and amend the Symptoms The first doth consist in moderating the Air and this more properly in a long inflammation the second is ease and quiet because too much motion heateth the body the third is watching and sleep for as the one doth put our bodies into action so the other doth refresh and cool them the fourth and last is order of diet a fifth may be added which is retention or inanition of excrements for hard and dry excrements do obstruct and hence are bred sharp and malign vapours which do course through the whole body and do render the inflammation more dangerous and then actions of the mind may take a part here also The whole cure may be performed by Diet Pharmacy and Chirurgery Diet for prohibiting Inflammation of superfluous Humours and their generation and making them more unfit for Fluxion and here the Patient's diet should be thin moist and moderately cooling as broths wherein are boiled Lettuce Borage Bugloss Spinage Purslain or Marigolds if in Summer time our green sauce as we call it is very good being made of Sorrel if he will drink wine let him mix it with three parts of water to one wine Fluxion is discharged if we dismiss its causes as Plethory and Cacochymy and these may be lessened either by Phlebotomy or Pharmacy If the Inflammation be large and the Patient young strong and full of Blood we may safely breath a vein and here we are to observe that we breath not a vein too far distant from the part affected both for Revulsion and Derivation the first being to be made in the opposite part whilst the second is made in the same side near the part affected And since the body is seen seldome so clean but that there is some ill humours or other mixtures with the Blood purging also is here said to be convenient and for this case Cassia newly extracted Tamarinds Sebestins and Syrup of Roses are very excellent or if you please to take any of these as for Electuaries Bolus or purging potions As ℞ Electuar Diacatholic ʒvi Lenitiv ℥ ss Cass recent extr ℥ i. pul Diasenn ʒi Cremor Tartar ℈ ij misce and of this let the patient take the quantity of a Chesnut every morning or this Bolus ℞ Cassiae recenter extr ℥ i. pulp Tamarind ℥ ss misce cum Saccharo fiat Bolus Or this Potion ℞ Aqu. Endiv. Fumar. Cichor an ℥ i. Aq. Rosar Damasc ʒvi Electuar Diacathol ℥ vi Electuar è Suc. Rosar 3ʒij Crem Tartar ʒss misce fiat potio mane sumenda The body being thus discharged cooling Syrups Electuaries or Trochisces are very properly to be used as Syrup of Violets Roses Mirtills Poppies Wood-sorrel or the like or these following ℞ Spec. Diarrhod abbat ʒij Aromatic Rosat Troch de Rhabarb an ʒi Sacchar candit solut in Decoct Agrimon Veronic ℥ iiij misce fiant Trochisci Of which let the patient take a dram or two a little before Dinner An Electuary for this use may be this ℞ Cons Rosar Rubr. Violar an ℥ ij Conserv Lujul. Paralis an ℥ i. cum Syrup Oxyacanth Granator Violar an ℥ ss misce fiat Electuarium of which let the patient take the quantity of a Nutmeg at his pleasure Clysters also may be very necessary and of these may this very successively be administred ℞ Rad. Fol. Malv Alth. Parietar Violar Agrimon Veronic an M. i. fl Melilot Chamomel an M. ss sem Anis Faenicul dulc an ℥ ss sem Faenugraec Lin. an ʒij coquantur in s q. aqu fontinae ad lbi colaturae adde Sacchar rubr ℥ ij Diacatholic ℥ i. Sal. Commun pug i. Ol. Violar Rosar an ℥ i. misce fiat Enema Or this purging potion ℞ Herb. Agrimon Veronic Cuscuth Scabios an M. ss sem Anis Faenicul an ʒij Liquirit ras ℥ ss coquantur in s q. aqu fontinae ad ℥ iiij colaturae adde Electuar Diacatholic ʒvi Syr. Rosar solutivar cum Rhabarb ℥ iss misce fiat potio these being all managed with a prudent conduct according to the variety of occasions We arrive next to the part affected and this is to be dealt with by Revulsives Interceptives and Repellers And as I have already declared that Revulsion is made in the opposite part so such things as are here most requisite are to be hot and attractive of this sort are fomentations made of Sage Chamomile Calamint Hyssop Lavender Pennyroial Dill Tyme and the like these being boiled in water and applied very hot until the part looketh red Lixiviums also are here very convenient and Vesicatories especially if the Humour be fierce and plentiful as in Inflammations of the eies these being to be applied to the neck Aqua pendens gives us this as the best Epispastick ℞ Cantharid praeparat ʒi sem Sinap ℈ i. Ferment ℥ ss Aceti Scillitic q. s fiat vesicatorium After these Defensatives are to be chiefly used these being most properly said to be for hindring of Fluxion being in Quality cold and dry fit for contracting the vessels as ℞ Bol. armen Sangu dracon Mastich an ʒij Empl. Diapalm ℥ ij misce expande super corio and apply it A stronger than this is ℞ Bol. armen Sangu dracon Mirtill Balaust cort Granator Coral rubr Sus Cin. an ℥ ss Farin Tritic. ℥ ij album Ovor. no. i. cum Aceti Olei q. s fiat Restrictivum To prevent all mistakes and errors we are to be well advised that after Application of these Medicines we commit not that error which is too common amongst some Chirurgions who roll strictly upon the affected part not considering thereby that they both do detain the Humours and oft times by this their ignorance or carelesness they make a fair way for the invasion of a Gangrene into the part The third and last way is by Repellers performed and their cheif use is to hinder the Fluxion of any Humour to the part affected These should be cold in Quality and so should also be either moist and waterish or dry and restringent and of these some may be Plantane Balaustines Roses Dragons blood Whites of Eggs Vinegar Bolarmeny Myrtles and the like as thus ℞ Aceti Rosati ℥ iiij Album Ovor. no. ij Bol. armen sangu Dracon an ʒij Pulv. Myrtillor Rosar rubr an ʒi misce fiat Cataplasma Or this ℞ succ Semperviv Portulac Plantag an ℥ i. Acet Rosat Vin. Rubr. an ℥ iss Ol. Myrtin Rosar an ℥ i. pulv Myrtillor Rosar Balaust Bistort an ʒi misce fiat unguentum And this thing we are to observe that these repelling Medicines by how much they do intercept they are not to be applied to the affected part but onely about it encompassing it And this may serve for curing of Phlegmons in General We come next to treat of the curing of Phlegmones according to the several times CHAP. XV. Of curing a Phlegmon in its beginning IN the
with a fever pain watchings blisters and the like she being ordered a cold and moist diet and her body being kept open with Chologogick clysters as oft repeated as occasion required keeping her Room cool by oft times sprinkling vinegar thereon and prescribing her convenient Juleps and Emulsions I applied to the part affected this Unguent â„ž ol Rosar â„¥ ij Cer. flav â„¥ ss Vitellor ovor n o ij misce fiat unguent She being drest three or four times in a day until the pricking pain abated with this unguent afterwards was applied this Digestive for warming and comforting the part â„ž farin Hord. â„¥ i. farin Fabar. â„¥ iij. coquantur in vino q. s tunc adde pulv fl Chamomel Melilot an â„¥ ss Scord. Ê’ i. ol Rosar Chamomel an â„¥ i. vitell ovor no. i. misce fiat Catapl and if any blisters do arise this following unguent is very good and proper â„ž Ol. violar Rosar an â„¥ ij Lâ—â—harg aur â„¥ ss Thur. Ê’ij Ceruss Plumb ust an â„¥ ss succ Plantag Sâ—mpeâ—â—â—â— an â„¥ ss misce in mortario 〈…〉 urgnentum Or this 〈…〉 aur â„¥ ii pulv Alumin Ê’iiss albumin ovor no. i. bene agitatum cum oleo Rosar â„¥ iij. Acet â„¥ i. misce fiat unguent CHAP. XX. Of an Erysipelas in the Face THIS for the most part ariseth from the nose it first growing red then doth swell and then spreads it self and sometimes it doth get into the head and neck The causes which may occasion this may be said to be two being either inward or outward outward as contusions wounds or the like which may be accounted capable enough to excite heat and pain or inwardly taken too much hot wine spice or the like a hot intemperiety of the Liver which doth breed this so plentiful a quantity of Blood a redundancy hereof and a Fluxion of Humours to the part affected The cure hereof is much different from the former and in this we are to make a diligent search as touching its causes happening either by an outward or inward occasion If by an outward this being removed the Erysipelas doth cease if from a redundancy of chollerick Blood which floweth into the face the outward veins are to be opened and hence do arise three intentions in this cure first a cooling of the hot intemperiety of the Blood of evacuating and discharging of this chollerique Blood and thirdly to hinder this Fluxion And these are to be performed by Diet Chirurgery and Pharmacy by Chirurgery in Revulsion by Phlebotomy which ought to be performed in the arm in the same side and here you may bleed plentifully if the patient can endure it if not you may repeat it besides this other Revulsives are good as Cupping-glasses Vesicatories these being applied to the neck and shoulders Pharmacy doth relate to the better tempering the intemperiety and for this you may take these as proper Medinces being very good and useful in this case to be used and administred as â„ž Pulp Prunor. damascinor â„¥ i. Crem Tartar Ê’i Rhabarb Ê’ij Cinamon pulv Ê’ss Santal citrin pulv ℈ ij misce fiat Electuarium cujus sumat patiens q. nuc castaneae omni mane Or this potion â„ž Tamerindor â„¥ ij Prunor Jujub an par no. 5. Passular enucleat â„¥ ss Hord. mundat pug i. sem Melon Lactuc an Ê’iij fl 3 cordial an pug ss fiat decoctum in colaturae â„¥ vj. solve Cass recent extr â„¥ ss pulv Jalap Ê’ss syr Rosar solutivar â„¥ ij misce fiat potio Or this of the Author â„ž rad Petroselin Faenicul Cichor Lactuc incis an â„¥ i. coquantur in aquae fontinae ut colatura redeat ad lb. huic adde vini albi lb. in his simul mixtis stent per noctem in infusione Senn. mundat â„¥ ss Rhabarb Ê’i Polypod querc â„¥ ss sem Faenicul Anis contus an Ê’ij Epithem Ceterach Capil vener an p. j. ZZ Ê’i hujus infusionis sumato â„¥ iiij his adde pulv Jalap Ê’ss Crem Tartar ℈ ij syr Rosar solutivar â„¥ ij misce sumat cum costodia As to his diet which is the third part let the Patient abstain from Wine and instead thereof let him drink Barly water or Julep of Roses or cooling Emulsions such as you have already directed you And thus much of the inward causes As to the outward Applications they ought to carry with them a moderate temper between heat and cold for when heat and pain do urge these do call for ease and mitigation and if pain doth proceed from heat here most properly are we to use coolers without astriction as is the Decoction of Mallows mixed with a little oyl of Violets or Roses in the end we are to use Digestives as we have formerly directed and prescribed And thus much of an Erysipelas getting into any part of the head A country man being vexed with an Erysipelas Phlegmonodes the which being anointed by the advice of a Barber with oyl of Roses for some daies this happening in the arm hence did arise pain inflammation and other symptoms so that at length the whole hand was correpted with a Gangrene the which at last being well scarrified and such convenient Medicines applied as I have shown in my discourse of a Gangrene he afterwards recovered Let this serve as a caution to young Chirurgions that Oyl doth add to the flame rather than extinguish it as Galen doth offer in lib. 5. de Simpl. A Gentlewoman a person of very good Quality had an Erysipelas all over her face the which at length had a Herpes miliaris joined to it in which time the Erysipelas imprinted its marks so as the whole face was marked therewith she being of a plethorick constitution when neither by the advice of Physicians by bleeding purging or application of several external Medicines good could be done after the applying of several Unguents this at last being applied brought her unto her health as â„ž Vnguent de Lithargyr â„¥ i. Hydrargyr extinct cum succ Limon Ê’ss Tuth praeparat Ê’iij Ceruss lapid Calaminar praeparat an Ê’ij aqu Rosar acet Rosar an â„¥ iss agitentur omnia in mortario pistillo plumbeis Of this you may read in Observat 34. Riverii CHAP. XXI Of Oedema AS the former two have their variety of diseases belonging to them so also hath this its various companions bred of and from the same Humour for from Flegm are bred Oedema Artheroma Steatoma Meliceris Nodi in Juncturis Ganglion Leucophlegmatia and the like This Flegm is the fourth part of the mass of Blood that is the colder and moister part thereof and if it so happen that this doth increase in quantity the expulsive faculty being stirred up by the great plenty of this Flegm this doth offer very fair to the generating of an Oedema This Flegm is cold and moist and by some called pituitous Blood And of this there is two sorts one Alimentary the other Excrementitious The first is the
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
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
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
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
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
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
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
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
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
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
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
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
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
received a perfect Cure CHAP. LVIII Of Exomphalos or Hernia Vmbilicalis EXomphalos is made by the Peritonaeum being either relaxed or rent and hence oft times happens that the Omentum and the Intestines do fall into its place If it happeneth by the Omentum it retains the colour of the Cutis and there will appear a soft and almost indolent Tumour and is reposed without any noise but happening by the Intestines it appears unequal and upon its Reduction it maketh a Murmuration If it happens from Flesh it appears hard if from Wind soft and this by the Learned called Exomphalos by us a Navel Rupture proceeds from the same Cause as the former and may be treated with the same Curative Method save onely in this place you are to mind that you cover the whole Rupture with hard and thick and large Bolsters that hereby it may sufficiently be kept in If it happens that it proves a flatuous Tumour of the Navel cure it as you do Physocele if a waterish Tumour this is to be thus treated by making a small Incision and keeping it open so long as untill you have discharged the whole Water Hildanus in his Centur. 3. Observ 64. relates of a pleasant story to this purpose so does Benivenius tell us of a strange one the last I will produce first because that of Hildanus I intend to give according to the Author himself with his Figures and Method how to make and apply the outward Dressings and Ligatures Benivenius chap. 6. Abditis relateth a strange story of John Binus who had a Son whose Navel grew out like a Mans penis four fingers in length and as it were had a Coat of the Testicles joyned to it out of which sometimes Spirits did fly the which many Physicians saw whereupon some of them judged some of the Intestines had thrust themselves out others the Omentum others attributed it to Wind and Humours but at length it was concluded that it was a Fleshy Excrescency and for the taking this off there was a strict Bandage made the which was every day contracted or bound closer untill the whole was eradicated the which being removed the Patient recovered his perfect Cure and Health This of Fabritius Hildanus is of a noble and pious Martron in Germany in whom not onely the Navel it self but a little above the Peritonaeum and some part of the Abomen it hung down dilated into a great Bag in this Bag also not onely the Omentum but somewhat of the Intestine was contained Sometimes a murmuring was there perceived and then pain was present sometimes proving very vehement otherwhile more remiss according to the quantity of Winds then present She affirmed to him she got this Affect in the time of her Childbearing Of the rest because Prolapses of this sort of the Navel or Abdomen can be seldom reduced into the Belly or if they might be they are not there retained without great difficulty they produce wonderful troubles to the Patients that are therewith vexed when they by reason of the weight do draw their upper parts downwards For this purpose he hath invented a new Bag by which this Extuberance may as well as possibly be drawn upwards and so elevated that the grieved Patient may bear the burthen with much less trouble and incommodiousness This is to be made of a strong doubled Cloth fitted to the Thorax so as that it descends no lower than the first Bastard Rib and so backwards to the Thorax from the Region of the Omoplates making a Ligature on either side placed two fingers breadth and perforated in several places to fit it the better to the Thorax To this Ligature is to be annexed this large one with the Bag so as it may be lifted up or taken down according to the will and pleasure of the Patient by the benefit of which holes this may be done This Figure you may see very fairly described in this following Leaf together with the Bandage with Figures directing how to make and use it CHAP. LIX Of Hydrocele or Hernia Aquosa HYdrocele or Hernia Aquosa do either possess the whole Scrotum or part thereof This Aqueous Humour is not collected in the Scrotum but in the Membrana Erythrois containing the Testicle for into this a thin fluid Humour does make its influx being much of the consistence of Urine distending this Erythroidal Membrane and the subsistance of the Testicle in process of time is also corrupted by its acrimony By Aetius Leonidas this Aqueous Tumour is said to be loose and without pain the which is not to be eased by any Cataplasms Fomentations Emplasters or Unguents There 's one onely Remedy which must discharge it and that is Section or Incision and this is very manifest and apparent because the Seminal Vein of this part ariseth not from the Cava as do the right but from the left Emulgent The Kidney being by this evilly affected not performing its proper function part of the Urine the which the Emulgent protracts to it self whenas it cannot descend to the Bladder from the ill-affected Kidney it falleth into the Membrance Elythrois and here breeds Hydrocele and this being sublated with the Testicle this Humour can no longer remain here as Dodonaeus observes cap. 39. Observ The Causes hereof may be many some being occult others manifest occult as this waterish Humour being gathered from the repleted Vessels Guido adds a Vice of the Liver herein or Spleen by reason of which there is a Liquor collected in the Hypocondries which with ease does make its descent manifest as Percussion Collision Fraction of Vessels which are in the Testicles for the Blood which flows into the Vessels is changed and turned by reason of the weakness of parts into an aqueous substance Percussion and Collision and the like are its Signs the Tumour vanisheth if Hunger hath preceded If the Habit of the Body be ill this Hernia proceeds from the ill accident of some Bowel if not hence it may from too much Liquor for Repletion is made by too much Potation Aetius taketh the Causes from the Humour it self the which if it be yellowish and pale the Hernia will appear from the Repletion of the Vessels if feculent from Percussion if white from a Vice of the Liver or Spleen the Veins of the Scrotum are tumefied if it be compressed the Humour floweth into the Vessels which formerly were empty It shineth and appears very bright and is soft light and clear by viewing it and applying a Candle on the opposite part It is a particular Dropsie and as a general Dropsie is bred by a collection of Matter as in a Critical Abscess by drinking more freely of Water than can be discharged by Vomit by Generation by interception or alleviation of a Sanguisick Faculty So a Hernia aquosa flatuosa do either come by a primogene affection or by succession of some other Distemper and for this reason Hollerius does prescribe here
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