origination hereof by the Arabians called undimia by the Greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signifies no otherwise then an eminency There are of natural or excrementitious Flegm these three sorts the first being acid so called from its taste the second salt Flegm the third glassy Flegm from its coldness thickness and toughness And if Flegm doth erecede from its nature by admixing it self with Blood it is called Oedema Phlegmonodes if with Choller Oedema Erysipelatodes if with melancholy Oedema Scirrhodes A great matter hereof is a great quantity of Flegm residing in the body cheifly about the extreme parts as the hands knees or feet these being the most remote from the Fountain of heat This Flegm is thrown forth from the greater vessels to the smaller the which being there deteined by the thickness of the Cutis is collected in the musculous parts and there doth form this Oedematous Tumour It is a Tumour soft indolent loose yeilding to the touch generated from a pituitous matter It is soft and loose and these two come from the Humour of thin Flegm indolent for it neither doth make or cause any pain or dissolve unity It gives way to the touch and is a white Aposteme and without heat white being most like its object Flegm without heat being like the matter out of which it is generated which is cold and moist A pituitous Humour redundant in the body is the cheif cause to the which a cold and moist air a flegmatick diet too much sleep and idleness and a cold dyscrasy both of Head Stomack or Liver may help forward to the encrease of its cause And as Galen saith Comm. 46. that out of Fluxion of Humours some are cruel as Chollerick fluxes and burnt Melancholy and others are more kind as this Oedema so this is a tedious and long disease because it is cold the native heat being herein very weak It is oft times soft and without pain and so carrieth the less danger but if it be hard and with pain it is dangerous As touching its cure here ought we first to use proper means by Retraction and Revulsion of the Matter and lessening of it Secondly because it is cold remove its cause by implanting heat and warmth herein Let the Air be warm and dry the Diet attenuating and drying here Wine is good because it doth digest and warm Let his diet be of good and light digestion as Chickens Rabbets Partridges and the like to which may be added all sorts of spices Let his sleep be moderate and let him avoid all passions of mind and venery and observe that he keep a good habit of his body After this let him use such evacuations as may both attenuate open and discharge this Flegm Bleeding here is in no wise to be used unless a Phlegmon do accompany it Fever or the like And for his use these Phlegmagogicks are very proper and convenient as â„ž Alo. lot cum aqu Majoran Agaric trochisc an Ê’i Mastich Cubebar an gr vi Troch Alhandul ℈ ss Cum syr de Betonic q. s fiant pillulae dosis Ê’i Or â„ž Pil. Coch. Ê’ij Aurear. ℈ i. Troch Alhandul gr iiij cum Oxymelit scillitic q. s fiant pil no. 18 quarum sumat 2 omni mane Or if you will â„ž Pil. Coch. ℈ ss extr Rud. ℈ i. Mercur dulc gr 15 ol Câ—ryophyllor gut i. misce sumat mane A potion preparing Flegm â„ž Hyssop M. i. Menth. M. ss Absynth M. ss sem Anis Faenicul Calamenth an â„¥ ss Rosar rubr â„¥ ss fiat decoctum ad lb. colaturae adde Sacchar lb. aromatizetur cum pulv Cinamom Ê’i or this potion â„ž aqu Meliss Bugloss an â„¥ ij in his in funde per noctem Rhabarb Ê’i Agaric trochisc ℈ ij pulv Cinamom ℈ ss ZZ Ê’ss colaturae adde Mann â„¥ ss Cambog gr iiij aqu Cinamom hordeat â„¥ ss misce fiat potio Or if you please this â„ž Electuar Diacatholic â„¥ ss Diaphaenic Ê’ij pul Agaric troch ℈ ss solvantur omnia in aqu Hyssop Rosar damascinar Faenicul an â„¥ i. misce fiat potio cui adde syr de Betonic â„¥ iss And because Oedema is a disease offending partly in quality partly in quantity in respect of its cold and moist quality we are to use such Medicines to the part affected as are warm and dry and in relation to its quantity we are to endeavour its discharge and evacuation And since here is required a double intention here ought we carefully to inquire and examine whether Repellers mixed with Digestives are in the beginning first to be used Galen doth satisfie us cap. 3. lib. 2. ad Glanc that they are to be used as you may find him there using a peice of sponge or linnen rags dipt in Oxycrate to which a little salt is added and so applying it over the part and then ordering it to be rolled up for Repulsion is this roller being dipt in vinegar and the sponge and the water do digest the pituitous Humour But it may be asked how Digestives being hot and dry may or can agree with water which is cold and moist in digestion Galen doth answer this Chapt. 8. lib. 1. that water doth digest and this we may see in the hands and feet of Fishermen who having been much imploied in the water you will find them both corrugated and wrinkled which corrugation is nothing else but the evacuation of that matter which formerly filled up the spaces But should an Oedema happen upon the Tendinous or Nervous parts we are to use little vinegar and for discussion of the matter this may be very proper â„ž fl Chamomel Rosar Mirtin Absynth Staechad a. M. ss Alumin Roch. Sal. commun an â„¥ ss Balaust nuc Cupress an M. i. Salv. Rorismar Squinanth an pug i. coquantur poscâ factâ ex Lixivio coquantur omnia usque ad Ê’ae partis consumptionem in quo madefaciatis Spongiam and this you are to use to the state Or this Cataplasm â„ž pulv Rosar rubr Mirtin Absynth Rorismar Staechad an Ê’ij pul fl Chamomel Melilot an Ê’i misce coquantur cum q. s Hydromelitis fine addendo pulv nuc Cupress Squinanth Balaust an Ê’iij Or this Cataplasm â„ž farin Fabar. mic pan an â„¥ iiij pulv Terrae cimol â„¥ ij sem Lin. Faenugraec an â„¥ j. Bol. armen Ê’i coquantur in s q. Lact. vaccin ad Cataplasmatis formam fine addendo Camphor Croc. an ℈ i. vitell ovor no. ij misce fiat Cataplasma Or this â„ž farin Hord. Fabar. an â„¥ iiij pulv Rosar ru Bacc. Laur. Mirtillor an â„¥ i. pul fl Chamomel Sambucin Melilot Ivae arthritic an â„¥ ss fim caprin â„¥ ij cum vino rubro fiat Catapl fine addendo Sapon nigr â„¥ iij. applicetur bis in die And because Quicksilver hath a very strange penetrating quality allowed it that it can command Flegm from
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
Medicines formerly applied by this Quack there was first used this Emollient Fomentation two or three times in a day with which the part affected was fomented ℞ rad Bismalv cum Tot. Lapath acut Screphular an ℥ ij fol. Malv Violar fl Melilot Sambucin Melilot an M. i. sem Faenugraec ℥ ss coquantur in aquâ ad 3 partis consumptionem The part affected being herewith near half an hour fomented cover the parts with this Catapl ℞ farin Fabar. Lupinor an lbss sem Fenugraec Lin. an ℥ ij rad Alth. recenter coct cribrat ℥ iiij pulv fl Chamomel Rosar Melilot Absynth an ℥ i. misce fiat Cataplasma With this being applied for fourteen daies and the Fomentation continued the hardned Skin grew soft the Pain allaied the ichorous Matter which flowed out of the Ulcer was prepared and brought to a fair Digestion after this was sprinkled upon the Ulcer Precipitate in pouder being washed in Plantane and Rose-water and over these applied this Empl. ℞ Empl. de Mucilaginib Diapalm an ℥ iiij De Ran. cum Mercur. ℥ i. Alumin ust Calcanth an ℥ ss ol Rosar q. s fiat Empl. molle And about the end this Unguent ℞ rad Scrophular Lapath acut cort Frangul an ℥ iiij succ Fumar. Scabios Acet an lbi Pinguedin Porcin lbij. conquassentur Radices cum succis ad eorum consumpt coquantur colentur colaturam serva ad usum ℞ hujus pinguedinis colatae lbi pulv Alumin Vitriol opt farin Lupinor bacc Laur. Ciner fuligin an ℥ iss Argent viv extinct ℥ ij Theriac ℥ i. fiat Vnguent in mortario With this anoint the whole Leg keeping his Body open with Conf. Hamech c. CHAP. XXIX Of a Gangrene and Sphacelus A Gangrene is that which doth feed on the flesh and poysoneth it and imprints a strange unnatural Quality in it By the Greeks it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from the verb 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is Exedere But there are more essential Definitions hereof by some it is said to be a change from a natural to a preternatural Colour and by these it is called Mortificatio Galen doth call a Gangrene the beginning of a Mortification in the part affected the which doth so trouble and infest the neighbouring parts that without the best of Medicine be applied by a very skilful hand it does speedily run it self into a Mortification Inflammation by him also is accounted as a very great Instrument hereof and here beginneth a change of Colour decay of Sense a turning to Mortification We more properly allow and decree it the beginning of a Mortification and that it very oft times happens the which I have very frequently found in my practice experimentally to follow or succed large Inflammations and thereby do corrupt the soft parts as the Muscles Cutis Veins c. A Sphacelus is worse than the former for under this name we may comprehend Syderatio Putrefactio Corruptio and Mortificatio 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by the Greeks is held to be a most intense Disease so is a Gangrene by the Arabians A Gangrene is a Disease consequent to the effect not to the cause Sphacelus is a Disease exeding and compressing the parts It is a perfect Syderation and Mortification for a Member being corrupted with a Sphacelus is found plainly cold and dead While the member is in a dying posture and not quite dead it is called a Gangrene this for the most part remaineth in the upper superficies and doth onely possess and affect the Muscles and soft parts in a Sphacelus not these onely but the Bones themselves become affected In a Gangrene the Skin groweth red by reason of its companion Inflammation in a Sphacelus it first groweth pale then livid and afterwards black In a Gangrene you have no very ill smell in a Sphacelus never expect a good smell In a Gangrene your greatest design must be to prevent the spreading of the Humour and if it hath got place to prevent its growth in a Sphacelus its lost labour then to act or treat any other waies than by Amputation for there is no hope of bringing a dead part to life It gains its Name of Syderatio from that of Plants being a proper passion of them when they lose their natural moisture the which doth afford them their full growth and beauty this affect is called Syderatio as if they were struck by the Stars The immediate Causes of a Gangrene are three Intemperiety of the part when the transpiration of the Spirits are obstructed and when both the Heat and Spirits of the part are suffocated Sometimes it cometh by cold and then is to be discharged by heat in Gun-shot Wounds it doth frequently happen by reason of large Contusions it is sometimes also bred by the carelesness of Physicians who in the curing of an Erysipelas in the beginning do order and prescribe cold things so being in Act and Power that they are made capable to destroy the natural Heat oft times by defluxion of Humours or venenate Pustles which are left uncured sometimes out of immoderate Driness other times arising out of the Interception of the vital Spirits and very often out of Obstruction in the beginning of the Nerves And since there is a Mortification and Extinction of life and Destruction of the native Heat let us consider which way and out of what universal Causes this may happen Mans innate Heat cannot be supported without a radical Moisture and its Spirits justly and in their order implanted in all the parts of his body so that consequently upon hurting or offering any injury to this radical Moisture its Spirits also will be resolved dissipated and consumed and therefore first there is an Intemperiety occasioned out of the vehement alteration of the manifest Quality Secondly out of the occult Quality a malign and virulent Substance is contracted in the Body and thirdly the Parts are thus mutually affected with an Interception and Suffocation of the vital Spirits As to the first Galen doth observe and offer that every thing is kept preserved and propagated by its natural Heat and Temper so that nothing can alter or destroy this sooner than a contrary preternatural Temper and Heat thus a Gangrene doth happen after a long and tedious continuance of an Inflammation made either by Affluxion or Congestion of some sanguinary or cholerick Humour the natural Humour being dried up by the preternatural It may arise secondly either from a concomitant Malignity either brought outwards to the Body by the biting of some venemous creature or by adhibiting of Septicks In a hot Intemperiety the Pain and Pulsation which formerly were concerned with the Pulsation is much more remiss and the red Colour of the Inflammation doth begin to change into a Lividness here also do arise Pustules filled with an ichorous Matter these being all Forerunners of its tending to Mortification and both Heat and
Blood do perfectly run to the Center whilst the other parts thereof do suffer Putrefaction It arising from cold doth cause and make a great and pricking Pain Soon after this it changeth its red Colour into Lividness and maketh it most cold afterwards sending the Blood away by its Coldness and dispatching the native Heat and dissipating its Spirits doth make the affected part perfectly void both of sense and motion a horrour and trembling attending it much like the fit of a Quartane Ague There is generally held five Signs of a Sphacelus First the affected part is much more heavy and dull than formerly it was Secondly the Floridness and Redness of the part do turn into a Lividness and Blackness Thirdly the part which was soft in a Gangrene groweth hard in a Sphacelus Fourthly the Cutis being taken up is seen with ease to separate it self from the Flesh And lastly there is no exquisite sense or perfection but a perfect Mortification remains We are if we intend to cure a Gangrene aright to study and find out the Antecedent Cause thereof and from thence to take our first Intention as thus If it happen from a fiux of hot and moist Humours let the Patient's Diet be cooling and drying for purging nothing is more proper here than Chologogicks as Electuarium Diaprunum Diacatholicon Lenitivum Syrup of Roses and the like Phlebotomy is very necessary also to prevent the further growth of Inflammation for opening the passages and making a more free Transpiration but in all sorts or kinds of Gangrenes this is not to be used For in a Cholerick and bilious Humour we are not to attempt it Blood being as the bridle to check and command this Choler In the case of applying of Topical Medicines observe these rules The first is taken from the Cause for if the afflux be cold and flegmatick evacuate more powerfully and warm the Humours with Defensatives The second is taken from the Age of your Patient for in a young body the Flesh and all its parts are soft and tender and therefore are you to order and prescribe milder Medicines than to those of a fuller growth A third ariseth from the Sex a Child being to be treated with more mildness and Gentleness than one of an elder age and a Woman more tenderly dealt with than a Man The fourth is from the Strength of the Patient for you may powerfully exercise your operations on such as are of a good and strong constitution whereas you are more sparingly and tenderly to use such persons as are weak and sickly The fifth ariseth from the part affected for the Eye Mouth Pudenda Anus Vertebre and other such sensible parts are not to be dealt with as you may deal with an Arm or Legg Sixthly the greatness of the Disease is to be much minded and regarded If it be new done and the Putredness not much nor made any deep impression to scarrify the part lightly and to apply Aegyptiacum alone is enough If it be more powerful and do threaten a Sphacelus here is to be made a deep Scarrification and you are to mix Spirit of Wine with Aegyptiacum very hot and often These are your general rules I come now to the prosecution of a particular Gangrene arising from Inflammation and here the first Intention is to be performed by Astringents or Desiccatives as â„ž Bol. armen â„¥ iiij Terr sigillat â„¥ ij Corn. Cerv. ust praeparat rasur Ebor. an Ê’ij Camphor Ê’iij Cer. â„¥ iij. Ol. Rosar lbi Acet â„¥ iiij Aqu. Rosar â„¥ iij. Albumin ovor no. ij misce fiat Vnguentum A Cataplasm for the same is this â„ž farin Hord. â„¥ iiij Bol. armen â„¥ ij pulv Gallar virid nuc Cupress Cort. Granator an Ê’iss Camphor Ê’i cum Oxymelite q. s fiat Cataplasma The second Intention is to revel the Humours and to send and discharge them into other parts And here this Bolus is proper â„ž Cass recentèr extract Ê’ij Electâ—â—r Diacatholic â„¥ ss cum Saccharo q. s fiat Bolus The third Intention is to restore the part to its former health and this is to be performed by evacuating the Blood and other compacted Humours from the part affected and therein concluded And since I have given you the general and particular Method of curing a Gangrene in general I shall still illustrate it with some examples It being a thing of great import as touching the Life and Limb of many a Man And for brevities sake because I do not desire to swell up my book with Tautologies or commit to your reading here any thing you shall elswhere find parallel I will present you with a History of a vertuous maiden Gentlewoman in Norfflolk near Norwich who after a long and tedious Sickness had a very large and great Inflammation seized her Foot the which very speedily spread her Legg and got upwards into her Thigh with a great Discoloration Pain Heat and Fever accompanying My never to be too much esteemed Uncle being sent for to this Lady could not go to her I being by Sir Thomas Brown's order sent for and finding all these already written symptoms upon her consulted with my self and reason what might be the most safe way to quit her from the ensuing danger she without speedy help might fall into with this Method and Almighty assistance I got her loosed from her fears and perplexities which threatned a Gangrene I first anointed her parts affected with this mixture â„ž Ol. Rosar Aueth Chamomel aâ— â„¥ ij Acet Acerâ—iâ—n â„¥ i. misce and having finished this Embrocation I applied to all the inflamed parts this Cataplasm â„ž farin Fabar. lbss farin Hord. Lupinor an â„¥ iij. pulv Rosar rubr â„¥ i. pulv fl Chamomel Melilot Sambuc an Ê’i farin sem Fenugraec â„¥ iij. Croc. Ê’i Bol. armen â„¥ ij Corn. Cerv. ust â„¥ ss Camphor Ê’iss pulv herb Rut. Scord. Absynth Scabios Virg. aur Agrimon Veronican â„¥ iss pulverisentur omnia misceantur cum Vin. Aqu. fontan an q. s his addendo Acet Rosat â„¥ ij coquantur ad Cataplasmatis formam fine addendo ol Rosar Aneth Chamomel an â„¥ ij By the application of this Cataplasm within three or four daies the enemy began to take his leave of her I continued every day anointing and applying this Cataplasm to her After this upon the back part of her Foot a new flux of Humours began to make their incursion and there they made two Ulcers in which were contained a great quantity of thick cold indigested Matter lying very deep and there spreading it self much resembling a Coar or Eschar for the removing and taking away of which I ordered this Fomentation with which the whole Foot was fomented eight or ten times one after another for three Weeks or a Month together â„ž fol. Rut. Scord. Absynth Veronic Meliss Betonic Salv. Hyperic an M. i. Tormentill Chamaedr Virg. aur Laur. Rorismar an
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
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
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
make and this requires two scopes to remove the compacted matter and that we take away the cause hereof We have already discoursed of Repulsion we more properly in this place and time speak of Digestion or Discussion This Digestion is an Evacuation of a thin matter gathered in a part by insensible Evaporation procured by the natural heat encreased by proportionate Medicines And this is said to be performed four waies for first the Humour is to be made thin then resolved into a Vapour afterwards drawn from the Center to the Circumference and lastly expelled or thrown forth by the pores of the Skin and these therefore do show that the proper Medicine to be here used is to be a Digestive a Medicine hot and dry in the third degree and of thin parts Of these Digestives some are mild some strong some simple others compound Of the simples are Dill Rue Chamomile Ammoniacum Galbanum white Lillies Lupines Fenugreek and the like Such as are stronger are Time Origanum Mint Pennyroial Hyssop and the like Of the strongest sort are Sulphur vivum and Chalk c. Of the compounds â„ž Malv Dialth Absynth Lilior Albor. an M. i. coquantur in aqu fontin q. s colaturae adde Pulv. Rosar Rubr. Ê’ij Pulv. Absynth Puleg Fl. Chamomel Melilot an Ê’ij farin fabar Lupinar Hord. an â„¥ iss cum ol Chamomel â„¥ iij. misce fiat Cataplasma Ever observing this that according to the strength Age Temper and Constitution of your Patient you endeavour to regulate and order your Medicines If the former will not serve you may make use of this Empl. â„ž Farin Fabar. â„¥ i. Farin sem lin Ê’ij Empl. de mucilaginib â„¥ i. Melilot â„¥ ss Pulv. Sem. Cumin Absynth a. Ê’i cum Ol. Chamomel q. s fiat Empl. Or this â„ž Fol. Mal. Alth. Violar an M. i. Rad. Alth. Irid. Lilior Alb. an â„¥ ss fl melilot Chamomel Aneth an p. i. Cumin â„¥ i. Bacc. Laur. Ê’ij Croc. ℈ i. cum Adipe Anatis Anserini Butyri recentis ol Lilior an â„¥ i. M. fiat Catapl Or this of Aquapendens â„ž Myrtillor Lactuc Solan a. M. i. Puleg Calamenth Hissop an M. ss coctis in aqua contusis adde Farin Faenugraec â„¥ iij. Pul. Betonic Chamomel an â„¥ i. ol Anethi Chamomeli a. â„¥ iij. cum decocto praedicto fiat Cataplasma CHAP. XI Of a Tumour in its State THEN is it properly said to be in its State when it can reach to no higher degree the beginning of this State doth carry with it some rellish of the Augment and here therefore are Anodynes and Digestives proper being equally mixed In its middle you are to mix more of the Digestives and at last to use Digestives altogether It is in this state that the matter is very near digested and converted into Pus And these have sharp Symptoms attend them for while this pus is making there are Fever and pain as two inseparable companions that go along with it these in its declination taking their leave with the Tumour And this we are to observe that when nature digesteth we ought to help her forward in her designs But a Tumour is very oft times seen to terminate into many other diseases and herein we are to consider the Pulsation if it hath been long if pain be not diminished when the heat endures then is its transition to be expected and where any one of these are it is an evident sign there is matter at hand against which we must be prepared and so mind the symptoms as Pain Tension Hardness Heat for these are toublesome companions and then are we to assist nature in the discharge hereof taking away their causes which is to be performed by Medicines as this or the like â„ž Ol. Chamomel Rosar a. â„¥ iij. farin fabar pul fl Chamomel an â„¥ ij Hyssop â„¥ iss Sapae dulcissim â„¥ 10. misce fiat unguent Or this Catapl â„ž Lapath Parictar Chamomel Melilot an Mâ—ss Rosar Rubr. pug i. fl Melilot Chamomel an p. i. farin Hâ—rd pug iij. cum s q. aquae fontinae fiat Catapl Or this â„ž Fl. Chamomel Melilot an pug ij Herb. Chamomel M. i. Coquantur omnia cum Radic Lilior Albor. â„¥ iiij simul contusis adde farin faenugraec â„¥ ij ol Aneth Chamomel an â„¥ ij Vini albi q. s fiat Catapl CHAP. XII Of a Tumour in its Declination WHEN all the former Symptoms do abate and cease then we generally hold we have arrived at the Termination and here according to Gal. cap. 1. lib. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 we are to use purely Digestives or Discussives and these are to be so much the stronger the declination of the inflammation being in its progress And in this part these two Cataplasms are very proper â„ž Hyssop Origan an M. i. coquantur in vino albo simul contusis adde Ol. Lilior Albor. â„¥ iiij Pulv. Puleg Absinth an â„¥ ss Farin Faenugraec â„¥ iss misce fiat Cataplasma Or this â„ž Alth. Malv an M. i. fl Chamomel Melilot Rosar Rubr. an pug i. Rad. Lilior Alth. an â„¥ i. Sem. Lin. faenugraec an â„¥ ss Ficuum pingu no. 10. furfur farin hord tritic an pug ij contusa coquantur in aqua ad mellis crassitudinem fine addendo ol Chamomel Axung Porcin an â„¥ iss misce fiat Catapl CHAP. XIII Of a Tumour tending to Suppuration THE true waies and methods of curing Tumours we have already shown but it oft times doth happen that a Tumour doth tend to suppuration that is the influxed Blood is converted into pus or matter whence doth arise another method of curing And here Galen doth propose two waies which are performed either by Digestion or Concoction but the first is the best for these two things follow concoction two much generation of this matter and an Abscess made hereof into another place In respect of its generation its long in curing in respect of the Abscess the Inflammation oft times doth run it self into another disease as oft times into a Gangrene as Jubertus observed in the wife of Rondeletius As touching the efficient cause of Purity or Matter Gal. offereth lib. de inaequ intemper cap. 3. that in an inflamed part there is found both a native and an extraneous heat the first preserving the part and doth administer such things to it as belong to its health and welfare the other Extraneous ariseth from the influxed Blood prolapsed out of the vessels and there putrifying this being contrary to the former and so doth destroy and pull down or extinguish the natural heat The first matter is thick laudable white equal well tasted but if the other prevail it appears livid red or black thin inequal grumous The Tumour offers it as a sign of its tending to suppuration by its intenseness and when the inflammation is great and the pain vehement and doth daily encrease and when pulsation joins with
this Tension and this be large when these signs are at hand use neither repelling Medicines nor Digestives but use your greatest care to assist nature in her progress of suppuration by maturating Medicines that is to prepare the matter and make it fit for expulsion and then to discharge it when we have thus prepared it And that therefore we may procure the Tumour for this suppuration and produce a good and laudable matter we are to encrease this Quantity of native heat by such Medicines as are of a digesting faculty the which ought to be of the native heat with the part These are to be applied from the beginning of the Augment to the end of the vigour Some of these are simple as Marshmallows â—iggs Chamomile Galbanum Bdellium Ammoniacum Hogs lard Goose grease and the like Of the compound may be reckoned Empl. Diachylon cum gummi de Mucilag Flos Vnguentorum or some of these Emplasters or Cataplasms Of which for this use these may be applied very properly â„ž Empl. Diachyl cum gum â„¥ i. De Mucilag Paracâ—ls an â„¥ ss Basilicon Ê’i Croc. ℈ i. cum Vitâ—l Ovor. no. i. misce fiat Empl. Or. â„ž Bdell Ammoniac an â„¥ ss Solventur in Lixivio claro adde Calc viv cum Axung contrit Ê’i Sulphur viv Ê’ss Alumin â„¥ ss mel Opt. â„¥ iss ferment veter Ê’ij misce â„ž Rad. Lilior â„¥ i. Alth. cum Rad. Malv an M. ss fl Chamomel Melilot an pug i. Ficuum pag. iij. sem lin faenugraec an Ê’iij fiat decoctum in vino albo q. s colaturae adde Vitâ—ll Ovor. no. ij Croc. ℈ ss Ol. Cham. Melilot an â„¥ ij misce fiat Cataplasma Or. â„ž Rad. fol. Alth. Malv an M. i. Coquantur pistâ—â—tur ut artis est quibus adde â—arin Tritic. â„¥ ij farin sem Lin. â—eâ—â—graec an â„¥ i. Butyr recent â—l Liliâ—râ— alb Vnguent Dialth an â„¥ iss Croc. Ê’ss vitell ovor no. ij misce fiat Catapl The matter by these orany of these or the like being brought to Suppuration this is to be discharged and this generally is to be performed by Incision or Caustick And before we attempt either of these we are well to understand whether it be ripe enough and this you may thus find out The Tumour at this time seeming by contracting it self to appear less than it was in its state then it draweth it self to a point its hardness is much abated and therefore discussed and by touching it with the finger we find it Fluctuatous the heat and pain ceaseth the part is changed in its colour the Cuticula is shriveled all these being good signs of its Suppuration This not being all drawn out you are to arm your Tents or Pledgets with this or the like â„ž Terebinth Venet. â„¥ i. Mell. Ê’ij succ Ap. â„¥ ss Farin Fabar. Ê’v misce fiat Linimentum After the Application of which apply Diachylon cum gummi or Empl. de Mucilaginibus All these being discharged and the Orifice being well mundified and deterged your next business is by the helps of Sarcoticks to fill up with flesh as Vnguent Basilicon Aureum and the like and then with Epouloticks to induce a Cicatrice as with Vnguent Diapompholigos Desiccativum Rubrum Sanativum or Diapalma And thus have I run through the four times of a Tumour and because a Phlegmon doth bear the greatest share in these four times and orderings I shall be much briefer in its discourse and so proceed CHAP. XIV Of a Phlegmon or Inflammation in General IT is by all Authors granted that a Phlegmon hath its four times and that out of Blood besides this doth arise several other Tumours as a Carbuncle Gangrene Sphacelus Pernio Phyma Phygethlon and several others And here let us first inquire what a Phlegmon is and whence derived It taketh its name 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifieth to inflame This is an Intemperiety not only of the simple but also of the Organick parts as Galen observeth in 13. Meth. Our latter Writers do make two distinctions about the material cause hereof the Blood being either natural or not natural the natural furnished with these conditions being of the same Blood with that which cometh from the Sanguinary mass having in it the four Humours and these Qualities as being hot in action and moist in consistence in colour red in taste sweet the unnatural being denied of these good Qualities and also devested and deprived hereof Thus out of pure and benign Blood ariseth an exquisite Phelgmon if this Tumour hath any other humours annexed or joined to it it occasioneth a various species of Inflammation as having Choller admixed it maketh Phlegmon Erysipelatodes if Flegm Phlegmon Oedematodes if melancholy Phlegmon Scirrhodes Besides these also other accidents belong to Inflammation for if an inflammation doth get into the membranes of the brain it maketh Phrenitis when it creepeth into the Tunica conjunctiva there it frameth Opthalmia when into the Fauces Angina into the Pleura Pleuritis and so into the Emunctuories Bubo Its causes may arise either inwards or outwards Inward causes are Plethory or plenty of Blood and this not having its free passage must necessarily inflame and putrify inflamed heat in the Sanguinary masse and this oft times doth exalt it self into Fevers the part hot and painful doth draw the Blood and this maketh up the Inflammation Outward causes may be said to be Aires which do inculcate and shut in this putrid matter Attrition Attraction solution of Continuity or Luxation these or any of these causing pain and so Inflammation As to the signs when you perceive a Tumour is soon made and doth soon encrease you may properly judge this an Inflammation when the patient doth perceive a great heat and burning arising from this heat the colour of the part Florid and Red occasioned by heat and thinness of parts pain great and a pulsation joined to this pain by reason of its hot intemperiety when any part extendeth it self upon compression aggravation and vellication of the nervous parts and the veins evidently appear which before lay hid when Tension is made by reason of the constipated matter all these are sufficient signs which may pretend to paint out Inflammation I shall follow Guido's method in the cure of Inflammations as first by removing the cause then come to the Inflammation it self and so to the discharging of the peccant matter And for this he propounds four methods according to the four times and whereas a Phlegmon hath a Beginning while the Blood is nowing an Augment when in its Flux it is made hotter a State when it is converted into Pus or Matter and a Declination when the Inflammation is digested resolved and the Tumour diminished So also the four Intentions shall be these first in having a respect to the order of diet secondly to hinder the Flux of Humours thirdly to discharge the Matter and then lastly to correct
times doth happen and arise from a weakness of the Kidneyes which are not strong enough to attract this plenty of Serum or may be occasioned by drinking too much Wine for as Galen saith this waterish Humour is the excrement of potion You may know it by its Splendor and Fluctuation if you press it with your Finger and a particular Sign of a waterish Tumour is that it is made with itching occasioned by the saltness which is contained in the Humour Such as cometh from an evil affect either of Liver or Spleen is very bad and dangerous not because of the Tumours but in respect of the principal parts yet they are not so dangerous as windy Tumours The Cure is to be performed by ablating the Causes and if this do arise from two much drinking order your Patient to lessen his quantity and abstain from this course and habit of living and use Driers and if it happeneth from a vice either of the Liver or Kidneyes this is to be corrected Hydragogicks are most proper here as â„ž extr Elater gr iij. Cambog Resin Jallap an gr v. faecul Rad. Irid. gr ii Ol. Macer gutt ij misce fiant pillulae quarum sumat 2 omne mane Or â„ž extr Rud. Ê’ ss Resin Scammon ℈ ss ol Nuc. mosch gutt ij misce sumat cum Custodia â„ž Resin Jalap Scammon an gr vj. Mercur. dulc ℈ ss pulv Jalap gr vj. cum syrup Rosar solutivar q. s fiant pillulae addendo ol Caru Ch. gut ij misce Or these â„ž Troch Alkakeng Ê’ss spec aromatic Rosat Diagalang an ℈ i. Philon. Roman ℈ ss pil de succin ℈ ss Terebinth venet in aquae vitae solut q. s fiant pil quarum sumat 2 or Ê’ omni mane Or this Condite â„ž Cons Absynth Menth. an â„¥ i. Cort. Citr condit â„¥ iss spec Diacalaminth Ê’ij sal Sambuc Ê’i spirit Nitr ℈ ss ol Cinomon gutt v. Macer gutt 10. misce fiat Conditum As touching Topicks the Humour is to be discharged by Digestives and here we ought to rarify the skin that it may with ease come forth and for this purpose this Cataplasm is very good and proper â„ž fol. Malv M.i. farin Lupinor â„¥ i. ol Aneth Chamomel an â„¥ ij coquantur contundantur in Vino albo fiat Cataplasma Or if you be for a stronger you may use this Unguent â„ž sem Sinap sem Vrtic Sulphur Spum mar Aristoloch rotund Bdell an â„¥ i. Ammoniac ol Aneth Cerae an â„¥ ij misce fiat Vnguent Or this â„ž Sal. Nitr Ê’10 Piper bacc Laur. an â„¥ i. ol Laurin â„¥ vi Cer. q. s fiat Vnguent If with these they are not cured they are to be opened and the Ulcers to be mundified with Resine Turpentine and Honey or Vnguentum ex Apio c. then is it to be impleted with Flesh with Vnguentum Tuthiae and dry it up with Pulvis Tuthiae Desiccativum Rubrum Diapompholigos or Diapalma Fabritius Hildanus relateth of a man of thirty years of age very strong and of a sanguine complexion who fell into a Leucophlegmatia that he swelled from the neck to his foot his Optick nerves being obstructed hereby he grew blind Upon ordering the Patient opening Apozemes and giving him preparative Decoctions a great Flux of Blood fell accidently from his Nostrils so that he bled above four pounds and hereby fell into a Syncope but being a little revived after his Flux was stopped and his Faculties beginning to gain a better habit and condition beyond the use of any Medicine this flux perfectly cured him of his waterish Tumour This is occasioned as the Greeks do call it 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from an aluminous salt of the Liver or some other principal part the which by its subtile penetrating quality doth force it self into diverse parts of the body CHAP. XXIV Of Windy Tumours UNTO this windy Commander do belong these several Souldiers as Pneumatocele Tympanites Priapismus Satyriasis and the like This Wind doth carry in it a very strange and wonderful power and force in our bodies and is as it were a certain Lightning scattered through the insensible Trunks insinuating it self into abstruse parts for it reacheth the Bones and doth create very great trouble in our Joints it bringeth greifs between skin and bones and doth ruffle and disorder the whole Man for where it is compact with any other Humours it doth there make both a long stay and doth stir up but many sad Symptoms This sheweth what Wind is whereof are bred these Tumours Let us now see what these Tumours are A slatulent Tumour by the Greeks is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and he that is afflicted with these is oft times girded in his Sides and stretches in his Belly It is oft times caused of Crudities and because it maketh the part thick by reason of the grosness of these Flations it doth oft times make troublesome and tedious work for the Chirurgion Its causes are flatulent Spirits viscid or vitreous Flegm and want of native Heat thus the heat is but small which doth work it self into these Humours and so doth somewhat dissolve them and so doth arise this flatuous Spirit and this being bred doth elevate the part where it once getteth footing because it cannot work its free passage by reason of the density of its parts It is seen to arise in several parts of the Body as well inwards as outwards Here is held by Avicen a double kind of this windy Tumour the one being made by a light Vapour assimulated to Althegeâ—â—um the which is nothing else than a Tumefaction like to a Cachexy this arising from the disaffection of the Liver and there is another Tumour arising from a windy Vapour and this by Avicen is called Inslatio This is bred from Flegm coming from the larger Vessels to the smaller until it hath arrived at the smallest and at the coldest parts It showeth it self apparent in compressing the Tumour with the Finger and you may then see it easily yeild to the touch as doth an Oedema Then upon this compression it maketh a noise for Wind being kept in and being by your Finger prest out from its quarters this never parts from its place without a noise or sound Thirdly it is deteined in a cavity Fourthly as Guido doth offer it appeareth lucid and splendid in its upper part Fifthly it is not alwaies free from pain And lastly being contained in the larger Vessels we daily find the great and many troubles and vexations it brings to mankind As touching the Cure pray observe with me this method wherein we are to observe an Order Mode Time and Substance Order this cheifly consisting in Diet. As touching the Patient's times or eating and drinking that he neither eat too soon or too late between meals or after supper going to Bed and the like or in his bed Mode that he neither eateth more
his rest by perplexing him more in the Night than in the Day These Tumours are hard bred from a hard Flegmatick thick and viscid Flegm which are not to be discussed but by hot Medicines and such as have a Faculty of making the Nerves spit forth this Matter contained in them these carrying with them an Emollient and lenifying quality and hence may you confidently make use of such Medicines here as I have set you down in my Tract of a Scirrhus adding thereto Argentum vivum Empl. de Ranis cum Merc. is very proper here also In the whole time your Patient lyes under your hands take care that he be ordered a sober Lie shunning Venery as the greatest enemy imaginable It proves much better if it have not touched the Bone than if it had but suppose it should get thither and foul it this is to be Scaled either by actual or potential Cautery the which being removed apply such convenient Sarcotick drying Medicines as may produce a new Skin over this And for this affect Powder of Myrrh Aloes Ireos Euphorbium Gentian Aristolochia rotunda and the like are proper I have seen these very frequent in St. Thomas Hospital in Southwarke and sometimes here in Norwich where I have met with the Signs very exact painting out Pains and Aches and nocturnal vexations as continually as the Day leaves it self to be shut up by the Clouds of the Night CHAP. LXX Of Tumours and Apostems of the Knee AFter long and difficult Diseases Tumours are oft seen to breed in the Knees and by how much the longer they are in breeding by so much the longer expect will be the getting of them extirpated They bring sharp and bitter pains with them because these Humours are crept into very sensible parts as Membranes the which do both distend and rack them The Cure hereof is difficult because this Humour is seldom seen bred but in Cacochymick Bodies and such as are of an evil habit of body and then because the part affected is cold and weak being far from the Fountain of Heat Sometimes it is made by Flatuencies crude and serous Humours the which do flow and mix themselves betwixt the nervous parts and Membranes As to the Cure if it proceed from Blood order a thin and cold Diet and for Revulsion Venesection is good and here observe your 4 times in its Cure But if it cometh from a waterish Matter the Body is to be purged by Phlegmagogicks and for your Topicks apply such Medicines as have in them an incisive attenuating rarifying and a powerfully drying quality as these â„ž Farin Orob Hord. Lent Lol. an â„¥ j. furfur â„¥ ss fl Chamomel Melilot Sambucin summitat Absynth Scabios Veronic an pug Stercor Caprin lbss Sapae â„¥ ij ol Rut. Chamomel Aneth an â„¥ iss coquantur in Lixivio vel in aqua Absynth composit cui addere possis Oximelit Scillitic q. s fiat Cataplasma For this Affect this Emplaster is also held to be good Ê’ Diachylon cum Gummi Paracels an â„¥ ss Oxicroc Ê’ij Melilot â„¥ ss Empl. de Ran. cum vel sine Merc. Ê’iij misce fiat Emplastrum A Maid of 18 years of age falling on the Ground hurt her Knee out of which did arise a large Inâ—lammation accompanied with many pains by applying Empl. ex Argilla Bol. Armen Bran the White of an Egge and a little Vinegar the pain somewhat abated and the Inflammation grew remiss About the Rotula a very large Tumour did arise which was also very hard in so much that without great pain to the Patient it was not to be contracted Hence was collected that there was Matter gathered about the Rotula and a very large Tumour did arise which was also very hard in so much that without great pain to the Patient it was not to be contracted And for the Cure hereof this Method was used that the Blood and Humours might be lessened and their Afflux to the part affected prohibited a drying and thin Diet was prescribed and the Patient afterwards thus purged â„ž Herb. flor Betonic Scabios Cuscuth Agrimon Veronic an M. ss sem Anis Ê’j fiat Decoctum in s q. aquae fontanae in â„¥ iiij solve Diacatholic Ê’vj Electuar e succ Rosar Ê’ij misce fiat Potio After this a Vein was breathed in the Arm out of which was drawn 10 Ounces of Blood then was prescribed a purging Apozem made of opening Roots Agrimony Veronica Majoram Rosemary and the like being made into a Cataplasm was afterwards applied to her Knee then was applied this Cataplasm â„ž Farinae Hord. farinae Fabar. an â„¥ iiij pulv Rosar rub Bacc. Laur. Myrtillor an â„¥ j. pulv fl Chamomel Melilot Sambuc Inae Arthritic an â„¥ ss fim Caprin â„¥ ij cum vino rubro q. s fiat Cataplasma fine addendo Sapae â„¥ iiij apply it warm twice in a day This was used for 3 weeks and the Apozem prescribed and taken and by these and a good order of Diet the pain ceased and the whole Tumefication vanished But in the lower part of the Rotula there was perceived a manifest Hardness for the emolliating of which all care was taken but in vain at length was applied a potential Cautery to this lower part the breadth of the Tendon then was the Eschar removed by this Liniment â„ž Vnguent Basilicon Butyr recent sine Sal. an â„¥ j. ol Amygdal dulc de vitell Ovor an â„¥ ss ol Rosar â„¥ j. misce fiat Vnguentum fine addendo vitell Ovor. no. j. Croc. ℈ ss This being removed there was found a thick viscid Matter lodging in the lower part of the Rotula and by applying of Pulvis Aluminis usti cum pauxillo Praecipitati taking great care that the Tendon might come by no injury or detriment the Ulcer was mundified and afterwards was induced a perfect Cicatrice and by these means the Patient perfectly recovered CHAP. LXXI Of an Abscess of the Foot THe Foot as well as the Hand is troubled and perplexed with viscous and strumatous Tumours oft times planting themselves in the Joynts sometimes making the Bones bare and foul The onely way to cure this Evil is to discharge the Matter by Resolution and if possible not to open it At the end of the Toe there oft times falleth a sharp pain arising without any manifest cause not without some inward occult Malignity without Tumour or Redness depriving it of sense or motion and hence oft times the end of the Foot being destitute of its native heat and colour is affected with a Lividness and Blackness and in process of time does terminate into a Gangrene and Sphacelus this more frequently happening more in aged people than in youth because as the parts themselves are a great way from the Fountain of Heat so also are aged people less capable to help towards the producing of this Heat into those parts and therefore in such cases let it be your first Intention to apply warm and