Juices and which are very grateful to the taste, after this manner. Take Juice of Apples that smell sweet, newly drawn out and settled four ounces: Juice of Lemmons three ounces: Rose-Water two ounces: Juice of Pomegranates one ounce: finest Sugar half a pound: Make of all a clear Julep for three Doses. If very thin Choler and sharp be in motion and cause either a Looseness or some other grievous fluxion; Juleps must be compounded which thicken, of Waters of Lettuce, Purslain, Plantain, flowers of Water Lilly, Red Poppy and Violets with the Syrups aforesaid. Yet we must observe that Syrup of Violets and other of the sweeter sort of Syrups, are not to be given alone; both because they loosen the stomach; as also because, ere they can Pass into the Veins, they are turned into an hot Vapour, which doth afterwards cause thirst to increase. And therefore there must evermore some Quantity of sharp Syrup be mixed with the sweet Syrups aforesaid, that they may more easily pierce into the Veins, and the better resist the Heat of the Fever. In the Progress of the Fever, when Coction gins to appear, to the foresaid Decoctions must be added Roots of Asparagus and Liquoris; Leaves of Agrimony, Pimpernel, Liverwort and Maidenhair. In Phlegmatic and Cronick Fevers, things more cutting, attenuating and opening are prescribed beginning with the more weak, such as are Syrup of Vinegar, of Maidenhair, Syrupus Bizantinus, with a Decoction of Egrimony, Maidenhair, Betony, Liquoris, Raisens'. And in the progress of the Fever unto the former we add Syrup of the opening Roots, Vinegar compound, of Hyssop, Oxymel simple, and compound. And to the Decoction we add the five opening Roots, Leaves of Hyssop, Carduus benedictus and (if the matter be very impact, Clammy and roapy) of Germander and Centory. Whereunto if Salt of Tartar and spirit of Vitriol be added, they work more happily. In Fever's springing from Melancholy, such things are added which do moisten, as Syrup of Violets, of bugloss, of borage and Apples, towards the Beginning: and afterwards Fumitory, of Epithymum, of the five opening Roots, Oxymel of Squils'; with a Decoction, first of Bugloss, borage, Cetrach or wall-fern, Maiden Hair, Fumitory, Hops; and afterward Dodder, Scordium, Centory, Bark of Capers, of the Ash-tree and of Tamarisk. And finally in bastard Fevers, which arise from the mixture of different evil Humours, the Medicines aforesaid must be mixed together; yet so that such as respect the most predominant Humour be put in the greatest Quantity. For the more nice and dainty soft of Patients, Medicinal broths are prescribed instead of Juleps: and also that the sick may not grow weary of the same kind of Medicine too long used; and these broths are made of such of the Roots and Herbs aforesaid as are most pleasant to the taste with a chick, or part of an Hen of Capon: unto which sometimes may be added one dram of Sal Prunella, or some drops of spirit of Vitriol, when we would have it more cooling than ordinary. Howbeit in slow and long lasting Fevers, caused by rebellious obstructions hard to be cleared, Germander though bitter and Cichory, Endive and Dandelyon, though bitter, may be boiled in Broths; and Montanus in his Counsels, doth cry up Cichory and Germander boiled in Broths as an admirable Remedy for such as have a long Fever with obstructions. In Fevers from phlegm a Decoction of Chamomel is excellent. Zacutus Lusitanus. Observat. 26. in the third Book of his Praxis admiranda. Also emulsions or Almond-Milks are very good in putrid Fevers, and are commonly more pleasing than Juleps. They are most in use when the Fever is Joined with a dry distemper of the Bowels, or a thin Catarrh, or an Inflammation of the Lungs and Parts serving to breath withal; or for variety, lest the Patient should be over tired with continual use of Juleps. Now the Composition of these emulsions, hath been described in the foregoing cures. Cold Water given in great Quantity in continual putrid Fevers, was wont to be in use among the ancients, and is commended by very many latter Physicians. But as we said the use here of was dangerous in the simple Synochus; so in this Case, we think the discreet Physician shall do best to for bear the same, for the reasons we delivered, in our Chapter of the simple Synochus. Yet will it be sometimes good, in extreme heat of a Fever to give a good draught of cold Water, to ten or twelve ounces with a few drops of Spirit of Vitriol: For hereby sometimes the same effects are wrought, which Galen attributes to cold Water being drunk, the quantity of three or four pints at a time; When as notwithstanding there are none of those dangers to be feared, which Galen himself confesseth did sometimes happen upon the preposterous drinking down of so great a quantity of cold Water as he adviseth. For the Spirit of Vitriol causeth that the Water breeds no Obstructions, but rather opens the same, quickly piercing and passing through the Bowels, not biding in the Hypochondria's as plain and single cold Water is wont to do; but is very like the acid Mineral Fountains and Wells, which though they are drunk in great quantity, do not lie heavy in the parts about the short Ribs, but are quickly pissed forth, and very good against Obstructions. To strengthen Nature, which in every violent Fever is much dejected, Electuaries are good, and strengthening Conserves and Preserves, compounded of Conserve of Roots of Bugloss, Leaves of Sorrel, Woodsorrel, Stalks of Lettuce, Flowers of Bugloss, borage, Violet, Cichory, and Roses, Pulp of Citrons. Whereunto are added the Powders of Coral, Pearls, Ivory, Hartshorn, Diamargaritum frigidum, Diatriasantalon, Diarrhodon Abbatis, Confectio Alkermes, & de Hyacintho; which are commonly after this manner compounded: Take Conserve of Flowers of borage, Bugloss, Roses, of each an ounce: Confectio Alkermes one dram and an half: Powder of Diamargaritum frigidum, Ivory, Coral prepared, and Pearls prepared, of each ten grains: Sugar of Roses, the weight of all the rest: three Leaves of beaten Gold. Make of all an Electuary covered over with Gold, of which let the Patients take often by itself out of a spoon, drinking a little of their ordinary Drink after it, or mingle s●me of it with their ordinary Drink, and with their Broths. Take Conserve of Cichory, Sorrel, Lettuce, and of the sharp Pulp of a Citron, of each half an ounce: Powder of yellow , and of Pearls prepared, of each one scruple: Spirit of Vitriol half a scruple. With Syrup of Violets make all into an Electuary. Take Conserve of the Flowers of Bugloss, Roses, and Violets, of each one ounce: Waters of Endive, Sorrel, and Borrage, of each three ounces. Mix them together, let them stand over the warm Embers and heat; then strain the Liquor through a searse; then add Confectio Alkermes two drams: Powder of the Electuary Diamargaritum frigidum half a dram: Coral prepared, Pearls prepared, and Shave of Ivory, of each one scruple: Syrup of Lemons and Pomegranates, of each three ounces. Mix all; give one spoonful at a time. For the more dainty and nice sort of People, in great debility of Natural strength, this following Julep very pleasant to the taste may be compounded: Take Waters of Sorrel, Orange flower, and Roses, of each one ounce and an half: Syrup of Lemons and Pomegranates, of each one ounce: Confectio Alkermes one dram: mix them. Let the Patient take hereof frequently in a spoon. Altering Medicines having been used for some days together, and such as prepare bad Humours, when the Fever gins to decline, we must set ourselves to purge out the said Humours, when the signs of Concoction do appear, avoiding the Critical days. And this must be done with Medicines a little stronger than those which were given at the beginning; of which sort are, Senna, Rhubarb, Agarick, Catholicum duplex, and such like; whose Matter and Dose must by the skilful Physician be accommodated to the Humours offending, and the Nature of the Patient. And some Physicians are so bold as to proceed to Scammoniate Medicaments, as Diaprunum solutivum, Diaphoenicon, Electuarium de succo, Rosarum & Diacarthamum. Which notwithstanding are very seldom to be used in continual Fevers, because Scammony is wont very much to inflame the Humours, and to cause vehement thirst; and that especially in burning Fevers, in which Scammoniate Medicaments are very hurtful. Yea verily, and Rhubarb itself, although a gentle and most excellent Medicament, is by some suspected as not safe in very Choleric Fevers, because of its notable heating and drying faculty. Howbeit the hurtful faculty thereof may in great part be corrected, by infusing the same in Cooling Waters, and by mingling therewith a Decoction of Tamarinds and cooling Herbs; and by adding thereto Cassia, Syrup of Roses, Syrup of Cichory with Rhubarb, and such like. If the Fever do still continue, Purgation must be ever and anon repeated, using between whiles preparatives & digestives, till the whole seminary of evil humours be taken away. For otherwise, if we cease Purging before the Fever be perferctly abated and gone; the Patient will be in danger of a Relapse. Yet this Rule needs some restriction. For if after many Purgations, a lingering fever continues, which doth by little and little pine the Patients, and seem to cast them into a Consumption; it will be the best course to leave Purging, and seek to conquer the Fever only by Alteratives and Dier. For it sometimes falls out, when there is some evil disposition of the Bowels, causing a protraction of the Fever, that so long as Medicaments are given, so long the Disease continues, because that Nature is weakened. Which afterwards (Purgation being omitted) gathers strength, concocts the Cause of the Disease, and being concocted, expels the same. But if a lingering Fever arise from Obstructions, as is often seen in Children, frequent and very gentle Purging, which draws away the Humours by little and little, is wont to remove the Disease; especially if the Purgation be compounded with Rhubarb, which both opens obstructions, and strengthens the bowels. The Commendations whereof celebrated by Montanus in his tenth Counsel of Fevers, is worthy to be set down in this place. He setting down the Cure of a Boy that had a lingering Fever arising from Obstructions: Among other things, I shall commend (saith he) one which I have by long Experience found never to fail, viz. That he take every day the Infusion of Rhubarb in Endive Water. For I never knew Fever from Obstructions, which was not cured by this Medicament, provided it were constantly taken without weariness, or giving over. For I have sometimes seen most gross Humours impacted into the narrow passages of the Body, and such Obstructions, as by reason of the weakness of Natural heat could hardly be removed, cured by Rhubarb. My Course therefore hath been to take one pint of Endive Water, and therein to infuse a dram of Rhubarb tied in a thin piece of Linen. Of which Infusion, having lightly pressed out the Rhubarb, I give four ounces in the morning; and this is the Dose for Children. Neither do I cease giging this Medicament, until I see the Fever and Obstructions wholly gone. For they will doubtless be cured, if all other things be rightly ordered, and suitable to the Cure. So far Montanus. But we are wont ordinarily to use a Diet Drink made with Rhubarb, which to such Children as are troubled with a lingering Fever and Obstructions, I am wont to give for their ordinary Drink with good success. It is thus made: Half a dram or a dram of Rhubarb (according as the Child can endure the taste thereof) grossly powdered and tied in a Rag, is infused in two or three pints of small Beer or Ale an whole day, cold: Of this the Child drinks for a month together, or longer if the stubbornness of the Disease require the same. Whereunto, if the Fever be very remiss, and the Child phlegmatic, a little Wine, or stronger Beer or Ale may sometimes be added, to qualify the unpleasing taste of the Rhubarb. After Purgation of the Morbific Matter, Nature is for the most part accustomed in the declination of the Disease, to purge away the relics of the Matter offending by Urine, which we may discern, because the Urines are then more thick, or more plentiful than ordinary; which endeavour of Nature must be assisted by Diuretic Medicaments which are most temperate, such as are Emulsions, and the Openers formerly set down in Juleps or Broths; whereunto, if the Fever be very gentle, some Roots of Fennel and Parsley, or Leaves of Wormwood, may be added, and that especially in Fevers of Phlegm, and continual Quotidians. But if Nature do expel the Relics of the Morbific Matter to the habit of the Body, Sudoroficks are to be used; not those hot ones, which are more properly called Sudoroficks; but others more temperate, which are the same in a manner with the Diuretics, and being of an attenuating faculty, do dispose the Humours in such sort, as Nature may more easily expel them by what place or way soever she is most inclined. Howbeit, to these may be added, Carduus Water, Spirit of Vitriol, and other things which shall be more fully described, when we shall treat of Malignant Fevers. Besides inward Medicaments, divers things are also outwardly applied, to temperate the Feverish heat, to confirm the strength of the principal parts, or to open the Pores of the Skin, and draw out the smoky Vapours, and Feverish Heat: viz. Epithems, Liniments, and other things to be applied unto the Region of the Heart, Liver, and other parts. Which are invented to mitigate the Heat, and are not to be applied save in the state or declination of the Disease, when the Heat diffuseth itself to the exterior parts; not in the beginning or augment, while it resides yet about the bowels; nor yet when the Crisis is at hand. An Epithem to be applied to the Region of the Heart may be thus compounded. Take the Waters of Bugloss, Sorrel, Water-lillies, Roses, of each three ounces: Vinegar of Roses, or juice of Lemmons one ounce: the Powders of Diamargaritum frigidum, and Triasantalon; of each one dram: Camphire and Saffron, of each five grains: mix all. Make hereof an Epithem to applied warm with Scarlet Cloth. For the more strengthening, and to make it smell the sweeter, ad three ounces of Orange flower Water, and one dram of Confectio Alkermes. Where we desire yet more potently to strengthen, solid Epithems are applied unto the Heart, made after this, or the like manner: Take Conserves of Bugloss and Roses, of each one ounce: Confectio Alkermes two drams: Powder of Diamargaritum frigidum one dram and an half. With Juice of Lemons, or Rose Water, make a solid Epithem, to be applied after the liquid one aforesaid. Or one yet more Cordial, may in form of a Lineament, be thus made: Take Confectio Alkermes, and de Hyacintho, of each three drams: Powder of Triasantalon, and Diamargaritum frigidum, of each two drams. With Water of Roses make all into the form of a Lineament or Ointment, wherewith smear the Be●ion of the Heart. Also to strengthen to and drive out the Sooty Vapours and the Feverish heat, young Pigeons are very good, being split through the Back bone, and applied to the Region of the Heart, which likewise are oftentimes sprinkled with cordial Powders as Diamargaritum frigidum and Triasantalon. Or before they be applied, the Region of the Heart is smeared with Confectio Alkermes and the cordial Lineament aforesaid. Also to the Liver, Epithems are wont to be applied, which are made commonly after this manner. Take Waters of endive, Cichory, Sorrel and Roses of each three ounces: Lettuce Water two ounces: Vinegar of Roses half an ounce: Powder of the Electuary Triasantalon one dram and an half: Spodium half a dram: Camphire ten grains: Make of all an Epithem. For to cool more powerfully, an Epithem may sometimes be made of Juices, after this manner. Take Juice of Cichory and Endive of each half a pound, Juice of Lettuce and Vinegar of Roses of each two ounces: Powder Triasantalon two drams: Mix all and make thereof an Epithem. Now it is very profitable to apply cooling Epithems not only to the Liver, but to the whole Region of the Hypochondriaes'; for they do not only further Coction, but also help the distemper of the bowels; and hinder the principal Parts from a deadly Consumption. The Region of the Liver may likewise be anointed with this following Ointment, which also may be applied to the Reins and Loins. Take Ointment of Roses one ounce and an half: Ceratum Santalinum one ounce: Juice of Endive one ounce and an half: Oil of Roses and Wax, as much as shall suffice, to make a Lineament. Whereunto add a little Vinegar of Roses, at the time of anointing. Also cooling things are profitably applied to the stones because of the great consent between them and the principal parts of the body; they therefore being cooled, the heat of the whole body is in great measure extinguished. To which purpose such an Epithem as this following may be made. Take Waters of waterlilly, Plantain, Roses, and Cichory of each three ounces. Vinegar of Roses one ounce and half. White wine two ounces. Mix all and dip a cloth therein cold, and warp the same about the Stones. Also the cooling of the hands and feet doth great good, because of the Consent they have with the whole body, by reason of the Arteries Veins and Nerves, which end in those parts. Neither need we fear lest it should hinder the avoidance of excrements by the pores, because they are few that come that way; so that there comes more good than hurt by the cooling of those parts. The Patients may therefore hold in their hands balls of marble, Ivory, Brafs or Lead. Or they may hold their hands in cold Water, with a little Wine and Vinegar mingled therewith. To the soles of their Feet may be applied the Leaves of Lettuce, of Water Lilly, wet in Water and Vinegar Or to wash both, Hands and Feet, the following Decoction may be provided. Take Leaves of Lettuce, Violets, House-Leek, Purslain; Vine Leaves, and Willow-Leaves of each one handful. Heads or Leaves of Poppy (if the Patient rest not) an handful: Vinegar one ounce: white Wine two ounces: Fountain Water as much as shall suffice. Make of all a Decoction. Hereunto may be added, if you please, a little Quantity of Lie, for to strengthen the Joints. Herewith let the Hands and Arms, the Legs and Thighs of the Patient be washed warm, twice in a day, or once at bed time. We are furthermore to note, that the Ancients frequently used baths of fresh Water to cure putrid Fevers, as we may see in Galen in his Book de Marcore. Cap. 7. and in the 11. of his Method Chap. 9 and 20. and in his 1. to Glauco Chap. 9 and those baths were either cold in a vehement Fever such as is an exquisite burning Fever; or Blood warm in the declination of Fevers when the signs of Concoction appeared. But in this Age of ours, these kind of baths cannot be used, without danger, and they are convenient only in one Case; viz. when the Fevers become very lasting and possessing a body hot and dry and lean, seems likely to turn to an Hectic. And onething yet more I shall add for a Conclusion of all, that if the Fever terminate with some Crisis, the relics of the Morbific matter, must be taken away with a Purge; especially if the Crisis were by way of Sweat or bleeding. For by those Evacuations only the thinner portion of the matter is voided forth, but the thicker being left behind, as afresh inflamed and brings the Patient into a Relapse. Only therefore that Critical Evacuation which is wont to proceed by way of Stool, is secure from a Relapse. Yet must we not so confide therein as to abstain usually from all Purgation. For the Parts about the Midriff are yet foul, and do corrupt the nutriment which comes into those Quarters, from whence proceeds either a relapse into the former, or some new Disease. Therefore it is for the best way (as some latter Physicians have observed) by repeating once and again a gentle Purge, so to cleanse away all the remainders of the morbific Cause, that all fear of a Relapse and all occasion of another Disease may be taken away. Chap. 2. Of the Symptoms which accompany Putrid Fevers. ALL Authors in a manner who have writ of Fevers, have described those Symptoms which either accompany or follow upon them, with their Cures at the end of their work, that so they might be best accommodated to all kinds of Fevers. Which Counsel of their though I shall not disallow, yet I have thought it much more commodious for the service of Practitioners, to Join them immediately after the Doctrine of putrid Fevers, seeing in those kind of Fevers they are wont to be most vehement and frequent, and require peculiar Remedies. So that although very many Symptoms are wont to be Cured by the Remedies aforesaid, accommodated to the Cause and the Disease: yet very many there are more offensive than the Disease itself, which are here briefly to be described. Headache, Want of Sleep and Rave, are Cured in a manner with the self same remedies viz. Revelers, repellers, derivers, resolvers and anodynes. Revelers are emollient Clysters and such as are Laxative, Gentle Purgations, Blood-letting, Cupping-Glasses, and washing the Feet. Repellers are frontals, Vinegars, Roses, Unguents. Or Liniments; Derivers are opening of the forehead Vein, and Vesicatories. resolver's are certain Oils, and certain Live Creatures applied to the Head, which likewise are anodynes. And while the foresaid Remedies are used, Juleps are given and Emulsions, to temper and qualify hot and sharp Humours. After all these come narcotick Medicines, which are not to be used, but upon extreme necessity when other things will do no good. The matter of all which Medicaments, is set down in our Chapters of the Frenzy and Headache proceeding from an hot Cause. But in the administration of the said Medicaments, one thing must be diligently noted, that they be not to be used, when the Crisis of the Fever is near: for they would then disturb the motion of Nature and hinder the Crisis. Which is to be understood as of all the rest, so more especially of the narcoticks. Against want of sleep and Rave, a Cataplasm laid to the Sols of the Feet will be very good, being made of fresh gourds beaten, the Leaves of the larger HouseLeek, of Lettuce and such like. As also to wash the Feet with a Decoction of refrigerating Herbs. For by this means the Coldness is communicated through the Nerves unto the Brain. Convulsions in Fevers, especially Malignant ones, do sometimes happen, by reason of Malignant Vapours which vex and fret the Skins which cover the Brain called meanings. Against which convulsion fits we must use revelling Clysters and Cupping-Glasses; also often give in Juleps or broths Epileptic Powders and finally anoint the Patient's Backbone with Oil of Chamomel, Violets, Sweet Almonds and of the Jndian Nut. When profound sleep happens to such as are in Fevers the same Remedies are given which have been described in the Cure of sleepy Diseases, only observing this one thing; that we give no very hot Medicine inward. The thirst of Persons Feverish is chiefly allayed with refrigerating and moistening drinks. But if thirst be so Violent that moderate drinking cannot assuage it (and to drink over much doth much hurt and oft times endangers the Patient's Life) we must by other means deceive and assuage the same. First therefore, let the Patients draw in the cold Air, and abide in Silence not speaking a word, let them keep their mouths close and breath through their Nostrils, and give themselves to sleep. Let them wash their mouths with Barley Water Bloodwarm, or with Water wherein hath been boiled Jujubees, Sebestens, Prunes, Lettuce, Purslain and such like. Let them hold in their Mouths a piece of Liquoris Scraped and steeped in Vinegar and Water, or let them wash their Mouths with Barley Water either simple or with a little Vinegar in it, or a little Juice of Lemons, Pomegranates, or a little spirit of Vitriol. Or let them hold in their mouths the Kernels of Pomegranates, or a Slice of a Citron, or a Lemon, or an Orange, Steeped in Rose-Water with Sugar; or Stalks of Lettuce, Endive, or Purslain; Leaves of Sorrel, Bits of a Gourd, Cowcumber or Melon first Steeped in cold Water; Or Acid Cherries, or red Currence, or Resberries, or Tamarinds, or a piece of Crystal, or the Stones of sharp Prunes upon which a little of the Pap Hangs, and such like. Also Sugar Dissolved in Rose-Water with a little spirit of Vitriol, and dried again, is very good to quench thirst. If thirst cannot be taken away with these lighter things they must be permitted to drink, not in the beginnings of the Exacerbations, or fits nor in the Augment, but very spareingly, but in the Vigour and especially when it is towards declining: for then large allowance of drink doth carry the heat outwards, and sometimes moves sweat; especially in the fits of Agues, in the declination of which, it is many times good for the Patient to drink unto satiety. Several Materials convenient to make Drinks in these kind of Fevers, are set down in the foregoing Chapter. But if thirst be caused by a Choleric Humour contained in the Stomach, the said Humour must be voided by Vomit or Stool. Vomit may be procured, if the Patient be Stomach-sick, with an ounce and an half of Syrup of Vinegar Simple, with five ounces of Barley Water, or of the Decoction of Rhadishes. If that will not do, purge the Patient with a Bolus of one ounce of the pulp of Cassia, and three drams of the pulp of Tamarinds, or with two ounces of Manna, dissolved in a Decoction of Prunes or Tamarinds; or the following Potion may be given. Take Cassia new drawn six drams: Mucilage of the seeds of Flea-bane half an ounce: the Decoction of Barley, Prunes, and Tamarinds, four ounces: Syrup of Roses one ounce. Mix all into a Potion. The Heat, Dryness, and Roughness of the Tongue and Throat, is cured by divers Remedies, apapplied to those parts, and contained in the mouth, compounded after this manner: Take of the Mucilage▪ of Quince seeds one ounce: the seeds of Mallows half an ounce: Powder of Diatragacanthum frigidum, and Sugar Candy, of each one dram: white Sugar, as much as shall suffice. Make of all a Lohoch. Or, Take of the Mucilage of Fleabane seeds, or Quince seeds extracted with Rose Water, or Lettuce Water half an ounce: Syrup of Violets, Lemons, or Pomegranates, an ounce and an half: mix them. Let the Patients take now and then a little, and bold it in their mouths. Or, Take cucumber seeds half an ounce: Quince seeds two drams: Gum Tragacanth one dram and an half: Beat the seeds and dissolve the Gums in the white of an Egg. Mix all, and make thereof little Cakes, for the Patients to hold in their mouths. Or, Take Seeds of Fleabane, and of Quinces, of each one dram and an half: Gum Tragacanth half a dram: Sugar Candy three drams. With Mucilage of Gum Tragacanth make all into little Cakes. Or with a thin Rag make Nodules, which shall be steeped in Rose Water, and held in the Patient's Mouth. If the roughness be very hard to remove, make a Gargarism of the Decoction of Barley, Roots of Marsh-mallows, Leaves of Lettuce, Purslain, Violet flowers, adding thereto Honey of Roses, Syrup of Violets, or Sugar Candy, or Oxymel simple, and such like. If filth cleaves to the Tongue, as it most times happens, it must be oftentimes wiped with a rough Cloth dipped in a mixture of Water and Vinegar. Whereunto also sometimes may be added, the Juice of Housleek, and Sal prunella. If the Heat be more vehement, with great blackness of the Tongue, more refrigerating Medicines must be mixed with the moistening ones, after this manner: Take Juice of Lettuce, Housleek, and Lemons, of each an ounce: Mucilage of Quince seeds and Sugar Candy, of each half an ounce: white Sugar as much as shall suffice. Make all into a Lohoch. Or, Take Green Housleek one handful: Vinegar of Roses three ounces: Barley Water one pint: Boyl all till the third part be wasted away. In the strained Liquor dissolve of Sal prunella one dram and an half: Alum a scruple: Syrup of Violets and Mulberries, of each one ounce: Make of all a Gargarism. Or Sal prunella alone may be dissolved in Housleek Water, and the Tongue and Throat washed therewith, which is very good; also some Portion thereof may be swallowed to cool the mouth of the Stomach, when it is likewise inflamed. Also outwardly; let the Neck and Throat be anointed with Oil of Violets, and fresh butter, washed in Rose Water, with which the Throat being as it were scorched and parched, may be moistened. For Cooling, the Ointment of Roses, and Galens cooling Ointment may be used, with others of like Nature. But the Leaves of Lettuce and Purslain being bruised and enclosed between two Linen , and so applied to the Neck and Throat, are much more effectual. Also those kind of Bugs which we call Sows, may be bruised and laid on in the same manner. In great Heat of the Breast, such as is wont to happen in Fevers, the whole Breast must be anointed with Oil of Violets, Water-lillies, and of sweet Almonds. Yea, and if the Heat be very vehement, Fomentations ought to be applied to the said part made of a Decoction of French barley, Lettuce, Water-lilies, borage, Violets, and such like; after which, irrigations ought to be used of the Oils aforesaid. Seeing that, according to the Prescript of Galen and Avicenna, in such like Fevers, great care is to be had of the breast, as of the Furnace of Heat. Now these kind of Remedies, according to the Rule of Trallianus, are seldom to be cold, because they drive the Heat inward; nor lukewarm, because they relax; but such things ought to be applied to the breast, as are actually hot, and potentially cold. Pain in the Loins is caused in Fevers by hot and plentiful blood boiling and working in the Vena Cava, and it must be eased by Emollient Clysters and Cooling, and Emulsions made of the Cold Seeds, adding Sal Prunella; and by anointing the Loins with Galens Cooling Ointment, with Juice of the larger Housleek, and Camphire, or Vnguentum Populeon, or Oil of Roses, Lilies, and Poppies; or with an Epithem made of Plantain Water, Rose Water, Vinegar of Roses, and Camphire; or with a Mixture of Rose Water, Oil of Roses, and Vinegar: all which are to be applied actually cold in the Summer, and a little less than bloodwarm at other Seasons of the Year. Disquietness, and tumblings, and toss, which are wont to happen in the Fever Assodes, and in the Fits of a Tertian Ague, are best cured by purging away the Choleric Humour which vexes and frets upon the Stomach, and other sensible parts, and that by Vomit or Stool, according as Nature seems more or less to affect the one or other way; also it may be drawn downwards by Clysters, and presently all Art is to be used to make the Patiented rest, and cold Drink is given, as also cooling Juleps, whereunto sometimes Syrup of Poppies, or a little Laudanum may profitably be added. Swooning Fits are wont to happen in those kind of Fevers which are commonly called Febres Syncopales, or Swooning Fevers, of which there are two kinds, as was said before; and the one is called Minuta, the other Humorosa. The Cure of which Fevers, much differing from the Cure of other Putrid Fevers, we have reserved unto this place, in regard of the said Symptom of Swooning. The Minuta Syncopalis, which is bred of Choleric Humours, sharp and venomous, must be cured after this manner. Let the Air be cold and moist, and a little astringent, that dissipation of the substance of the Body, may be thereby prevented. Let the Patients Diet be thin, cooling, and restorative, of the Broth of Chickens boiled with Sorrel, Purslain, etc. To which may be added, Rose-water, Juice of Pomegranates, and a little Sugar. Bread steeped in the Juice of Pomegranates, or of Oranges may be given, if a more liberal Diet is to be granted, as also Cream of Barley, or Panadas with Juice of Lemons or Pomegranates. Also Restorative Broths of pressed Flesh with the foresaid Juices. To the stronger sort are given the Yolks of Eggs with Juice of sour Grapes, the Stones of Cocks, the Flesh of Pullet's, Hens, Partridges, qualified with the aforesaid Juices. Let the Patients drink with their Meat, if they have no Inflammation of any bowel, thin Wine not very old, nor yet new and windy; or Beer that is indifferent strong, not new, or very stolen. When they eat not, or otherwise if there be Inflammation, let their Drink be Barley Water, or Water in which a piece of a Loaf hath been boiled, with Syrup of Pomegranates, Lemons, Citrons, Julep of Roses, etc. Sleep is good out of the Paroxysm, but in the same it hurts. And finally, special Care must be taken that nothing provoke the Patient to Anger, Sadness, and the like Passions. In the Paroxysm, Resolution of the Spirits must be prevented by blowing cool Air with Fans upon the Patients, and by sprinkling them with sweet smelling Waters. Their Face must be sprinkled with cold Water, or Water of Roses, and Vinegar minled. With which the Stones of Men, and the Dugs of Women must be bathed cold. If Heat and Spirits will not be revoked from the Heart to the outward Parts of the Body, it is to be reveled and forced back by binding of the extreme Parts, and by nipping and pinching them; also pluck the Patients often by the Nose, pluck them by their Hair, and call upon them often by their Christian Name. Give of the Crum of White-bread steeped in the Juice of Pomegranates, of thin fragrant Wine, tempered with Rose-Water; and when necessity urges, some Cinnamon Water mingled with Rose Water. In the mean space, Restorative Broths are not to be omitted, wherewith Confectio Alkermes, and such like may be mingled. Also Cordial Potions are often to be given out of a Spoon, made after this manner: Take Water of Roses two ounces: Orange flower Water one ounce: Cinnamon Water half an ounce: Confectio Alkermes one dram: Pearls prepared, and Coral prepared, of each half a scruple: Sugar Cakes made with Pearl six drams: Mix all, and make thereof a Julep, or Cordial Potion. To these may be added the Electuaries, and Conserves, and Preserves, described in the foregoing Chapter. Also the inner side of a Loaf hot out of the Oven sprinkled with Rose water and Vinegar, may be applied to the Patient's Nostrils, and Mouth. To the Heart, Cooling and strengthening Epithems may be applied. To straiten the Pores, and prevent the Evaporation of the Patient's strength and Spirits, wrap them in Linen sprinkled with Powder of Roses, Balaustians, and ; or let their shifts be sprinkled with Rose water, and a little Vinegar. Let their whole Body, especially the Back be anointed with this following Lineament. Take Oil made of unripe Olives, one ounce and an half: Myrtles, Quinces, and Mucilage of▪ Seeds of Flea-bane, of each six drams: Gum Arabic dissolved in Rose-Water two drams, white Wax as much as shall suffice make all into a Lineament. A special regard is to be had of the stomach, because the Humour offending is chiefly there collected. Now the region there of must be anointed with Oil of Roses and Quinces: and then also may be laid on a Toast of Bread, wet in Juice of Quinces and unripe Pomegranates. Or if it be afflicted with great heat, foment the stomach bloodwarm, with a Decoction of Purslain and Roses, o● with Juice of Nightshade, Purslain, Sowr-Grapes adding thereto Oil of Roses and Quinces. The Swooning Fits being removed and the Patient strengthened, we must bend our minds to remove the Fever and its Cause. Which may be done, by Alteratives and Evacuators proper for turning Fevers, which we have described in their proper place: viz. Where the Cure of burning Fevers is set down. The Cure of the second sort of Swooning Fevers, which is called Febris Syncopolis Humorosa, which is caused by abundance of Phlegmatic and crude Humours, is in a manner contrary to the Cure of the Minuta newly described. For the Air ought to be temperate, inclining to heat, light, pure and dry. Meats, of good Juice easily digested, prepared with Hyssop, Fennel and such like Herbs. Let their drink be thin and not very strong. Let their sleep and Watch be Moderate. But Frictions or artificial Rubbing of the Body, and by Galen much extolled in this Case. In the 12. Method Cap. 3. They must be used from the beginning of the Disease, with Course , beginning above and so Rubbing downwards; first on the Thighs and Legs; afterwards on the Arms, shoulders and Back. Let the with which the Frictions are performed be first Smoked with Storax, Lignum Aloes, Frank-Incense Cloves etc. When after friction the Limbs are lustily warm, anoint them with Oil of Dil, of Chamomel, of Orice, of Castus and others of a resolving Faculty. Such Frictions as these are highly commended, because they call the natural Heat and spirits together with the Humour offending which did Choke the natural strength, into the outward Parts. In the fit the Sick-party must be roused, by pulling the Nose, Rubbing the Ears, plucking off of Hairs, Loud calling etc. Also sweet Smelling things must be Applied to the Mouth and Nostrils; as Cinnamon and Orange flower Water, Vinegar wherein Cloves have been steeped, inside of a white Loaf dipped in Hippocras alone, or Cinnamon Water, or the following cordial Water. Take Waters of Bawm, Rosemary and Orange flowers of each one ounce; Cinnamon Water half an Ounce: Confectio Alkermes one dram: Syrup of preserved Citron Peels and of Gillyflowers of each one ounce: Mix all into a potion or Julep, which the Patient must often take of, by a Spoonful at a time. Also Electuaries may be made after this manner. Take Conserve of flowers of Bugloss, Rosemary, and of Citron Peels preserved, of each half an ounce: preserved Nutmeg three drams: Consectio Alkermes two drams: Species of Diambra and Diamoschum dulce of each one scruple: With the Syrup of preserved Citron Peels, make all into an Electuary. Unto the Heart Epithems may be applied and young Pigeons to the stomach and Stones; Fomentations may be applied, and other things administered, which have been propounded in case of decay of strength. While these things are in doing, frictions must ever and anon repeated, which must in this Disease never be omitted. When the Patient hath a little gathered strength, the Morbific Matter is to be drawn out by Clysters and Purgations (in which Hiera cum Agarico, in regard of the stomach, is very profitable) which ought to be gentle and frequent, yet so as fitting Preparatives be administered between Purge and Purge. Want of Appetite is common in a Manner to all Fevers: for when the stomach is inflamed, thirst is increased, but Appetite of eating diminished. Yet sometimes Appetite is so dejected that the Patients can hardly sup a little broth. Which Loathing of Meat is caused by Vicious Humours collected in the stomach or soaked into the coats thereof; or of corrupt and Malignant Vapours which infest the stomach. It ought to be Cured by Evacuation of the Morbific Matter by Vomit or Stool, and first with an infusion of Rhubarb and Tamarinds. But in the declination, if the Fever be not strong, with Hiera Picra dissolved in a Decoction of Barley, Vetches, Wormwood and other detergent things. Afterwards we must use Clysters, which occasionally do revel from the stomach. Also acid and refrigerating things are frequently to be given, as Syrup of lemons, Pomegranates, some Cherries &c. given alone or with cold Water. In the declination or when the Fever ceases, Syrup of Roman Wormwood may pofitably be given, either alone or mixed with acid Juices or Syrups. Let Meats that are grateful be presented to the sick. For as Hypocrates teaches in Aphor. 38. Sect. 2. The Pleasanter Meat and drink, though somewhat the Worse, is to be preferred before that which is bitter and not so pleasant. Also let them eat but little and seldom, for much and frequent eating causes Want of Appetite even in those which are well. And let their Meats be sauced (provided they have no cough) with Juice of unripe Grapes, Vinegar of Roses and Juice of Lemmons. If the sick do so abhorer all Meats that they can take nothing at all, let them have nourishing Clysters given them twice or thrice in a day; the excrements being first avoided by a cleansing Clyster. When the Fever is wholly allayed and gone, if want of Appetite do remain, let the sick person Moderately excercise, and use Capers, Saxifrage, Olives; let him change place and go into a colder Air. And finally if these helps suffice not let the Patiented use Wormwood Wine and pills of Hiera Picra, which do powerfully cleanse away such Humours as are fast sticking in the Coats of the stomach. Hiccupings and Vomiting which betid persons in Fevers are opposed by divers Medicaments, the materials whereof are to be sought for in our cures of those Infirmities of Vomiting & Hiconping & to be Judicially accommodated to such persons as in Fevers are troubled with those Symptoms. But special care is to be taken that a critical Vomiting be by no Means stopped. Hiccoughing sometimes proceeds from immoderate use of refrigerating things, as Lemnius witnesses, whose words Schenkius doth thus relate. Hiccoughing in Fevers doth sometimes follow over abundant use of Refrigerating Juleps; and I have seen many so affected by the unadvised Rashness of Physicians, which Symptom contrary to the expectation of all Men, I Cured by giving the Patiented Wine to drink. A Looseness befalling one that hath a putrid Fever, if it be critical (that is proceeding from the Conquest of Nature over the Morbific Matter and tending to expel the whole or Part thereof) it must not be stopped; neither must a Symptomatick Looseness be presently stopped, at the very first, if it do not very much weaken the Patient, lest the Vicious Humour do flow back again to some principal Parts. When it is seasonable to stop it, it must be done with a gentle astringent Purge, with cleansing and Corroborating Clysters; by Medicines taken in and outwardly Applied, which do thicken, strengthen and bind. All which may be taken out of our Cure of a Diarrhoea or Looseness: beginning with the gentler and proceeding if need be to the more strong by Degrees. Sweats if they be not Critical (that is caused by Nature expelling the Humour offensive) but Symptomatical [that is, caused by the vehemency of that Disease dissolving the Body, and hunting the Humours through the Skin] and doth very much weaken the Patient, they must be suppressed by cooling the Air, with sprinkling cold Water and the leaves of the Willow and Vine-tree upon the pavement; and if need be by opening the Windows; the Body being cooled and ayred by little and little, the being light upon the Patient, and a Flock-bed being put instead of a Featherbed: also by often sprinkling the Patient's Face with Water and Vinegar mingled together, and finally by the use of cooling Astringent Medicaments; such as are cooling Epithemes applied to the Heart, Liver, and whole Belly, and often changed. Ointments made of Oil of Roses, of Myrtles, of Mucilages, and Astringent Powders, are to be anointed upon the whole Body; but especially upon the backbone. Powders of Roses, Balaustians, Pomegranate rinds, Myrtle, Mastich, Terra Samia &c Must be sprinkled upon the Neck, Throat, under the Armpits, and in the Groins. Or let the Patient be wrapped in a Linen Cloth, sprinkled with a mixture of Vinegar and Water, and the aforesaid powders strewed thereon; being in the mean time careful that no Inflammation, or Tumour be in the parts about the short Ribs: for than we must abstain from Astringent things, at least such as are strong. The Sweat must not be wiped off, but suffered to dry about the Pores of the Skin, so to stop them that more may not follow. Also we must give in at the Mouth, Medicaments that thicken and strengthen, as Barley Water boiled with Lettuce and cooling Seeds; Restorative Broths, with Juice of Pomegranates, sour Grapes, Powders of Corals, Pearls, shave of Ivory, Sanders, or Baulaustians. Juleps of the Waters of Roses, Lettuce, Purslain, with Syrup of Pomegranates, dried Roses, or Quinces. Conserved Electuaries, of Conserve of Roses, Corals, Pearls, Terra Sigillata, powders of Diamargaritum frigidum, and such like. AN APPENDIX. In the Cure of most acute and pernicious Fevers, one thing is diligently to be noted that such Fevers seldom happen without some inward and peculiar disorder and commonly Inflammations of some of the inward Bowels as Liver, Spleen etc. So that we must evermore be careful of the Parts under the short Ribs, of the Head, the Breast, the Womb; Reins and Bladder: that by all means possible we may hunt out, which of those is much out of order, and as much as may be restore the same to its Natural Constitution. Chap. 3. Of a Tertian Ague. AN Ague, or Intermittent Tertian Fever, is caused by an Excrementitious Choleric Humour, contained in the first Region of the Body, and there putrefying. A Tertian Ague is either Legitimate and Exquisite, or Illegitimate and bastard. A Legitimate or Exquisite Tertian Ague, is terminated in twelve hours, and is caused by the putrefaction of Natural Choler. But a bastard Tertian hath fits that last above twelve hours. But if it exceed twenty four hours, it is termed Tertiana extensa, a stretched Tertian. And it is caused either by Preternatural Choler putrefying, or by Natural Choler mingled with other Humours, especially with phlegm. Also Tertian Agues are Simple, or Double, or Triple. A Simple Tertian, is that whose Fits come every other day. A Double Tertian is that whose Fits come every day. And although herein it differ not from a Quotidian or every day Ague, yet they are known one from the other by their proper Signs, showing the abundance of Phlegm or Choler in the Patient; of which Signs in their place. Sometimes notwithstanding in a double Tertian there are two fits in one day, the other day remaining free; and this some latter Physicians do call two Tertians, and make it to differ from a double Tertian. Which Distinction notwithstanding is of small moment. A Triple Tertian is when there are three fits in the compass of two days. This is a most rare and seldom seen sort of Fevers. Yet Galen propounds one single Example thereof, and I saw another in the year 1637. in a certain Gentleman, who once in sixteen hours had a fit of a Tertian Ague. And all the fits did every one of them terminate in the space of ten or twelve hours, by sweat. Now these divers Paroxysms are made by a different matter putresying in different places, so that each one hath as it were its peculiar Chimney where it is first kindled. Now the Humours causing Tertian Agues, are collected chief in the first Region of the Body, viz. In the Liver, the bladder of Gall, the Stomach, the Mesentery, the Pancreas, or in the Veins of those Parts. Their Causes, are all such things which engender Excrementitious Choler, viz. An hot and dry distemper of the Spleen, youthful Age, Hot Constitution of the Air, Watch, Cares, Anger, Fast, use of hot Meats, over much Exercise. To these are added, for the breeding a bastard Tertian, such Causes as engender Phlegm and Melancholy. Hereupon, such as have hot Livers, and by Glutinous and bad Diet, do breed many Crudities, are subject to bastard Tertians, by reason of the mixture of Choler with crude Humours. And hence also it is, that in Summer time, crude Humours bred through weakness of the Natural Heat, by eating of Fruits, and over much drinking, being mixed with Choler, do breed bastard Tertians. The Signs to know an Exquisite Tertian by, are these: That this Fever always gins with great shaking Fits, whereas in a Quotidian Fever or Ague, there is only a light shivering or coldness. After the cold shaking Fit, follows great Heat, sharp and biting, Intolerable Thirst, great and frequent breathing, want of Sleep, Headache, and sometimes Rave. After the shaking fit, sometimes there follows a vomiting of Choleric Humours, or a purging by Stool. The Urine is sometimes Yellow, Yellowish-Red, or Red. The Fits last not above twelve hours, and they are terminated by Sweat. Also the Causes forecited, breeding Choler, have preceded. In a bastard Tertian, all the foregoing Signs are more remiss than they are in an Exquisite one, but more intense than in a Quotidian Ague. And according as there is more or less phlegm mingled with the Choler, the Fits come nearer to those of an Exquisite Tertian, or of a Quotidian; but in respect of the vehemency of the Symptoms, and the length of the Fit itself. So that the Paroxysms of a bastard Tertian may be lengthened out to sixteen, eighteen, or more hours. Although they may be sometimes shorter, because of the paucity of the Matter, and be terminated within the space of eight, ten, or twelve hours. The Prognostic of this Disease, is taken out of Hypocrates, in Sect. 4. Aph. 59 Exquisite or exact Tertian Agues last but for seven fits at most. And in Aphor. 43. of the same Section, All Intermitting Fevers are void of danger. Which is to be understood only of such Tertians as are void of all malignity. For there are Malignant and Pestilent Tertians, which though they have evident Intermissions; yet do they often kill the Patients. Furthermore, many things fall upon the Neck of a Tertian, which may breed danger, although the Fever of itself be not dangerous. Haly writes, and common Experience shows, That if such as are sick of a Tertian Ague, have Ulcers, Scabs, or Pustles breaking out in their Lips, it is a token the Ague will leave them. For it is a kind of Critical Evacuation in those parts. A Looseness befalling one that hath a Tertian Ague, the matter being digested, ends the Disease. And this is the way by which alone Nature doth perfectly expel the Cause of these Fevers. For seeing the Original Cause of these Fevers is contained in the Gallbladder, or the Liver, or the Mesentery, and other Parts in the first Region of the Body; although that which steams and vapours therefrom in every fit, do get into the habit of the Body, and is purged away, either by Sweats, or by insensible Transpiration, or by Pushes and Pimples; yet the gross parts and settle of the Humour abiding in their place, which unless by the benefit of Nature, or Medicaments it be purged away by stool, it is wont to be the Cause either of a long Ague, or of Obstructions, or of a Relapse, or of other stubborn Diseases. Agues are wont to be of small durance and little danger, if the habit of the whole Body be good, if the bowels be well affected, if it be Spring or Summer, if the Patient eat little, and drink sparingly. And contrary wise, they are wont to be long and more rebellious, if there be an evil disposition of the Liver or Spleen if the Patient abound with phlegmatic Humours or Melanchollick, if the Winter or Autumn be in their full force, if the Patients do eat much, or by much drinking do oppress their Natural Heat. The Cure, as in other Fevers, is to be directed to the Fever, its Cause, and strength of the Patient. The Fever calls for Coolers; the Cause requires Coolers likewise, and withal such things as digest and purge the Humour offending; the Patient's strength calls for things that corroborate and vigorate the same. And in the first place, A Cooling Diet must be appointed, and which moistens; it must be the very same in an exquisite Tertian, which we before prescribed in our Cure of Continual Fevers. But in a bastard and single Tertian, a fuller Diet somewhat, is to be enjoined, especially if the Disease prove to be long; for then solid Meats are to be given on the welday, and five or six hours before the fit. But in a double Tertian, as in an exquisite Tertian, the Sick must be nourished only with broth, and other supping things. This is a most pleasant Drink out of Forestus, for those which have a third day Ague. Take Fountain Water two pints: Cinnamon half an ounce: Sugar three ounces: Let all be strained cold and raw, through an Hippocras Bag. The Patient must not eat when the Fit is coming, according to that saying of Hypocrates, in Aphor. 11. Sect. 1. For Nature (as Galen shows in his Commentary on that place) by Concocting of newly eaten Meat, is called away from Concoction of the Morbific Humours. Add hereunto, That in the fit of an Ague, the whole body is filled with a filthy vapour, which doth mar, and for the most part corrupt that meat which is eaten near the fit. But if the fit prove so long, or the Patient's body so hot and dry, so lean and thinly woven together, with wide pores, that it is soon dissolved and dissipated, and cannot hold out to the end of the fit; the Patient in such a case may be allowed to eat in the fit, and it will be better to eat when the fit is in the state or height, than at any other time. Howbeit, in the beginning also, and in the augmentation, necessity compelling, Meat may be given. For so Galen in the tenth of his Method, Chap. 5. was compelled to give Meat even in the beginning of the fits, unto such as had this kind of Ague, being of a hot and dry temperature, unto whom fasting is extremely hurtful, lest they should fall into swooning fits. And in imitation of him, Amatus Lusitanus in the 68 Cure, of the fourth Century, to one that was full of, and vomited pure Choler, and by that means fell into swooning fits, he gave bread dipped in water, and sprinkled with Juice of sown Grapes in the beginning of the Ague fit; by which means he hindered the aforesaid Symptoms. There is one thing yet further to be observed both in this, and all other Agues, That the Patient do neither eat, drink, nor sleep, before the fit. But it will be good that the Patient go to stool, by means of a Clyster, provided the same be administered before the beginning of the fit. Having therefore ordered a convenient Diet, we must forth with proceed to evacuate the Morbific Matter, which seeing it sticks in the first Passages, it must be voided not only by Clyster, but by Purges and Vomitories. Clysters in an exquisite Tertian, must be made of an Emollient and Cooling Decoction, with Cassia, Catholicum, Diaprunum simple, and purgative. But in a bastard Tertian, let the Decoction be of Emollient and Cutting simples, dissolving therein Diaphoenicon, Honey of Roses, etc. Purgative Medicaments in an exquisite Tertian, must be the same which have been propounded in continual Fevers. But in a bastard Tertian, there must be added Agarick, Senna, Catholicum, Diaphoenicon, and others, such as the Judicious Physician shall conceive most suitable to the constitution of the sick. And in every sort of Agues, Cream of Tartar may profitably be added to the Medicaments, because it opens Obstructions, is potently cleansing, and yet cools withal. Purging Medicines are to be given on the day of Intermission, and that in the morning, as commonly is used; if the time of Intermission fall within those hours: if not, the middle space between the two fits must be chosen. And at any hour of the day or night, we may give a Purge, provided it be far from the Fit, and the Stomach have digested what was last eaten. But in a double Tertian, 'tis an hard matter to choose a convenient time to give a Purge, because many times, not above three or four hours do fall between two fits. Yea, And sometimes the fits are so long, that the one gins before the other be ended, which makes them be called Febres Subintrantes, encroaching or intruding Fevers. For then the speediness of the occasion or opportune time, requires the uttermost diligence of the Physician. Now the more commodious hour of giving the Medicine, is thus to be chosen. In a double Tertian not encroaching, the Medicament must be given in the end of the Fit, at such a distance from the following Fit, that the working of the Physic may be over ere the other Fit come. But in an encroaching Ague, when the latter Fit interfers with the former, the Medicament must be given in the beginning of the declination, as soon as it gins never so little to remit. And in both Cases the Patient must drink Broth, three hours after the Medicament is taken; yet so, as that there must be remaining three hours from the Broth-taking before the next Fit begin. So that the Medicament, is to be given at least six hours before the next Fit. As for Vomits, What was said of them in the Cure of Continual Fevers, may be here very commodionsly applied; because the abundance of evil Humours contained in the Stomach, mesentery, and Cavity of the Liver, which is wont to cause these Fevers, is brought away by Vomit; which sometimes cannot be moved by purging Medicines given again and again, as Fernelius hath well observed. And therefore, If in the beginning of the Fit, the Patient be vexed with Vomitings, the Physician shall do well to follow that motion of Nature. And seeing the gentlest sorts of Vomits, will not ordinarily serve the turn, we must proceed to the middle sort, such as is especially Asarum, of the powder whereof, half adram, two scruples or one dram, is given in Broth, or some other convenient Liquor. Others give the Decoction thereof, which is made of three drams of Asarum Roots, boiled in Chicken Broth, or in Barley Broth made with Raisins. The Chemists do give white Vitriol prepared, and Salt of Vitriol, and also Aqua Benedicta, which is made of Crocus Metallorum. Which, as other Medicaments made of Antimony, as they do sometimes happily rid away such morbific Matter as is lodged in the first passages about the Stomach and mesentery, etc. So do they require a prudent and skilful Physician to administer them; otherwise they are like a sharp Knife in the hand of an Infant, or like a Sword in the hand of a Madman. The first passages of the Body, or first Region thereof, being purged, at least with one Purge, a Vein is to be opened in the Welday. Yea verily, And if the Patient be Plethoric, the Urins red and thick, the Cure is well begun by Blood-letting, for the Purge will afterwards work the better. If the Blood appear very Hot, Adust, or Putrid, Blood-letting must be repeated; which yet is left to the Judgement of the Physician, according as he finds the Patient's constitution. After Purgation and Phlebotomy, we must endeavour to prepare the Humours, by Juleps such as were set down in the Cure of Continual Fevers; the matter whereof must be varied, according as Phlegm or Melancholy is mingled with Choler, as was observed in the place aforesaid. In the mean time, whilst the Medicines aforesaid are making, the Feverish heat is to be allayed with cooling Epithems applied to the heart & Liver, such as were propounded in Continual Fevers, with this Caution, that they be never laid on, but in the height of the Hotfit, or rather when it first gins to abate. To the Liver also and the Loins, Ointment of Roses, or the cooling Ointment of Galen may be applied. Also Emollient and cooling Clysters, will be very good at the end of the Fit, as well as in the beginning. The matter being prepared certain days, by the use of Juleps, Purgation must be again used, with Senna, Rhubarb, Catholicum, Syrup of Roses; adding thereto Agarick, if Phlegm abound. And And if the Patient be strong; we may add Diaprunum Solutivum, Electuarium de Succo Rosarum, or Diaphaenicon. The Body being again purged, after the use of Juleps, if the Fits return and seem longer than they were before, it is a sign that gross Humours, and such as stick fast in the Body, do nourish the Fever, and breed Obstructions: In regard of which, cleansing, opening and cutting things are to be used The Principal of which is Wormwood, which is exceedingly commended by Galen. In his 1. Book ad Glauconem Chap. 9 and Century, which in regard of the rare virtues it has in curing Agues, is called Febrifuga, that is to say Ague-Queller. But because these Herbs are hot, they may be qualified by the Commixture of cooling things, after this manner. Take Roots of Grass, Cichory, Asparagus, of each one ounce: Leaves of Agrimony, Sorrel, Cicbory, Endive, of each one handful: vulgar Wormwood and Centaury, of each an handful: Boil all to a pint. In the strained Liquor dissolve three ounces of Syrup of Lemmons. Make all into a Julep for to be taken at three times in the morning. The Juleps being finished, a Purgation must be again administered or a Vomitory, if Nature affect to discharge herself that way. For then, the signs of Concoction appearing, these Fevers are sometimes happily Cured by Vomiting. And Galen in his first Book ad Glauconem Chap. 10. Writes that many are Cured of this kind of Ague only by a Vomit yea verily and daily experience shows, that Aqua Benedicta doth eradicate these Fevers or Agues for the most Part, unless some contumacious obstructions of the Bowels do hinder. Many Experiments hereof are propounded by Martinus Rulandus in the Centuries of his Cures. But, it is, as was said before, a vehement Medicament, and not to be given without extreme Caution. Some give an ounce of Aqua Benedicta with the Infusion of half an ounce of Senna, and so it works more by Stool than by Vomit. Others use Cambogia, others Mercurius Dulcis with Scammony. Which Medicaments, seeing they do potently Evacuate, do often Pluck these kind of Fevers away by the Roots, but they are to be given only to such as are strong of Constitution. To these Medicaments exquisite Tertians and Bastard ones too, are wont to give place. But if the Agues do yet stubbornly resist (as it ofttimes falls out) Solemn Purgation must be made with an Apozem to be taken three days, made of the Materials of the foresaid Juleps, adding thereto Senna, Rhubarb, Agarick, Syrup of Roses of Cichory with Rhubarb and such like. Yea verily and although the Ague be gone before the use of this Apozem, if a Voluntary Looseness do not befall the Patient. For the solution of an Ague by Sweat or insensible Transpiration, as not to be trusted unto, giveth suspicion of a Relapse; because by them the thinner Part only of the Humour is Evacuated, the thicker being left behind: which can no other ways be Evacuated, save by Stool. Before the Apozem aforesaid be used, if there be a Distension in the Parts under the short Ribs, let this following Emollient, attenuating and strengthening fomentation be applied. Take Roots of Marsh-Mallows, Grass and Asparagus, of each one ounce: Roots of Enula Campana and the middle Bark of Tamarisk of each half an ounce: Leaves of Mallows, Violets, Agrimony, Maidenhair and Wormwood, of each an handful: Lin-Seed and Faenugreek Seed, of each one ounce: Flowers of Chamomel, Melilot, Roses of each a pugil: Boyl all in three Parts of Water and one of white Wine, put in towards the conclusion, with two ounces of Vinegar: with this Decoction foment the Parts under the short Ribs Morning and Evening, for two days before the use of the Apozem. After Fomentation, anoint the said Parts with this following Ointment. Take Oil of Lilies, Sweet Almonds and Tamarisk of each one ounce: Ointment of Marsh-Mallows two ounces: and a little Wax. Make all into a Lineament. If after all these remedies, the stubborn Ague do yet lengthen the time and keep its ground; and the Patient's Face appear swollen, and palish, also their Liege swell towards night: they are to be plied with such Medicines as are commonly prescribed for obstructions of the Liver. Among the rest, Montanus doth very much commend the Decoction of Cichory and Germander in Broth; which he says is admirable in long Fevers that are caused by obstructions. Yet, it is to be noted; that the length of a Tertian Ague is some times caused by an hot and dry distemper of the Liver, perpetually produces a Choleric Humour, the Cause of new Fits. Which is often observed in many, which being of a dry and meager constitution of body and wholly Choleric, have had a Tertian Ague three or four months together, especially in the more hot season of the year, without any tension of their Bowels, or any abundance of Humours. To such as these, strong purgers, and strong aperitives or heaters do hurt. But such as these are to be plied with a cooling and moistening diet, with Juleps and Broths of the same Nature. And the superfluous Humours are to be Purged away by little and little with Emollient and Refrigerating Clysters, with Cassia, Tamarinds, Catholicon and Syrup of Roses. But in this case especially great miracles are performed by a bath of Bloodwarm Water, which doth extinguish the hot and dry distemper which is imprinted upon the Bowels. Let the Patient use these baths, on the Well-day, but without sweeting. Sometimes also the Length of Tertian Agues arises from the evil disposition of some of the Bowels, especially of the Liver and Melentery; which cannot be Cured by purgations though never so oft repeated, because that evil Quality remaining still in the Liver, causes new Morbific Matter daily to breed, which produces new Fits. Which evil Disposition or Quality of the Bowels, is taken away by Diuretics, Sudorosicks and other resolving Medicaments. With which faculties these following simples are endued viz. Wormwood, Centory, Carduu●, Roots of Dictamnus, of pimpernel, Tormentil etc. Of which are made Decoctions, Powders, and such like, which must be given for divers days together before the Fit. A dram of Venice Treacle is ordinarily given with white Wine, before the Fit, three times one after another. Some give a walnut preserved in Sugar or Honey after the same manner. When the Heat of Venice Treacle is feared, it is at first given by itself, and a draught of Plantain-Water is given after it. My Master Varandaeus did often use this as a Specific Medicine. A Cup of Hippocras given before the Fit will work the same effect, with which pleasant Medicine many have been Cured. Yet must it carefully be observed, that these remedies must not be given, till the Patient hath been diligently Purged. Zechius Frequently used these following Pills, which are most effectual for opening Obstructions, strengthening the Liver, and taking away the distempers of the Bowels. Take Treches of Rhubarb, of Eupatorium, and of Wormwood, of each half a dram: Powder of Diarrhodon Abbatis one scruple: with Syrup of Wormwood make a Mass of Pills. Of which let the Patient take one dram in the morning three days together, drinking after them a draught of Broth made with Cichory and Maidenhair. Montanus was wont to give many days together a scruple of Troches of Rhubarb or of Wormwood, with Broth in which Barley, Parseley Roots, Cichory and borage have Boiled. Let the Region of the Liver be anointed morning and evening before Meals, with a Lineament made of two ounces of Ceratum Santalinum, Juice of Cichory half an ounce: Juice of Wormwood two drams: and a little Vinegar of Roses. In l●ke manner let the Region of the stomach be anointed with this Lineament. Take Nard Oil, Oil of Wormwood and of Quinces of each half an ounce: Gallia Moschata one scruple: white Wax as much as shall be requisite. Make all into a Lineament. Besides the Medicaments hitherto propounded, which respect a regular and Methodical Cure; there are many other specific and Empirick Medicaments, both internal and external; both commended by Practitioners, and frequently used by the common People; out of the almost infinite number whereof I shall here set down such as are the choicest. And among these Medicines may be reckoned, such things as were before propounded, to amend the evil Quality of the Liver and Mesentery which is wont to make long Agues: whereunto, these things following may profitably be added. And in the first place, Spirit of Sulphur in a Legitimate Tertian, or one very near Legitimate, after bleeding and Purging, being given with Purslain Water in the vigour of the Fit, doth powerfully extinguish the heat of the Fever; and if the Humour be thin, drives the same out by sweat, that there remains no matter for a new Fit, and so is the Disease Sometimes plucked up by the Roots. It is given from half a scruple to a scruple, with four ounces of Purslain Water. And sometime the said spirit is mingled with Salt of Wormwood, which is also of great Efficacy in the Cure of Agues the Composition is thus. Take Salt of Wormwood half a dram: Spirit of Sulphur a scruple: Carduus Water four ounces: Mix them. Let the Patient take it when the Fit Approaches and he covered with many . Some Affirm that the Juice of Plantain Clarified and drunk to the Quantity of four ounces, an hour before the Fit, doth Cure a Tertian Ague. Some give it with Vinegar and Saffron after this manner Take of the Juice of Plantain four ounces: Vinegar of Roses half an ounce: Saffron three grains: Mix them and give the Patient to drink, two hours before the Fit. Manardus prefers a Decoction of Chamomel, or the distilled Water thereof, to the Quantity of four ounces, two hours before the Fit. A Medicine commonly used, and often successful, is, a little Potion made of Rose-Water, Plantain Water and Aqua Vita of each a spoonful; given before the Fit. These following are outwardly applied. Take Leaves of Hyssop and tansy cut small, of each a pugil; Myrrh two drams: Mace, Nutmegs, Cloves and Cinnamon, of each half a dram: Venice Turpentine and Juice of Tansey, of each one ounce: Mix all and spread them upon a Rose-Cake, fried in a frying Pan with Canary Wine, which being covered with a Linen Cloth must be applied hot to the Region of the stomach, an hour before the Fit. Or, Take Wormwood and Green Mint of each a pound: Crust of Bread toasted and steeped in Vinegar half a pound: pulp of Quinces, or Conserve of Quinces made with Honey two ounces: Mastich half an ounce: Mace and Nutmeg of each two drams: Let all be beaten and lustily wrought together, with Oil of Quinces. Make hereof a Cataplasm to be applied before the Fit. It provokes sweat and takes away the Pains of the stomach. Or, Take Nutmeg, Cloves, Cinnamon, of each three drams: Myrrh and Ginger of each two drams: Make all into a Powder; mix it with Liquid Pitch and make thereof a Plaster for the stomach. Also this following Cataplasm may profitably be applied to the Liver. Take white and Red of each one dram: Barley Meal two drams: Aloes half an ounce: Flowers of Violets and Roses dried of each one dram: With Juice of Wormwood and Vinegar make a Cataplasm, to be applied to the Region of the Liver one hour before the Fit. Neither are those Medicines wholly to be rejected which the common people are wont to apply unto the Wrists of such as have Agues. For not only the Opinion of People is hereby satisfied, who conceive that many are cured with these Remedies; but somewhat they may effect, by communicating their virtues unto the Heart by those notable Arteries which are situate in the Wrists. The chief of which kind of Medicines are these that follow. Take Leaves of Plantain, Celondine the great, of each one handful: Cobwebs, Nettle Seeds, Soot from the Chimney, and common Salt, of each one dram: the strongest Vinegar as much as shall suffice. Make of all a Cataplasm to be applied to the Wrists a little before the fit, and to be repeated fresh three or four times. Mousear beaten with Salt and Vinegar, is by some accounted of great efficacy, being applied to the Wrists before the fit. Of some, the smallest sort of Housleek or Mous-teat is commended, being used after the same manner. Others commend the Leaves of Shepheards-purse beaten with Salt and Vinegar. Platerus applies unto the Wrists the inner bark of the Nut-tree sleeped in Vinegar; which he saith, had been by him used with success. Finally, Others apply such things as are apt to blister the Skin, as Garlic, Onions, Crowfoot, and the like; which are less safe than the former, and very troublesome to the Patient. Chap. 4. Of a Quotidian Fever. A Quotidian Ague is so called, because its fits do return every day. Wherein it agrees with a double Tertian, and a triple Quartan, but is distinguished from them by signs proper to itself. This Fever is most rarely seen, so that among six hundred Patients that have Agues which come every day, scarce one of them is troubled with a Quotidian or every day Ague. This Ague is caused by phlegm putrefying in the first Region of the Body: And therefore all such things as multiply phlegm in the Body, may cause this Ague, such as are, a cold and moist distemper of the Bowels, old Age, Child's Age, an idle life, Autumn Season, Meats cold and moist, long Sleeps and such like. The Diagnostic Signs are such as testify phlegm to abound in the Body; as greatness of bulk, softness and fatness, white colour, or pale, dull sense, profound sleep, and dreams of Waters. Also this Fever for the most part comes in the night, and that without shaking, only with a coldness or light shivering, because the Morbific Matter being benign, and not much an Enemy to Nature, doth less provoke her; and therefore the heat is not suddenly drawn inward as in a Tertian Ague, but retires by little and little. The time of Coldness being over, Heat is slowly and unequally kindled, so that the Patient feels sometimes heat, and then cold, and then heat again. Also the heat is mild, and not at all scorching, and thirst little. The Urines are at first white, thin, and undigested; and in the process they appear more thick, and better coloured. The Pulse is small, seldom, and slow. The Parts about the short Ribs do swell, and are commonly puffed up, and distended. The fits do commonly last twelve hours, and do not end but so as to leave some Feverish heat behind them; because this Fever is like a fire of green wood, which is both long in kindling, and leaves much smoke behind it. Sometimes the sit is extended to twenty four hours, and it seems to be a continual Fever. Now these Signs are very variable, and appear more intense or remiss, according as the phlegm is either simple, or mingled with other Humours; and likewise according to the different kind of the phlegm which putrefies. So that, according to Galen in his Book of Plenitude, Chap. 11. Salt phlegm makes the Patient's thirsty; acid or sour phlegm makes them hungry; sweet phlegm makes them sleepy; tasteless phlegm makes them without appetite to Meat: and likewise Fevers which are caused by acid or Glassy phlegm, are wont to come with a shaking fit. This Fever is wont to be perpetually long, because of the thickness and contumacy of the Morbific Matter, and lasts forty days, and sometimes three or four months. Neither is it without danger, seeing it may degenerate into a Cachexy, Dropsy, Lethargy, and other grievous Diseases. The longer or shorter durance of this Fever, is known by the signs of Crudity and Concoction, and also by the Evacuations, which for the most part Nature endeavours by Vomit, Stool, or Sweat: For those Evacuations appearing, show the Disease shorter: but if Nature endeavour no Evacuation, the Disease will prove the longer. A Quotidian Ague that comes in the day time, is less dangerous than that which comes a nights, as Hypocrates doth teach us in 3. Epidem. Sect. 5. T. 64. He calls the former a Diurnal, the latter a Nocturnal. The reason of which Prognostic, is because that the Diurnal have longer fits; for teaching unto night, in which the pores of the Skin are closed, the putrid vapours are kept within, not having freedom to breath forth by which means, the fits are lengthened, and as Hypocrates himself saith, do very often bring the Patient into a Consumption. Ad hereunto, That seeing the Intermission happens in the night, we are forced to give the Patiented Meat in the night, which is un●easonable, and hinders the Patient from sleeping; by which means great weakness is caused, and the Patient is much hurt, and the Functions of the Body quite put out of frame. The Cure must be in a manner the same with that which was propounded for a bastard and lingering Tertian, yet so as that among such things as prepare the Humours, and open Obstructions, we make choice of such, which have a greater power to attenuate and cut the Humours. Also in this Fever a special care is to be had of the Stomach, which for the most part is grievously afflicted; and therefore must be recreated with strengthening Medicaments, both given in, and out wardly applied, The Cataplasm of Mint and Worm wood, propounded in the Cure of a Tertian Ague, is very good in this case. Zacutus Lusitanus propounds two Medicines, with which he glories that he had vanquished most stubborn Quotidian Agues. The one is a Decoction of Chamomel, made after this manner: Take Flowers of Chamomel three pugils: Tops of Roman Wormwood two pugils. Boyl all in three pints of Water to a pint and an half. Add to the strainings four ounces of Sugar. Let the Patient drink five or six ounces every morning. The other is a Decoction of China and Guajacum drunk twenty five days together; which though Physicians are afraid to use in such Fevers as these, because of the overgreat heating and drying Faculty; yet is it mightily commended by such as have writ whole Books of the Spices and Drugs of India. Yet we must remember that Zacutus Lusitanus practised Physic in a Country cold and moist, where these Medicines may more safely be used. And therefore in other Countries that are hotter, they must not be given save unto very Phlegmatic and Cachectical bodies. Chap. 5. Of a Quartan Ague. AQuartan Ague is that which hath its Fits returning every fourth day, and it is caused by Melancholy putrefying in the first Region of the Body. Now Melancholy is of two sorts; Natural, and Preternatural. The Natural is bred of the thicker and more earthy part of our Nourishment, being cold and dry. The Preternatural, is caused by adustion of Choler, and is therefore hot and dry. Hence arise two sorts of Quartan Agues; for that which is bred of Natural Melancholy, is called a legitimate Quartan; that which is bred of Preternatural Melancholy, is called a bastar Quartan. Howbeit, the bastard Quartan may also come of Natural Melancholy, being mingled with some portion of Choler. Again, A Quartan Ague is either Single, Double, or Triple. A Single Quartan is when one Fit alone comes every fourth day. A Double is when two Fits happen upon two days one immediately after the other, and the third day is free. A Triple Quartan is when the Fits come every day, as they do in a Quotidian, and in a Double Tertian. Now these Double and Triple Quartans come of Melancholy putrefying in divers parts of the Body. The Signs to know this Ague by, are first, such things as argue that Melancholy abounds in the Patient. Unto which must be added the coming of the Fit upon the fourth day, which is the peculiar sign. Also the form of the fit differing from the fits of other Agues, doth discover this Disease. For it gins with yawning and stretchings, together with heaviness of the whole Body; after which follows cold, and then shivering and shaking, in which the Patients seem to have their bones broken. Also the heat is kindled by little and little in a cold and thick Matter. The Pulse is seldomer and slower than in other Fevers. The Urines are at first white, thin, and watery; but in the progress they are more coloured, and thicker. Now these signs appear in a legitimate Quartan. But in a bastard Quartan, the vehemence of the Symptoms being greater, doth argue the Humour to be thinner and hotter. But a bastard Quartan is not distinguished from a legitimate, herein alone, in that in a bastard Quartan, the heat, thirst, watch, and other Symptoms, are more vehement; but in that the legitimate gins of itself, without any Fever foregoing; but a bastard Quartan succeeds other Fevers and Agues, by reason of the adustion of the Humour which caused those Diseases, by means of which adustion, it degenerates into Preternatural Melancholy. A Double Quartan is easily known by the Course of the fits. And a Triple Quartan is distinguished from a Double Tertian, and a Quotidian, not only by the Signs of Melancholy abounding, and by the form of the Fits; but also because it was first a Single, or a Double Quartan before it came to be a Triple Quartan. For very rarely, or never doth a Quartan Ague begin with a Triple; but a Simple or Double Quartan degenerates into a Triple. As for what concerns the Prognostic; this kind of Ague is wont to be longest of all others; and that which gins in the fall of the leaf continues all Winter commonly, and goeth not away till the Spring come. Yea and some Quartans continue a year or years. Summer Quartans are the shortest. In all of them we must have a continual eye to the signs of concoction which signify the solution of the disease to be at hand; and with these, for the patiented to make black urine is a good token. A legitimate Quartan is longer than a bastard Quartan because the former proceeds from a thicker, the latter from a thinner Humour This kind of Ague is wont to be very safe from danger, especially the legitimate, being accompanied with no grievous affection of any of the bowels. But the bastard Quartan is more dangerous. and if the Liver, Spleen, or any other part be grievously damnified, it degenerates into a Dropsy, Aged persons above sixty years, being taken with a Quartan Ague, do for the most part die of it: because their natural heat is too weak to overcome so contumacious an Humour. An intermitting Quartan, being changed into a continual, is for the most part deadly. Because that Fever whose motion was outward, is changed into one whose motion is inward. Which mostly falls out in the Winter, the cold meeting with the humours which were but outward and beating them back into the innermost Closets of the Body. The which also come to pass by unseasonable use of sharp and vehement purges. For thereby of simple Quartans, double, triple, and continual are generated. A Quartan Ague coming upon one that hath the falling sickness cures the same, according to Hypocrates in the 70 Aphorism of the 5 Section. Those that have Quartan Agues are not much troubled with Convulsions. And if having first Convulsions, a Quartan Ague follows, they are freed from their Convulsions, Now the reason which Galen in his Comment gives hereof, is; because the thick matter which caused the Convulsions is by the long heat of this Ague, attenuated and digested. Also by the shaking of the Body in the cold Fits, the said Humour is more easily ejected. We must also add, that the evil Humours lurking in the Brain and other parts, as also in the veins, is transferred to the Hypochondria and more ignoble parts, where the Melancholy Quartanary Humours are seated, and so leaves the parts aforesaid. A bloody flux coming upon a quartan Ague, tends to health, according to Hypocrates in the 48 Aphorism of the sixth section. To such as are splenetic a dysentery is good. Now in a quartan Ague, commonly the Spleen is misaffected, and a melancholy humour is common to a quartan Ague and a misaffected Spleen▪ but this must be understood of a short dysentery, for a long one is wont to be mortal; as we have it in the 43. Aphorism of the said section. Such as being troubled with the Spleen have a flux of the Belly with pain, if it turn into a long dysentery or Bloody flux, they fall either into a Dropsy or a Lienterie, and die. To bleed at the nose in a quartan Ague, is a very bad sign. Because the Humour which causes a quartan is too thick and too cold to be voided that way; and because such bleeding is symptomatical, and if it continue will breed a dropsy; it must presently be stopped by opening the basilica vein, out of which the putrid blood may flow, because the pure blood comes from the Nose. The quartan Ague hath a double cure according to the two kinds thereof. For the remedies used in a bastard quartan, must be far different from those which are used in a legitimate one. And that we may begin with a Legitimate quartan: we must presently set ourselves to vanquish the cause thereof, not regarding the Fever. And seeing the cause thereof is an humour cold and dry, thick and earthly; we must use medicaments that do heat, moisten, and attenuate. Also the Peccant Humour must be at seasonable times evacuated, which notwithstanding will require a long time to do; because of the extreme contumacy of the Humour and length of the disease. But before these medicines be used, we must appoint the patiented a convenient diet. Let the patiented therefore use meats of good juice, easy to digest, of thin substance, and moderately heating and moistening; as the flesh of young Animals and mountain Birds, new Eggs soft boiled, Fishes that are taken in stony Rivers. In the state of the disease we may allow the patiented Salt Fish, Capars, and Olives▪ Galen 1. ad Glauco. Grants likewise Pepper and Mustard. Among Herbs borage is commended and Bugloss, Pimpernel and Spinach, Fennell and Parsly Roots, but especailly Turnips, which must be first boiled in water, and afterwads in fat broth which is very good for such as have the quartan. Crato in his Counsels collected by Scholtzius, brags that he had cured many of the quartan Ague by the second broth of turnips seasoned with Butter and Sugar. Of fruits, Apples, and stewed Prunes, Raisins of the Sun, fat Figs, Almonds, Dates, Pine-kernels are good. And finally, to Spice their Meats, let them use Cinnamon, Nutmeg, and Saffron. Let the Patient abstain from Meats which are thick of substance and clammy and are long in passing through; such as the Flesh of Swine, Beef, Deer, Hares and Water fowl, from Pease and Beans, Colewort, Course Branny Bread, Cheese, Nuts, Walnuts and Chastnuts; from Flesh much Salted, or dried in the Smoke; from fruits, Raw Herbs, from Vinegar, Verjuice, because they are thought as all other sour things to ferment Melancholy and make it work Let their drink be small Ale or bear of moderate strength and meanly hopped neither new nor hard, Pure and well Clarifiedwhite Wine or Claret that is not strong, with Water in which the Bark of Tamarisk or the Leaves of Egrimony have been steeped, or a Decoction of Salsa Parilla, or Barley Water that hath Steel quenched in it. Let them eat sparingly, no more than may barely preserve strength; for too large feeding breeds crudities which makes the Disease of long continuance. But above all, they must be very spare in drinking, because nothing makes this Disease more rebellious and hard to Cure than over much drink and moist things, for they fill and Swell the spleen. Crato forbids all use of drink in the fit, which to forbear doth much as he says help the Cure. On the fit-day, the Patient must eat six hours before the sit comes. And afterward nothing must be taken till the fit be over. Long sleep is good, because it moistens, but it must be forborn in the beginning of the Fit. On the days of Intermission light exercise before Meat, is good; or in place thereof, frictions of the whole Body, after the Patient hath been at Stool. If thee Patient be costive, a Clyster or Suppository must be given. Finally let the Patient be as cheerful as may be and avoid sadness The Patient's Diet being thus ordered; first a gentle Purgation must be administered, by a Clyster and a purging Medicament. the Clyster may be thus Made. Take Roots of Bugloss two ounces: of the four Emollient Herbs, mercury and beets of each one handful: Fat Damask Prunes five Pair: of the four larger cool Seeds and Annis Seed of each two drams: Epithymum three drams: Boyl all to a pint and an half: in the strained Liquor dissolve Catholicum one ounce: Oil of Violets and Chamomel of each one ounce and an half: Red Sugar one ounce: Make of all a Clyster, which must be given the day before the following Potion, at a seasonable time. Take Senna half an ounce: Annis Seed a dram: Leaves of borage and Fumitory of each one handful. Liquoris three drams: Boyl all to three ounces: in the strained Liquor dissolve Manna and Syrup of Roses of each one ounce: Make all into a potion. Galen in I. ad Glauco. Ch: 11. Bids us give only gentle and benign Medicaments in the beginning of this Ague, otherwise, it is to be seared, that if we use stronger Medicaments, of a simple Quartan, we shall make a double, a triple or a Continual Fever. After the first Purge v, Blood must be drawn from the Basilica Vena of the left Arm. Yet, if the Liver be affected, it may be drawn from the right Arm. And their Opinion is Ridiculous, who say that we must expect Concoction before we let Blood, because then the Blood will be more thin and apt to flow: for it is better digested and prepared, if first some Quantity thereof be taken away. Neither must we give ear to them which say, that Blood-letting is not to be allowed of in a Quarran Ague, unless redundancy of Blood do show itself by the Swelling of the Veins and by other signs. For there is evermore at the beginning a Plethora ad Vires viz. Such a fullness of Blood as the Strength of the Patient cannot manage, unless a Quartan do follow some other long Fever. But that Precept of Galen formerly mentioned in I. ad Glauconem, is worthy of all Commendation, which says that if the Blood which first comes away be Black and impure, that then the greater Quantity is to be taken away: but if it be Red and Pure, little must be taken, and the Patient must not be let Blood any more. The well days are fittest both for Bleeding and purging. Yet some let Blood upon the fit day, five or six hours before the Fit. which is not Ammis, because the Humours beginning then to be moved, are more easily drawn out. Zacutus Lusitanus says, that it is very good to let Blood when the Moon is in the full. For then, by reason of the Moon's influence, that earthy Melancholic Humour doth Boyl and become more fluid and Apt to come away with bleeding. And he doth Testify that many have by bleeding at that time been helped, and some perfectly cured, who could not by any other means receive Help. But Botallus contrary to the mind of Galen and all other Physicians, doth aver that frequent Blood-letting doth cure the Quartan Ague, yea when it threatens a Dropsy; and he endeavours to confirm his Opinion by reasons and examples. Which notwithstanding is to be rejected as a Paradox, seeing the Refrigeration of the whole Body caused by much Beeding, makes the Morbific matter more thick and contumacious. The flux of the Hemorrhoids, is very good in Quartan Agues, and many are thereby Cured. For seeing the Hemorrhoid Veins are branches of the Mesaraick Veins, in which the matter of this Disease is contained, when they are opened they Evacuate the immediate cause of this Disease. If therefore a flux of the Hemorrhoids happens in such as have been accustomed thereunto, it must not be stopped. If it be too sparing, it must be furthered. As also if Nature seem to incline that way (which is known by itching of the Fundament, and by some drops of blood coming that way) the Blood must be made to come by application of Leeches. But in such as have not been used to have their Hemorrhoid Veins opened, after bleeding in the Arm, it is good to let them blood in the Ankle Vein; by which oftentimes the Ague ceases; or at least that Bleeding, with other Remedies, will hasten the Cure; especially in Women whose Courses are stopped, or flow not sufficiently. The opening of the Vein between the little Finger and the Ring Finger, called Vena Salvatella, is approved by the Ancients, and many later Physicians, who said it cures the Quartan Ague. But very many others reject this Conceit, as being founded upon no reason, because the foresaid Vein is a Branch issuing from the Arm Veins. Yet being commended by others with many Experiments, I conceive it ought not wholly to be neglected. Some hold, it ought to be opened in the Conjunction of the Moon with the Sun; others when the Moon inclines two hours before the Fit, at three several times, in three immediately succeeding Fits, which in some persons hath happened very well. After these first Evacuations, we must bend our study to concoct and prepare the Humours, with certain Juleps, compounded after this, or some such manner: Take Roots of Asparagus, Bruscus, Cichory, Bugloss steeped in white Wine, of each one ounce: Bark of Tamarisk half an ounce: Leaves of borage, Bugloss, Ceterach, Maidenhair, Fumitory, Germander, Ground-pine, of each one handful: Liquoris one ounce: the three Cordial Flowers, of each one pugil. Boyl all to a pint and an half. In the strained Liquor dissolve Syrupus Bizantinus, and Syrup of Maidenhair, of each two ounces. Make thereof a Julep to be taken at four times, four mornings together. Which must also be continued many days, for the Matter being contumacious, requires long preparation. Or if the Patient be nice, and squeezy, Broths must be made of part of the foresaid Simples, choosing such as are most grateful to the taste, whereunto, as also to the Juleps, Cream of Tartar may profitably be added. With these Preparative Medicaments, between while, Purgatives must be given; so that every third or fourth day the Patient must take a Purge, with this Caution, That as long as the Matter is very crude, we use mild Purgatives: and when Concoction gins to go well forwards, we must then give such Purgers as are a little stronger. Now the Materials for these Purgations are very well known, so we need not reckon them up. It is sometimes good to prescribe an Apozem both Purgative and Preparative, for four or five Doses, that a good part of the Morbific Matter may be cleansed away. Which Apozeme may be made of the Materials of the foresaid Juleps, adding Purgatives thereunto. But if the thickness and contumacy of the Humours, with the cold distemper of the Bowels, do seem to threaten that the Disease will be long and bring a Dropsy, we must then fly to such Medicaments as do powerfully cut and divide the said Humours; of which this following Apozeme may be compounded. Take of the five opening Roots steeped in white Wine, of each one ounce: Enula Campana, Gentian, Aristolochia, and Asarum Roots, of each half an ounce: Leaves of Germander, Agrimony, Hops, borage, Ceterach, Wormwood, and Centaury, of each one handful: Liquoris, and Raisins stoned, of each one ounce: Senna one ounce and an half: Epithimum one ounce: Agarick newly trochiscated three ounces: Ginger and Cloves, of each one dram: Boyl all to a pint and an half. In the strained Liquor dissolve Syrup of Cichory with Rhubarb five ounces: Troches of Capars, and Salt of Wormwood, and of Tamarisk, of each one dram. Make of all an Apozeme, for five Doses to be taken in the morning. In this Chronic and lasting Disease, an obstinate Perseverance is necessary, that the perpetual vicissitude of Medicines may concoct and purge away the Cause thereof. For this is in a manner the only Cause why many that have Quartan Agues remain uncured, because after the use of a few Medicines they grow weary, and wholly reject and disdain all the rest. For a continual Use therefore, certain Purgatives are always to be in a readiness. Which may be made in the form of a Magistral Syrup, or of Pills, or in any other form. A Magistral Syrup may be made of the Materials of the Apozem Aforesaid, adding a triple quantity of the Purgative Ingredients. Pills for frequent use may be thus compounded: Take Aloes diligently steeped with the Juice of Wormwood, half an ounce: Gum Ammoniack dissolved in Vinegar, and afterward thickened, two drams: choice Myrrh a dram and an half: Gummy, Turbith, and Agarick newly made into Cakes, of each two drams: Diagridium one dram: Salt of Wormwood and Tamarisk, of each two scruples: Saffron half a scruple. With Oxymel simple, make all into a Mass of Pill-stuff. Let the Dose be half a dram, or two scruples, twice in a week. If the Patient be of an hot Constitution, these following Pills may be used. Take Polypody of the Oak half an ounce: Roots of Asarum, and seeds of Broom, of each one dram: Crystal of Tartar one dram and an half: Flowers of Bugloss and borage, of each half a pugil. Boyl all in a sufficient Quantity of Water, Of the Liquor strained, and very well clarified, take half a pint: Juice of odoriferous Apples very well clarified four ounces. Infuse therein Senna one ounce: Turbith and Agarick, of each three drams: Mace, Cloves, Cinnamon, and Epithimum, of each one dram. Let them digest together three days in Balneo Mariae, then strain and press them out. And add yet of Extract of Aloes made with Endive and Sorrel Water one ounce: Myrrh dissolved in Wine over the fire and strained two drams: Salt of Tartar one dram: Let all evaporate and thicken over a gentle fire, adding towards the conclusion, of the Powders of Diarrhodon Abbatis, and Laetificans Galeni, of each one scruple: Salt of Wormwood and Tamarisk, of each half a dram: Extract of Saffron half a scruple. Make a Mass of Pill-stuf for the use aforesaid. Also a Purging Medicament very familiar, and most easy to prepare, but very profitable, may be made of three ounces of the Decoction of Wormwood, wherein two drams of Senna hath been infused, which must be taken now and then. These Purging Medicines are wont to be given the day before the fit, because the Patients are then stronger than at other times. Yet many contend that they ought to be given before the fit, because the matter being agitated by the fit, is made more apt for Expulsion. This Opinion they underprop with the Authority of Hypocrates in his Book de Affectionibus, who would have a Medicine Purging downwards to be given at the beginning of the Fit. And although in Galens Judgement, that is none of Hypocrates his writings, but of his Son in Law Polypus; yet they conceive it ought not therefore to be of no Authority, seeing Polypus also was a very Learned Man, and frequent Experience confirms this Opinion; as the said Experience is set down by Arculanus, Genitilus, Amatus Lusitanus, and others, who have ordered that the Purging Medicament should be given four hours before the Fit. Which practice notwithstanding, hath need of much wariness and prudence in the Physician, seeing the shaking fit intercepts the evacuation, and in the Ague Fit the Humours are moved with a motion quite contrary to that wherewith the Purge doth move them; by which means great disturbances may fall out in the Patient's Body. Wherefore this course is not to be followed but in strong Bodies. The Consent of Physicians is greater and more general touching the giving of Vomits in the beginning of the Ague Fits, because Nature is at that time more prone to that kind of Evacuation. Neither is it to be doubted, that a Vomiting caused in the beginning of the Fit, and at the same time often repeated, doth make the Disease gentler and shorter. The Materials of Vomitories are set down in our Cure of a Tertian. But in a Quartan Ague, Asarum is preferred before the rest, one dram being given in Powder, in white Wine, and three or four times repeated. In the Intervals of purging, Clysters must frequently be given, which do accustom Nature to expel the hurtful Humours into the Guts, and do by little and little bring away some of the morbific matter contained in the Meseraick Veins. The Disease continuing (as for the most part it is long and lasting) we must sometimes rest, and abstain from Physic a month, or thereabouts; that Nature in the mean time may gather strength, be wearied with continual use of Medicaments, and may set herself to concoct the morbific matter. And afterward we must return to our Preparatives and Purgatives. Howbeit, in a long Ague, we must not always use the same Medicaments; lest Nature be over much used thereunto, and the Patient become weary of them. Also because from more gentle Aperitives and Purgatives, we must pass on to such as are stronger. Various sorts of Purgatives have been already propounded. And these following Aperitives besides the Apozems aforesaid, and the Juleps, may be used in the progress of the Disease, when the Signs of Digestion begin to appear. Take White Wine three pints: Enula Campane Roots three ounces: Bark of Capar Roots half an ounce: Tops of common Wormwood dried one ounce: Infuse them three days in Balneo Mariae. Reep all together without straining, and give of this Wine to the Patient two or three ounces in the morning, two hours before meat. And these following Pills may be used either alone, or with the said Wine. Take Roots of Gentian two drams: round Birthwort Roots one dram and an half: Mugwort one dram: Briony dried three drams: Myrrh and Saffron, of each one dram: Asarum Roots two drams: Aloes one ounce: With Oxymel of Squils' make all into a Mass of Pill-stuf. Let a dram be given every day by themselves, or a little before the taking of the Wine aforesaid. To these Pills, Steel prepared may profitably be added, if the Patient be able to walk after the taking of them. For the use of Steel in all Chronic Fevers is very profitable, because it potently opens Contumacious Obstructions, which are wont to foster those Diseases. Or to open and strengthen at once, the following Electuary may profitably be prescribed. Take Conserve of Elecampane Roots, Conserve of Wormwood, and Maidenhair, of each one ounce: Preserved Citron Peels▪ half an ounce: Confectio Alkermes three drams: Preserved Myrobalans, two: Powder of Diarrhodon Abbatis two drams: Salt of Wormwood and Tamarisk, of each one dram: Saffron two scruples. With Syrup of preserved Citrons, make all into an Opiate: of which let the Patient take the quantity of a Chestnut every morning, two hours before meat. Or if in the morning the Patient take some other Medicine, then may the Electuary be taken two hours before Supper. To the same intent is commended as a most excellent Remedy, the Extract of Germander mixed with Salt of Tamarisk made into Pills. Add hereunto, Discussers, and Diaphoreticks, which are very useful to discuss the relics of the declining Disease, when signs of Concoction appear. For they do not only discuss the said relics, but they do likewise correct that distemper which is bred by so long a Disease, and amend the ill habit of the Body; and strengthen the Stomach, Liver, and other Bowels, weakened by the length of the Disease. Among these Medicaments, Venice Treacle challengeth the first place, being by older and later Physicians commended to this Use. It is given one hour before the fit, one dram in weight, with Wine, or in a Decoction of Germander. Or if its heat be feared, it may be given with a Decoction of Agrimony, or with the Juice or Water of Plantain. This Medicine must be repeated before divers Fits one after another. It may also be given in the mornings for some days together on the well-days. But a little before the fit, it operates happily, because it hinders the increase of cold, and doth more commodiously discuss the Humour, which is cause of the fit, now beginning to work in the Veins, and by this means it diminisheth the fit, and if the morbific matter be little, takes it quite away. Here, notwithstanding, great Caution is to be used, lest Treacle, or other such hot Medicines, should be given when the Humours are yet crude; for they dissolve the putrid Humours, from whence ariseth a confusion in the Body, and an increase of the Ague Fits; so that a single Quartan comes to degenerate into a Double, and Triple, yea, into a Continual Fever. As it happened to Eudemus the Peripatetic, as Galen relates in Lib. de Praecog. ad Posth. Cap. 2. & 3. in whom was a single Quartan, the Physicians of Rome having given him Treacle unseasonably, was changed into a Triple. Howbeit, afterwards when the Signs of Concoction appeared, Galen gave him of the same Treacle, and cured him. Among other Diaphoreticks, some commend the Roots of China, and Salsa parilla, whose first and second Decoction being given twenty days together, doth sometimes cure contumacious Quartans. But they work more effectually, if with the Primary Decoction, Purgatives be mingled. Other Remedies are also given before the Fit, which are accounted specifical, and appropriate to this Ague, and being given towards the declination, they do very often keep back the fits, and cure the Quartan. The chief of this sort, are these which follow: Take Green Leaves of Plantain one handful: Green Sorrel half a handful: Vinegar and Treacle, of each three ounces. Distil them, and let the Patient take of the distilled Liquor three ounces, half an hour before the fit. Or, Take Sugar-candy three drams: Ginger two drams: Camphire one dram. Make all into a Powder. Give one dram in warm Water. Ten Grains of Saffron in powder, given with white Wine before the fit, doth much weaken the same. Seed of wild Rue given before the Fit in white Wine, cures. Heurnius assures us that with the following Troches, many have been cured, even in the Winter, with once taking. Take Seeds of Rue, Parsley, Myrrh, and new Andromachus Treacle, of each one dram: Opium half a scruple: Make all up into little Cakes or Troches. And let the Patient take one of those Cakes in Water, before the fit. Narcoticks do indeed much abate the fits; but unless the greatest part of the morbific Humour have been before abated, and the Obstructions much lessened, they may do hurt, because they may retain the vicious Humours in the Body, and breed Obstructions, and other worse Diseases. But given in a small quantity, and mingled with things which open and cut, as in these Troches, they can do less hurt. Also to restrain the Fit, gentle Purgers are profitably given an hour before it comes, which do revel the Humours, more by soliciting and provoking Nature, than by their purging. To which intent, such as these which follow are prescribed. Take Senna, Polipody of the Oak, Time, Epithimum, of each one dram: Borrage flowers a pugil. Make a Decoction to three ounces. Give it an hour before the Fit. Or, Take Senna three drams: Turbith one dram: Cinnamon half a dram: Saffron and Ginger, of each ten grains: Sugar, the weight of all the rest. Make of all a Powder, divide it into three parts. Give the Patient one part before the fit, in white Wine. Quercetanus in his Dispensatory, doth exceedingly commend Camillus his Pills of Sagapenum; of which he gives only one at the beginning of the fit, for divers days together; and a little after he anoints their Backbone with a Lineament composed of Treacle, Aqua vitae, Oil of Bays, or of Spike. And two or three hours after the Pills are taken, he gives Broth with opening Roots, borage, Bugloss, Time, and an odoriferous Apple boiled in it. Now those anointings of the Backbone, are very good to mitigate the cold fit, and must often be used, although the foresaid Pills are not used. For they are frequently useful, when the shaking fits are vehement and importunate. And these Anointings are made, not only with the foresaid, but with very many other Medicaments; as with Oil of Dill, Chamomel, Orice, Costus, Rue, the Peppers, and other hot things, with Aqua vitae, Treacle, Cloves, Castoreum, Mustard seed, Pepper, and other things mixed therewith. Now these Liniments are more effectual, if the backbone be anointed therewith by the fireside, an hour before the coming of the fit; and the sick party be presently thereupon conveyed to a hot bed, and hot Tiles sprinkled with odoriferous Wine, and wrapped in Linen , be applied to the Sols of the Feet, and Palms of the Patient's Hands. While the aforesaid Medicaments are used, a special care must be had of the Spleen, because that part is always affected in this Disease: And therefore those Medicaments which ordinarily are prescribed for Obstructions of the Spleen, viz. Fomentations, Liniments, and Plasters. Yea verily, and sometimes a Bath of lukewarm Water, after many Evacuations have been celebrated, is good, not only to mollify the Spleen, but also to moisten the whole body, and to further the Coction of the morbific matter. The bath may be used on the days of intermission, giving diligent heed that it be no other than lukewarm. For if it should be hotter, it is to be feared, lest the Humours being thereby dissolved, should run on a sudden into divers parts of the Body, and breed dangerous, very dangerous Imposthumes. Finally, Such things as are wont to be laid to the Wrists, are not to be neglected, seeing Authors of good account do make some reckoning of them. For Rondeletius affirms, That he hath used this following Medicament, with great success. Take Leaves of Elder, Sage, Dovesfoot, Rue, of each half a handful: Marigolds a third part: a handful of Salt, and a little Wine. Beat all together, and apply to the Wrists before the Fit. Crato applies the Roots of Nettles being beaten and moistened or steeped in Vinegar, to the Arteries of the Wrists, and of the Feet. And Sennertus relates that a certain Citizen having had a Quartan Auge the whole Autumn and Winter, and at last being afflicted with most sharp pains in his left shoulder, by the persuasion of a certain woman, he applied Crowfoot to his wrist, which raised a Push, and freed him both from his pain and Fever. A Bastard Quartan is cured with the same Medicines in a manner, which have been propounded for the Cure of a Tertian; adding to the Decoction of Juleps and Apozems, such things as do peculiarly regard Melancholy adust. Whereunto may be added all the more temperate, and less heating Medicaments, which have hitherto been propounded for a Legitimate Quartan. In the beginning therefore it is good to use borage, Bugloss, Fumitory, Hops, Sorrel, Cichory, Ceterach, Scolopendria, Agrimony, and Odoriferous Apples. Whose Decoctions, distilled Waters, and sometimes their clarified Juices may be prescribed in the form of a Julep, an Apozeme or Magistral Syrup. But in the Progress of the Disease, it will be good to add unto the Simples aforesaid, the Bark of Capar Roots, of Tamarisk, Enula Campana, Polypodie, and Wormwood. While the Patient useth these Preparatives, Purgatives are frequently to be interposed; which are to be given the Day before the Fit, and to be repeated twice a Week. To which Intent Various Forms may be prescribed. But for such as are Delicate, a Laxative Ptisan, Syrupus de Pomis Saporis, or the Broth of a Chicken, qualified with borage, Bugloss, Pimpernel, and three drams, or half an ounce of Senna, may profitably be given. Blood-letting in the beginning must not be omitted, and so such quantity of blood must be taken away, as shall correspond unto the Quantity and Quality of Blood, and to the Age and Constitution of the Patient. If the Disease prove long, when the fervour of the blood is abated, Vomits may profitably be administered; especially to such Patients as are troubled with Stomach-sickness and Vomitings in the beginning of their Fits. Among Vomitories good for a Quartan, Asarum (as was said before) is the principal, being given to the quantity of a dram in white Wine, and divers times repeated, if the Disease shall not after once or twice giving, be discussed. Hereunto add fomentations and liniments applied to the parts under the short ribs, to correct the evil disposition of the bowels (which continually affords new matter for the fits) and to soften and make thin the fast, settled and impacted Humours: which may be prescribed after this manner. Take Roots of Marsh-mallows, of Lilies, of Enula campana, Barks of capar Roots, and the middle rind of Tamarisk, of each one ounce; Leaves of Mallows, of Marsh-mallows, of Pellitory of the wall, of borage, Bugloss, Pimpernel, Wormwood of each one handful; Lin-seed and Parsley seed, of each an half ounce; flowers of Chamomel, Melilot and Dill, of each one pugil: make a decoction in three parts of water, and one of white wine added towards the end. With which decoction foment the Hypochondria, twice a day, far from meals. Take Ointment of Marshmallows, one ounce and an half; Oil of Lilies, Chamomel, Roses and Wormwood, of each an half ounce: make all into a Lineament, which must be used after the fomentation. Or Oils alone may profitably be applied to the same Parts, laid on with wool. And finally a bath of warm water either alone or with emollient and qualifiing things boiled therein, or of Barley and Almonds as is usual, will be very convenient to cure this disease. For it corrects the distemper of the bowels, rectifies the heat and dryness of black Choler, mollify that which is hard, opens the passages and widens them, and digests crude Humours. Wherefore the frequent use thereof will be most convenient, using the caution before specified. Now the operation thereof will be exceedingly advanced, if preparative Medicaments and such as open obstruction be given to the patiented, upon entrance into the bath. Among which the chief is a decoction of Wormwood and Enula Campana, which is exceeding good to digest all contumacious Humours. provided the over great heat of the Bowels, do not dissuade the use thereof. In which case it may be tempered by the mixture of other things fore recited. And while these things are doing, gentle purgations must be repeated, as we advised before. And when the disease doth indeed decline, those specified medicaments propounded in the Legitimate Quartan, may here also be brought into use. In the whole course of the disease we must be careful of the Breast, lest a Consumption betid the same, for the Humour offending in this Disease is of a corroding quality Chap. 6. Of Compounded or Complicated Fevers, and particularly of a Semi-Tertian. GAlen in his second Book de Crisib. cap. 7. and 9 and in his second Book de Differ. Feb. Cap. 7. and Avicen. Fen 1. Lib 4. Tract 4. Cap. 16. Do propound many compositions of Fevers. Namely when putrid Fevers are compounded with nonputrid, as when an hectic is joined with a putrid; or of a putrid with a putrid, which is done many ways viz. Either continual Fevers being complicated with continual or intermittent with intermitent, or continual with intermitent. The Composition of two continual Fevers, is a thing controverted among authors, and a man shall hardly observe it in the course of his practice. An intermitting Fever or Ague is complicated with another intermittent, either of the same kind, or different: compound intermittents of the same kind are a double and triple Tertian, and a double or triple quartan, which have been expounded in their proper places. Of several kinds are when a tertian is compounded with a Quotidian or quartan; which also is very rarely seen in Practice. Intermittents are complicated with continuals two ways viz. An intermittent tertian with a continual Quotidian, or a Quotidian intermittent with a continual tertian. and each of these is termed a Semi-tertian, constituting Species or sorts thereof. Yet that is properly and truly a Semi-tertian which is made of an intermitting Tertian and a continual quotidian: and consequently is caused from choler putrefying without and phlegm putrefying within the vessels. By Hypocrates and Galen in 1 Epidem. it is named Horrifica, or the shaking Ague because it causes the patiented to shake, not only at the first coming of the fit, but in the whole course of the disease and especially in the beginning and augment, two fits being met and joined in one, viz: Of the tertian and quotidian Ague, with many reduplications, which are nothing else but unequal shaking and shivering motions, returning divers time in one and the same Ague Fit, by reason of the mutual fight of the two Fevers; in which, if Phlegm overcome, there will follow shiverings, and coldness of the extreme parts. And then again, when Choler doth vanquish, the Body becomes warm, and the Fever seems to tend towards the vigour; whenas phlegm again getting the better, they are again brought into a cold and shivering condition; and this Contention is wont to last till the Fever comes to its height. Hence it is that those shaking fits come only every other day, viz. When the fit of the Tertian Ague is upon the Patient, being joined with the Quotidian. But while the Quotidian alone is present, there is wont to be no shivering Fit. Yet we must take notice, That there are some Malignant Fevers, which without a commixion of a Tertian and Quotidian, without that same fight of Choler and Phlegm, do shake the Patient; in which the Shiveverings come from sharp Vapours, and malignant, which do arise out of the corrupt Matter of malignant Fevers, and do beat upon, and pull the sensitive parts, and nip or twitch them as it were. Now this Semi-Tertian properly so called, is either exquisite, wherein an equal portion of putrefying Choler and Phlegm is redundant, such as hath been now described; or it is a bastard Semi-Tertian, which is again twofold: For either it hath Choler abounding, or Phlegm. In the former there are more Symptoms of a Tertian; in the latter of a Quotidian. And so if Choler abound, the whole Fever is more horrid, and sometimes it hath a shaking fit accompanying the same; also it proves more fervent, and some portion of Choler is voided forth by vomit, stool, or sweat. But when Phlegm prevails, a more vehement cold doth possess the extreme parts of the Body, and there are few shiverings; and the pulse it more and longer depressed, and the fit is longer before it grow towards its height, and remains in its consistency a long time; yet doth it cause no great thirst, nor burning. This Fever is known by what hath been said thereof, being continual, and cold, with many reduplications, and very great Symptoms. Because it comes every other day with a shaking cold fit; but upon the even days it comes only with a coldness in the extreme parts of the Body. The Urines are crude, thin, and without colour; sometimes troubled, with no Sediment, or that which bodes no good. The Pulse is frequent and unequal. The Differences are known by the Signs of more or less of Choler and Phlegm, propounded. As for the Prognostic of this Fever, it is a dangerous Disease, and therein the Stomach and Nervous parts are very much affected. And it is attended with dryness of the Tongue, Thirst, Swooning, Watching, and sometimes with Rave, and dead Sleeps. Hypocrates reckons it among acute Diseases because of the Choler; and among Chronic Diseases because of the Phlegm, in 1. Epidem. And Avicenna saith, That it lasts sometimes seven months, and sometimes ends in Chronic Diseases, and an Hectic. The Cure of this Fever is to be taken from what hath been formerly said of the Cure of a Tertian, and a Quotidian Ague; and seeing it is continual, it must be handled with the same Method which was set down in the first Chapter of this Section, as common to all putrid continual Fevers. So that when Choler chief bears sway, we must use most of those Simples which respect Choler; and when as phlegm prevails, we must principally use such things as do prepare and purge that Humour. And finally, When both Humours are equal, the Remedies proper to each must be used in equal proportion likewise. SECTION III. Of Pestilential Fevers. The Preface. All Authors (very near) who have writ of Fevers, do distinguish a pestilential Fever from a malignant, and do treat of each of them severally in divers Chapters; so that by the name of a pestilential Fever they do understand the true Pestilence or Plague; and by a such malignant Fever, they mean that which is commonly called the sp●●ted Fever, or such a Fever which though it be epidemical and contagious, yet it is not so dangerous but that more live then die of it: whereas the true essence of the Plague consists in this that more die thereof than recover. But for as much as these Fevers differ one from another only according to the greater or lesser degree of malignity, and must be cured with the same Medicaments; we have thought it more convenient to include all these kind of Fevers in one Chapter, and to handle them all under the name of Pestilential Fevers. and consequently this last Section shall consist of two Chapters, the first of which shall treat of the Pestilential Fever; and the later of the Measles and small Pox: For seeing a Malignant Fever does always attend them all Authors do justly treat of them in this place. Chap. 1. Of a Pestilential Fever. That Fever is termed Pestilential, which does afflict Nature not only by a bare distemper, or by heat arising from putrefaction, but also with a Maliguant and venomous quality. This is wont to be for the most part Popular and Epidemical; so that many are at the same time sick thereof: yet sometimes it is sporadick or single afflicting but here and there one, which arises from evil Humours that have attained a venomous quality. It is likewise Contagious, so that it may be caught not only by means of the common Cause, Viz. Corruption of the Air or Diet; but also by Conversing with those that are sick. It is also commonly called a Malignant Fever, whereas many diseases are termed Malignant. by reason of their evil and cruel symptoms in which no venomous quality is found, in which alone the essence of a Pestilential disease consists. In what Fever soever therefore, this same venomous quality is found, whether it be a diary, an hectic, or a putrid Fever, it is rightly termed Pestilential: although a dairy and hectic are much controverted, touching which consult the Authors. Now this same venomous quality ariseth from the corruption of Homors, which consists not in a bare change of the temperament, or in ordinary putresaction, such as is found in putrid Fevers; but in a destruction of the whole Nature and Essential substance of the same Humours. As Wine when it is turned an iosipid tasteless Liquor, is totally and essentially corrupted; but when it becomes vinegar, it is said simply to putrefy. And a Pestilential Fever differs from the Plague as a species or sort differs from the genus or kind, because there may be a Pestilence without a Fever, as Hypocrates hath taught us in his third Epidem, in many places; and also Galen in his Exposition of the said Book. and in his ninth Book, de Medic. Facultatib. Cap. de Terra Samia. And this is suitable to Reason forasmuch as the venomous Quality is not necessarily attended with putrefaction, which is the Cause of a Fever. For that same venomous quality may be produced in the Humours, by a perfect corruption of their substance, and introduction of a new form, of which that venomous quality depends. And certain it is, that so oft as a new from is introduced, the former is corrupted; unto which mutations there are requisite preparatory alterations, but not putrefaction so that Humours may undergo such a corruption without putrefaction; but because the Humours of our body are very liable to putrefaction, they can rarely undergo so great a corruption, without the Intervention of putrefaction likewise; wherefore those Pestilences are very rare, which are not accompanied with a Fever: Yea verily and by an intense, profound and fordid (as they are wont to say) putrefaction, such a Corruption as that of the Plague is wont to be raised. So, many Fevers, which at first were not pestilential, if by the Ignorance of the Physician or negligence, the disobedience of the Sick, or the fierceness of external causes, they have been mis-handled, the putrefaction becomeing more intense, they turn in the end to malignant and Pestilential Fevers. And that corruption does often precede Putrefaction is collected from such as are infected with the Plague by contagion; in whom a malignant, and venomous quality is first transfused, and therewith the Humours are corrupted, which corruption is followed by putrefaction, whence it comes to pass that such as have the Pestilence have sometimes no fever for the first days of their illness; but afterwards the Fever gins to show itself, when putrefaction is bred; some such things we see in a part that is affected with a Gangrene, which is first corrupted, and afterwards puertfied. A pestilential Fever is caused, when the Humours being corrupted and having attained a venomous quality, do come to putrefy: And so it affects the Heart by those two means Viz. By a putrid heat and a malignant quality. Now this corruption of Humours, is not always after one sort, but sometimes it is more intense and sometimes less and according to its divers degrees, the venomous quality arising therefrom is more or less pernicious; from whence proceeds the greater or less Malignity of Fevers. And hence arose that common distinction of Pestilential Fevers among Physicians, into a Pestilential fever simply and properly so called and into a Malignant Fever; calling that a pestilential Fever properly so termed wherein is the true Plague; having this peculiar, note or character, that more die than live and recover; and calling that simply a malignant Fever which being less pernicious, more live than die of it. The differences of a Pestilential Fever are taken either from the matter wherein that venomous Quality is produced; or from the place wherein the said matter is contained: and so they follow the difference of putrid Fevers, which in respect of the matter of putrefing are divided into the Fever Sunochos, Tertiana, Quartana, and Quotidiana, according as the matter putrefiing it, Blood, Choler, Melancholy, or Phlegm. And in respect of the place wherein the Humours putrefy, they are divided into continual and intermittent; according as the aforesaid Humours are lodged within or without the veins: even so pestilential Fevers, some are termed Synochi, others Tertians, Quartans or Quotidians; some continual, others intermittent: though Hypocrates hath said in the 43. Aphorism of the 4 Section, That intermitting Feave● are void of danger however they intermit, which only is to be understood of such as are void of all malignity; for we see almost▪ every year (in our country at least) tertian intermittent Fevers, which being extremely malignant, do at the third or fourth fit kill the patients: others which bring them into great danger, especially by the cruelty of the Symptoms. There are other Differences of a pestilential Fever taken from the intensnes of their degree or Remissness; namely, as some eaten greater, other lesser, some partake of greater malignity some of lesser. They are said to be simply greater or lesser, according as the Putrefaction is greater or less, or as the preternatural Heat ariseing therefrom, is more intense or remiss; more malignant or benignant, according to the greater or less intention of the venomous quality Hence it comes to pass, that sometimes a pestilential Fever hath extreme putrefaction, and malignancy at the highest; and than it is wont to be most fierce, and therein in regard of the malignancy the vital faculty is exceedingly afflicted; and in regard of the extreme putrefaction, the other faculties are likewise hurt, and cruel symptoms follow thereupon. But sometimes in this Fever the putrefaction is very high, and the malignant quality remiss; and then the Fever is troublesome by reason of the putrefaction; but the vital faculty is less afflicted. contrarily sometimes Putrefaction is little, but the malignant quality intense: and then the Fever in regard of putrefaction shows no such bad symptoms & seems remiss; yet the strength of the patiented is more than ordinarily weakened. For sometimes the putrefaction is so remiss that it is in a manner none at all; but the malignant quality in a very high degree: and then we have a Fever, which seems neither to the Patient nor by standers any thing troublesome; but it seems at first sight mild, as mild can be, when as indeed and intruth it is very mortal; for when the malignant quality is increased, the patient's strength is dejected, and the Heart wholly overwhelmed: and this kind of Fever doth not only deceive the Patients and bystanders, but sometimes the Physicians themselves are thereby cheated; whiles there being no sign present either by crudity or pravity of Humours, the Pulse being in a manner in its natural state, and the heat of the Body at first appearance seeming mild and gentle, it leads unto destruction. Some such thing is likewise wont to happen in the first difference, viz. When it is joined with the highest degree of malignity: for putrefaction being by convenient medicaments subdued, and the signs of recovery appearing; death notwithstanding sometimes ensues by reason the malignant quality did remain uncorrected. And finally the differences of a Pestilent Fever are taken from its adjuncts, and they are very many and most evident, for there is no evil symptom, nor kind of deadly disease which is not sometimes joined with this Fever. The symptoms are Headache, Watch, Raveing, Dead sleeps, Thirst, Stomach-Sickness, and Vomiting, want of Appetite, Swooning▪ Fainting, Hiccoughing, Unquietness Looseness, Sweats and such like, which are common also to other kind of Fevers. But there is one Symptom proper and peculiar to a pestilential Fever, which doth not happen in other Fevers; viz. Purple Specks, or Spots on the whole Body, but especially in the Loins, the breast and back, like unto Flea-bite for the most part; which the Italian Physicians name Peticulae or Petechiae; and these Fevers which have these Symptoms, are commonly named Purpuratae or Petechialis, Purple or Spotted Fevers. For these Purple Spots do not appear in all Pestilential Fevers; but when they appear, they are a most certain Sign of a pestilential Fever. Now we call them Purple Spots, because they are for the most part of a Purple colour. Yet they are many times of a violet colour, Green, bluish, or black, and then they are far worse, and do signify greater Malignity. And although these Spots are for the most part like Flea-bitings: yet they appear somewhat greater: So as to represent those black and blue marks which remain after whipping, and then they are worse. And sometimes they are very large, and possess whole Members, and a great part of the body; viz. the Arms, Thighs, and back, and then the parts appear tainted with redness; which in few hours oftentimes vanisheth away, and then returns again, as it were by Fits, whilst the Fever undergoes its Fits, or Exacerbations; wherein the blood boiling, doth send forth it's thinner Exhalations to the surface of the Skin, by which the Skin is not swelled; but only infected with a red Color. Oftentimes notwithstanding, by these Ebullitions, the Skin is in divers parts puffed up with a certain redness: and makes certain broad and soft tumours in the Skin, which in a few hours vanish away, and are commonly called Ebullitions of the blood. In these, and the aforesaid, there is always some Malignity, but so light, that it threatens no danger; unless in the progress of the Disease it prove more intense. Now the Spots aforesaid like to Flea-bite, do differ from those Pushes, which are wont also sometimes to appear in these Fevers, and are mentioned by Hypocrates in Epidemiis, which have an Head, and are a kind of Tumours, which come sometimes to Suppuration, or Exulceration. But the Purple Spots, have (as was said) no eminence or Head, and were unknown to the Ancients, being described only by later Physicians of after Ages. As to those Diseases which are joined to a Pestilential Fever, we may affirm what hath been said of the Sym ptoms; viz. that many deadly Diseases are joined with these Fevers; namely, Frenzies, Squ● i●es, Pleurisies, Inflammations of the Lungs, Inflammations of the Liver, bloody Fluxes, and very many more. But the chief Diseases which show themselves in a Pestilential Fever, are two, viz. a Pestilent Bubo, and a Carbuncle, which declare the venomous quality to be in the highest degree, and are not found but in the true Pestilence, and are wont commonly to accompany the same: So that the common People call them by the very name of the Pestilence. The Causes of Pestilential Fevers, are some Internal, others External: and the Internal are some Immediate, others Mediate. The Immediate Cause of this Disease, as we hinted before, is a corruption of the Humours, joined with putrefaction. From the Corruption they acquire an evil and venomous Quality and from Putrefaction the Fever is bred. The Mediate Causes are a Plethory, cacochymy, and Obstructions. Now we understand such a Plethory, or fullness of Blood; not as distends the Vessels, but such at least as the strength of the Patient cannot master, which not being regulated by Nature, doth easily undergo Corruption, and Putrefaction. Now a cacochymy, or abundance of evil Humours, is easily corrupted and putrefied. Finally, Obstructions are apt to breed all kind of Fevers: forasmuch as Humours being close shut up in an hot and moist place, wanting free transpiration, do easily putrefy. The Internal Mediate Causes, are by Authors commonly called Morbosus Apparatus, a sickly Disposition of Body; and the efficacy thereof is so great, that it alone is sometimes sufficient to produce a gentle Pestilential Fever, such as is commonly called a Malignant Fever simply, or a Purple Fever, without the Intervention of any External or common Cause. For we ofttimes see, when the year is not Pestilential, and there is no Epidemical sickness abroad, some persons through the evil Condition of their Humours, fall into such Fevers, which are accompanied with many Symptoms of Malignancy; yea, and with other Purple spots. Concerning the point of Obstruction, we must observe, that it doth necessarily concur as the principal Cause in Malignant Fevers, which proceed from Internal Causes, and are not Epidemical: but that Epidemical Fevers▪ which proceed from a common Cause; viz. A Pestilent constitution of the Air, or are gotten by Contagion, have not necessarily any Obstructions for their Cause. For the venomous quality is received only by breathing in the corrupt Air, or only by Infection from others, by which venomous Quality the Humours of the Body, declining from their own proper Nature, do of their own accord putrefy. For even as Fruits that will not keep, and other things ap● to corrupt, though they have never so much freedom of the Air, yet cannot be preserved from Corruption: Even so the Humours, when they have conceived that pernicious Quality, are apt to Corrup-tion: so that though there be no Obstruction present, they necessarily fall into a Putrefaction, and a Fever. Howbeit, Putrefaction being by this means brought into the Humours, when Nature doth no longer rule them, they are wont for the most part to breed Obstructions, whereby the Fever is augmented; so that in these Fever's Obstructions may Concur, which though in the beginning they were not the Cause of the Fever, yet do they follow the same, being cherished by the Causes of the Fever, and being infected with Pestilential Venom. The External Causes of Pestilential Fevers, are the six Non-natural things, which as they are necessary, so do they necessarily alter our bodies: and when they are far departed from their Natural condition, they breed in us Malignant and venomous Qualities. Among these, the Air holds the chief place: which as it is a most common Cause, so Diseases that are common doth for the most part proceed from some fault thereof. Now the Air becomes vicious and hurtful to men, for the most part by a threefold means. First, If it be not blown through with wholesome Winds. Secondly, If it be polluted with the Infection of putrid and stinking Exhalations. Thirdly, If by an excess or preposterous condition of the first Qualities, it doth so alter Men, that thereby evil and malignant putrefactions of the Humours be engendered. The first is evident enough. For if the Air be not blown through, and stirred with Winds, it is easily corrupted. Whence Hypocrates in the 3. Epidem. Describing a most grievous Pestilential constitution, saith; This year had no Winds. And the Second is most effectual and frequent, viz. When Putrid, Filthy, and malignant vapours are mingled with the Air, and do infect the same, which is wont to arise from divers things, viz. Lakes, Pools, Fishponds, and other quiet and still Waters, or such as are full of mud, or wherein Flax, or Hemp have been steeped. Or from the stink of Privies, Dunghills, and nasty Allies. Or from the unburied bodies of such as have been slain in battle. Or out of Dens or Caves or Caves (wherein the Air having been longshut up, hath gained a filthy putrefaction) being opened by an Earthquake, or some other casualty. But the third Reason, which consists in the Excess, Inequality, or Preposterous condition of the first Qualities, may happen divers ways, and especially when there is a great excess of Heat and moisture. For those Qualities, when they are extranious and adventitious, and increased above their Natural condition, they are the principles of putrefactions. Hence a Southern Wind lasting long in the Seasons of the year, according to Hypocrates in Epidem. was the principal cause, of all Pestilential Fevers there described. But a dry Constitution of the Air, though in the Opinion of Hypocrates, it's more wholesome than a moist; yet because excess of Qualities, is hurtful to our Nature; certain it is that a very dry Constitution of the Air, more than ordinary, doth produce Pestilential Fevers; especially if it be joined with Excessive Heat. A clear example whereof we have in Livy in the first Book of his History Decad. 4. viz. How by over great dryness, a Pestilence happened at Rome, because there had been little or no Rain that year: neither was there scarcity of Water from Heaven alone; but the Earth was scarce able to continue her Springs. Now this dry Constitution doth therefore 'Cause the Pestilence, because the Humours being above measure burnt & dried up, degenerate into the Matter of Biles, Carbuncles, and consequently of a Pestilential Fever; and being very much thickened, they produce grievous Obstructions; whereby in a matter otherwise well disposed thereunto, Malignant putrefaction is easily bred. Add hereunto, That this immoderate dryness of the air, doth corrupt the Corn, hindering it from attaining its due maturity. For it brings the Corn sooner out of the Earth, and it gives it at first plentiful nourishment, and afterward Scanty, whereby the Corn is unequally digested, being Burnt without, but within qui●e Raw; like Flesh scorched with an over violent Fire: and so it proves a Cause of indigestion, and divers Crudities. It is proved also from Hypocrates, That immoderate Cold doth produce a Pestilence 1. Epidem. Sect. 5. tempest. 1. where he saith. In the Country of Thasus, a little before the appearance of Arcturus (a Star or Constellation) and whilst He appears, the North Wind blowing, there are many and great Rains. In which places he fetches the Cause of a Pestilential Season, from over great Coldness. Also we may read in Livy Lib. 5. Decad. 1. That a Pestilential Season was caused by vehement Cold; in these Words. The year was remarkable for a Cold, and Snowy Winter, so that the Ways were stopped up, and the River Tiber was unnavigable. So sad a Winter was followed by a grievous and Pestilential Summer, Mortal to all kind of Living-Creatures; whether i● were occasioned, by the sudden change of the Air from one extreme to another, or by some other means. And the reason of this Accident is at hand, viz. That by reason the Pores of the Skin are closed up by the extreme Cold, so that the vapours cannot steem forth so as naturally they should, there follows the greater putrefaction, and more grievous poison; whereupon follows more dangerous fevers, than in the Summer, in which the condition of the air, although in some sort it gives beginning to the Disease, yet doth it make the pores and passages wider, Through which that which putrified does exhale, and the natural and preternatural evaporations do readily breathe out. Inequality of the Season is wont also to be the Cause of this kind of Fevers; viz. when it is sometimes Hot, sometimes Cold; sometimes wet, sometimes dry in a short time; or when these various seasons do endure longer one after another. As when after long vehement Hot weather, a freezing cold claps in, or after long rains, an extreme drought steals upon us, or contrariwise. Or when after a preposterous fashion, it is hot in Winter and cold in Summer. Now these inequalities of Seasons may help the production of Pestilential Fevers; because in them, the humours are exceedingly disturbed, by which means they arrive unto an evil condition, far from their natural stare and fit to produce malignant Diseases especially in those bodies which during the Course of the Seasons aforesaid, by disorderly Course of Diet and living, have contracted either a Plethory a Cacochymy or some notable obstructions. To this kind of Causes may be added the malignant Influence of the Constellations, which by changing the Air, are wont diversely to affect the Bodies of Living Creatures. Such they say are, the Conjunction of the superior Planets, Saturu, Jupiter, and Mars, in humane Signs, such as Virgo and Gemini, and especially when Mars is Lord. Which do bring Diseases in otherwise they by change of the Air, so far as to corrupt the Nature and substance thereof. And that change is wrought two ways; and is by the manifest qualities, as when by the Influence of the Stars the air is so long and so far changed by excess of the first qualities of Heat, Moisture, Cold and Dryness, that at length it's proper Substance becomes vitrated the other is by occult qualities, when by the secret power of the Stars, without any notable excess of the first qualities the substance of the air is so changed, that it receives a certain degree of corruption contrary to our Life. Touching the first, no man doubts, seeing it is clear by Common Consent of Philosophers that inferior Bodies are governed by the Heavenly Constellations. And as the alterations of the Air, which happen in the four seasons of the year, do arise from the yearly motion of the Sun: so the great diversity of years, whereby one proves very moist, another exceeding dry the Sun holding every year the same Course in the Zodiac; can depend on nothing, but the various aspects of the Constellations. The other way because it is occult, is not so freely granted by all. How be it by common Consent of Astrologers, it is held for certain, that the Stars do act upon inferior Bodies in a threefold manner, viz. by their Motion, Light, and Influence The light and beat do alter these Sublunary Bodies according to the first qualities and especially Heat. But the Influences do induce both the first qualities for example the cold which Saturn causes, cannot depend upon his Motion nor his Light) and also the hidden and occult ones. For seeing Pestilential Diseases do ostentimes happen, no great mutation being made in the air in regard of the first qualities; but when they rag●, the 〈◊〉 appears exceeding pure, and puret sometimes, than it is wont to do when there is no pestilence stirring; neither have very hot and moist seasons preceded, from which great putrefactions are wont to arise, it to be conjectured, that these pestilential Diseases do arise from some malignant Influence of the Stars. Ad● hereunto, that Pestilences are wont to rage even in the depth of Winter, which no remarkable alteration of the first qualities hath preceded. For in such a Case▪ these diseases are to be attributed to the hidden power of the Stars which have (as Astrologers teach) a power of corrupting the Air; no extraordinary mutation of the first qualities being made therein. And this is that divine principle in diseases, which Hypocrates acknowledged, and according to the Exposition of Galen is in the Air, but is produced by the Celestial Bodies and hidden causes. It is also hinted at by the same Hypocrates, in the second Epidem. Sect. one. When he says. The time and the Diseases do answer one another, unless some innovation happen in the Superior Powers Neither does that hinder which is brought as the opinion of Plato, out of his Epinomis, that the Course of the Heavens and heavenly Bodies have always good influence here below, and from them nothing but preservation and benefit do flow. And Aristotle in the ninth of his metaphysics Chap. 10. Says that in those Bodies which are eternal and aethereal, neither error nor corruption is found. And Averrhoes says in his 1 De Caelo. cap. 24. The Heavenly Bodies do contain the Elements, preserve them, and universally are unto them instead of a form. whence it's collected, they cannot infect them with a poisonous and malignant quality. Ad hereunto that if pestilential diseases should be raised by influence of the Stars, they would at one and the same time in●ect the whole World almost, seeing those influxes are universal causes, and by the circulation of the Heavenly Bodies, do affect all the quarters of the World. But these diseases do peculiarly invade some one Region only. And finally if the Stars were said to be malefick and of an evil disposition; God the Author of them would be accounted the cause of Mischief, which is full of Impiety. These objections, I say, do not a whit prejudice the truth propounded, which may thus be answered. All created substances are considered two ways; either as they are things in being and do concur to the completing and perfection of the Universe, and in that respect, they are all good: for to be and to be good are one and the same, neither hath the High God blessed for ever created any thing which ought to be termed evil, simply considered. or they are considered in regard of their operations, and then they may be termed evil, forasmuch as they may damnefie some other things by reason of the antipathy & inbred Enmity of Nature. And although almost innumerable contrarietyes of nature are found in the world, yet must they all be termed good in respect to God their maker, & in regard of the Univers, whose perfection consists chief in variety. Furthermore the operations of things created, may be termed evil two ways absolutely or simply considered in themselves, or in respect of somewhat else; They are absolutely evil when at all times, in all places and upon all occasions they do perpetually evil; and in this sense no Creature can be found which is evil; in respect of some other thing, the operations of things may be termed evil when they hurt one and do another good; and so there is nothing in the whole universe so hurtful, but that it hath some other ways its uses & benefits, for which it was created: So all poisons though most hurtful to men or other Animals, yet conveniently used they do a great deal of good to them. And in the Art of Physic there is scarce so deadly a poison found, but that out of it, by skill of Art, an healthful medicine may be drawn. And finally the actions of Stars upon these inferior Bodies are considered two ways, either in respect of the whole sublunary world containing the Elements and all mixed things: and so the action of the Heavens and Stars is simply benign, engendering, conserveing, vivifieing all things, & doing all other good offices which tend to uphold the univers; & in this sense most true it is, that these inferior Bodies are cherished & sustained by the influence of the Heaven and Heavenly Bodies, or they are considered in respect of the proper nature of this or that Element, or this or that living creature: and then it is no absurdity to say that there are some influences hurtful to some Element or living Creature in such or such a part ●● and so affected which depends not of any fault of the stars (for they are of a most perfect nature) but rather of the imperfection of sublunary things which cannot suffer any considerable mutation without the corruption of their proper substance: now these divers natures and qualities of the stars, produced in sublunary Bodies by their divers concourse and influence were ordained by the great Architect of this universe, for the Conservation of the whole world which being 〈◊〉 up of so divers and so contrary natures, had need of as g eat variety in the influence of the Stars, that all things might be preserved, as it were in an even balance out of which diversity of influences notwithstanding, it could hardly come to pass but that some parcel of things so different should sometiems suffer, not in any whole kind o● sort (which should tend to the destruction of the universe) but only in some individuals that were less able to resist and for the most part misaffecred, and only in some part of the Air more disposed to receive malignant influences. From whence we may conclude, that those corruptions do chief depend upon the defect of sublunary bodies forasmuch as many places are in the world, where the air is so perfectly constituted and the inhabitants ●o evenly tempered, that let never so malignant Influences of Stars show● upon them, yet are they never infected other pestilence. To the same kind of Causes must we refer the Defects and Eclipses of Sun and Moon, unusual Meteors and especially Blazing Stars: which are never wont to appear but that Epidemical and Pestilential Sicknesses, and Divers changes in the World do follow, as is confirmed by the experiments of many Histories: whence that usually Cited verse of Claudian is become as a Proverb. In Caelo nunquam Spectatum impune Cometam. A blazing Star does not appear. But some Beholders plagued are. A most evident witness whereof was that hairy Comet which appeared Anno 1618. Towards the East on the 27 of November and was afterwards seen near upon the whole Month of December, moving and shining. It's thicker and more solid part being turned towards the Sun, did behold the East, and did far exceed Venus, both in the clearness of its shining, and in its largnes, thickly compacted and conglobated together. The remaining part, being more thin, and less enlightened by the Sun, because of its thinness did move like fairly spread beard and stretched towards the West. This Comet first appeared under the sign of Libra near the Aequinoctial Line; but by a private and peculiar motion of its own, it was carried from thence, through the feet of Virgo, the middle of Boötes and the tail of the greater Bear. And at length, its light decreasing by little and little and the matter whereof it consisted being dissipated, it vanished between the great Bear and the Dragon. It was carried with the common motion of the Stars from East to West, but it seemed to be moved some what swifter than the Stars, for in the first Days of its Apparition, it was wont to rise a little before five in the morning; and afterwards it risen about four a Clock and before four, and so sooner and sooner, till it prevented the Midnight, and Bedtime. And we have reason to believe, that this Comet was the Prognostic and sorerunner of malignant and pestilential Diseases, and also of those Wars, wherewith whole Europe in a manner, hath since that time been laid Waste. And although the Air be chief among the mediate Causes of malignant and pestilential Fevers: yet sure enough other non-natural things do concur to their generation, as I shall particularly and berifly declare. The next to air are Aliments, because bad Diet Causth a sickly disposition of the body, which is an internal efficient, and Causasine qua non, or malignant and Pestilential Fevers. Whereupon Galen in his Book De Cibis boni et mali Succi, and in the 1. de Differ. Feb. Chap. 3. Does demonstrate, that from bad and corrupt Diet Pestilential Diseases do arise. Now meats are said to be evil and the Causes of those diseases in many respects. And in the first place, when the Fruits of the Earth and of Trees, by reason of a bad constitution of the year viz. Over moist or over dry, or corrupted by mists, or some tempestuous weather, or some malignant influence of the stars; do, being eaten, produce bad Juices in the body. Secondly, when there is great Famine and scarcity of Corn: From whence came that Proverb Ho loimos meta limon, the Plague follows famine. For then the poor common People are forced to fill their bellies with such meats as are cheap and bad, whence arises abundance of bad Humours. And which is much worse, when a plenty presently follows famine, they do then suddenly cram themselves with much meat, which by the languishing heat of their internal parts cannot be well digested, and thereupon those meats come to participate of a malignant putrefaction. Thirdly, When Aliments, which in their own Nature are good do by some way or other, gain putrefaction or some evil quality, such are wheat, barley, beans, and pease, and other kind of grain, which being either overlong kept, or ill laid up in a moist place, or otherwise misaffected, do come to be musty, or have some other putrefactive quality. Such is flesh over long kept, or stinking or such as is of beasts that were not killed, but died of some disease: as Julius Obsequens relates, that in the Isle called Lipara when the Sea was made hot, the fires which by means of an Earthquake were forcibly vomited out of the Mount Aetina, and had boiled the Fishes casting them upon the sho●●● the Inhabitants eating greedily of those Fishes, a sore Pestilence followed. Neither is there less power in drinks, when putrid and corrupted wines or beer or other liquors are drunk; or when water is drunk out of putrid and muddy Lakes, or otherways infected. As good Histories do ●●sti●ie that numerous Armies, have been destroyed by pestilential Diseases, with drinking such waters. These non-natural things mentioned viz. Ayr and Meats and drinks, have the greatest force to engender malignant Fevers. but the four remaining viz. things voided or retained Motion and Rest Sleep and waking, with Pamons of the Mind, are of less efficacy, and do only concur as adjuvaut Causes, or such as dispose the body to conceive a malignant pucrefaction; as in our exposition of them shall presently appear. The ●●tention of Courses in women, or of some other accustomed evacuation Men, as of the Hemorrhoides, blee●●ing at nose, and Looseness, which betides some persons, at certain seasons; when they happen in a pestilential year, they are wont to produce a malignant disease. For those things which are wont to be avoided as superfluous and burdensome to Nature, if they be retained in the body, they do easily conceive putrefaction so likewise over great evacuations either of blood or other humours, do much weaken the Body, and do 'Cause that Natural Heat being weakened, it is soon infected by the vicious and pestilential impurities of the Air. As for motion and rest, certain it is, that overmuch Idleness is a Cause, that Natural heat is not sufficiently e●entilated, and consequently the Humours conceive putrefaction: so over great exercise does very much open the pores, and dissolves the Heat; whereupon the body becoming weak and more apt to take impression, does easily receive the Infection. And too much sleep, makes many Excrements and fills the body with Humidities, which easily putrefy, but too much watching does engender Crudities, and they easily putrefy, because Natural Heat cannot well master them: and because by them, many obstructions are caused, by which Transpiration is prohibited, and at length putrefaction engendered. And finally, passions of the Mind, are wont vehemently to exagitate the body and to disturb the humours: and so they much Dispose the body to receive infection; and especially fear and Sadness which Drawing the vital Spirits inward, do as it were choke and smother them, whereby the vigour of the Heart is so broken, that it cannot sufficiently resist the venom and first assaults of pestilential Sicknesses, yea verily and the Humours being stirred in the veins and vehemently disturbed, are thrust out of their Natural constitution, and do conceive a malignant putrefaction. Insomuch that some have conceived, that Pestilential Diseases are bred in Camps and at Sieges of Towns, not so much through bad Diet and stink of dead Carcases, as through Terror, Fear, Anxiety and dread of Death, which do exagitate the Humours, and put them into a tumultuary Combustion and Fluctuation. The Signs of a pestilential Fever do some of them foretell the disease when it is coming; others declare it to be present; and others witness where it has been. All which must be set down, because the first tend to Preservation, the second to Cure, and the third sort to be a Caveat to such as are not yet infected. The Signs which foreshow a pestilential Fever, are taken from three things viz. From the the Disposition of the Body, from the Presence of Causes, and from some intermediate dispositions. Those bodies are disposed to receive pestilential Infection, which have collected evil Juices through bad diet, and by a preposterous use of the six non-natural things aforesaid. Or such as being plethoric do gorge themselves and inordinately and unseasonably replenish themselves. Furthermore some that are neither plethoric nor cacochymical, do dispose their bodies to the reception of this disease, while they torment their minds with most troublesome passions, or give themselves immoderately to carnal embracements; for from these two Causes, the pestilential fever is very ordinarily produced, forasmuch as by them corruption is easily introduced even amongst good humours for Passions of the Mind do distract and draw away the spirits, from their proper operations and overmuch Carnal embracement, does weaken all the powers of the body▪ but, the Spirits being distracted, and the virtues weakened, the Humorrs change their Nature, and grow corrupt. Finally, those whose principal Members are weak, or some ways tainted, either from the womb, or by bad diet or any other external Cause; which have an hot and moist temperature; which have a very thin or very compacted habit of body, are all disposed to pestilential Fevers, for hot and moist bodies are subject to putrefaction, thin bodies are liable to all 〈◊〉, compacted constitutions, have no free transpiration. The presence of such Causes as can breed a pestilential fever do portend the same: and consequently i'll seasons and unnatural temper of the year, Dearth, and Scarcity of Victuals, Wars and other Causes, reckoned up before, when they appear, they declare the Plague to ●● approaching. Those intermediate dispositions are, when such a disposition o● body and the Causes aforesaid being present, we see a Man more ●ad than ordinary, an unexplicable fear in him without good ground or cause, the Colour of the face changed; is not rightly disposed in point of die; is disturbed with bad dreams; infested with weariness which comes without labour, thirst, watch, stomachsickne●; it is easily conjectured, that man will have the Pesttilence: for all there thing do declare, that the humours do attain another nature, and do corrupt▪ from whence comes a pestilential Fever. Such Signs as declare the Pestilence to be present are exactly to be propounded and therefore all the Heads of Signs must be run over out of which this Disease may be known▪ which Heads of signs, are taken from the three kinds of symptoms, because the symptoms are the Effects of Diseases, and Causes can no way so conveniently be known as by their effects. And therefore, some signs are taken from the Actions hurt, some from Excrements voided, and others from qualites changed. Unto which Heads a fourth must be added taken from supervenient Infirmites'. To the right understanding of which, these things following must be premised. Frist, we must know that the same signs in a manner do show a pestilental Fever properly so called, and a Fever simply malignant, and that the signs of the one and the other do differ only according to more and le●s; so that in the pestilential Fever the symptoms are more, and in the malignant Fever less cruel; yet there are some adjuncts more proper to the one than the other which we shall declare in their proper place. Secondly, we must note, that there is no true, proper and Pathognomonick sign of these Fever's viz. Such an one as wherever that sign is, there is the pestilence, and where that sign is not, there is no pestilence; no not the Bubo or swelling in the Groin nor the Carbuncle; seeing that many have them not though they have the plague, and many have Buboes and Carbuncles that have no malignity in them: neither are those purple spots any such pathognomonick sign, although a malignant Fever is from them termed the spotted Fever, forasmuch as many have a malignant Fever without any such spots; & those spots do sometimes appear on women that want, their courses, and in some Children by reason of a light ebullition of ●lood, without any Fever, which I have often seen in both. Howbeit by a Concurrency and collection of all signs and tokens these Fevers may certainly be known, Thirdly, we must mark, that all the signs which shall be propounded, are not found in all sick persons of these Fevers; but only a part of them, which notwithstanding will be sufficient, punctually to discover the kind of the disease. For according to the variety of patient's bodies & the intention or remissness of the disease, now these kind of symptoms, & anon those do; chief show themselves. Finally, it must be known, that the signs of a pestilential and malignant Fever (although they are also found in other Fevers) yet are made in some sort pathognomonick in this Fever in a twofold respect. First, because in these Fevers, they are so conditioned as in other Fevers they are not. For the Headache, Illness at Stomach, Vomiting, the manner of the Heat and other signs, when they accompany pestilential Fevers, they have a peculiar malignant condition whereby they differ from themselves when they accompany other ordinary Fevers; which is well known to them that are but indifferently exercised in the Practice of Physic. Secondly, because the symptoms do not observe the same proportion among themselves in these Fevers, which they do in ordinary ones. So that the heat being gentle to the touch, the pulse not much changed, do show a small Fever: yet with them is joined mighty Headache, watch and sometimes raveings, and other symptoms which are wont to accompany a burning Fever. These things being thus premised, we shall describe the order of signs, beginning from the actions hindered. Because therefore, the Heart is chiefly afflicted in these diseases, by the malignant and venomous quality thereof, therefore its action viz. The Pulse, is diversely changed, according to the variety of times and the divers condition of the diseas●▪ For sometimes at the first, it is in a manner natural, and very like the pulse of persons in health, as Galen shows in the 3 de presag. cap. 4. but in the progress and augmentation of the disease, it is little, weak and unequal. Also the frequentness of the pulse is always more than the increase of heat can require, because the Heart being provoked by the malignant quality, doth in that regard disturb itself more than the necessity of eventilation doth require. Likewise the signs of this Fever are. Cardialgia, Heart burning or pain of the mouth of the stomach, which Hypocrates condemns as a sign of malignity 1. Progn. in these words, Pam of the mouth of the stomach, with distension of the Hypochondria and Headache, are signs of malignity. Sometimes great thirst, exceeding the measure of the Patient's heat and sometimes want of thirst, with a vehement Fever, and dryness of the Tongue, for both are signs of malignity Great want of appetite which make many abhor all kinds of meat, as much as if they were the most loathsome medicines. Now this is wont to arise from malignant vapours which vex the stomach. Stomach Sickness and vomiting arising from the same Cause, especially when it happens in the beginning of the disease, and is so divers that some presently vomit what they eat; other vomits as soon as they have taken broth, but they vomit not the broth which they took, but divers kinds of Humours; some keep any kind of meat, but vomit their Drinks, juleps, Emulsions and whatever drinking matter is given them, presently; great thirst notwithstanding remaining, with dryness and blackness of the tongue. A frequent and inordinate shivering, which comes divers times in a day, springing from sharp and biting exhalations of an adverse quality to our natures, which are carried unto the sensitive parts: which kind of shivering does rarely happen in other putrid Fevers, because the vapours in them have not the like malignity. In malignant intermitting tertians, sometimes a sign of malignity is taken from the shaking and the cold. For it sometimes happens, that in the beginning of the fit, with a light coldness or shivering, the heat doth so much retire inwards, that the flesh of the patiented is very cold and the face is like that of a dead person, and the pulse so little as if it did not beat at al. After which follows an Heat, which neither in the Augment nor in the state, doth to the touch feel great or sharp; yea and the flesh of the patiented is either lukewarm to feel to, or coldish even to the declination. The pulse, when the heat comes, doth more appear, yet it is small, unequal, frequent and very weak: and many other symptoms of a pestilential Fever are present, which may sufficiently prove, that there are intermitting malignant Fevers as well as continual; as was hinted before. Wearyness of the whole body, Heaviness, and a breaking as it were of the members appear in the beginning of the disease, by reason of the foresaid vapours, dispersed through the whole Body Pains of the Head, Watch and Raveing, which all come from the same causes, viz. from sharp and venomous vapours; which when they lodge themselves in the membranes of the Brain, they cause headache and in as much as they heat and dry the very substance of the brain, if the alteration be but small, they cause watch, if great they cause rave. And to these symptoms, besides Heat and Dryness, the venomous quality contributes much, because in the vulgar Fevers such symptoms do not happen, unless the distemper be much more than ordinary. And pains in this Fever, have a peculiar property to be very divers, & to shift places. For sometimes only the fore part of the head, otherwhiles the hinder part, now the forehead, anon the eyebrows are cu●a●under as it were with pam, and sometimes other parts as the shoulderblades, the sides, the back, etc. Sometimes it is fixed in one part, otherwhiles it changeth place and vexes now this, now that part of the body. In some patients drowsy and sleepy dispositions happen, viz. In such as have their brains full of phlegmatic excrements: which phlegmatic excrements, are desolved by hot vapours ascending from the inferior parts, and do hinder the functions of the Brain. The urine in these pestilential Fevers, is sometimes like the urine of sound persons, namely when the humours do more offend through a malignant Quality, than by putrefaction; & sometimes it continues so for the first days; afterwards it becomes thick & troubled. Sometimes in the state of the disease, it appears concoct, though the sick are in a perishing condition. sometimes, it is thin and crude, having no sediment, or such a sediment as is more like an excrement than a sediment. But most commonly it appears thick and troubled, and of an high colour; and hath a thick, red, distrubed and scattered sediment. And finally all evil dispositions of urines, do happen in this disease, according to the divers alterations of the putresieing and corrupted Humours. Choleric fluxes of the belly, which either comes of themselves or through some like occasions by some gentle Clyster or medicament; which bring many to their end, So Hypocrates relates in 3. Epidem. In a pestilential Constitution there described, that many died of the looseness and Bloodyflux: For the Humours being made more furious by the malignant quality which is in them, do exceedingly provoke Nature, so that she endeavours to drive them out the nearest way: Now in these Stools, there is wont to be a mighty stink, by reason of the extreme corruption of the humours. An abundance of Worms is wont to be avoided in this disease, especially at the beginning: For the great Putrefaction doth very much dispose the Humours to breed Worms. Frequent sweats, small, short and unprofitable do break forth in the beginning of the disease. The Heat is mild and gentle to feel to, so that they searse seem to have a Fever, whereupon Galen 9 Simp. cap. de Bolo Armen, & Avic. fen 4. lib. 1. cap de febre pestilenti. Do teach that pestilential Fevers have oft-times a mild and gentle Heat; and the reason is, because these diseases are rather caused by a malignant and venomous quality, than of an ordinary distemper and Pucrefaction. Readness of the eyes isoften seen in pestilential Fevers, because the membranes of the Brain are in a sort inflamed by sharp vapours ascending into the head, which they easily communicate to the Tunica adnata or skin of the eyes so called, which is propagated from the said membranes Finally, purple spots like Flea-bite, called by later Physicians Peticulos or Petechiae, are the proper and peculiar Signs of a malignant Fever. For they are found in no other kind of Fever; forasmuch as they do arise from a vicious quality of the blood or other humours, joined with malignity. Yet there do appear in other diseases, spots very like unto those aforesaid, but springing from a far different Cause; viz. From the over thinness of the blood, which being exagitated by the heat or the expulsive faculty, does sprout forth of the Capillary Veins into the Skin. These spots, are wont for the most part to appear in such as have some flux of blood, because the blood in such is more thin and watery: and also in splenetic persons, in such as have the Jaundice and old obstructions of the Bowels, and (in a word) in all such, who by reason of the weakness of their Bowels, do breed watery blood and are apt to fall into a Cachexy. For in such persons, the blood being made thinner than ordinary, sometimes flows out at the Nose, sometimes at some other part, and sometimes it comes out of the Capillary Veins into the Skin; where being retained, it losethits own coluor, and becomes either bluish, or black, or light red, and causes great variety of spots; which notwithstanding are very far different from the spots of pestilential fevers, and do argue nothing but the watery thinness of the blood and weakness of the Liver. Now those spots which come out, in Pestilential fevers, do arise from Humours putrefiing and infected with an evil quality. Furthermore, those spots do break out sometimes critically and sometimes Symptomatically. Critically, when as Nature having either in Part or in whole overcome the putrefaction and corrected the bad quality, does drive the corrupt humour to the external parts; And then the disease is evermore abated. Symptomatically when Nature is pricked forward by the quantity or evil quality of the morbific matter, does transmit a portion thereof unto the Skin, before it be concocted, or the evil quality thereof amended. And from thence the Patient receives no Ease, but rather, Nature having unprofitably wrestled with the disease, it is a token rather that she is conquered than conquers. The Colours of these spots are divers▪ and do show the Diversity of the humours by which they are bred. For the red spots are bred of the purer sort of blood, and the black from choleric blood more or less adust. As for the store of these spots, sometime they appear in greater numbers and sometimes in less. They begin to appear sometimes on the fourth, fifth, seventh, or ninth, or some other critical day, if their coming out portend any good; sometimes on other days, when there is little good to be hoped for thereby. Sometimes they are seen in all parts of the body, but most frequently in the Loins, breast and Neck. Now the Diseases which come, upon a pestilential fever for the most part are, something coming out like Pox called Exanthemata; Pushes and Ulcers of the Mouth; Carbuncles; Rise in the Groin and behind the Ears. The Exanthemata aforesaid, differ from the purple spots, because in the spots there is only the colour changed, but here is a certain rising in these Exanthemata to an head. Sometimes they are like warts, and sometimes less, resembling millet seed. Sometimes they are red, being caused by blood sometimes white, proceeding of phlegm or Serosities; yellow from choler; purple from adust Choler; bluish or black, by reason of great burning or Mortification. Some break out Symptomatically, others Critically, others in a middle way. Some dry away, others come to matter, others grow to be ulcerous. To these may be referred bushes appearing in the Mouth which have all the differences of the forsaid Exanthemata, and are sometimes so malignant, that the sick can hardly endure to eat and drink. From Children they often Cause Death because they will not endure the pain of eating and drinking. These bushes do sometimes degenerate into Ulcers, which breed very great trouble to the patients, hindering the motion of their tongue and especially their swallowing. But sometimes Ulcers are bred in the Mouth immediately without any pustules or bushes foregoing which the Greeks call Aphthe: of which there are many sorts. For some are superficial, others profound; some clean, others foul; some benign, others malignant; some with a Crust, others without. And the Crust is sometimes white, sometimes yellow, sometimes bluish or black. Those which are deep, filthy and malignant and that have a black Crust, are the most dangerous. Carbuncles and Buboes, are wont to rise in divers parts of the body, but especially where the Glandules are; because the expulsive faculty being provoked by a malignant quality does expel the pernicious matter from the internal parts especially the more noble ones to the external: so that from the Brain she sends it to the Glandules or kernels behind the Ears; from the Heart, to the Armpits; from the Liver to the groins; whence swell under the Ears called Parotides, & those in the Groin called Bubones, do arise. Which kinds of tumours do chiefly appear in a true pestilential fever, especially those in the Groin, which therefore the common people call the Pest or Plague. But Carbuncles and Parotides orrisings behind the Ears, do also break out in malignant Fevers, but in such as are at the top of malignity, and come very near the Nature of true Pestilential Fevers. Signs commemorative, are chief in request when Physicians are called to view the Corpse of the dead, at ●uch times as there is a Plague abroad, or some suspicion thereof, that it may be known whether the party died of the plague or not. And first of all, in such dead bodies there do sometimes appear those spots of which we spoke before and sometimes marks, or stripes, as it were after whipping: for these are the tokens of a Pestilential disease and venomous, seeing those that are poisoned have also these signs. And those spots do especially denote the Pestilence, when they are of a lead Color or black. Also those Exanthemata spoken of before, do show the same, especially if they have a bad Color: but much more the Buboes, Tarotides and Carbuncles whereunto may be added such signs as have appeared in the Course of the disease: for the recounting of them will make a certain demonstration. The Prognostic of Pestilential Fevers is so uncertain, that nothing can be certainly affirmed touching their Event, until certain tokens appear either that Nature or the disease hath gotten victory; which is not wont to happen, unless about the end of the state or the Beginning of the Declination. Where the discreet Physician ought to delay and suspend his Judgement touching the Issue of the disease in the Beginning and the Augment We must nevertheless propound the chief tokens out of which we may draw a great Conjecture, whether the disease will end in Death or Health, by help whereof we may foresee, what is to be hoped or feared. yet not being over confident: for Experience hath taught us, that many have escaped, with most mortal signs; and others have perished under all the tokens of Recovery. But we shall pass over all such prognostic signs which are common to all acute diseases, of which Hypocrates hath discoursed largely in his Prognostics, Coick, Predictions, Procheticks, and epidemics and likewise in his Aphorisms, which may have a place likewise in this disease. But we will propound only such as are proper in a special manner to pestilential Fevers, from which a more certain Prediction may be drawn. Now these may be drawn from the same fountains from whence we drew the Diagnosticks. First Therefore, in these Fevers, if the pulse keep a tenor and equality, be the Fever never so great, it gives always some matter of hopes. Contrarily an inordinate, unequal and contracted pulse, is dangerous, especially if it appear weak from the Beginning. But those differences of pulses are not so dangerous in malignant Fevers, as in ordinary ones. For although an intermitting pulse in a young man, be so deadly a sign, that Galen testifies, though he had seen many old folks and children escape having an intermitting pulse divers days and yet escaped. Pulses like those of persons in Health are very dangerous: for they signify that Nature out of weakness abstains from the Concoction of Humours. For where by an evil and pernicious quality, the strength is exceedingly weakened, Nature being weak, does not set herself to digest the matter, not meedling with the Humour which hath caused the disease: so that no endeavour of coction being used, no labour follows, and there is either no Fever, or a very little one. We have an example hereof in external tumours, in which so long as the Part is almost overwhelmed by the plenty or i'll condition of the matter, there is neither Pain nor Terror; but whereas Nature gins to fight against the matter and to turn it into quittor then the fever is much increased. Even so in malignant seavers, the Patients seem sometimes freed from their fever, whereas they grow worse and draw towards death: as we may see in Hypocrates 3. Epidem. Secti. Aegr. 2. where Hermocrates from the twentieth day to the twenty fourth seemed to have no Fever, and yet on the twenty sixth he died. Raving is very common in this Fever. neither is it to be feared, if it be lessened by sleep, and especially if it vanish away with a plentiful sweat: for 'tis a sign that the matter is drawn from the Brain, into the habit of the Body. But a persevering dotage, is pernicious, because it's a token that it degenerates into a true Frenzy. The contractions and hoppings of the Members, which do often happen in this Fever, are Convusive motions and very pernicious, and that the more if joined with raving, for they signify the brain to be extremely hurt Trembling motions of the hands and Tongue are wont to be deadly and are by Hypocrates much condemned in the 1. Prognost. For they show great weakeness, and that Nature is overcome by the disease. deafness though in the beginnings of occult diseases it be exceeding dangerous, according to the Doctrine of Hypocrates; yet if it appear in the State of a disease it portends health, especially in malignant Fevers. And I have observed a thousand times, that such as being sick of Pestilential Fevers, were taken Deaf in the State of the disease, did all escape, though the other symptoms were never so dangerous; for it is a token that the brain, being sufficiently strong does thrust the humours from the internal to the external parts. Sneezing, according to Hypocrates, even in deadly diseases (provided the Lungs be in good Case) do give Hope of recovery. But in malignant Fevers, be the symptoms otherwise never so dangerous, they promise Recovery. Frequent Heart-burnings or Hiccoughing, do portend danger, and signify that the stomach is grievously afflicted by the venomous quality. Extreme averseness to meat, is very dangerous for it signifies the Stomach to be mastered by the malignant quality of the Humour, and that its temper is wholly overthrown, so that it refuseth and abominates laudable nourishment, which it most familiarly affecteth in time of Health. Suppression of all evacuations in the beginning and augment of the Disease, is counted a good sign. For it shows that the morbific matter is not so malignant, as to provoke Nature to excretion before the due time but that Nature does yet conquer, and will in due time expel the matter, provided there be no sign that the Humour will settle in the Head, Belly or any principal part. But in the state of the disease for nothing to be evacuated, but for worse signs to appear in some principal member; is bad. For it's a sign the disease will either last long, or give little hope of Life. For the matter which in divers days could not be overcome, does bring some great damage in the same member, as a frenzy, Lethargy, and others which arise after the eleventh of fourteenth day, which can very hardly be cured by all the Medicines imaginable. Blood that is drawn by Phlebotomy, if it appear no ways faulty, but pure and according to Nature, 'tis a dangerous token. For it is a plain argument that there is more of a venomous quality, than of putrefaction; or that putrefaction may lurk in the Veins next the Heart, which cannot be drawn away by Phlebotomy. From Urines in a Pestilential Fever, there is scarce any, or a very uncertain prediction to be made. For not only the confused, troubled, thinner, and thicker Urine▪ are bad, as in other Fevers: But also that Urine which is like the Urine of a healthy Person. Yea verily, and many have died, after the Urines have showed signs of Concoction, and then became crude again. Howbeit, Concocted Urines, and which have a laudable Enaeorema continuing many days; and daily more uniting itself▪ and descending by little and little into the bottom of the Urinal, doth perpetualy promise certain recovery, even in malignant Fevers. For it cannot be, that a lusty and strong natural Faculty, which discovers itself plainly in these Urines, should not rise●s against the malignant Quality, and at length overcome the same. And therefore I have oftentimes with great confidence foretold a good event from the signs of Concoction persevering in the Urines in such as have had malignant Fevers, attended with most grievous Symptoms, so that all the Bystanders were in great fear of their Lives. A Fat and oily Urine, black or livid, with a black or bluish settling, doth certainly betoken death. Very much Urine being made, and no abatement of the Fever thereupon is dangerous, because it signifies a melting of the Body. Sweats in this Fever, although they come well conditioned, and in the Critical day, doth seldom perfectly judge the Disease. And sometimes the Fever is abated by Sweat on the first day; and then the Symptoms grow high, and after many Sweats the Patient dies. For plentiful Sweats, not diminishing the Disease, doth arise from the melting of the whole Body. Neither must we therefore believe, that Critical Sweats doth never any good in these Fevers. For by how much less Venom there is in the Disease, they do so much the more good; as it happens in ordinary Fevers. And we find by Observation, that 'tis far the better for the Patients to Sweat often at the beginning of the Disease (provided they be not worse after their Sweats) for 'tis a sign that Nature doth attenuate the Matter by little and little, and expel the same by Sweat. Looseness of the Belly is a very uncertain sign. For oftentimes a Looseness at the beginning of the Disease hath been good, which yet experience shows, is sometimes a deadly token. Again after some Coction, we have seen the Patient killed, by a looseness, and sometimes by the same recovered: Yet we must thus distinguish. When a venomous Quality hath the mastery, the more the Matter goes away by Stool at the beginning of the Disease, the less danger. But when the Disease arises most part from putrefaction of the Humours, they are worse that are lose, at the beginning of the Disease. Purple spots▪ when they are many and large, and of a benign colour, and break out Critically they foretell that Nature will Conquer. But if they be few, small, & of a bad colour, and are Symptomatically put forth, they signify that Nature is never worsted. And further, If they go in again, it's the worst sign of all; for it shows that the morbific Matters reflux into the inward parts. Exanthemata, or wheels appearing in divers parts of the Body, are effects of greater malignity than Purple Spots, and consequently portend greater danger. Carbuncles and Buboes, or rise in the Groin and some other parts, doth witness greatest malignity, and threaten most danger: seeing they are wont to follow those Fevers whose peculiar Character it is, that more die of them than recover. Carbuncles & Buboes, by how much they are the further from the Heart, grow faster and come quicker to ripen, by so much the less dangerous are they. But if Tumours increase suddenly with bad Symptoms, 'tis ill. Carbuncles very great, of a filthy colour, with an eating Ulcer, or which turn into a Grangrene, are deadly: as also those which are near the Heart, or rise upon the Throat Experience hath taught that many Carbuncles are more dangerous than few; and contrarily many Buboes or other rise are more safe, than few. Perotides (or rise behind the Ears) in malignant and Purple Fevers, are in the Augment and state deadly. But if they appear when the Disease doth never so little decline and come to Suppuration, they are a good token. The Cure of a Pestilential Fever is divided into two parts. The first contains the preservation of those that have it not; the second contains the healing of those that have it. The preservation from the Pest consists chief in taking away of those Causes, which make Bodies fit to receive the Pestilence, and breed it in them. And they are Internal or External; the Internal are a Disposition of the Body apt thereto, a Plethorie, a Cachochimy, and Obstructions. The External are especially, a vitiated Air, and a wand'ring Contagion. Bodies disposed to this Disease, are such as either Naturally or Accidently, are more moist than they ought to be; Weak lax and rare, dense and compact. Moist bodies must be dried; dry must be preserved in that temper; the former must avoid full diet, much drinking and all moist nourishments; such as are especially Fruits that will not keep, Herbs, Fishes, Meats made of milk; the South air, such as comes from lakes, and especially the air of the night, Idleness, long Sleep, especially Sleeping after dinners, Batheings and whatever else can moisten the Body. Let weak bodies be strengthened, with a restorative diet and with strengthening medicaments. Those of a rare lax and thin constitution, need the same ways of prevention with the moist. But the dense and compacted constitution▪ because it is most of all disposed to a pestilential disease must more carefully be freed from a plethorie, cacochymy and from obstruction; which causes, seeing in all bodies they may breed this kind of Fever, as internal causes, we m●st perpetually study their removal. A Plethory requires Phlebotimy provided nothing do advise the contrary, as a very cold or hot season of the year, and a pestilential Constitution of the Air in which a vein must not be opened, unless a Plethora ad vasa do manifestly urge the same; or some usual evacuations of blood by courses, hemorrhoids, or nose-bleeding, have been stopped. For the blood being exhausted the air which is breathed in will more easily imprint its pestilential quality, and in case the disease happen, the Patient will the hardlier escape, for being weakened by blood-leting even as they who drink poison after blood letting, it penetrates the more and they are with more difficulty recovered. Also when we fear poison, we let not the patiented blood, so Galen Lib. 7. de diff. Feb. Cap. 4. Where he propounds a preservation from a pestilential Fever, he prescribes indeed Purgation and opening of obstructions; but he makes no mention of Phlebotomy To Cacochymy we must oppose purgeing, such as is proper for the bumors offending, convenient preparation being premised if it seem necessary: with this caution, that benign medicaments be only used, abstaining from such as have a malignant and deadly quality. with which it will be good to mix some bezoartics and such things as are Alexipharmical. Obstructions are caused by the multitude of humours their thickness and clamminess. The multitude will be helped by such urine as evacuates the thickness; by such as attenuate the cla mminess by things that are abstersive or cleansing. In respect of external causes, Precaution must be made first by correcting the excesses of the air viz. By cooling that which is too hot, as we taught in continual Fevers; by drying that which is over moist, with sires both in streets & in private houses, and that as much as may be made with sweet woods as Juniper, Bayes, Rosemary and such like. Secondly by removing all the causes above recited which do infect the air. Thirdly by consuming and dissipating the infections in the air. which may be done by kindling of fires, as was said in correcting the moisture of the air, and the perfumes of sweet smelling and Alexipharmical materials. Also by vehement agitation of the air, to which end the frequent discharging of great Guns will be very effectual. But if the air shall be very much infected, so as therefrom a Fever truly pestilential shall arise, the best kind of preservative is to change the air, and they that are forced to continue, or to converse in places infected and among the sick: have need of many other cautions and they must often use Antidotes. All which are at large set down by such Authors as have treated expressly of the Plague, and from thence the reader must fetch them; because my design is but briefly to touch such things as are requisite to the cure of the true pestilence; because few Physicians of any note dare hazard themselves in the cure of the true Plague: & contrarily seeing both in England & in France and whole Europe over; all Physicians in a manner have employed themselves in the cure of spotted and malignant Fevers; I have thought it most worth my pains to direct this cure to that kind of pestilential Fever, which is simply called malignant and the spotted or purple Fever. Yet so that it may serve for the cure of the true Plague; seeing as we said at the beginning, the same Medicines and the same Indications, will serve for both. The Cure therefore of those which are actualy sick must be directed unto the Fever, the putrefaction and the malignant quality. The Fevers must be opposed with Coolers and Moisteners, the Putrefaction with Evacuators and Alterers. The malignant quality with Antidotes. All which intentions must be satisfied by a threefold Medicinal Means after the manner following. The same diet must be appointed in this Fever which was appointed in the continual Fevers. Only this one thing must be observed, that sharp things must be oftener used in drinks and broths as being very fit to resist putrefaction and the malignant quality. Also touching drink this must be observed that the use of wine and strong drink is sometimes good in this Fever, because they and especially wine are very cordial and contrary to the malignant quality. Yet many times they do much hurt and increase the heat of the Fever. Wherefore the prudence of a physician, is in this case very necessary, that he may contemplate the Nature of the disease and constitution of the patiented: for by this means he shall know whether the use of wine or strong drink be safe or no For if the Fever be very small, but the venomous quality very intense, and the body of the patiented abound with phlegm, wine well allayed with water may be safely given and to good purpose. But on the other side in an high Fever and a choleric constitution, to give wine or strong drink is pernicious. This I have learned by a mutlitude of Experiments and especially in the year 1623. When the Purple Fever was rife at Montpelier after the City had been beseidged. Which Fever was so malignant, that a third part at least of those which had it died, and it differed from the true Plague only in the point of a Bubo: forasmuch as not only whelks and Exanthemata, red, bluish and black, but also Carbuncles and swell behind the ears did often appear. For to such Sick persons whose pulse was not very quick and like the pulse of a sound person, their Tongue moist and they without thirst, I gave wine with good success; and I was inclined to continue the use thereof, by reason of the good the patients found thereby, and because by the use thereof the Fever was not at all augmented, neither did any thirst or dryness of the tongue arise thereby. But in such whose Fever was more strong, with thirst, dryness roughness or blackness of Tongue, I wholly forbade wine, and kept them perpetually to the use of cooling and tart drinks. But it is to be remembered, that in the first days of the disease wine must never be given, lest the crude matter be too much agitared, but only about the state, when the signs of malignity do begin more and more to show themselves. Howbeit Zacutus Lusitanus in the 93. Obs. Lib. 1. of his wonderful Cures and Cases, relates that in a pestilential Fever, the patiented being extreme thirsty, with a dry and black tongue and past hope, he gave wine with most happy success, so that the patiented was cured there with alone. But here that saying of Cornelius Celsus is to the purpose, Those which Reason could not, have many times been cured with Rashness. Diet being ordered, the cure must be begun by blood-letting, a Clyster being premised: for bleeding is very convenient, both in regard of the Greatness of the disease, the hot distemper and the putrefaction. But in defining the quantity of blood which is to be taken away, prudence is necessary, when in regard of the malignant quality, it does no good but hurt; for thereby the vital faculty is exceedingly weakened, and those which are let blood after being poisoned, are hastened to their death. Therefore if a malignant and venomous quality be more than the putrefaction, which may easily be known by the proper signs a foresaid, little blood must be taken away but if putrefaction be more considerable than the venomous quality, blood must be taken in a greater quantity. And consequently, if by reason of a sickly Constitution of body, and of putrid humours contained in the veins, the malignant Fever have been produced chief; blood-letting may safely be repeated, once, twice or thrice until the Burden of vicious humours contained in the veins be discharged. And that especially if Inflammation of any of the Bowels be feared, which many times happens in malignant Fevers. Now bleeding must be used betimes and at the beginning of the disease for if the disease shall have taken progress and the malignity be diffused into the whole Mass of blood; bleeding does not only no good, but very much weakens Nature; so that very many Authors hold, that blood must not be let after the fourth day is past. And truly, forasmuch as malignant Fevers do at several times differ much one from another, in regard of the different degree of Malignity; when they begin to be rife once, diligent observation must be made, what good the Patients receive by blood-letting. For some Fevers being of the kind of Synochi, in which there is great putrefaction and little malignity, are much lessened by Phlebotomy. And others whose Nature consists very near wholly in malignity do become more pernicious by blood letting. This appears in the true Pest, in which by the experiment of many approved Authors, it is assured, that all which were let blood died So Wierus relates in an Epidemical Catarrh which wandered all Europe over in the year 1580. in which all in a manner recovered, so that scarce one of a thousand died; yet all that were let blood died thereof. Now we must diligently observe that which Galen hath taught us in the 14. Method chap. 10. that in the Cure of Carbuncles it is good to take blood till the Patient faint away, that the boiling blood which causes the Carbuncle may be plentifully evacuated. Whenas the same Galen, Lib. de Curate. per venae, S. Cap. 14. Commands that in Phlegmonous tumours blood be taken away, till the Colour Change, unless the Patient be weak, or the Phlegmone malignant. Whereby is intimated, that Galen admits copious blood-letting in a simple Carbuncle that is void of malignity but not in a malignant and Pestilent one; which agrees to an hair with the former Precept propounded by us. As concerning the times and intervals of blood-letting wherein it is to be iterated, this is to be noted: that if the disease proceed slowly, the bloodletting must not be hastened: for the patient's strength is too soon weakened; so that it cannot hold out, till all the morbific matter be expelled. According therefore as the disease is moved; so the Physician ought sooner or later to let the Patiented blood. And there is a great Controversy, whether Purple spots or weals appear; Phlebotomy is to be used. For some account it to be an hamous Crime to let blood when the Exanthemaia appear, because at that time the humours are moved from the Centre to the Circumference, which motion must be by all means furthered; and by blood-letting the humours are put into a clean contrary motion, and the blood is drawn from the Circumference to the Centre, when as the inner parts being emptied, it must needs be that the blood contained in the outward parts, should run inwards again; which Galen plainly teacheth in his 9 Desanit. Tuend. Cap. 10. viz. That the Blood when a vein is opened, does flow back from the whole bulk of the body into the internal parts. And the same Galen in his Comment upon the 9 Epidem. Does conjecture that Simon. of whom Hypocrates spoke having broad bushes came out, had no good from his vomit, because such juices were thereby to be evacuated, which took their Course to the Skin. Howbeit, by the more sound Advice of Doctors it's concluded, that the Purple spots appearing in the beginning of the disease and on those days in which a vein is wont to be opened, if blood were not sufficiently taken away before, it must even then be drawn in immoderate quantity; Nether is there any danger to be feared by so doing; seeing that same Eruption of wheals, which comes in the beginning of the disease, is not critical but Symptomatical only, arising from an exceeding ebullition of blood, and from the fervency of malignant and putrefying Humours; and therefore the Motion of Nature cannot be hindered, when there is more to hinder. For in Case the Patients' body being Plethoric, the Urme thick and red, you shall not let blood because of the Exanthemata or weals breaking forth; Nature will scarce be able to Master such a quantity of Humours, and it is to be feared lest they should rush into some internal part of the body and breed therein a pernicious inflammation. Howbeit, blood at such a time must be sparingly taken away, not so as the veins may be emptied, which might cause a retraction of the evil humours inward again but only so as to take away their over great abundance, which being taken away, the veins draw no new blood, but only fall a little together as it were and become a little loosened so as to purse themselves the better, and consequently to be the better able to rule the remaining blood. And so is the motion and expulsion of Nature furthered which she endeavours towards the Surface of the body, for she being eased of part of her load wherewith she was oppressed, does more easily cast off the remainder, and drive the same out. Which we do every where behold in our practice, whiles the very same day oftentimes, in which a vein is opened, yea verily sometimes a few hours after, pleantiful sweats, critical and healthy do break forth. And in truth, though nature were so strong that she could sufficiently rule all the redundant blood, seeing that in plet horick bodies the blood is wont to be thick and by these eruptions into the Skin, the thinner part of the blood only is evacuated, and the thicker abiding in the veins does more and more putrefy, and makes the disease much more dangerous. But I hold the most advised Course to be a little after the Blood-letting, to fasten many Cupping glasses, that the motion of the humours to the outward parts, may be hereby the more assisted; of the Admonstration of which cupping-glasses, we shall speak by and by. Now it must be diligently noted, as we said before, that we observe the time in which the Exanthemata do begin to appear. For if it be in the beginning of the disease and before the fourth day, in which time their breaking forth cannot be critical, and no help comes to the patiented thereby; but the symptoms do rather grow more vehement, in which regard blood-letting ought by no means to be hindered. But if they break forth after the fonrth day and that in great quantity, so that the sick party is thereby bettered, and the symptoms lessened; it is much betteer to abstain from blood-letting, and to fix many Cupping-glasses with Scarification, that the motion of the Humours out wards may thereby be well furthered. What we have hitherto said of blood-letting, is to be understood of opening a vein in the Arm, which does quickly diminish the blood. Howbeit sometimes, 'tis very profitable to open the inferior veins viz. if the patiented be weak, and cannot suffer a reiteration of the former phlebotomy. But this is especially good in women; for it is as Ribasius says Lib. 7. Chap. 10. proper to women and very efficatious, because it imitates the manner of their Natural evacuations. Yea verily & when they want their courses that kind of bleeding is proper for women, because naturally they have much blood in these veins which are high the womb. Also it is good for such, in whom we fear a translation of the matter into the brain, which is often wont to happen in these Fevers and to cause a Frenzy. Which may be perceived easily (as we said in the prognostic) by the Urins thin, white, and void of Color; and when the Urins are so, it will be very good to open the inferior Veins. Also Oribasius relates in the forecited place that he was taken with a pestilential Fever, and having two pound of blood drawn from his inferior veins, he recovered: and all that used the like bleeding, were recovered. The opening of the Hemorrhoid veins by Horsleeches works the same effect. For seeing by this means the blood is drawn out by little and little, there follows little abatement of strength. Yet is the blood reveled from the in most bowels, where is wont to be the Heat and the Matter which foments the disease. and this is special good for Melanchollick persons, because in such, Nature is wont to evacuate earthly blood, by these ways. After Sufficient blood-letting, Revulsions must be celebrated by Cupping-glasses, both dry and with Scarification. Dry ones, when we would only revel: but Scarified one's when the redundancy of blood is not wholly taken away by blood-letting, which the patient's strength could no longer bear. For, blood is drawn by Cupping with much less expense of strength and besides the venomous spirits lurking within, are thereby drawn to the Surface of the body. But Authors agree not touching the places where Cupping-glasses are to be applied: for some and especially all Italian Physicians very near do hold they ought to be applied to the inferior parts viz. to the thighs and buttocks and no where else, that the venomous matter may be drawn from the Heart to the most distant parts: but that they are not good to be fastened to the shoulder blades or the Back, because they draw hurtful humours from other parts towards the Heart. Others are of a contrary opinion, that Cupping-glasses are best to be applied to the shoulders and back, viz. that poisonsom humours and vapours may be drawn from the Centre to the Circumference which motion is most suitable to the motion of nature in this disease: But I am of opinion that Cupping. glasses should be fastened to each and every of the places aforesaid; and that is is good to set them first upon the lower parts, that some portion of malignity may be drawn back unto the more remote parts: But because the Glasses fixed in those parts, cannot sufficiently draw back the venomous homors and vapours from the heart and its neighbouring parts; it is good to fasten them likewise to such parts as are near the heart viz. To the shoulders and back. For by this means the motion of nature is very much furthered, seeing that experience doth teach that the eruption of the spots is commonly in those parts which by frequent fixing of cups is much furthered. Which Mercatus hath most elegantly delivered in these words. Howbeit in the mean time, while the Body is plied with other medicaments, small cupping-glasses must either many at once, or a few frequently be applied. And if the venom of the disease or the weakness of the Patient be much, they may be fixed without any, or with very little scarification. In which kind of use and upon that occasion, it is the best course to scarrify those which are set upon the Back over against the heart which experience hath taught to be of such moment that. Anxieties & Inequality of the Pulse, and other grievous accidents have thereupon ceased. Wherefore we must not cease applying of them, until the venomous accidents are mitigated or wholly taken away. But the Reason urged by those of the former opinion, is of small moment for the fear lest ill humours should be drawn from other parts unto the Heart. For this reason might peraduenter be of some force: if they should be used at the beginning of the disease the whole body being full of humours. But after an universal evacuation sufficiently procured by blood-leting they can cause no such danger; which is made manifest by a clear example drawn from a pleurisy, in whose beginning, if the pained side should be cupped, doubtless it would bring the Humours more and more to the grieved part. But when after often blood letting a cupping-glass is fixed upon the pained side, it doth not only draw nothing from other parts to the place affected, but that humour which is fixed and wedged into the part is thereby powerfully drawn out, so that ofttimes the disease is thereby perfectly cured. Although in this disease, there is more danger of drawing Humours to the part affected, because it is in a manner external and near the Cupping-glass Zacutus Lusitanus in Observe. 13. Lib 5. Praxeos admirandoe doth very much commend cups with scarification, fastened near the groins and armpits. for by such cuppingglasses so fixed the vicious humour is drawn to the ignoble parts and to those common Emunctories, unto which nature is wont to expel the same. Among revulsive remedies, Frictions may very will be reckoned, being often exercised upon the extreme parts of the Body with a course cloth. But that Friction is most commended. which is made upon the whole Body with the Lineament of Aetius, which is thus compounded. Take of sweet Almonds and fountain water of each three ounces: Sal nitre two drams. Boil them together till the water be consumed, and with this Oil warmed, let the patient's body be rubbed all over with the hands being dipped therein. Aetius doth prescribe Oil of Savin, but because it is too hot. Oil of sweet Almonds was by Baptista Montanus, fitly substituted in its place. This ointment doth open the pores of the Skin, that nature may more fitly expel the venomous vapours thereby. Vesicatories do likewise powerfully draw out evil and venomous juices and serve for revulsion being applied in divers parts of the body: Commonly they are applied to the hinder part of the neck; for they do both draw out the matter, and drive it from the head, and serve well to cure such sleepy symptoms as are usual in these diseases. But where great malignity doth possess the whole Body and grievous symptoms afflict the patients, one vesicatory will not suffice but more must be laid on: I am wont when the disease is very violent to lay them on in five places viz. The Neck, both the Arms on the inside between the bending of the Arm and the Shoulder, and to both the Thighs, in the space between the Groin and the Knee, with happy success. The great profit of this Remedy we may learn from Galen, who in Lib 5. Method. Cap. 12. relates, that of pestilential Fever all recovered, who happened to have exulcerations in divers parts of their Bodies; because the morbific matter was evacuated by those ulcers. And because the use of these Vesicatories do often cause the Strangury (for the Cantharideses do by a peculiar property affect the Bladder) it will be good when they are applied, to give the Patiented emulsion, that may temper the acrimony of the urine. This symptom may likewise be prevented by mingling the powdered Seeds of Ameos with the vesicant plaster, which seeds have the faculty to keep the Cantharideses from hurting the bladder Amongst Revulsive Medicines may likewise be mustered, the Cataplasm of Radishes commended by Crato: The Radish (says he) because it powerfully draws the malignity of matter it is good to apply the gross powder or scrape thereof to the feet, having first cleansed them with salt and vinegar. And the following Cataplasm may be better for the same purpose. Take scrape of a radish and the two Briony Roots of each two ounces, seeds of Garden Cresses one ounce. Grains of Paradise half an ounce, Sea Salt three drams, Mix all and sprinkle them with the strongest Vinegar, and make them up into a body, with a sufficient quantity of soft soap, till it become like a Cataplasm, & apply it warm with tow to the soles of the feet, when the patiented is disposed to sleep. To this Cataplasm may profitably be added leaves of Rue, Nettle, Sage, Scordium, Pigeon's dung, juice of Rue and Vinegar. A Cataplasm of Snails beaten hath the like Efficacy, and powerfully draws unto the nether parts hurtful humours and vapours, as Galen highly commends the same, for powerfully attracting and disscussing the waters of Hydropic Persons. These revulsory Remedies have place during the whole Course of the disease after universal evacuations viz. Phlebotomy and Purgation: of the use whereof we are now to speak, that so we may pass from Chirurgery to Pharmaceutick Remedies. Now it is much controverted among Practitioners, whether we ought to purge in the beginning of malignant Fevers. Many reject purging at that time, not only because of that well known precept of Hypocrates, that Concocted humours are to be purged, but crude humours not: but also because in this disease the malignant humours are too much exasperated by purgations, and diffuse their malignant quality the more abroad, and by sharply provoking or Nature, they produce pernicious fluxes whereas otherwise of themselves in these Fevers, melting fluxes. do often arise and bring the patients to their long home. But others contend, that sometimes there is such plenty of evil and venomous humours in the first passages, that unless they be first removed by purging, or very much lessened, they infect the rest of the humours, so that Nature cannot master them, however assisted by antidotes and corroborating medicaments. We conceive this Controversy may be thus composed; viz. that in the beginning of this disease we must abstain from purgations for the reasons fore alleged; and that the sink of putrid humours which lies in the first passages (which the truth is do very much hinder the Cure) be drawn away rather by frequent Clysters, than purging Medicaments. Howbeit, if their be so great a quantity of i'll humours in the first Region, that it seems impossible sufficiently to evacuate the same by Clysters (which chief happens, when evil humours abound in the stomach, and then there is great loathing of meat, bitterness in the mouth, stomach sickness and vomiting) or when there are many worms, it is very good in such a Case to draw away the matter by a purging medicament that the morbific matter contained in the veins, may afterward be the more easily subdued. Which matter it is that cannot be purged before concoction, and of that must the saying of Hypocrates be understood, that only concocted humours must be purged. But the matter contained in the first region and that mass of excrements may be drawn away without any preparation or concoction premised, and is ordinarily purged out only by Clysters, as we said before. Now those Medicaments which we give to purge the first Region, must be chosen from amongst the most benign and gentle purgations, avoiding the most vehement, yea and the middle sort too, so that we may safely use Ca●●ia, Manna, Tamarinds, syrup of Roses, and Cichory compound. And it is Scarce lawful to arise to Senna and Rhubarb, or at least to mix them with the others in a small quantity, when a great abundance of evil humours do afflict the patiented. The former of these Medicaments were propounded in our cure of continual putrid Fevers, and how we should purge in the beginning of them. But Clysters are to be used, not only in the beginning of the disease, to free the first region from excrements; but they are to be given in the whole Course of the Disease, if the patiented be not loossbellied, and that every or every other day. For by those the daily excrements are brought out, and some portion of the Morbific matter is also by little and little drawn away, Likewise the humours mounting upwards, are brought down to the places more suitable to the intent of Nature. Now these Clysters must be composed of an emollient and refrigerating decoction, adding gentle laxatives; for sharp ones and scammoniated, do over much irritate nature to excretion and often produce perricious fluxes. And the truth is ●is best in the vigour of the disease to put no purgers into the Clysters, lest a Looseness be caused which is very incident to this disease, so that they are rather to be of the nature of an internal fomentation, then of a laxative Medicine. But if in the Course of the disease the belly seem to be lose: we must not therefore abstain from Clysters, but we must use such as do moderately deterg and refrigerate, and in Juleps we must dissolve syrup of Pomegranates with powder of Coral prepared. While the foresaid Medicines are using, we must endeavour to correct the Feverish Heat, Putrefaction and malignant quality, with these following Medicaments. And first of all the altering Juleps which were propounded in the Cure of continual putrid Fevers will be very convenient, of the decoction chiefly of the Roots of Sorrel, Cichory, Grass, Bugloss, Sharpe-pointed Dock; the leaves of Endive, Cichory, Sorrel, Pimpernel, Maidenhair and Tamarinds. Whereunto must be added such things as by a Specific property do fight against the venomous quality, commonly called Alexipharmaca or Antidotes, as roots of cinquefoil, Tormentil, white Thistle; leaves of Scordium, Carduus, Scabious, Scorzonera, Meddow-sweet; Flowers of Marygolds, Vetonica rubra; bits of Lemons or Citrons and their seeds; Skins of odoriferous apples, Shave of Hartshorn etc. with the Syrups of Lemons, Pomgranats, Vinegar, of the juice of Sorrel etc. and we must frequently mix tart things with them such as juice of Citrons, or of Lemons, Spirit of sulphur or of vitriol: for they do mightily resist the putrefaction and the venomous quality. Touching the Pomecitron Athenaeus reports, that once in Egypt certain condemned men were exposed to death by biting of beasts, and they were bitten indeed by the Asps, but had no harm thereby: because as they were led to executiou, a Woman out of Pity gave them some Pomecitrons to refresh them & quench their thirst: which having eaten, they received no hurt by the biting of those venomous Beasts. Now all parts of the Pomecitron have an antidotary quality; and therefore it is profitably cut in pieces rind and all, and boiled with Roots and Herbs aforesaid to make juleps; and it is likewise to good purpose steeped in small drink which the patiented ordinarily uses, unto which it gives a fragrant smell from its rind and a tartness from its pulp: howbeit the juice only hath a cooling faculty. The acid spirits of sulphur and vitriol are highly extolled especially by Chemist, and their rare virtues approved by long experience have caused that long since they have been entertained by Galenists, and ordinarily prescribed. And that it may appear how highly the Chemist esteems of them let it suffice to cite the words of Mindererus alone in his 18 Book De Pestilentia, where treating of spirit of vittriol and sulphur, and of other Medicaments made of sulphur: There is (he says) no putrefaction whose neck they break not; no infection which they do not overcome; no pravity of Humours but they can conquer. Verily (to deal clearly) if I should be for bidden or hindered from the use of vitriolated medicaments, I should never come to cure the Plague, or always without my weapons. To the same Juleps may sometimes be added Sal prunella because it powerfully cools, and extinguishes the Feverish heat; and it hath besides a kind of diaphoretic faculty, by means whereof it is excellently fitted for malignant Fevers. In place of juleps for the more delicate sort of Patients, may be substituted sometimes medicated Broths, made with the Leaves of borage, sorrel, Pimpernel, and other herbs that are not offensive to the palate, with Skins of fragrant apples, with the pulp and juice of Citrons and a chick; and to them sal prunella may sometimes be added, for to cool more effectually. Also Emul●ions may be made of sweet Almonds, and the greater cool Seeds, with the Decoctions of the Juleps. And for the greater quelling of the venomous Quality, to the aforesaid Seeds may be added Seeds of Citrons, of Navew or Turnip, and of Carduus Benedictus. And to commend the taste, the aforesaid Syrups may be mingled therewith. Now in the whole Course of the Disease, Antidotes must be used, not only mingled in Juleps, Broths and Emulsions, as was said before, and shall be further declared: But also contrived into other forms. And because all are not to be used indifferently, nor at all times of the Disease; that their right Use may be well distinguished, they must be sorted into four Tribes. The first contains those, which besides the Specifical Quality by which they resist poison, are cold and dry and moderately astringent; and consequently they hinder putrefaction, strengthen the Heart, bridle the Venom, that it cannot be so easily spread into the whole Body, and hinder the dissolution of the parts thereof by a kind of compression; as , Terra Sigillata, Coral, Cinkfoyl Roots, and the Roots of Tormentil. The second Tribe contains such as by their coldness and the tenuity of their substance do resist putrefaction, and restrain the venomous Quality; as Juice of Lemons, Spirit of Sulphur and of Vitriol, as all acid things, and Vinegar itself. The third comprehends hot & Diaphoretick medicaments, which expel venomous Humours and Vapours from the Heart, and bring them from the Centre to the Circumference; as Angellica, Zedoary, Dictamnus, Meddow-sweet, Scordium, Carduus, Scabious, Treacle, Mithridate, Treacle water. The fourth contains such as by a Specifical virtue, without any excess of the first Qualities, do oppugn the venomous Quality; as Bezoar stone, Hartshorn, Unicorns-Horn, Troches of Vipers, and such like. The Medicines of the First, Second, and Fourth Tribe, do best agree in the beginning and the Augment; and those of the Third Tribe in the state and Declination. Now these medicaments must be exceedingly varied, and diversely mixed, according to the different degree of malignity or putrefaction; according to the various Intention or Remission of the Fever; and according to the divers temperaments, Sex and Age of the Patient; and according to other Circumstances: the determination whereof depends wholly upon the Judgement and Prudence of the Physician, and cannot be determined by any certain Rules. Only one thing I shall advice you of, which is very well known, viz. That when there is a vehement burning of the Fever, we must chief use Refrigerating & cooling things; but the hot and Diaphoretic must not be meddled with; which notwithstanding will be very proper, when the Fever is more remiss and the malignant Quality is that which most offends. Of these Tribes therefore, divers medicaments m●y be Compounded, according to the judgement of the Physician. But least young Practitioners should be wholly destitute of some forms, I shall add a few, in imitation whereof, they may devi●e a thousand others, as the occasion of practice shall require. Take Roots of Sorrel, Bugloss and Tormentil of each one ounce. Leaves of Endive, Cichory, Sorrel, Pimpernel, of each one hand u●. Tamarinds one ounce. Boil all to a pint. In the strained Liquor dissolve syrups of Pomegranates and Lemons of each an ounce and half. Makes of all a Julep to be taken at thrice: adding to every dose a drant of Confection of Hyacinths bezoarstone six grains. This form of a Julep, may do well in the beginning of the Fever. But if the Fever be very high and the Patient of a Choleric constitution, a dram of Sal Prunella may be added to every dose, or as much spirit of vitriol or sulphur, as may suffice to make it moderately tart, or both of them together. ●u● in a Fever not very high may be added to the decoction, Roots of the white-Thistle and of Cinkfoul, Leaves of Scordium and Scabious. Take sweet Almonds blanched one ounce: Seeds of Melones, Gourds, Navew, Citrons and Carduus of each two drams: Beat them together in a Marblemorter, pouring on by little and little a pint and half of the aforesaid Decoction; Syrup of Lemmon three ounces; Sal prunellae three drams. Make an Emulsion for three Doses, to be taken twice or thrice in a day. In the whole cour●e of the Disease, let the Patients use in their Broths the Confection of Hyacinths, or the following powder, which is not unpleasant. Take of prepared 〈◊〉, Pearls prepared, shave of Ivory Hartshorn, and Bezoar, of each one scruple. Mix them. Make of all a powder, of which, give half a scruple in every mess of Broth. The Innovators of this Age, who endeavour to banish Gems, Pearls, Coral, and all Cordial things from the use of Physic; and cure all Fevers, even those that are malignant, with Blood-letting and mere refrigerating Apozemes; may be convinced wi●h this one Experiment, at least touching Coral and Pearls: which being powdered, if they be infu●ed in Vinegar, Juice of Lemons, Spirit of Vitriol, or Aquafortis; they take away all the Acrimony of those Liquors. Whence we may gather, that the same Medicaments taken into our bodies do sweeten and mollify the acrimony and malignant quality of humours and reduce them to a moderation. They which have tasted the solutions of Pearls and Corals, made in juice of Lemons or distilled Vinegar, do know the truth hereof very well. Where the malignant and venomous quality is very rise Alexipharmaca or Po●on-quellers, are to be given in Juleps, broths the ordinary drink of the Patients, and 〈◊〉 they take in, that by a perpetual and incessant Conflict, the troublsom Enemy may be opposed. Bezoar stone is given alone to the quantity of five or six grains, with water of Meadsweet, Scorzonera, Carduus, or such like not only to oppose the malignant quality, but also to help the Diaphoretick motion; for this stone is reputed for a sweeting Medicament, which notwithstanding many approved Authors doubt of, because they could never see any sensible effect, by the giving thereof. And truly (to speak out my mind) there can no great Confidence be put in this stone; because although we may allow to the true and genuine bezoar stone, those faculties which are hereunto ascribed; yet because the great price thereof Causes that many Traders take a world of pains to sophisticate the same, we can now a days hardly get any but counterfeit. A clear testimony whereof is, that the writers of the Indian Histories do aver that Bezoar stone is very scarce and of great price among the Indians themselves; when we have plenty of them and cheap enough. More credit should of right be given to that same Root, which the Spaniards have in this Age of ours brought out of Italy; which they call Contra yerva which signifies the Poison-pelting or Antidotary Herb, because the powder thereof is a present remedy against poisons, and drives them out of the body by sweat, or insensible transpiration. And they Conceive that Plant to be the Common ordinary food, of Those beasts in which the Bezoar stone is found, and that the stone hath its virtue primarily from thence. A scruple or half a dram of this Root powdered may be given in Carduus matter, or other medicaments. Mendererus cries up this following powder. Take Sugar Candy three drams, white-ginger two drams. Camphire one dram. Make all into a powder; the dose one dram in some convenient liquor. But the Author doth advise that in great pains of the head or stomach, Camphire is warily to be used; which yet he highly commends in pestilential diseases; and avouches that seasonably given, il doth more good than the most precious bezoardic medicaments. I conceive the powder is too hot because of the Ginger, and I have Composed this following in imitation thereof, Which I have used with happy success. Take mineral Bezoar three drams: Sal prunella two drams: Camphire one dram. Make of all a powder: Give one dram at a time in Carduus water, or some other convenient Liquor. Powders may likewise be made of the fragments of precious stones whose virtues many deride & others as much admire; so that from the times of the Arabian Physicians to our days many compositions are prepared of them in the shops, as Electuarium de Gemmis, & Confectio de Hyacintho. But in pestilential and venomous diseases many have extolled the great virtue of the Smaragd, amongst the rest Avenzoar, Mindererus, and Zacutus Lusitanus. Avenzoar 2 Teisir. tract. 1. Cap. 5. That himself being poisoned, was thereby cured. Mindererus Lib. de Pestilentia Cap, 15. Relates that to a woman in a Pestilential Fever who abhorred all Physic, he gave the following Powder which she might easily swallow having neither taste nor smell; which when she had taken the conbustions of cruel symptoms being allayed, and the disease turning to health, she was cured. Take of the Smaragd stone prepared, East-india Bezoar of each six grains: Hyacinth prepared three grains, mix them. Make of all a powder for one Dose. And Zacutus Lusitanus, relates that a Portugal Gentleman, having through poison fallen into a looseness and a Consumption, from which no abstersives, astringents or Antidotes could free him; he was cured only by the Smaragd, the powder whereof to the quantity of twelve grains he took every other day in conserve of quinces, and when he had taken it five times he was cured of his Looseness. The Physicians of Mountpelier, do use in this Fever as a most profitable Antidote, no ways heating; the Troches of Vipers, which are usually prepared as an ingredient into Andromachus Treacle, which they give from one scruple to half a dram in cordial waters or Juleps. Yet the flesh of vipers were better being dried, which hath no venomous quality (as people imagine) but is rather a potent Antidote; which is much abated by boiling; for it is boiled in water to make the troches. So that we see greater effects wrought only by the heart and Liver of vipers, being dried, without any other preparation The Alexipharmick Medicaments of the third Tribe viz. The Diaphoreticks and sweaters must be given only in the state or declination of the disease, as was said before. which is to be understood, when they are given in a fever simply malignant or spotted: for in the true Plague they must be used at the very beginning▪ that the venomous quality which would quickly kill the Patient may be suddenly and potently opposed, and the malignant vapours discussed. Yea verily and in simple malignant Fevers, if the venomous quality seem to be greater than the putrefaction they are likewise to be given at the beginning in small quantity; making choice of such as are least hot, mixing them with Juleps and other cooling medicines formerly precribed. Now of these Diaphoretick medicaments there are divers degrees, for some are more hot, as Angelica, Zedoary, Dictamnum, Treacle, Mithridate, Treacle water; which are never to be given when the heat of the Fever is at the highest, but only when the same is much abated, and when the signs of malignity do very much prevail. But others are less hot, as Scabious, Carduus Meadsweet, Scordium, which may safely be given, though the Fever be in its height. And these distinctions are carefully to be observed in practice. and as for the forms of particuliar medicaments, every Physician can vary them, according to the different degree of the Feverish Heat and of the Malignity. But I shall here describe such as are most effectual Take water of Meadsweet and Carduus of each two ounces: juice of Lemmons one ounce: old Treacle half a dram, two scruples or one dram, according as the fear of heating the Patient is more or less. Mix all into a potion. give it warm and cover the patiented somewhat more than ordinary. if there be great vehemency of symptoms, new Treacle will be more convenient, because of the vigour of the Opium by means of which the vehemency of the symptoms will be allayed, and the boiling of the Humours will be restrained: yea and sometimes when it seems unconvenient to use Treacle as in the beginning of the disease especially, Laudanum Opiatum given to two grains & mingled▪ with Antidotes, do much good. For by the Narcotick and congealing power thereof those fervent Spirits so vexatious to the Heart, are as it were fixed; and the morbific matter (which is most pernicious while it is in motion) is thereby stopped and remains in a manner unmoveable, whence it comes to pass, that Nature not being provoked by the malignant humours and spirits, recollecting her strength, doth more easily apply unto herself the virtue of Antidotes Aqua theriacalis seems fit to be preferred before Treacle itself. For seeing it is exceeding thin and spiritous, it doth more easily and suddenly pierce into and pass through the whole body and Cause sweat. And because there are many descriptions of Treacle water, their dose ought to differ according as they are compounded of Simples more or less healing. I shall in this place propound the chief. And first of all, the Treacle water of Bauderon is most excellent, because it is exceeding temperate. For there goes no other Liquor thereinto than Vinegar and Juice of Lemons, by which the hot Ingredients are very much tempered, and therefore it may be given from half an ounce to an ounce in Sudorofick decoctions or waters. And although this is less heating than any of the rest prescribed by divers other Authors; yet have I invented another, easily made, which is more cooling, and does no less oppose the Fever than the malignant quality, and may consequently be used in the whole course of the disease, at any period thereof. It's composition is as followeth. Take twelve fresh and juicy Lemons. Take away the bark or rind and the seeds and press out the fuyce, and add thereunto the said rinds and seeds; and three pints of juice of Scordium, juice of sorrel, of Goat's Rue; of scabious, and Carduus, of each one pint. Shave of Hartshorn four Ounces. Old Venice Treacle six ounces. Let the rinds of the Lemons be cut into thin chips, let the seeds be beaten, and such herbs as have little juice, let them in the beating be moistened with the juice of Lemons and let all be distilled in balneo Mariae. Of the water give one ounce by itself or mixed with other Liquors. The hotter sort of Treacle waters are made with white Wine or with spirit of wine; which must be warilly given and in lesser quantity; yet they pierc more than the other and move sweat, and are chiefly used in the true Pestilence. Howbeit in some Cases they may by the prudent Physician be used. Among the many Descriptions of such Treacle waters, I will propound in this place, two of the most excellent. Take roots of Angelica, White-Thistle, Gentian, Tormentil, Zedoary, Hartshorn, of each one ounce. of the three , of each half an ounce. Treacle three ounces, Camphire a scruple. beat all and steep them three days together in two Pints of strong white-wine, in a warm place. Then distil Them in Balneo Mariae, and keep the water for use, the dose is, from two drams to half an ounce, in refrigerating Juleps, adding spirit of vitriol to correct the Inflammation thereof. Take Spirit of Wine, very well rectified one pint and an half. old Treacle eight ounces. Elect Myrrh four ounces. Oriental Saffron one ounce. Camphire half an ounce. Infuse all for twenty four hours in Balneo Mariae. afterward still them in the same Bath; and you shall have a very effectual water. The Chemists do exceedingly cry up their Bezoardica Mineralia, because they are Sudorofick or Diaphoretic at least and yet do not at all heat: which they endeavour to prove by their having no taste, in which regard they are easily taken even by the most nice Patients, that loath unpleasant medicaments. They also commend their Medicine which is called by them Mixtura Simplex or Mixtura Spiritalis, made of Treacle Water Camphorated, spirit of Vitriol and of Tartar: and they mingle a dram hereof in Juleps and antidotary Potions. A Physician that undertakes the Cure of malignant Fevers ought to have divers Antidotes in a readiness, and to change them ever and anon, lest nature be too much accustomed to one and the same, and slight the virtue thereof. Also the nature of the venomous quality is not always one and the same but very divers according to the diversity of the patient's bodies. So that what hath helped one, will do another no good; so that when he hath for some time used one antidote, he must try another and another. While the foresaid diaphoreticks are using, if we have a Mind at any time to help their Operation, that they may more powerfully bring out the poison into the surface of the Body, some external helps may be used: viz. Cupping-glasses, both dry and with scarification, many and often set on and Vesicatories, of which we spoken before; which are most convenient in the state of the disease and at what time Sudorofick Medicines are given; as also Oil of Scorpions of Matthiolus, which is much commended by all Practitioners; for it calls forth the poison residing in the profound parts of the body unto the external parts, And therefore the Emunctories of the body, as the Groins and Armpits, with the Pulses of the Templs, Hands and Feet, ought frequently to be anointed with this oil warm; viz. thrice or four times in a day, or else every third hour. Where this Oil is not to be had, a Lineament may be made of Treacle dissolved in Juice of Lemmons adding a little saffron and Camphire. If at any time Nature being oppressed with the malignity of the Poison and overcome, and seem not to act, but as it were to submit herself with hands bound to the mercy of the humour. The strongest diaphoreticks, are then to be given, in a large dose, that the daunted mettle of the heart may be as it were spurred up, And then the strongest sorts of Treacle waters and Bezoardicks which have greatest force to penetrate, must be used: and the addition of Camphire will much help their penetration and outwardly, at such a time this following fomentation, will wonderfully assist the operation of such things as are taken in, and will help to drive out the malignant vapours. For by this Method, many have been reduced from the Gates of Death. Take roots of Angelica and Gentian, of each two ounces, Leaves of Bawm, Origanum, Scordium, of each two handfuls. Seeds of Carduus benedictus one ounce. Flowers of Chamomel, Mullien, Melilot, St. John's wort, Centaurie the less, Staechados, Rosemary, Marygold, of each two pugils. Make a decoction of all in water, adding towards the end a little white-wine, wherewith foment the feet, Groins, Armpits, and sides warm with sponges. If dryness of the tongue, thirst and other signs do show that the Fever doth prevail as much as the malignant quality, we must abstain from the fomentation, and instead thereof let a Hen cut down through the Back, or the Lungs or Caul of a Weather new killed, be applied to the patient's Belly. In the whole Course of the Care, the greatest Cure of all must be to preserve the patient's strength, which is much dejected by the Venomous quality. It is best kept up, first by Convenient broths made with a Capon, unto which, when necessity urges may be added the distilled broths of flesh, and especially the Aqua Caponis which is made in Balneo Mariae per Descensum, as the common manner is now to make it. Consection of Hyacinths given in broths, doth repair the strength, and doth oppugn the malignant quality. In the same broths Jelly of hartshorn, doth satisfy both Endications. If the strength of the Patient be very much decayed; we may make bold with Confectio Alkermes, provided the Heat of the Fever be not very violent. And finally, wine is the most cordial thing in the world, of the use whereof in this disease, I spoke before, treating of the Patients Diet. The only smell of wine doth much refresh the Patient's strength, and much more a toast dipped in Canary and Rosewater and so held to the Nose. And in this Case also Confectio Alkermes and de Hyacintho are wont to be put into alexipharmical Potions. Or in extreme dejection of strength, Potions merely cordial may be thus made. Take Orenge-flower water and Rose-water of each one ounce and an half. Confectio Alkermes one dram. Syrup of Apples one ounce. Juice of Lemmons three drams. Make all into a potion. If the Fever be not intense Cinnamon water may be given to the quantity of one dram or three drams. and sometimes Amber Grief may be added, to the quantity of five Grains or Seven. Neither in extreme Weakness of the Patients must we so much fear those hot cordials, that we should resuse to save the patiented from present death, for fear of augmenting the Heat of the Fever for we must always regard that which is most pressing, and when the patiented hath a little recovered strength if the hot cordials have made some increase of Heat, it may afterward be tempered by potent coolers, as Sal Prunella, and Spirit of vitriol, mixed in juleps and ordinary Drink. This Method being observed by the discreet Physician, in his administration both of Strengtheners and of hot Antidotes and sweaters; will prove happily Successful. After these things, must follow the Application of Epithems and Living Creatures to the Region of the Heart; fomentation of the Genitals with Confectio Alkermes dissolved in Wine; Bags to be laid upon the stomach, and other both internal and external Medicaments, largely by me described in my Chapter of Weakness or Decay of strength. As for Epithems, there is Caution to be used in their application, Because very many Authors do wholly reject the use of them; because they are wont to be compounded of refrigerating and repelling things; viz. of the waters of cooling herbs and Vinegar, by which the venomous quality is beaten back to the heart, and the transpiration thereof, which ought always to be promoted, is hindered. But this reason cannot hinder the use of Epithemes, seeing we may compound them of cordial and diaphoretic waters that have repelling no or astringent quality in them, and without Vinegar (which some do yet allow) adding cordials thereunto; and by these things mingled together, Epithems may be made, not only which strengthen the heart, but also open the pores of the skin, that through them the malignant vapours may more easily transpire. Of such Epithems this may be an example. Take waters of scabious and Carduus, of each four ounces. Orengflower water two ounces. Con'fectio Alkermes two drams. Powder of Diamargaritum frigidum one dram. Saffron and Camphire of each six grains. Make an Epitheme and apply it warm to the Region of the Heart frequenly. Take Confectio Alkermes half an ounce, Powder of Triasantalon and Diamargaritum frigidum, of each one dram and half, a little Orengflower water. Make of all a Lineament to be applied to the part after aforesaid the use of the foresaid Epitheme. Neither must we here omit such Epithemes as are to be applied to the parts under the short ribs, because of the reasons of their use propounded in the Cure of putrid Fevers, from whence the Materials must also be fetched. At length whenas the malignant and venomous quality is mastered by the Remedies aforefaid, and the Fever abated and the Disease gins to decline, and the signs of Coction do manifestly appear; pargation must be used, which by the experienced Physician may be accommodated to the strength and constitution of the Patient. I shall here, for the sake of Beginners propound only one example. Take Senna half an ounce. Annis seed one dram. Leaves of Scabious and Scordium, of each half an handful. Liquoris three drains. Boil all to three ounces. In the strained Liquor dissolve the infusion of four scruples of Rhubarb Made in bugloss water with yellow . Manna and Syrup of Roses of each one ounce. Make all into a Potion. And for the most part one purge is not sufficient in the declination of the disease when the Patient gins to recover health; but purgation must oftentimes be repeated twice or three times at convenient distances, that the evil humours may be perfectly rooted out. Otherwise there will be danger of a Relapse, or at least the Patient will be long in Recovering prsecte health. Because though nature; be str●ng enough to master the relics of the Morbific matter yet can she not do it but in a long time and in the mean space the body is long in recovering its former strength. For the perfect Completing of this Cure, it remains only that we speak something of the Correction of such symptoms as happen in this disease. Now their cure is very near the same which hath been propounded in the second section of this Treatise Chap. 2. where we delivered the Cure of such symptoms as attend putrid Fevers. And the symptoms of this Fever are the same in a manner with those of putrid Fevers, the difference being only in degrees of more or less; and therefore the same Remedies will suit with both. Howbeit I shall here set down such things as have been frequently tried in the taming of such symptoms as attend malignant and Pestilential Fevers, and which have proved most successful. And we shall withal declare the Cure of such diseases as do Supervene upon these Fevers. And first of all, In Pains of the Head, Want of sleep, and Raving, at the beginning Revelers of all sorts must be used, as opening of the inferior veins and of the Haemorrhoids; emollient Clysters, frictions of the nether parts, Cupping-glasses, first set upon the Calves of the Legs, afterwards upon the Back and shoulders, both dry and with scarification; and Vesicatories, which in a simple Delirium or Dotage arising from a Choleric matter, must be applied to the Arms and thighs. But if with the Raving there be joined a dullness and sleepunes, a Vesicatory must be applied also to the Neck; and then Repellers must be applied unto the Forehead and Oxyrrhodines; of which it is to be noted, that they are not so good in malignant as in mere putrid Fevers; because the venomous vapours must by all means be expelled, and at no hand be kept within the body. And therefore first gentle repellers must be applied, and if the vehemence of the foresaid symptoms shall compel us to fly to the stronger, we must not use them long together. Among Repellers of the gentler sort is reckoned that common frontal of the flowers of water Lilly Violets and Roses, the greater cool seeds and Chermes berries, bedewed with the Vapour of vinegar, And if that will not suffice, let this following be laid on. Take Unguentum populeum one ounce, Conserve of Roses and violets of each half an ounce. Oil. of Roses six ounces. Vinegar of Roses two drams. Mix them all and receive them in tow and put them between two and apply them to the forehead. Mean while the Emulsions of the four greater cool seeds may be used, from which cool and gentle vapours are wont to be carried unto the Brain, which are wont to mitigate the foresaid symptoms. Which if they suffice not, narcoticks may be added, which do wonderfully hinder the ascent of sharp and malignant Vapours unto the brain, and procure sleep. Yet they must be given in a small quantity, as half an ounce of Syrup of poppies; or if necessity compel, two grains of Laudanum opiatum with conserve of roses may well be given; or they may be dissolved in some Julep; or in stead there of new Treacle may be given to the Quantity of half a dram. Howbeit these narcoticks are seldom to be given and in small Quantity, because they Concentre the poison, howbeit they are by some accounted sudorosicks. After repellers have been used a day or two, we must come to derivers, among which is reckoned a vesicatory applied to the Neck of which before, whereunto must be added blood-letting from the forehead vein to the quantity of five or six ounces: which is very successful provided blood was before sufficiently taken from the veins of the Arm. Also horseleeches may be fastened behind the Ears. which is a good remedy but less effectual than the former, because by leeches the thinner part only of the blood is drawn away; whereas by the forehead vein sometimes in a frenzy more corrupt blood is drawn away; whereas by the Arm. At length, in the state of a Frenzy, or at the beginning of the declination, resolvers are to be applied, especially living Creatures and their Parts, as the Lungs of a wether which is better than young prdgeons or whelps, because it doth safely encompass the whole Head. Now these Animals do partly resove evil humours contained in the brain, and partly ripen and digest them, that Nature may afterward more easily expel them, Some do unadvisedly apply them in the beginning of a frenzy, because by increasing the Heat, they increase the Flux of Humours to the Brain, and increase the Raving. In the Inflammation, Dryness, and Blackness of the Tongue, Remedies propounded in the aforesaid place are convenient; especially such as are composed of Water, or the Juice of Housleek, and Sal prunellae. Whereunto this following of Mindereus may be added, because Experience hath taught, that it is very effectual. Take fresh butter washed in Rose-water, two ounces: Sal prunelloe half a dram. Mix them, and keep the mixture in cold Water. Give the quantity of an Hastifer or bean, oftentimes in a day, and let the Patients hold it as long in their Mouths, as they can possibly. It is a sign that the Cure goes well forward, if the black Sootiness go away, and the dry chopped Tongue begin to grow moist, and pselings come away, and the dry chopped Tongue begin to grow cough up the peelings of their Throats. But then their palate is pained, and that very thin Skin where with it is covered, can hardly bear any thing in regard of its tenderness, but it's offended with every light tartness, and the least Acrimony imaginable, because the former Inflammation having left it in divers parts Flaid, it must be covered with new Skin; and so it requires to be perfectly cooled and healed. To this purpose the following Jelly will be most convenient. Take Seeds of Flea-bane and Quinces, of each one dram and an half: Gum Tragacanth one dram. With Water of Roses draw out a liquid Mucilage, whereunto add the like quantity of Syrup of Violets. Make it in manner of a Jelly; of which let the patients take often in a Spoon and hold it long in their Mouth. Warm Milk does mitigate the pain Caused by Gargarisms, tempers the Inflammation, moistens the Tongue and Throat, and attracts the Venom to it. These following Pills may conveniently be used. Take Seeds of Cucumbers picked and bruised, one ounce: White of an Egg as much as shall susfice. Make Pills, which let the Patients often hold in their mouths. Or, Take Seeds of Gourds and Melones cleansed, and of white Poppy, of each one dram. Liquoris and Gum Tragaganth of each one dram and an half. Beat all to powder, and with the Mucilage of Quince Seeds drawn with Rose-water, make Pills to be held in the mouth. And because this Inflammation, Dryness, and Blackness of the Tongue, proceeds from the burning that is within. Juleps very Refrigerating are good to cool the same; unto which may be added, Sal prunellae, and Spirit of Vitriol. Also they may be mingled with the Patients ordinary drink. The Cure of extremity of Thirst was sufficiently propounded in the aforesaid place. But in a malignant Fever, it will be happily extinguished, with these two Medicines newly commended, viz. with Sal Prunellae, and Spirit of Vitriol, taken in Juleps, and in the ordinary drink of the Patient. Want of Appetite, Stomach-sickness, Vomiting, and Hiccuping, must be cured according to the Method delivered in the aforesaid Chapter. Yet we shall add one thing touching vomiting; that it doth sometimes so vex those that have malignant Fevers, that they presently vomit what ever they take, and though they have Thirst, with Dryness and Blackness of Tongue; yet can they bear no kind of Liquor or drink: but vomit all their Juleps, Emulsions, Ptisans, and their small Beer presently after they have drunk them. This most grievous Symptom is suddenly cured, as it were by a miracle, with a dram of Salt of Wormwood, given in a spoonful of fresh Juice of Lemons, as I have learned by Experience. A Looseness is very frequent in this Disease, and herein the wisdom of the Physician is very necessary. For if it be unseasonably stopped, the venomous Matter is kept within. And if it be let alone, it weakens the Patients, and many times brings them to their deaths. In the Cure of this Looseness, we must therefore thus proceed. If it be so moderate that it weaken not the Patient, it must not be stopped, but only moderated by Strengthening Clysters, But if it be immoderate, and do very much weaken the Patient, it is wont to be a melting Looseness, that Thaws the Patient as it were away, and must be boldly stopped; which new Treacle to the quantity of half a dram, or Laudanum Opiatum, to the quantity of two or three grains, will effectually perform. Yet I have often seen a pernicious Flux which threatened to kill the Patient, stopped as it were in a Moment, by giving of powerful Diaphoreticks in a great Dose; which did expel by the Skin that venomous Matter, which by vexing and grating upon the Guts, and other Bowels, did cause such a melting and consuming Looseness. Worms do very often vex those that have these Fevers, and are plentifully bred by the great putrefaction of the Humours. These are conveniently drawn away by sweet Clysters, and by potions against the Worms; especially such as are made of a Decoction of Seordium. For Scordium is equally good against the malignity and the Worms. And to temper the heat thereof, it must be boiled with Purslain, Sorrel, and Hartshorn. Also burned Hartshorn is profitably boiled against the Worms. For Forestus in the fourth Observe. of his sixth Book, that no Remedy did so much good to such as having a malignant Fever were troubled with Worms and a Looseness, as burnt Hartshorn given to the quantity of a dram in convenient Juleps. When the malignant and venomous Quality bears great sway in these Fevers, that they come near the Nature of the true Pest; in such Patients there are commonly rise behind their Ears, and Carbuncles. Wherefore we will here subjoin their Cure. In the beginning of a Parotis, or Rising near the Ear, as soon as it gins to appear, the Part recipient must be relaxed and widened as it were, and if the swelling rise but slowly, the motion of Nature endeavouring to expel the morbific matter that way must be assisted, by applying drawing things to the swelling, and by giving Antidotes and Diaphoreticks. To relax the Part, make an Injection of Ointment of Marsh-mallows, and lay on afterwards moist Wool which is greasy, from the Sheep. Attraction may be caused by applying Whelps, or young Pigeons, by which also the pain will be mitigated. Plasters made of Leven, Figs, Onions, Doves-dung, adding thereto butter, Hens-grease, fresh Hogs-grease, and Oil of Lilies, or sweet Almonds. If by these Attractives the Part be overheated, and the pain be too much increased; they may be omitted by fits, laying on in the mean time the Cataplasm made of the Crum of White-bread; or 'nointing with the aforesaid Oils, being laid on with unwashed Wool; or with Ointment of Marsh-mallows, as was said before. And because the part is not sufficiently capable to receive the morbific matter; to derive another way a portion thereof, a veficatory must be applied to the hinder part of the Neck, and also the Diaphoretic formerly cited must frequently be given. The Matter being called forth into the external parts, let Suppuration be endeavoured, by laying on a Cataplasm made of the Roots of Marsh-mallows, and of Lilies with Figs, Meal of Linseeds, and the Oils and several sorts of Grease aforesaid. When Suppuration is made, let the Tumour be opened; let the rest of the Matter be digested, by continuing the Cataplasm, or by laying on a Plaster of Diachylon. Let the Ulcer be cleansed with that common Digestive made of Turpentine, Yolks of Eggs and Oil of Roses. Let the Ulcer be kept long open with a Tent, that all the Venom of the Disease may sufficiently be purged out, and at last heal it up and Cicatrize it. Yet this one thing is to be observed; That if the Tumour doth so increase as to cause danger of Suffocation, or Choking, it must be opened before it be perfectly ripe: For so some portion of the matter being drawn ●orth, the Tumour will fall somewhat, and the danger of Suffocation will be avoided. In like manner, If the malignity be very intense, that the Patient seems likely to miscarry before the Tumour be ripe; then also it must be opened before its due time that the force of the Venom may expire▪ whence oftentimes the Patient recovers. And upon this Account, in the Pest the Buboes or swell in the Groin, are wont to be opened, before they come to Suppuration. Finally, It were a Wickedness to pass over in silence a rare Experiment, which happened to me in that same Epidemic Fever, which cruelly raged and ranged at Montpelier, in the year 1623. So that near half of those that were sick died of the Disease. But especially, So many as had swell by the Ears (which was wont to happen about the ninth or eleventh day of the Disease) they all died within two days after; there preceding or happening at the same time Raving, Stupidity, Convulsions, with an unequal, frequent, and very small Pulse, as it were the creeping Pismire-Pulse. And after I had seen divers in this condition, who could not be helped by Antidotes, or by drawing things laid to the swelling; musing with myself it by any means possible, they might be delivered from so certain destruction: I began at last to think, that therefore these swell proved to fatal, because the Part in which they happened was not capable to receive all the Morbific Matter, which being retained within kills the Patient, and that therefore the work of Nature being only begun in those swell, might be supplied by evacuations, viz. Blood-letting, and purgation; whenas also Galen in his 3. de Comp. Medic. Secund. Loca. Cap. de Parotidibus, In the Cure of these swell prescribes Blood-letting. But this advice was contradicted by the extreme weakness of the Patients, which was so great that they seemed to be even now in the pains of death, which also itself soon followed. But Galen in the forecited place, when He prescribes Blood-letting in the Cure of such Tumours, does propound two conditions, viz. If blood abound, and the strength of the Patient will bear bleeding. Both which Conditions were absent in these Cases, for blood had been before sufficiently drawn, both by repeated Phlebotomies, and Cupping-glasses: Also the Patients were extremely decayed in their strength. Weighing all these things with myself, I conceived that golden saying of Cornelius Celsus, was in this Case if ever seasonable, viz. That many things are done rightly in time of eminent danger, which were otherwise to be omitted: And that its better to Experiment a doubtful Remedy in one or two persons, than to leave so many persons to undoubted Destruction. I was also encouraged by conceiving, that this great weakness of the Patients, was rather from oppression of the Morbific Matter, than dissipation or dissolution of their strength. For therefore their strength did suddenly decay, because Nature was not able to cast off her heavy burden, and I hoped when that burden was made lighter, she would be freed. Add hereunto, That bleeding might be so ordered, that no danger should be feared therfrom, viz. If two or three ounces only were taken away at first, for trial sake, and if the success were good, a greater quantity might be taken away afterward I resolved therefore upon this course. And a Merchant of Montpelier named Bernardier being the first I met with, and a tumour arose behind his left ear on the eleventh day of the disease with such a pulls & other symptoms as aforesaid; I prescribed bleeding to the quantity of three ounces which the Chirurgeon being an Ancient and experienced man refused to do for fear the patient should die under his hands; afterwards being emboldened by my presence & authority he took away three ounces of Blood, after three or four hours, I visit my patient again, & find his pulls a little stronger & not so unequal; then I caused him to bleed six ounces, after which his pulls was and stronger. The Blood was very corrupt: The day following I prescribed him a Purge of Senna, Rhubarb and syrup of Roses: and so the patiented was recovered from the jaws of death. And afterwards all the sick that had using behind their ears, first I Bled several times a little at a time, and the day following Purged them: and so all of them (to God be the Honour and Praise) so many as were thus ordered happily recovered; and never any afterwards that had those rise behind their ears, died in the whole year Howb it it is to be noted (which we hinted in the prognosis) that the swelling doth often appear critically and profitably, and thereby the sick are recovered of their diseases; viz, So oft as they appear in the declination of the disease▪ and this is easily seen by the abatement of the symptoms which follow upon the rise; and such are wont to happen in Fevers of less malignity But in the time aforesaid. such was the malignity of the epidemical Fever▪ that the tumours behind the Ears would often break forth in the state of the disease and symptomatically and deadly; until by the remedies aforesaid, their obstructive faculty was taken away. In a carbuncle superveneing upon a bu●●ing Fever, if before its appatition, Blood were not sufficiently taken away. If the patient can bear further blood-letting open that vein which is nigh the carbuncle, that the greater attraction may be made of the veremous matter to the part affected. Afterward let the Tumour be scarified on every side round about and that with pretty deep gashes and foment it a while with warm salt water, that the corruption of the blood may be hindered, and the ●fflux thereof promoted. A while after apply a grain of a Caustick to the middle of the Pastle, and upon the whole swelling, lay this following Cataplasm, Take leaves of Rue, and Scabious bruised of each one handful: three pair of dried Figs bruised; sharp Leven an ounce; Pepper powdered one dram; two yolkes of Eggs: Mix all into a Cataplasm, which must be applied for two days together. And then lay on this following. Take Juices of Comphry the greater, Scabious, S of each one dram; old treacle four scruples; Salt one dram; two yolks of Eggs: mix them all and apply it to the tumour. Also at the beginning may be applied the Cataplasm de Arnoglosso described in the Dispensatory of Bauderon. But to the Eschara after the application of the Caustick, apply Vnguentum Basilicum, adding thereto Treacle, Oil of scorpions, and the yolk of an Egg. When the tumour is grown, lest the malignant matter should flow back again to the internal parts let the compass thereof be anointed, with ointment of B●lus, twice or thrice in a day: And upon the Eschara or Crust, that it's falling off may be hastened, ●y Vnguentum Basilicum with butter, and Sow's grease mixed therewith after the crust is come away, let the ulcer be cleansed with this following ointment. Take juice of Marygolds, wormwood, Scabious, and Smalladg of each one ounce; choice of Myrrh, Florentine Oris, Aloes, Sarcocolla, of each one dram; Honey of Roses two ounces: Make of all an ointment, to be used till the sore be perfectly curred Chap. 2. Of the Measles, and small Pox. THat Fever which is commonly attended by the Measles and small Pox, may justly be reckoned among Malignant and pestilential Fevers; seeing it is Epidemical and contagious, and kills very many children, to whom it commonly happens What is the difference between the Measles and small Pox, Authors are not yet well agreed. But custom hath obtained that those same larger pustles or Whelks like unto Warts (from whence they have their name) should be called in latin Varioloe, in English the small Pox; but those little pustle● and as it were asperities of the Skin with a deep redness like St. Anthony's fire or the rose, which are discussed within five or seven days without suppuration, are called in latin Morbilli and in English Measles. There is also another kind of pustles common to Children like unto the small Pox in respect of the fashion and size; but herein it differs in that the small Pox gins with redness and inflammation; but these are white and as it were bladderes full of a wheyish humour, which within three days break and dry up and are wont to cause no danger, and commonly break forth without a Fever. It is described by Vidus Vidius, in these words; Some besiáes the two former sorts do add a third which they call the crystals, For so they term certain Bladdrs full of matter, which shine like Crystal, wherewith the Skin is in divers parts diapered; the common people call them Ravaglione. unto which all men are not so subject as unto the small Pox and measles, neither are they so greviously afflicted under them. wherefore these bladders ought not to be reckoned as a third sort with the small Pox and Measles Touching the small Pocks, and Measles Authors dispute much, and especially whether these be new diseases, or if they were known unto the ancients, and what is the next and immediate Cause of them. But since I affect all possible brevity in my Lectures, I have been wont to omit all controversies, propounding only the plain and naked decisions of them; and accordingly, I shall briefly unfold what is to be thought of the foregoing questions. And in the first place I conceive the small Pocks and Measles to be no new diseases, seeing they rise from a most ancient Cause, viz. the impurites of the maternal blood; which when the Arabians observed, they accounted it no new disease. But if they had first come abroad in their times, they would have mentioned their novelty. And although, they were the first that exactly described them; and Hypocrates and Galen with the rest of the Ancients, have scarce mentioned them; we must suppose that therefore the Ancients did not write distinctly of them, because they are only accidents of a malignant Fever and critical eruptions, which do not make a distinct disease by themselves. Or because in Greece through the mildness of the Air these disease were so light, as not to deserve the Care of a Physician. Even as in the Western Indies, in regard of the great temperateness of the Air, it was wont to be to be light, that it was scarce taken notice of before the coming of the Spaniards into those parts. But a Blackmore which was brought thither, being taken with Pestilential small Pocks, the malignant and venomous quality being spread by Insection, the disease began so to range and rage, that a great part of the Indians were slain thereby. For whereas before, those impurites of their Mother's blood remaining in them, were wont easily to be discussed, through the Clemency of the Air; now when a venomous quality was added to them, they caused grievous Diseases. Now that the Mother's blood is the true Cause of the Small Pocks and Measles, is hence chiefly gathered, because among many thousands of Men, it is hard to sinned one, who once in his Life hath not had these diseases. But a disease common to all Men, must needs depend upon some common cause: such as are the principles of Generation viz. the seed and Mother's blood. But the seed cannot be the cause of the small Pocks and Measles, because from it come hereditary diseases, such as last a Man's Life time; it remains therefore that these diseases spring from the Mother's blood, with which the Child is nourished in the Womb. For therein, be it never so pure, some impurites are found, which communicate their pollution to the parts of the Child; and that pollution of the parts, doth defile the Mass of blood; and being provoked by some occasion, doth make the same to boil, by help whereof, the blood ferments and becomes purified, both it and the parts aforesaid. This the Arabians do mannifest by a clear example of Wine, which being poured whiles it is new into musty or otherwise il-qualited Vessel receives that i'll quality from the Vessel but when it gins to work and puresie, it cleanses both itself and the Vessel. Now this working doth commonly happen to Children; howbeit sometimes to those that are elder and have attained Man's estate, because it is evermore set on work by some external Cause, such as is especially a certain disposition of air proportionable to this disease whence it comes to pass that sometimes the small Pocks, sometimes the Measles are rise, because the Air is sometimes inclined to the one and sometimes to the other. Neither can those impurites of the Mother's blood, infect her and cause in her the same diseases, althought Hypocrates says in his Book de Natura Pueri that there are three parts of the blood, one most pure, with which the Child is nourished; another impure, wherewith the Mother is nourished; and another, most impurer, which is kept in the Veins of the Womb, the whole time of Going with Child, and after the Birth is purged away in the Childbed purgations. For first, seeing the Mother hath parts more hard and solid, they do not so soon take impresion as the tender and soft body of the Child. Again that most impure part of the blood which is kept in the Veins of the womb and of the Afterbirth, the whole time of belly-bearing, doth infect the blood in the passage, which is carried through those parts to Nourish the Child: whence the Child contracts and evil quality, which in its time is the Cause of that ebullition in the blood of the Child. But that impurest part of the blood remaining in the foresaid places, doth not infect the body of the Mother. Furthermore, it's not to be wondered at, that the breaking out of the small Pocks and Measles, is sometimes so long deferred, as that some have them at Man's estate. For those impurites do not substantially remain in the body as many imagine: for they would be corrupted by long stay and acquire a most grievous putrefaction. But only an evil quality is by them imprinted upon the parts of the Child, which in process of time infecting some part of the humours, becomes offensive to Nature; which than rousing herself, doth drive those infected portions of the humours, into the Skin. And forasmuch as in the Mass of blood a twosold excrement is found, the one thick the other thin: of the thick, the small Pocks are bred, of the thin, the Measles. And although the evil and malignant quality be one and the same, insecting both excrements: yet because the Nature of the excrements is different, the Analogy of the external Cause unto them both is Different. whence it comes to pass that sometimes the small Pocks and sometimes the Measles are Epidemically spread abroad. And although the small Pocks are wont to break forth in the whole body, yet are they wont to appear in greatest quantity in the face, feet and hands; which is otherwise in the purple spots of the Purple Fever, for they appear most on the breast and back. The Cause of which difference is this, that inasmuch as the small Pocks arise from an ebullition of the blood, by help whereof an Excretion is made of the excrements lurking therein, unto the Skin; and the Liver being the Fountain and original of blood, whose Emunctories are the Face, Hands, and Feet, whence it comes that such as have hot Livers, have red and rubied faces, and feel intense heat in the palms of their hands and Sols of their feet; it follows that the small Pocks and Measles must come out there more than any where else. Contrariwise the purple spots which appear in malignant Fevers, do arise principally from the Misaffection of the Heart, and therefore they break out chief in parts near the Heart, and especially about the Loins; because in them the Vena Cava ascendens and the Arteria aorta which are annexed unto the Hair, have their Course, Also another difference is to be noted between the small Pocks and Purples; because the small Pocks and Measles appearing on the third or fourth day from the beginning of the Fever, are wont to be critical, and for the most part void of danger: but the purple spots, though they appear on the seventh day are commonly Symptomatical, and render the disease worse; whenas a man would think it should be otherwise, for a disease is more crude on the fourth than the seveuth day. But the Cause of this difference consists herein; that in the small Pocks and Measles the Fever commonly gins at the highest; so that not only on the third and fourth day, but also on the first or second days, excretions may be in them critical. But malignant Fevers proceed more slowly, and their beginning is commonly Extended to the seventh day: so that Excretions which then happen cannot be critical. Now that the Pox and Measles come so soon to their state and not the malignant Fevers, is hence; because the Pox and Measle-Feaver comes from the lightest putrefaction, and rather from an Ebullition of the blood than from any intense putrefaction of the matter; and therefore Nature by help of Coction makes it to cease before the seventh day, because it was a light Fever and rose from the slightest Causes. But in malignant Fevers, so great and fordid is the putrefaction that it cannot be corrected in the fourteenth nor sometimes in the twentieth day. And therefore the spots breaking out before that time, the disease is exasperated; because Nature was forced to expel them, without Concoction and symptomatically. The expulsion therefore of small pox and Measles is caused, by an Ebullition of the blood: which Ebullition according to Avicennas' doctrine, is twofold; the one perfective, the other corruptive. The perfective or depurative is that, in which only the impurer and excrementitious parts of the blood, are by Nature purged forth, that the whole mass may afterward remain pure; and then the small Pocks are innocent, which are cured without any help of Physic. But the corruptive is, wherein not only the excrementitous parts of the blood, but the sincere blood itself is putrefied whence arise dangerous and deadly pox, and according as there is more or less putrefaction, in more in more or fewer parts of the blood, so is the danger more or less. This corruptive Ebullition doth chiefly happen, when those diseases are epidemical being occasioned by a malignant Constitution of the Air, by which an ebullition of the humours and a malignant putrefaction is caused; whonce many and dangerous small Pocks are caused; which are sometimes (according to Rhasis) the Forerunners of the Plague. Pocks and Measles are reckoned among acute diseases because ordinarily they are terminated within the space of fourteen days. Now some do wittily observe a double order of times in times in this disease viz. the time of ebullition and the time of eruption: the time of ebullition is commonly terminated in four days; so that the first day is counted the beginning, the second the Augment, the third the state, and the fourth the declination: for then the Fever and other symptoms are wont to remit. But the beginning of the Eruption of the Pox is the fourth day itself, the Augment reaches to the seventh, the state until the eleventh, the declination unto the fourteenth, at which time the Pocks are dried. Howbeit oftentimes they are not dry until the twentieth day. Differences of sinal Pocks and Measles, are taken either from the substance, in regard of which, some are more or less Phlegmatic, Bloody, Choleric, or Melanchollick: or from the Quantity, in which regard they are more or less in number; greater or less; profound or Superficial; or from the Quality, in which respect some are red, others white, yellowish, Violet coloured, Livid, black, according to the diversity of Humours of which they are compounded; or from the time, in respect whereof some come quickly out, others slowly; some are soon, others late ripe, or dissolved: or from the place, in which respect, some occupy only the Skin. others do seize upon the internal Parts also, as the Throat, Lungs, Guts, Liver, Spleen, and other bowels. The Diagnosis respects either the Disease present or at hand. The small Pocks and Measles, when they are present, are subject to the outward Senses, and need therefore no other signs. But these signs following declare them to be at hand. Pain in the Head with Pulsation in the Forehead, and Temples; great Sleepiness: Terrors in Sleep; sometimes Rave, Tremble and Convulsions: Sneezing; frequent Yawning; Hoarseness, Cough, Difficulty in breathing. Heat, Redness, and Sense of pricking over the whole body. Pain of the back which comes sometimes alone, or appearing with few other Symptoms in a Synorchus' Fever, it shows the small Pocks will come out. For seeing through the back are carried the great Vein and Artery, in which the malignant blood boiling, does send forth sharp vapours to the Nerves, and neighbouring Membranes; it must needs be, that pains should be felt especially in those parts. Great Anxiety and unquietnels. Tears flowing of themselves. Shining before the Eyes, and their Itching, a swelling of the Face with some Redness. A vehemency of the Symptoms at first, so that the Disease seems of a sudden to have attained its vigour. All which are caused, either by many and thick vapours sent up by the boiling of the blood, into the Head, Diaphragm, and other parts; or from the Nature of the Pocks themselves, now beginning to invade, the parts; or by a Fluxion caused by heat, which dissolves the Humours in the Brain. It's of great Moment to foresee the small Pox; but much more to foretell their event, which the following Prognostic Signs will declare. And in the first place those small Pox are wont to be void of danger, which come out soon and easily, and do quickly ripen. In which the Fever is moderate, without great Symptoms, which ceases after they are come out or is very much abated. In which the voice is free and breathing easy. Small Pox, which at first are red, and white, soft, distinct, few, round, pointed, coming only in the Skin and not inwardly, are wont to be safe. All the Signs aforesaid do signify the paucity of the Morbific Matter, it's Obsequiousness, Benignity, and the strength of Nature, lustily expelling. Contrary wise dangerous and deadly Pox are known, by a great Fever, which lessens not after they are broke forth; for it signifies the malignant and venomous humours are not sufficiently expelled unto the Skin, but that the greatest part of them remains yet in the Veins. Great anxiety and unquietness; which comes from the same humours boiling in the Veins. Difficulty of breathing, which signifies either pustles or Impostumes in the Lungs; or a squinsy, or great decay of strength. Great thirst which declares the inward burning; and if with the thirst, shortness of breath be increased, Death is at hand. A Looseness or bloody Flux, which shows the malignant humours have their recourse inward, which is a course quite contrary to that of Nature and therefore deadly, so that few of those which after the Pox coming out, are taken with such a Looseness do escape. A Bloody Urine is a most deadly sign; and likewise if by stool pure and sincere blood be voided. Sometimes also by the Nostrils, Gums, and other parts of the body blood is voided, which are commonly deadly Signs. For they signify the extreme Acrimony and malignity of the blood: which doth vehemently provoke Nature, and compels her to a preposterous excretion thereof. Also Pox long a coming out are very bad, which signify the contumacy of the matter, or the weakness of Nature, Many, Great, Double and united Pox, do show an overabundant quantity of Morbific matter, and are bad. So are hard ones showing the thickness and incoctibility of the said matter. Also flat ones which show the weakness of the expulsive faculty, and they are worse, if they have a black spot in the middles of them, which argues extraordinary malignity. And green, bluish and black which spring from that sort of choler called Bilis porraca, or Atra Leeke-green or black Choler are a bad sign. They are worst of all which when they are come forth do presently vanish, and the tumour of the parts falls: for they signify the retirement of the Humour inwards; and none of those escape who have the Pox on this manner going in again, but they die commonly within twenty four hours. They are also dangerous, when sports like those of the purple or spotted Fever, are mingled among the pox; especially if those spots be livid or black. For they signify not only that same light putrefaction, which is wont to happen in the small Pox by means of the ebullition of blood: but also that intense and profound Malignity is peccant; from which much greater danger is threatened to the Patient. Dung or Urines in this Disease livid or black do portend great danger: for they signify that Melancholy abounds in the Veins, and infects the whole Mass of Blood. The cure of the small Pox & Measles is performed in the satisfaction of four Indications. whereof the first consists in the Evacuation of the peccant humours. The second in assisting the motion of nature, or helping to expel the Pox. The third in the opposition of the malignant and venomous quality. The fourth in correction of symptoms. All which that they may be conveniently effected, first a convenient diet must be appointed, which must be the same which was ordered in the cure of putrid Fevers: howbeit some things must be particularly noted. First that the patients be kept in a warm room, to the end their pores may be kept open, & the breaking out of the small Pox may there be furthered. therefore they must be kept in a Chamber well shut, which the cold air must in no wise enter into. For many Children that had benign Pox, have been killed by letting in the cold air upon them, viz. the morbific matter being thereby driven back into the inward parts. And for the same cause they must be moderately covered with ; but so that the heat of the air or the weight of the may not augment the heat of the Fever, The foresaid cover are wont commonly to be made of red , because they are thought by some Analogy to move the boiling blood to the external parts. Many are also wont to keep an Ewe or Weather in the chamber or on the bed; because those Creatures are easily infected and draw the venom to themselves, by which means some Ease may happen to the sick persons. A decoction of Barley, or of the roots of Sorrel, or of Heart's horn is profitably used for drink, in the beginning of the disease especially, and when the Fever is vehement. But if the Fever be not▪ very violent, a decoction of Barley and Figs will be very profitable, viz. Effectually driving the Humours to the Skin; and Forestus and Amatus did continually use the same with good success. Furthermore, Whereas in the whole Course of the Disease, Sleep aught to be moderate, yet in the Augment when the Pocks break forth, long Sleep is hurtful, and it is better to watch more than ordinary. That therefore the aforesaid Jndications may be fulfilled, the Cure must be begun by Blood-letting (if Blood in any sort is redundant, and the Age of the Patient is like to bear it) and a Vein must be opened as soon as may be. But if the Physician shall not be called the first day, yet he shall do well to take blood before the breaking forth of the Pocks or while but few are come out; which time is wont commonly to last until the fourth day, from the first onset of the Fever. In which Case notwithstanding, diligent heed is to be taken. For if upon the breaking forth of the Pocks, the Fever and its Symptoms be abated; it is better to leave the business to Nature working well, which will sufficiently expel the whole Morbific Matter to the Skin. Also Blood-leting is not in this case necessary, since experience shows, that an infinite company of children having gentle Pox, and not Plethoric are happily cured without bleeding. Nay rather in the former case sometimes blood-letting may do hurt, because the expulsion of the small Pox is caused by an ebullition of blood: which ebullition if it be small, it will by blood-letting be lessened very much, and so it will become insufficient perfectly to purge the mass of Blood from its impurities. Contrariwise, if upon the Eruption of the Pox, the Fever becomes more strong, there be anxiety, difficult breathing, an urine thick and red, and other symptoms seem greater its a sign that naure is oppressed, with the over great burden of humours, and that she cannot govern them conveniently; and that therefore Phlebotomy is necessary, that a part of the burden being taken away, nature may be the better able to expel the rest. In one word, when there is an Ebullition perfective merely and depurative, blood is not to be taken away, but in a corruptive blood-letting is extremely necessary yea even in that which hath less malignity in it, whose degrees have been specefied before, And so necessary is blood-letting in dangerous Pox, in which the corruptive Ebullition is wont to happen, that the tender age of infants must not hinder it. For it is grown into a custom to let children blood when they are four years old and sometimes when they are three. The physicians of Paris in their tender age and while they suck do let children blood. Which yet the tender age of infants doth hardly admit, with that light nourishment of milk, and the plentiful efflux of their humours by transpiration; neither can this new licence of letting such young ones blood be justified by any countenance from the wise Authors ●f Physic. In pretty big children, many times once blood-letting will not serve the turn, but it must be repeated if the Fever remain intense or if Raving or any other grievous Symptom do urge, Yea verily when the Pox are perfectly come out, which for the most part is within nine days, if the Fever be very urgent, blood must be again let and the Patients ordered, as those who have a putrid Fever. If blood-letting be suspected because of the tenderness of the children's Age, or because the fitting season is now past; the superfluous blood may be diminished by Cupping-Glasses with Scarification, applied to the back, shoulders, and things, which may also well be used in the state of the disease, seeing the Motion of Nature from the Centre to the Circumference, is by them promoted. But care must be taken that in young Children the Scarifications be not too deep: for it happens sometimes that an unadvised Surgeon cuts so deep, as to cut asunder some Veins and let out the fervent and boiling blood, so that there is great trouble to stop the same. Purgation is suspected in this disease; for it makes a motion contrary to that of Nature viz. from the Circumference to the Centre; and to whomsoever, having Pocks, a looseness happens, the Pocks commonly strike in, and the Party dies, as I said in the Prognostic. Yet observe, that many times purgation is to good purpose practised before the pocks come out, and before the Fever grows vehement, viz. when the Children are in the Neutral state of Decidence. For then if i'll humours abound, they are profitably diminished by purging, that Nature may afterward, more Cheerfully set upon the Expulsion of the Remainder. But when the Pox gins to appear, Purging will be pernicious: And likewise, if there be great malignity abroad, as in an epidemical Constitution, when very many Children die of that disease; it is better wholly to abstain from Purging; because in diseases which are very malignant and Pestilential, Purgation in the beginning of the Disease, is very hurtful. Now the Purgatives must be compounded of gentle Simples viz. Rhubarb, Cassia, Manna, Tamarinds, and Syrup of Roses. In the Course of the disease, if the belly be hard and bound it may gently be removed, but not provoked; and that by a suppository of honey alone without salt; or with a Clyster of Breath or milk, or a decoction of French barley, Raisins and Liquoris with sugar and yolkes of Eggs. After blood-letting and other evacuations (if necessary) the expulsion of the pox must be helped forward, not only with specific medicines driving the humours to the Skin, but also with diaphoreticks and Alexipharmicks; especially if the Pox be Epidemical and being very malignant, do threaten great danger. There is a vulgar Medicine commended by Rhasis, Avicenna and all the Arabian Physicians to drive out the Pox; which also the greatest part of our later Physicians use, according to the description of Avicenna, which is thus. Take Fat figs seven ounces. Lentils shalled three drams. Lack two drams and an half. Gum traganth and fennel seed, of each two drams. Boil all in a pint and half of fountain water to the third part. Let the patiented drink thereof. Rhasis adds Saffron fifteen grains, Raisins five drams, because Saffron opens and corroborates, and the Raisins do strengthen the Liver. And Traganth although it do incrassate and astringe, yet is it therefore mingled with the rest, that it may prohibit the over great ebullition of blood. Lentils are by some neoterics rejected, because they are restrictive and may hinder the coming forth of the Pox. But the Authority of so many and such noble Princes of Physic, must not rashly be rejected; but we must rather determine, that Lentils shalled are with great reason put into this composition; viz. that by their astringent and incrassating faculty, they may bridle the Fervency of the humours and hinder their falling upon any noble part; to which purpose Gum traganth was added, as I hinted before. This is taken out of Galen, who in the 1. De Aliment. Facult. Cap. 18. Doth teach us that Lentils twice boiled do Strengthen the Natural parts, and by their astriction stop the flux of the belly. The Lentils may therefore be put in or left out according to the Judgement of the Physician who manages the Cure as there is more or less necessity of attenuating and driving the humours into the Skin. For if the matter be subtle and the ebullition great, the Lentils may profitably be put in for the Intent aforesaid. But if the matter seem to be thick, so that Nature can but slowly drive it into the Skin than must they be omitted and the Gum traganth; and only the other attenuating and diaphoretic things used for the drink. By which it appears, that we must not too strictly adhere to the forms of Medicaments propounded by Authors; but that in several occasions they must be variously changed. Let this following Receipt serve for an example, compounded partly of the foresaid simples and partly of others that are diaphoretic and resist malignity; which may much help such as have this disease, in making the Pox to come well out. Take Rootes of Fennel and Sorrel of each one ounce. Hartshorn shave half an ounce Leaves of Scabious, Scordium, St. Johns-wort of each one Handful. Three pair of fat Figgs. Gum Lackwit three drams. seeds of Navew or Turnip & Carduus Benedictus of each two drams. Lentils unhusked half an ounce. Gum traganth one dram and an half. Boil all to a pint and half. Of the straining take three ounces. Syrup of Lemmons one ounce. Mix them. make of them a Julep let the Patient drink thereof twice or thrice in a day. If the Malignity be very great, as commonly it happens in Epidemical small Pocks, we must chief use Antidotes. and consequently all those remedies which we have propounded in malignant Fevers will be good in this disease, respect being had to the Age and strength of the Patiennt. And among others, Confection of Hyacinth, Bezoar stone, Powder of Coral, Pearls, Hartshorn; oil of Scorpions of Matthiolus, must be used frequently, with other things, the manner of whose use may be learned out of the foregoing chapter. Neither must such things be omitted as do restore the Patient's strength, both inward and outward which may be also learned out of the foregoing Chapter, and by the prudent Physician administered in due season. And it must be heedfully remembered, that such medicaments as drive out the Pox are not to be used in all patients. For sometimes they break forth so violently, that they have need to be restrained for a while. For the great ebullition and immoderate Fervour of blood, if they be not tempered. are wont to destroy the Patients; and therefore, it is good in such a Case to use bridlers and coolers, For example, a Julep many be thus composed. Take Whole barley one pugil. Cinquefoil roots and Tormentil roots of each one ounce. Leaves of Sorrel, Endive and Woodsorrel of each one handful. Lentils excorticated half an ounce. Gum traganth one dram. Boil all to a pint. In the straining dissolve four ounces of Syrup of Lemons or Pomegranates. Make of all a Julep for four doses, to be taken twice in a day. Amatus Lusitanus in the 18. Cure of the third Centurie propounds an example of such kind of Pox arising from boiling humours and cured only by coolers and thickeners. which example I thought good to cite in this place word for word, that the young beginners may perceive, in what cases the Cure is most to be yaried. The Boy of Altarasius (says he) began to have the small Pox, some of which did run together, so that in two days they flaid his Miserable Carcase: for the pustles crept along and did only flay osf his Skin; which I have likewise observed in other Children. Against which, I thus set myself to work; First because this matter was too thin, I endeavoured to thicken the same, and not only so, but to abate the evil quality of the Liver and internal parts, that no more such thin subtle Humour might be bred. This I did with refrigerating Medicaments, as Syrup of Roses, of Cichory simple, of Endive and Violets with waters of like Nature mixed with them. He was anointed with Ceratum Santalinum. But the Diet likewise helped much, which was ordered cold and moist. By all which the matter became thicker and the pox began to appear thick and large. And for ordinary drink prescribe a decoction of barley and of Sorrel roots. And these remedies must be continued, until the Fervency of the humours shall begin to abate: if Nature seem to want their assistance. These things might suffice for a direct Cure of the small Pox. But because they may bring great damage to divers parts, both internal and external, we must endavour the Prevention and Cure thereof. The internal parts may especially be preserved with a decoction of Lentils, of Gum Lac and Traganth, described before. For Gum Lackwit defends the Liver and Spleen, Lentils the Guts, and Traganth the breast. But the Lungs are peculiarly preserved by Conserve of Roses and Violets, and Syrup of Violets Jujubees, myrtles, Dried Roses, Poppies and also these following LOHOCHES. See in my Dispensatory (at the beginning of the Lohoches) what a Lohock is; and why so called. Take Conserve of Roses one ounce and half, juice of Lentiles thrice boiled six drams. poppy seeds an half dram. Gum traganth one scruple. with Syrup of dried Roses make all into a Lohoch. Or this of Avicenna, which is commended by Guainerius and Forestus. Take Lentils unshaled and finely powdered three drams. White Poppy seeds one ounce. Conserve of Roses two ounces. Julep of Roses, as much as shall suffice, Mix all into a Lohoch. Or such a Lohoch as this following may be made only of Syrups. Take Syrup of violets, jujubees and dried Roses of each one ounce. Syrup of Poppies half an ounce. Mix them▪ let the Patient lick thereof often out of a spoon, and swallow it down leisurely. But if a flux be at present into the Lungs and cause hoarseness and suffocation; it must not only be stopped with the foresaid Remedies, but reveled by Cupping-glasses, both dry and Scarrfied, and by bleeding, if nothing else hinder. Also give the Patients to drink a decoction of Barley, Jujubes and Liquoris, and let them use this following Lohoch. Take Seeds of Marsh-mallows, Melons, Cucumbers, and white Poppy, of each two drams. Raisins stoned and Jujubes of each four pair. Boil all to a pint. In which dissolve conserve of Roses and Violets of each half an ounce. Powder of Diatragacanthum frigidum three drams. Sugar Candie and Sugar of Roses, of each as much as shall suffice. Make all into a Lohoch. The Jaws and throat may be fenced against the Pox, before they break out, with this following Gargarism. Take French barley one pugil. Plantain Leaves two handfuls, red Rose Leaves one pugil, Balaustians, seeds of Sumach of each two drams. Boil all in two pints of water to a third parts consumption. In the strained Liquor dissolve Syrup of Mulberries and Pomegranates of each one ounce. Mix all into a Gargarism. If the young age of Children cannot admit a Gargoyle, a Lohoch may be made, of Syrup of Mulberries, Pomegranates, of dried Roses; either alone, or mingled with red Rose and Plantain waters. Which must often be given them in a spoon. Wherewith if the Fluxion cannot be stopped by reason of the abundance of the rheum, so that there is fear of Suffocation impendent; such things must be used, which widen the passages, and help excretion, after this manner. Take Mucilage of Fleabane seed and Oil of sweet Almonds new drawn, of each one ounce and half Whitest Sugar two ounces. Mix them. Make of all a Lambitive to be given every hour. If by means of the Acrimony of the flux, or the Plenty of the small Pox, an Ulcer be beard in the Jaws or Throat; it must be cleansed with barley water and honey of Roses, or with alum water. and if it tend to corruption a little Aegyptiacum Ointment must be mingled therewith. The guts will be preserved by the same remedies which were appointed to preserve the Lungs. But if a present Loosens, or dysentery be urgent, first detergent and lenitive Remedies must be used and afterwards astringents. And so Clysters must be made of calybeated Milk, of Sugar and yolkes of Eggs: and afterwards of a decoction of barley and red Roses with the yolk of an egg; and last of all, of a decoction of Plantain, Knotgrass, and Prunella or , and other Simples set down in our Cure of the Disentery. And it is to be observed, that a looseness in children that have Pox, is oftentimes caused by worms, which lasts dureing the whole disease, whence they are in the danger of Death; because the expulsion of the Pox is thereby hindered wholly or lessened. Which is easily known by the thickness and viscosity of the excrements, and their grey or whitish colour: then must be administered such things as kill Worms: and sweet Clysters must be injected. Sometimes also the kidneys are affected and are exulcerated, whence arises Pissing of Blood. In this Case it is good to give an emulsion of the four greater cool seeds, with trochiscs of Alkekengy, de Carabe, and other things set down in our chapters of Pissing of Blood. Among external parts, the Eyes are most of all to be guarded from the small Pox. For being endued with a soft and humid substance; the matter of the Pox is easily driven unto them: whence arise grievous calamites and sometimes total Blindness. Before the Pox break out therefore, or when they begin to appear, the Eyes must be anointed every hour with Plantain and Rose waters, in which a little saffron is dissolved; or with the following Eyesalve, which doth more effectually preserve them. Take water of Roses and Plantain, of each one ounce and half. Powder of Sumach seeds two drams. Infuse them a little while hot. then strain the liquor hard out. to the strained liquor ad Camphire ten grains. Saffron five grains. Make all into a Water for the Eyes. It will be yet more effectual, if Instead of the waters, the juices of knot-grass and Sheperds-pouch be mingled with the rest. And if some Pox begin to Peep out of the Eye itself, pigeons blood must be often dropped in, that their resolution may be hastened. then also this following Eye-water is to be used. Take Red Rose water two ounces. Eye-bright water half an ounce trochisci albi Rhasis one dram. Tutty prepared one Scruple. Champhire five grains. Saffron two grains. make all into an Eye-water and wet the Eyes often therewith, with a thin linen rag. But when the Eyes so swell that they cannot be opened, they must often be washed with a decoction of Linseed, Fenugreek seed, Quince seed and Mallow seeds; and so the swelling will fall and the Eyes open and if when the Eyes are opened, there appear clouds in them they must be scoured off with Sugar-candy finely powdered. And finally if the Eyes are ulcerated, they may be cured with this following Eye salve. Take Washed Ceruse three drams: Sarcocol one dram: Gum traganth one Scruple: Opium two grains: With mucilage of Gum traganth drawn out with Plantain water make all into little cakes or trochiscs, which must be dissolved in women's Milk, or red Rose water, when it is to be used and in all other things proceed, as Practitioners teach at large, in the Cure of Ulcers of the Eyes. To preserve the Nostrils, they must often smell to Vinegar. But a Collyrium of juice of knot-grass, and shepherd's pouch, Sumach seeds and camphire formerly praised, will work more effectually; let the tent be often moistened therein, and put up into the Nostrils. If notwithstanding, the Pox do grow within the Nose, they quickly become hard Scabs, which are often to be anointed with Oil of sweet almonds, that they may the sooner fall off. And finally if an Ulcer happen in the Nose, it must be dressed with a lineament of the Oil of Eg-yolkes and juice of Plantain, stirred together in a leaden Mortar. To preserve the Face, some wash it with Rose-water and other Astringents. Which I cannot approve of: for a great part of the impurities flows unto the Face. For the Skin tthereof long lose and soft, is very fit to receive Excrements. Wherefore if those impurities which Nature sends hither, be repelled, being retained within they may cause great hurt; and therefore the motion of Nature is no ways to be hindered. But this aught to be the Physician's care, to hinder that the Pocks which break out in the Face, do not leave behind them pits and Scars, which doth often deform the Countenance. And this he shall in good measure perform, if when the Pocks are ripe, and are high and white in the middle (which is wont to fall out upon the ninth day of the Disease) he cause them to be anointed with a Feather twice a day with Oil of sweet Almonds, drawn without fire, until the Crusts fall off, For by this Medicine the Acrimony of Choler is tempered, the ripening of the Pocks is hastened, and the falling off of the Crusts furthered; which otherwise sticking fast, doth exulcerate the Skin more deeply, by reason of the Quittor which lies under them. Oil of Nuts new drawn without fire, mixed well with a like quantity of Rose-water, till they come to the form of a Lineament, is excellent for the same purpose. If by neglecting the Remedies aforesaid, or through the extreme malignity of the Humour, there remain Pits and Pock-holes, all diligence must be used to repair the same. Which notwithstanding is extreme hard to do perfectly; although many have taken great pains thereabout to gratify Virgins, and other Women, who are exceeding careful to preserve their Beauties. Among infinite Medicines recorded by Authors to this intent, I shall propound the choicest. And in the first place, Oil of Eg-yolks does nourish and engender Skin, and therefore is very convenient to fill the Pock-holes. Wethers Suet fresh and new, melted and done out with a Feather, is effectual to the same purpose. But the filthiness of Pock-holes is much amended, if they be washed first with Yarrow-Water, or Cows-dung-water, distilled in May, and then anointed with Mansgrease. Forestus does much magnify this following Ointment. Take Oils of sweet Almonds and white Lilies, of each one ounce: Fat of a Capon three drams: Powder of Peony Roots, of Orice and Lytharge of Gold, of each ten grains: Sugar-Candy one scruple. Mingle all well in a warm Mortar, strain them through a Cloth, and 'noint the Pock-holes therewith morning and night. And afterwards let them be well washed with Water distilled out of Calves-feets: and when that is not at hand, use the Water of Yarrow in stead thereof. Neither must I omit that which many Practitioners do teach, viz. That when the Pocks be ripe, they must be bored through with a golden or a silver Needle, lest the Quittor tarrying long in them, should leave holes in the part. Which Practice, is notwithstanding, now in a manner grown out of use, since Experience has taught, that the Pocks being bored are longer in healing and doth longer hold their Crusts, because of the Weakness of Natural Heat, caused in the Part by boring, whereby more deformed Scars are left behind. And therefore it is better to abstain from this boring, and to commit the evacuation of the Quittor to Nature alone. To conclude this Cure, I shall subjoin how those dispositions of Itching and Exulceration which happen to persons that have the small Pocks, may be remedied. And in the first place, When the small Pocks come forth, or when they begin to ripen, sometimes an huge pain or Itching does afflict the Patients; especially in the Palms of the Hands and Soles of the Feet, because the thickness of the Skin in those parts hinders the Eruption of the Pocks. Which Symptom you shall help, if you cause those parts to be held in hot Water, or Foment them a long time with an Emollient Decoction. But when there is great Itching in the Face, which compels the Patients to scratch, whence great deformity and foul Scars follow; use this following Remedy. Take leaves of Pellitory of the Wall one handful: Flowers of Chamomel and Melilote, of each half a pugil. Boil them in a pint of Scabious Water, To the strained Liquor ad three ounces of Honeysuckle Water. With this Liquor hot, often let the Itching Pocks be moistened, by dipping a thin Rag or Cotton Wool therein, and so applying the Liquor gently to them. Now the Ulcers which arise from deep and malignant Pocks, are to be cured with Vnguentum album Rhasis, or with an Ointment of Lead made after this manner. Take Calcined Led two ounces: Litharge one ounce: Ceruse washed and Vinegar, of each half an ounce: Oil of Roses three ounces: Honey of Roses one ounce: Three Yolks of Eggs: Myrrh half an ounce: Wax as much as shall suffice. Make all into an Ointment. FINIS. A PHYSICAL DICTIONARY, Expounding such words, as being terms of Art, or otherwise derived from the Greek and Latin, are dark to the English Reader. This Dictionary is of use in the reading of all other Books of this Nature, in the English Tongue. LONDON: Printed by Peter Cole in Leaden-Hall, and are to be sold at his Shop, at the sign of the Printing-press in Cornhill. 1655. A Physical Dictionary. A A Pophlegmatisms, Medicines drawing phlegm out of the Head. Agaricktrochiscated, See the London Dispensatory in English. Apozem, A Medicine made of the Broth of divers Herbs, and other Ingredients; unto which sometimes certain Syrups are added. Animal Faculties, The Powers of Hearing, Seeing, Smelling, Tasting, Feeling; of Imagination, Understanding, Memory, Will, Going, Standing, and all Voluntary Motion. Aranea Tunica: The Cobweb-Coat, or Tunicle Abdomen: The Belly, or Paunch Apoplectic Water: Good for the Apoplexy Autumn: Harvest, the Fall of the Leaf Actual Heat: is Heat that may be felt by the hand, such as is in Fire, and all things heated thereby; or in the Body of one in a Fever: It is oppoied to Potential Heat, viz. That cannot be felt by the Hand, as the Heat in pepper, in Mustard seed, in a Flint, in unslaked Lime: and the contrary of Actual Cold. Affected: Troubled, Diseased: An Affect, a Disease, Trouble, Disorder. Aquae Acidulae: The Spa Waters, like those of Epsam, Barnet, and Tunbridg, with us. Absurdities: Unreasonable things Acrimony: Sharpness, such as in Mustard, Pepper, and in divers Humours of the Body which cause sickness. Ascent: Going up. Apply: lay on. Actually Cold: see Actual Heat. Augment: Increase. Accidentally: By hap, by chance, upon occasion. Adventitious: not Natural, but springing from external causes. Actracting: drawing together, or causing. Attracts: draws to. Accident: something that happens upon a Disease; vide Symptom. Adstriction: binding together, shutting up. Antecedent Cause: foregoing Cause. is opposed to the Conjunct Cause. Abundance of Phlegm in the Body is the Antecedent Cause of the Optic Nerves being stopped by phlegm; but the Phlegm in the said Nerves, is the Conjuct Cause etc. of other Diseases. Articulate Voice: A distinct Voice, such as that of Mankind, termed Speech. Abstergent: Cleansing away filth. Access: Addition, joining to, help, or company. Afflux: flowing to. Astringents: Medicines that bind together, and straiten the Pores and Passages of the Body. Astriction: binding, knitting together. anodynes: Medicines which assuage pain. Anastomosis: an opening of the Mouths of Veins, by which means Blood issues. Astringe: bind, fasten, close. Acute: sharp, violent: a Disease is termed Acute, when it quickly changeth to health or death. Adustion: burning: Adust, burned. Blood is said to be adust, when by reason of extraordinary heat, the thinner parts are evaporated, and the thicker remain dreggy and black, as if they were burnt. Asthmatical: troubled with shortness of breath. Attest: witness, declare. Aneurism: a Swelling caused by a dilatation of the Arteries external Coat, the internal being broken. Axungia: Grease. Atrophy: want of Nourishment, when the Body pines away. Attenuating Medicaments: are such as make thick Humours thin. Axiom, or Theorem: an acknowledged, undoubted Truth. Adjacent: lying near, bordering upon. Aromatized: Spiced, perfumed. Anus, the Fundament. Astringe, to bind. Atoms: small Moats hardly visible, and that cannot admit of any division. Adverse: contrary to, of a contrary Nature. Augment, is the time of a Disease, while it grows still more vehement, until it comes to its height, which is called the state of the Disease, and then the Augment ceases, because the Disease is now at a stand, and increaseth no more. Alteratives, are such Medicines as only change the qualities of the Body and its Humours, by heating, cooling, moistening, drying, etc. they are opposed to such as do cause Vomiting, Purging, Sweeting, Transpiration, etc. Adjuncts of a Disease, are qualities, dispositions, and Symptoms annexed thereunto. Aliments, are what ever is taken into the Body to nourish the same; as all kinds of Meat and Drink. Adjuvant Causes, are such as serve and assist the principal Cause; so is the Tailor's Boy an adjuvant Cause assistant to his Master, the principal Cause of a Garment. So in Diseases, whatever assists the Primary Cause, is termed an Adjuvant Cause. Alexipharmical things, are such as resist Plague, Poison, and all venomous Diseases. B BAlneum Mariae; the manner of stilling or digesting, when the Glass containing the Ingredient, stands in a Vessel of Water, with Fire made under it. Bolus: A Morsel; a Medicine to be taken from a Knises point. Bellilucanae Thermae: Hot Baths in France, so called from the place where they are. Breathing of a Vein; Blood-letting, properly if but little Blood be taken away. Bronchia; the hollow gristly Pipes that spread themselves through the Body of the Lungs, being Branches of the Weazand or Windpipe. C CAruncle; a little bit of Flesh that grows and sticks out on any part of the Body. Catarrh; a Defluxion or Distillation of Humours from the Brain, into any part of the Body, especially the Lungs, causing Coughs. Condense, to make thick. Contention; Digestion in the Stomach, etc. Cataphora; a deep sleep. Cupping-glass, is that which Physicians use to draw out Blood with Scarifying of the Skin, Glasses fastened with lighted Tow or Flax. Catalepsis; Congelation, or stifness of the Body. Caustics, are Medicines which burn the Skin and Flesh to make Issues, etc. Coronal Suture; the Seam which runs through the Crown of the Head, where the two sides of the Skull close. Crude; Raw, undigested: So Meat not well boiled or roasted, is Crude; and Blood and other Humours not well digested by the Stomach, Liver, etc. are called Crude. Conjunctiva; a Coat of the Eye, so called because it sticks fast unto the Eye, and keeps it in its place. Actual Cautery, is burning with a red hot Iron. Congelation, freezing together, stifness with Cold. Constipation, stopping up. Colic, pain and gripping of the Gut Colon; and because the pain proceeding from the Stone, is very like thereunto, it is called the Stone-Collick. Cerates, Medicines made of Wax, and other Materials, stiffer than an Ointment, and softer than a Plaster, to be applied to divers parts. Cephalick, or Capital Opiate, Head Electuary. Cephalick Pills, Head-pils. Cephalick Plaster, Head-Plaister. Collyrium, an Eyesalve. Convulsion, a drawing together, a shrinking together. Contracted, drawn together. Cornea, a Coat of the Eye like the Horn of a Lantern. See Veslingus in English. Chirurgeon, Surgeon. Circumvolution, turning round like a wheel or whirlwind. Compression, thrusting or squeezing together. Contusion, Bruising, a Bruise. Cold seeds, See the English Dispensatory. Compress, thrust together, squeeze. Condense, thicken, condensing, thickening; a Condensation, a thickening. Coarctation, a straitening, thrusting together. Contraction, drawing together, shrinking up, etc. Contracted, drawn together. Confirmed, A Disease is said to be confirmed, when it is perfect, settled, and hath taken root. Couched with a Needle, that is, taken away with a Needle, or pressed down with a Needle. Centre, is properly the middle point within a Circle, from whence all Lines drawn to the Circumference, are equal; it is taken figuratively for the middle of any thing. Continuity, the oneness, the joining together without interruption. Compact, firmly united, well thrust and crowded together. So Gold, Led, and other Metals, are said to be compact, compared to Cork, Sponge, and light Wood which are not compact, but hollow and pory. Concocted: An Humour is said to be concocted when it is either turned into good Blood, as sweet Phlegm is wont to be; or when it is separated from the Mass of blood, and made fit for expulsion. Concoction; a boiling, or boiling together: when the meat in the Stomach is changed into a substance like Almond Cream; that change is called Concoction. Cataplasm; a Pultiss. Cavity; hollowness. Crisis; by bleeding at the Nose, or by vomit, page 57 that is a breaking away of the Disease by Nature's Conquest of the Cause, which she drives forth by the Nose or Mouth. Crystalline Humour; a part of the Eye which resembles a little Cake of Crystal; if you open a Calf's Eye carefully, you may take it out whole. Conus, is a Geometrical Figure, representing a Sugar-Loaf, or an Extinguisher; which Philosophers make use of when they teach how the Eye perceives its Object. Connatural; which is bred with a Man; as he that is born with one Eye, or but two Fingers: such a Disease is termed Connatural. Convex; bunching out like the backside of a Buckler or Platter. Conjunct Cause of a Disease, is the immediate Cause; so Phlegm stopping the Optic Nerves is the Conjunct Cause of Blindness; whereas taking of cold, swimming in cold water, eating phlegmatic meats, sleeping after Dinner, were the remote, or far distant Causes, etc. Constriction, a drawing together, a straitening. Congestion; a gathering together or heaping up. Cumulation; the same with Congestion. These words are opposed to defluxion. When a part is diseased by an Humour sent from another part, it is termed Defluxion; when the Humour is first gathered in the part itself, by reason of its own proper weakness, it is termed Congestion or Cumulation. Conjoined Matter; see Conjunct cause. Corroding; biting, gnawing, eating. Consolidation; closing up of a Sore or Wound, etc. Carus; foulness, rottenness, corruption of a Bone. Cicatrize; to bring to a Scar, to close up a wound or sore. Commissura; the Mould of the Head, where the parts of the Skull are united. Cavous; hollow. Critical Evacuations by bleeding, stool, etc. are such as Nature procures to drive out her vanquished Enemy; and are means and tokens of Recovery. Symptomatical Evacuations are such as proceed from the vehemency of the Disease, before Nature hath mastered the offending Humour, and they prove bad tokens. Calcine; to burn to Ashes in a Crucible, etc. Corrode; eat, fret; Corroding, eating, fretting. Cronical; long lasting. Cacochymical; abounding with evil Humours. Critical day; See Day of Judgement. Corrosion; a fretting, eating asunder. Conjugation; a pair of Nerves is so called. Cardialgia; Heartburning. Crudities; Rawness, indigestion. Chylus; a Liquor like a Posset, into which all Meats are changed in the Stomach, if the Digestion be good. Cydoniatum; Conserve of Quinces, or Marmalade. Cardiogmos; Heartburning. Carminating Medicines; are such as do break Wind. Constringe; draw together. Carminative; expelling Wind. Chalibeat Vinegar, and Chalibeate Water, are such as have steel quenched in them. Carabe; Amber. Cronical Diseases; such as usually last very long, as Quartan Agues, Stone, Dropsies, etc. Crystal of Tartar; Cream of Tartar. Consistence; Body, or Substance. Catheter; an hollow Silver Instrument to thrust into the Bladder when the Urine is stopped by a stone, to thrust back the stone, and let out the Urine. Complication of Diseases; when divers Diseases are in the Body at the same time, especially if they depend one upon another. Coalition; healing up, growing together of a Wound or Ulcer; or any Part that ought to be open, as of the Privity in some Girls. Coincide; is to happen together at one and the same time. Cachectical Persons, are such as have their whole Bodies blown up with a soft and moist swelling, with the colour of the Face white, or lead-colored. Also their Legs especially swell, and their Face is bloated. Coindicants, are divers things in a Disease or Patient, which plead for one and the same Remedies. So in a putrid Fever, the person being full bodied, and the season warm also, the person lusty and young: The Fever, the fullness of Blood in the Patient, his Age and strength, and Season of the Year, are Coindicants that he must be let Blood. Contraindicants, are divers considerations that dissuade a Remedy: As when in a putrid Fever, old Age, Winter Season, Weakness, are Contraindicants, that dissuade from Blood-letting; which the Fever simply considered, doth indicate, or persuade and hint out. Coction of Humours, is their being separated from the Mass of good Blood, and fitted for expulsion: As when thin Humours are moderately thickened, and tough clammy Humours are cut and divided. This Coction of Humours is known by the Urine, when it hath a light, even, and smooth settling, etc. Causa sine qua non; The Cause without which a thing cannot be, though it be not the principal Cause thereof: So a Tailor's Shopboard is a Cause sine qua non, without which a Garment cannot be made, though himself and the stuff, the shape and the end be principal Causes. Commemorative; bringing to remembrance what is past. Cicatrize; is to bring un●o a Scar, which is done when Wounds and Ulcers are healed up. Contumacy; stubbornness, rebellion. D Diuretics; Provokers of Urine. Diagnosis; the knowledge of a Disease. Distillation; a flowing down of thin Humours from the Brain into several parts. Decoction; the Liquor where in things are boiled, the Broth of Herbs, and other Medicaments. Diagnosticks; the Signs to know what Disease a Patient hath. Defluxion; the same with Distillation: also a running together of Humours into any part, causing pain or swelling, etc. Delirium; Dotage, raving, talking idly, in time of sickness especially. Diarrhoea; a simple Looseness, without Inflammation of the Guts, any extreme pain, or voiding of Blood. Diaphoenicon; see the London Dispensatory in English. Diacatholicon, Diacarthamum; see the Dispensatory. Diet; this signifies in many places a Diet drink. Diminished; Lessened. Diminution; a lessening. Discuss; dispel invisibly: as a Plaster that makes a swelling go away without breaking, is said to discuss the same. because the Matter of the swelling is not seen to come away; but is turned into steams and vapours, and partly drinks up the substance of the Plaster, and so vanisheth invisibly. Declination of a Disease; is the breaking of the Disease, when it gins to tend to health, which is known by the Symptoms growing more gentle. Diverting Medicines; which turn aside the Humour causing the disease, so that it flow not into the part offended. Dislocation; putting out of its place. Derived; turned away from. Diffuse; spread abroad. Dissipated; scattered abroad. Demonstrated; clearly proved from undeniable Arguments. Depravations; marrings spoilings, hurting. Depressed; made flat or hollow, dented in. Distemper; any excess of the four first qualities, Heat, Cold, Moisture, Dryness. There are reckoned four simple or single distempers, viz. a Hot, a Cold, a Moist, a Dry: and four compound, viz. Hot and Moist, Hot and Dry, Cold and Moist, Cold and Dry. Dilated; widened. Dilatation; widening. Debility; weakness. Distortion; writhing, wresting, crooking. Dissipating: spread abroad, driving away. Derivations: drawing an offensive Humour from the part diseased, to some other part near it. Digestives: Medicines which prepare evil Humours for to be driven out by Nature. Dissolved: melted, consumed away. It is used of swell that are brought down by Ointments or Plasters; and in other cases when the Humour causing the Disease, is invisibly driven away. The Drum mentioned in page 96. is a pretty little hollow bone in the Ear, covered with a thin Skin like a Drum, which being beaten upon by another little bone like a mallet, doth cause sounds to be heard in the Ear. See Veslingus his Anatomy in English. Diapedeses; is an issuing of the blood through the Pores of the Veins. The Day of Judgement, or Critical day: is that day in fevers especially wherein it appears, on which side sentence is given, whether on the ●lantifs, viz. the Diseases; or on Natures, the Defendant; so that by some Evacuation, or swelling, or other great mutation to the better or worse, it appears whether the Patient is like to recover or not. Distension: stretching. Depraved: marred, spoiled. Dilatation: widening, opening. Diaphragma: the Midrif. Dyspnaea: shortness of breath. Dysentery: a Bloodyflux. Diagrydiates: Medicines that have Scammony or Diagry dium in them. Dissolution of Natural Heat: a decay of Natural Heat. Diaphoretic Sweats: which are caused by Nature, oppressed with a malignant Humour, and forcibly driving the same out by Sweat. Dung-gate; the Arse-hole. Distillations by descent: are when the Liquor which comes from the Materials stilled, doth not rise up above the said Materials, as in ordinary distillation; but falls down under the Materials stilled, which are therefore laid upon a Grace, that the bottom of the Vessel may be empty, and free to receive the distilled Liquor. E EXcrement: the Dregs of Digestion in the Body, voided by Dung, Urine, and Sweat. Evacuation: an emptying or voiding forth, purging. Epispastick: a Plaster to draw a Blister, called also a Vesicatory, or any strong drawing Plaster. Errhines: Medicinal Liquors to be snuffed up th● Nostrils to purge the Brain. Empyema: Empyems a corrupt matter between the breast and the lungs following a Pleurisy. Erysipelas' Oedematosum: a tertian swelling arising from choler and phlegm. Eliphantiasis: a leprous disease, which makes the Patient's skin like the Hide of an Elephant. Electuary: See the London Dispensatory. Expulsion: driving forth; as of Excrements, Dung, Urine, Sweat, etc. Expel: to drive forth. Eruption: breaking forth. Extinguished: quenched, put out. Emunctuaries or Emunctoryes; certain ways and passages that Nature finds to drive ill Humours into, from the Principal Parts; as certain Kernels behind the Ears; and in the Groins, under the Armpits, etc. where rise happened in time of Pestilence etc. Essentially springing P. 11. that is primarily and principally, not accidentally or occasionally. Ebullition: boiling and working of the blood in the Veins, like New-wine in a Cask. Extension: stretching out. Extenuation: Leanness, Consumption of flesh. Extenuating making thin. Expulsive faculty: the power of our body which drives forth Dung, Urine, Sweat, Vapours etc. every part partakes of this Ability, or Faculty. Eminent: near at hand approaching. Erysipelas: a swelling caused by choler. Erysipelas Phlegmonodes, or Phlegmon Erysipelatodes. Is a swelling caused by Inflammation of Choler and Blood. Emulsions: Almond milks; and milks made of cool Seeds, etc. Electuaries. Medicines made up of Conserves of Flowers or Herbs; to which is added some sweet Spicy powder for the most part, and so with Syrup it is made up in the form of Mithridate or Treacle. Epithemes: are Medicines applied in Bags, commonly upon the Heart or Stomach Liver or Spleen etc. Certain convenient powders being put in a Bag, or between two , and so wet in Wine or other convenient Liquor, are laid upon the Stomach, Heart, etc. Essential to the Disease: that is of the being or substance, so that without that, the disease could not be. So Heat is Essential to a Fever. Excrements: dregs and refuse of our meat and drink after Concoction, voided by dung, Urine, Sweat, and invisibly through the Pores. Excrementitious: of or belonging to Excrements, impure, preternatural humours are so called. Extenuate: make thin. Expressed: Squeezed out. Epidemical: common to a whole Nation. So the the Plague, small Pocks, Looseness, Sweating-sickness, etc. when they are rise all over a Nation▪ or Country at one time, they are called Epidemical diseases. Ehxir Proprietatis. A Medicine invented by Paracelsus. Take of the best Aloes, Myrrh & Saffron, of each half an ounce: Powder them and put them into a Glass. Then take Muscadine made tart with Oil of Sulphur, and pour upon the powder, till the liquor stand four fingers above the powder: Let them stand and digest in a warm place. Then pour off the Liquor and put on more, till all the Colour and virtue be drawn out from the powder. At last still the settlings with a gentle fire, and pour that which comes away, to the former Liquor, and let all stand and digest a Month in a warm place, close stopped. The name signifies such a Quintessence, as hath a special propriety of agreement with Man's nature, whereby it comforts and restores the same, in all kind of weakness. Emollient: Medicines that soften. Eroded: eaten a sunder, eaten up. Extraction: pulling out. Exquisite: perfect, in an high degree. Escharoticks: see Caustics potential. Embrochated: moistened, bedewed, bathed. Erosion: fretting, eating. Eclegma. See Lambitive. Extreme parts: the Arms and Legs. Emplastic diet: consists of such meats as are of a clammy substance, viz. Calf's Head and Feet, Sheeps-trotters; all Feet of Beasts, Tripes, Gellys, etc. Excreta and Retenta: things voided out of the Body, things retained, or kept in. Eradicate, pluck up by the Roots. Exasperated: pained, vexed, molested. Equivocal: Signs of a Disease, are such as are common to it and other Diseases. The Efficient Cause: is the working or making Cause, so a Tailor is the Efficient of a Garment; The Material Cause is the stuff, a thing is made of which the Efficient works upon; So the Cloth or Silk is the Material Cause of the Garment. The formal Cause, the shape that makes it a Coat, or Cloak, or Doublet; the Final Cause, is the end why it was made, viz. to hid nakedness, keep off Sun and Cold, and to adorn the body. Emulgent Veins: which bring the Wheyish Excrement of the blood unto the Kidneys where it becomes Urine, and is passed by the Urecers into the Piss-bladder. Evaporation: a steaming out of Vapours. Egress: coming forth. Evaporated: steemed away, as Water that spends away in boiling. Evacuators: Medicines which empty out evil Humours, either by vomit, Purge, etc. Exhalations: Vapours drawn up by the Sun, out of the Earth and Waters. Eventilated: Fanned, purged as Corn by fanning. So Exercise is said to eventilate or fan the Body; because the motion opens the Pores, and drives many vapours out. Eneorema: that which hangs like a cloud in Urines, especially when the Disease is breaking away. Emollient Decoction: a softening moistening Decoction, made for Clysters to soften and moisten the hardened Excrements of the Guts. An Eschara, or Eschar; is the Core that falls off from a part that hath had a Caustick applied thereto. F FVmigations: Perfumes and others things, burnt to qualify the Air in a sick man's chamber. Fracture: breaking, as fracture of the Skull or Arm, etc. Fomentation: when linen or Sponges are dipped in some Liquor, and applied to the diseased part, and after renewed. Functions of the Brain: the Abilities of the Brain, to Hear, See, Imagine, Understand, Remember, etc. Frictions: Rubbing. Furor Vterinus: Womb-Madness; when Women are mad by reason of a disorder in the Womb. See the Chapter of that Disease. A Flux of Humours: flowing of Humours. Febris Catarrhalis: a Fever caused by Rheum falling from the Head. Fabric: Frame, making up, composition. Frontal Vein: Forehead Vein. Fortified: strengthened. Fistula: an hollow, deep, but narrow Ulcer that will not be closed up. A pair of Forceps, a small Instrument like a pair of Tongues, to draw forth any thing out of the Ears, etc. Fluid: apt to run and flow like Water, and other Liquors. Filtration: straining through a brown Paper, or by means of a piece of cloth hanging out of one Vessel into another. Filter: to strain as aforesaid. Fermentation: the working of Humours, as new drink works in the Barcel. A Fever Symptomatical, is a Fever caused by some other foregoing Disease; in respect of which Disease, the Fever is but a Symptom or Accident. A Flatulent and Pituitous Colic, is a Colic caused by wind and phlegm. Formicans Pulsus; a weak, feeble, quick Pulse, that seels under the Fingers like creeping Pismires, from whence it is named. Form: See Efficient Cause. Fluxive: apt to flow and run like Water and other Liquors. Friable: is crumbly, short, like costly Cakebread, Piecrust, Puf-past, etc. So Fishes that have a short crumbly substance, not clammy or slimy, such as Sols, Smelts, Trout, are said to be friable in comparison of Eels, Carp, Tenches, etc. G GVm Animi: Indian Amber. Gargarisms: that is, Medicines to Gargoyle in the Throat to wash sore Throats, de Gutteta: a Powder used in Falling-sickness and Convulsion of Children by the French. It is described page 33. at the bottom. Going about: by fits. Generating: breeding, begetting. Glandules: Kernels, such as are about the Throat, a●d are called the Almonds of the Ears, and such as the Sweetbread, etc. Gate-Vein: Vena Porta. See Veslingus Anatomy in English. Generous Wine: strong Wine, as rich Canary, Muskadine, etc. Glutinations: Clamminess like Gum about the corners of the Eyes. Glutinators: things which glue and close up broken Veins, etc. Glutinous: clammy like Glue. A Gangrene: is a corruption of a part tending to the utter deading thereof. H HYpochondria: the parts beneath the Ribs. Hemiplegia: the Palsy possessing one side. Hydrelaeum: a Bath and Ointment; that is, of Water and Oil beaten together. Hippocras Bag: a Bag of Wool shaped like an Extinguisher, through which Hippocras and divers Medicines are strained. Hereditary: from Father or Mother, to Son or Daughter. Hydromel: Honey and Water, Mead, Metheglin. Hemorrhoids: Veins of the Fundament, to which Leeches are applied. Head-Herbs: Rosemary, Betony, Sage, Lavender, sweet Marjoram, Hyssop, Balm, Cowslips, Roses, Violets, Lettuce, borage, Bugloss, etc. Habit of Body: is the whole bulk and substance thereof. Humidity: Moisture. Holy Fire: a red Inflammation, St. Anthony's fire, the Rose. Hemorrhagies: breaking forth of Blood from any part of the Body. Hysterical Fits: Fits of the Mother, Womb-sickness. Hermetical Physicians, and Hermit's: Chemists, such as trade with Furnances, Pots, and Glasses, to draw Spirits, Oils, Waters; to make Salts, Quintessences, etc. called so from Hermes Trismegistus, an old Egyptian Philosopher, who is thought to have been a Chemist. Horrors: Shivering. I INfuse: that is, steep. Inflammation: great Heat. Indication: is an hinting to the Physician what he is to do. So extreme heat is said to give indication of cooling; extreme fullness of blood gives indication of blood-letting; want of a woman's Courses gives indication of blood-letting, etc. Jugular Veins: that is, the Throat Veins. See Veslingus Anatomy in English. Insensible Passages: which cannot be seen, nor felt, by reason of their smallness. Influence: flowing in. Inherent: sticking fast within, seated and abiding within. Inordinate: disorderly, unnatural, and unfitting. Internal and External Senses: The Internal are, Common Sense, Imagination, Understanding, Memory: The External are, Seeing, Hearing, Smelling, Tasting, Feeling. Intercepted: stopped in the middle way. Internally and Externally: inwardly and outwardly. Juleps: pleasant Drinks made of distilled Waters, or the broth of Barley, and other convement things, and sweetened with Syrups or Sugar; given chief in Fevers to cool and quench Thirst. Infusion: a strained Liquor wherein Medicaments have been steeped, either hot or cold. Incrassate: thicken. Incrassating: thickening. Insensible: not to be perceived by the outward Senses, of Seeing, Hearing, Smelling, etc. Illumination: enlightening. Influx: flowing into. Inversion; turning the inside out. Intermission: ceasing, leaving off. Inveterate: old, of long continuance, rooted. Inclination: that is, by holding the vessel on the one side, and so pouring the clear from the settle: this is called to clarify by Inclination, in opposition to clarifying with the white of an Eglantine by boiling, or any other way. The Iris: a party-colored round Circle in the sight of the Eye like a Rainbow, from whence it hath its name. Incarnate: to breed flesh. Irritation: provocation, stirring up. Involuntary Tears: which are not shed by force of sorrow working upon the mind, but by force of a bodily Disease. The day of Indication: is that day in a Fever on which may be collected what will betid upon the following Critical day. So the sourth day doth hint what is like to happen on the seventh; and the eleventh hints what is like to happen upon the fourteenth; and the seventeenth what will happen upon the twenty one; and the twenty four what will betid upon the twenty eight. Therefore the fourth, eleventh, seventeenth, twenty four, are called days of Indication, or telling and declaring. Judged, see Day of Judgement. Infirm: weak. Insipid: Tasteless. Incising Medicaments; are such as cut and divide tough phlegm, and other clammy humours, whereby they become fit for expulsion; such is Oxymel, etc. Intestines: the Guts. Intention and Remission: Increase and decrease, growing stronger or weaker. Injection: is a Medicinal Liquor cast with a fitting Instrument into the Womb, Bladder, or Fundament, when there is forenessof hemorroids, etc. Inserted: fastened or planted into. Inspissate Juice: is Juice of some Herb boiled till it be thick, as Honey. Illustrated: made clear and manifest. Invasions of the Gout: fits of the Gout, or of Agues, may be called Invasions of the said Diseases. Intense: vehement, strong. Indicate: declare, point out. Impacted: wedged in, thrust far in. Irrigations: moistenings, sprinklings, waterings. Intervention: coming between, happening together with. Intermediate: coming between. Intermitting Pulse: is that which holds up a while, and then beats again; and then stops, and then beats again, which is a sign of great weakness. Incoctibility: an unaptness to be concocted or digested, or an impossibility thereof. L LEnitive: a gentle, refreshing, cordial Medicine. Ligatures: or strings wherewith the Joints of Bones and the Gristles are compact and bound together. Lozenges: the same with Tablets, being the form of a Medicine made up. Luxation: is when one Join is loosened from another. Lineament: Ointment. Ligatures: bindings of several parts to draw the blood and Humours from the part diseased, to the parts bound, by reason of the pain of binding which must be very hard and strait. Looseness of continuity: separating and dividing of things closed and united. So a wound is termed a loosening of continuity; because, it separates these parts of the skin and flesh which were formerly united together. Laxe: lose, slack, as an unbended Bowstring. Livid: black and blue. A Lambative or Lohoch: is a medicine to be licked from a Liquoris stick, and to be swallowed softly down, being chief ordained for the Lungs. Iron-water: Water wherein Iron hath been quenched. Smith's forge-water. Laxative: which makes the belly lose. Livid: black and blue, Lead-coloured. M meanings: or films of the Brain, coats that cover the brain. Masticatories: that is Medicines to be chewed to bring away Rheum. Mes●eraick Veins: little Veins that are thought to carry chyle from the stomach to the Liver. See Vestingus Anat. in English. Malignity: venomous or poysonful quality of certain humours and Diseases which make them very dangerous, and for the most part deadly. Matter, or Quittor: a snotty kind of filth which comes out of Imposthumes when they break, and out of Ulcers when they are in a good way of cure. Magistral Syrup: is such an one as is invented by a Physician for his Patient, in opposition to those Syrups commonly kept in shops. Matrix: Womb. Membrana: skin or coat of the Arteries, Veins, etc. Membranes, skins or coats. Mortification: a deading of any part of the body. Malign: venomous, poysonful. See Malignity. Mother: the Womb in Women is so called. Mitigation: abatement, lessening, growing mild. The Medium: is that through which we see, as principally the Air, which we look thorough upon objects; also the Water and Glass, Horn, or what ever is clear, and may be seen through, may be termed a medium of fight. Mammilarie passages, or productions: certain little knobby bunchings out of the Nerves, which serve for smelling, resen bling Teats, called therefore Teat-like productions. See the English Anatomy. Malax: soften. To Malax a lump of Pilstuff, is to soften it, that it may work up into Pills the better. Mercurial Purges: Purges made of Quicksilver, Chemically prepared, such as Mercurius dulcis, some kind of Precipitate, Mercurius vitae, etc. Macerate: steep. mesentery: the skin which knits the Guts together, and runs all along among them, embossed with Fat. See Vestingus his Anatomy in English. Membranous: of the Nature of Skin or Parchment. Morbifical, or Morbific matter; is that which is the principal cause of any Disease. Minorative purgation: is gentle purgation, such as takes away only a part of the matter of a disease: it is opposed to Eradicative purgation, which is strong, and pulls the whole matter offending up by the Roots; as it were. N NVtrition: Nourishment. Narcotick medicines: stupefying medicines: that dull the sense of feeling, and cause profound sleep. Nitre: salt Peter, as some hold; but Matthiolus conceives the true Nitre is rarely found in these days. Natural functions: actions of the stomach, Liver, Spleen, Gal, Kidneys, in concocting the meat, making blood, and separating and expelling the excrements. Nauseousness: sickness of the stomach inclining to vomit. Nidorous: smelling of fat, or scorched Roast-meat, or fried Oil. Noxious: hurtful. Nausiosis of the Veins: is when the Veins are sick of bad blood, and doth as it were spew it out into the habit of the body: from whence comes scurvy-spots, morphew, scabs, etc. Neotericks: are late writers in physic, or any other Art, so called in opposition to the Ancient Authors. O ORgans: peculiar parts of the body fitted for some notable service of the Spirit, such as the Eye to see, the Ear to hear, the Nose to smell, the Skin to feel, the Lungs to breath, Stomach to digest. Os Sacrum: the great bone whereon the Ridg bone resteth. Opisthotones: a Convulsion so named, when the Body is drawn backward. Oval form: that is the shape of an Eg. Original: beginning, foundation. Oedema: a swelling caused by phlegm, which is soft and whiteish, and has little heat or pain with it. Obstruction stopping. Opiate signifies an Electuary: properly it is put for Venice Treacle, Mithridate, Diascordium, etc. which have Opium in them: from whence the name is derived. But secondarily, it signifies any Electuary or Antidote made up in such a body as Treacle, etc. though it have no Opiate in it. Orifice: the whole which is made by a Surgeon when he lets blood. Also the mouth or passage into the Womb, or Stomach, etc. Optics: a Part of Natural Philosophy (though falsely reckoned for a branch of the Mathematics) opening all the Mysteries of sight, and the reasons of the Deceptions, or mistakes thereof, and teaching to make augmenting Glasses, mutiplying Glasses, Perspective Glasses, burning Glasses, etc. Obliqne: slantling, athwart, crooked, Obnoxious: liable, or subject unto. Ophthalmy: an Inflammation of the Eyes, causing foreness and redness. Oscribosum: the bony Sieve. A bone full of small holes, like a Sieve or colendar, placed above the Nose, through which Snot and Snivil, is drained from the brain. Occult: hidden, unknown. Oxycrate: Vinegar and water mingled together. Organical Disease. See similar diseases. The Systole, or diastole of the Pulse: are the double motion thereof. For when the Artery is extended by the blood, Issuing out of the Heart, and smites the Finger of him that feels the Pulse; that motion is called Diastole, or a widening and stretching of the Artery: but when the Artery falls, contracts itself, and sinks from under a Man● Finger, that motion is called Systole, a contraction. Oxyrrhodine: Vinegar of Roses, and Medicines made principally thereof. P PRognosis: the foreknowledge of Diseases. Plethora: a too great fullness of good blood in the body. Paralysis: the Palsy. Paraplegia: Parisis, Palsy. Peripneumonia: an Inflammation of the Lungs, or Lights. Pericranium: the skins which compasseth the Skull. A Pugil of Herbs viz. as much as is taken up between the Thumb and the three fore-Fingers. Physical Regiment: is the right ordering of a Patient, having taken a Purge, or other strong Medicament. As to keep the Patiented warm, to give posset or thin-broath after every stool; not suffer him to read, or her to Sow or hold down the head, or to be sad, or to sleep; especially after a vomit, etc. Frenzy: raging, Madness joined with a Fever. see Chap. 11. Book 1. Prognostic: foretelling. A Prognostic sign is a sign foretelling what will become of the Disease, and patiented. Privation: loss. Plethoric: full of blood, too full of blood. Pores: little holes in the skin, through which vapours and sweat come out. Sometimes they are visible upon the Arm or Leg, being swelled and closed with cold; resembling a Goose skin for roughness. Preternaturally: otherwise then the Course of Nature requires. Perspicuous: clear, that may be seen through, as Glass, fair-water, etc. Peritonaeum: the inner coat of the Belly, which covers the Guts: See the English Anatomy. Poplar Ointment: in the shops called Populeon. See the English Dispensatory. Potential coldness: that is coldness in operation, though not to the feeling. So a draught of Whey in which cooling Herbs hath been boiled, being drunk down warm from the fire; is said to be actually hot, because it is so to the hand and palate; but Potentially cold, because it afterward cools the stomach, Liver, etc. Pulsation: beating of the Arteries, in any part of the Body. Precede: go before. Preparing of humours: is the qualifying of them, so as that they may be fit for expression which preparation consists in separating them from the mass of good blood: in making them thick, if they be too thin and sharp: in cutting them and making them thin, if they be too thick and clammy. Phlebotomy: blood-letting. Preternatural: beside the intent or custom of Nature▪ vide Preternaturally. Propriety: a pain by propriety, is when the cause of the Pain is in the part pained, so when the Headache comes from the Humours in the Head, it is called a pain by propriety; when it comes from Humours in the Stomach, or any other part that sends up vapours; it is called Headache by Consent. And the like may be said of other Symptoms or accidents. A Pyramid: is a Geometrical figure, broad and angular at the bottom, and growing less and less towards the top, till it come to a point. The Sepulchers of the Egyptian Kings were made in this form, and therefore called Pyramids. Naturalists do make use of this Figure to show how the Eye receives the representations of visible objects. Pupil of the Eye: is the middlemost round circle, which we commonly call, the sight of the Eye, and which in Cats, is seen to widen and contract itself. Pulse: Beans, Pease, Hastivers, French-pease, etc. called so, because they are gathered by pulling, and not by mowing down, as corn. Probable: likely, possible. Profound: deep. Producing: breeding, causing. Peccant Humour: the Humour offending, causing the Disease. A Phlegmon: is an Inflammation or swelling caufed by blood. If no other Humour be adjoined, it is a true Phlegmon. If choler be joined, it is called a Phlegmon erisipelous; if phlegm, aedematous; if melancholy, Scirrhous. Paroxysm: the fit of an Ague, of the Mother, or any Disease that comes by fits. Perforated: bored through. Putrid: rotten, filthy, stinking. Pustula: a pustle, push, or whelk. Ponderous: weighty. Peristaltickmotion of the Guts: is whereby the Guts do contract and purse themselves together above the excrements, and so squeeze them out. Pomum curtipendulum: an Apple so called. Pubes: the hairy Hillock above the privities in men and women. The word signifies ripeness, because that hair being grown out, testifies the parties to be fit to engender. Paerineum: the space which runs like a ridge between the privities and fundament in men and women. Preposterous: unnatural, undue, unfitting. Perturbation of the Eyes: a troubled, drowsy, frighted look of the Eyes. Procatarctick Causes: primary, first working and occasional Causes. So in a Fever, the next immediate Cause, is putrefied choler etc. but the first working & occasional causes, were the patients taking cold, by swimming in the cold-water; whereby the pores became shut, and the Matter of the Disease was retained in the Body. So the Procatarctick Cause of worms in Children, is their greedy eating of Fruit; but the immediate Cause, is putrid humours occasioned by those Fruits; out of which humours the worms breed. Precipitated: thrown headlong, forcibly cast down. Palliative Cure: is when a Disease is not taken away, but only mitigated and made more mild, so that the patient may have as much ease as possible. Or if the Disease deform the Body, a palliative Cure, does hid as much as may be that deformity. So an Eye being thirst out, cannot be properly cured; but it may admit of a palliative cure, in assuaging the pain, and other Symptoms, and by putting into the place thereof a Glass or other Artificial Eye. Potent: powerful. Perspirable: the Body is said to be Perspirable, when the invisible Pores or holes in the skin, are kept open, so that the vapours arising from evil Humours may freely breathe out. See Transpiration. Pernicious; deadly, causing death, & destruction. Protraction: is a lengthening out of a Disease and making the same to last long. Pharmaceutick Remedies: whatsoever kind of Medicines are made by the Apothecary. Preposterous: disorderly, undue, unfit, the Cart before the Horse. Quittor.: See Matter. R Repletion. over much fullness of blood, or Humours. Resolution, weakening or dissolving the strength of a part, as when it is palsyed etc. Revulsion: drawing back of blood or Humours from the part affected. Repelling: Medicines which draw back the humour from the part affected, Repellers, the same. Relaxing: Slacking as the string of a bow when the bow is unbent, is said to be relaxed or slackened. To Revel: to draw back Humours from the part diseased. Remitted: lessened, abated. Restriction: exception, limitation. Ruption: breaking, or tearing asunder. Relics remainders of an Humour after Solemn purging, bleeding etc. Retraction: drawing back. Radical moisture: the fundamental juice of the Fundamental juice of the body, which nourishes and preserves the natural heat, as the oil in a lamp preserves and feeds the flame. Reveled: drawn back, Revulsives, remedies to draw back the Humour from the Diseased part. Repelled: driven away. Retentive: faculty, the power in our body and its parts to hold fast its nutriment and what ever is agreeable thereunto. Rough Artery or Aspera Arteria, is the windpipe or Weasand, which is rough on the out side with circles and gristly rings. Reduced brought bach again. Refractions: breaking of the Representations of visible objects. a term used by the writers of Optics, or the Art of seeing. Recruted: repaired, restored, made up, a military Resolving medicaments: are such as loosen and scatter evil humours which are gathered and combined together in some diseased part of the Body. Repercussives: medicines which drive back the Humours from a diseased part. Relaxation: looseness. Refrigerating: cooling. Resp ration: breathing. Reflux: flowing back again. Recipient part, is that part which receives the Humour offending. S Suppository: that which is put into the Fundament to cause solubleness. Sudo● osick: that is causing sweat. Subeth a deep sleep. Scarefication: is a cutting of the Skin that it may bleed into a Cupping-glass. Superficies: the outside of any thing. Stuphes: Stoves or Hothouses to sweat in. Spiritus acousticos: is that portion of the spirit which in the Ears discerneth sounds. Strangulation: choking. Sternon: the breast bone, See Veslingus Anatomy in English. Sphinchter: is the Mussel of the Arse. Stupor: dulness. Spasmus: cramp or Convulsion. A Scruple is twenty grains or the weight of so many barley corns. Sternutatories: medicines to snuff into the nose to provoke sneezing. Stupefying: taking away the sense of feeling; benumbing. Stupid: that is benumbed, besotted, hath no feeling or sense, blockish. Symptoms: evil dispositions of the Body which depend upon and accompany a disease; as Heat, th●●st, Headache, want of sleep, stomach-sickness, faintings, swoonings &c. Sympathy: fellow-feeling, a disease is said to come by sympathy, when the principal cause is in some other part, with which the part offended hath a fellow-feeling. So pains of the Head caused by evil Humours in the stomach, are said to come by sympathy. And sickness of stomach caused by stone in the kidneys is a disease of the stomach by sympathy. Nerves Sinews, certain strings carrying the faculty of Motion and sense from the Brain into all parts of the Body see Veslingus Anatomy in English. Scorbut: the Scurvy. Steeled in which steel hath been quenched or infused. Scorbutic persons, that are troubled with the scurvy. Spinal: of or belonging to the Backbone. Serous matter: wheyish, like whey. Sutures: seams of the Head, where the parts of the skull are joined together. Species of the Objects: representations of things seen. For the visible things themselves do not enter into the eyes, but certain images, and figures of them. Situation place or posture. Species retained in the Mind: the shapes and patterns of things seen or heard etc. State of the disease: is when it is at the highest and does neither increase nor decrease. Saphena: A vein of the foot which is usually opened in women; see Veslingus Anatomy in English. Sal-prunellae: salf-peter purified with Brimstone Clean white salt Peter is as good for use, only the Chemist's love to mend Magnificat and many times take great pains to little purpose. Sphacelus: deadness of any part, when the flesh and bone are dead; sphacelation signifies the same. Superfluous: over much, unnecessary etc. Speculum Oris: an Instrument wherewith the Mouth and throat is kept open, that the parts diseased may be seen and dealt with. Scirrhus: an hard swelling without pa●●. Suppurated: an Impostume is said to be suppurated, when it gathers matter & inclines to break. Suppuration: a collection of matter in an imposthume. Suppression: stoppage. Solution of continually: a dividing of such parts as were naturally united; so every wound and Sore, is called a solution of continuity etc. Stupes: cow or cotton-wool. Sealed Earth: Terra Sigillata, it is a kind of Medicinal Earth brought out of the straits & sealed in little flat cakes, to avoid Imposture the Seal is wont to be the great Turk's badge viz. the half moon. Sparadrap: a cerecloath. Sediment: the settlings and dregs of Urine or any other liquor. Suppression: stoppage. Sincere excrements; are such as are pure and unmixed, as choler alone etc. Sudoroficks: medicines causing Sweat. Suffocating, choking, Suffocation a choking. Subject; a logical term, it signifies any thing that hath somewhat adjoined and annexed to it. So the Body is the subject of Sickness & Health, of Beauty and deformity. The Head is the subject of pains, and other parts are the subject of other accidents. The Soul is the subject of virtues and Vices, of Happiness and Misery etc. Suffusion: a shedding abroad of Humours; as when an Humour is shed abroad in the Eye and hinders the sight, it is called a suffusion. A Seton is an Hole made in the skin and a skein of Silk, or yarn, or such like drawn through, and kept in, in which being removed daily causes the matter and humour to come away. Sulphurus and Bituminous baths: that is hot baths like those of Bath in Summerset-shire, whose Heat and virtue springs from a tincture of Brimstone and Bitumen which they bring out of the Earth. Suppuration: is when a swelling comes to gather Head, breed matter and is ready to break. Specific quality: a peculiar hidden property, not springing from the first qualities. Similar Diseases: are such as befall the substance of the Body, not considered as form into any organ or limb or part; and they are all kind of Distempers. Organic diseases are such as are proper to the organs and Instruments of the Body as such, viz. what ever mar their Fabric. Common diseases are such as are liable both to the Similary and Organick parts viz. Solutions of Unity. T Tablets: are the same with Lozenges: they are Medicines made up in flat four squared Cakes with acuted angles. Torpor: numbness. Transpiration: the passage of the vapours through the pores of the skin of the whole body invisibly, only causing a smell according to the humours, in some more in some less, in some offensive in others not so. Tumour: swelling. Tincture: the virtue or strength of any thing drawn forth by steeping the same in spirit of wine, vinegar, or any piercing liquor', the said Liquor containing the virtue and oftentimes the Colour of that which was steeped in it is called the tincture thereof. Tile tree: a Linden tree there grow two on Newington green they bear sweet blossoms. Trepan: an Instrument made to boar an hole in the skull. Turgent: swelling, working, moving too and fro spoken of the Humours of the Body when they are in a Combustion, and full of motion. Tacamahaca: A sweet Gumm. See the London Dispensatory in English. Translation: carrying of an humour from one part to another. Tunicles: little coats or skins of which the eye is partly made up. See the English Anatomy Terminated: ended. Topical Medicines: such as are outwardly applied to the part affected, or the part which sends the Humour etc. Transparentnes: such a clearness as is in Glass, Horn, the Air, Fair water, or any other thing which we can see through. Troches or Trochiscs, medicines made up in the form of little flat Bowls, whence they have their name. Tunica retiformis: the net-like Coat or tunicle Thorax: the Chest. Treble Quantity: thrice so much. Tartarous matter: congealed hard matter like the hardened Lees of wine which are called Tartar. Transpire: breath through. V VErtigo: a swimming in the Head. Vesitatoryes: a Medicine applied to the skin to cause a blister. Vertebrae: the turning bones of the whole back. Ventricles of the Brain: certain hollownesses of the Brain. Venenosity: poysonfulness. Vapours: Steams ascending into the Head, like the Steams we see mounting from a mess of hot Broth, or Meat, etc. Vital function: faculty of the Heart causing Life, Pulse-beating, and Breathing. Visive Nerve: the seeing Nerve. The Sinnew wherewith the Objects of sight are carried into the Brain, to the Imagination or Common-sence. See Veslingus Anatomy. Vaporous Matter: steaming, reaking matter. See Vapours. Ulcerated: having an Ulcer or running sore. Visor, or Visive Spirits: the Spirit wherewith we see. Universal evacuation: is a general purging of the whole body, all at once. Vitrous Humour: a moisture like to molten-Glass. which goes into the making up of the Eye. See Veslingus Anatomy in English; and cut up an Eye of a Calf, Sheep, etc. Wea tunica: a coat of the Eye, resembling the skin of a Grape, from whence it is named. See Veslingus Anatomy in English. Voluntary faculty: that power of our Body which works according as we please; as the power of going, running, speaking, etc. whereas the powers of beating in the Pulse, of digesting in the Stomach, and Eiver, of making blood, flash, fat, etc. do not work according to our wills. The former we can exercise, or suspend, and moderate them as we please, but the latter not: which are therefore termed involuntary. Wula or Columella: the palate of the mouth. A Vehicle: that which serves to carry. Vermicular: Worm-like. The Pulse is so called, when it is weak, and lifts itself unequally, sometimes more, sometimes less; like the creeping of a Catterpillar. ureters: certain long pipes or passages, which bring the Urine from the Kidney to the Bladder. See Veslingus Anatomy in English. Viscous, cleaving and roaping, like Bird-lime. Vicissitude, the following of one thing upon the neck of another. Venery: Lechery, the immoderate exercise or doting upon such Acts as tend to Generation. W WIld-Poppies. Red-Poppies which grow among Corn, called likewise Corn-Rose. Watery Humour: a certain liquor like water, which goes into the Composition of the Eye, See Veslingus Anatomy in English. Water-Gate: the Privities in Women. Z ZAcutus Lusitanus: a famous Physician; A Jew that pacticed at Amsterdam in Holland. He has wrote divers excellent. Treatises of Physic, suitable to the Principles of Hypocrates and Galen. FINIS. The Virtues, Use, and variety of Operations of the True and Philosophical AURUM POTABILE, Attained by the Studies of Doctor Freeman, and Dr. Culpeper, and left with his Widow, and administered by a Physician in her House near London, on the East side of Spittle-fields, next door to the red Lyon. The Virtues are as follow: IT Cures all Agues, whether Quotidian, Tertian, or Quartan: as also it cured divers people of that most horrid putrid Fever, which so violently seized on men's Bodies (both before and after Michaelmas 1653.) to the great admiration of many; and when the parties Diseased have been both senseless and speechless, for that neither that, nor any other Medicine or Panacaea, though never so gentle, could safely be administered into the Body, it hath beyond all hopes, by external application on the stomach revived them. It cures the Gout of all sorts perfectly being administered as the Physician shall advise. It causeth Women subject to Abortion, or Miscarriage, to go their time: and yet being given when the time comes it causeth a speedy and easy delivery. It is an infallible cure for the French Pox and doth it with such ease, speed, and Secretness, that none of the nearest relation shall take notice thereof. It cures the Green-sickness and all sorts of Jaundice, It provokes the Terms. It is good for Aches and all afflictions coming of cold. It helps the Rickets. But to what purpose do I nominate diseases in particular, when it is an universal Remedy for all diseases being administered as the Physician shall advise? For its chief aim is exhilarating the vital spirits and heart. It both binds and stops Fluxes, yet Purges; it both Vomits, and stays Vomiting; it causes Sweat, yet cures preternatural Sweatings and performs all its operations as Nature itself would, have it, because it only fortifies her in her Centre. To conclude, It is an Universal Fortification for all Complexions and ages, against all sorts and degrees of Pestilential and contagious Infection, both preventing before their possession, and extirpating of them after it. REader, By reason of the mistakes in the printing of this Book in Latin, there are two words mis-translated: And by reason of the foulness of the English Copy, there are some other mistakes in printing. All which are thus to be amended. PAge 24 line 46. for violent springing read violent Convulsion springing p. 32. for Ephor. read Escar p. 51. l. 39 for ●● r. do p. 53. l. 7. for proceed r. preceded p. 59 l 14 r. four ounces p. 116 l. 39 for pure r. impure p. 148 l. 28. for nevertheless get r. nevertheless the Lungs get p. 160 l. 12 for can endure r. cannot endure l. 23 for sets more r. feels more p. 167 ● 33 for blood r. blood-letting p. 184 l. 40 for Acorns r. Alkermes l. 45 for Acorns r. Alkermes p. 256 l. 47 for Gloves Cloves p. 259 l. 16 for primary, r. external p. 290 l. 34 for be thirst r. be no thirst p 329 l. 7 for can pass r. cannot p●● l. 10 for Wine r. Wind p. 332 l. 4 for Turnip Water r. Orange-flower Water p. 341 l. 44 for after dinner r. before d●ner p. 367 l. 9 for scattering r. scalding p. 373 l. 40 for bred r. cured p. 378 l. ●7 for warm r. worn p. 386 l. 51 for spring Water four ounces r. spring Water four pound p. 428 l. 32 for Turnip Water r. Orange-flower Water p. 432 l. 29 for suppression r. suppuration p 499 l 18 for decrease r. increase p. 501 l. ●● for contained r. continued p. 542 l. 52 and 3● these words [the Moon] at the end of the 53 line, must be taken from that line, and read at the end of the 52 line p. 567 for great r. grate p. 580 l. 42 for but r. both p 590 l. 40 for be r. being p. 612 l. 10 for puortfied r. putrefied p. 615 l. 1● for in r. no p. 622 l. 11 for terror r. Fever for whereas r. whenas p. 624 l 15 for Urine r. things p. 630 l. 50 for Italy. India p. 633 l. 11 for care r. cure and for cure r. care and l. 46▪ for repelling no r no repelling and l. 57 for after aforesaid r aforesaid after p. 639 l. 26. for Hair r. Heart