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
these most properly ought to be opened being nearer related to the affected part where more good may be expected than from the Arm. Should these be stopped they breed a Consumption in the Lungs a Dropsie in the Liver by suffocating the Liver as it were in its native heat and if they flow immoderately the Blood being evacuated the Liver is cooled thereby is excited a Dropsie and a decay of the whole Body For this immoderate Flux take these ℞ pulv Alo. Thur. Balaust Sangu Dracon an ℥ ss misce cum albumine Ovi fiat Vnguentum Or this ℞ ol Rosar Cer. alb nov an ℥ j. Axung Porcin ℥ ij pulv Plumb alb ℥ iss liquefiant praedicta supra marmoream injiciantur tunc adde plumbum Or this ℞ Axung Porcin ol Lin. an ℥ ij succ Taps Barbat Cynogloss an ℥ ij coquantur ad succorum consumptionem postea adde Sacchar Saturn ℥ ss cum pulv sem Lin. q. s fiat Vnguentum Or this ℞ Tuth praeparat Coral rubr Plumb an ʒiij Lap. Calaminar Lithargyr aur an ℥ ss ol Rosar ℥ iss succ Taps Barbat ℥ iss misce fiat Vnguentum Or if Pain Heat or Acrimony be urgent you may use some ot these ℞ ol Rosar ℥ ij Ceruss ℥ ss Lithargyr aur ʒij Cer. nov ʒiij Opii ℈ ss vel ℈ j. misce fiat Vnguentum Or this ℞ Thur. Myrrh Croc. an ʒj Opii ℈ j. fiat Vnguentum cum ol Rosar Mucilag sem Psyl addendo vitellor Ovor. no. j. Or this ℞ ol Rosar Olivar Myrtin an ℥ ij succ Plantag Milii an ℥ ij Acet ℥ j. coquantur ad succorum consumptionem tunc adde Bol. Armen Sangu Dracon Thur. Chalyb praeparat pulv an ʒj Cer. flav q. s fiat Vnguentum Or this ℞ Vitellor Ovor. no. j. ol Rosar Violar an q. s fiat Vnguentum addendo Vnguent Rosat Popul an ʒiij misce Amatius Lusitanus Cura 3. Cent. 5. writeth of a man about 45 years of age who was formerly vexed with a Venereous Disease from whence came from him every moneth Blood through his Hemorrhoids as the Menstrues in Women elsewhere He had such a plentiful Evacuation of Blood the which when he failed of his accompanied time performing its duty by these Veins he vomited much Blood out of his mouth being of a yellowish red without Cough or Fever and for the preventing of which evil he comes to advise with Lusitanus who advised him to be chearful and to the parts he orders 4 Leeches to be applied the which extracted six Ounces of Bloud after this prescribed him a good Diet and cooling Syrups as Syrups of Endive Fumitory Woodsorrel and the like for some days together and taking a purging Potion of Manna Rhubarb with Diaphoenicon c. with this order the Blood followed its former course and the Patient grew well Oethius writes also of one who when his Flux was obstructed below he did every moneth spit Blood at the mouth as you may have it lib. Observat CHAP. LXVII Of an Aneurism THis is a soft Tumour yielding to the Touch made by Dilatation or Relaxation of an Artery Every Artery except those which are dispersed through the Brain have allowed them a double Coat the inward of which being either corroded or rent the outward may extend so much as to cause an Aneurism Aneurisms may be made by Anastomasis Diapedesis Ruption Erosion or Wound of the Arteries It happeneth in most parts of the Body but chiesly in the Throat It is a Swelling encreasing by degrees and hath the same colour with that of the Skin a continual Pulsation If it be small it easily yieldeth to the Touch. It is difficult in Cure If it be large and in the Axillaries or Inguens in which the Vessels are large here expect no cure Incision very oft times causeth such a Flux of Blood and Spirits that it both dischargeth Art and Life very speedily This too often happens by the imprudence of an ignorant Chirurgion by pricking of an Artery instead of a Vein and so occasioning this Pulsation Pain and Tumour Some allow inward Causes as Intension of the Spirits Contusions Concussions Obstructions these being accounted as the chief of the inward Causes Some also do adde Melancholy Blood to be a Cause hereof lodged in the Veins and Arteries but the most usual sign of its Causes is drawn from the ignorant Chirurgion who by pricking too deep does wound the inward Artery the which is not easily to be cured by reason of its Spermatick Substance and Motion and thus the Blood by degrees is percolated out of the Arteries and making a Cavity for it self formeth this Aneurism the Matter hereof being a Spirituous Blood made by Dilatation the outward Matter is made by Grumous Blood thus raised together It generally receives these two Methodical Scopes in its Cure viz. Pharmacy and Chirurgery and where the one takes not the other must be attempted The first are Repellers and Restringents and convenient Ligatures or Lead strictly bound over the part or such an Astringent as this may serve the turn as ℞ Pulv. Bol. Armen Terr sigillat an ℥ ij Pulv. Rosar rub Sang. Dracon an ʒij Gallar immatur nuc Cupress an ʒi misce cum Albumine Ovi parum Aceti Oleo Rosarum fiat Restrictivum Let this remain on for two or three days These are to be used in smal Aneurisms but in large Aneurisms not happening in the Head or in the Groins they are accounted Mortal according to Aetius lib. 15. cap. 10. Some Artists do tie up the Artery both above and below and then divide between these two Ligatures but this Operation is dangerous painful and troublesom and seldom bringeth any benefit But to preserve Life I would rather if it happen in a place where it may lawfully be performed and exercised have Amputation made and before you begin this be sure to purge the body with Cassia Manna and the like and order cooling Juleps Emulsions and Hordeate Decoctions and keep the Body open by Purging and Clysters Hildanus in his 44 Observat relateth of a young Gentleman who being troubled with the Itch upon which sending for a Barber to breathe a Vein for him he pricked the Artery instead of the Basilick Vein whence did arise an Aneurism For the ablating of which above a moneth was used variety of Medicines to little or no purpose the Tumour equalled the bigness of a Goose Egge it was pale and hard in which was so perfect a Pulsation that it elevated the Dressings and Rollers as they might with ease be perceived He could not extend his Arm his pain was not great but onely when he would extend it Seeing how desperate it was he was very unwilling to undertake its Cure but being perswaded by the Prayers Desires and Requests of the Patients Friends to take it in hand he used this Method a good Order of Diet being prescribed to the
us it is an Art which informeth with reason how we may cure prevent and mitigate diseases by the help of the hand but it s most proper and essential definition is taken from eradicating diseases by Art and manual Operation for as 〈◊〉 hath it such medicines as are applied to Tumours Wounds Ulcers or Fistusaes cannot so properly be said to be cured by Chirurgery because this health is purchased and procured by help of medicine which was applied But where an Abscesse or Impostume is opened by Incision bones dissocated or fractured reduced by the hand Fistulaes dilated Cataracts couched Cancers taken of by Instrument and the like these may well come under the name of Chirurgery it being from the use of the hand that it taketh its name for it is derived 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 à mann opera and thus Chirurgery quasi 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 As for its subject matter I have already shown man being alone the proper Instrument hereof As to its end it was ordered and framed to repair natures wants to help her necessities to make her curvations right And to its order and method it is divided into Theory and Practice The first teacheth and is called science acquired by demonstration and knowledg of the principles of Art this carrieth with it the precepts of Art The second practice found out by Knowledg and Reason arriving at a greater degree of perfection by manual Operation and this daily experience adds to its lustre and truth It may also be divided into general and special parts These held general as the Articulations or soft parts Those special which teachthe right way of Operation about Tumours wounds ulcers fractures disâ—ocations and the like The scope of Chirurgery directs the Chirurgion to the well knowing and understanding these four parts as to remove solution of continuity to restore union where wanting to separate parts unnaturally united and to supply defects The first is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the joining part the second 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the separating part the third 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the removing part the fourth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the supplying part The first performed by Consolidatives Agglutinatives adducing Luxated bones and curing fractures The second acted by Incision Phlebotomy or Scarrification or Amputation as in wry necks hare lips imperforated Anus and Penis The third is finished by extirpating tumours as Ganglions Cancers Nodes Strumaes Scrophulaes Stones Cataracts drawing out of water from the Abdomen or Thorax by a Paracenthesis Amputation and the like The fourth he supplies in restoring Ruptures into their proper places as in restoring a new nose and bringing the blind eie to its sight And these are to be done Citò Tutò Jucunde suddenly without pain safely without cheat or imposture and pleasantly without fear or fallacy And that the Chirurgion may perform these with honour and repute let him take a turn with me in the several borders of this Chirurgick garden where he may first see what is natural what unnatural what preternatural thereby the better to furnish himself with Indications or Intentions against these or any thereof And the first that offer themselves here are the things of nature for whose end this first intention is appointed and that is health its cause effect its strength and temper all which are to be kept in their order and beatuy These are generally allowed unnatural or preternatural as a disease or distemperiety for this is said to be a praeternatural effect of it self and hurting action by its cause and this may hurt by action hindring it or by accident and then by symptoms which follow a disease as a shadow doth the body There are three general Intentions here requisite The first arising from a preternatural thing taking from its contrary as union from Solution of continuity coldness from heat heat from coldness driness from moisture and moisture from driness ablation from matter exceeding and encreasing from matter diminishing apertion from obstruction and dilatation from angustness astriction from amplification reposition into its proper place from whence it made its recession And as we are to observe this order of contrariety so also are we well to understand it which affect ought first to be cured the curing of which is the principal cause of curing the other and without which no perfecture The second Intention sheweth how we are to keep those parts intire which are placed according to nature and to discharge and expel those that are preternatural and we may understand an incurable disease these three-waies First when the disease of its own nature is incurable as the Elephantiasis or confirmed Secondly when the patient useth not such means as should be proper for his recovery Thirdly when the curing of one distemper threatens another greater and more terrible The third Intention is performed by opportune helps and conveniency use of right and proper medicines and these are either Medicinal or Instrumental Instrumental for living well and keeping a good order as Pharmacy Phlebotomy Emplaisters Uuguents Powders and the like The unguents a Chirurgion should alwaies have in readiness satisfying his common Intentions are these unguent Basilicon to maturate and convert into Pus Apostolorum to deterge and mundify Aureum to incarn and fill up Aâ—â—um to agglutinate and consolidate Dialthaea to mitigate and ease pain Instruments for all occasions large and small some for searching others for cutting for some drawing out extraneous bodies and others for putting or reducing parts into their respective places And these bring me to the Chirurgion himself which is to be the man onely engaged both in their applications and administrations and let us see what person he ought to be how qualified armed furnished and exercised To consider in what chair of honour and esteem a Chirurgion is seated may well require his care and study learning and excellency and since there is such a conjunction of the mind with the body such a connexion and society that they generally take shares of one anothers good and bad fortune as some deliriated with fevers whilst others are blown up with madness by the fury of choller To see the wonderful effects of blood while melancholy acts her innumerable changes in our bodies may well call into admiration the best of mens knowledg our thoughts varying according to the diversity of tempers in our bodies Thus are we troubled with diseases inflamed by anger sweetned by love exhilarated by joy dejected by sorrow tempered by sweetness shaken by fear and to search out the depth of these their originations and causes their diversity of shapes and postures may well require a quick sight to penetrate a powerful wit to search out a well guided reason to consider of He therefore that will enter this stage of Chirurgery must well understand its various scenes and acts for it s he alone guided by the provident hand and
act contrary to the rules of nature and have unnatural effects The one again being either alimentary proper for life and growth of the body the other excrementitious more proper for cleansing its sinks and channels As the Humour is so also is generally seen its Colour for as Blood is of a pure florid rosy colour so doth it give colour to the Muscles It is this that graceth the cheeks by affording them a a share of its redness and as it is made of Chyle and Blood so also doth it send forth its white and red and by how much the red exceedeth the white by so much are the Muscles more red than the Skin Choller is citrine and yellow thin and griping and as the four Humours do work man into a good humour so this burneth him into a passion it gives a lively paint of its colour in the Jaundies Flegm is white and washy and so are they that have too much of it being very cold and subject to Oedematous Tumours Dropsies and Agues Melancholy is black and masketh the whole body with an Ashy colour this is long and tedious in executing its office it being the most heavy an dsad part of the blood but at length bringeth forth the terrifying Scrophula Corroding Cancer Scirrhous Tumours Quartane Agues and the like and we daily find when it hath hatched them up to any growth it is very long if ever before it be made to part with them Besides these there are two others one a serous Humour which serveth as a vehicle to the blood ordered by nature for thinning it that it may pass to its smallest capillary vessels Part of this is sucked up by the kidneys where having made a short stay it maketh its further progress into the bladder and there remains whilst it be loaded the which being therewith filled is let out as useless and unprofitable Besides these comes Wind taking its circuits and turns and in our bodies is occasioned and bred by ill digestions crudities and wind the former making watery Tumours whilst this maketh slatuous Tumours But that we may well understand the foundation of these Humours let us examine from whence they are bred and whence they come 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or Blood as it is the cheifest and of the greatest service for life so ought this to take the preheminency in our discourse It is made from the temperate part of chyle in the stomack sent through the small guts into the milky vessels in the mesentery whereby nature hath ordained it a Receptaculum commune being here planted by Divine Providence as a bag for reserve for the most part full from whence passeth this chyle along the great Artery just by it untill it reacheth the Subclavian vein from thence it marcheth into the right ventricle of the heart by the vena cava and from hence is carried into the left ventricle of the heart by the Arteria venosa from the lungs and is there elaborated and made pure blood sweet of taste and florid in colour mild and benign This sanguification is a similar action and performed by assimulation and therefore taketh this chyle aforesaid as its subject matter for this assimulation and as they dewell together so do they assimulate together and this is done by process of time never passing to the liver as the Ancients dreamed for the chyle seldom or never reacheth it This blood as the vital liquor is sent through the whole body by its veins and arteries as its proper trunks and channels And although at its first appearance it sheweth it self pure and free yet hath it alwaies these three Humours adjoined to it as three several substances as Choller Flegm and Melancholy distinguishable one from another not only in taste sapour or colour but also in their effects for as Galen observeth lib. de natur homin the melancholy humour is acid choller bitter blood sweet and flegm having little or no tast and out of those being benign and pure is bred Scirrhus Erisipelas Phlegmon Oedema It is hot and moist which are the two species of its natural and unnatural temper and as Gal. lib. de Atra bile cap. 2. it is of a very red colour in its humour and is made of the best of juices and so bred from the best of tempers made by a temperate heat and those are its natural tempers As of its unnatural its proper substance is changed as its thinner part converted into Choller as Gal. 2. de Differ where he saith the thinner part is converted into yellow choller whilst the thicker turneth into melancholy Next to this is choller called by the greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 it being a humour hot bred out of the thinner and hotter part of the chyle and blood It hath but few spirits somewhat of Sulphure in it most of Salt and Earth It s parvity of spirits are evident in that it is of its own nature bitter neither hath it in it any great quantity of Sulphure for if we view its masse carefully it being neither Oleaginous or pingued neither doth it soon take fire yet it taketh Sulphure in it being principally exalted by adustion whence it bred this bitterness and although its salt excelleth in quantity yet doth it not gain preheminence It s flegmatick watery substance doth enlarge its liquid faculty its earthly parts thickeneth it and gives it the body it bears its heats and driness are sufficient signs of its being an enemy to the radical moisture and so unfit for nutriment that it is declared by all to be excrementitious This heat is the manifest cause of its bitterness made by a perpetual digestion of the blood thus milk unless oft times stirred in its boiling soon burneth and turneth bitter and as from heat and motion do colours change from white into red as Quinces being pale by boiling gain a red colour and chyle turned into blood by circulation and heat so also choller is as readily discharged of its first taste by adustion and perpetual digestion As to its uses Aristotle will grant it no waies useful Coryngius and some others do as much cry up its value offering that it serveth to warm the liver and to help digestion Helmontius calls it the balsom of the blood deduced from the liver to the mesentery but this is contrary to Anatomy for Anatomy teacheth that this humour is carried out from the liver not brought into it but onely sucked up by the Parenchyma thereof as through a strayner Others there are also as Zerbus amongst the rest that offer that if the bladder or gall be removed from the liver the substance of the liver would soon be dissolved and melted And to conclude this it s most proper use is to render the excrements fluxile The third is Flegm by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and this also is of two sorts natural and not natural The natural humour is cold moist crude in substance white in
Lancet and prepare himself for this Operation First let him make a pretty strict bandage a little above the elbow of that arm which he intends to bleed not too strict because he will very seldome hereupon but meet with obstruction in bleeding the Artery being too close girt that it cannot discharge it self into the vein And as to his Lancet let him make his apertion a little sloping or upon placing it a little obliquely let him get his Lancet into the vein and so lift it up not penetrating too deep lest he commit those errours which daily are acted by ignorant Pretenders and Quackes who oft go so deep as that they prick an Artery and so cause Aneurisms and pains Let the Orifice that you make be neither too great or too small the first endangering the Division of the vein whilst the second runs it into a Tumour Here also is he to judg of the goodness or badness of the Blood and so according to his judgment may take away more or less and also considering the necessity of the disease the strength of the Patient and the quantity and quality of the Blood The veins which are generally opened are these the Frontal vein one under the Tongue the Cephalick Mediana and Basilick but of every of those in their order and as necessity requireth The Frontel vein is most properly opened in infirmities of the Face and in pains of the Head Two veins of the Temples opened in continual Head-ach in distillations of the Head and Eies The veins under the Tongue in Anginaes Apoplexies pains of the Teeth the Jugulars good in preventing suffocation Squinsies Asthmaes Dyspnaea and the like The three in the Arm the first being the outward or Cephalick this may safely be opened in distempers of the head as Mania and other hot passions The second Mediana so called in respect of its Scituation being made both of the Cephalick and Basilick vein in opening of this vein is made a general evacuation of Humours this oft times opened in pains of the breast and Pleurisies The third is Basilica or Hepatica by some called Axillaris this dischargeth those parts which are beneath the Neck as the Brests Sides Liver Spleen and Pleurisies And this note of the three in all sicknesses and times except in time of Pestilence That vein is to be taken which is most full and large In the Feet also are three veins Ischiatiea Saphaena and vena Poplitis these or some of them are generally opened in Obstruction of the Monstrues in bringing them down pains stoppings swellings and the like I shall conclude this with these directions In an Apoplexy open the Cephalick vein if this appears not open the Mediana In a Lethargy open the Frontal or Cephalick vein In a Squinsey those under the Tongue In a Pleurify the Basilica and here bleed while the Blood doth change its colour In diseases of the Lungs vena Axillaris or Mediana In inflammations of the Liver Basilica or Hepatica In obstruction of the Spleen the Basilick or Hemorrhoidal veins In diseases of the Womb the Sciatick vein In restraint of Menstrues Saphaena In pains of the Hips first open the Basilica then the outward malcolus below CHAP. VII Of Evacuation of matter erring in Quality IF a Tumour or Fluxion happeneth in respect of matter not onely erring in Quantity but also in respect of Quality that this may be discharged we are to consider two things First whether this matter may be altered as if hot cooled c. Secondly to remove the subject matter hereof and in the first if Plethory Phlebotomy is proper if less Pharmacy is most convenient And herein are we to observe these two Rules that the matter may first be educed or sent forth being contrary to the true genus of the part and then if it doth still remain to alter it The most proper way to deal with this is by our later writers found out which is by discharging the body hereof by purging Medicines which do work both quickly and safely ordering the strength of the Medicine according to the vigour and strength of the Patient and herein also are we to mind the motion of the Blood for if it doth move to the eies this is to be revelled first by Cupping-glasses without Scarrification Secondly that the parts ought to be rubbed for the better thinning the Humour thirdly frictions which are proper for revelling from the Center to the Circumference And Galen nameth the last when parts are obstructed we ought to obstruct with Medicines but these are tedious painful and troublesome Our later Writers have found out better means and methods as by washing with warm water which doth revell by opening the pores another sort is by vesicatories and these are in great use in Apoplexies Rheumatisms or Distillations the third and last is an actual Cautery and Fontinels and Setons very much in use in our times And in all these we are to observe that Revulsion doth take its indication from that part from whence the Humour sloweth not from the Humour flowing and this being known we are to understand the parts which we are to revell CHAP. VIII Of a Tumour the part affected drawing to it self Preternatural Bodies THE greatest occasion or cause of attraction in a Tumour of a preternatural body is cheifly to be attributed to Laxity and Intemperiety of the part and pain This Intemperiety is therefore first to be removed by running it into a better temper And this may be executed with oyl of Roses Violets and the like having fine linnen rags dipt therein and so applied and these are oft to be repeated to prevent inflammation For this use also Vnguent Rosatum Refrigerans Galeni Populcon Album Camphoratum If pain occasioneth this we are here to give ease by Anodynes according to Galen 13. Meth. 1. and if any preternatural bodies offend discharge them either by Medicine or Instrument if pain cometh from venome cure this as you do venomed bodies and herein also are you to consider the times of the poyson for the longer it hath got room and entrance the deeper doth it imprint its venomous Qualities and Effects In this case Venice Treacle Methridate and the like are very good Spirit of Wine here also is very proper And thus are we to vary our methods according to the variety of our Objects In venenate distempers in cold poysons we use hot Medicines and in hot poysons on the contrary cold Medicines as Rue Frogs Scordium and the like commended by Dioscorides Galen doth furnish us with many pleasant stories of poyson and amongst the rest he doth offer that if any be bitten with a Scorpion if the same Scorpion be taken opened and applied to the part affected it draweth out its own poyson This generally being here observed that before you apply any Medicine to the poysoned part you first well foment the part with a hot and sharp Lixivium and when the place beginneth to
origination hereof by the Arabians called undimia by the Greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signifies no otherwise then an eminency There are of natural or excrementitious Flegm these three sorts the first being acid so called from its taste the second salt Flegm the third glassy Flegm from its coldness thickness and toughness And if Flegm doth erecede from its nature by admixing it self with Blood it is called Oedema Phlegmonodes if with Choller Oedema Erysipelatodes if with melancholy Oedema Scirrhodes A great matter hereof is a great quantity of Flegm residing in the body cheifly about the extreme parts as the hands knees or feet these being the most remote from the Fountain of heat This Flegm is thrown forth from the greater vessels to the smaller the which being there deteined by the thickness of the Cutis is collected in the musculous parts and there doth form this Oedematous Tumour It is a Tumour soft indolent loose yeilding to the touch generated from a pituitous matter It is soft and loose and these two come from the Humour of thin Flegm indolent for it neither doth make or cause any pain or dissolve unity It gives way to the touch and is a white Aposteme and without heat white being most like its object Flegm without heat being like the matter out of which it is generated which is cold and moist A pituitous Humour redundant in the body is the cheif cause to the which a cold and moist air a flegmatick diet too much sleep and idleness and a cold dyscrasy both of Head Stomack or Liver may help forward to the encrease of its cause And as Galen saith Comm. 46. that out of Fluxion of Humours some are cruel as Chollerick fluxes and burnt Melancholy and others are more kind as this Oedema so this is a tedious and long disease because it is cold the native heat being herein very weak It is oft times soft and without pain and so carrieth the less danger but if it be hard and with pain it is dangerous As touching its cure here ought we first to use proper means by Retraction and Revulsion of the Matter and lessening of it Secondly because it is cold remove its cause by implanting heat and warmth herein Let the Air be warm and dry the Diet attenuating and drying here Wine is good because it doth digest and warm Let his diet be of good and light digestion as Chickens Rabbets Partridges and the like to which may be added all sorts of spices Let his sleep be moderate and let him avoid all passions of mind and venery and observe that he keep a good habit of his body After this let him use such evacuations as may both attenuate open and discharge this Flegm Bleeding here is in no wise to be used unless a Phlegmon do accompany it Fever or the like And for his use these Phlegmagogicks are very proper and convenient as â„ž Alo. lot cum aqu Majoran Agaric trochisc an Ê’i Mastich Cubebar an gr vi Troch Alhandul ℈ ss Cum syr de Betonic q. s fiant pillulae dosis Ê’i Or â„ž Pil. Coch. Ê’ij Aurear. ℈ i. Troch Alhandul gr iiij cum Oxymelit scillitic q. s fiant pil no. 18 quarum sumat 2 omni mane Or if you will â„ž Pil. Coch. ℈ ss extr Rud. ℈ i. Mercur dulc gr 15 ol Câ—ryophyllor gut i. misce sumat mane A potion preparing Flegm â„ž Hyssop M. i. Menth. M. ss Absynth M. ss sem Anis Faenicul Calamenth an â„¥ ss Rosar rubr â„¥ ss fiat decoctum ad lb. colaturae adde Sacchar lb. aromatizetur cum pulv Cinamom Ê’i or this potion â„ž aqu Meliss Bugloss an â„¥ ij in his in funde per noctem Rhabarb Ê’i Agaric trochisc ℈ ij pulv Cinamom ℈ ss ZZ Ê’ss colaturae adde Mann â„¥ ss Cambog gr iiij aqu Cinamom hordeat â„¥ ss misce fiat potio Or if you please this â„ž Electuar Diacatholic â„¥ ss Diaphaenic Ê’ij pul Agaric troch ℈ ss solvantur omnia in aqu Hyssop Rosar damascinar Faenicul an â„¥ i. misce fiat potio cui adde syr de Betonic â„¥ iss And because Oedema is a disease offending partly in quality partly in quantity in respect of its cold and moist quality we are to use such Medicines to the part affected as are warm and dry and in relation to its quantity we are to endeavour its discharge and evacuation And since here is required a double intention here ought we carefully to inquire and examine whether Repellers mixed with Digestives are in the beginning first to be used Galen doth satisfie us cap. 3. lib. 2. ad Glanc that they are to be used as you may find him there using a peice of sponge or linnen rags dipt in Oxycrate to which a little salt is added and so applying it over the part and then ordering it to be rolled up for Repulsion is this roller being dipt in vinegar and the sponge and the water do digest the pituitous Humour But it may be asked how Digestives being hot and dry may or can agree with water which is cold and moist in digestion Galen doth answer this Chapt. 8. lib. 1. that water doth digest and this we may see in the hands and feet of Fishermen who having been much imploied in the water you will find them both corrugated and wrinkled which corrugation is nothing else but the evacuation of that matter which formerly filled up the spaces But should an Oedema happen upon the Tendinous or Nervous parts we are to use little vinegar and for discussion of the matter this may be very proper â„ž fl Chamomel Rosar Mirtin Absynth Staechad a. M. ss Alumin Roch. Sal. commun an â„¥ ss Balaust nuc Cupress an M. i. Salv. Rorismar Squinanth an pug i. coquantur poscâ factâ ex Lixivio coquantur omnia usque ad Ê’ae partis consumptionem in quo madefaciatis Spongiam and this you are to use to the state Or this Cataplasm â„ž pulv Rosar rubr Mirtin Absynth Rorismar Staechad an Ê’ij pul fl Chamomel Melilot an Ê’i misce coquantur cum q. s Hydromelitis fine addendo pulv nuc Cupress Squinanth Balaust an Ê’iij Or this Cataplasm â„ž farin Fabar. mic pan an â„¥ iiij pulv Terrae cimol â„¥ ij sem Lin. Faenugraec an â„¥ j. Bol. armen Ê’i coquantur in s q. Lact. vaccin ad Cataplasmatis formam fine addendo Camphor Croc. an ℈ i. vitell ovor no. ij misce fiat Cataplasma Or this â„ž farin Hord. Fabar. an â„¥ iiij pulv Rosar ru Bacc. Laur. Mirtillor an â„¥ i. pul fl Chamomel Sambucin Melilot Ivae arthritic an â„¥ ss fim caprin â„¥ ij cum vino rubro fiat Catapl fine addendo Sapon nigr â„¥ iij. applicetur bis in die And because Quicksilver hath a very strange penetrating quality allowed it that it can command Flegm from
times doth happen and arise from a weakness of the Kidneyes which are not strong enough to attract this plenty of Serum or may be occasioned by drinking too much Wine for as Galen saith this waterish Humour is the excrement of potion You may know it by its Splendor and Fluctuation if you press it with your Finger and a particular Sign of a waterish Tumour is that it is made with itching occasioned by the saltness which is contained in the Humour Such as cometh from an evil affect either of Liver or Spleen is very bad and dangerous not because of the Tumours but in respect of the principal parts yet they are not so dangerous as windy Tumours The Cure is to be performed by ablating the Causes and if this do arise from two much drinking order your Patient to lessen his quantity and abstain from this course and habit of living and use Driers and if it happeneth from a vice either of the Liver or Kidneyes this is to be corrected Hydragogicks are most proper here as â„ž extr Elater gr iij. Cambog Resin Jallap an gr v. faecul Rad. Irid. gr ii Ol. Macer gutt ij misce fiant pillulae quarum sumat 2 omne mane Or â„ž extr Rud. Ê’ ss Resin Scammon ℈ ss ol Nuc. mosch gutt ij misce sumat cum Custodia â„ž Resin Jalap Scammon an gr vj. Mercur. dulc ℈ ss pulv Jalap gr vj. cum syrup Rosar solutivar q. s fiant pillulae addendo ol Caru Ch. gut ij misce Or these â„ž Troch Alkakeng Ê’ss spec aromatic Rosat Diagalang an ℈ i. Philon. Roman ℈ ss pil de succin ℈ ss Terebinth venet in aquae vitae solut q. s fiant pil quarum sumat 2 or Ê’ omni mane Or this Condite â„ž Cons Absynth Menth. an â„¥ i. Cort. Citr condit â„¥ iss spec Diacalaminth Ê’ij sal Sambuc Ê’i spirit Nitr ℈ ss ol Cinomon gutt v. Macer gutt 10. misce fiat Conditum As touching Topicks the Humour is to be discharged by Digestives and here we ought to rarify the skin that it may with ease come forth and for this purpose this Cataplasm is very good and proper â„ž fol. Malv M.i. farin Lupinor â„¥ i. ol Aneth Chamomel an â„¥ ij coquantur contundantur in Vino albo fiat Cataplasma Or if you be for a stronger you may use this Unguent â„ž sem Sinap sem Vrtic Sulphur Spum mar Aristoloch rotund Bdell an â„¥ i. Ammoniac ol Aneth Cerae an â„¥ ij misce fiat Vnguent Or this â„ž Sal. Nitr Ê’10 Piper bacc Laur. an â„¥ i. ol Laurin â„¥ vi Cer. q. s fiat Vnguent If with these they are not cured they are to be opened and the Ulcers to be mundified with Resine Turpentine and Honey or Vnguentum ex Apio c. then is it to be impleted with Flesh with Vnguentum Tuthiae and dry it up with Pulvis Tuthiae Desiccativum Rubrum Diapompholigos or Diapalma Fabritius Hildanus relateth of a man of thirty years of age very strong and of a sanguine complexion who fell into a Leucophlegmatia that he swelled from the neck to his foot his Optick nerves being obstructed hereby he grew blind Upon ordering the Patient opening Apozemes and giving him preparative Decoctions a great Flux of Blood fell accidently from his Nostrils so that he bled above four pounds and hereby fell into a Syncope but being a little revived after his Flux was stopped and his Faculties beginning to gain a better habit and condition beyond the use of any Medicine this flux perfectly cured him of his waterish Tumour This is occasioned as the Greeks do call it 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from an aluminous salt of the Liver or some other principal part the which by its subtile penetrating quality doth force it self into diverse parts of the body CHAP. XXIV Of Windy Tumours UNTO this windy Commander do belong these several Souldiers as Pneumatocele Tympanites Priapismus Satyriasis and the like This Wind doth carry in it a very strange and wonderful power and force in our bodies and is as it were a certain Lightning scattered through the insensible Trunks insinuating it self into abstruse parts for it reacheth the Bones and doth create very great trouble in our Joints it bringeth greifs between skin and bones and doth ruffle and disorder the whole Man for where it is compact with any other Humours it doth there make both a long stay and doth stir up but many sad Symptoms This sheweth what Wind is whereof are bred these Tumours Let us now see what these Tumours are A slatulent Tumour by the Greeks is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and he that is afflicted with these is oft times girded in his Sides and stretches in his Belly It is oft times caused of Crudities and because it maketh the part thick by reason of the grosness of these Flations it doth oft times make troublesome and tedious work for the Chirurgion Its causes are flatulent Spirits viscid or vitreous Flegm and want of native Heat thus the heat is but small which doth work it self into these Humours and so doth somewhat dissolve them and so doth arise this flatuous Spirit and this being bred doth elevate the part where it once getteth footing because it cannot work its free passage by reason of the density of its parts It is seen to arise in several parts of the Body as well inwards as outwards Here is held by Avicen a double kind of this windy Tumour the one being made by a light Vapour assimulated to Althegeâ—â—um the which is nothing else than a Tumefaction like to a Cachexy this arising from the disaffection of the Liver and there is another Tumour arising from a windy Vapour and this by Avicen is called Inslatio This is bred from Flegm coming from the larger Vessels to the smaller until it hath arrived at the smallest and at the coldest parts It showeth it self apparent in compressing the Tumour with the Finger and you may then see it easily yeild to the touch as doth an Oedema Then upon this compression it maketh a noise for Wind being kept in and being by your Finger prest out from its quarters this never parts from its place without a noise or sound Thirdly it is deteined in a cavity Fourthly as Guido doth offer it appeareth lucid and splendid in its upper part Fifthly it is not alwaies free from pain And lastly being contained in the larger Vessels we daily find the great and many troubles and vexations it brings to mankind As touching the Cure pray observe with me this method wherein we are to observe an Order Mode Time and Substance Order this cheifly consisting in Diet. As touching the Patient's times or eating and drinking that he neither eat too soon or too late between meals or after supper going to Bed and the like or in his bed Mode that he neither eateth more
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
Medicines formerly applied by this Quack there was first used this Emollient Fomentation two or three times in a day with which the part affected was fomented ℞ rad Bismalv cum Tot. Lapath acut Screphular an ℥ ij fol. Malv Violar fl Melilot Sambucin Melilot an M. i. sem Faenugraec ℥ ss coquantur in aquâ ad 3 partis consumptionem The part affected being herewith near half an hour fomented cover the parts with this Catapl ℞ farin Fabar. Lupinor an lbss sem Fenugraec Lin. an ℥ ij rad Alth. recenter coct cribrat ℥ iiij pulv fl Chamomel Rosar Melilot Absynth an ℥ i. misce fiat Cataplasma With this being applied for fourteen daies and the Fomentation continued the hardned Skin grew soft the Pain allaied the ichorous Matter which flowed out of the Ulcer was prepared and brought to a fair Digestion after this was sprinkled upon the Ulcer Precipitate in pouder being washed in Plantane and Rose-water and over these applied this Empl. ℞ Empl. de Mucilaginib Diapalm an ℥ iiij De Ran. cum Mercur. ℥ i. Alumin ust Calcanth an ℥ ss ol Rosar q. s fiat Empl. molle And about the end this Unguent ℞ rad Scrophular Lapath acut cort Frangul an ℥ iiij succ Fumar. Scabios Acet an lbi Pinguedin Porcin lbij. conquassentur Radices cum succis ad eorum consumpt coquantur colentur colaturam serva ad usum ℞ hujus pinguedinis colatae lbi pulv Alumin Vitriol opt farin Lupinor bacc Laur. Ciner fuligin an ℥ iss Argent viv extinct ℥ ij Theriac ℥ i. fiat Vnguent in mortario With this anoint the whole Leg keeping his Body open with Conf. Hamech c. CHAP. XXIX Of a Gangrene and Sphacelus A Gangrene is that which doth feed on the flesh and poysoneth it and imprints a strange unnatural Quality in it By the Greeks it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from the verb 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is Exedere But there are more essential Definitions hereof by some it is said to be a change from a natural to a preternatural Colour and by these it is called Mortificatio Galen doth call a Gangrene the beginning of a Mortification in the part affected the which doth so trouble and infest the neighbouring parts that without the best of Medicine be applied by a very skilful hand it does speedily run it self into a Mortification Inflammation by him also is accounted as a very great Instrument hereof and here beginneth a change of Colour decay of Sense a turning to Mortification We more properly allow and decree it the beginning of a Mortification and that it very oft times happens the which I have very frequently found in my practice experimentally to follow or succed large Inflammations and thereby do corrupt the soft parts as the Muscles Cutis Veins c. A Sphacelus is worse than the former for under this name we may comprehend Syderatio Putrefactio Corruptio and Mortificatio 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by the Greeks is held to be a most intense Disease so is a Gangrene by the Arabians A Gangrene is a Disease consequent to the effect not to the cause Sphacelus is a Disease exeding and compressing the parts It is a perfect Syderation and Mortification for a Member being corrupted with a Sphacelus is found plainly cold and dead While the member is in a dying posture and not quite dead it is called a Gangrene this for the most part remaineth in the upper superficies and doth onely possess and affect the Muscles and soft parts in a Sphacelus not these onely but the Bones themselves become affected In a Gangrene the Skin groweth red by reason of its companion Inflammation in a Sphacelus it first groweth pale then livid and afterwards black In a Gangrene you have no very ill smell in a Sphacelus never expect a good smell In a Gangrene your greatest design must be to prevent the spreading of the Humour and if it hath got place to prevent its growth in a Sphacelus its lost labour then to act or treat any other waies than by Amputation for there is no hope of bringing a dead part to life It gains its Name of Syderatio from that of Plants being a proper passion of them when they lose their natural moisture the which doth afford them their full growth and beauty this affect is called Syderatio as if they were struck by the Stars The immediate Causes of a Gangrene are three Intemperiety of the part when the transpiration of the Spirits are obstructed and when both the Heat and Spirits of the part are suffocated Sometimes it cometh by cold and then is to be discharged by heat in Gun-shot Wounds it doth frequently happen by reason of large Contusions it is sometimes also bred by the carelesness of Physicians who in the curing of an Erysipelas in the beginning do order and prescribe cold things so being in Act and Power that they are made capable to destroy the natural Heat oft times by defluxion of Humours or venenate Pustles which are left uncured sometimes out of immoderate Driness other times arising out of the Interception of the vital Spirits and very often out of Obstruction in the beginning of the Nerves And since there is a Mortification and Extinction of life and Destruction of the native Heat let us consider which way and out of what universal Causes this may happen Mans innate Heat cannot be supported without a radical Moisture and its Spirits justly and in their order implanted in all the parts of his body so that consequently upon hurting or offering any injury to this radical Moisture its Spirits also will be resolved dissipated and consumed and therefore first there is an Intemperiety occasioned out of the vehement alteration of the manifest Quality Secondly out of the occult Quality a malign and virulent Substance is contracted in the Body and thirdly the Parts are thus mutually affected with an Interception and Suffocation of the vital Spirits As to the first Galen doth observe and offer that every thing is kept preserved and propagated by its natural Heat and Temper so that nothing can alter or destroy this sooner than a contrary preternatural Temper and Heat thus a Gangrene doth happen after a long and tedious continuance of an Inflammation made either by Affluxion or Congestion of some sanguinary or cholerick Humour the natural Humour being dried up by the preternatural It may arise secondly either from a concomitant Malignity either brought outwards to the Body by the biting of some venemous creature or by adhibiting of Septicks In a hot Intemperiety the Pain and Pulsation which formerly were concerned with the Pulsation is much more remiss and the red Colour of the Inflammation doth begin to change into a Lividness here also do arise Pustules filled with an ichorous Matter these being all Forerunners of its tending to Mortification and both Heat and
Blood do perfectly run to the Center whilst the other parts thereof do suffer Putrefaction It arising from cold doth cause and make a great and pricking Pain Soon after this it changeth its red Colour into Lividness and maketh it most cold afterwards sending the Blood away by its Coldness and dispatching the native Heat and dissipating its Spirits doth make the affected part perfectly void both of sense and motion a horrour and trembling attending it much like the fit of a Quartane Ague There is generally held five Signs of a Sphacelus First the affected part is much more heavy and dull than formerly it was Secondly the Floridness and Redness of the part do turn into a Lividness and Blackness Thirdly the part which was soft in a Gangrene groweth hard in a Sphacelus Fourthly the Cutis being taken up is seen with ease to separate it self from the Flesh And lastly there is no exquisite sense or perfection but a perfect Mortification remains We are if we intend to cure a Gangrene aright to study and find out the Antecedent Cause thereof and from thence to take our first Intention as thus If it happen from a fiux of hot and moist Humours let the Patient's Diet be cooling and drying for purging nothing is more proper here than Chologogicks as Electuarium Diaprunum Diacatholicon Lenitivum Syrup of Roses and the like Phlebotomy is very necessary also to prevent the further growth of Inflammation for opening the passages and making a more free Transpiration but in all sorts or kinds of Gangrenes this is not to be used For in a Cholerick and bilious Humour we are not to attempt it Blood being as the bridle to check and command this Choler In the case of applying of Topical Medicines observe these rules The first is taken from the Cause for if the afflux be cold and flegmatick evacuate more powerfully and warm the Humours with Defensatives The second is taken from the Age of your Patient for in a young body the Flesh and all its parts are soft and tender and therefore are you to order and prescribe milder Medicines than to those of a fuller growth A third ariseth from the Sex a Child being to be treated with more mildness and Gentleness than one of an elder age and a Woman more tenderly dealt with than a Man The fourth is from the Strength of the Patient for you may powerfully exercise your operations on such as are of a good and strong constitution whereas you are more sparingly and tenderly to use such persons as are weak and sickly The fifth ariseth from the part affected for the Eye Mouth Pudenda Anus Vertebre and other such sensible parts are not to be dealt with as you may deal with an Arm or Legg Sixthly the greatness of the Disease is to be much minded and regarded If it be new done and the Putredness not much nor made any deep impression to scarrify the part lightly and to apply Aegyptiacum alone is enough If it be more powerful and do threaten a Sphacelus here is to be made a deep Scarrification and you are to mix Spirit of Wine with Aegyptiacum very hot and often These are your general rules I come now to the prosecution of a particular Gangrene arising from Inflammation and here the first Intention is to be performed by Astringents or Desiccatives as â„ž Bol. armen â„¥ iiij Terr sigillat â„¥ ij Corn. Cerv. ust praeparat rasur Ebor. an Ê’ij Camphor Ê’iij Cer. â„¥ iij. Ol. Rosar lbi Acet â„¥ iiij Aqu. Rosar â„¥ iij. Albumin ovor no. ij misce fiat Vnguentum A Cataplasm for the same is this â„ž farin Hord. â„¥ iiij Bol. armen â„¥ ij pulv Gallar virid nuc Cupress Cort. Granator an Ê’iss Camphor Ê’i cum Oxymelite q. s fiat Cataplasma The second Intention is to revel the Humours and to send and discharge them into other parts And here this Bolus is proper â„ž Cass recentèr extract Ê’ij Electâ—â—r Diacatholic â„¥ ss cum Saccharo q. s fiat Bolus The third Intention is to restore the part to its former health and this is to be performed by evacuating the Blood and other compacted Humours from the part affected and therein concluded And since I have given you the general and particular Method of curing a Gangrene in general I shall still illustrate it with some examples It being a thing of great import as touching the Life and Limb of many a Man And for brevities sake because I do not desire to swell up my book with Tautologies or commit to your reading here any thing you shall elswhere find parallel I will present you with a History of a vertuous maiden Gentlewoman in Norfflolk near Norwich who after a long and tedious Sickness had a very large and great Inflammation seized her Foot the which very speedily spread her Legg and got upwards into her Thigh with a great Discoloration Pain Heat and Fever accompanying My never to be too much esteemed Uncle being sent for to this Lady could not go to her I being by Sir Thomas Brown's order sent for and finding all these already written symptoms upon her consulted with my self and reason what might be the most safe way to quit her from the ensuing danger she without speedy help might fall into with this Method and Almighty assistance I got her loosed from her fears and perplexities which threatned a Gangrene I first anointed her parts affected with this mixture â„ž Ol. Rosar Aueth Chamomel aâ— â„¥ ij Acet Acerâ—iâ—n â„¥ i. misce and having finished this Embrocation I applied to all the inflamed parts this Cataplasm â„ž farin Fabar. lbss farin Hord. Lupinor an â„¥ iij. pulv Rosar rubr â„¥ i. pulv fl Chamomel Melilot Sambuc an Ê’i farin sem Fenugraec â„¥ iij. Croc. Ê’i Bol. armen â„¥ ij Corn. Cerv. ust â„¥ ss Camphor Ê’iss pulv herb Rut. Scord. Absynth Scabios Virg. aur Agrimon Veronican â„¥ iss pulverisentur omnia misceantur cum Vin. Aqu. fontan an q. s his addendo Acet Rosat â„¥ ij coquantur ad Cataplasmatis formam fine addendo ol Rosar Aneth Chamomel an â„¥ ij By the application of this Cataplasm within three or four daies the enemy began to take his leave of her I continued every day anointing and applying this Cataplasm to her After this upon the back part of her Foot a new flux of Humours began to make their incursion and there they made two Ulcers in which were contained a great quantity of thick cold indigested Matter lying very deep and there spreading it self much resembling a Coar or Eschar for the removing and taking away of which I ordered this Fomentation with which the whole Foot was fomented eight or ten times one after another for three Weeks or a Month together â„ž fol. Rut. Scord. Absynth Veronic Meliss Betonic Salv. Hyperic an M. i. Tormentill Chamaedr Virg. aur Laur. Rorismar an
open and by purging it from its Flegm and waterish Humours as this ℞ Extr. Rud. ℈ i. Pil. Coch. ʒss Resin Jallap gr vi misce or this ℞ Pil. sine quib aur Indic an ʒss Resin Scammon ℈ ss misce for two doses The part affected is to be treated with Coolers and Discussives as are Mallowes with Barley Meal and Cicers being made into a Decoction or some of my discussing Cataplasm already prescribed or this ℞ Farin Fabar. ℥ i. Hord. ℥ ij coquantur poscâ ad formam Cataplasmatis in fine ebullitionis adde pulv Rosar rubr ℥ ss post unam ebullitionem ab igne remove tunc misce album vitel Ovor. no. Ol. Rosar parum misce fiat Cataplasma If the Psydracium be ulcerated and a moist Humour cometh from thence apply this ℞ Litharg aur ʒi Ceruss ℥ ss Alumin ʒij fol. Rut. cum Aceto Oleo simul mixt fiat Vnguentum with which anoint the Skin and having well embrocated it with this you may conclude your Cure with this Liniment ℞ Lithargyr aur Ceruss pulv an ʒij Sulphur ʒi Ol. Rosar q. s fiat Linimentum And lastly aqua Scahiosa is by many held to be most excellent here Alome being added to it CHAP. XXXIV Of Hydrocephalos THIS is a proper Tumour of the Head arising for the most part from Water and hence doth it take its name This is a Distemper which doth very oft come into the World with young Infants being either bred with them in the Womb or else so as they are bringing into it It may also be occasioned by a careless or ignorant or unhappy Midwife It may well be called a Cephalick Dropsie for it doth contain in it a proper Waterish substance known by its indolency softness its easie yielding to touch but chiefly from its inundation of Water running out of one place into another in its compression These Tumours do often times vary for in some they are small whilst in others they do appear very large It is a peculiar Disease in the Head of young Children the which ariseth from too much Humidity of the Head for which very Cause they which are much troubled herewith do seldom live long as both Galen Aetius and Paulus do observe This Tumour by Galen in Libr. definitionis is thus designed as being a collection of waterish Humours or feculent Blood in some parts of the Body which doth force it self up to the Head And here is a double meaning to be explained the one whereas he calleth it not only a collection of a Serous Humour but also of a feculent Blood as when the Head Cranium suffers an outward Contusion or Collision and the Veins by this Collision do sprinkle their Blood between the Cutis and Pericrane This Blood here thus putrifying doth make a most soft Tumour and if a serous aquosity were collected the which by dayly experience may well be offered to happen from a Contusion thus happening it may frame a Hydrocephalos Aetius lib. 6. cap. 1. will have that a Hydrocephalos may be generated from a Feculent or bloody Matter the which being changed into a thin substance A second of Galens is that a Hydrocephalos is a collection of an aquous Humour in some part of those Bodies which have a forcing quality towards the Head out of which it may be conjectured that Galen doth offer that Hydrocephalos to be a Disease of some part of the Head not a Dropsie of the whole Head and this is confirmed by Aetius and Paulus who treating of Hydrocephalos do allow four species hereof First when this Humour getteth between the Brain and Membranes Secondly when it lyes between the Membranes and the Skull A third between the Bone and the Pericrane And Lastly when between the Pericrane and the hairy Scalp I have already shown you part of its Signs that it is a Tumour soft in touch whitish in colour indolent turgid much like a Pillow to other parts easily yielding to touch and as speedily filling up its former made vacancy the Finger being removed If it ariseth from a Contusion it doth appear first red and doth carry pain with it as Aetius doth write but being afterwards changed into a thin substance it doth spread it self without pain In those where it happeneth between the Pericrane and Bone they answer plainly the rest for here it is hard in Tumour and very painful by reason of the distention of the Pericrane If it happeneth as sometimes it doth between the Membrane of the Brain and the Skull it will be a Tumour but not yield to compression nor soft to touch Here it maketh the Infant soon to give way to it and to yield up its Ghost Its Causes may be said to be sometimes outward sometimes inward One of the outward may be said to be that which is mentioned by Paulus in Children newly born who had their Heads but ill bound up by their Midwives Another is contusion or collision or ruption of one or many Vessels Another cause is a cold Air or too much Water or thinness of its passages or Vessels out of which this Serum or matter do recide as Aetius hath it or also too cold or waterish Milk which it may suck from the Nurse these may be said to be the inward Causes hereof as when the Brain is too much cooled or the matter being here first collected and hence sent to the Brain Every Hydrocephalos is very slow in its motion as Aetius doth prove Lib. 6. Cap. 1. For it hath a cold Brain inwardly from its beginning arising from its inward Cause and also an outward by and from its outward Cause by reason of its delay and contaction To draw all these to one head there is to be allowed two Species of a Hydrocephalos One in which this waterish Humour is contained and made by an inward Cause that is out of an abundant collection of this serous matter in the Body The second doth not contain the sincere Serum but as it were a mixt feculent Blood the which doth eat it self out of the lacerated Veins arising from Contusion or some other outward Causes As to its Presage Paulus Aetius and Galen do offer that if this Humour be collected between the Brain and its Membranes it is mortal in other parts it may admit Cure by curing its Causes and removing its Effects But here as well as in other parts of the Body the Rules of Celsus and Galen are to be observed every Disease is so much the more dangerous by how much it gets into a greater bulk and bigness As touching its Cure we shall begin with that which is extant between the Hairy Scalp and Pericrane And herewe are to observe that every Hydrocephalos is to be cured by discharging of this waterish substance which is to be performed by purging the whole and cleansing the affected part And with this we are to begin with general Cephalick Purgings in
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
onely vomited up Flegm then he perceived the pain again in the same Side so as it turned not to the sound then was conjectured that there was a new Collection of Matter in the Side and he being prepared for the discharge of the same the Empyema was opened by a Caustick being laid on the Side and Matter for a long while came from the Side and at length the Patient perfectly recovered CHAP. L. Of a Tumour of the Diaphragma THE Diaphragma hath two sorts of Tumours belonging to it and either of them do bring the Patient in danger of death the one long the other short for by the Excrements forcing here they may make a Tumour both with or without a Fever If without a Fever from the beginning pain and difficulty of breathing a small and a hard Pulse and these Excrements we are to allow to be thin and crude and thence do follow a Tension of the Bowels because the Muscles are extended to the Diaphragma And if a Fever be joyned to these Tumours Experience does satisfie it is not sharp and it ariseth from the too long contention of Excrements in the part affected An Inflammation of the Diaphragma beginning there necessarily does follow a Fever and in respect of the Affect because the Tumour is made of hot matters and in relation to the part affected by reason of its near bordering upon the Heart there do generally follow from this Inflammation Pain and Difficulty of Breathing and therefore as Galen saith Breathing here in this case is small and frequent lib. 5. de loc affect sometimes Convulsions do succeed these Inflammations When such a Tumour of the Diaphragma is offered to you for cure let your first Intention be to discharge the Matter or Substance that is lodged And because the Origination of this does generally arise from Fluxion this also is to be prohibited and this is done by discharging the fluent Matter If you take them in the beginning they may give some hopes of Cure but if they be of any long continuance they admit of no Cure because they generally hurry the Patient into a Consumption and will not be taken hold of by the best of Medicines As to the Cure the first Intention is to discharge this Matter by well purging and clearing the Body of its Excrements and here such things are most proper as can discharge both Flegm and Water such as is Elaterium Radix Sambucinus or the like Phlebotomy is no ways proper here for the peccant Matter is cold and therefore Discussives are here most convenient And these may be said to be of two sorts some to be administred inwardly whilest others are outwardly to be applied and these ought to be both emollient and relaxing as Butter Fat 's Marrows and the like and these are to be ordered according to the Humour and the Strength of the patient first beginning with milde Medicines and then proceeding with such as are stronger as Oyl of Chamomile Dill and the like Here also you may use Emplasters and Unguents as of Mallows Marshmallows Lilies with Linseed Fenugreek seed c. preserving and desending the inward parts with such things as can discuss as Treacle Methridate Sarsaperilla c. I once saw in a Gentleman a Tumour bred in the Diaphragma out of crude and thin blood in which pain and difficulty of Breathing a hard and small pulse were present the Matter and Humour was cold and tough and crude and this shewed it Mortal for it brought him into a Consumption and the Abscess breaking he did spit up Blood and much indigested Matter These Tumours although they are bred of a thin and cold Matter yet in the place affected they thicken and for the performance of this there is required pain difficulty of Breathing a hard and a small pulse little or nothing changing it self no apparent Tumour shewing it self and if to these Tumours a Fever do joyn it self as Experience does oft times shew it doth it is not sharp yet they bring Death with them and when they persevere and are not resolved they bring the patient into a Consumption and so lay him even with the dust as it did the aforesaid Gentleman CHAP. LI. Of Exuberancy of Milk MAny Women in their first days after being delivered of their Burthen have a great redundancy of Milk because much Blood is sent thither and not taken away or sucked out for the helping of which it is thought by some that Repellers are very proper to be applied before such Women be delivered and so to hinder the address of Blood thither for after this much Milk being received it cannot afterwards be so well repelled but ought to be discharged by the Breasts or drawn out by Sucking or otherwise It may be prohibited if the Blood do not flow violently by these Medicines following as â„ž Bol. armen â„¥ j. Sangu Dracon Oliban an Ê’ij Ol. Rosar â„¥ ij Cer. acet an parum misce fiat Linimentum Or my Emplaster oft times used in this case with good success â„ž Emplastr Diapalm â„¥ ij Ol. Rosar â„¥ ss pulv Sangu Dracon Ê’j misce Or this â„ž Ol. Myrtin â„¥ ij Amygdal dulc â„¥ ss Terebynth Venet. Ê’ij pulv Mastich Bol. armen Corall Sangu Dracon an Ê’j pulv Myrtil Balaust Rosar rubr an ℈ ij pulv Salv. Betonic an ℈ j. misce cum cerae citrinae q. s fiat â—mplastrum A Schirrus does oft times proceed from coagulated Milk in Women as it fell out in a young Woman whose left Brest while she was giving her Child suck was wholly correpted with an Inflammation the which being allayed a large Tumour and Hardness remained which gave me suspition of a Scirrhus Her Body being well purged with a lenitive purgation the Brest and its circumjacent parts anointed with Oyl of Roses to which was added a little Vinegar and this for some days was used afterwards the whole Brest was anointed with this Liniment â„ž Empl. de Mucilaginibus Ê’ij ol Lilior Amygdal dulc pingued Gallinae an â„¥ j. Gum. Amoniac solut in Acet scillitic colat â„¥ ss misce fiat Vnguentum Over which was applied this Cataplasm â„ž fol. rad Alth. q. s incidantur minutissime postea coqu in aqua mortario pistentur fiatque cum farin Fabar. Axung Porcin Gallinae proprio decocto Malvar Cataplasma By these Medicines and the Body being well purged and a good order of Diet observed the hard Tumour grew soft and resolved and to the Ulcer I applied powder of Precipitate and over this Empl. de Ranis cum Merc. And with this method beyond expectation she recovered her perfect health CHAP. LII Of a Caruncle in the Yard and its manner of Extirpation AMongst the most dangerous and frightful Affects which do seize on Humane Bodie this of a Gonorrhaea may be well reckoned and this is excited by many causes for Acrimony and Thinness of the Sperm may be one cause so that
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
such things as are to be given in either kind of Dropsie this sometimes happening between this and the Erythrois sometimes between the Erythrois and Dartos As touching the Cure all Causes are to be removed the ill Habit of the Body corrected from too much Drink the Patient ought to be prescribed the plenty of this watery Humour to be discharged and evacuated and the whole Habit of the Body amended And for the performance of these Purgatives Diaphoreticks and Diureticks are very proper instrumental Weapons to discharge this invasive companion of which I have already presented you with many in my Tract of Aqueous Tumours As touching outward Applications these ought to contain in them a power to discharge this Water contained in the Testicles this to be performed either by Repellers driving it back or by educing it by the part affected or by Scarrification Hollerius does offer this as an excellent Plaster being made of fresh Cows Dung adding thereto a third part of Bol. Armen and Dragons Blood A Fomentation for the same may be this â„ž Lixiv. Barbitoâ—sor iiij in his coquantur Cumin â„¥ iiij Rut. Absynth Puleg Petroselin Apii an â„¥ ss Sal. j. with this let the part affected be fomented Or this â„ž Cumin Bac. Laur. sem Sesel Rut. an â„¥ j. fiat Decoctum in vino rubro fiat Fomentum Or for this use take this Cataplasm â„ž Stercor Vaccin ij Sulphur Cumin an â„¥ ij Empl. de Bacc. Laur. pulv Juniper Anis an Ê’ij misce cum pauco mellis fiat Cataplasma Or these â„ž Cumin Baccar Laur. fimi Columbin Castor an part aequal coquantur cum oleo Rosarum pauc Cerae First apply your Baths then anoint the part affected and afterwards apply your Caplasms If these fail we are to come to Apertion which may be used two ways either by Incision or Caustick if by Caustick the place is to be cauterized in the place where the Water is and then after it is once discharged a new Collection is to be prevented And here Galen does order the part to be kept open for a long while by placing in a Silver Pipe into the affected part Guido maketh a Seton and keeps it a long while Celsus teacheth the place of Incision saying If it be a Child that is herewith troubled it is to be laid open in the Inguen and the water to be drawn upwards If in one of a greater age this is to be opened in the bottom of the Scrotum and that way the water to be let out taking this as Advice that water is not to be left long in the Scrotum lest by its delay there it does the Testicle injury or hereby there grows a Hernia carnosa The Body being well prepared for your Operation of Incision and a good order of Diet prescribed let the Patient be well placed then in the upper part even to the Tunica Erythrois is the Scrotum to be incised this is somewhat to be separated in its outward part from the Membrane it self And because the Water wholly is contained in this Coat so the Testicle swims therein and lest this Water should descend with a crooked Needle and double Thread the whole Coat is to be apprehended besides the Seminal Vessels and then to be moderately bound and tied after this divide the Membrane in the lower part of the Ligature lengthways and draw out the water or liquor contained within then with a long Tent it being of a moderate thickness being dipt in the White of an Egge to which some restrictive Powders have been added apply it to the side of the Testicle and about the lower part of the Scrotum anointing the Inguens and Abdomen with Oyl of Roses the day following let this Digestive be applied â„ž Terchinth lot Ê’ij Cer. nov â„¥ ss Gum. Elem. Ê’j ol Rosar Amygdal dulc â„¥ ss ol de vitell Ovor Ê’ij dissolve Gummi lento igne cum ol Terebinth Cerâ cum pauxillo Oleorum liquefactis fiat Vnguentum fine addendo Croc. ℈ j. With this let the Tents be armed which are to be put into the Orifice afterwards apply a mundefying Powder to cleanse the Ulcer and keep it open for near two moneths and then close up the Wound with a Cicatrice I conclude with a History of Hildanus who writes of a Commissary 40 years of age a man strong and of a good Habit of Body vexed for many years with a watery Rupture unto whom both many inward and outward Medicines were prescribed and applied without any success and it growing to a great bulk that it occasioned a large Tumour in the Scrotum and proved so painful that the Patient would rather yield to any Method which could give appearance of ease his Body being prepared and a good order of Diet ordered him with administring Purgings and their reiterations with Bleeding c. he being conveniently placed the Scrotum was opened in the upper part of the Coat Erythrois and this on the fore part somewhat separated and because the whole Testicle did swim in water which was contained in that Coat that the water might make no further descent with a crooked Needle and double Thread the whole Coat and Seminary Vessels were moderately taken up and bound after this in the lower part of the Ligature the Membrane was divided lengthways and by degrees was drawn forth some pounds of Water after which was applied a Pledget long and thick enough dipped in the White of an Egge Bol. Armen and the like then was applied the same Digestive I formerly have described and with this were armed the Tents and Pledgets and over these Vnguentum Basilicon and with all care the Ulcer being mundefied digested and filled with Flesh it was skinned and the Patient perfectly recovered Riverius relates another story of a Child of 15 moneths old who was troubled with a watery Rupture in his right side of his Testicle with Matter contained in the Dartos equalling the bigness of a small Egge and this he had almost from his first coming into the world how he received his Cure I will commit you to the Author himself CHAP. LX. Of Pneumatocele or Hernia ventosa THis windy Rupture does happen with and without a Dropsie if with a Dropsie cure the Dropsie and the Rupture will be dismissed if without a Dropsie we are to use Topical Medicines and these ought to be Digestives and purge the Body from the flegmatick and windy Humours and if possibly gain a digestive faculty in the Stomach and these you have already prescribed in Tumours arising from wind This Tumour is known from the former because it is more lucid and red than it the Veins are puffed up and the splendour appears more bright than the former and is suddenly framed and as speedily discharged And having already furnished you with Medicines for discharging the Antecedent Cause we now arrive at the Conjunct Cause which is this flatuous Spirit
got into the Scrotum or its Coats the which we shall thus endeavour to discharge by outward Medicines as Fomentations Oyls Unguents Emplasters Cataplasms and the like neither here using Caustick or Incision For Fomentations you may use these â„ž Origan Calamenth Puleg an M. ss sem 4 Calid major sem Vitic Bacc. Laur. Juniper sem Cumin an Ê’ij fl Melilot Chamomel an pug ij Sal. Ê’ij coquantur in s q. vini albi ad 3 partis consumptionem Or this â„ž Lixiv. Barbitonsor iij. Cumin Bacc. Laur. an â„¥ ij fol. Laur. Rorismarin Rosar rubr Meliss Menth. Majoran an M. j. Sal commun â„¥ iiij with this bathe the part affected with a Sponge Or this â„ž Acet fortissim ij in quibus coquantur rad Pyreth Staphis ac Bacc. Juniper Laur. Cumin an â„¥ ss fol. Laur. Haeder terrestr Salv. Thym. Rorismarin an pug j. bathe also with this the affected part or with this â„ž sem Cumin Bacc. Laur. Rut. Chamomel Bacc. Juniper Absynth an â„¥ i. misce fiat Fomentum cum aqua vino mixta Oyls for the same are these â„ž ol Rut. Laurin an â„¥ iss ol Petrol â„¥ i. ol Spic Terebinth an â„¥ ss misce Or â„ž ol Chamomel Rut. an â„¥ i. ol Aneth Nard an Ê’iij spirit vin Ê’ij Cer. q. s fiat Vnguentum Or â„ž ol Castor Rut. Euphorb an Ê’vj Vnguent Martial â„¥ ss misce Or for Cataplasms take these â„ž sem Cumin Bacc. Laur. sem Sesel Rut. an â„¥ i. stercor Bovin j. Sulphur viv Cumin an â„¥ ij mel q. s fiat Cataplasma Or this â„ž Farin Fabar. â„¥ iiij sem Danc. Cumin an â„¥ ss Bacc. Laur. Juniper an Ê’ij fl Chamomel Melilot Rosar rubr Lavendul an pug j. Salpug iss cum vini albi q. s fiat Cataplasma Or â„ž Farin Fabar. ss sem â—â—nugraec cumin an Ê’ij sem Apii Rui. an Ê’j fl Chamomel pug ij pulv Rui. Absynth Scord. Rosar rubr ad Ê’ss câ—quantur omnia in vino albo q. s fine addendo Oximelit Scillitic q. s fiat Cataplasma Empl. de Bacc. Laur. is here also very good or this mixt Emplaster â„ž Empl. de Melilot de Bacc. Laur. de Ran. cum Merc. an Ê’iij nitr Cumin Sulphur Calc viv Sal. an ℈ j. ol Laur. Cerae q. s fiat Empl. Benivenius cap. 81. Abditor writes of a Person of Quality who having his viscera and Stomach so filled with Wind that it proved very troublesome to him and when the part was compressed there was perceived no exition and hence not onely the Bowels and the Brest but the Scapulaes also were extended with incredible pain and the Spirits very narrowly conâ—ined all convenient and proper Medicines being prescribed and used without any effect the third day the Gentleman dieth the dead Body being dissected the Intestines and the other viscera were seen to be much swelled and puffed up with wind and in the left Ventricle of the Heart was found a hard Callosity equalling the largeness of a Nut and these two were generally held to be the onely Causes of his Death CHAP. LXI Of Sarcocele or Hernia carnosa THis is a Tumour contra naturam which is generated about the Testicles out of a Scirrhous Flesh or it is a Tumour bred out of the defluxion of thick Humours which are collected between the Coats of the Testicles and they there not assimulating there oft times grows as it were a Hyposarcosis oft times Varices accompany the Tumour and these are very troublesom and these Humours being thick and viscid bred from Flegm and Melancholy as they breed Scirrhous Tumours in other parts so also do they generate a hardness in these It is known by its Hardness Asperity Inequality and Indolency It ariseth from Melancholy it having a sublucid colour If it ariseth from Flegm it does not differ from the colour of the Cutis If it ariseth from burnt Melancholy it hath a pricking pain and the Tumour is inequal in some places soft in others hard If the Tumour be not confirmed cure it as you do a Scirrhus by using Emollients then Discussives but the last seldom does any good here But if these fail you are to come to Section but if it be Cancerous attempt nothing Matthiolus affirmeth that he hath absumed a Sarcocele by the onely using of Pulvis Radicis Anonidis being taken for many moneths But if it yields not to Medicine Incision is the next remedy and this way or method is not void of danger the Testicle being either left in or taken out And by the way we are to consider that if any fleshy substance grows about the Coats or Testicles this is wholly and absolutely to be taken away in this case for more safety the Vessels are therefore to be drawn out and tied and afterwards incised and cauterized for to leave any part hereof does more represent the ignorance of a Quack than knowledge of an Artist for no Son of Art will give the advantage of a new growth whenas he may well prevent any appearance of the same by a careful managing of his Operation and taking care of preventing all accidents for a small quantity but left remaining will soon run up like a rank Weed to a great bulk and this in a short time grows worse and worse If the Tumour be not very hard the Chirurgion comprehending the whole Tumour that is the whole tumefied Substance in the Testicle every way encompassing it let him make his Incision even to the Tumour above the Scrotum then abduce the Testicle from the Scrotum drawing a strong Needle and Thread through the middle Process above the Region of the tumefied Testicle and then drawing it back again through the same part of the Process then tie both of them these being performed cut off the whole Process the Testicle being concluded with it It being ablated apply a Repercussive Medicine and strengthen the neighbouring parts with convenient rollings and bolsterings and heal up your Ulcer as you do others Fabritius Hildanus tells a very pleasant story of a young man who embracing his Mistress in Veneral Ceremony he being near ready to eject his Spermatick succus was prevented of his intended purpose by a Messenger which rushed in unawares by opening the Chamber door and disturbing him in his pursuit on which his Sperm receded and was retained Upon which a pain seized on his Groin his Testicles tumefied and the pain began to be remiss in his left Testicle and the Tumour vanished and returned to its former state but about the right the Tumour continued the which in process of time turned into a great fleshy Rupture and he being called to the Patient amongst other Physicians in consultation saw not onely Flesh about the Testicle concreted but found it also extended with serous Humours so that it equalled near the largeness of a Childs Head CHAP. LXII Of Circocele or Hernia Varicosa THis is nothing else than
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