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
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
part affected was applied Emplastrum de Cicuta and this Clyster was administred â„ž Rad. Alth. cum Tot. fol. Violar Malv Parietar Mercurial an M. j. fl Chamomel Melilot an M. iss coquantur in aqua s q. ad tertiae partis consumptionem in j. colaturae solve Benedict Laxativ â„¥ j. Mel. Mercurial â„¥ ij ol commun Ê’iij Sal. pug j. misce fiat Enema The next day was ordered this Apozeme for digesting of this Melancholy Humour â„ž Herb. Lapath acut Rad. Polypod Q. Petroselin an â„¥ j. Herb. Agrimon Veronic Cuscuth Fumoterr summitat Lupul a. M. j. fl 3 Cordial an pug j. Liquirit Vvar passar Rhaharb Rapontic an â„¥ j. sem Faenicul Anis an â„¥ ss coquantur in aqua fontana s q. ad tertiae partis consumptionem hujus colaturae accipe j. syrup de Fumoterr Epithym an â„¥ ij Aqu. Cinamom â„¥ iss misce fiat Apozema pro tribus dosibus to be taken for three mornings Afterwards was prescribed this Purging Potion â„ž Decoct praescript â„¥ viij in quibus infundantur macerentur Rhabarb optim Ê’ij Senn. mundat â„¥ j. in dimidia parte hujus Decocti solve Diaturbith cum Rhabarb Ê’j syrup Rosar Solutivar â„¥ j. misce fiat Potio Empl. de Cicuta was every day renewed and afterwards he took this Purge â„ž Confect Hamech Ê’iss Extr. Cort. Esul ℈ ss aqu Cinamom â„¥ ss misce fiat Potio After this the Tumour began to lessen and then was applied this Emplaster â„ž Empl. Diapalm â„¥ ij pulv Mastich Rosar rubr Myrtilor Radic Symphyt major an Ê’j cum q. s ol Rosar fiat Emplastrum After this he applied a small Knot oft times doubled and this was joyned to the Ligature and this was for repressing the Tumour and for dilating or throwing out of the coagulated Blood and by these Remedies and by Gods blessing he perfectly recovered the use of his Arm. CHAP. LXVIII Of a Paronychia and Pterygion IT s place and seat is generally at the Fingers ends here it fixeth it self and from hence does it send forth its pains It s Figure is longish somewhat Oval It is a Preternatural Tumour apostemated small and scarce perceivable beginning at the Fingers ends arising from a hot venenate and nitrous Blood and oft times places it self between the Bone and the Periostium At its first appearance it is mild and gentle but afterwards grows fierce and troublesom causing pains Fevers sometimes a Caries and Putrefaction of the Bones It 's called Paronychia because it is a Distemper 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 marching to the roots of the Nails Fabritius de Aqua Pendente maketh no difference between Paronychia and Pterygion Pterygion is a Hyposarcosis or Excrescence of the Skin and this does not immediately reach the Nail Aeginetta cap. 81. lib. 3. shews the difference where he calls Panaritium an Abscess fixing it self about the roots of the Nail Pterygion to be an Increment of Flesh spreading out of another part of the Nail The Blood of its nature is hot here being kept in and denied a Difflation Redness arising from this great Heat Pain from this Intemperancy and Solution of Continuity by this violent Matter distending and aggravating the nerveous tendonous and membranous parts These are sometimes said to be bred by an inward cause occasioned by a nitrous sharp cholerick venenate fervid and most thin Blood or Humour the which is infixed in the affected part External Causes may be Contusions after which followeth an Ecchymisis of Blood under the Cutis or between it and the tendonous parts or between the Bone and Periostium this Blood being putrefied large Inflammations increase and Pain and other Symptoms appear The Generation of this nitrous Blood is to be hindered and that it may not flow is to be intercepted and revelled and that which hath already flown is to be weakened by Repercussives or Suppuratives but of these in their order Revulsive Medicines are such as are to be applied to the opposite part and these are hot and attracting amongst which may be reckoned Scarrification Friction Vesication and the like Interceptives commonly called Defensatives have a Stiptick Faculty shutting the Mouths of the Vessels and by the Coldness and Stipticity they thicken coagulate and hinder the Flux of Blood Of either of these you may find various in my former Tracts Of Repellers these are Cold Moist and Restringent and do repell the inâ—â—uent Blood and hinder its coming to the part affected So long as you have any hopes of repelling an Humour follow this freely where this is not to be done come to the use of Suppuratives Take this one for all in this place most proper â„ž Pulv. rad Bismalv Consolid Major an â„¥ ss sem Lin. Foenugraec an Ê’iij Malv Alth. an mj Plantag Hyosciam an mss Vngul Rosar rubr mj Farin Hord. Lol. an â„¥ iss fl Melilot Chamomel au pug ij pulv Gallar Melicor an Ê’ij Bulliant simul in lacte vaccino vel aqua fontana Caepar Sub. cinerib coct â„¥ ss fine addendo Ol. Rosar Myrtin an â„¥ ss Lilior albor Chamomel an â„¥ i. Vitellor Ovor. nâ— Croc. ℈ ss misce fiat Cataplasma Fabritius Hildanus useth a decoction of Cows milk here wherein were boiled Mellilot flowers Chamomel flowers Quinch-seed and Lin-seed and so Fomented the part after which he opened the Skin the which being opened dropped one or two drops of a reddish thin Substance this being discharged he applies a little Venice Treacle which was dissolved in Aqua vitae and with this the pain soon vanished The Incision being made we are to Mundify the part with Mel rosarum unguentum ex Apio or Aegyptiacum For this use also Precipitate is very good Glandorp is fearful of using these sharp Medicines these being very subject to cause Pain and so he prescribeth Anodyne Mundifiers as Oyl of St. John's Wort affirming that this doth both Digest and Mundify the compact Matter lenify the Pains deterge and incarn Very oft a Caries of the Bone follows a Paronychia and here most drying Medicines are most proper as Falloppius his Powder â„ž Pulv. Rad. Peucedan Irid. an â„¥ i. Euphorb ℈ i. misce As curing a Pterygion Having already acquainted you that it is nothing else but a Hyposarcosis about the Nail and this sheweth its own Indication which is to ablate the superfluous Flesh and for this cause Vnguent Egyptiacum or Alumen ustum or Praecipitatum is excellent good Or this â„ž Vnguent Populeon Ê’iss Alumin ust Ê’ij misce Or this â„ž Vnguent Diapompholig Ê’ij Alum ust Ê’i or the like And thus much of those CHAP. LXIX Of Nodes of the Legs THese very often happen after a long continued venereal Disease the which do not shew themselves very speedily but in what plases so ever the lurk in they creat very great and Nocturnal Pains being and having in them a contrary quality to most of other Tumors to bereave the Patient of
may oft times see a suffused eie a hare lip a polypused nose in his neck and throat strumous and scrophulated tumours in his mouth and throat Cancers and Anginaes his shoulders distorted his muscles cut prickt or wounded his nerves contracted or lacerated his veins and arteries ancurismated and variced his bones luxated and fractured and the whole sometimes gangrenated and sphacelated his hands the proper Instruments of his livelihood corrupted with Chiragra and other Tumours his wrist dislocated his very singers ends terrified with Parony chiaes and Hypersarcocal excrescencies May we not oft times see the brests that first give us suck or nutriment suffer the torments and unhappy assailing unruly disquiet of Cancers Strumaes Worms Stones Clefts and the like Is not the Penis the proper instrument of generation accompanied with Phymosis beset with Ulcers Caruncles venereous and malign ulcers whilst sometimes it is seen to have an imperforated Glans The Scrotum is very oft times seen loaded with pains and troubles tumesied by Ruptures and made capable of inflammation and gangtene the Hips greived with Scyaticks and running pains pestered with venereal aches and dislocations the muscles of the thigh oft wounded tumesied inflamed lacerated ulcerated and abscessed as well as its bone fractured the knee swel'd with oedematous Tumours the leg shortned by amputation occasioned inwardly by a desluxion of humours or outwardly by some external causes causing gangrene Sphacelus or the like Do not they and the foot also by joint consent take share of hydropical tumours scorbutick ulcers gouts and other pains and when we have well considered these may we not own with Job man hath not a part free from distemperiety In its constancy and firmness it is to be preferred before any other Art under the Sun for as it came soon after him into the world so it never leaves him to his dying minuit nay it continues longer for he being dead it serves to help his succeeding generation The truth of this daily experience makes good for although our life be but vita brevis yet our art is Ars Longa and although it may be subject to change yet this is to be better born with being like man with whom it is concerned but this is more constant life is no life without health and is not this our daily friend afforded us by our wise Creator for promoting and perfecting the same It is by this Art of healing we have our daies lengthned by cutting off distempers eradicating their causes and extripating their effects and indeed what is health else than the keeping of the whole body perfect and intire And this may then most properly be said so to be when all its actions are freed from the chains of impediments and pains for this great happiness of health is onely that affection of the body which from the first do make every of its actions answer its nature This made Democritus write that he would have every man study the Art of healing because as it is honest so also it is profitable and useful for life Which brings me to the next branch of it which showeth its fruit necessity and profit This is a feild very large considering either its order condition age or sex wanting no fruit it is this alone that produceth health by divine permission a more excellent thing than which this great world cannot boast of to live is to be buried alive without it No man therefore ought to be held in a greater estimate in a Common weal than he that keeps the people thereof in health This made â—â—omer the Prince of the great Poets prefer one Physician well furnished with vertues and knowledg in his Art before many of other men It is here alone guided by nature that can see distempers and snatch them out before they take root discharge such as are adherent destroy them in the bud hinder them in their growth repress their vehemency mitigate their pains extinguish their fervour that can restore the semiputrid to health recreate the afflicted refresh the troubled strengthen the languishing and bring the half dead to a whole life But should these fail yet we have this to defend us before the great Doctor of our Souls if to the utmost of our endeavous and judgments and these strengthened by care and study we use and apply the best of medicines our best knowledg can guide us to we have discharged our parts and let us leave the success to that God who can work beyond the waies of man whose secrets are past finding out And this part I will conclude with this maxim That this Art is by so much the more excellent and to be had in esteem by how much it is necessary useful and profitable Of its liberality and Charity our great Master hath left a lively example who had no respect to persons when he went and exercised this Art of healing And although in Kings and Potentates it may receive Princely rewards and amongst Lords and Knights fair gratuities yet also must it be furnished with the graces of Charity and Humility thinking no scorn to help the meanest this being its rule Quod tibi fieri non vis alteri ne feceris it being a maxim in natural Morality as well as Philosophy And as Riches may spur-on to honour and both to the obtaining of fame and credit so let charity and conscience command your diligence and care in the managing the same for the poor for they are Gods creatures framed in the same mold and although they be not furnished with the same plenty of outward gifts yet may they ore top the rich Miser or covetous Churle in vertues and other excellencies And let this be your comfort that the great Pay-master who keeps in his Register-book all thy good actions will not be wanting to add store to your stock knowledg to your Art success to your practice and crown your cures with credit and when death his Bayliff shall with his Habeas Corpus summon thee to the great Audit of the world the Angels will Joy in thy happiness and eternal bliss will Crown thee hereafter Thus have I given you an account of the Antiquity and Origination of Chirurgery its honour and excellency its learning and nobility its subject its constancy and firmness its fruit necessity and profit its liberality and charity We come next to know what Chirurgery is and of what parts it depends That we may arrive at the essential knowledg of Chirurgery we ought first to consider what it is what is its subject matter for what end it was made and ordered and what order ought to be kept in it As to the first Cornelius Celsus calls that Chirurgery which cures by the hand being the most evident part of Physick to which is adjoined both Diet and Pharmacy Or if you please it is a branch of the Curative part of Medicine which teacheth how to restore health by manual operation and medicine Ambrose Parry telleth
have already writ of Tumours from whence we shall derive this method in our beginning of Tumours first acquainting you with the name of a Tumour then its essence and causes then its difference and symptomes its signs and presages and after these its universal cures both as touching general and particular Tumours Of each of these in their Order CHAP. II. Of the name of a Tumour IT hath its name from the Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifies inflammation or extutuberance and hence by Celsus and Avicen a Tumour is said to signifie a preternatural extuberance and by Galen is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Tumor praeter naturam by the Asiaticks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 as it were a condensed or conglobated matter by the Arabians Apostema which by the Greeks signifieth an Abscess which is a substance converted into Pus or as Aqua pendens calls it an eminency of the body this I call a preternatural disease in which some parts of the body are indecently extended being hereby unfit for performance of their proper action Hippocrates doth christen all Tumours with the name of Oedema Galen appearing somewhat doubtful and incertain doth sometimes reckon this amongst diseases of the similar sometimes amongst the Organick parts Haliabbas is of his Opinion Guido defines an Aposteme a disaffection composed of three sorts of diseases aggregated into a bulk And Avicen thus expounds them ill complexion ill composition and a common solution of Continuity which is found in every Tumour Tagaultius after Guido defineth an Aposteme to be an Inflammation made in a member beyond its proper nature and form Falloppius holdeth a preternatural Tumour to be a Disease in magnitude and therefore simple and onely consistent in a great extention Fabritius de Aqua pendente offereth a preternatural Tumour for the most part to be a compound disease and taketh its denomination from that which hindereth action Read calls it sometimes a Disease sometimes holds it to be a light Affection for the most part incident to the Organick parts encreasing their quantity by superfluous humours Or if you please after all these you may take a preternatural Tumour to be a material Intemperiety dissolving the Union of the parts and sometimes hurting them in magnitude figure and sight CHAP. III. Of the Causes of Tumours A Tumour is said generally to have four causes attend it as a Material Efficient Formal and Final cause By Guido the first is called the conjunct cause The second when Nature frameth any part so weak as that it is not able and strong enough to keep the excrements of other parts out of its territory A third cause when any part of its substance is too rare or loose the fourth is a natural Humidity with exemplification of the part Another cause may be said to be the Site of the part for the upper parts are said to be less capable of receiving humours than the lower part Falloppins offereth six heads as so many Observations of Tumours The first when it begins to putrifie it spreds and extends it self speedily and suddenly groweth into a lump or masse Secondly there are Humours which â—ake Tumours and these are either 〈◊〉 or preternatural Thirdly when some parts change and remove themselves 〈◊〉 of their proper places into other 〈◊〉 strange places as you 〈◊〉 in Ruptâ—â—â—â— and Dissocations A fourth is such â—â—mours as are bred of waterish 〈◊〉 as Hernia Aquosa Ascitis and the like A fifth when vapours wind and the like either naturally or preternaturally do frame a Tumour And the sixth is that which maketh the body unnatural to it self as Sanies Excrements and the like But to bring this discourse of Falloppius to one head you may find six Humours generally in our bodies of which are generated these six Tumours as out of Blood Choller Flegm Melancholy Wind and Water Phlegmon Erysipelas Oedema Scirrhus Pneumatocele Hydrocele Besides these we have Insects and other Animals that very oft times are the occasions of Tumours as Falloppius once observed in a Maid who having a large Tumour about the Inguen the Chirurgion in his presence opening the same saw it filled with Worms Amongst the primary causes may well be reckoned Air for out of its Contagion ariseth many Tumours Secondly Contaction as a cold Stone may occasion a Tumour and for this Falloppius brings in another story of a Woman who sitting upon a cold stone was afflicted with a cold Tumour And a third may be solution of continuity and this proveth either occult or manifest thus after fractures we oft times find large Aposâ—emes to appear and what was the occasion of Luxation is very oft also the occasion of Tumours as too much contracting or binding of a part may occasion a Tumour as Gangrene biting of Beasts taking of offensive things inwardly these being sufficient matter for Humours to breed from If a Humour do suddenly excite a Tumour this is its evident cause and the cause hereof is either Congestion or Fluxion The one when bred carried in the part onely whilst the other maketh its further progress by Fluxion as Aqua pendens observeth And therefere as he adviseth we ought well to consider the part mit tant and the part recipient for the matter doth not move it self but is moved by some other as by the part mittant per 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and by the part recipient per 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The mittant part ought first to be strong and able to expel the supersluities as the attractive is made by the part recipient And this bringeth me to the inward causes and here sometimes the matter is hedged into one place so that it cannot make its exit Another may be its passage out of one place into another and this is properly called Fluxion a Fluendo from thus â—lowing and as intemperiety is the cause of pain or solution of Continuity so also is this intemperiety made either by outward or inward causes CHAP. IV. Of the Differencies of Tumours THE true Differencies of Tumours by Aqua pendens are generally taken from these two Fountains as from Humours and the depending parts and from these two do arise the cheif intentions in Tumours Falloppius doth offer seven things which belong to the Differencies of Tumours First a disease when it receiveth more or less Secondly the material cause hereof diversified and then are its Species and Differencies diverse Thirdly when the efficient cause when manifold doth draw many species to it The fourth is the Fountain of accidents which followeth the disease The fifth the time which is the cause of all the differencies of Tumours The sixth the subject of the Tumour And seventhly the motion of the disease for it is as its owner and moveth as he moveth Besides these are we to consider of the times of diseases for some are short some long some quick others slow and therefore are we well to
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
grow red to apply your other Medicines as for example â„ž Fob Absynth Scord. Rut. Angelic Hyperic Salv. Agrimon Veronic au M. j. Rosar Rubr. m. ss Scabios Menth. Meliss an p. ij coquantur omnia in Lixivio q. s colaturae adde Spirit vini lbj with this foment the part and then may you use such proper and mundifying Medicines as are most requisite as â„ž Vrguent Basilicon Buâ—â—r recent au â„¥ ss Ol. Amygdal Dulc. â„¥ j. Theriac Andromach â„¥ j. cum Vitel. Ovor. nov ij misce fiat Vnguent Or this â„ž Pulv. Mirrh Alo. Aristoloch Rot. Irid. Florentin Angelic an 3j Theriac solut in aqu vitae 3j cum mel q. s fiat unguent Or this â„ž Pulp Caricar â„¥ iiij Ferment act â„¥ j. Sinap 3iij Sal. gem torrefact â„¥ ss Sal. commun torrefact 3j Sapon moll Theriac an 3j Vitellor ovor no. iij. Ol. Lilior alb q. s fiat Cataplasma Or this Emplaster of Falloppius â„ž Pic. naval â„¥ j. Sal. nitr â„¥ ss Sem. Sinap 3ij Caepar Allior sub prunis coct an â„¥ iij. Assafaetid Sagapen an 3iij Stercor Columbin â„¥ iss Aristoloch rotund Dictam Cretens an 3j Ol. Lilior q. s fiat Empl. If all these fail apply live Pigeons opened to the part affected and if these do not answer expectation make a speedy address to the actual Cautery Another cause hereof is loosness of the passages the which unless they be stopped do make a Tumour as if an Humour do flow out of several parts of the body into one particular part unless this be altered it is very easily raised up into a Tumour if this happeneth with an Intemperiety we are to mix restringents with coolers as thus in Fluxes of the Head take this for a defensative â„ž Pulv. Rosar rubr Myrtillor Balaust Gallar Mastich Sang. Dracon Bol. Armen Oliband Santal omnium an 3j Ol. Rosar q. s Cer. alb parum Acet rosat â„¥ ss misce coquantur omnia ad aceti consumptionem his addere possis albumin Ovor. no. j. vel ij Or this â„ž Pulv. Santal omn. Sangu Dracon Bol. Armen Pic. Colophon an 3j his adde Empl. Diapalm â„¥ j. Acet 3j misce fiat Empl. And these are proper Medicines here and by Galen called strengthening as well as restringent Medicines because they strengthen by compression as Gal. 2. ad Glauc 14. And having thus passed over the general Indications arising from the matter of a Tumour and its curative scopes as Phlebotomy and Pharmacy we come now to treat of the four times of Tumours CHAP. IX Of the four times of a Tumour and first of its beginning THE knowledg of these times are very proper for our Diagnosis Prognosis and Cure They are four in number Beginning Augment State and Declination That time most properly called the Beginning when a part begins to tumefy thus if a Tumour be made in a recipient part Expulsion and Repercussion is the Intention and this Repercussion is nothing else but Illision and Impulsion of the Humour which floweth either from the whole body or some part thereof into the affected part This Repulsion is a double motion from the part hurt and from another part sending to this hurt part And here we are to advise that when members are loose and soft then are we to strengthen with Medicines of a contrary affect that is with such Medicines as are compact and dry Gal. 14. Meth. cap. 17. saith that pure cold things do repel as cold water and he there adds that others which are not cold yet are restringent as Mint Roses Wormwood and the like and these he saies do repel these for the most part are to be used in the beginnings of Tumours but not alwaies in every kind of Tumour For experience teacheth us that in Pestilential or Venereal Buboes if in the beginning we should apply repelling Medicines we should send the peccant matter to the heart In these six cases apply no Repellers in the beginning as if it be bred by a venenate matter and repelling here you soon do shut up the doors of life If the matter be critical yet this doth not alwaies deny Repulsion for in a violent Fever in which it happeneth that the matter doth send it self to the membranes of the brain in this critical case the Fluent matter is to be repelled lest otherwise the brain becometh inflamed And then when this Tumour happeneth either in a Cacochymick or Plethorick body When the matter sloweth to the emunctories we are not to repel as Galen adviseth 6. de Comp. per loc cap. 2. Then when the part into which this Tumour hath got footing groweth weak as Galen also hath it Meth. 13. cap. 7. And lastly when pain and exasperation of the part is present for then Anodynes are more proper as Galen citeth 6. de Comp. Medic. these I have formerly shown you in the differencies of Tumours but this being their more proper place to bring them into I have also here given you their brief repetition and in all other causes we may and ought to come to use Repellers in the beginning of Tumours Avicen speaking of repelling Medicines ordereth us not alwaies to use one sort or kind thereof but in cold cases to use hot Repellers and in hot cases to use cooling Repellers Now if pain ariseth in the beginning and draweth somewhat of Humour to it here are you to use mild Repellers these being of a sufficient capacity to lenify the parts being stirred up by pain Such are Lettuce Purslain Trifole Nightshade Endive Violets and Plantane these being endued with a waterish moisture do much better in this case than such which are two astringent And out of these may you frame many sorts of Medicines by adding thereto Oyl Water Vinegar and the like And of these may you make stronger or weaker Medicines as occasion may require as â„ž Malvar Parietar Plantag an M. j. coquantur in aqu fontin contusis adde farinae Fabarum Hor dei an â„¥ iss Pul. Rosar rubr â„¥ ss Ol. Chamomeli â„¥ iiij cum decocti praedicti q. s addendo fl Chamomel Melilot in pulv a Ê’j fiat Cataplasma tepide admovendum CHAP. X. Of a Tumour in its augment THE Augment of an Inflammation or Tumour as Gal. hath it cap. 4. lib. de Morb. Tempor is when the Influx hath ceased and the part affected Tumefies more than it did formerly And the reason hereof by Aquapendens is because the blood prolapsed out of the vessels doth necessarily grow hot and putrify whence the blood is poured out and converted into a Spirit Aâ—â—cen saith that the Augment is then most properly to be so called when the Tumour encreaseth so that it is extended We may know when Tumours have arrived at their Augment by their causes and Symptoms by comparing its times and therefore here our intention is two-fold for that some part hath already made its Flux and other part is still to
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
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
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
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
skin it Hildanus tels us of one who in an impure coition with a Strumpet had all his genital parts so dilated that a malign Vapour passed to the next immediate Veines and afterwards coursed through the greater to the Liver and so infected the whole mass of Blood hence were generated many crudities instead of Blood And as nature is alwaies careful to defend her noble parts and to vindicate them from blemish and injury she generally sends these Humours to the Ingâ—ens as to its Emunctâ—ories and here they breed these Tumours we call Buboes which were made of a hot and sanguinolent matter the which with ease came to suppuration others there be which being generated of could and thick Humours do require a longer time to suppur ate and a greater diligency to cure the Matter was sharp and malign and many Medicines being used both inwards and outwards with small success The Tumour appeared but small and was very hard and after having applied many attractive Cataplasms and Emplasters by the benefit of a Caustick it did break out of which for six or seven dayes space it did run near ten pound of Matter About the Rotator of the Thigh broke out several Abscesses out of which did also run such a great Quantity of Matter for some months that many thought him scarce curable but by care and convenient Medicines he recovered Schenkius relates of a noble man about 30. years of age who having recreated himself in Venereal embraces with a young noble woman being filled well both with wine and venery had soon after his fulness of pleasure an implacable pain about his Hips and in his left Groyn did grow a large and red Tumour the which after wards turned it self into an Ulcer to which applying Diachylon cum gummi and such like Medicines it was speedily brought to suppuration the which being opened a great quantity of Purulent Matter came out much like to that of Pultice his Spirits almost being exhausted he fell into a consumption accompanied with a Hectick and afterwards within a little while leaves the world with his pain I write this as a Caution to young Chirurgions that they do not supress such Venereal Buboes or leave any Venenate or Virulent matter to lodge in such Tumours or Abscesses they at last turning to Fistulaes if not bring a Consumption with them and so Death CHAP. LXIV Of a Pestilential Bubo THis Tumor by the Arabians is cal Althois It is a Tumour long and moveable in its Vigour sharp with a mucronated Turbination immoveable and deeply fixed in the Glandules in which the Brain exonerates it self into these Glandules somewhat of its venenate and pestiferous Matter as to those which are in the Throat and Ears the Heart to those which are under the Axillaries and the Liver to the Inguens It consisteth of a thick and viscid substance as a sharp Anthraxâ—ixing â—ixing an Eschar in the part Of these are two conjunct Causes the Efficient is strength and vivacity of the expulsive Faculty of these principal parts which expulsion is made by these to the Emunctuories The material Cause is corrupt Blood deprived of its proper Nature Effence and benign Quality and altogether altered and changed from its pristine Substance that it turneth an enemy to its nature And here ought we to enquire into the cause of this Corruption It is to be noted in an Inflammation and Erysipelas the fluent Blood is good because it is not expelled only aggravated in Quantity This is expelled in respect of its ill Quality Galen giveth this as a Cause as Corruption when that be received be of an evil juice they being of the worst Nutriment Another Cause is corruption of Air the which being attracted doth force it self into the Spirits and so corrupt the whole Mass of Blood we do own a Pestiferous Bubo to be an Inflammation of the Glandulous parts and here therefore we are to mind the whole colour of the Body For in a Pestiferous Bubo this is sometimes changed Another sign is a dry and black Tongue another is a thin and waterish Urine his Excrements very fetid because this putrid Heat doth corrupt them In a Pestiferous Flux there is oft times a Cholerick Flux adjoyned and the Excrements are of various colours frequent Vomiting and stinking Sweats a general Itch over all the Body pains of the Head oftimes Delirium great pain and griping in the Stomach by reason of the putrid Humours sent thither from the Guts then Syncope and at last Death In this case Death is generally to be presaged the disease being so potent and forcibly assailing the natural Fort that it cannot long hold out As to the Cure First cure his Air this being as a main Actor in this Tragedy and therefore sprinkle his room with Vinegar or burnt Tarr c. let his Dyet be thin because his Humour is thick all Passions are to be shunned Venery â—led from as the greatest enemy because it is a great disease Galen ordereth Venae Sectio and in every putrid Fever you may see him ordering Phlebotomy as you may see it in 11. Meth. cap. 14. And in a Pestilential Bubo there is concomitant a putrid Fever and therefore Bleeding is very requisite Besides these the common signs of the Bloods offending in Quality requires Bleeding But this is to be done and performed both warily and judiciously for in some cases it is by no means to be admitted as in the Small Pox appearing or Buboes for by Venesection here we send the peccant Matter inwards to some noble part and so instead of quenching we rather add Fuel to the Fire And in purging be sure you observe to mix somewhat of an Alexipharmick to strengthen the Parts As to the outward Applications Epispasticks Cupping Glasses and the like Medicines are the only proper Instruments to abate the Fury and fetch forth the Malignity Somtimes Causticks also do take goop place here anointing the Skin first with Oyl of Lilies that the more loose the Skin be made the deeper the impress the Cupping Glass may make And being thus brought to Suppuration apply Venice Treacle or Mithridate plaster-wise Or for this use you may use this Unguent â„ž Vnguent Dialth â„¥ iss Ol. Scorpion â„¥ ss Mithridat Solut. in â—q vitae Ê’ss this hah in it a discussing Quality Or this â„ž Vnguent Basilicon â„¥ iij. Ferment acr â„¥ ij Ol. Lilior alb Chamomel an â„¥ ss Theriac Andromach cum vitellor Ovor. n â— ij misce fiat Vnguentum A Vesicatory applied under the Bubo is very proper As if it were in the Throat apply a Vesicatory to the Scapulaes and after they have performed their work cut them open and discharge the Matter and keep them open for some time by applying Beets or Ivy-leaves or Melilot-plaster to them These may be ufed if your Patient lives to use them But this is very rare for they seldome are cured they dying the first day and very few
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
us it is an Art which informeth with reason how we may cure prevent and mitigate diseases by the help of the hand but it s most proper and essential definition is taken from eradicating diseases by Art and manual Operation for as 〈◊〉 hath it such medicines as are applied to Tumours Wounds Ulcers or Fistusaes cannot so properly be said to be cured by Chirurgery because this health is purchased and procured by help of medicine which was applied But where an Abscesse or Impostume is opened by Incision bones dissocated or fractured reduced by the hand Fistulaes dilated Cataracts couched Cancers taken of by Instrument and the like these may well come under the name of Chirurgery it being from the use of the hand that it taketh its name for it is derived 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 à mann opera and thus Chirurgery quasi 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 As for its subject matter I have already shown man being alone the proper Instrument hereof As to its end it was ordered and framed to repair natures wants to help her necessities to make her curvations right And to its order and method it is divided into Theory and Practice The first teacheth and is called science acquired by demonstration and knowledg of the principles of Art this carrieth with it the precepts of Art The second practice found out by Knowledg and Reason arriving at a greater degree of perfection by manual Operation and this daily experience adds to its lustre and truth It may also be divided into general and special parts These held general as the Articulations or soft parts Those special which teachthe right way of Operation about Tumours wounds ulcers fractures disâ—ocations and the like The scope of Chirurgery directs the Chirurgion to the well knowing and understanding these four parts as to remove solution of continuity to restore union where wanting to separate parts unnaturally united and to supply defects The first is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the joining part the second 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the separating part the third 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the removing part the fourth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the supplying part The first performed by Consolidatives Agglutinatives adducing Luxated bones and curing fractures The second acted by Incision Phlebotomy or Scarrification or Amputation as in wry necks hare lips imperforated Anus and Penis The third is finished by extirpating tumours as Ganglions Cancers Nodes Strumaes Scrophulaes Stones Cataracts drawing out of water from the Abdomen or Thorax by a Paracenthesis Amputation and the like The fourth he supplies in restoring Ruptures into their proper places as in restoring a new nose and bringing the blind eie to its sight And these are to be done Citò Tutò Jucunde suddenly without pain safely without cheat or imposture and pleasantly without fear or fallacy And that the Chirurgion may perform these with honour and repute let him take a turn with me in the several borders of this Chirurgick garden where he may first see what is natural what unnatural what preternatural thereby the better to furnish himself with Indications or Intentions against these or any thereof And the first that offer themselves here are the things of nature for whose end this first intention is appointed and that is health its cause effect its strength and temper all which are to be kept in their order and beatuy These are generally allowed unnatural or preternatural as a disease or distemperiety for this is said to be a praeternatural effect of it self and hurting action by its cause and this may hurt by action hindring it or by accident and then by symptoms which follow a disease as a shadow doth the body There are three general Intentions here requisite The first arising from a preternatural thing taking from its contrary as union from Solution of continuity coldness from heat heat from coldness driness from moisture and moisture from driness ablation from matter exceeding and encreasing from matter diminishing apertion from obstruction and dilatation from angustness astriction from amplification reposition into its proper place from whence it made its recession And as we are to observe this order of contrariety so also are we well to understand it which affect ought first to be cured the curing of which is the principal cause of curing the other and without which no perfecture The second Intention sheweth how we are to keep those parts intire which are placed according to nature and to discharge and expel those that are preternatural and we may understand an incurable disease these three-waies First when the disease of its own nature is incurable as the Elephantiasis or confirmed Secondly when the patient useth not such means as should be proper for his recovery Thirdly when the curing of one distemper threatens another greater and more terrible The third Intention is performed by opportune helps and conveniency use of right and proper medicines and these are either Medicinal or Instrumental Instrumental for living well and keeping a good order as Pharmacy Phlebotomy Emplaisters Uuguents Powders and the like The unguents a Chirurgion should alwaies have in readiness satisfying his common Intentions are these unguent Basilicon to maturate and convert into Pus Apostolorum to deterge and mundify Aureum to incarn and fill up Aâ—â—um to agglutinate and consolidate Dialthaea to mitigate and ease pain Instruments for all occasions large and small some for searching others for cutting for some drawing out extraneous bodies and others for putting or reducing parts into their respective places And these bring me to the Chirurgion himself which is to be the man onely engaged both in their applications and administrations and let us see what person he ought to be how qualified armed furnished and exercised To consider in what chair of honour and esteem a Chirurgion is seated may well require his care and study learning and excellency and since there is such a conjunction of the mind with the body such a connexion and society that they generally take shares of one anothers good and bad fortune as some deliriated with fevers whilst others are blown up with madness by the fury of choller To see the wonderful effects of blood while melancholy acts her innumerable changes in our bodies may well call into admiration the best of mens knowledg our thoughts varying according to the diversity of tempers in our bodies Thus are we troubled with diseases inflamed by anger sweetned by love exhilarated by joy dejected by sorrow tempered by sweetness shaken by fear and to search out the depth of these their originations and causes their diversity of shapes and postures may well require a quick sight to penetrate a powerful wit to search out a well guided reason to consider of He therefore that will enter this stage of Chirurgery must well understand its various scenes and acts for it s he alone guided by the provident hand and
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
understand their diversity of times Hence also are we to consider the largness or smalness of a Tumour and its species without the knowledg of which we cannot be said to understand the curative method its causes which are conjunct with the disease the circumjacent parts and the symptoms which do follow either from the nature or cause thereof and lastly the signs And when we have thus far arrived we are to consider the four great Tumours in general as Phlegmon it being as our first to treat of it proceeding of blood the Son of nature generated for the treasure of life Secondly of Erysipelas arising from choller the fury of the gall Thirdly of Oedema coming from Flegm the proper instruments of the joynts Fourthly of a Scirrnus bred of Melancholy the lumpy and terrene masse of the rest Of every of these are bred various Tumours according to their various shapes and changes but of these in their proper places CHAP. V. Of the Vniversal way of curing Tumours HE that will undertake the curing of Tumours ought well to understand his curative scopes and intentions and the well timing of Tumours is a very great matter here And here may we expect a Tumour either already made or in its making And hence ariseth a double intention the one prohibiting Fluxion whilst the other cure is wrought by discharging the matter already flown because removing of causes do hinder Fluxion If this happen from Plethory breathing of a vein is very proper whilst in a cachochymick body purging is as useful When a Tumour doth proceed from Fluxion we are to begin our cure from the matter flowing and hence cometh our first intention and this is performed by Repellers Revellers and Interceptives save onely in these seven cases set down as our seven cautions by Galen First when the matter doth flow to the Emunctories or glandulous parts secondly when a venenate matter floweth for this sends it more inwards and so poysoneth the heart Thirdly when this matter floweth Critically not crossing Nature in her own way Fourthly when Fluxion is excited in a Cacochymick body Fifthly when the part to which this matter maketh its Flux is weak and its heat but mean Sixthly when there is vehement pain for here is more need of anodynes and then seventhly when this Fluxion is near some principal part And as touching these curative scopes we are first to probihit its Origination and by this means to hinder its augment secondly to understand the quality of such things as are to be applied for as Galen saith 13 Method 16. we do destroy the breed of a Tumour if we well understand its cause and this being ablated the Tumour is soon seen to vanish Fluxion and congestion are the two cheif causes of Tumours the first offending either in Quantity or Quality and so with violence doth seize suddainly upon any member either by reason of its loosness or weakness Congestion being when a Humour is gathered into a part gradatim by reason of this weakness of the digestive and expulsive faculties CHAP. VI. Of Phlebotomy its manner of Operation and where it is most properly performed IN this Discourse we have many things do offer themselves to our consideration As when there is a fulness Evacuation is in use and here is to be let out as much as is necessary If there be a Plethory Quoad vires here it is to be repeated And as touching the part which is to have the lancet exercised on it whether from above or below this also is to be minded and regarded because Derivation which Evacuation from the adjacent part doth not agrees in the beginning of the cure because this would make the Fluxion larger and the Attraction to the part affected greater And if we will make Revulsion aright we ought well to understand the place of Fluxion that we may happily revell in the opposite part Thus if the right kidney be hurt we open a vein in the left arm in Tumours of the groin vena Poplitis And if any may question our meaning between the upper and lower parts Galen himself giveth them this answer All the parts above the navel including the Liver and Stomack are called the upper parts and thus have we one part of the vena Cava called the ascendent Trunk the other below these are properly called the lower parts This knotty difference between Repulsion Revulsion and Derivation is not very easily untied I shall thus endeavour to loosen it Fluxion arising from Expulsion showeth expulsion if it followeth from the quantity of matter this is either to be revoked or evacuated and hence ariseth this twofold intention Revultion and Evacuation This being out another thing is to be observed the matter that slows hath three places one from whence it floweth the second whither and this is to the part affected and thirdly through what parts before it arrives hither These being found out we are to consider how to discharge this matter and thereby prevent its further spreading secondly we are to prevent the Fluent matter which hath got passage into the channels that it flow not to the part affected and so run this also into a Tumour And the well consideration of these may well make us use study where and when to make this Revulsion and where to make evacuation And in both of these we are to observe Hippocrates Rule that all be done secundum rectitudinem and this is to be performed two waies as by comparing the left with the left and the right with the right for with these there is held a proper consent Thus the Liver vein hath a rectitude with those veins which ascend up to the head Thus upon an immoderate Flux at the right nostril by applying a cupping glass to the Region of the Liver the Flux doth suddenly stop if the left by applying one to the spleen doth work and perform the same effects Galen hath also two species of Revulsion the one from the upper parts to the lower from the right to the left the second not so exact which we use when the matter is much and threatens danger Galen also in diseases of the upper parts doth revel by opening the upper veins as in Tumours of the head he doth order the Cephalick vein to be opened and Falloppius saith in a Squinancy he hath breathed the left arm and the Humour presently vanished and in some cases this is very proper In Tumours of the Axillaries being venenate if we should open the lower veins we must consequently draw its venome inwards to the heart and vice versa if we should open the upper veins in a pestilential Bubo we may well make a free passage for the pestiferous matter to make its address to the heart which is not onely a great fault in the Chirurgion but also as unhappy to the Patient And thus have I shown some of its benefits I now come to teach the young Chirurgion how he is to use his
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
beginning of a Phlegmon repelling Medicines are most proper as Galen doth offer for hindring or stopping the matters descent or arriving to the part affected But lest any may object as Aquapendens doth propose why in the beginning the Blood being in the smaller and capillary vessels may we not insensibly evacuate this matter by the affected part as by digesting it and drawing it out from other parts and by attenuating and turning it into a vapour Repellers being wholly dismist I give being led by the same Author this as an answer we are rather to use Repellers in the beginning of an Inflammation for these causes For first that which floweth is but small and thin and therefore by the help of Repelling Medicine we send this Fluxed matter to another part Secondly because Evacuation by Repulsion is sooner performed for it is by this Medicine alone that the Blood is sent and dimissed out of the smaller into the greater vessels And thirdly by these we do perform another intention which is the allaying the extraneous heat And these are to be regulated according to the Crisis of the body for if there be a hot crisis both of the whole and the affected part here are we to use mild and gentle Repellers as the white of an Egg Rosewater and Vinegar and oyl of Roses leaving out the Vinegar if you please dipping fine rags herein and applying them to the affected part Or this Cataplasm ℞ Pulv. Rosar ʒi Farin Hord. ℥ ij coquantur in Poscâ fine addendo parum ol Rosar As also on the contrary if the crisis be cold the Inflammation large we are to use stronger and let this serve for a reason hereof because here is signified a great plenty of Blood and here conveniently may be used these following ℞ Vnguent Rosat lot in aqu Plantag pulv Rosar Plantag an ʒij Aceti parum fiat unguent Or this ℞ Ol Rosar ℥ i. Aqu. Rosar ℥ iss Albumin ovor no. ij misce or this Cataplasm ℞ farin Hord. ℥ ij pulv Rosar Plantag Malicor an ʒiss cum succis Semperviv Lactuc Solan Oxycrat an q. s fiat Cataplasma Or this Unguent ℞ Mucilag sem Psyll extr cum aqu Plantag Acet Rosar ℥ iiij succ Plantag Solan an ℥ ss ol Rosar ℥ i. coquantur ad succorum consumptionem fine addendo Vuguent Rosat ℥ i. misce fiat unguent Or this ℞ Lactuc Malv Plantag an M. ss Semperviv M. i. Coquantur in Oxycrat q. s fiat Catapl fine addendo pulv Rosar Rubr. Plantag cort Granator an ʒij Farin Hord. ℥ iiij misce fiat Cataplasma but if the beginning doth turn towards the Augment then may you use this ℞ Malvar parietar Plantag an M. iss coquantur in aqua contusis adde farin Hord. ℥ ij pulv Rosar R. fl Chamomel Melilot an ℥ ss ol Chamomel ℥ iiij misce cum decocti praedicti q. s fiat Catapl This here also is to be observed that these Medicines be oft times changed lest they do inflame the affected part CHAP. XVI Of Curing a Phlegmon in its Augment GAlen cap. 4. lib. de Morbis doth mention that for the Augment when the Flux ceaseth and the part seemeth more affected than it was formerly and therewith increaseth and the reason hereof may be this because the Blood which formerly was shut up in the vessels now falls out and doth grow hot and putrefy an at length is converted into a vapour And hence doth arise this Intention the discussing of this vapour or evaporation of this matter And this being discharged out of the vessels is not to be treated with Repellers or cured thereby as it was when it was hedged in but rather evacuated by Digestives These 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 do cure by educing the Fluxed matter and converting it into a vapour and so do discharge it by insensible passages or pores of the Cutis And of those some are simple some compound some mild others strong Of the simples are Chamomile Marshmallows white Lilly Roots Faenugreek Melilot Cumins Rue Bayes and the like Stronger are Tyme Origanum Mint Pennyroial Calamint Hyssop c. The strongest are Nitre Sulphur Vivum Lyme once extinguished Out of these mixed with some of the former Repellers you may make a compound Medicine they being a like tempered are very proper here As ℞ fol. Malv Absinth Plantag an M. ij Coquantur in aquâ fontinae contundentur Trajectis adde farin Fabar. Hord. an ℥ i. pulv fl Chamomel Melilot Rosar rubr Absynth an ʒiss Ol. Rosar Chamomel an ℥ i. Oximelit simpl ℥ ij misce fiat Catap. Or ℞ Chamomel rad Alth. Aneth an M. ss rad Lilior alb no. ij coquantur omnia in aqu Hyssop q. s fiat colatura Colaturae adde farin Fabar. Hord. Lupinor an ℥ ij pulv sem Faenugraec Rosar an ʒij Ol. Rosar Aneth an ℥ iss misce fiat Catapl CHAP X. XVII Curing of a Phlegmon in its State THAT is generally related and supposed the State when the matter can make no further progress that is when very much pain is perceived and a great heat doth accompany the part There may a question arise what Medicines may be here most proper Gal. chapt 16. lib. 13. Method saith that Digestives do chiefly take place here and in another place chapt 4. lib. 1. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth offer that the indication of curing a Phlegmon in its State ought to be both Repelling and Digesting In the first part therefore of the State Repellers and Digestives equally mixed are very proper of this sort may be ordered such as these ℞ rad Alth. ℥ iij. Lilior alb ℥ i. fol. Malv Partetar Plantag Chamomel an M. j. sem Lin. Faeungraec an 3iij coquantur omnia in Aquae fontinae q. s fine addendo farin Hord. Fahar Lupinor an ℥ iss pulv Rosar rubr fl Melilot Chamomel an 3ij Ol. Anethi Rosarum an ℥ ij misce fiat Cataplasma Or this ℞ Lapath Parietar Malv Plantag an M. i. contundentur coquantur colaturae adde pulv fl Melilot Chamomel an ℥ ss pulv Rosar rubr 3i misce fiat Catapl Or this ℞ rad Lilior alb ℥ ij fl Chamomel ℥ i. Aneth Calaminth an M. ss coquantur in a quâ fontinâ q. s colaturae adde pulv fl Chamomel Melilot an 3ij pulv sem Aneth ℥ ss farin Hord. Fabar an ℥ ij farin sem Faenugraec ℥ ss misce cum Ol. Chamomel Vnguent Dialth an ℥ iss fiat Cataplasma CHAP. XVIII Of curing a Phlegmon in its declination IN its declination according to Galen cap. 1. lib. 6. pure Digestives are to be used such as you already have ordered you in the general cure of Tumours and you may very well follow the same method and use the same Medicines as you have already set you down there for your direction I shall conclude this chapter with this history Hildanus
relateth of a Phlegmon in the Perinaeum equalling the bigness or largeness of a Goose Egg accompanied with a pricking pain with a hardness both of the Scrotum penis for which was applied this suppurating Cataplasm ℞ rad fol. Alth. Malv an M. i. coquantur pistentur his adde farin Tritic. ℥ ij farin sem Lin. Faenugraec an ℥ i. Butyr recent ol Lilior alb Vnguent Dialth an ℥ iss Croc. ʒss Vitell Ovor. no. ij misce fiat Cataplasma of which is to be applied warm two or three times in a day The abscess being broken a great quantity of fetid and putrid matter came out for many daies together and continued so long that it left a large Ulcer for the cleansing of which was used spirit of Wine and Vnguent Aegyptiacum over which was applied this Cataplasm ℞ farin Lupinor Fabar. an ℥ iss pulv summitat Absynth Scord. Rut. an ℥ ij Coquantur cum Oxieml simpl q. s fiat Catapl fine addendo dum calens est Mirrh Alo. an ʒiss The Ulcer by these being well deterged and filled with flesh by a good cicatrice and well ordering of the body the Patient recovered to his perfect health CHAP. XIX Of an Erysipelas FROM Choller ariseth this Erysipelas accompanied with many other Tumours bred also from this Humour as Herpes miliaris Herpes exedens Pustulae and the like There is generally allowed three sorts of Choller natural unnatural preternatural The natural is that fourth part of the Blood which hath a hot and dry temper in it being of a reddish yellow colour and bitter-sweet in taste much like tosted honey This is one of the natural Humours so called for a double cause because they perfect natures work and are as vehicles for nutriment and conservation of the body for if man were without blood he could not be nourished if without Spirits he could not be said to live and were it not for this natural bilious Humour man would soon swell into a Dropsy A second sort hereof is said to be not natural because this yeilds no perfection to the body its substance being altogether unfit for this office of nutriment this hath in it no bitterness or sharpness of this sort is that of the bladder of the Gall and should this contain any sharpness in it it would soon fret the guts into pieces and besides this daily experience showeth it is free of all Acidity for it daily passeth through the Kidneyes into the Bladder and then maketh its exit But this Question in the Physick Schools hath been very oft times controverted Was not this Humour framed and ordered for deterging the capillary vessels that Chyle might pass to the Liver and so the Blood hereby consequently there made But this consequence may be very readily denied for the Chyle does never reach the Liver and this may appear different from the other in that it is not so natural There is a third sort hereof different from both the former being neither good to help the body in its nourishment nor yet so mild as unnatural which although it do not nourish the body yet doth it not offer any mischeif to it this is both unprofitable and unnatural and preternatural alwaies hurting the body and so is called preternatural Choller which properly perse and in se is apparently so There is another sort of preternatural Choller which mixeth it self with other Humours and doth make them worse the one having in it Serum and Flegm and this is very fit and proper for obstruction There is a second sort doth mix it self with tough viscous Flegm and this is called Bilis vitellina and this doth promote and help forwards obstructions A third is burnt choller by admixture and this doth make frame our great pains and excoriations whilst it doth lodge in the vessels and when it getteth out from hence is the most apt Author of cancerous Tumours and Melancholick vlcers And thus much of the differencies of Choller We now arrive to an Erysipelas the proper subject of this Chapter and Guido doth give that distemper which adhereth to the Cutis the name of Erysipelas Some of the Ancients called it Ignis sacer ignis because it burneth like fire sacer being sent as a punishment from the Sacred hand but it is more properly called Erysipelas quasi 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 For as 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth signifie redness by some called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 so 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 doth as well signifie near And thus may we define it calling it Erysipelas because it maketh all its neighbouring parts red It is a hot Tumour arising from the aforesaid choller possessing some exterior part of the body A true and simple Erysipelas is bred of thin subtile hot and chollerique blood and this appearing in any one part of the body doth form and fashion this disease and because it cannot by reason of its thinness have any consistence in the inward flesh it therefore doth content it self with getting into the outward parts of the cutis and there it doth exercise its terrifying Qualities You may know it by its hot signs having belonging to it a large heat pain a red colour or rather somewhat turning yellowish But because these signs are so near related to those of a Phlegmon I shall here make a larger distinction between them And thus it first doth differ from a Phlegmon in that a Phlegmon doth apprehend both cutis and subject flesh in this onely the cutis is concerned Secondly this is much hotter for you see it appear as it were burnt up by its blisters by how much the choller is hotter than blood Thirdly here is less pain Fourthly its redness doth oft times change into a blackness or blewness Fifthly it yeildeth to the touch Sixthly upon the touch the redness doth vanish Seventhly here is no tension Eightly it doth differ from a Phlegmon in that it never doth move from its place whereas this spreads it self and encreases about its neighbouring parts That which doth proceed from yellow choller is mildest it is a bad sign if an Erysipelas turns inwards In Tumours Wounds Fractures and Dislocations it is generally held mortal or if it doth tend to suppuration it is no waies to be accounted a good sign neither may it be judged but very very bad if it do possess the neighbouring parts of a bone being bare As touching its Cure according to Galen in his Arte medendi whereas it is a disease encreasing in a great quantity of choller this is to be evacuated and the whole Cure performed by diet Chirurgery and Pharmacy As to the first we are to observe that the Air be cold and moist so naturally or made so by Art let the Patients diet be cold and moist and as this choller is thin let him take such diet as is cooling and thickning and for his broths may very properly be
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
the most extreme parts of the body it may very well and properly be here applied and made use of and for which this composition is most excellent ℞ Axung porcin ℥ iiij Pinguedin human ℥ ij Ol. Chamomel Aueth an ʒij Styrac Calamit Benzoin Mastich an ʒss Theriac Methridat an ʒi Argent viv ℥ iss agitentur omnia bene in mortario quibus adde Ol. Spic Salv. granor Juniper an ℈ ss misce fiat linimentum With this you may anoint the part affected or you may apply this often in this case applied with good success by my self ℞ Empl. Diachyl cum gum Paracels an ℥ i. Oxycroc ʒij Vnguent Praescript ℥ ss misce extende super alutam parti admovetor Or this ℞ Empl. de Ran. cum ☿ ℥ ss Pic. Burgund ʒij Taccamahacc ʒiij Empl. Paracels ℥ ss misce pro usu It seldome or never is brought to suppuration by reason both of its coldness and that it for the most part is very far distant from the Fountain of Heat but should it tend that way Empl. Diachylon cum gummi or a Cataplasm made of white Lilly roots Marshmallow roots and the like as you have already prescribed and shown you may do both very well here and be very serviceable A young Maid about eight years of age being much troubled with a Phlegmonous and Oedematous Tumour in the outward part of Her lower Mandible which came to suppuration fearing its fecies would hinder its cicatrice before I could open the Abscess I first tried by Guido's Counsel to resolve it who saith that Apostemes being sometimes suppurated do end in resolution the which was confirmed by Parraeus his experiment who averreth that he cured a suppurated Aposteme by mixing Quicksiver with Diapalma and so applying it and thus I took to an Ounce of Diapalma a dram of Hydrargyrum and applied to the suppurated Aposteme and within four daies it was wholly resolved and for discussing the suppurated matter to the following Conditions are these necessary that the matter be small in Quantity thin and serous occupying the superfificies of the Cutis and not penetrating that it be in a strong and young body happening in the soft parts and a convenient time of the year By the vertue of which Medicine and observing of which method a young Gentlewoman was perfectly cured of an Oedematous Tumour which was but little suppurated upon the Region of Her Loins the largness of the palme of a hand CHAP. XXII Of a Scirrhus OF Melancholy cometh Scirrhus Cancer Vlceratus non Vlceratus Elephantiasis Psoras and others Our late writers do call this Scirrhus Durities because it is a hard Tumour destroying sense lodging in a Member in that Capacity as that it produceth little or no pain or it may be called a preternatural Tumour having no infesting symptome It is by some called Apostema Lapidosum by Avicen Sephiros It is the onely brat of Melancholy and this Melancholy hath a double construction For there is 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or succus Melancholicus 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 atra bilis Between which two there is a vast difference the succus or juice being as the fecies or dregs of the Blood and is drawn from the purest part of it by the spleen the other Black Choler being caused of immoderate heat and burneth the parts and like vinegar being poured on the ground it boyleth and raiseth it self from thence There are four species of Melancholy first when its species are burnt it frameth an illegitimate Scirrhus Secondly when Melancholy is made preternaturally by other Humours it doth take share of their qualities Thirdly when it is made thick by too much cooling or drying of Humours Fourthly when it is mixed with Flegm Blood or Choler then it maketh Scirrhus Oedematodes Scirrhus Phlegmonodes Scirrhus Erysipelatodes There are four waies also shown to the making of burnt Melancholy The first is made of yellow Choler burnt and so representing a yellow sinder and doth burn like it The second is made of thick and viscid Flegm The third is made of burnt Blood which is very bitter The fourth is made of Melancholy Juice being both acid and corroding There are two kinds of Humours which do make this Scirrhus the one being a Crudity as Flegm thick and yet not viscid the second is vitreous matter or a glassy substance of Flegm And hence may we take a Scirrhus either to be exquisite or not exquisite and therefore if Flegm be in a great quantity it shapeth out Scirrhus Oedematodes if Choler be predominant Scirrhus Cancerosus Or if you please a Scirrhus is bred out of a natural melancholy Humour which is cold dry and thick and from glutinous Flegm and hence it may be defined a Tumour hard and indolent a Tumour proceeding from a thick and glutinous Flegm or a natural melancholick Humour It may be known by these Signs it is a Tumour without pain hard to touch if not exquisite it is scarcely perceived Every Scirrhus hath not pain and this necessarily happeneth because it is deprived of sense Melancholick Scirrhous Tumours are generally of a leaden colour but a Scirrhus arising from a Flegmatick Humour carrieth in it the natural colour of the Cutis They take their principal Causes from the beginning of thick and tough Humours and collecting themselves in the parts and that occasioned by evil Diet generating a thick and viscid Humour as by reason of intemperieties of the Liver or Spleen all such causes may be said outwardly to generate thick juices as a cold or dry Air Watchings suppression of Menstrues and the like Expect to do no good on an exquisite Scirrhus for this alwaies is to be suspected If it happeneth about the Joints Knees or these remote parts be not too forward to undertake them If it be exquisite and not turning Cancerous yet it is hard to cure for first the Matter is dried up and then cold and compact and so tedious and that which is lapidous gives no way to Medicine As to the cure the external causes are first to be removed by choosing a thin Air hot and moist free from Fogs and Mists let the Patient shun thick leguminous and cold Diet let his Drink be Wine to help forward Digestion and warm the parts and let him get himself clear of all passions of the mind After this are we to take care to remove the inward causes by preparing the Humour with Syrup of Apples Bugloss Fumitory Hyssop Oxymel Balm and the like This being done we are to purge this melancholick Humour with Senna Polypody black Hellebore Confectio Hamech c. of these or the like may be framed excellent compound Medicines as this Apozeme ℞ rad Faenicul Scorzonar Bugloss an ℥ ss cort Tamarisc Cappar Polypod Q. an ℥ i. sem Anis Faenicul an ℥ iss Citr ʒij fol. Capill vener Scolopendr Meliss Lupul Thym. an M. i. fl 3 Cordial an pug ij Passular
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
a solution of Continuity occasioned by much Matter distending the Nervous parts Heat and Inequality it is hot like the Humour that breedeth it The greatest matter here to be minded is the Hardness and Thickness of the matter if you see a black and livid Colour in the place and a Hardness accompany it this is a Pathagnomonical Sign if you meet with a melancholy Humour and a melancholy Habit of Body and the Brest suspected and the Body capable of entertaining such a Tumour furnished with evil Juices this giveth a fair prospective to the thoughts of a Cancer The Cancer which is Ulcerate may well be known by these Signs For its Ulcer carrieth with it a fetid Smell having thick swelling and blewlooking Lips horrid in aspect and accompanied with great Pain In its beginning it is hard having a blewish Colour and pricking Pain about it The event showeth the success for you may never expect a cure of this if any hopes may prompt on to proceed it will be with a great difficulty if you extirpate it there oft times remaineth a Cancerous Ulcer or it maketh its reversion some other way and to some other part so that as wise Hippocrates saith if the Patient be thus cured this Cure will onely be as a means to shorten his daies We ought not to meddle with ulcerate Cancers these by Galen held to be altogether incurable Cap. 5. lib. de atra bile they coming from black Choler neither ought we to attempt the Cure of any other without Amputation the which way and method of cure doth carry with it great danger and hazard as Celsus offereth Cap. 28. lib. 5. As to the Cure these three things are to be minded that we have a great respect to the Patien'ts Diet prescribing convenient Medicines and well ordering the part affected and these are performed by Diet Pharmacy and Chirurgery And because the best kind of these are bad enough to be treated with that it may have its great force and fury stormed and its spreading venemous Quality the better contracted and lessened we are here to begin our work with universal order and method of the whole Body The better to strengthen the other adjacent parts and to allay the fury and anger of this so potent an enemy we are first to look to the good order of Diet which in Quantity should be thin although moist in Quality and endeavour to quell the antecedent Cause by prohibiting the generation of this Humour and purge gently your Patient by degrees and in purging observe this rule that you often prepare the Humour the antecedent Cause being conquered lay Seige to the conjunct Cause with all such Engines as may storm the force of the matter contained in the part affected and if any furious motion hereof may either disturb the Quiet unsettle the Rest or discompose the order of this princely Fabrick use all means to prevent the incursion of this private Enemy And for the first intention it being the most proper and ready method for hindring the augment of a Cancer and keeping it within its bounds Purgation is as an excellent weapon And here may you furnish your self with many excellent Methods being either made into Apozems Pills Pouders Potions and the like As for an Apozeme take this ℞ rad Faenicul Asparag Lapath acut Scrophular Polypod querc Sanicul cort interior Frangul an ℥ i. Agrimon Veronic Cuscuth Cetrach Fumar-Capil vener an M. ss fl Genest Sambucin an M. ss sem Anis Faenicul dulc an ℥ i. Liquirit rasur Vvar passar exacinatar an ℥ iss coquantur omnia in s q. aquae fontinae ad tertiae partis consumptionem ad libram colaturae adde syrup de Scolopendr Epithym an ℥ iss Aqu. Cinamom ℥ i. misce fiat Apozema pro tribus dosibus Or this Potion ℞ Conf. Hamech ʒiij Extr. Hellebor nigr gr vj. Aqu. Cinamom ℥ ss cum q. s Decocti prioris fiat potio mane sumenda Or this ℞ rad Bugloss Acetos Cichor an ℥ ss Agrimon Cetrach Epithym a. M. ss Senn. mundat ℥ iss fiat Decoctum ad lbi fine addendo fl ʒ Cordial an pug i. in colaturâ infunde per noctem Rhabarb elect ʒiij pulv Cinamom ℈ iiij exprime Liquorem in hac solve syr Violar de Pomis an ℥ iss misce fiat Apozema Some of the aforesaid Pills mentioned in the cure of a Scirrhus may well be used and taken here Sudorifique Decoctions are also very prevalent here as ℞ Lign Sarsafr ℥ ij Lign Guajac Sarsaperill an ℥ iss Cinamom ℥ ss coquantur omnia in s q. aquae fontinae addendo sem Anis Faenicul dulc an ʒij rasur Liquirit ℥ ss Of these make a Decoction of which the Patient may drink three or four times in a day And as touching the part affected Repulsion and Digestion Scarrification and Section according to Galen lib. 14. Meth. are very proper for evacuating and discharging of the repletion of Humours As for the first two Repulsion and Digestion Galen doth order these to be used both before and in the time of Purgation and then to use Digestives when the Body is sufficiently purged these being made and composed of such things as may not contain any corroding Quality in them and of the Simples may be reckoned these Plantane Nightshade Knotgrass Lettuce Sowthistle Pomgranates Balaustians and the like Avicen doth much commend Tutthy being washed and mixed with oyl of Roses Paulus doth commend Nettles bruised Some do admire the powder of Frogs and others as much do praise an Unguent made of them Others have a great value for Empl. Diacalcitheos dissolved in the juice of Nightshade and oyl of Roses in Cancers not ulcerate But for compound Medicines take these ℞ succ Solan ol Rosar an ℥ iij. pulv Ranar. ustar testar Cancr an ʒiij pulv Rosar rubr ʒi Tuth praeparat Lithargyr aur pulv Plumb ust lot an ʒi Agitentur omnia in Mortario plumbeo fiat Vnguent ℞ Theriac veter ℥ i. succ Cancror ℥ ss succ Lactuc ol Rosar an ℥ iss Vitell. ovor no. ij sub cineribus coct Camphor ʒss agitentur omnia in mortario plumbeo fiat Vnguent Or this ℞ pulv Plumb Ceruss Min. an ℥ ij Litharg aur ℥ i. ol Lin. lbss Cer. q. s fiat Empl. Or this pretious Unguent so much admired by Franciscus Arcaeus in Cancerous Tumours ℞ ol Rosar Omphac lbss sev Hyrcin Vitulin Vnguent Rosatum Populeon an ℥ iiiss succ Solan Plantagin Acetos an ℥ iss Vini granator ℥ iiss coquantur omnia lentissimo igne ad succorum Vini consumptionem postea colentur colaturae adde Ceruss ℥ iiss Litharg aur ℥ 5. Plumb ust Antimon an ʒ10 Tuth praeparat ℥ iss Cer. Alb. q. s fiat Vnguent in Mortario plumbeo All these or any of these may be used in the beginning of a Cancer when it is but small but if it hath arrived at a greater bulk and largness
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
shall I conclude this Chapter of pestilential and not pestilential Carbuncles CHAP. XXVII Of Epinyctis PAVLVS and Celsus do write this to be a very bad Pustle having in it an ashy or black Colour about which doth grow a vehement Inflammation with nocturnal pains joined to it The parts affected herewith are the outward parts of the body which may easily be perceived by the Humour imprinting its Colour wherever it taketh It is made of burnt Blood The Pustles arise of their own accord with a reddish Colour somewhat tending to a lividness sometimes to a blackness They are most commonly seen in young Children and aged Persons they bring no great danger without they be ill treated There is three Intentions required in this Cure a good order of Diet being cold and moist a discharge of the peccant Matter and here both Bleeding and Pharmacy are conveniently to be prescribed according to the age and strength of the Patient and then in applying convenient Medicines to the affected part As â„ž Vnguent Basilic â„¥ ij Vitell. 〈…〉 2 Axurg Huma Caprin an â„¥ ss ol Rosar Ê’iij Croc. ℈ ss misce fiat Vnguent Or this Unguent â„ž Vnguent Rosat â„¥ ij Vitell ovor no. i. Cer. all parum Acel paul fiat Vnguentum This use if Inflammation if you be to mundify use Vnguentum Aegyptiacum or ex Apio fill up with Aureum or Basilicon and skin it with Diapalma or Desiccativum Rubrum A Wine-Merchant being troubled with black and sublivid Pustles about which was a vehement Inâ—lammation and nocturnal pains when as he could receive no ease or benefit by other things prescribed him by the advice of a Woman he was ordered to anoint them with oyl of Juniper by the help of which he rested very well and had more ease by this than he could ever obtain by all his former Medicines both inwardly taken and outwardly prescribed and at length was hereby perfectly cured CHAP. XXVIII Of Herpes Miliaris and Herpes exedens THIS by Avicen is called Formica It ariseth from a cholerick Humour and when as this cholerick Humour is made preternaturally thin and hot it frameth Herpes exedens or that Disease by Celsus called Ignis sacâ—r by Avicen Formica corrosiva because by its corrosion it doth spread it self This preternatural Choler mixing it self with Flegm it formeth that Herpes which hath many small Pustles in the skin like to Millet or Hyrse-seed and thence is called Herpes miliaris And since as we may apparently find that there are two sorts the one from Choler mixed with Flegm the other arising from a dust Choler our present discourse shall onely reach to the first the latter more properly ought to be reckoned amongst Ulcers The Signs of the first are many small Pustles like Millet-seed in the upper part of the Cutis and arising from the mixture of Flegm then they encrease in their number the former growing old and when they are opened or rent the Matter which cometh forth from them is between Sanies and Pus partly reddish being somewhat of a mixt Colour between red and white All the Causes may be related to those of an Erysipelas save onely that this Tumour is made from a redundancy of preternatural Choler an Erysipelas coming from natural Celsus doth propose that as Ignis sacer hath little danger so amongst such creeping Diseases its very hard to cure for sometimes there is an Intemperiety of the Liver which may be another Cause of this difficulty This cure may be performed by having a respect to the whole habit of body and since it doth not much irresemble an Erysipelas I do commend you thither to â—etch convenient Medicines both inward and outward which may do you great service in this Cure The second sort Herpes exedens is so called from Erodendo for it doth not onely erode the Cutis but doth also depopulate the subject Flesh Celsus Cap. 28. de sacro igne lib. 5. doth describe its nature when he saies it is made with an Exulceration of the Cutis not very deep large sublivid inequally planting its self in the extream parts As often therefore as we see an Ulcer to grow and increase and to make small Ulcers and many small Cavities penetrating no further then the Cutis this we may properly call Formica Corrosiva It is to be cured with Cholagogicks as the former and whereas it is a Disease arising from a preternatural hot and sharp Choler proceeding with Putredness Phlebotomy is no waies proper here for it very oft times doth arise from Cacochymy purging with Senna Damask Roses and the like in Whay or good Cassia Manna or â—eâ—itive Electuary or a Decoction of Sarsaperilla China and Guaiacum And as touching the part affected these are very proper here to be used â„ž succ Tabasc â„¥ iij. Cer. Citrin â„¥ ij Resin Pin. â„¥ iss Terebinth venet â„¥ i. ol Mirtin q. s fiat Ceratum molle â„ž Camphor â„¥ ss Album ovor no. iiij succ Plantag Solan an â„¥ i. Plumb ust Ceruss alb Lithargyr aur an Ê’ij pulv Troch alb Rhas sine Op. Ê’i ol Rosar â„¥ iiij Pomat â„¥ ij fiat Vnguentum With this let the Patient be anointed three or four times in a day Or this â„ž succ Plantagin Lapath acut Solan an â„¥ i. succ Polygan â„¥ ij Lithargyr aur â„¥ i. Tuth praeparat Antimon an â„¥ ss Alo. citrin Ê’iij Cer. alb ol Myrtill ol Rosar an parum misce fiat Vnguentum both for deterging and drying up of the Ulcer I shall conclude this Chapter with this History of a young Gentleman who was burnt from his foot to his knee but very slenderly that it did scarce hurt the Cutis coming to an Emprick who from the first used Empl. ex Argilla Bol. armeny with the whites of Eggs mixed with the Juices of Nightshade and Housleek dipping clothes therein and applying them to the part affected the pain which was but small grew into a great degree by the use of these he became vexed with a Fever disquiet and afflux of Humours to the affected part and Inâ—lammation of the whole Thigh even to the Hip and at length a Herpes exedens correpted the whole Thigh so vehemently that some Chirurgions thought to have made Amputation but at length was thus cured having first prescribed him this Potion â„ž rad Scrophular Cort. interior rad Frangul rad Polypod an â„¥ ss Herb. Fumar. Cuseuth Scabios an M. ss fol. senn Ê’iij misce fiat Decoctum in aquâ ad â„¥ iiij in quibus solue Conf. Hamech Ê’ii syr Rosar solutivar â„¥ i. misce fiat potio the day following he was bled in the Basilica of the same side the Herpes was and the Humour prepared with a purging Apozeme against Melancholy already prescribed in a Scirrhous Tumour The body being thus prepared we arrived at Topicks and here because the Cutis was already made hard by the use of cold
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
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
it does continually flow An Imbecillity of the Testicles does give another great suspicion hereof Another Cause amongst some is attributed to Coition with a Menstruous Woman Oft times it happens by overstraining the inward parts a thing very frequent in snch who being in their Drunken fits do act beyond their power of Reason If the Seed therefore which is thus thrown forth be pure and is not in any respect tinged with any strange quality and is void of all fetid smell this either does shew and express a plenty thereof or a weakness of the Retentive Faculty or Convulsion of the Spermatick Vessels But if it be accompanied with any other vitious Humours and furnished with thin ill Juices and appears with another colour strange to its own proper nature and yieldeth a smell which sheweth no good Concoction this first of all does calefie and by its acrimony does corrode pricketh and invadingly ulcerateth And this Ulcer does much differ from that which exerciseth it self in the Bladder and thus may with ease be distinguished where the Neck of the Bladder is ulcerated the pus or Matter does as it were compactly precede the Urine it self and the pain between making water is most mightily sharp about the ulcerated part On the contrary the Bladder it self being ulcerated there is no pain felt nor Matter pissed forth secreted by the Urine but cometh along with it The Urine does yield a strange strong smell where the Bladder is affected with an Ulcer When the Urinary passage is ulcerated the Yard is very painful and heavy and bendeth downwards An Uâ—â—er contracted in the Neck of the Bladder or in the cavity of the penis unless it be both speedily and knowingly cured does convert it self into preternatural Caruncles by which the Urinary passage is obstructed For as out of most pure Blood the best Flesh is generated so also vicious Juices enwrapping or keeping company with the Ulcers there is oft times seen a spongious Flesh to grow and breed And therefore when we have arrived at the sure knowledge that this unnatural Guest hath made his entrance into these quarters which we may speedily find out by the search of a Candle and to gain advantage of this Disturber of the Humane peace we ought if Plenitude be a main wing of its vigour to discharge this by Evacuation And here let the Patient use a thin Diet if the Juices be sharp and thin thicken them so as that they may give strength to the Spermatick Vessels if we do here find or meet with any weakness strengthen them And for clearing this Method observe with me these Curative scopes First loosen the Body with emollient Clysters made of Mallows Violets Pellitory Lettuce French Barley and the like adding thereunto Cassia in the end After this breathe the Basilick Vein 〈◊〉 the right Arm. These two being premised let the Thighs be washed with a Decoction of Red Roses French Barley Violets red Poppies and the like Let the Kidneys Spine and Testicles be cooled with this â„ž Vnguent Rosat Refriger Galen an â„¥ j. ol Violar â„¥ ss pulv Rosar rubr Santal Citrin Spod an Ê’j Camphor grâ—iij Acet Rosat gutt aliquot As to the part affected deterge it first with a Decoction of French Barley in which have been put some Mel Rosarum this being made lukewarm is by a Syringe to be injected into the Yard Then produce a Cicatrice with this following â„ž Aqu. Rosar Plantag an â„¥ iiij Sacchar candit â„¥ j. Ceruss Lithargyr aur Alumin Roch. an Ê’iss Camphor ℈ ss misce fiat injectio Trochisci albi Rhasis do here also very well but if you have a mind to dry more powerfully adde to the former a little Aegyptiacum Shun all strong Diureticks which may force or drive the Humours to the ulcerated parts and such things are especially to be used which have a quality in them to lessen the pain For this purpose Lac Amygdalatum is very good A Hyposarcosis in the Neck of the Bladder or in any part of the Urinary passage may be collected out of the great difficulty of Urine the which comes not onely out by drops but by forcing and endeavour to perfect this So that sometimes upon a great straining while the Patient makes water he hath a Laxity joyned with it Neither can that Urine come right which hath its passage obstructed by a Carunculous Flesh Neither doth it easily come forth unless it be compressed with the Hand Oft times there is seen such Obstruction that unless the Catheter be called in use there 's no coming forth of Urine to be expected There is a twofold Method in curing of a Caruncle of the Yard the one is performed by Instrument the other by Medicine A Fomentation for this purpose may be this â„ž fol. Malv M. j. rad Alth. Ap. Faenicul an â„¥ iij. sem Lin. Cydonior Foenugraec an â„¥ j. fl Chamomel Staechad Melilot Puleg Origan an pug ij Caricar pingu â„¥ iss coquantâ—r omnia usque ad radicum dissolutionem cum hoc foveatur radix penis Or else dip Sponges herein and apply them to the part affected After it is thus fomented it is to be absterged with such an Unguent as this â„ž Vnguent Dialth Agrip. Oesyp Butyr an â„¥ j. ol Amygdal dulc Lilior albor Chamomel an â„¥ ij Ammoniac â„¥ iss Succ. Ap. â„¥ iij. Mucilag semin Foenugraec rad Alth. Lin. an â„¥ ij boil them all untill the consumption of the Juices then adde the Fat 's and strain it off and to the strained Matter adde a little white Wax Here also are you to make use of searching Candles made of white Wax And for this Affect a Leaden Probe is excellent good for that whereas besides that it is an Anodyne so also hath it a very drying faculty When these fail we come to the use of a Catheter but this without a very respective care and steddy hand does very often occasion strange Hemorrhagies and so thereby doth frequently bring fear both to the Physician and the Patient But should such a Flux as this appear this may with ease be stopped by injecting into the Passage with a Syringe some Plantane water and Rose water to which the White of an Egge should be added Here also are you to mind how upon applying your Candle what part thereof is either bent or bruised or compressed for upon this part is to be applied your Medicines you intend to use and for this purpose Philips Emplaster is reputed to be a most excellent and sovereign Medicine in this Affect because it healeth the adjacent parts and keepeth them whole and safe but that which grows with the Ulcer it taketh away without pain This is its description â„ž Aerugin Auripigment Chalcat Alumin Roch. an â„¥ ij his adde Acet acerrim perfus inter duos marmoreos fiat pulvis subtibissimus exponantur Soli. Then put it into fresh Vinegar again after dry it as formerly let this be done for 8
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
comfortable Medicines here If they run into a Gangrene treat it as I have already directed you in the cure of a Gangrene Hildanus writeth of a young Gentleman who upon too much walking had a Tumour occasioned in his Foot and for want of convenient Medicines thereto applied there speedily happened an Inflammation and within a very few days a very large Phlegmon accompanied with great pain and Fever yet by this following Method his Patient was eased and recovered To him first was prescribed a thin Diet then was ordered this Purging Potion â„ž Electuar è succ Rosar Ê’ij pulv Rhabarb Ê’ss cum syrup Rosar solutivar â„¥ j. Decoct Agrimon Veronic Rad. Lapath acut Cort. interior rad Frangul sem Anis fiat Potio The day following he breathed a Vein in the Arm the Hip Knee and all the inflamed parts were freed from Inflammation by this following Unguent â„ž ol Rosar â„¥ ij ol Lumbricor Axung Human. an Ê’ij misce and afterwards was applied this Cataplasm â„ž sem Cydonior Foenugraec Alth. an Ê’ij pulverizentur macerentur in aqua calida tunc adde farin Hord. â„¥ iij. pulv Rosar rubr â„¥ ss coquantur s q. aquae fontanae ad Cataplasmatis formam fine addendo vitella ovorum no. ij cum albumine Apply this and renew it as often as occasion requireth By these the Pain abated the Matter began to shew it self and by Basilicon being applied to the part it was discharged and by the use of the Cataplasm the Patient was perfectly recovered Thus have I carried you through the whole Discourse of Preternatural Tumours both in General and Particular in which I have with all care and industry endeavoured to shew you their Definitions Differences Causes Signs Presages and Cures Si quid novisti rectius istis Candidus imperti si non his utere mecum FINIS An Index of the Chapters AN Introduction to Chirurgery 1 Of Humours 34 A particular Scheme of Humours 45 A general Division of Tumours 46 Cap. 1. Of the Names of such Authors which have writ of Tumonrs in general 55 2. Of the name of a Tumour 57 3. Of the Causes of Tumours 59 4. Of the Differences of Tumours 62 5. Of the Vniversal way of curing Tumours 64 6. Of Phlebotomy its method of Operation and where it is to be most properly performed 66 7. Of Evacuation of Matter erring in Quality 72 8. Of a Tumour the part affected drawing preternatural Bodies to it self 74 9. Of the 4 Times of a Tumour and first of its Beginning 78 10. Of a Tumour in its Augment 81 11. Of a Tumour in its State 84 12. Of a Tumour in its Declination 86 13. Of a Tumour tending to Suppuration 87 14. Of a Phlegmon or Inflammation in general 91 15. Of curing a Phlegmon in its Beginning 100 16. Of curing a Phlegmon in its augment 103 17. Of curing a Phlegmon in its state 105 18. Of curing a Phlegmon in its declination 106 19. Of an Erysipelas 108 20. Of an Erysipelas in the Face 119 21. Of Oedema 123 22. Of Scirrhus 132 23. Of aqueous Tumours 140 24. Of windy Tumours 145 25. Of a Cancer 153 26. Of a Carbuncle 175 27. Of Epinyctis 182 28. Of Herpes miliaris and Herpes exedens 184 29. Of a Gangrene and Sphacelus 190 30. Of Artheroma 208 31. Of Steatoma 212 32. Of Melicoris 215 33. Of Psydracium 218 34. Of Hydrocephalos 220 35. Of Talpa or Testudo 231 36. Of Tinea 234 37. Of Ficus 237 38. Of Cataract 240 39. Of Hordeolum 249 40. Of Vnguis 250 41. A Polypus 253 42. Of Parotis 258 43. Of Epulis and Parulis 261 44. Of Ranula 263 45. Of Strumae and Scrophulae 265 46. Of Bronchocele 275 47. Of Angina 278 48. Of a Tumour of the Tonsils 283 49. Of Empyema 288 50. Of a Tumour of the Diaphragma 294 51. Of Extuberancy of Milk 297 52. Of a Caruncle in the Yard and its manner of Extirpation 300 53. Of Ruptures in general 310 54. Of Bubonocele or Hernia Inguinalis 314 55. Of Enterocele or Hernia Intestinalis 319 56. Of an Intestinal Rupture the Peritonaeum being lacerated 327 57. Of Epiplocele or Hernia Omentalis 334 58. Of Exomphalos or Hernia Vmbilicalis 337 59. Of Hydrocele or Hernia Aquosa 341 60. Of Pneumatocele or Hernia Ventosa 349 61. Of Sarcocele or Hernia Carnosa 352 62. Of Cirsocele or Hernia Varicosa 356 63. Of a Venereal Bubo 359 64. Of a Pestilential Bubo 365 65. Of Phyma and Phygethlon 370 66. Of the Hemorrhoides 372 67. Of an Aneurism 378 68. Of Paronychia and Pterygion 383 69. Of Nodes of the Legs 387 70. Of Tumours and Apostems of the Knee 389 71. Of an Abscess of the Foot 393 FINIS ERRATA Page 6. line 18. read call l. 27. put out and. p. 12. l. 8. r. environed p. 16. l. 24. r. scite p. 22. l. 3. r. l. e. p. 28. l. 5. r. perfect cures p. 46. l. 16. r. Erysipelas p. 84. l. 11. r. this hath attended it p. 96. l. 9. r. Electuar Diacatholicon Ê’vj p. 98. l. 17. r. Succin p. 188. l. 14. r. Chamomel in many places r. aqu fontanae p. 225. l. 18. r. oft tiâ—es onely p. 229. l. 13. r. ceased to live p. 232. l. ult r. Unguent ex Apio p. 237. l. ult r. Ulcers It s Origin and Antiquity It s Origination shown in a great part by Holy writ As to its honour and Excellency It s learning and vertue It s Subject Mans upper parts The scene changed The middle Region The courage abated and this Sun Ecclipsed The third Region Nature made unnatural to it self by diseases It s Constancy and firmness It s fruit necessity and profit It s liberality and Charity What Chirurgery is It s end for which it was framed It s Order and method Into general and special parts In the Chirurgick garden grows things natural unnatural and preternatural Whâ— natural What preternatural or unnatural Three general Iâ—tentions The first The second Three waies to know how to cure a disease The third What person a Chirurgion ought to be Exercised in Anatomy Well read in Physick The knowledg of medicine proper for him What a humour is What blood is How 〈◊〉 Blood hot and moist Choller hot and dry A similitude between milk and choller Its uses What flegm is What melancholy 4 Species of melancholy The name of a Tumour It s difinition 4 Causes of Tumours 6 Heads of Tâ—mours by 〈◊〉 Observation of Falloppius A History The causes of Tumours are either congestion or Fluxion Inward causes Falloppius offers seven things as touching the differencies of Tumours From whence cometh our first intention Galens 7 Cautions Note Hippocrates his Rule How the young Chirurgion should open a vein If the thin matter cannot be digested it is to be revelled and bow this as to be done Observat Observat A Lixivium Urguent Catapl Empl. If made by loosness of a part Unguent
onely vomited up Flegm then he perceived the pain again in the same Side so as it turned not to the sound then was conjectured that there was a new Collection of Matter in the Side and he being prepared for the discharge of the same the Empyema was opened by a Caustick being laid on the Side and Matter for a long while came from the Side and at length the Patient perfectly recovered CHAP. L. Of a Tumour of the Diaphragma THE Diaphragma hath two sorts of Tumours belonging to it and either of them do bring the Patient in danger of death the one long the other short for by the Excrements forcing here they may make a Tumour both with or without a Fever If without a Fever from the beginning pain and difficulty of breathing a small and a hard Pulse and these Excrements we are to allow to be thin and crude and thence do follow a Tension of the Bowels because the Muscles are extended to the Diaphragma And if a Fever be joyned to these Tumours Experience does satisfie it is not sharp and it ariseth from the too long contention of Excrements in the part affected An Inflammation of the Diaphragma beginning there necessarily does follow a Fever and in respect of the Affect because the Tumour is made of hot matters and in relation to the part affected by reason of its near bordering upon the Heart there do generally follow from this Inflammation Pain and Difficulty of Breathing and therefore as Galen saith Breathing here in this case is small and frequent lib. 5. de loc affect sometimes Convulsions do succeed these Inflammations When such a Tumour of the Diaphragma is offered to you for cure let your first Intention be to discharge the Matter or Substance that is lodged And because the Origination of this does generally arise from Fluxion this also is to be prohibited and this is done by discharging the fluent Matter If you take them in the beginning they may give some hopes of Cure but if they be of any long continuance they admit of no Cure because they generally hurry the Patient into a Consumption and will not be taken hold of by the best of Medicines As to the Cure the first Intention is to discharge this Matter by well purging and clearing the Body of its Excrements and here such things are most proper as can discharge both Flegm and Water such as is Elaterium Radix Sambucinus or the like Phlebotomy is no ways proper here for the peccant Matter is cold and therefore Discussives are here most convenient And these may be said to be of two sorts some to be administred inwardly whilest others are outwardly to be applied and these ought to be both emollient and relaxing as Butter Fat 's Marrows and the like and these are to be ordered according to the Humour and the Strength of the patient first beginning with milde Medicines and then proceeding with such as are stronger as Oyl of Chamomile Dill and the like Here also you may use Emplasters and Unguents as of Mallows Marshmallows Lilies with Linseed Fenugreek seed c. preserving and desending the inward parts with such things as can discuss as Treacle Methridate Sarsaperilla c. I once saw in a Gentleman a Tumour bred in the Diaphragma out of crude and thin blood in which pain and difficulty of Breathing a hard and small pulse were present the Matter and Humour was cold and tough and crude and this shewed it Mortal for it brought him into a Consumption and the Abscess breaking he did spit up Blood and much indigested Matter These Tumours although they are bred of a thin and cold Matter yet in the place affected they thicken and for the performance of this there is required pain difficulty of Breathing a hard and a small pulse little or nothing changing it self no apparent Tumour shewing it self and if to these Tumours a Fever do joyn it self as Experience does oft times shew it doth it is not sharp yet they bring Death with them and when they persevere and are not resolved they bring the patient into a Consumption and so lay him even with the dust as it did the aforesaid Gentleman CHAP. LI. Of Exuberancy of Milk MAny Women in their first days after being delivered of their Burthen have a great redundancy of Milk because much Blood is sent thither and not taken away or sucked out for the helping of which it is thought by some that Repellers are very proper to be applied before such Women be delivered and so to hinder the address of Blood thither for after this much Milk being received it cannot afterwards be so well repelled but ought to be discharged by the Breasts or drawn out by Sucking or otherwise It may be prohibited if the Blood do not flow violently by these Medicines following as â„ž Bol. armen â„¥ j. Sangu Dracon Oliban an Ê’ij Ol. Rosar â„¥ ij Cer. acet an parum misce fiat Linimentum Or my Emplaster oft times used in this case with good success â„ž Emplastr Diapalm â„¥ ij Ol. Rosar â„¥ ss pulv Sangu Dracon Ê’j misce Or this â„ž Ol. Myrtin â„¥ ij Amygdal dulc â„¥ ss Terebynth Venet. Ê’ij pulv Mastich Bol. armen Corall Sangu Dracon an Ê’j pulv Myrtil Balaust Rosar rubr an ℈ ij pulv Salv. Betonic an ℈ j. misce cum cerae citrinae q. s fiat â—mplastrum A Schirrus does oft times proceed from coagulated Milk in Women as it fell out in a young Woman whose left Brest while she was giving her Child suck was wholly correpted with an Inflammation the which being allayed a large Tumour and Hardness remained which gave me suspition of a Scirrhus Her Body being well purged with a lenitive purgation the Brest and its circumjacent parts anointed with Oyl of Roses to which was added a little Vinegar and this for some days was used afterwards the whole Brest was anointed with this Liniment â„ž Empl. de Mucilaginibus Ê’ij ol Lilior Amygdal dulc pingued Gallinae an â„¥ j. Gum. Amoniac solut in Acet scillitic colat â„¥ ss misce fiat Vnguentum Over which was applied this Cataplasm â„ž fol. rad Alth. q. s incidantur minutissime postea coqu in aqua mortario pistentur fiatque cum farin Fabar. Axung Porcin Gallinae proprio decocto Malvar Cataplasma By these Medicines and the Body being well purged and a good order of Diet observed the hard Tumour grew soft and resolved and to the Ulcer I applied powder of Precipitate and over this Empl. de Ranis cum Merc. And with this method beyond expectation she recovered her perfect health CHAP. LII Of a Caruncle in the Yard and its manner of Extirpation AMongst the most dangerous and frightful Affects which do seize on Humane Bodie this of a Gonorrhaea may be well reckoned and this is excited by many causes for Acrimony and Thinness of the Sperm may be one cause so that