thereof twice in a day within three daies perfectly recovered CHAP. XXV Of a Cancer AND because this is a Tumour doth happen very frequently in our Art and proves an enemy both very powerful and painful that we may understand the right way of dealing herewith it generally happening in the Brest let us first consider the Brest it self and its parts The Brest according to our Countryman Wharton is said to be framed of a glandulous spongeous Parenchyma not divided into distinct conglobated Glandules but is rather to be accounted a conglomerated Glandule but in a Scirrhus and in a Cancerous Tumour they appear knotty It hath Veins Nerves Arteries and Lymphaducts and a porous Cavity its Veins and Arteries come from the Subclavians it hath its Nerves from the fifth pair and from other Originations Lymphaducts are here very frequently scattered and as touching its Porosities or porous Cavities these do serve for its Excretion or its excretory uses they being more large in the Brest then in the common Ductus which is opened with many small Foramulaes their general use is to prepare the Milk fit for the Infant and for the making this there is held a great controversy some holding the Blood to be the Prima Materia hereof whilst others do contend as stoutly for the Chyle to be its Origination The first is not to be defended for if Chyle be to be made most properly into Blood it may very properly be accounted retrograde for Blood to turn into Chyle And such as do stand up for the Chyle to be the onely substance of the Milk they do offer this as their assertion that the Chyle doth immediatly pass through the Milky vessels into the Brest or that it is there received into the Veins and thence effused through the Thoracick Arteries into the Brests and that they have a power or faculty to separate the Blood from the Chyle and to dispose it through the Mammillary vessels into the Body and this they call Milk but the way or passage which should conduct this to the Lactiferous vessels is not yet arrived at Our worthy Wharton's opinion is that Milk is peculiarly a nervous Juice not properly constituted for the substance of the Milk but also for carrying a double Matter with it as being both Chylisick and Spermatick and these two do breed the greatest part of the Milk not immediatly sent from the Ventricle to the Brests by the Milky vessels but carried by or through the Ductus chyliferus into the Subclavian thence circuled with the Blood through the Ventricles of the Heart and so passeth through the Thoracick Arteries and in time of the Mother giving milk it is refunded into the ample capacity of the Brests and there do separate the Sanguineous part from the Chyle and do reduce it through the Mammary Veins into the Meditullium of the body And this he offereth as the cheif matter or substance of Milk and the most proper nutriment for the Infant And since we daily see the young sucking Babe is nourished by alluring this Milk from its mothers Brest by her Nipple it is very necessary that it should contain in it such a substance as may give it satisfaction And as the more noble part thereof doth come from the Succus nervosus so also ought it most properly to be derived from hence for the Infant 's nutriment but thus much as touching Milk We arrive now to that which nearer concerns our enquiry which is the tract of a Cancer and this by the Greeks is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by us a Cancer from the resemblance it hath with a Sea-Crab For as the one hath expanded claws and feet in several places being of a livid or cinerish colour so also is this Tumour of a round Figure of a livid Colour and sticketh or adhereth so close to the part affected as a Key to a Door or a claw of a Crab in its griping having in it by some reported to carry in it exalted Veins but this is more fabulous then true for not in four of a hundred as Falloppius observes can you see them thus apparent It carrieth with it a train of horrid pain and heat shewing it self to view both cruel and horrible it ariseth from black Choler As Tagaultius supposed it ariseth from the Fecies of Blood but this is onely his opinion for this doth more properly frame and make a Scirrhous Humour and that which to the whole body doth make an Elephantiasis to a private or particular part doth also frame a Cancer and where this black Choler is sharp and hot it maketh an Ulcerate Cancer and by reason of its thick Juice it can neither be repelled or discussed for as it slighteth and contemneth the company or acquaintance of mild Medicines so also doth it like Lard or Oyl turn into a flame rage and fury by the applying of any strong or vehement Medicine The Causes of this Atra bilis are many for first in the Liver is bred this natural melancholick Humour which is called the Fecies of the Blood and hence ariseth a Scirrhus so this Atra bilis is made up of the adustion of the other Humours and without flattery is the worst of all the rest and as it groweth more putrid sharp and malign it doth more speedily violently and painfully create an ulcerated Cancer Sometimes it ariseth from a hot intemperiety of the Liver which burneth it and by this burning is bred Atra bilis Sometimes as Galen saith cap. 10. lib. 2. ad Glaâ—c from weakness and intemperiety of the Spleen it being made incapable to attract this melancholick Humour in so much that it is kept up and burnt up in the body Sometimes it happeneth from a suppression of the Menstrues Outward causes may also affect this as a thick and viscous Diet as Onyons Leeks Beans and the like It may arise in any one part of the Body sometimes it doth throw it self forth into several places but the Brest being a soft loose part is most subject to its Tyranny and receiving the impress of its malitious stamp Sometimes it happeneth in the parts of the Face Nose Lips Mandible and Tongue Sometimes in the Inguens and Thigh a lively example of which I had in a Gentlewoman my Patient in Norwich when I writ this Another reason that a Cancer doth soonest grow acquainted with the Brest before any other part is in respect of the great consent that there is made between the Breast and the Womb by the Veins through which this thick and feculent Blood is sent and dispatched and for the same reason is it that there have been seen so oft times Cancers of the Womb. At its first touch it doth appear hard in respect of its thick Humour it is of a livid Colour and the more malign the Humour is the more livid the Colour of the Tumour is and then painful for here is made
a Dilatation of the Veins in the Testicles conglomerated in manner of Varices and these as Celsus and Paulus write are either the Veins of the Scrotum or those in the Membranes of the Dartos or those which do nourish the Testicle and therefore Celsus adviseth if the Rupture be in the Scrotum you are to apply thin and sharp Instruments to the Veins and with these the Veins are to be cauterized and there to be most cauterized where most variced or twisted The general Curative Method here is the same to that prescribed in curing of a Scirrhus the Intentions here are three to repell the flowing Humour to discharge and dry up that which hath already slowed and to astringe the dilated Vessels Now Astringents do satisfie these two scopes for as being cold and restringent they repell the fluent Humour as being drying they dry it up and by its Astriction do also bind up the dilated Vessels And for this Affect Balaustians Red Roses Pomgranate Rinds Juice of Hypocystus Bol. Armen Dragons Blood Mastich Olibanum Glue Amber and the like these or any or some of these mixed with the White of an Egge and a little Vinegar may very well be used here but if these do no good come to the use of Incision or Caustick and here are we to be very careful in onely cauterizing the parts where they are thus twined or twisted together after which done remove the Eschar then deterge and digest it But if the Veins of the Dartos be tumefied you are to make your Incision in the Groin and the Membrane is to be drawn through there with the Testicle and after this separate the dilated Vessels from the Coat either with your Fingers or a convenient Instrument then tie up the Vessels and cut them off under your Ligature then repose or reduce your Coat and Testicle And if the Rupture be in the Erythrois or Tunica vaginalis and either two be dilated proceed in the same Method as in the Dartos but if it be between the inward Coat and the Testicle it self make your Incision in the Inguen draw out the Vessels amputate the Testicle and cauterize the parts And this is Paulus his Method and Distinction As touching Hernia Humoralis take this brief Description of it It is framed out of a Confusion of many Humours in the Scrotum or between the Coats which enwrap the Testicle Oft times also it is seen to be bred in the proper Substance of the Testicles You are to cure this as you do the former And thus much of Ruptures CHAP. LXIII Of a Venereal Bubo WE arrive now at the Inguens where we may meet with these four following Tumours Bubo Venereus Pestiferus Phyma Phygethlon of each of these in their order These Glandules have their proper names as well as others and hence is it that they are called Bubones by us in England called the Popes eye in veal and mutton They are held to be eight in number and very large There is held to be a great commerce between the Nerves and these Glandules for it is very credible that the Nerves do conveigh somewhat hither as their excrementitious succus and also do send hither any nerveous quality that at any time doth perplex them but they do not unload themselves into these as into their excretory ports but into their adjoyning vessels and hence it is that they are placed at the greater division of the vessels neither is it less probable that they take somewhat from hence as a nutritive juice the which being allured by a similar attraction of the Glandulous substance the Lymphaducts to pour out their Lympha here and by the benefit hereof these Glandules do separate one and leave the other And this is confirmed by their sweetnes and delicacy they having a familiarity with the nutrive Succus And the reason they are so large and numerous is because the Crural Nerves had need to have such large Organes for discharging their superfluities We come now to their Diseases with the Affects these being either simple or not malign Tumours or pestilential or venereal Tumours The Causes of all which may be reduced to two The first being the hindrance of the Circulation of the Blood and hence ariseth a Tumour by reason of the continuity and impetuous afflux of the Blood from the heart through the Arteries and by reason of its making no reflux from these through the Veins An evident example we have hereof in Contusions of the Glandules and in their Obstructions A second common Cause ariseth generally from the Nerves themselves spitting forth their superfluous Humidities being either here vitious in Quantity or Quality now these are 2 common causes Every special Tumour hath its specifick causes differences and thus if these superfluities only err in quantity or quality as in viscidity thicknes or the like it frameth a simple Tumour If from a malign quality there ariseth a Tumour being of the same nature as malign and thus being either venereal or pestilential it occasioneth a venereal or pestilential Tumour We are now to enquire of the efficient causes of this venreal Bubo and this poyson oftimes is communicated to the Liver and hence is sent into the Inguens as its proper Emunctuories and hence ariseth these venereal Buboes The cheif matter of which they are bred is of a part of thick cold and viscid Humours which may wel be perceived by the hardnes whitenes ilnes of pain and colour of the Tumour Sometimes they arise from a hot sharp cholerick Humour with a great pain and a conjunct heat and these make them so oft to run into Ulcers being both virulent corroding As to the cure never-use digestives lest the thinner part being resolved the thicker excrement lyes and encreaseth inwards much less Repellers for these do drive the virulent matter inward and therefore Attractives and Suppuratives here only do take best place The Tumour being made ripe open it with a potential Cautery As touching the cure of the whole body neither purge bleed or keep any order of dyet Make your orifice not very large but so as you may lodge in it a pretty handsome large Tent for discharge of this peccant Matter you may keep it open for 20 or 30 dayes according to the greater or lesser quantity of Matter This being discharged we may both prescribe purging bleeding and a good order of dyet It being discharged cleanse it well fill up with flesh and skin it And thus may you cure the kinder sort of a Venereal Bubo but if it proves more rebellious then instead of Suppurating Medicines we should come to the use of Cupping Glasses every other day and after these to apply Diachylon cum gummi mixed with black Soap and these will maturate the most rebellious Buboes and having brought it thus deterge the Ulcer by keeping it a long while open and freed of its peccant Matter then fill up with flesh and
In the middle Region you have natures most curious cabinet wrought with various Roomes wherein are lockt up the vital Treasury the wheels and Instruments whereby the watch of our life is alwaies kept in motion from our first hour to our last minuit Here dwels the kingly heart the great master of courage and warrior exercising its nectarean faculties by giving life and vigor by its vivifying and quickning heat and as the Sun in its Caelestial Sphere yeilds lusture and beauty by its motion and light so also is our heat light life and motion upheld propagated and preserved by the heat and motion of the heart This part is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from a word which signifies to leap it s called Cor à Currendo it being ever in motion it hath Lungs allowed it for tempering its heat and fanning its fervency here 's also a Diaphragma distinguishing or separating the instruments of nourishment from those of life being as a muscle most different from all others Its Sides and Ribs are guarded with a Pleura inward bred of spermatick fibres this serves for keeping the lungs from being intangled with the ribs besides these is a Mediastinum framed as a partition wall or thick hedg dividing this trunk in the middle this keeps the heart up from falling Thus may you see how serviceable every part is for performing its office and service to the heart as its Prince and at the first view we might well conjecture that this might be framed with safety being the only and main Engin of life But this also suffers its gloominess and takes shares with all its parts of sicknesses and diseases How oft have we seen this Prince of life which bestowed its vigorous influences to the body as the Sun doth to Plants to be ecclipsed by a cloudy slegmatick excrescensy this watch furred and run into dissolution by Dropsy Worms and insects Is there not seen Tartarous stones as well as coagulated slegm the one endeavouring to dissolve this princely pallace whilst the other stop its channels to suffocation do not wounds and Apostems suddenly happening here as speedily put out this candle of life Is not this princely palace oft parcht by Fevers surrounded with Agues stormed with Cardiacal Syncopes washt away with the inundations of strange Dropsies poysoned with malign fevers obstructed by flegm are not its flabellums burnt up by inflammation consumed by Asthmaes and Empyemaes rotted by ulcers turned into wash-pools by Dropsies is not here a lung oft times converted into purulent matter and an Asthma into a Squinsey are not our sides pricked with a pleurisy troubled with a Peripneumony These and many others take up their Quarters here and although Physick and Chirurgery have the two substantial leggs of experience and Reason to defend them yet the great knowledge hereof must come from that great Doctor who hath Heaven for his chair and the Earth for his foot-stoole Thus have I carried you through the fortunes and misfortunes of his middle Region We arrive now to his lower and 3d room his natural part and here have we most exactly represented the Liver with its interwoven distributions of the vena porta and vena cava with the vesica fellea and its several capillary vessels with its meatus cisticus its porus biliarius and ductus communis framed from the separation of the gall or bilious humor from the blood and conveying it into the intestines and here also may we see the Almighty disposing variety of Organs for diversity of uses and for its outward guard you may see it furnished with a fleshy Armour made of muscles under it the two Spermatick coats of the Peritonaeum the enwrapping and keeping warm the parts within these being laid bare may we meet with a crisped kell with its curled veins covering the bottom of the stomack and keeping it warm under this lies the strange Series of Intestines strangely wheeled about contrived with much Art and framed with variety of circles here lodged for sending forth with more expedition the excrements from the body to see such a length of intestines contracted about such a small mesentery as it appears in its natural sight may well challenge the greatest of admiration how finely checquered with white purple veins ordered for conveighing its chyle and keeping it warm by its blood already made and elaborated here is also a Pancreas tied to the guts as a pillow to prop and keep up the veines arteries and nerves as well as a juice to help forward expulsion here also is placed the spleen ordered to help forward concoction furnished with arteries for drawing away its most feculent blood to ventilate the natural heat of the spleen and to invite a vital faculty to it here also are planted the kidneys ordered for expulsion and avoiding of exerementitious wheyish matter the which being altogether unprofitable for nourishment is sent from thence by the ureters into the bladder and by the good laws of nature is here also placed the bladder ordered as a Receptacle of this urine the which for a time it retaineth and being therewith overloaded doth exonerate it self thereof Thus have I shown you through all the Rooms of Nature's lower Region where you have seen how every part is imploied whilst it enjoies its true function but these also are robbed of their excellencies taken off from their offices deprived of their faculties and laid open to the enemy by diseases troubles wounds and Tumours Stones and Dropsies thus may we see the Peritoneal spermatick sibres extended by Dropsies the Kell burnt up and parched in long and tedious distempers distorted and disaffected by instammations and Ruptures the Intestines blown up and swelled with Collicks pursed up and convolved by Iliacks torn and lacerated with Herniaes wounded and pierced with fistulaes the Liver the magazine of blood inflamed its trunks and channels obstructed by varices and melanchollick feces hindred in its actions and motions by Tumours the spleen suffer scirrhous tumours and obstructed with excrementitious blood the kidneys fretted with gravel inflamed by pain tormented with stones and ulcers closed up by obstructions and Trychiacis its pipes stopped by flegm stones or gravel the bladder suffer resolution and that which was made the receptacle of urine oft times proving the receptacle of stones and gravel perplexed with Ischuries and Dysuries pissings of blood preternatural tumours abscesses Ulcers Caruncles and the like Thus have I given you a short survey of the inward parts their beauty splendor and formes to which also are added their various sicknesses pains and diseases and may we expect in reason that the outward Coffin or Chest may fare better and be more free from diseases than these No sure where the Jewels are lodged there generally are held the security for as poor man is subject to outward storms and winds so may we as readily find him as capable to receive the impress and stamp of diseases In his face we
Lancet and prepare himself for this Operation First let him make a pretty strict bandage a little above the elbow of that arm which he intends to bleed not too strict because he will very seldome hereupon but meet with obstruction in bleeding the Artery being too close girt that it cannot discharge it self into the vein And as to his Lancet let him make his apertion a little sloping or upon placing it a little obliquely let him get his Lancet into the vein and so lift it up not penetrating too deep lest he commit those errours which daily are acted by ignorant Pretenders and Quackes who oft go so deep as that they prick an Artery and so cause Aneurisms and pains Let the Orifice that you make be neither too great or too small the first endangering the Division of the vein whilst the second runs it into a Tumour Here also is he to judg of the goodness or badness of the Blood and so according to his judgment may take away more or less and also considering the necessity of the disease the strength of the Patient and the quantity and quality of the Blood The veins which are generally opened are these the Frontal vein one under the Tongue the Cephalick Mediana and Basilick but of every of those in their order and as necessity requireth The Frontel vein is most properly opened in infirmities of the Face and in pains of the Head Two veins of the Temples opened in continual Head-ach in distillations of the Head and Eies The veins under the Tongue in Anginaes Apoplexies pains of the Teeth the Jugulars good in preventing suffocation Squinsies Asthmaes Dyspnaea and the like The three in the Arm the first being the outward or Cephalick this may safely be opened in distempers of the head as Mania and other hot passions The second Mediana so called in respect of its Scituation being made both of the Cephalick and Basilick vein in opening of this vein is made a general evacuation of Humours this oft times opened in pains of the breast and Pleurisies The third is Basilica or Hepatica by some called Axillaris this dischargeth those parts which are beneath the Neck as the Brests Sides Liver Spleen and Pleurisies And this note of the three in all sicknesses and times except in time of Pestilence That vein is to be taken which is most full and large In the Feet also are three veins Ischiatiea Saphaena and vena Poplitis these or some of them are generally opened in Obstruction of the Monstrues in bringing them down pains stoppings swellings and the like I shall conclude this with these directions In an Apoplexy open the Cephalick vein if this appears not open the Mediana In a Lethargy open the Frontal or Cephalick vein In a Squinsey those under the Tongue In a Pleurify the Basilica and here bleed while the Blood doth change its colour In diseases of the Lungs vena Axillaris or Mediana In inflammations of the Liver Basilica or Hepatica In obstruction of the Spleen the Basilick or Hemorrhoidal veins In diseases of the Womb the Sciatick vein In restraint of Menstrues Saphaena In pains of the Hips first open the Basilica then the outward malcolus below CHAP. VII Of Evacuation of matter erring in Quality IF a Tumour or Fluxion happeneth in respect of matter not onely erring in Quantity but also in respect of Quality that this may be discharged we are to consider two things First whether this matter may be altered as if hot cooled c. Secondly to remove the subject matter hereof and in the first if Plethory Phlebotomy is proper if less Pharmacy is most convenient And herein are we to observe these two Rules that the matter may first be educed or sent forth being contrary to the true genus of the part and then if it doth still remain to alter it The most proper way to deal with this is by our later writers found out which is by discharging the body hereof by purging Medicines which do work both quickly and safely ordering the strength of the Medicine according to the vigour and strength of the Patient and herein also are we to mind the motion of the Blood for if it doth move to the eies this is to be revelled first by Cupping-glasses without Scarrification Secondly that the parts ought to be rubbed for the better thinning the Humour thirdly frictions which are proper for revelling from the Center to the Circumference And Galen nameth the last when parts are obstructed we ought to obstruct with Medicines but these are tedious painful and troublesome Our later Writers have found out better means and methods as by washing with warm water which doth revell by opening the pores another sort is by vesicatories and these are in great use in Apoplexies Rheumatisms or Distillations the third and last is an actual Cautery and Fontinels and Setons very much in use in our times And in all these we are to observe that Revulsion doth take its indication from that part from whence the Humour sloweth not from the Humour flowing and this being known we are to understand the parts which we are to revell CHAP. VIII Of a Tumour the part affected drawing to it self Preternatural Bodies THE greatest occasion or cause of attraction in a Tumour of a preternatural body is cheifly to be attributed to Laxity and Intemperiety of the part and pain This Intemperiety is therefore first to be removed by running it into a better temper And this may be executed with oyl of Roses Violets and the like having fine linnen rags dipt therein and so applied and these are oft to be repeated to prevent inflammation For this use also Vnguent Rosatum Refrigerans Galeni Populcon Album Camphoratum If pain occasioneth this we are here to give ease by Anodynes according to Galen 13. Meth. 1. and if any preternatural bodies offend discharge them either by Medicine or Instrument if pain cometh from venome cure this as you do venomed bodies and herein also are you to consider the times of the poyson for the longer it hath got room and entrance the deeper doth it imprint its venomous Qualities and Effects In this case Venice Treacle Methridate and the like are very good Spirit of Wine here also is very proper And thus are we to vary our methods according to the variety of our Objects In venenate distempers in cold poysons we use hot Medicines and in hot poysons on the contrary cold Medicines as Rue Frogs Scordium and the like commended by Dioscorides Galen doth furnish us with many pleasant stories of poyson and amongst the rest he doth offer that if any be bitten with a Scorpion if the same Scorpion be taken opened and applied to the part affected it draweth out its own poyson This generally being here observed that before you apply any Medicine to the poysoned part you first well foment the part with a hot and sharp Lixivium and when the place beginneth to
living beyond the fourth I shall conclude this Chapter with this History related by Petrus Bayrus lib. 20. cap. 8. of a Woman which had a Pestilential Tumour bred behind her Ear and he being sent for about eight hours after it was perceived it grew into a large Bulke in that time with much pain the pain afterwards began to cease but the Venome descended to the Heart and did horribly trouble and vex it neither could she beleive herself to live an hour being by his directions ordered to smell to Vinegar and Rose-water after this she was bled on each Cephalick first Breathing a Vein on the contrary Side then on the distempered Side Then was there applyed a large Ventose to the Part affected with a deep Scarrification reiterating its application And when there was drawn near half a pound of Blood by this Ventose the Patient began to find her self somewhat better and to have some hopes and found manifestly that the Venome receded from her Heart by these Frictions Odours Cordial Powders and Potions and the like that by Divine Blessing and help of these Remedies she perfectly recovered Hollerius saith live Oysters being applied to Pestilential Buboes do attract all the Venome from them CHAP. LXV Of Phyma and Phygethlon IN cap. 1. lib. 2. ad Glauc Phyma is said to be a Tumour in a Glandule which encreaseth with some Vehemency and hasteth to Suppuration for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 agrees with all sorts of Tumours arising out of the Earth and these happen not only in the Inguens but very oft in the Axillaries for these Glandulous Bodies being very loose are the most apt to give Entertainment to all strange Appearances Fluxions and Tumours particularly in the Groins because of their depending Site strong Motion and humid Redundancy After here having prescribed a convenient Dyet and the general Method which we have already shown you in a Bubo we are to apply Digestives to the place affected and then Suppuratives and the Tumour being by these made ripe we are to discharge the Matter either by Caustick or Instrument and the rest of Cure perform as you have already directions in curing of a Bubo Phygethlon is an Inâ—lammation and part of Erysipelas or an inflamed Erysipelas and this you are to cure by Phlebotomy Purging and Diet. As touching the affected part you had better apply Digestives than Suppuratives because this Tumour hath a mixture of Choler and hence it is that Galen lib. 6. Simpl. doth praise Atriplex and the Leaves of Garden Mallows and a cold Cerate and is at length to be cured with mild Discussives Lusitanus Cent. 6. Curat 82. telleth of a young Gentleman troubled with a Phygethlon under his Axillary the which did spread to a very large bigness in process of time it grew soft and livid and so proceeded with Pulsation that both Physician and Chirurgion conjectured Matter to be lodged in it and therefore by a general consent it was opened but the Success was miserable for it was scarce opened but the Blood flew out impetuously with a great noise of Spirit upon which the Patient presently dieth with his inclining downwards and he speedily departed this miserable Life CHAP. LXVI Of the Hemorrhoides HEmorrhoid is a Compounded word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifies Sanguis and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 fluo and this is a Flux of Blood The Veins of the Anus onely gain the place of their dwelling and being or they are Tumours encompassing the Veins of the Anus excited by the great inâ—lux of Melancholy Blood resembling somewhat of a species of a Varix Some of these at certain times do open themselves and so do discharge and exonerate the Blood others there are that onely tumefie Some are hidden others more manifest Such as flow they pour out almost all Blood mixed with a yellowish Serum which is as a Vehicle to make its more speedy exit and by its acrimony does make a more speedy opening of the Vessels Such as do not flow do either lodge in some small Bladders and by some called Vesicales and these are made by the influx of Flegm and Serum resembling Grapes from whence they are called Vvales from the efflux of Bloud being laudable in quality but bred by a copious Redundancy They are different in their Magnitude some being large others small in their multitude some having many Orifices others few in their Figure some narrow some broad in their Colour some being of a blackish colour others more red in their Place some being in the Anus others in the Sphyncter others bordering upon the right Gut in their Constitution some being mild others more cruel and painful These Hemorrhoides arise as both the ancient and modern Anatomists allow from the Splenetick branch deducing its issue from the Porta produced downwards towards the Rectum and then carrid backwards to the Coccix and there to be inserted and propagated But from the Vena cava there are two Branches produced from the Os sacrum or Coxendix and sent to the Anus the one from the right the other from the left part the which are disseminated through the Muscles of the right Gut and Anus and do there constitute these Hemorrhoidal Veins here pouring forth their Blood and this is confirmed with good reason for the rectitude of the Vessels the Blood flowing downwards by its weight must necessarily fill its Vessels and being girt up or constringed being thus filled by the Muscles does make way for this Apertion And to give a better light to the well ordering and curing of both sorts let us make an exact Anatomical Inquiry about these parts These Hemorrhoidal Veins again have an Artery belonging to them to feed them this Blood first coming from the Porta to the Anus for from the great Branch of the Porta is this carried to the Spleen and thence through the Mesentery is it sent to the right Gut These Veins are onely two arising from the Cava and the Porta for this cause because these serve as do the other Veins of the Body for nourishing the parts with Blood and thus are the parts of the Anus nourished therewith This was a thing unknown to the Ancients and therefore it is necessary that the Melancholy Blood should this way be discussed for by this Passage onely is Melancholy best discussed and the Schirrus of the Spleen cured Besides these these also are by nature as Scavingers to cleanse the feculent Blood and make a sound Body and when therefore she cannot perform these we make our speedy address to Phlebotomy and the Evacuations thus made we daily find to yield great comfort and ease to the troubled Patient Besides these not being kept open a man having a great quantity of Melancholy Humour lodged in him the whole Body will hereby be less capable to undergo any other Method which may be prescribed And lastly in Malign Fevers being lodged in the larger Vessels and there putrefying the Blood
these most properly ought to be opened being nearer related to the affected part where more good may be expected than from the Arm. Should these be stopped they breed a Consumption in the Lungs a Dropsie in the Liver by suffocating the Liver as it were in its native heat and if they flow immoderately the Blood being evacuated the Liver is cooled thereby is excited a Dropsie and a decay of the whole Body For this immoderate Flux take these ℞ pulv Alo. Thur. Balaust Sangu Dracon an ℥ ss misce cum albumine Ovi fiat Vnguentum Or this ℞ ol Rosar Cer. alb nov an ℥ j. Axung Porcin ℥ ij pulv Plumb alb ℥ iss liquefiant praedicta supra marmoream injiciantur tunc adde plumbum Or this ℞ Axung Porcin ol Lin. an ℥ ij succ Taps Barbat Cynogloss an ℥ ij coquantur ad succorum consumptionem postea adde Sacchar Saturn ℥ ss cum pulv sem Lin. q. s fiat Vnguentum Or this ℞ Tuth praeparat Coral rubr Plumb an ʒiij Lap. Calaminar Lithargyr aur an ℥ ss ol Rosar ℥ iss succ Taps Barbat ℥ iss misce fiat Vnguentum Or if Pain Heat or Acrimony be urgent you may use some ot these ℞ ol Rosar ℥ ij Ceruss ℥ ss Lithargyr aur ʒij Cer. nov ʒiij Opii ℈ ss vel ℈ j. misce fiat Vnguentum Or this ℞ Thur. Myrrh Croc. an ʒj Opii ℈ j. fiat Vnguentum cum ol Rosar Mucilag sem Psyl addendo vitellor Ovor. no. j. Or this ℞ ol Rosar Olivar Myrtin an ℥ ij succ Plantag Milii an ℥ ij Acet ℥ j. coquantur ad succorum consumptionem tunc adde Bol. Armen Sangu Dracon Thur. Chalyb praeparat pulv an ʒj Cer. flav q. s fiat Vnguentum Or this ℞ Vitellor Ovor. no. j. ol Rosar Violar an q. s fiat Vnguentum addendo Vnguent Rosat Popul an ʒiij misce Amatius Lusitanus Cura 3. Cent. 5. writeth of a man about 45 years of age who was formerly vexed with a Venereous Disease from whence came from him every moneth Blood through his Hemorrhoids as the Menstrues in Women elsewhere He had such a plentiful Evacuation of Blood the which when he failed of his accompanied time performing its duty by these Veins he vomited much Blood out of his mouth being of a yellowish red without Cough or Fever and for the preventing of which evil he comes to advise with Lusitanus who advised him to be chearful and to the parts he orders 4 Leeches to be applied the which extracted six Ounces of Bloud after this prescribed him a good Diet and cooling Syrups as Syrups of Endive Fumitory Woodsorrel and the like for some days together and taking a purging Potion of Manna Rhubarb with Diaphoenicon c. with this order the Blood followed its former course and the Patient grew well Oethius writes also of one who when his Flux was obstructed below he did every moneth spit Blood at the mouth as you may have it lib. Observat CHAP. LXVII Of an Aneurism THis is a soft Tumour yielding to the Touch made by Dilatation or Relaxation of an Artery Every Artery except those which are dispersed through the Brain have allowed them a double Coat the inward of which being either corroded or rent the outward may extend so much as to cause an Aneurism Aneurisms may be made by Anastomasis Diapedesis Ruption Erosion or Wound of the Arteries It happeneth in most parts of the Body but chiesly in the Throat It is a Swelling encreasing by degrees and hath the same colour with that of the Skin a continual Pulsation If it be small it easily yieldeth to the Touch. It is difficult in Cure If it be large and in the Axillaries or Inguens in which the Vessels are large here expect no cure Incision very oft times causeth such a Flux of Blood and Spirits that it both dischargeth Art and Life very speedily This too often happens by the imprudence of an ignorant Chirurgion by pricking of an Artery instead of a Vein and so occasioning this Pulsation Pain and Tumour Some allow inward Causes as Intension of the Spirits Contusions Concussions Obstructions these being accounted as the chief of the inward Causes Some also do adde Melancholy Blood to be a Cause hereof lodged in the Veins and Arteries but the most usual sign of its Causes is drawn from the ignorant Chirurgion who by pricking too deep does wound the inward Artery the which is not easily to be cured by reason of its Spermatick Substance and Motion and thus the Blood by degrees is percolated out of the Arteries and making a Cavity for it self formeth this Aneurism the Matter hereof being a Spirituous Blood made by Dilatation the outward Matter is made by Grumous Blood thus raised together It generally receives these two Methodical Scopes in its Cure viz. Pharmacy and Chirurgery and where the one takes not the other must be attempted The first are Repellers and Restringents and convenient Ligatures or Lead strictly bound over the part or such an Astringent as this may serve the turn as ℞ Pulv. Bol. Armen Terr sigillat an ℥ ij Pulv. Rosar rub Sang. Dracon an ʒij Gallar immatur nuc Cupress an ʒi misce cum Albumine Ovi parum Aceti Oleo Rosarum fiat Restrictivum Let this remain on for two or three days These are to be used in smal Aneurisms but in large Aneurisms not happening in the Head or in the Groins they are accounted Mortal according to Aetius lib. 15. cap. 10. Some Artists do tie up the Artery both above and below and then divide between these two Ligatures but this Operation is dangerous painful and troublesom and seldom bringeth any benefit But to preserve Life I would rather if it happen in a place where it may lawfully be performed and exercised have Amputation made and before you begin this be sure to purge the body with Cassia Manna and the like and order cooling Juleps Emulsions and Hordeate Decoctions and keep the Body open by Purging and Clysters Hildanus in his 44 Observat relateth of a young Gentleman who being troubled with the Itch upon which sending for a Barber to breathe a Vein for him he pricked the Artery instead of the Basilick Vein whence did arise an Aneurism For the ablating of which above a moneth was used variety of Medicines to little or no purpose the Tumour equalled the bigness of a Goose Egge it was pale and hard in which was so perfect a Pulsation that it elevated the Dressings and Rollers as they might with ease be perceived He could not extend his Arm his pain was not great but onely when he would extend it Seeing how desperate it was he was very unwilling to undertake its Cure but being perswaded by the Prayers Desires and Requests of the Patients Friends to take it in hand he used this Method a good Order of Diet being prescribed to the
divine assistance that can maintain and keep up our sorts and castles from the assailing batterings of wounds and contusions c. and by him also may herbs and roots seeds and berries gums and fruits be made capable instruments to banish the enemy having once made its entrance It 's by his Art the swelling bubbles of scalding water are disperst the burnings of gun-powder allaid its pain removed and its black marks fetched out It s by his Art dislocated Articulations and fractured bones are brought into their right form and order old ulcers and fistuales dilated mundified incarned and cicatrized Herniaes and Stones bound up and drawn forth and since these and many more are committed to his care and charge what skill knowledg fathoming of diseases and judgment ought he to have and be furnished with to undertake this task Take with me this as a short character of a good Chirurgeon he being a man both honest and careful in his art prudent and provident for his patient expert and skilful for defending himself well learned and educated for discourse with others well exercised and practised for the help of both He ought to be well furnished with books these being as so many safe Pilates to conduct him in his unknown way and to keep him off from the shelves and rocks of mistakes and errorsin his Art Adorned with learning for this makes him appear as a Sun whilst others less literate shine but as smaller Stars this conducts him to the tree of knowledg whilst others can onely boast of their impudence and ignorance it is this gives life to his practice chearfulness to his study and security to his conduct And as we seldome see a wise man gain knowledg from a fool so is it as rare to gain awise medicine from an ignorant block He ought to be well exercised in Anatomy for hinc discimus artem rectissime operandi securitate incidendi It being as the cheif pillar or basis on which Chirurgery planteth its foundation this is the great magazine from whence she fetcheth her richest treasure of knowledg It is the knowledg of this which bringeth Honour to his name Praise to his practice Worth to his skill Plenty to his wisdom Gain to his industry Reason to his judgment and a great measure of success to his undertakings hence he learns how and where to make right oblique and transverse incisions by this he finds out the Origination of the nerves the trunks and channels of the veins and arteries here may he find the difference between a nerve and a vein a Tendon and a Muscle a vein and an Artery a Bone and a Cartilage These may well convince their utility necessity and profit in Chirurgery He ought to be well read in Physick by which he may as well gain the knowledg of removing the cause as the discharge of effects and this gives a great light to the well timing of diseases for outward medicines are very oft applied with little success when they are not conducted with a cunning hand and a solid judgment Besides these a Physician is not alwaies at hand to defend the Chirurgion or to assist him which should upon necessity put him upon this excellent study which gives life to his knowledg by teaching him to eradicate the growth of a distemper It is his best friend at Sea and as great assistance in the Wars in helping him to pull down fevers in frightning agues in curing scurvies in discharging Itches in allaying Calentures and in bringing life vigour courage and health to his dying weak faint and sick Patients He is to be armed with Instruments both great and small the greater for greater uses whilst the smaller he carrieth as daily companions but of these you shall read more at large with their figures elsewhere The knowledg of Medicine is also very proper for him and a main wing of his Art it is by this that he can draw and heal dry and close up repel and resolve digest and suppurate attract and emolliate escharioticize and ease pain some of these being proper in Tumours whilst others are more useful in Wounds and Ulcers but of these also in their order And when a Chirurgion hath purchased all these thus furnished adorned armed educated and experienced there remains yet somewhat to add to his excellency as a quick sight having an eie pointed upward to fetch down a blessing upon his practice a nimble wit to apprehend every advantage that he may get from his Seniors a pleasant countenance to call chearfulness into the Patient's cheeks a couragious spirit in things which he well understands and are safe but as wary in matters of danger prudent in his presages courteous in his behaviour chast temperate not given to too much wine or venery Charitable to the Poor for conscience and charity as well as to the Rich for fame and profit furnished with undauntedness in amputations and Lithotomy having a steddy hand to act with evenness and without trepidancy a hawks eie sharp and clear to look into the distemper dexterous at his work He that is thus furnished may well assure himself he is in a happy estate of knowing how to remove solution of continuity restore union separate parts unnaturally joined remove superfluous bodies and then supply nature in her defects taking this as his guide 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 CHAP. II. Of Humours SInce daily experience showeth that out of Humors Tumours do take their Originals our present task shall be to treat of the matter of Humours of what they are how made and how many they are what good and mischief they do and then show you their Introduction in one Scheme their general Division and then arrive at Tumours themselves To understand the nature and essence of a Humour is and ought to be the work study and care of a Chirurgion as well as a Physician there being no disease with matter which is not framed of a confused mass of Humours It his hence that all Tumours Wounds Ulcers and Fistulaes and their differencies have their acknowledgments and distinctions the which is the only cause which makes both Physicians and Chirurgions run presently to the tempering of the Blood that is to the correction of those Humours which are the occasion of these Tumours By Physicians a Humour is taken for a thin and liquid body flowing and cruising in our body Tagaultius doth call them more properly Humours which are juices made by the Liver in the sanguinary mass for its nutrition and thinning of the blood all over our body All these are Choller Flegm and Melancholy adjoined to the Blood scattered and sent into our veins and arteries the which the variety of their colours and consistence will make good as Galen hath it lâ—b Natur. Human. Of these some are natural some not natural Those called natural because so ordered according to nature for keeping defending sustaining and nourishing the life of man Those counted otherwise which
act contrary to the rules of nature and have unnatural effects The one again being either alimentary proper for life and growth of the body the other excrementitious more proper for cleansing its sinks and channels As the Humour is so also is generally seen its Colour for as Blood is of a pure florid rosy colour so doth it give colour to the Muscles It is this that graceth the cheeks by affording them a a share of its redness and as it is made of Chyle and Blood so also doth it send forth its white and red and by how much the red exceedeth the white by so much are the Muscles more red than the Skin Choller is citrine and yellow thin and griping and as the four Humours do work man into a good humour so this burneth him into a passion it gives a lively paint of its colour in the Jaundies Flegm is white and washy and so are they that have too much of it being very cold and subject to Oedematous Tumours Dropsies and Agues Melancholy is black and masketh the whole body with an Ashy colour this is long and tedious in executing its office it being the most heavy an dsad part of the blood but at length bringeth forth the terrifying Scrophula Corroding Cancer Scirrhous Tumours Quartane Agues and the like and we daily find when it hath hatched them up to any growth it is very long if ever before it be made to part with them Besides these there are two others one a serous Humour which serveth as a vehicle to the blood ordered by nature for thinning it that it may pass to its smallest capillary vessels Part of this is sucked up by the kidneys where having made a short stay it maketh its further progress into the bladder and there remains whilst it be loaded the which being therewith filled is let out as useless and unprofitable Besides these comes Wind taking its circuits and turns and in our bodies is occasioned and bred by ill digestions crudities and wind the former making watery Tumours whilst this maketh slatuous Tumours But that we may well understand the foundation of these Humours let us examine from whence they are bred and whence they come 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or Blood as it is the cheifest and of the greatest service for life so ought this to take the preheminency in our discourse It is made from the temperate part of chyle in the stomack sent through the small guts into the milky vessels in the mesentery whereby nature hath ordained it a Receptaculum commune being here planted by Divine Providence as a bag for reserve for the most part full from whence passeth this chyle along the great Artery just by it untill it reacheth the Subclavian vein from thence it marcheth into the right ventricle of the heart by the vena cava and from hence is carried into the left ventricle of the heart by the Arteria venosa from the lungs and is there elaborated and made pure blood sweet of taste and florid in colour mild and benign This sanguification is a similar action and performed by assimulation and therefore taketh this chyle aforesaid as its subject matter for this assimulation and as they dewell together so do they assimulate together and this is done by process of time never passing to the liver as the Ancients dreamed for the chyle seldom or never reacheth it This blood as the vital liquor is sent through the whole body by its veins and arteries as its proper trunks and channels And although at its first appearance it sheweth it self pure and free yet hath it alwaies these three Humours adjoined to it as three several substances as Choller Flegm and Melancholy distinguishable one from another not only in taste sapour or colour but also in their effects for as Galen observeth lib. de natur homin the melancholy humour is acid choller bitter blood sweet and flegm having little or no tast and out of those being benign and pure is bred Scirrhus Erisipelas Phlegmon Oedema It is hot and moist which are the two species of its natural and unnatural temper and as Gal. lib. de Atra bile cap. 2. it is of a very red colour in its humour and is made of the best of juices and so bred from the best of tempers made by a temperate heat and those are its natural tempers As of its unnatural its proper substance is changed as its thinner part converted into Choller as Gal. 2. de Differ where he saith the thinner part is converted into yellow choller whilst the thicker turneth into melancholy Next to this is choller called by the greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 it being a humour hot bred out of the thinner and hotter part of the chyle and blood It hath but few spirits somewhat of Sulphure in it most of Salt and Earth It s parvity of spirits are evident in that it is of its own nature bitter neither hath it in it any great quantity of Sulphure for if we view its masse carefully it being neither Oleaginous or pingued neither doth it soon take fire yet it taketh Sulphure in it being principally exalted by adustion whence it bred this bitterness and although its salt excelleth in quantity yet doth it not gain preheminence It s flegmatick watery substance doth enlarge its liquid faculty its earthly parts thickeneth it and gives it the body it bears its heats and driness are sufficient signs of its being an enemy to the radical moisture and so unfit for nutriment that it is declared by all to be excrementitious This heat is the manifest cause of its bitterness made by a perpetual digestion of the blood thus milk unless oft times stirred in its boiling soon burneth and turneth bitter and as from heat and motion do colours change from white into red as Quinces being pale by boiling gain a red colour and chyle turned into blood by circulation and heat so also choller is as readily discharged of its first taste by adustion and perpetual digestion As to its uses Aristotle will grant it no waies useful Coryngius and some others do as much cry up its value offering that it serveth to warm the liver and to help digestion Helmontius calls it the balsom of the blood deduced from the liver to the mesentery but this is contrary to Anatomy for Anatomy teacheth that this humour is carried out from the liver not brought into it but onely sucked up by the Parenchyma thereof as through a strayner Others there are also as Zerbus amongst the rest that offer that if the bladder or gall be removed from the liver the substance of the liver would soon be dissolved and melted And to conclude this it s most proper use is to render the excrements fluxile The third is Flegm by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and this also is of two sorts natural and not natural The natural humour is cold moist crude in substance white in
Carbunculus or Anthrax a Tumour without pustles These are the names and differencies of its names and parts These oft follow a Phlegmone Abscessus sometimes coming without an inflammation premised Sinus a profound and cavernous ulcer which for a while hath lain Obscure Fistula the aforesaid Sinus stretched out at length the which not being speedily cured in process of time grows hard and runneth into the substance of a Callous Gangraena an imperfect not absolute mortification of a part Sphacelus by the Latines called Sideratio it being a perfect corruption and mortification of the solid parts 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 This is the ofspring of Choller and this is twofold 1. True and legitimate and here the cutis is onely affected without ulceration 2. Not exquisite or illegitimate where not onely the cutis but the subject flesh is terrified An Illegitimate Erysipelas is twofold One bred of thick and sharp choller exact and sincere and this is called an Erysipelas with ulceration the second of Choller mixt with other humours and then this Erysipelas may be termed Either Phlegmonosum Oedematosum Scyrrhosum To these also belong Herpes Miliaris bred of the thinner part of choller Herpes exedens made of the sharper part of it and this it showeth by its actions for it both corrodes and exulcerateth the whole cutis and subject flesh 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 This also cometh under a double consideration First as to its symptomes for it is a Tumour rare and lax and without pain bred of a flatulent and windy spirit Secondly as a disease and thus is its Origination twofold First bred out of flegm alone for it 's â— Tumour loose fungous and without pain arising from the thinner part of flegm and this is called Oedema Legitimum The second having other humours mixt with it and thence Oedema illegitimum This most commonly beareth these 3 differencies Oedema Phelgmonodes Oedema Erysipelatodes Oedema Scirrhodes To these also are related Hydrocele when a waterish humour is collected in the Scrotum Ascites a waterish dropsie filling the inward membranes of the Abdomen Leucophlegmatia Hyposarca Anasarca 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 This is a hard Tumour without pain 1. Exquisite wanting sense and admitting no cure 2. Not exquisite not alwaies without sense but the patient feeleth somewhat of it The exquisite as well as the not exquisite either first from the begining do encrease and grow bigger or else secondly are so made by transmutation Such as grow from the begining are said to be those which do breed from thick â—legm and so are resolved into a thinner substance or from melancholy It s natural for all Scirrhous Tumours to arise from Melancholy Some of these are pure without any mixture and these are called Legitimi Others have other Humours joined to them and these are named Illegitimi And these also have their three differencies Phlegmonodes Erâ—sipelatodes Oedematodes Such Scirrhous Tumours as are bred by Transmutation are made by Phlegmon Erysipelas and Oedema Vnder Melancholy Tumours are Cancer made without Ebullition Phagoedena with a Tumour Malign Ulcers Psora Lepra Elephantiasis c. These do border upon Scirrhous Tumours Painful and dangerous affects of the Arteries happening by contusion in the Abdomen Enchymomata Metasmata Aneurismes painful and miserable Symptomes Varices swellings of veins by thick and grumous blood Chaerades or glandular Strumaes Sarcocele or Hernia Carnosa made when the flesh grows between the coats of the Testicles Of Inflations are Tympanites or the dry Dropsie Strange Tumours in the Penis occasioned by Winds Pryapismus Sataryasis Of the serose Tumours may be reckoned Hydrocele or a watery Rupture Hydrocephalos a watery Tumour of the head Ascitis watery Dropsie There are other Tumours also which are very troublesome to mankind bred out of Humours as Epiplocele when the Omentum falleth into the Scrotum Enterocele when there is an Intestinal Rupture Enterepiplocele when there happens a Hernia of both Cirsocele or Hernia varicosa made by a twisting of the vessels Bubonocele or Hernia Inguinalis Omphalocele or Hernia Vmbilicalis Some also arise out of flesh as Sarcocele being a fleshy Rupture Epulis an excrescence growing in the gums Parulis small abscesses of the gums Polypus an excrescency growing in the nostrils In the Head are Artheroma carrying in it the substance of pultice Steatoma that of fat or suet Meliceris that of Honey And thus have I conducted you through the whole Garden of my first scope wherein you have seen not onely the Origination and Antiquity Honour Excellency and Nobility Learning and Vertue the subject Matter and Subject the Constancy Firmness the Necessity and Fruit the Liberality and Charity of this noble Art of Chirurgery but also I have shown you what this Art is of what Parts it consisteth and to what noble End it was framed With these also have I presented to you the Chirurgion and shown you how he ought to be furnished armed qualified and endued After this conducted you to the true knowledg of Humours whence they were made for what use some of which being and serving for building up our life and growth whilst others being planted as vessels of a lower Orb are imploied for washing cleansing and keeping in decency our Channels and other Rooms With these have I adjoined the natures consistencies colour tastes and uses of these Humours and have concluded this Introduction with a general division of Tumours whence you may gain their several Affects Causes and Differencies I come now to enter the Stage of Tumours where I shall act every part in its Order concluding this Introductory discourse with this saying of thâ— Poet. Principiis Obsta sero Medicina paratur Quum mala per longas invaluere moras OF Preternatural Tumours IN GENERAL CHAP. 1. Of the names of such Authors which have writ of Tumours in general A Tumour by Falloppius is held to be a Preternatural disease very difficult because it hindreth construction and hence it may raise in us a diligent enquiry hereof how this first happened what may be the best and safest way to sail herein what the best order to observe But before we lanch too deep in this main Ocean let us take and purchase such Pilots as may safely bring us of from the Shelves and Rocks of fears and distrusts and amongst the Graecians may Hippocrates and Galen well be call'd for assistance who writ a Book de Tumorib praeter naturam and Paulus Aegiâ—etta Amongst the Latines are very few of the Ancients The first is Octavus Oratianus Cornelius Celsus the best amongst them Of the Arabians are Rhasis Haliabbas Albucasis and Avicen Amongst our late writers are Gabriel Falloppius Hieronymus Fabritius de Aquaâ— Pendente Gulielmus Placentinus Ambrosaeus Parraeus Johannes Vigerius Johannes de Vigo Johannes Tagaultius and many others Of our own tongue we have Crooke de Tumoribus Vlceribus Banister Read Paul Berbet and the like Let these serve as a small Scheme of such Authors who
and amend the Symptoms The first doth consist in moderating the Air and this more properly in a long inflammation the second is ease and quiet because too much motion heateth the body the third is watching and sleep for as the one doth put our bodies into action so the other doth refresh and cool them the fourth and last is order of diet a fifth may be added which is retention or inanition of excrements for hard and dry excrements do obstruct and hence are bred sharp and malign vapours which do course through the whole body and do render the inflammation more dangerous and then actions of the mind may take a part here also The whole cure may be performed by Diet Pharmacy and Chirurgery Diet for prohibiting Inflammation of superfluous Humours and their generation and making them more unfit for Fluxion and here the Patient's diet should be thin moist and moderately cooling as broths wherein are boiled Lettuce Borage Bugloss Spinage Purslain or Marigolds if in Summer time our green sauce as we call it is very good being made of Sorrel if he will drink wine let him mix it with three parts of water to one wine Fluxion is discharged if we dismiss its causes as Plethory and Cacochymy and these may be lessened either by Phlebotomy or Pharmacy If the Inflammation be large and the Patient young strong and full of Blood we may safely breath a vein and here we are to observe that we breath not a vein too far distant from the part affected both for Revulsion and Derivation the first being to be made in the opposite part whilst the second is made in the same side near the part affected And since the body is seen seldome so clean but that there is some ill humours or other mixtures with the Blood purging also is here said to be convenient and for this case Cassia newly extracted Tamarinds Sebestins and Syrup of Roses are very excellent or if you please to take any of these as for Electuaries Bolus or purging potions As ℞ Electuar Diacatholic ʒvi Lenitiv ℥ ss Cass recent extr ℥ i. pul Diasenn ʒi Cremor Tartar ℈ ij misce and of this let the patient take the quantity of a Chesnut every morning or this Bolus ℞ Cassiae recenter extr ℥ i. pulp Tamarind ℥ ss misce cum Saccharo fiat Bolus Or this Potion ℞ Aqu. Endiv. Fumar. Cichor an ℥ i. Aq. Rosar Damasc ʒvi Electuar Diacathol ℥ vi Electuar è Suc. Rosar 3ʒij Crem Tartar ʒss misce fiat potio mane sumenda The body being thus discharged cooling Syrups Electuaries or Trochisces are very properly to be used as Syrup of Violets Roses Mirtills Poppies Wood-sorrel or the like or these following ℞ Spec. Diarrhod abbat ʒij Aromatic Rosat Troch de Rhabarb an ʒi Sacchar candit solut in Decoct Agrimon Veronic ℥ iiij misce fiant Trochisci Of which let the patient take a dram or two a little before Dinner An Electuary for this use may be this ℞ Cons Rosar Rubr. Violar an ℥ ij Conserv Lujul. Paralis an ℥ i. cum Syrup Oxyacanth Granator Violar an ℥ ss misce fiat Electuarium of which let the patient take the quantity of a Nutmeg at his pleasure Clysters also may be very necessary and of these may this very successively be administred ℞ Rad. Fol. Malv Alth. Parietar Violar Agrimon Veronic an M. i. fl Melilot Chamomel an M. ss sem Anis Faenicul dulc an ℥ ss sem Faenugraec Lin. an ʒij coquantur in s q. aqu fontinae ad lbi colaturae adde Sacchar rubr ℥ ij Diacatholic ℥ i. Sal. Commun pug i. Ol. Violar Rosar an ℥ i. misce fiat Enema Or this purging potion ℞ Herb. Agrimon Veronic Cuscuth Scabios an M. ss sem Anis Faenicul an ʒij Liquirit ras ℥ ss coquantur in s q. aqu fontinae ad ℥ iiij colaturae adde Electuar Diacatholic ʒvi Syr. Rosar solutivar cum Rhabarb ℥ iss misce fiat potio these being all managed with a prudent conduct according to the variety of occasions We arrive next to the part affected and this is to be dealt with by Revulsives Interceptives and Repellers And as I have already declared that Revulsion is made in the opposite part so such things as are here most requisite are to be hot and attractive of this sort are fomentations made of Sage Chamomile Calamint Hyssop Lavender Pennyroial Dill Tyme and the like these being boiled in water and applied very hot until the part looketh red Lixiviums also are here very convenient and Vesicatories especially if the Humour be fierce and plentiful as in Inflammations of the eies these being to be applied to the neck Aqua pendens gives us this as the best Epispastick ℞ Cantharid praeparat ʒi sem Sinap ℈ i. Ferment ℥ ss Aceti Scillitic q. s fiat vesicatorium After these Defensatives are to be chiefly used these being most properly said to be for hindring of Fluxion being in Quality cold and dry fit for contracting the vessels as ℞ Bol. armen Sangu dracon Mastich an ʒij Empl. Diapalm ℥ ij misce expande super corio and apply it A stronger than this is ℞ Bol. armen Sangu dracon Mirtill Balaust cort Granator Coral rubr Sus Cin. an ℥ ss Farin Tritic. ℥ ij album Ovor. no. i. cum Aceti Olei q. s fiat Restrictivum To prevent all mistakes and errors we are to be well advised that after Application of these Medicines we commit not that error which is too common amongst some Chirurgions who roll strictly upon the affected part not considering thereby that they both do detain the Humours and oft times by this their ignorance or carelesness they make a fair way for the invasion of a Gangrene into the part The third and last way is by Repellers performed and their cheif use is to hinder the Fluxion of any Humour to the part affected These should be cold in Quality and so should also be either moist and waterish or dry and restringent and of these some may be Plantane Balaustines Roses Dragons blood Whites of Eggs Vinegar Bolarmeny Myrtles and the like as thus ℞ Aceti Rosati ℥ iiij Album Ovor. no. ij Bol. armen sangu Dracon an ʒij Pulv. Myrtillor Rosar rubr an ʒi misce fiat Cataplasma Or this ℞ succ Semperviv Portulac Plantag an ℥ i. Acet Rosat Vin. Rubr. an ℥ iss Ol. Myrtin Rosar an ℥ i. pulv Myrtillor Rosar Balaust Bistort an ʒi misce fiat unguentum And this thing we are to observe that these repelling Medicines by how much they do intercept they are not to be applied to the affected part but onely about it encompassing it And this may serve for curing of Phlegmons in General We come next to treat of the curing of Phlegmones according to the several times CHAP. XV. Of curing a Phlegmon in its beginning IN the
with a fever pain watchings blisters and the like she being ordered a cold and moist diet and her body being kept open with Chologogick clysters as oft repeated as occasion required keeping her Room cool by oft times sprinkling vinegar thereon and prescribing her convenient Juleps and Emulsions I applied to the part affected this Unguent â„ž ol Rosar â„¥ ij Cer. flav â„¥ ss Vitellor ovor n o ij misce fiat unguent She being drest three or four times in a day until the pricking pain abated with this unguent afterwards was applied this Digestive for warming and comforting the part â„ž farin Hord. â„¥ i. farin Fabar. â„¥ iij. coquantur in vino q. s tunc adde pulv fl Chamomel Melilot an â„¥ ss Scord. Ê’ i. ol Rosar Chamomel an â„¥ i. vitell ovor no. i. misce fiat Catapl and if any blisters do arise this following unguent is very good and proper â„ž Ol. violar Rosar an â„¥ ij Lâ—â—harg aur â„¥ ss Thur. Ê’ij Ceruss Plumb ust an â„¥ ss succ Plantag Sâ—mpeâ—â—â—â— an â„¥ ss misce in mortario 〈…〉 urgnentum Or this 〈…〉 aur â„¥ ii pulv Alumin Ê’iiss albumin ovor no. i. bene agitatum cum oleo Rosar â„¥ iij. Acet â„¥ i. misce fiat unguent CHAP. XX. Of an Erysipelas in the Face THIS for the most part ariseth from the nose it first growing red then doth swell and then spreads it self and sometimes it doth get into the head and neck The causes which may occasion this may be said to be two being either inward or outward outward as contusions wounds or the like which may be accounted capable enough to excite heat and pain or inwardly taken too much hot wine spice or the like a hot intemperiety of the Liver which doth breed this so plentiful a quantity of Blood a redundancy hereof and a Fluxion of Humours to the part affected The cure hereof is much different from the former and in this we are to make a diligent search as touching its causes happening either by an outward or inward occasion If by an outward this being removed the Erysipelas doth cease if from a redundancy of chollerick Blood which floweth into the face the outward veins are to be opened and hence do arise three intentions in this cure first a cooling of the hot intemperiety of the Blood of evacuating and discharging of this chollerique Blood and thirdly to hinder this Fluxion And these are to be performed by Diet Chirurgery and Pharmacy by Chirurgery in Revulsion by Phlebotomy which ought to be performed in the arm in the same side and here you may bleed plentifully if the patient can endure it if not you may repeat it besides this other Revulsives are good as Cupping-glasses Vesicatories these being applied to the neck and shoulders Pharmacy doth relate to the better tempering the intemperiety and for this you may take these as proper Medinces being very good and useful in this case to be used and administred as â„ž Pulp Prunor. damascinor â„¥ i. Crem Tartar Ê’i Rhabarb Ê’ij Cinamon pulv Ê’ss Santal citrin pulv ℈ ij misce fiat Electuarium cujus sumat patiens q. nuc castaneae omni mane Or this potion â„ž Tamerindor â„¥ ij Prunor Jujub an par no. 5. Passular enucleat â„¥ ss Hord. mundat pug i. sem Melon Lactuc an Ê’iij fl 3 cordial an pug ss fiat decoctum in colaturae â„¥ vj. solve Cass recent extr â„¥ ss pulv Jalap Ê’ss syr Rosar solutivar â„¥ ij misce fiat potio Or this of the Author â„ž rad Petroselin Faenicul Cichor Lactuc incis an â„¥ i. coquantur in aquae fontinae ut colatura redeat ad lb. huic adde vini albi lb. in his simul mixtis stent per noctem in infusione Senn. mundat â„¥ ss Rhabarb Ê’i Polypod querc â„¥ ss sem Faenicul Anis contus an Ê’ij Epithem Ceterach Capil vener an p. j. ZZ Ê’i hujus infusionis sumato â„¥ iiij his adde pulv Jalap Ê’ss Crem Tartar ℈ ij syr Rosar solutivar â„¥ ij misce sumat cum costodia As to his diet which is the third part let the Patient abstain from Wine and instead thereof let him drink Barly water or Julep of Roses or cooling Emulsions such as you have already directed you And thus much of the inward causes As to the outward Applications they ought to carry with them a moderate temper between heat and cold for when heat and pain do urge these do call for ease and mitigation and if pain doth proceed from heat here most properly are we to use coolers without astriction as is the Decoction of Mallows mixed with a little oyl of Violets or Roses in the end we are to use Digestives as we have formerly directed and prescribed And thus much of an Erysipelas getting into any part of the head A country man being vexed with an Erysipelas Phlegmonodes the which being anointed by the advice of a Barber with oyl of Roses for some daies this happening in the arm hence did arise pain inflammation and other symptoms so that at length the whole hand was correpted with a Gangrene the which at last being well scarrified and such convenient Medicines applied as I have shown in my discourse of a Gangrene he afterwards recovered Let this serve as a caution to young Chirurgions that Oyl doth add to the flame rather than extinguish it as Galen doth offer in lib. 5. de Simpl. A Gentlewoman a person of very good Quality had an Erysipelas all over her face the which at length had a Herpes miliaris joined to it in which time the Erysipelas imprinted its marks so as the whole face was marked therewith she being of a plethorick constitution when neither by the advice of Physicians by bleeding purging or application of several external Medicines good could be done after the applying of several Unguents this at last being applied brought her unto her health as â„ž Vnguent de Lithargyr â„¥ i. Hydrargyr extinct cum succ Limon Ê’ss Tuth praeparat Ê’iij Ceruss lapid Calaminar praeparat an Ê’ij aqu Rosar acet Rosar an â„¥ iss agitentur omnia in mortario pistillo plumbeis Of this you may read in Observat 34. Riverii CHAP. XXI Of Oedema AS the former two have their variety of diseases belonging to them so also hath this its various companions bred of and from the same Humour for from Flegm are bred Oedema Artheroma Steatoma Meliceris Nodi in Juncturis Ganglion Leucophlegmatia and the like This Flegm is the fourth part of the mass of Blood that is the colder and moister part thereof and if it so happen that this doth increase in quantity the expulsive faculty being stirred up by the great plenty of this Flegm this doth offer very fair to the generating of an Oedema This Flegm is cold and moist and by some called pituitous Blood And of this there is two sorts one Alimentary the other Excrementitious The first is the
this as Galen directeth cap. 10. lib. ad Glaucum is not to be dealt with unless by Amputation and this I think in no wise may be said to come under the name of an exact way of cure because it neither yeildeth the part its native Heat but taketh away with it the sound as well as the disaffected part And that we may proceed more effectually in this operation when occasion and necessity may command or oblige it observe with me these Rules being as so many just Guides which will hardly fail you in your conduct as first that Cancer which doth adhere to the Brest or Brests is very deplorable Secondly that which doth happen in the Head Neck or Shoulders or also in the Inguens all these are to be pronounced incurable Aetius cap. 44. lib. 10. gives this for a reason because they creep and get in so deeply into the fleshy parts that they are not to be got out thence Thirdly although it be not thus adherent yet it is not without great danger Fourthly a worse Symptome then any of the former which is also seen very frequently unless the Tumour be wholly extirpated cured and cicatrized it may either grow again in the same place or in some other place and so bring a life full of greif and a certain dissolution of the whole in the end Ulcerate Cancers do require Amputation by reason of the great pain and heat they do carry with them And that we may proceed methodically herein I shall here offer what Instruments are most proper for this work as Incision Knives a Dismembring Knife large Needles Sponges other Needles and the like the which you shall have more fully afterwards I having there presented the young Chirurgion with a draught expressing his Instruments and all other postures which he may use And before I set down the method of Amputation be pleased to listen to that famous History of Ambrose Parrey relating to a Maid of Honour belonging to the Queen Mother who being perplexed with a Cancer in her Brest which did equal the largness of a Walnut had applied to it Plates made of thin Lead rubbed over with Quicksilver the which although they did not cure her Brest yet afforded her the kindness of preventing its increase The above nominated Lady growing weary of applying these Leads thinks upon a new Physician who coming to her very confidently promiseth her a perfect cure and rejecting these Plates as trifles began his cure with Emollient and heating Medicines and added such things as attracted pain upon the Application of which the Tumour did suddenly grow to a vast bulk and largeness and so much extended the Brest that it did break in the middle whence issued out an immoderate Flux for the stopping of which he makes present use of corrofive and caustick Pouders by the Application of which pains and Inflammation Place this Figure Fol. 〈◊〉 so seized on her that poor Lady instead of her promised health she yeilded her self to the Grave in the sight of her Physician This I bring in as a Caution to all younger Brethren hoping it may direct them to use more Reason than Passion Study than Ignorance in their Art and not like Mountebanks fall on a sudden upon desperate matters but rather with Judgment and Reason back their Art and secure their Reputations I shall here breifly present you with my methodical way of Amputation which I used in Norwich not many years since in a Woman whose Brest I amputated the which being ablated weighed near two pounds Her Body being prepared by Apozemes and convenient Purgations both for hindring the Augment and in some measure to prevent a Fever and she in every respect being made fit for the Operation being a Woman of an undaunted courage never did shrink at the Extirpating of the same Having made ready my Restrictives of Bolarmeny Draggons blood Mastich and the like with convenient Buttons Pledgets Boulsters and Rollers the Operation was thus performed by drawing through two large Needles through the body of the Brest armed with Silks cross waies by the help of which I had the advantage to elevate the Brest for the better extirpating it and its Radix The Brest being amputated with my dismembring Knife I with my Fingers expressed all the Blood from the remote parts after this done I applied my Buttons made of Tow to the Veins and Arteries being covered with the Restrictive whilst others were onely dipt in Acetum and so well sprinkled with Calcanthum Rubrum After these was applied my large Pledget or Cap armed with a Defensative then with convenient Bolstrings and Rollers I performed and compleated my first intention Here let the young Chirurgion take notice as a just Caution that he attempt nothing of this Operation in a large and thick Brest it being both dangerous and no waies safe Within two daies after I took of my first dressings and then applied such Medicines as might remove the Eschar the which being ablated I deterged the Ulcer filled it up with Flesh and induced a perfect Cicatrice and the Woman did receive a perfect Cure But within 2 or 3 years after whether by a blow or the like given her on her Brest I know not but it flew out again A Mountebank coming to this Town promised her upon her address to him a perfect Cure but poor Woman she was treated after the same manner as the Lady of Honour was which I have already told you of for he applying very attracting Medicines drew both her out of her troubles by sending her into another world and what she had into his own pocket If an Ulcerate Cancer might happen to our lots to be dealt with this by Galen's authority is not to be medled with But because it is cruel and doth seem uncharitable to give no ease if possible to the afflicted Patient we may use this double Method if any good may be epected the first is to be performed by Amputation or Caustick or we are to endeavour to see what an Issue may do being made a little beneath the Brest By some this Pouder is much commended which is reported to have cured many ulcerated Cancers in the Lips Nose and other parts ℞ Atrament Sutor lbiss Auripigment Sulphur viv an ℥ iiij Sal. gem ℥ iij. cum Aceto misce omnia in vas impone quod omni è parte lutatum ita ut fumus exire nequeat Put it into an Oven and keep it there until they be all burnt and dried this is a Caustick and this he puts about the confines of the Cancer and one part being burnt therewith he applied it to another so ordering it until he had burnt away all the Brest After which he applies this Unguent ℞ Mel. despumat ℥ iiij Sev. Hyrcin Limatur Cupr an ℥ iss Lithargyr aur ℥ i. misce ad ignem fiat Vnguent Fallopius doth offer this as a great secret in an ulcerate Cancer being onely made of
Carbuncle are these A Pestilential constitution of the Air as in the time of the Plague A slender and as it were an unperceivable Fever and the Patient doth oft-times walk while he falleth down dead Thirdly loss of the natural colour of the Face Fourthly the Tongue doth grow black or yellow Then the Urine thin and troublesome Besides these Liquid and Cholerick dejections Seventhly a prostration of the Appetite and vomiting Eightly much hot or cold Sweats Ninthly a grevious perplexity of Mind Tenthly difficulty of breathing and a raw Urine Eleventhly pain of the Head and Vertigo 11 sometimes deep sleeps sometimes great watchings 12 Syncopes especially when Death doth come to seize 13. the Crust which formerly was cinerish doth now grow blacker and lastly that which was formerly blew is now quite coloured with black The immediate cause hereof is the Fluxion of a most vehement Blood to the part affected which is thus excited by a redundancy of the whole Gal. Com. 12. lib. 3. Epidem doth call the pestiferous the worst The other are also dangerous because they do arise from vitious Humours and do produce a strong Fever The part inflamed doth never suppurate but by the exust Heat and by how much the more the larger and greater in number they are by so much the more tedious and by how much the nearer they get to the Heart or any other principal part by so much the more dangerous If it seizeth on the Membranes of the Brain it causeth Delirium if the Brain it self it proves mortal In the Cure hereof the Fervour of the whole mass of Blood is to be minded and a good order of Diet to be observed and this redundancy of Humours wholy evacuated and this to be done by Phlebotomy And here you may safely breath a Vein until your Patient be ready to faint according to Galen's authority Aphorism 23. Sect. 1. For in a Carbuncle is a very large Inflammation Cap. 1. lib. 2. ad Glauc Here ariseth a great dispute about the most proper place to bleed in for Gulielmus Placentinus will have us bleed on the opposite side for Revulsion and Guido doth join with him Falloppius offereth as there is a double Humour in a Carbuncle â—lowing and already flown so also should there be proposed a double evacuating Method The fluent Humour to be discharged by Revulsion whilst the Flux is to becarried of by Derivation But because as it for the most part happeneth that when the mass of Blood doth flow apart of this melancholick Humour doth flow therewith for this reason also are we to use Pharmacy as by ordering Manna Cassia Diacatholicon Confectio Hamech Electuar è succ Rosar and the like Decoctions made of Scabious Sorrel Cichory will do well here used or appropriated as I have already shown and directed in melancholy Tumours As touching Topicks we are to mind these three things in the part affected as the Crust the Inflammation tending to blackness and the Symptoms about the Crust Paulus will have us here to make deep Scarrification that this melancholy matter may the better be got out and either to apply Sponges or Pledgets dipped in spirit of Wine and Aegyptiacum Niter or Salt to the part these and the actual Cautery are to be used in the great and virulent Carbuncle But if it be not of so great a moment I take two Eggs and boyl them on sinders until the white be hard then I take out the Luteum of the Egg and mix Salt with it and so apply them hot and thus are you to serve it for four daies if it requireth stronger use Aegyptiacum if it yeilds not to these use the actual Cautery and for ablating the Eschar take a little Butter Axungia or Dialthaea or the like let it be deterged with Mel Rosarum Turpeâ—tine or the like Or with this â„ž succ Ap. â„¥ i. Mel. Rosar â„¥ i. farin Fabar. Ê’ij misce fiat Vâ—guentum Or apply to the part this Cataplasm made of Bean meal of Lupines French barly Scordium Ruâ— Wormwood boiled in Oximel resisting putrefaction Upon the Carbuncle apply this â„ž Calc viv â„¥ i. Sapon moll q. s fiat Vnguentum and let it ly upon the Ulcer for two or three hours You need not fear pain for dead flesh is ever void of that and for the removing of the Caustick you may apply this â„ž Butyr non salit â„¥ iss vitell ovor no. ij Vnguent Rosat Basilic Aurei an â„¥ i. Theriac Andromach Ê’ij fiat Vnguent to be applied upon the Eschar and then mundify it with Vnguentnm ex Apio then fill up and cicatrice As touching a pestilential Carbuncle Antidotes are to be given with Scordium Rue and the like in them We are here also to support the Heart against the invasion of this malign Enemy with Cordials as â„ž Aqu. Theriacal â„¥ ss Tinctur Croc. Ê’ij Vin. Hispanic â„¥ ij Spirit Lavendul Aqu. Mirabil an Ê’i Aqu. Angelic Rut. Borag Meliss Calendul Cardu benedict an â„¥ iss Conf. Alkerm Ê’ss cum syr Meliss Caryophillor q. s fiat Cordiale cujus sumat patiens cochlearia 2 vel 3 in languoribus And for defending its adjacent parts apply this Defensative of Chalmaetius â„ž Bol. armen â„¥ ij Terr sigillat â„¥ i. Corn. Cerv. ust Rosar rubr Ebor. an Ê’i Camphor Ê’ij Cer. â„¥ iss ol Rosar lbss Acet â„¥ ij Aqu. Rosar â„¥ i. Albumin ovor no. misce fiat Cataplasma Phlebotomy here is very proper and useful Let the Medicines you apply to the part affected be very potent and attractive having in them an Alexipharmick Quality to which you may add Mithridatum Venice Treacle and the like Cupping-glasses applied here with deep Scarrifications are very beneficial and if you be necessitated unslaked Lime put upon the part will effect the same Riverius observat 9. writeth of one of four years of age who was afflicted with a Carbuncle in the middle of his Forehead with a red Tumour accompanied being black in the middle and the whole Face tumefied to which was applied a Caustick to the black part and for removing the Eschar an Unguent made of Basilicon to which was added some Treacle oyl of Scorpions and the Yolk of an Egg and to the whole Tumour was applied a Cataplasm of Arnoglossus purging and bleeding being afterwards prescribed a Vesicatory to his Neck and a Cordial ordered for supporting of his Spirits with Confectio de Hyacinth c. the Fever abated the Inflammation grew more remiss and every thing did seem mitigated In this case the Vesicatory did perform the greatest part of the Cure by deriving a great part of this virulent Humour And to every Carbuncle I think it very proper to apply it to all the neighbouring parts and not to use Vnguentum ex bolo so generally used in these Tumours because Repellers applied to the Face in its Inflammations are more generally subject to the doing more harm than good And thus
open and by purging it from its Flegm and waterish Humours as this ℞ Extr. Rud. ℈ i. Pil. Coch. ʒss Resin Jallap gr vi misce or this ℞ Pil. sine quib aur Indic an ʒss Resin Scammon ℈ ss misce for two doses The part affected is to be treated with Coolers and Discussives as are Mallowes with Barley Meal and Cicers being made into a Decoction or some of my discussing Cataplasm already prescribed or this ℞ Farin Fabar. ℥ i. Hord. ℥ ij coquantur poscâ ad formam Cataplasmatis in fine ebullitionis adde pulv Rosar rubr ℥ ss post unam ebullitionem ab igne remove tunc misce album vitel Ovor. no. Ol. Rosar parum misce fiat Cataplasma If the Psydracium be ulcerated and a moist Humour cometh from thence apply this ℞ Litharg aur ʒi Ceruss ℥ ss Alumin ʒij fol. Rut. cum Aceto Oleo simul mixt fiat Vnguentum with which anoint the Skin and having well embrocated it with this you may conclude your Cure with this Liniment ℞ Lithargyr aur Ceruss pulv an ʒij Sulphur ʒi Ol. Rosar q. s fiat Linimentum And lastly aqua Scahiosa is by many held to be most excellent here Alome being added to it CHAP. XXXIV Of Hydrocephalos THIS is a proper Tumour of the Head arising for the most part from Water and hence doth it take its name This is a Distemper which doth very oft come into the World with young Infants being either bred with them in the Womb or else so as they are bringing into it It may also be occasioned by a careless or ignorant or unhappy Midwife It may well be called a Cephalick Dropsie for it doth contain in it a proper Waterish substance known by its indolency softness its easie yielding to touch but chiefly from its inundation of Water running out of one place into another in its compression These Tumours do often times vary for in some they are small whilst in others they do appear very large It is a peculiar Disease in the Head of young Children the which ariseth from too much Humidity of the Head for which very Cause they which are much troubled herewith do seldom live long as both Galen Aetius and Paulus do observe This Tumour by Galen in Libr. definitionis is thus designed as being a collection of waterish Humours or feculent Blood in some parts of the Body which doth force it self up to the Head And here is a double meaning to be explained the one whereas he calleth it not only a collection of a Serous Humour but also of a feculent Blood as when the Head Cranium suffers an outward Contusion or Collision and the Veins by this Collision do sprinkle their Blood between the Cutis and Pericrane This Blood here thus putrifying doth make a most soft Tumour and if a serous aquosity were collected the which by dayly experience may well be offered to happen from a Contusion thus happening it may frame a Hydrocephalos Aetius lib. 6. cap. 1. will have that a Hydrocephalos may be generated from a Feculent or bloody Matter the which being changed into a thin substance A second of Galens is that a Hydrocephalos is a collection of an aquous Humour in some part of those Bodies which have a forcing quality towards the Head out of which it may be conjectured that Galen doth offer that Hydrocephalos to be a Disease of some part of the Head not a Dropsie of the whole Head and this is confirmed by Aetius and Paulus who treating of Hydrocephalos do allow four species hereof First when this Humour getteth between the Brain and Membranes Secondly when it lyes between the Membranes and the Skull A third between the Bone and the Pericrane And Lastly when between the Pericrane and the hairy Scalp I have already shown you part of its Signs that it is a Tumour soft in touch whitish in colour indolent turgid much like a Pillow to other parts easily yielding to touch and as speedily filling up its former made vacancy the Finger being removed If it ariseth from a Contusion it doth appear first red and doth carry pain with it as Aetius doth write but being afterwards changed into a thin substance it doth spread it self without pain In those where it happeneth between the Pericrane and Bone they answer plainly the rest for here it is hard in Tumour and very painful by reason of the distention of the Pericrane If it happeneth as sometimes it doth between the Membrane of the Brain and the Skull it will be a Tumour but not yield to compression nor soft to touch Here it maketh the Infant soon to give way to it and to yield up its Ghost Its Causes may be said to be sometimes outward sometimes inward One of the outward may be said to be that which is mentioned by Paulus in Children newly born who had their Heads but ill bound up by their Midwives Another is contusion or collision or ruption of one or many Vessels Another cause is a cold Air or too much Water or thinness of its passages or Vessels out of which this Serum or matter do recide as Aetius hath it or also too cold or waterish Milk which it may suck from the Nurse these may be said to be the inward Causes hereof as when the Brain is too much cooled or the matter being here first collected and hence sent to the Brain Every Hydrocephalos is very slow in its motion as Aetius doth prove Lib. 6. Cap. 1. For it hath a cold Brain inwardly from its beginning arising from its inward Cause and also an outward by and from its outward Cause by reason of its delay and contaction To draw all these to one head there is to be allowed two Species of a Hydrocephalos One in which this waterish Humour is contained and made by an inward Cause that is out of an abundant collection of this serous matter in the Body The second doth not contain the sincere Serum but as it were a mixt feculent Blood the which doth eat it self out of the lacerated Veins arising from Contusion or some other outward Causes As to its Presage Paulus Aetius and Galen do offer that if this Humour be collected between the Brain and its Membranes it is mortal in other parts it may admit Cure by curing its Causes and removing its Effects But here as well as in other parts of the Body the Rules of Celsus and Galen are to be observed every Disease is so much the more dangerous by how much it gets into a greater bulk and bigness As touching its Cure we shall begin with that which is extant between the Hairy Scalp and Pericrane And herewe are to observe that every Hydrocephalos is to be cured by discharging of this waterish substance which is to be performed by purging the whole and cleansing the affected part And with this we are to begin with general Cephalick Purgings in
have digested it open it with an Incision knife or Lancet and let out every part of the Humour which is contained CHAP. XL. Of Vnguis ALTHOUGH this by the Greeks is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 yet this is not so easie by us understood or described for if we may conceive the whole Fibrous Membrane arising in the greatest Angle of the Eye and produced above its White to the Cornea and sometimes extended as far as to the Pupil we may view and perceive this lively expressed adherent in this part Celsus doth oft times say that it ariseth from part of the Nostrils and sometimes from part of the Temples and where it toucheth the Pupil it adhereth to it Paulus affirmeth this is without much difficulty to be discussed as by applying thereunto white Wine and White Wine Vinegar mixed together or Eye-bright and Sugar or Fennel-water Niter or Salt If it hath had a long time to grow and cometh to any perfection as Celsus directeth it is to be cut out for which he useth this Method Let the Patient be placed in a convenient State with his Head somewhat downwards on one one side that you may come the better at the Tumour and let him be so held and placed as that he do not disturb your Operation and then with a sharp Hook being a little bent or made crooked apprehend the Unguis and with a small Needle and Thred draw through it and so by compression eat it off Paulus's way is thus He uses a strong and long Horses hair and with this he doth comprehend the Unguis and so in a short time doth eat it off And here ought we to take care how we apply our Silk or Hair or any other thing with which we do or may intend to eat of those lest when we come to the Angle the Caruncle it self benot cut off also and so there happeneth another Mischief by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 out of which a Humour doth always flow After it is clean taken away Paulus would have a little fine Pouder of Salt sprinkled on it mixed with the White of an Egg and so applied upon Cotton or Lint We rather approve of Pompholix being poudred both for deterging and drying and over all to put a little Sheeps Wool Celsus doth put over his Liniment being made of Honey but the true and more proper way is to use more drying Medicines such as have no corroding quality or do stir up any Inflammation A Girle of ten years old being much perplexed with a tedious and troublesom weeping at the right Eye to which convenient Medicines not being applied the Humour that made its course thither grew sharper after which followed an Inflammation and an Erosion of the Pupil hence the Pupil grew into a great thick hard and white Cloudiness which depraved the Sight by its long continuance there being but little hopes left of doing good to this Patient yet by the request of her Friends and perswasions by these following Medicines she following directions recovered her sight to the Front was applied this Defensative ℞ Farin Hord. ℥ ij pulv Rosar rubr nuc Cypress Gallar Cort. granator an ʒiij pulv fl Betonic Euphrag an ʒi misce in mortario cum aqua Betonic Euphrag Acet Abumine ovi fiat defensativum Into the Eyes was instilled this Collyrium ℞ Mucilag Sem. Cydonior cum aqu Rosar extract ℥ j. Aqu. Foenicul Euphrag an ℥ ij Mel. Rosar ℥ ss Tuth praeparat Corn. Cerv. ust praeparat an ʒss Camphor gr iiij With this Collyrium and a good Diet with a good Order in purging being observed and by the benefit of a Seton she recovered her perfect sight If the Collyrium be not strong enough you may add Extract of Celandine to deterge the thick and viscid Matter which sticks to the Pupil CHAP. XLI Of a Polypus WE come next to the Nose where we may meet with a Polypus the which by Paulus lib. 6. cap. 25. Is said to be a Preternatural Tumour arising in the Nostrils so called from the resemblance it hath with the Fish Polypus as Galen hath it and also from its substance it being made of a Flegmatick and viscous substance It s proper place wherein it inhabits is the Nostrils where it both obstructs the Nostrils Respiration and in some measure doth hinder the Speech Celsus doth add that where a Polypus is thus produced as that it reacheth the Fauces they which are correpted herewith are soon suffocated This Tumour is like White flesh soft filling the Nostrils not uniform but doth appear as many Caruncles knotted or joyned together or hanging one on another some coming to the Cartilages some to the Bones either of the Nose or Spongy Bones Albucasis lib. 2. saith that it ariseth from a flegmatick matter and hath no Veins for its nourishment Whence it is most likely it is made of pituitous Blood which floweth to the Brain and is thence sent through the Nostrils There are many Differencies hereof as Paulus Albucasis and others do own for sometimes it is hard adherent livid painful and cancerous not to be cured with Instrument Another sort is soft loose white indolent bordering only on the Cartilages of the Nose or to the Bones or to its Spongeous Roots being pendulous It is so pendulous as it oft times is seen to hang out beyond the Nose Sometimes it is drawn upwards sometimes it passeth the other way to the Fauces Hyppocrates doth describe all its Differencies de Polypo and the manner of curing Celsus doth order us to put up a sharp Iron through the Nostril made in form of a Spatula and with this to resolve the Polypus from the Bone taking all care that the Cartilage be not hurt and being cut with this draw it out Paulus openeth the Nostrils and delateth it and with a Spatula made in form of a Myrtle leaf doth cut it out orbicularly But I shall not hang on either of these These do shew the Nostrils to be free from a Polypus if breathing through the Nostrils be free and without any Obstacle I rather with a great satisfaction admire and approve of Fabritius de Aqua Pendente whose Method and Instrument is both safe and harmless which Operation is made with safety and with repute for this Instrument doth apprehend cut and draw forth the Polypus the which are the three chief intentions in this Cure And besides these advantages it keeps and defends all the other parts of the Nose in safety and harmless It apprehends and draws it out without effusion of Blood for it neither cuts nor divides no other Veins or Vessels than such as are spread or interwoven into these Caruncles of which this Polypus is made I shall after I have presented you with its commodities shew you the exact Figure of this Instrument it cureth suddenly safely without pain and danger This Instrument doth perform
called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by the Latines Ranula it lodging under the Tongue It is occasioned by a moist pituitous gross and thick Substance falling from the Brain into the Tongue much resembling in it the Substance of the White of an Egg being somewhat of a more yellowish Colour And here observe if the party be plethorick breath a Vein under the Tongue and use proper and peculiar Gargarisms for this purpose and anoint it with some restringent Unguents or rather open it with some red-hot Iron Instrument being sharp the manner of which is thus Get a bended hollow Iron-plate which hath a hole in the midst making the Patient to hold open his mouth you must so fit it that the hole is to be just upon the part which you intend to open with the Instrument open the part so as you may hurt none of the circumjacent parts when you are ready to burn it thrust your Thumb under the Patients Chin that you thereby may somewhat elevate the Tumour and hereby you may open with more certainty Being thus opened throw forth the contained Matter after which wash the Patients Mouth with Barley-water and Sugar of Roses and thus may the Ulcâ—r be safely cured Gulielmus Placentinus doth order only Aqua Aluminosa to be held under the Tongue in which hath been boiled a little Myrrh Gesner in Histor animal lib. 2. pag. 51. writes That a Physitian related to him that he saw a Tumour under the Tongue the breadth of two Fingers which hindered the speech and that this Tumour was cured by drawing a Needle through it and afterwards opening it with a sharp Instrument the which being done came out matter from thence much like that of an Artheroma resembling coagulated Milk to the quantity of as much as would fill two hands the which being discharged he ordered the Patient to gargarize his Mouth with Aqua mulsa and sent into the Ulcer of the same by a Syringe and the Body being well purged and by the use of Restringents the Patient perfectly recovered CHAP. XLV Of Strumae and Scrophulae THIS Tumour doth arise with much â—ase from too much fibrosity thickness and viscidity of the nutritive Succus and for this cause only is it that this Juice is so difficultly despersed into all the parts of the Body and therefore must confidently redound in some place and with ease lay its first grounds and Foundations of a Tumour There is held a great difference between Strumae and Scrophulae and by Dr. Wharton in his Book De glandulis the one of these is called by him Wenns the other the Kings evil Scrophula signifying the first and Struma the latter Scrophulae are soft Wenns hard the first pale carrying in them the colour of the Skin the second having a redness turning to lividness Scrophulae soft and not much penetrating Strumae immovable and deeply fixed the Kings-evil swellings generally encrease into a great bulk and magnitude and besides their glandulous Fleshes they do carry in them several sorts of Juices in their little Bags the which do help much forward their growth and bulk It is credible that these concreted Juices are as some rejected Excrements thrown from the glandulous Flesh in its nutrition for these Glandules have no excretory Vessels and therefore necessarily they should carry their Excrements in their Bags And this is one reason of their growth Secondly the Blood effused from hence through the Arteries is more plentiful than that which is reduced through the Veins and hence therefore may there arise another reason of its growth Thirdly The Nerve which keepeth here is but small and that makes them so dull and hence is it that were the parts pricked with Needles the Patient would not much complain of pain Now as touching Strumaes these are not always seen to run into a bulk or magnitude but sometimes they encrease sometimes they lessen and at length do vanish These Tumours do receive their proportion from the reductory Vessel and are discriminated from its first genus here is nothing found besides Nerves Vâ—ins and and Arteries And by how much the Veins are better capacitated and enabled to convey and carry off that which is sent them from the Arteries by so much also are these Strumatous Tumours less capable of running into bulk than such as are Scrophulated And how these Tumours are translated from one place into another I attribute chiefly to the Nerves in their Operations these being most proper Messengers to carry to and fro Now if there be any matter carried to the Emunctuory Vessels or Glandules and be there excerned the Struma doth soon lessen and sometimes doth wholly vanish and is very often seen by applying of Hydrargyrical Mêdicines or Salivation to consume and waste away these having in them a very powerful influence of making the Nerves spit forth their Humidities into the Emunctuory Glandules And hence by Paulus and Celsus these are said chiefly to arise in three places more especially as in the Inguens Axillaries or about the Neck or Throat but most chiefly about the Neck and Throat because here they be nearer the Head their Fountain from whence they draw their flegmatick Matter to their conglomorated Glandules Some of these Strumaes do succeed other Distempers whilst others do breed of themselves Sometimes an outward Cause may occasion them as by applying too hot resolving or too drying Medicines As to their Presage we ought here to consider their different places where they make their abode for these are also either small or great loose or fixt few or many painful or without pain arising from Flegm or Melancholly Some being in the inward part of the Neck whilst others do border on the outward Some terrifying young Children whilst others do lay their impresses on people more aged And by how much they are more movable by so much are they with less difficulty cured yet take them at the best the Chirurgeon will find work enough to get well off clear them with repute Such as adhere to the Bones are incurable there are three ways of eradicating them Either when the Radical Moisture which is carried and reserved in their several Cystuses or Bags is sucked up by the Nerves or the affluxed Blood reduced by the Veins or a free transpiration brought to the part affected The first and main cause of this translation is the Nerve which doth bring and breed the first rudiment of a Struma out of its matter and to help forwards this work both Veins and Arteries are as its Assistants The curing also of these Diseases are very difficult in that most generally such as are troubled with these swellings outwardly they also have them inwardly As to the Cure the thick Lympha is to be incised tempered and evacuated the Glandules softned the Humour if possibly either to be discussed or suppurated and at length if no otherwise to be overcome is to be treated with Escharioticks And
signifies Aspera Arteria and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Tumour and therefore by Celsus is said to be a Tumour arising between the Cutis and Wind-pipe and by him is numbred amongst Abscesses whose Matter is lodged in a Bag or a Coat which is dull Flesh somewhat like Honey or Water Celsus doth here also propose two sorts of Medicines as Caustick and Instrument by burning Medicines so as that the Cutis and Bladder may be burnt and thus the Matter discharged but this is a great deal of trouble to a little purpose and therefore he more readily comes to Incision And here he orders a direct Incision to be made into the Coat so as the vicious matter may be separated by the Finger after which let it be well mundified with Vinegar to which adde some Salt or Nitre and in every Abscess we are to take notice that there is a small Vein or Artery that doth feed it and its Membrane whereto it doth adhere to the sound part in the other part it is free If any Patient should come to your hand with such an Abscess be always careful of these four Intentions as in the ordering your Patients Diet in preparing and purging the antecedent Matter in removing the Matter contained in the Tumour and in applying convenient Topicks Let his Diet be thin his Air hot or temperate for purging these may serve â„ž Pil. de Agaric Pulv. Hier. Colocynth an Ê’ij cum syrup de Stechad q. s â—iâ—nt pil dos a Ê’i ad Ê’iss In this case Sweating is also good And as to Chirurgery you may use this Unguâ—nt and Emplaster â„ž Sulphur Sandarach an â„¥ ss Euphorb â„¥ i. cum Cerae olei q. s fiat Vnguentum After anointing herewith apply this Emplaster â„ž Rad. Ireos Sal. Gem. an â„¥ i. Terebinth q. s Diachyl cum Gummi Apostolor an Ê’i misce fiat Emplastrum If these will not do Rogerius does advise us to make a double Seton so as that the Humour may slow out by degrees In old people very commonly the Larynx is so attenuated and the Muscles as it were so dried up and as it were discharged of their Fleshy Substances that it happens frequently in chewing that some part of the Aspera Arteria is seen to fall and this was verified by Osualdus Gabelchoverus de observationibus suis who writes of an old Gentleman that could not take down any liquor as Beer Wine or any liquid substance but a great part of his Aspera Arteria would slip yet he could take and eat his meat very well without any hindrance The same I knew of one Mr. Goodman a Minister here in Norfolk a man of about 40 years of age who could eat his meat very heartily without any lett or disturbance but when he hath had occasion to drink was forced to bend himself forward and by degrees let his liquor pass down very moderately lest a part of his Wind-pipe should slip out and so prove very troublesom to him I have been oft in his company when I have both seen him use this Method and also taken all care to prevent the falling down or relapse of his Aspera Arteria CHAP. XLVII Of Angina IT is called Angina from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which is all one to Sâ—rangulo the which doth signifie every Affect both of the Jaws and Throat whereby Breathing is hindred or if you please it is that Affect of of the Throat the Larynx being overstraitned by some inward occasion so causing Suffocation It is a very acute Disease and is an Inflammation of the Fauces Of this there are two sorts one Legitimate the other Illegitimate To the one a Feaver is a continual companion but it hath nothing to do with the other There are three species of a true Squinancy one with Inflammation and not in the Fauces neither apparent in the Neck but in the Throat and this bringeth speedy danger of Suffocation A second accompanied with a manifest Phlegmon with no Tumour or Redness in the the Neck A third when the Neck seemeth to be inflamed with the Fauces having along with it Tumour Râ—â—ness Heat and Pain The inward Cause is Blood abounding and oft times peccant the which doth not alone raise this unless more vitiated by a sharp and four Lympha The outward Causes are evident Cold Fish-bones being received the wrong way cold Drinks and too much Repletion A Bastard Squinancy is made by a pituitous Distillation falling upon the Fauces and Muscles of the Neck exciting a Tumour without Redness Heat and Feaver Of these are â—â—de three Differencies by some Authorâ— and these they christen with three 〈◊〉 names as Cynanche Parasynanche 〈◊〉 che but these are but of small moment towards our encrease of Knowledge The Diagnostick Signs are when the Patient cannot move his Neck and breatheth with difficulty neither can he well swallow and finds a pain and heat in his Jaws That is accounted most dangerous which with the most speed doth threaten Suffocation and yet is neither perceived in the Cheeks neither doth it any ways appear in the Neck yet there is felt a vehement pain and the Spirits scarce seem to be drawn for oft times this Suffocation doth happen the first day There is no Squinancy with safety and the lesser the Tumour the greater the danger and Hippocrates lib. 4. Aphor. 34 35. saith if the Humour of the Angina be carried to the Lungs it maketh its exition before the seventh day otherwise the Patient grows in danger of Suffocation And if it hath made its efflux without leaving any evil symptom in this time the Flux being converted into Matter this is to be suppurated and not kept here for where it is not cleansed from hence the Patient doth very readily run or fall into a Consumption This Lympha and Bilis is to be tempered in the Bloud and to be very speedily revelled and derived and therefore are we first to breathe a Vein in the right Arm and this is as oft to be repeated as necessity may offer And if this will not do breathe a Vein under the Tongue but this is to be performed at the beginning then cool the body with Clysters or Purges and let your Patient have convenient Gargarisms prepared for him as â„ž fol. Rosar rub Balaust an pug 1. cort Granator â„¥ ss fol. Querc m. 1. Alumin ust ℈ i. coque ex aqua ferreata 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 adde syrup Diamor â„¥ iiij misce In the end you may order this discussive Gargarism â„ž rad Liquirit cort Granator an Ê’ij fl Balaust fol. Rosar rub an pug 1. Jujub no. 12 Ficuum no. iij. Passular Corinth Ê’iij coque in aqua Hord. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in his solve syrup cap. Vener Mel. Rosat an â„¥ iss misce This following also in the beginning is very proper â„ž fol. Ros rub Sambucin an M. j. coquantur in Cervisia tenniore q. s fine addendo
or nine times untill it hath lost all its Acrimony and Mordacity This Powder being thus made take of Litharge of Gold â„¥ ij Oyl of Roses â„¥ iiij with which boil it being mixed with the former to the consistence of an Emplaster This is to be put at the end of a Searching Candle or Leaden Probe so as that it falleth not off This is in much esteem for this Affect But because all Bodies have not one and the same constitution and temper therefore are Medicines to be changed accordingly and after the Application hereof you are to inject into the part affected Goats Milk or other Milk or Rose water to which may be added a little Camphire and these to be applied untill the pain cease You may know when the Caruncle is extirpated when out of its inordination it is perceived about the ulcerated part and also out of the copiousness of the effluent Matter the which also whilest it is extracted the Candle does appear as if it were wholly imbued with it and after this if the Urine flow liberally freely quickly and copiously and in its right method there will be left but little occasion of doubt but your Patient will do well it being discussed and extirpated The Ulcer is to be discharged by a Liquor sent into the part affected through the Syringe as â„ž Centuaur maj Apii Caud equin an M. ss Hord. contus â„¥ j. coquantur in aquae fontanae lbij. ad consumpt med colaturae adde mel â„¥ ij utere The Ulcer being cleansed you are to induce a Cicatrice as with this or the like â„ž Aqu. Plantag Rosar rubr an â„¥ iiij Ser. Lact. caprin â„¥ ij Ceruss Ê’vj Alumin Roch. Marmor candidissim Spod Crystal an Ê’iss Camphor ℈ j. fiat pulvis subtilissimus And this is the whole Method which is and ought to be used for a Caruncle Unto these also might I adde Phymosis and Paraphymosis but Fabritius Hildanus has writ most exactly hereof and thereto do I commend the curious Chirurgeon I shall conclude this Chapter with this History of a Gentleman who fell into a suppression of Urine by a tumefied Caruncle in his Yard generated by an impure and immoderate Coition A Chirurgeon being sent for to search him with a Catheter occasioned a great Flux of Blood the Patient being in much pain and thus suppressed in his Urine grew into a Fever for prevention of which I breathed a Vein afterwards ordered an emollient and cooling Clyster and anointed the Perinaeum and all its adjacent parts with a cooling Unguent after this I prescribed him a Vomit of Sal Vitrioli by vertue of which he vomited up much pituitous Matter and in the second Vomit went out an Ounce or two of Urine whereby he found himself somewhat cheared and thus by degrees his Bladder was altogether unloaded within 4 or 5 hours and the part affected being cured with Sâ—l Prunella Injections and Clysters such as you have already prescribed the Patient recovered Riverius in his 14 Observat writeth that Charles the Ninth King of France being much afflicted with this Distemper was by these following Medicines cured for which Cure was given 200 Pieces of Gold â„ž Cass recenter extr â„¥ ss Suc. Liquirit Ê’j Electuar è succ Rosar Ê’ij Aq. Lupul â„¥ iiij fiat potio mane sumenda And for ten days after he drank of this Decoction half a pound â„ž rad Liquirit Alth. Sebest Passul an M. iss Alth. malv. Apii Petroselin an Ê’ss aqu fontan lbij. coquantur ad mediae consumpt After which were applied these two Unguents â„ž ol Rosar lbij. Ceruss Venet. â„¥ iiij Camphor â„¥ ss Tuth aqu Rosar lot praeparat â„¥ ss Lithargyr praeparat â„¥ iij. pulv Antimon opt â„¥ iss Op. Thur. mascul vel Oliban Mastich Alo. Epatic an ℈ ij misce servetur in pixide plumbeo The second for Consolidation was this â„ž Vnguent Rosat aqu Rosar lot Vnguent alb Camphorat an â„¥ j. Pomat. â„¥ ss misce Keep thefe for use The way of applying these is at the end of a Searching Wax Candle it being rubbed over with Oyl of sweet Almonds and if there be a double Carnosity then apply the first Unguent to both of them for fifteen or twenty days and as it seemeth to dissolve and to turn into pus then abate the applicacation of the first the Urine coming free and with ease and for eight or ten days afterwards apply the second untill no further Matter come forth Hitherto hath our Discourse treated of the Parts as they arise from the Head even to the Penis the next which we shall produce are the variety of Herniaes or Ruptures and these as they arise shall offer themselves with their several Forms Shapes and Places their Causes Signs and Cures and Differences and shall begin with an Intestinal Rupture and so proceed to the rest in their order and form CHAP. LIII Of Ruptures in general WE arrive now to Herniaes or Ruptures the which for the most part do dwell on the Hypogastrick Region And whereas other Humours have allowed them three Causes as being bred either out of an Influx of Humours or Decumbency of Parts or Congestion All these have their lively Forms and Shapes in the Tumours of the Testicles for Tumours are made here either by Humours flowing as Inflammations Erysipelaes Oedema and Scirrhus or from the Decumbent Parts or from Congestion as from Water or any other Humour These kind of Tumours are better and oftner cured by Chirurgery than Pharmacy And as they are various in their Places divers in Shapes and manifold in Forms so do these and every of them make various Intentions and Indications for the Chirurgeon And that every thing may fall successive to the wish both of Practiser and Patient in this place it will be very proper to know well and understand the Parts framing the Testicles they being as the chief Causes and Effects of most of these Ruptures Celsus lib. 7. cap. 28. does account the Testicles to be Glandulous Bodies wrapt about and twisted with various Vessels Coats and Ligaments By the Greeks they are called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 as being two in number and these are the Authors and Workmen of the Seed for they have allowed them a vernaculate faculty of attracting and educing the Spermatick Matter from all the parts of the Body The Coats of the Testicles are four the first called Epididymis immediately enwrapping the Testicles from whence it taketh its Name the second Elythrois so called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or quasi rubro similis or vaginalis the third Dartos 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 because it is easily excoriated and lieth next the Scrotum the last is the Scrotum it self To these Testicles also belong Vasa deferentia Vasa praeparantia the Cremaster Muscles and the like This may serve as a brief Anatomy of the Testicles and its neighbouring parts We proceed now to the various Differences of Ruptures before we treat singly of each by it self