further appear From Choler is produced Herpes and its differences From the Pituitous or Phlegmy humor proceeds Oedema From the Melancholly humor Scirrhus From black Choler Cancer From the watry humor Hydrocephalus Hernia aquosa But of the wheyie humor and the thin excrementitious matter called Ichores from which various less swellings by the Latines called Tubercula do arise there is a very vast difference and oftentimes these ferous and wheyie humors as likewise the salt and cholerick humors are mingled with other and from hence originally proceed divers Wheals or Pushes in the â—kin as to instance Psydrasia Vari Sudamina Spinyctides and Terminthi Essere Arabum Elcydria Scabies Lepra Graecorum Vitiligo Impetigo and Lichen Crusta Lactea Achores Favi Tinea with many other of the like Nature Moreover from the humors there is derived also a certain peculiar kind of tumors yet nevertheless differing from those we have hitherto made mention of in a twofold respect The former difference lies in this that it proceeds not from one single humor but from more to wit Phlegm I mean such as hath other humors Melancholly or Choler mixt therewith yet notwithstanding so that the cause conjunct may not any longer be said to be an humor but some other matter generated from out of those humors The later difference consists in this that the aforesaid matter is included in some one peculiar Membrane Tumors of this sort are Strumae and Scrofulae Bronchocele Ganglia Nodi Melicerides Atheromata Steatomata Testudo Talpa and Natta Out of the humors likewise where you are to understand such humors that degenerate into another matter take their rise and original those tumors which the intelligent Artist cals Polypus Pamela sub lingua bernia carnosa Verrucae Fungi and others the like There are moreover tumors that have their very being from malignant humors and these are Variolae Morbili Lepra as the Arabians or Elephantiasis as the Greeks name it Tumors Venereal of different kinds Bubones and pestilential Carbuncles From flatulency or windiness are derived Emphysemata as the Grecian Authors or Inflationes as the Latines call them and all other flatulent tumors whatsoever From the solid parts lying out of their proper places arise Hernia in the Cods and Navel when the Intestines fal down thither Epiplocele And hitherto also is to be reduced Aneurisma a tumor that hath its original from an Arterie dilated as in like manner Varix being a tumor from a dilated Vein From the Bones proceeds that which we term Exostosis and from the Vertebrae or turning Joynts of the Back when they stick out is caused Gibbositas like as in other parts also tumors arise when disjoynted or broken Bones slipping out of their own place happen to fal down thither But now those tumors receive various appellations by reason of the part affected of which enough hath been written already in its due place And moreover as concerning divers of these Tumors this is to be taken notice of that very many and that in most Countries have indeed been not a little infested by them and that they have been likewise as ordinarily cured of them but yet notwithstanding what the German Italian French Spanish and other names of several Nations are and unto what names of the Grecians Latines and Arabians they may fitly answer is not alwaies manifest which very thing hath exceedingly perplexed and puzled the studious Physitian in his perusual of Authors And of this also Johannes Philippus Ingrassias who took a worlâ— of pains in comparing together and explaining the Greek Latine and Arabian names extreamly complains as wil appear by what he writes in his Book of tumors Tract 1. Chap. 1. page 220 after this manner I cannot but exceedingly admire and withall greatly lament the so great unhappiness of our Age in the which we are evermore infested with divers and almost innumerable kinds of Diseases and day after day are sadly afflicted especially more with this kind of Tumor he here speaks of Dothien or Furuâ—â—â—lus by reason of an unwholsome and corrupt kinâ— of Dyet insomuch that questionless the Affect â—s most perfectly known but as for name it hâ—th none other than what is as obscure and as ambiguous unto most men as that of Epinyctis and Psydâ—acion so that hence we find it a business of the highest difficulty to discover the proper head of the Disease and the Method of curing it either in the Latines or the Greeks and Arabians themselves writing in the Latine Tongue Of the signs Diagnostick Prognostick and of the indications and Cure of Tumors in generall some there be that are wont to assert many things But in truth there is but very little that can be said as concerning Tumors in this manner that is generally considered but what for the most part is agreeable to certain species of them of all which we wil now speak in order and particularly in the Chapters following Chap. 2. Of Tumors arising from Humors in general THat kind of Tumors which is caused by the Humors is found to be most frequent and usual and therefore we wil treat of it in the first place The primary and nighest cause hereof is a humor elevating and raising up a part beyond Natures intention unto a greatness more than is ordinary Which said humor having for the most part a certain excess of qualities adjoyned wiâ—h it and thereupon becomes either hot or cold or moist or dry derives that quality unto the part affected the which quality since it differeth from the temper of the grieved Member must therefore necessarily excite in the same an unequal temper and hence it is that an intemperies or distemper is concomitant with a Tumor The Causes Now of the humors that cause these Tumors there is great diversity For both the Natural and preternatural humors whose differences we have already spoken to in their proper place excite Tumors hereunto belongs the matter that is wheyey and waterish filth and corrupt matter and all things else into which the humors degenerate and which are to be found in Tumors and yet are not in the number of the parts of the Body of which there is great variety Galen in his second Book to Glauco The variety of such things as are often found in Apostems and seventh Chapter writes that in Apostems there have been found to be substances conteined like unto Stones Sand Shels Wood Mud or Slime the filth of Baths the dregs and lees of Oyl together with many other such like resemblances And in his fourteenth Book of the Method of Physick and twelfth Chapter he further informs us that in Tumors have been discovered substances resembling Nails Hairs Bones Shels and Stones And that Worms also may be found in Tumors frequent experience testifieth Fallopius with others have seen such Tumors and I my self have more than once beheld the like Nicolaus Remigius in his third Book of the worship of Devils and first Chapter writes that
symptoms are sensibly diminished The Signs Prognostick 1. As for the Prognosticks of Tumors in general take this for an observation That in reference to the place aggrieved inward Tumors are alwaies accounted to be more dangerous than those which are external and as considered of themselves they have in them more or less danger of death according to the excellency and use of the part affected 2. By how much the greater the Tumor as likewise by how much the greater the intemperies or the distemper accompanying it is and by how much also the humor exciting the Tumor is more malignant and vitious with so much the greater danger and difficulty is the Cure thereof to be expected And on the other side look by how much the humor generating the Tumor is more mild and benign so much the less of danger is there in it and likewise so much the less of difficulty in the curing thereof But of all the sorts of Tumors those arising from a windiness are with the greatest facility remedied as being in a manner discussed and dissipated of its own accord 3. Al Tumors deriving their Pedigree from the humors Tumors arising from the humors how many waies terminated unless they make a retreat and then vanish either of their own accord or forced thereunto by Medicaments taken in for Natures assistance are usually terminated these four waies as Galen in his B. of an unequal temper informe us to wit either by dispersion which you may likewise cal discussion wrought by insensible transpiration or else secondly By suppuration when as the humor which causeth the swelling is converted into a purulent matter or else thirdly By corruption when as the constitution and the radical heat of the part affected is destroyed and wholly corrupted by the pravity and malignancy of the matter or else lastly By induration when the matter that gives being to the Tumor hath acquired an accidental and adventitious hardness Of Resolution an infallible sign is a lightness in the Member contrary to its former weight and heaviness and a cessation of the troublesome heating with which it was formerly disquieted The signs of a tumors resolution The Signs of a neer approaching suppuration are these The signs of the suppuration of a tumor viz. a pain and palpitation in the part together with a Feaver either now invading it or at least the increase of a Feaver already and formerly present according to that of Hippocrates in his second Book and forty seventh Aphorism While the peccant and crude matter is under concoction and until it arrive at a ripeness and maturation as we usually term it Feavers are alwaies present But so soon as the concoction of the crude or raw matter is compleated so that the filth and impostumated matter appear then the part becomes in a manner lighter than it was the heat abated diminished the pain asswaged and a part of the Tumor is eminently elevated and begins to grow sharp or sword-pointed and this sharp point forthwith becomes of a white colour and the part if touched with the Finger seems softer and the purulent matter sensibly appears to fluctuate and yeild unto the touch of the Hand Yet notwithstanding it oftentimes chanceth that the filth and corruption lies altogether hid and obscured so that it may not easily be discerned either by reason of the depth of the place or the thickness of the part as Hippocrates in his sixth Book Aphorism 41. doth rightly advertise us Signs of maturation which is nothing else but a ripening of crude or raw matter now nigh at hand Signs of corruption and induration are a blackness or a Leaden colour of the part affected A sign of Induration is a diminution of the Tumor but an augmentation of its hardness A sign of the Tumors retreating and decreasing is a sudden and unexpected lessening of the swelling which said diminution if it proceed from an internall cause is evermore evill unless the matter retiring be evacuated by a fit and convenient way Upon the going back of the matter immediately there follows a Feaver if there were none before or if there were any before it is now much augmented and other evil symptoms arise from the retention of the matter in the Body Now the best way of freeing the part of any Tumor that grieves and afflicts it is that which is performed by resolution and next unto this that which is wrought by suppuration but it is very il that Tumors or swellings should be hardened and it is far worse nay worst of all that the part it self should be corrupted The Cure The nature of a Tumor or swelling in it self simply considered i. e. as it is magnitude augmented affords no useful indication at all but it is taken from the Cause conteining for upon the removal of this forthwith the swelling vanisheth If there be a distemper accompanying it then for the better effecting the Cure it is expedient in Tumors that are hot that we use means to cool them if they be cold that we heat them if moist that by the help of Art we exsiccate and dry them and lastly if they be dry it is requisite that we should moisten them But then in this alteration of the parts their Nature Temper Action Use Figure Scituation and Sense al which prescribe the measure of alteration are carefully to be considered of which I have already treated at large elswhere in my Institutions the fifth Book second part second Section and first Chapter In the removal of the Cause we must heedfully look whether the Tumor be already compleated the Causes of a tumor how to be taken away and not like to receive any further increase or addition or otherwise whether it may not be further augmented For if the Tumor be already arrived at its perfection then there is no more required but that we look back unto the conteining Cause and then that we take the best course to remove it But if the Tumor be not already at the heigth but only in a tendency thereunto we must then also look back a little further unto the Antecedent Cause as likewise the Câ—uses more remote and those al of them we ought speedily to remove And this is especially to be done whenas the Tumor is generated from an afflux of humors For in this kind of Tumor the fluxion it self is to be opposed and if possible all its Câ—uses to be taken away Now the Fluxion may be totally removed if the flowing humor be either evacuated by drawing of Blood or by Purgation or if the course of the flowing humor be turned another way which is effected either by drawing it back unto the contrary parts or by intercepting the motion of the humors in their passages or by repulsing of them from the part affected or lastly by deriving of them unto the parts adjacent Now the Causes of a Fluxion are taken away A Fluxion how it may be taken away if we
encrease and so the Cicatrice should thereby be raised the higher For in regard that the Skin is a Nervous substance it cannot therefore be so generated anew as the flesh but in place and stead thereof there is somthing generated that is like unto the skin and this we cal a Cicatrice This is likewise to be taken notice of That Epulotick Medicaments ought to be endued both actually and potentially with a drying faculty and that therefore for the producing and causing the Cicatrice Emplasters are most fitly and commodiously administred and applied Gabriel Fallopius in his Book of Ulcers Chap. 13. propoundeth this Unguent which he termeth de Tutia Magistrale and he there writeth that of al that he had ever seen this is absolutely the best Viz. Take Oyl of Roses and Oyl Omphacine of each six ounces Oyl of Myrtle and the Vnguent Populeon of each three ounces Plantane Leaves and Garden Nightshade of each two handfuls Let the Herbs be cut very smal and let them be mingled altogether for the space of eight daies shaking and stirring them wel together every of those daies Then strain them and to the straining add of Wax four ounces mingle it with the rest upon the fire until that they be al melted after this mingle them better with a Wooden Spatter and while it is yet blood warm add of the Litharge of Gold or Silver six ounces Ceruss two ounces Tutty prepared two drams burnt Lead six drams Brass burnt unto a redness three drams Camphire one dram and half stir them wel about in a Mortar by the space of two hours An Epulotick Pouder Take the Roots of Tormentil Bistort Round Aristolochy Acorn Cups Egg-shels burnt Frankincense Dragons blood of each half an ounce Lapin Calaminaris one dram Litharge two drams and make a Pouder This following Emplaster is likewise very useful the which I have oftentimes made trial of and that with very good success Viz. Take of the Vnguent Diapompholyx the Emplaster Diapalma and the Emplastrum Gryseum of each one ounce Gum Elemi two drams Sugar of Saturn one scruple Wax as much as wil suffice and make an Emplaster Chap. 3. Of an Ulcer with a Distemper BUt it many times so happeneth that the ulcer is not solitary and alone and pure but that other preternatural Affects are conjoyned therewith whereupon also the Cure is varied And therefore we intend in the next place to treat of these ulcers in special An ulcer with a Distemper And first of al there is indeed oftentimes a distemper conjoyned with an ulcer which when it happeneth the Cure of the ulcer is then much hindered For in regard that the Nature of the part is the Efficient cause of the Cure of the ulcer and that the blood is the matter if the part be intemperate neither of these can be in that right temper that they ought to be neither can the ulcer be filled up with flesh nor closed with a Cicatrice unless the flesh lying underneath it be in its natural temper as Galen tels us in his third Book of the Method of Physick Chap. 8. But what the differences of the Distempers are we have already acquainted you in the second Book of out Institutions Part 1. Chap. 3. which here also have their place and there may concur together with the ulcer a difstemper that is hot or cold moist or dry a distemper hot and moist hot and dry or cold and moist cold and dry and indeed the distemper may be either with or without mater But of the distemper with matter we shal speak in the following Chapters Here therefore in this Chapter we shal treat only of a Distemper without matter The Causes Now such a Distemper as this either it was present before the rise and appearance of the ulcer or else it was excited even in the very time of the ulceration But for the Causes of these Distempers what they are we have likewise told you in the place before alleadged Which that we may apply unto ulcers a hot distemper in ulcers is excited by a hot Air by too many Swath-bands and bindings and by Medicaments that are over hot And on the contrary a cold distemper is caused by the cold Air from the not sufficiently fencing and guarding the ulcer with Swathbands and warm Rowlers against the coldness and injuries of the external Air as likewise it is excited by cold Medicaments The moist distemper is produced by the moist Ambient Air and hence it is that in some places the Air is greatly hurtful unto ulcers and by the â—fflux of humors touching which more in che Chapter following A dry distemper is caused by a dry Air by Medicaments that are over drying and by the want or scarcity of Aliment Of Compound Distempers the Causes are likewise compound Signs Diagnostick The signs of a hot Distemper are that heating Causes went before and also that not only the Lips but even the very flesh it self of the ulcer appeareth more red than usual and the sick person himself perceiveth a great heat in the ulcer which for the most part a pain followeth Cold Medicaments being thereunto applied do exceedingly refresh and delight and withal do greatly benefit the Patient and on the contrary hot Medicaments are greatly hurtful the excrements of the ulcer are sharp and biting A cold distemper cooling Causes went before it in it the Lips of the ulcer decline unto a whiteness or unto a wan leaden color and they are soft and hot things are helpful and agreeable unto the ulcer but cold Medicaments are on the contrary very hurtful If the Distemper be moist then moistening Causes had their precedence the flesh is soft and appeareth lank and flaggy and somtimes it groweth forth overmuch the excrements of the ulcer are many such things as are drying do benefit and those Medicaments that moisten do greatly hurt And lastly A dry distemper is known by this That drying Causes went before the Lips of the ulcer appear dry and squallid and hard the excrements of the ulcer are but few or none at al. Moisteners are profitable but drying Medicaments cause much hurt unto the sick person Prognosticks 1. Whereas as Galen tels us in his fourth Book of the Method of Physick Chap. 1. for the healing and curing of ulcers the flesh that lieth underneath them ought to be altogether temperate therefore it is that these ulcers become hardly curable by reason of the distemper in the part lying next under it 2. Ulcers with a distemper either hot or cold or moist are cured without any great difficulty For with one and the same pains and at the same time and with the very same Medicaments we may both remove the distemper and cure the ulcer 3. But those ulcers that are attended with a dry distemper are the hardest of al to be cured because that the cure of the ulcer being for a while neglected and laid aside it behoveth the Physitian to be altogether intent and
this is first of all to be evacuated for otherwise it wil continually cherish the Malady by fomenting the matter thereof And so if the French Disease be Joyned therewith this is first to be cured in regard that the Areae cannot be taken away unless this be first removed As likewise the distemper of the Bowels upon which the breeding of the vicious humors doth very much depend is to be corrected And the antecedent Cause being taken away the Containing Cause of the Areae is then to be removed which Galen doth by Repressers and Digestives but we ought withal to do our endeavor that the skin may be restored unto its natural temper And therefore in the first place the whol body is to be purged by fit and proper Medicaments according to the Nature of the peccant humor And moreover Galen for the particular evacuation of the head administreth Apophlegmatisms also which we have elsewhere explained But for the matter which is yet in its flux and in the beginning thereof before the Areae are yet made Galen maketh use likewise of Repellers And the same likewise we are taught by Avicen where he telleth in that the Medicaments in the Alopecia ought likewise by a moderate astriction to corroborate the skin of the head for in the seventh part of his fourth Book Tract 1. Chap. 6. he saith thus And it is requisite that there be in those Medicaments a comforting and strengthening thereby to prevent and hinder in the head the reception of malignant matter But otherwise and if the Alopecia and Ophiasis be already present Repelling Medicaments have then no place even as likewise they have no place in Scabies or Scabbiness But if the Areae be already made and the matter impacted into the skin we ought then to use Digestives Now these are hot of thin parts and not greatly drying For if we make use of those things that dry overmuch not only the vitious humors but even the very aliment of the hair wil be then discussed Yea since that in the Areae confirmed the distemper of the skin is hot and dry therefore cold and moist Medicaments are to be mingled with the rest But now these Medicaments that take away the nighest cause of this Malady are termed Metasyncritica of the preparing of which Galen teacheth in his first Book of the Composition of Medicaments according to their places Chap. 2. and in his fourteenth Book of the Method of Physick Chap. 12. To wit in the first place if there yet remain any hairs that are corrupted these are to be plucked out either with the Volsella an Instrument purposely made to pul out hairs or they are to be drawn forth with a Dropacism or else the place may be shaven with a Razor And then afterward let the head be washed with a Ley in which Maidenhair Golden Maidenhair Southernwood and the like Plants have been boyled After the washing let the place be rubbed with a Linen cloth that is not over moist nor yet over dry until the skin begin to be red when this is done then let Topicks be administred Now such like Medicaments are Mustard seed Cresses white Lily Roots which as it is said wil likewise restore those hairs that burnt places have been deprived of by fire or scalding Rocket seed Nitro Oyl of Bayes liquid Pitch Sulphur the pouder and ashes of Southernwood the Root of Sowbread and Hellebor the seed of Stavesacre and Doves dung and these being the strongest and most powerful of al Thapsia and Euphorbium Which aforesaid Medicaments notwithstanding by how much the newer and fresher they are by so much the sharper they are also and the older they be the more they lay aside their sharpness and tartness But out of these such of them are to be made choyce of that are proper and convenient unto each of these Affects and these are also rightly to be administred For those Medicaments that were by us even now mentioned they are not al of them fit for al kinds of Areae or at al times or after any manner administred or in al ages but unto each of these there are such Medicaments as are fit and proper and each of these Medicaments have likewise their due time and manner of use and unto the Malady when it first begins and being yet but smal the weaker sort of them are to be administred but if the Malady be inveterate then the stronger sort of them and unto the softer bodies such as are the bodies of Children and Women the weaker Medicaments but unto such as are at their ful age and unto Men the stronger sort of Medicaments are to be applied Galen acquaints us with divers Compositions that had been examined by long Experience and approved of in his first Book of the Composition of Medicaments according to the places Chap. 1. to wit Those of Heras Crito Orestinus Ortho the Sicilian Cleopatra Archigenes Asclepias Dionysodorus Soranus and others Galen himself commendeth this following Take Leaves of the Greek Reed burnt half an ounce the Vrchin burnt one dram Moufedung two drams bruise and mingle them wel with Vinegar and so anoint the place therewith Or Take ashes of the burnt Reed Goats hair burnt Maidenhair Bears fat liquid Pitch Rosin of the Cedar of each alike and this he calleth the admirable Remedy Or Take House Mice burnt a piece of linen Cloth burnt Horse Teeth burnt Bears Fat the Marrow of a Hart the rind of the Reed equal parts of al Honey as much as wil suffice and make an Vnguent Or Take Euphâ—rbium Thapsia Oyl of Bayes of each two drams live Sulphur both the Hellebors of each one dram Add Wax six drams which may be moistened with Oyl of Bayes or old Oyl or liquid Pitch and mingle them together And this Medicament is of al other the strongest and therefore most convenient for the Malady when it is become inveterate In the Malady that is more mild it wil be sufficient to use a Medicament made of Southernwood or the roots of the Reed burnt mixt and incorporated with old Oyl Oyl of Bayes or liquid Pitch Or Take Rocket seed Cresses Nitre equal parts of them al and let them be mingled with Oyl of Bayes or liquid Pitch This that followeth is yet more mild and therfore fit for Women and Children Take Southernwood the ashes of the Root and Rind of the Reed Frankincense of each of these equal parts Bears Fat and Oyl of bitter Almonds of each as much as wil suffice and make a Liniment But if it be needful to make it stronger then add thereto Spuma Maris live Sulphur Bulls Gall Rocket seed Nitre or even Thaplia also Or Take Mustard seed Thapsia the seed of Cresses equal parts of them al when you have beaten them into a very fine pouder then add Oyl of Bayes and Rosin of each alike as much as will suffice and at the fire make hereof an Emplaster according to art Such like Medicaments good store of them
end of the disease after other evacuations without any remission or abatement of the symptoms and together with a great debility of the Natural powers and strength of the body these are very dangerous and pernitious 4. As for those of them that break forth and shew themselves symptomatically and have their original from crude and extreamly opposite and as I may so say rebellious matter these evermore prove to be pertinacious i. e. resisting all good means that shal be used and they alwaies make much work and business both for Nature and the experienced Physitian and withal they cast the Patient into an extream hazard and the greatest dangers that may be For why they are in a place very nigh unto the Brain from the which both humors and vapors may easily be communicated unto the Brain and to its Membranes from whence an Inflammation of those parts and dotage or madness may be excited 5. Those Parotides which being bred at the very instant of the Crisis shal not be suppurated but before ever they are suppurated shal vanish they wil return get growth and so become to be judged of according to the manner and upon the account of their return even as are the returns of Feavers into the like circuit But there may notwithstanding be some kind of hope left that some Impostumes may arise in ihe very Joynts themselves Thus Hippocrates in the sixth of his Epidem Comment 4. text 1. The Cure In the Cure of the Parotides we ought in the first place wel to consider whether they be critical or symptomatical and what kind of Humor it is that they are bred of and from which they proceed If the Parotis break forth critically and so the disease from thenceforth be quite taken away or at least diminished then the whol work is to be committed to Nature according to the Precept of Hippocrates in his first Book and the twentieth Aphorism and nothing else is then to be done but only that those things that mitigate pain as they have been already propounded in the Chapter of an Inflammation be laid thereupon the which may likewise at one and the same instant together help forward the suppuration But then it must not be forgotten that in the Parotides whether they be critical or symptomatical whether the matter be much or little and whether it be benign or malignant that however it be yet Repellers or drivers back have no place at al as Galen teacheth us in his third Book of the Composition of Medicaments according to the place affected and second Chapter lest that the matter be driven back from the more ignoble part unto that which is more noble and especially the Brain that lieth so neer thereunto Yea moreover if the Tumor break not forth sufficiently and the humor that by reason of the disease fals and settles it self in the affected part be not by the vigor of Nature in a sufficient abundance thrust forth then in this case the gentler sort of Attractives such as are the Oyl of Camomile of Flower-de-luce of Dill and of Melilote are to be made use of But then the stronger sort of them are not to be administred but with an especial care and caution lest that the pain should be encreased and the Natural powers and strength dejected After this we are to take notice whether or no Nature attempt any resolution and discussion for which purpose she is to be assisted and furthered by discussive Medicaments or else whether which indeed is alwaies far more commodious it tends toward a suppuration and in this case likewise Nature her self is to be aided and holpen forward by those Medicaments that promote concoction and digestion of the crude matter Now the Medicaments of either sort are before propounded in Chap. 5. where we treated of an Inflammation and in the eighth Chapter where we discoursed concerning Bubo The suppuration being made and past the Impostume is then to be opened and as we have already in its proper place declared so to be cured In the Parotides that are Symptomatical Natures endeavor where it fals short is to be furthered and promoted and the overgreat abundance of the antecedent cause if any such thing be present is to be lessened and abated For if that there be present either an abundant store of blood or else of vitious and naughty humors we are not to fear that hereby Nature may be averted from and hindred in her work of expulsion but rather to expect that being eated of some part of her burden she will afterwards the more easily expel that which remains and ought to be emptied forth If yet notwithstanding an evacuation of the antecedent cause preceding she be not as yet able as she ought sufficiently to expel then the expulsion is to be forwarded and holpen on by the application of Cupping-glasses and other attractives And hence it is that either a discussion of the matter or which indeed we usually practise as most requisite the conversion thereof into Pus or matter is to be procured by those or such like Medicaments as are propounded in the eighth Chapter where we treated of the Bubo Tumor And yet notwithstanding here in this case the condition of the matter is to be heedfully regarded so that if it be more than ordinarily cold and thick the Discussers that we use are to be proportionably hotter and stronger and if there be any cause to fear that the matter may be hardened Emollients are likewise to be made use of After the softening of the matter as aforesaid albeit otherwise the matter tend likewise thereunto a suppuration is by all means to be promoted and furthered the Impostume to be opened and as we have already often declared in this manner the Cure is to be effected Neither is it to be expected that this Tumor should be broken of its own accord nor are we to wait til then forasmuch as the Pus being long reteined is oftentimes wont to produce many sad and dangerous symptoms And Gulielmus Fabâ—cius in his second Century Observ 39. relateth that he had observed that in a certain yong Maiden while she was afflicted with the Parotis we are now speaking of and yet notwithstanding was not so far amiss and ill as to take her bed being all the while free from any Feaver much about the fourteenth day of the Disease an Impostume likewise to the bigness of ones fist appeared â—orth the which said Impostume being not timely opened the Girl thereupon was suddenly surprized with a Feaver Swooning fits Vomitings and Qualms together with the loss of rest and sleep and miserably afflicted with a pain in her Back and Reins and albeit the Impostume was afterward of its own accord broken yet notwithstanding in regard that very little or no Pus at all flowed forth but rather sought its way and passage downward it was not long ere it cost her her life Chap. 13. Of a Carbuncle A Carbuncle hath very neer alliance
the moisture be consumed and then with a sufficient quantity of Wax and adding thereunto Ammoniacum and Galbanum dissolved in Vinegar of each three drams and Flowerdeluce Root wel bruised two drams make an Emplaster Or Take Ammoniacum Bdellium Galbanum Opopanax Styrax liquid dissolved in Vinegar of each one ounce Litharge of Gold ten drams let them boyl in Vinegar afterwards add Pellitory live Sulphur of each half an ounce Oyl of white Lillies and Wax of each a sufficient quantity Make an Emplaster But now in the administring of these Medicaments we ought alwaies seriously to observe whether the Scirrhus arise from flegm or else in truth from a Melancholick humor For if it hath its original from this last it is then more warily and cautelously to be handled than if it proceeded from flegm lest that it turn into a Cancer and especially if it incline toward a suppuration we must have a care that it be not too much irritated by hot Medicaments Chap 20. Of a Cancer THe Cancer by the Greeks called Carcinos and Carcinoma so termed because it resembleth the Water-Crab or Crevish is generated from an adust Humor or black Choler And yet notwithstanding Celsus seemeth to put a difference between Carcinoma and Cancer For in his fift Book and 28. Chapter he calleth the disease that we treat of in this Chapter only Carcinoma But in the same Book and 16. Chapt. he giveth the name and appellation of a Cancer in general unto certain creeping Ulcers under which he likewise comprehended the Erysipelas that is exulcerated the Gangrene also and the Sphacelus But yet notwithstanding al other Physitian whatsoever use the words Carcinoma's and Cancers as Synonyma's that is as words signifying one and the same Disease For a Cancer is a Preternatural Tumor arising from black Choler round of a wan color or somwhat blackish painful and which when the Veins every where round about are filled and strut out resembleth the feet of the Crab Crevish or Crawfish The Causes The Cause of a Cancer is black Choler in which either yellow Choler or the Melancholy Humor hath degenerated by reason of its being burnt For the Melancholy Humor while it yet continueth to be Natural and is not yet burnt doth never cause or produce a Cancer but another Species or kind of Scirrhus But from the black Choler alone if it be burnt which sticketh fast in the Veins neither can it by reason of its thickness penetrate into those streight and narrow passages as the Melancholy humor doth that causeth the Scirrhus the Cancer is excited and generated But now of this black Choler there is a certain difference for some of it is more mild and moderate or less hot and sharp but then another sort of it is very sharp and hot That which is more mild causeth a secret hidden Cancer that is not exulcerated but that that is more hot and sharp exciteth an exulcerated Cancer Now the said black Choler is more or less sharp according as it is more or less burnt or arise from a humor that is more or less sharp Whereupon it is That that which proceedeth from yellow Choler adult and burnt is worse than that which hath its original from a Melancholy humor And leek by how much the longer it abideth in the place affected and by how much the more it is putrefied and burnt by so much the more it is rendered the worse And hence it is that the Natural Melancholy humor also which first exciteth a Scirrhus if it stick and abide long in the part and especially then when it is not handled with al care and caution in the applying of heating and moistening Medicaments it afterward exciteth and causeth a Cancer But whether the Cancer be without any Ulcer or no and whether the black Choler be mild and moderate or else exulcerated and the cause more sharp yet however notwithstanding in and of it self it is alwaies without a Feaver although accidentally a Feaver may happen thereupon In the mean time we say the Cancer it self is a hot Tumor For although some there be that doubt whether a Cancer be to be ranked and reckoned up among the hot or the cold Tumors as there be likewise that question whether black Choler be a hot or a cold humor and although by the Arabian Physitians a Cancer is accounted and reckoned up among the cold Tumors and Galen seem to incline thereunto in his Book of black Choler Chap. 4. and in his 2. to Glauco Chap. 10. yet notwithstanding it is by the same Galen in his Book of Tumors Chap. 8 10 11. most rightly and truly reckoned up among the hot Tumors since that it hath its original not from the Melancholy humor cold and dry but from black Choler hot and dry For albeit the Melancholy Humor may possibly give the first occasion of this Tumor yet however notwithstanding the Cancer is not generated from it unless the said Melancholy Humor degenerate and turn into black Choler whether this happen in the Vessels or in the part affected like as somtimes a Scirrhus as ere while we told you that is produced from a Melancholy Humor may pass and turn into a Cancer And this is the conjunct cause of a Cancer to wit black Choler a humor hot and dry sharp Salt corroding and corrupting al things generated and bred from the heat of other humors the heat now ceasing or at least being not so vigorous that it may excite and cause a Feaver as it is wont to be in a Phlegmone and Erysipelas It is likewise generated from other Causes For now and then a hot distemper burneth up and inflameth the Humor and so generateth black choler and somtimes the Food Meat and Drink being such as hath in it a disposition and tendency unto the generating of such a like humor by the frequent use thereof and in process of time becometh the Cause of black Choler and somtimes the very Spleen it self being grown weak and not able to attract and draw unto it self that that is generated of the Melancholly humor doth thereupon leave this humor in the Body which after it hath been for a while deteined in the Body is inflamed and burnt up The very same likewise happeneth if either the monthly Courses in Women be suppressed or the Hemorrhoids obstructed And in truth the Cancer is generated and bred in all the parts both external and internal and yet notwithstanding it especially appeareth as Celsus tels us in his fifth Book Chap. 28. in the superior parts about the Face Nosethrils and Ears Lips the Paps or Breasts of Women which chiefly by reason of their laxity and loosness do very easily receive that humor and then again in regard of the consent and agreement it hath with the Womb they readily admit of those vitious and naughty humors that ought to have been purged forth through the Womb. The Signs Diagnostick At the first beginning the Cancer is not so easily
Squils half an ounce Gum Ammoniack dissolved in Vinegar two drams Borax a dram and half Allum half a dram mingle them c. Or Take the Root of sowr Sorrel and Elecampane cut into smal pieces of each one ounce Hysop and Penyroyal Leaves of each half an ounce boyl them in Vinegar until they be soft and tender and then bruise them very smal Add hereto of soft Soap half an ounce Ammoniack dissolved in Vinegar two drams Myrrh Frankincense Borax of each half a dram mingle them Chap. 24. Of Sudamina and Sirones SVdamina which the Greeks cal Hidroa and likewise Exanthemata are with us those Esflorescences or Pushes or Wheals that stick and have their residence in the utmost Skin of the body like unto the grains of Millet that by their exulceration do exasperate the Skin Some there are that wil likewise have them to be called Eczesmata By Pliny in his third Book and Chap. 4. they are termed Papulae Sudorum or sweating Pustules Rhases and Avicen name them Asef or else with the Article Alasef or Hafef and Alhafef It is an Affect that is very common and familiar unto Children and yong persons especially those that are of a hot temperament and constitution and such as in the hot Summer time use overmuch motion and exercise happening and arising in the Neck Shoulder-blades Breast Arms and Thighs but yet notwithstanding more frequently neer about the privy parts and the Fundament or Arse whereupon it is that Hippocrates in the third of his Aphorisms Aph. 21. reckons it up among the Summer Diseases The Causes Now these Sudamina have their original from the many Cholerick and sharp biting sweats that corrode the Skin and cause a roughness or ruggedness therein exulcerate after the manner of Ulcers and excite in the said Skin a certain kind of itching And they arise more especially in a hot and moist Summer after the use of those things that are hotter and sharper than ordinary extream labor and pains from inhabiting in a place hot and moist a wiâ—d not sufficiently piercing and purifying overgreat and excessive sweats and lastly the filthiness and nastiness of the Apparel Signs Diagnostick These Tubercles are sufficiently manifest For in the Skin there appear a roughness and itching Pustules Prognosticks The Affect is not in the least dangerous but for the most part is cured by the help and strength of Nature without the use and application of any Medicaments The Cure And therefore let the Patients wearing Apparel be sweet and clean and let him often shift himself If the Affect be mild gentle and moderate it is then cured by only washing with Rose Water or Plantane Water unto which notwithstanding there ought to be added a grain or two of Camphire But if it be more grievous and if that Cholerick Humors abound in the Body they are to be altered and evacuated Afterward this Bath is to be made use of Take the Root of sowr Sorrel and white Lillies of each half a pound Briony three ounces of these Herbs following viz. of Mallows Violets Marsh-mallows Pellitory of the Wall Bears-foot of each one handful Fumitory three handfuls the flowers of the Water-Lilly Red Roses and Beans of each one handful Bran two pound Boyl them in pure and sweet Water for a Bath After the Bath if there be occasion let this Unguent be administred Take Oyl of Violets of Roses of the Water-Lillies or at some cal it the Water-cress of each half a pound Juyce of Lemmons three ounces Litharge one ounce Ceruss or white Lead half an ounce Camphire one dram let them be wel stirred together in a Mortar and make hereof a Liniment Sirones Hither likewise belong those Pustules that the Germans cal Seuren that arise either in the hollow of the Hand or on the soles of the Feet or both in the which there lieth hid and secret an exceeding smal sort of Worms under the Scarf-skin which they term Sirones or Chirones Now the Affect ariseth chiefly in these places because that the more thick and gross Ichores or ulcerous Excrements are in every scabbiness detained and held under the Skin which in the aforesaid place is more thick than elswhere Signs We may know whether or no these Worms lie hid in the Pustules if the itch that is here felt be greater than that which is wont to be at other times perceived in these places These Chirones are for the most part digged forth with the Neddle and after this that so they may not be bred anew the place is to be wel washed with Wine or Vinegar in which Salt Alum or Nitre hath been dissolved or else with a Ley that is made of the Ashes of Broom Sprigs or the Boughs of the Oak Tree After it hath been washed and throughly dried again let it be anoynted over with this Unguent following viz. Take the sharp Dock or as some call it sowr Sorrel Scabious Wormwood Tansey the Leaves of Peaches of the Ash tree of Henbane and of the Walnut of each one handful let them be al wel and throughly bruised together and together with those Juyces take of the Fat or Lard of an old Hog two pound let them boyl all together until the Juyces be consumed and afterwards add of Ship Pitch one pound and half and let the whol be stremed through a Cloth and then Take Myrtle Frankincense Mastick of each two ounces let them be poudered very smal and let them be put into the streining and then let them be moved and stirred about with a Spatula until they have the likeness and consistence of an Vnguent And whensoever there is any occasion to make use of and to do and act any thing herewith then unto six ounces of this Unguent we may add one ounce of Quick-silver extinguished and killed with fasting Spitrle or shaken together with the white of an Egg and by this means you may Cure within fifteen daies all kind of Scabbiness whatsoever it be of this Nature or those Sirones that are accompanied with an itching And thus much may suffice to have been spoken touching these Tumors or rather Tubercles Sudamina and Sirones Chap. 25. Of Epinyctides and Terminthi EPinyctis is so called because it ariseth in the Night as Galen in his second Book of the Method of Physick Chap. 2. and Celsus in his fifth Book and 28th Chapter hath informed us Yet notwithstanding Paulus Aegineta in his 4. Book Chap. 9. and Aetius Tetrab 4. Serm. 2. Chap. 61. conceive that they are so called not because it ariseth in the night but because in the night time it doth more vehemently excruciate and torment the Party thus affected But both these reasons may very wel stand together to wit that this Tubercle ariseth by night and that it doth likewise in the night time most grieve excruciate the Party affected therewith Paulus Aegineta therefore and Aetius in the places alleadged define the Epinyctides to be small Ulcers breaking forth of their own
and Chap. 8. maketh a twofold sort of this Tumor differing according to the Nature and quality of their Causes The one he deriveth from cholerick blood the other from a salt and nitrous Flegm but this more rare Others there are that assert that this kind of Tumor doth arise from an exhalation or vapour of hot fervent Blood or else the admixture of the Cholerick and Salt humors The Causes Whosoever knoweth and understandeth the Nature of serous wheyish humors wil not deny that such like Tubercles may possibly be excited from serous or wheyish humors being such as are sharp and easily moved and likewise such as without much ado vanish and are discussed Which appeareth and may be confirmed even from hence that this Malady may be and is removed especially by Venesection or blood-letting which said Venesection doth chiefly and principally qualifie and allay that extream and fervent heat of the serous and wheyish part of the blood Yet notwithstanding the itch that is somtimes greater and somtimes less likewise teacheth us that there is not one alone difference of this wheyish humor but that somtimes this said whey is more mild and moderate and somtimes again more sharp and hot somtimes thinner and somtimes thicker as likewise thus much which I my self have very often observed that these Tubercles while the the Patients are in a hot place they then break forth and appear and that when they expose themselves unto a cold Air the Essere then vanish and as soon again on the contrary to bud forth in the cold Air and to vanish in a hot place the former whereof seemeth from hence to happen to wit because the humor is very thin and moveable and therefore is instantly driven in again by the cold ambient Air but the latter because the Humor is not altogether so movable and thin but somwhat more thick which for that very cause cannot transpire in a cold Air but in a hotter Air it wil transpire or breathe through But this wheyish and thin Humor is for the most part generated from the fault of the Liver which from some preternatural cause is disposed to generate and breed this humor Now that said Humor waxeth extreamly hot from the Causes Procatartick as they cal them that stir and move the blood And this happeneth likewise in the Winter time and in cold Regions rather than in hot Signs Diagnostick It is easily known by those notes and marks that are above mentioned to wit there somtimes goeth before an Ulcerous Lassitude and then there break forth in the whol body itchy Pustules as if the party had been pricked by Bees or stung with Nettles The Prognosticks 1. These Tubercles vanish of their own accord within a very short space although there be no course taken for the curing of them and they are not suppurated neither doth there issue forth of them any humidity at al. And if this should somtimes so happen yet this chanceth rather by reason of the scratching of them and also from the vehemency of the Itch which is extream troublesom to the sick persons than by means of the Tumor 2. Somtimes these Essere go before Cholerick Feavers and therefore such as are very frequently molested and grieved with these Tubercles ought not in any case to neglect the Cure lest that they fal into Feavers and some more grievous Disease The Cure For the most part there is no need at al to administer Topicks but if the fervent heat of the Blood and Humors be by Venesection and the administring of Medicaments that alter qualified and kept under the Tubercles wil then soon vanish and the smoothness and Natural color will forthwith return unto the Skin To wit in the first place a Vein is to be opened and so much of the blood drawn forth as the state and condition of the body requireth And afterwards if there be any need at al thereof the Cholerick and wheyish Humor is to be drawn forth by Tamarinds Myrobalans Rheubarb afterward let there be administred the Juyce and Syrup of Pomegranates Ribes Syrup de Agresta or Varjuyce Whey with the Emulsion of the four cold seeds and the like Milk tart and sowr c. It is likewise very requisite to put the sick person into a Bath of warm Water Let his Diet likewise be cooling and moistening Chap. 27. Of Scabies or Scabbiness SCabies or Scabbiness ariseth likewise from adust matter as doth also the Itch that is as it were a certain Praeludium and forerunner of Scabbiness and the like Affects Now Scabies by the Greeks and Latines is called Psora an Affect sufficiently known in the which there is not only present some kind of foulness and deformity of the body but a distemper also even of the very Skin together with a swelling and exulceration from whence it is that the actions of the Skin are likewise hurt But more especially in the Scabies or Scabbiness the top and utmost part of the Skin is affected insomuch that out of it as Galen tels us in his fourth upon the Aphorisms and the 17. Aphor. there is some such like thing cast forth that beareth a likeness and resemblance with the casting of Serpents From whence it likewise differeth from the Itch for in the Itch there is only a roughness of the Skin in which there is nothing that fals off notwithstanding the scratching whereas in the Scabies there is not only a roughness of the Skin but likewise a distemper with a swelling from which by scratching the bran-like bodies are easily and readily separated and together with them divers Ichores likewise and filthy purulent Excrements The Causes But what the Cause of the Scabies is in this Authors seem not so wel to agree Galen in his Book of Tumors Chap. 1. 3. tels us that Sabies also and Lepra are Melancholick Affects and likewise in the seventh Sect. Aphor. 40. that Cancers Elephantiases Lepra's and Psora's are al of them Melancholy Affects and the same he also tels us in other places But Avicen in the seventh Book of his fourth Tome Tract 3. Chap. 6. writeth that the matter of Scabies is the blood with the which Choler is mingled and that converted into Melancholy or salt flegm and with him the other Arabian Physitians agree But the very truth is that although in the Scabies the humor be not alwaies one and the same yet in every Scabies there is some kind of mixture of the adust and melancholy hot and dry humor And furthermore there is one sort of Scabies that is moist another that is dry The moist in the which there sloweth forth a certain matter that is moist and withal rotten filthy and purulent but the dry is that in which there is but little or none of the aforesaid matter cast forth And concerning this latter it is that Galen seems to speak as being such wherein that melancholy humor doth more superabound But Avicen and the rest of the Arabian
destruction of the innate and natural heat as on the contrary the life of the part dependeth upon the preservation and safety of the said Native heat we conclude that whatsoever destroyeth the Native heat of the part that same may likewise be accounted a cause of the Gangrene and Sphacelus Now the Native heat is destroyed when by its contrary it is either corrupted or suffocated or dissipated or altogether extinguished for want of Aliment It is destroyed by its contrary either acting by a manifest quality and cold or else by a secret and hidden quality as by poyson It is suffocated when the transpiration it hindered It is dissipated by a greater heat It is extinguished if necessary food and sustenance be denied so that there are as you see five causes of the Generation of a Gangrene and Sphacelus to wit overmuch cold a poysonous quality the hinderance of transpiration a vehement external heat and a defect of Aliment and the heat flowing in For first of al we see that oftentimes in the Winter those that take Journeys in the Snow and Ice have the extream parts of their feet and of their hands their Ears and their nostrils almost dead with cold by reason of the vehemency thereof and thus it happeneth somtimes also that by reason of Medicaments over cooling in a Phlegmone or an Erysipelas carelessly and incauteously administred the part is taken and surprised with a Gangrene or a Sphacelus although I had rather refer this case unto transpiration hindered There is also a very great power of destroying the innate heat in those things that are poysonous and such things as destroy our Bodies by a secret and hidden quality For somtimes the humors in our bodies do so degenerate and acquire so great a malignity that they bring a Necrosis or deadness unto those parts whither they are by Nature thrust as we see it done in a Carbuncle And so in like manner the biting and stingings of poysonful Creatures do corrupt and putrefie the parts And the same also is done by the Septick Medicaments which if they be not wisely and carefully administred have in them a power of corrupting the flesh especially in places that are hot and moist as in the Emunctories the privy parts and the other places that are like unto these Thirdly Transpiration hindered exciteth likewise a Gangrene For whereas our heat standeth in need of perpetual ventilation and cooling if this be denied it is suffocated by the abundance of Vapors And for this very cause in great Inflammations and especially in the moist parts there very frequently happeneth a Gangrene the Native heat being extinguished as otherwise likewise we see that a little flame is extinguished and put out by casting thereon good store of water and that the flame is stifled if it be put under a Cupping-glass that hath no hole or vent in it or any other Vessel whatsoever that is kept covered which is preserved in a Cupping-glass that is perforated or any other Vessel that is open And this chiefly happeneth if in Feavers especially if they be malignant the humor be with violence either thrust forth or that of their own accord they rush unto any one part And so I remember that here a certain Citizen that was taken with a malignant Feaver from the humors that were thrust down unto the Scrotum had the said Scrotum al of it so inflamed and mortified with a Sphacelus that there was a necessity of cutting off the whol Scrotum or Cods so that the stones hung down altogether naked and bare which yet notwithstanding the Gangrene being cured became afterwards covered again with flesh that grew out of the Groyns That Inflammation likewise which the Gangrene followeth is sometimes caused by Wounds and these not alwaies great but oftentimes also very smal and sleight Wounds that seem inconsiderable and of no moment So Henricus ab Heer relateth in the first Book of his rare Physical Observations Obser 12. That he was present and saw a man fifty nine yeers of Age who having pared the Nails of his Toes and cut them to the quick was presently surprized with a Gangrene and within a very short space died thereof And he telleth us likewise of two other eminent persons who being desirous to have the hard and callous brawniness of their feet pared away were both of them taken with a Gangrene that within a short time caused their deaths And this may likewise be done by Emplastick Medicaments in great Inflammations and especially if they be unseasonably applied in moist places which frequently produce there a suffocation of the Native heat Fourthly A preternatural heat likewise and such as is extraneous and from without produceth the Gangrene by wasting the Radical moisture and the Native heat and so many times a Gangrene followeth after great burnings And lastly A Gangrene ariseth from the defect of Aliment to wit the blood and the spirit flowing in that is altogether necessary and requisite for the cherishing of the Natural heat implanted within For whereas the innate heat standeth in need of continual Nutriment as the flame doth of Oyl if this be denied it languisheth and is extinguished like as is the flame when the Oyl in the Lamp faileth And in this manner a Gangrene happeneth unto the external parts of the body somtimes in an Atrophy Consumption and the like Chronical and long continued Diseases that extenuate the body And for this very cause it is that when the greater Joynts are put out of Joynt if they be not again wel and rightly set then the disjoynted bone presseth together the vessels that lie neer and hindereth the influx of the blood and of the Spirits into those parts that lie underneath from whence there followeth a leanness and consumption of the said parts and in process of time very frequently a Gangrene also And so it is found by experience that from a hard Tumor about the Vena Cava where parting several waies it descendeth into the Thighs pressing the same together and hindering the descent of the blood into the Thigh a Gangrene very often ariseth And in this manner a Gangrene likewise happeneth if any part be too hard and long bound about with Ligatures and bands or else if Medicaments that are over astringent shal be imposed upon any part Signs Diagnostick It is no hard matter to know the Gangrene For the color of the part beginneth to be changed and turned unto black the flesh to grow loose and flaggy the pulse and sense to be diminished and the heat to be abolished Which said Symptoms the more the Gangrene tendeth unto a perfect corruption and a Sphacelus by so much the more are they increased and made more evident For in a perfect and absolute corruption and Sphacelus the life and sense of the part are wholly abolished there is no pulse at al to be perceived the part whether you cut or burn it is insensible of pain the flesh appeareth to be
a wollen Cloth be wee therein and so imposed upon the place affected it hath likewise been happily and successfully administred in the Gangrene of the Cods of which we have spoken above Take Vitriol one ounce the tops of the Oake one handful Frankincense half an ounce Camphyre two drams Vrine two pints and half boyl them to the Consumption of a third part and then strain them But the Aegypriack Unguent is not alone to be applied but upon the Unguent that Cataplasm is also to be imposed which resolveth drieth and hindreth putrefaction such an one as Johannes de Vigo in his second Book first Tract and seventh Chapter describeth and commendeth and which many other Physitians and Chirurgeons now a daies likewise make use of And all these are to be applied blood-warm and they are so long to be continued untill the putridness be removed But if the Malady wil not yield unto these Remedies then we are to have recourse unto those that are stronger to wit Causticks such as those Trochisques of Andro Polyidas Musa and Pafio which dissolved in Vinegar and Wine may be imposed upon the part Many indeed do here commend and prefer Arsenick before all other Remedies but Gulielmus Fabricius doth and not without good Cause reject and altogether disallow of it in the Cure of a Gangrene as that that not only hath in it a Septick and putrefying faculty and a quality of melting the flesh as it were but that likewise produceth very great and grievous Symptoms vehement pain Dotings Syncope's and the like the malignant vapours being communicated unto the principal part It is therefore more safe to make use of an actuall Cautery as that which hindereth and preventeth putridness drieth and corroborateth the part This is also much commended Take Mercury dissolve it in Aqua fortis when it is dissolved precipitate it the Oyl of Tartar after it is precipitated wash it Or Mercury alone dissolved and mingled with the Water of the Trinity Flowers and wollen Cloaths wet in this Liquor may be imposed on the part The Crust in what manner soever it be produced is to be taken away by those Medicaments that have been above declared in the first Part and Chap. 13. touching a Carbuncle Neither are we to wait so long til Nature shal altogether have separated the Corrupt from the Sound but the highest part of the Crust is with the edge of a Knife or a Penknife to be cut even unto the sound part that so there may be a way made for the Medicaments unto the deeper parts and the rest that are corrupted For if we expect until the Crust shal be freed of its own accord it may possibly happen that under the Crust a new putridness may be contracted The rest of the Cure is in the same order to be proceeded in as is fit to be done in Ulcers Fourthly If the Gangrene happen from overmuch heat A Gangrene from too much heat then a Cold Diet being prescribed and the hot humors being duly qualified and evacuated if the Malady take its original from an internal Cause the Member affected is to be scarified and then washed with such a Decoction as this Take the Water of Endive Sorrel Lettice Nightshade and Vinegar of each one pint Syrup of Sorrel two pound of Lupines half an ounce Water Germander half a handful Salt three ounces boyl them till a third part be consumed After this the Aegyptiack Unguent and the Cataplasm but even now mentioned is to be imposed and the rest which were before prescribed are speedily to follow Where notwithstanding this is to be observed that unless in case of urgent necessity we must not have recourse unto the actual Câ—utery lest that hereby to wit by the power and force of the fire the extraneous heat which is the Cause of the Gangrene be augmented Fifthly and lastly If the Gangrene arise from the defect of Aliment and Blood and Spirits A Gangrene by reason of an Atrophy in the part and chiefly in truth if it be by reason of a Driness and an Atrophy necessaâ—ry Nutriment being denied unto the part then meats that are hot and moist easie of Digestion and such as generate much and good blood are to be given unto the sick Person and outwardly the body is likewise to be moistened with Oyntmentâ— of sweet Oyl or with Oyl of sweet Almonds and all things are carefully to be avoided that exsiccate and dry the body And unto the part it self that is already affected with the Gangrene the Aliment is by all manner of means to be attracted And therefore here there is no place left for Defensives in regard that they shut and stop up all passage of the blood and Spirits unto the part affected And therefore we are not only to anoynt the part affected and the other members with the Juyce of Earth-worms which is made of the said Earth-worms first washed in Water and then in Wine so put into a great Vessel with good store of the Oyl of sweet Almonds Violets and melted by a gentle and moderate heat over hot Embers and afterwards strained which is a sprecial and soveraign Remedy in the Atrophy and extenuation of the parts but the part affected is therwith likewise gently to be rubbed and chafed unto which also Cupping-glasses not scarified are to be applied But it wil be most fit and requisite if there be already present a putridness to administer those things that do alike both attract and resist putridness such as are Salt Water boyled with Water-Germander Liquid Pitch with the meal of Lupines of the bitter Vetch Orobus Myrrh and the like But if the Gangrene hath already made any progress the part is then to be scarified and the Aegyptiack Unguent and that likewise that is compounded of Pitch and those other things a little before mentioned are to be laid thereon A Gangrene from the interception of the blood spirits Moreover If the Gangrene happen from the interception of the Blood and the Spirits likewise whatsoever the Cause then be that thus intercepteth the blood and the spirits it is immediately to be taken away as if the said interception be from the binding of the part it is forthwith to be loosened and withal those Medicaments that resist putridness as likewise those that discuss that that is corrupted such as are those that are made of the Meal of Beans of the bitter Vetch Orobus of Lupines Aloes Water-Germander and the like are to be imposed And if the Gangrene hath already gotten unto any heighth the place is to be scarified and those other things that are required in al Gangrenes are to be done If an astringent and repelling Medicament be the Cause the said Medicament being removed the heat is to be recalled by Frictions Lotions and Anointings And so we must also proceed in the Gangrene that hath its original from other Causes that intercept the Spirits For the Cure of the Gangrene
with his own Eyes he beheld while they took out of an Impostume ful of filth and opened in the Calf of a Mands Leg a certain round substance or Globe such as is to be seen in Weavers Shops And Wierus in his Book of the Devils impostures Chap. 13. relates that in the incision of an Impostume on the left side of a certain Gâ—â— above the Spleen there was taken forth an Iron Knife and after it there issued out abundance of filth and corruption The like whereunto Langius also hath observed in his first Book and thirty eighth Epistle Now if any such strange thing chance to happen the Vulgar People are wont to ascribe it presently unto the Sorceries Spels and Charms of their Devilish Neighbors But there is no necessity why for all things that are evacuated out of Impostumes besides purulent matter we should by and by have recourse to such Causes as these or rank them among the supernatural Causes of humors seeing that many of these contingents may be generated out of the humors erewhile rehearsed For whenas Experience makes it manifest that in most parts of mans Body smal Stones Sand and Gravel Hairs or such like and also divers kinds of Worms may be produced out of the excrementitious humors and that likewise not only in the Body of man strange and wonderful kinds of Worms and other little Animals may be bred out of the Corruption of others it should not seem any great wonder that the matter in Tumors especially if it be naught and hath been long there shut up and deteined doth admit of those various and strange mutations happening by means of its rottenness and putrefaction But yet notwithstanding if such things be found in Impostumes that are come to a suppuration and likewise in Tumors which cannot be generated in mans Body by nature or at leastwise by Natures strength alone without the concurrence of Art such as are all things formed of Metals Bodkins Knives Iron Nayls and the like then indeed they cannot be referred unto natural causes but may upon more than probable Grounds be imputed unto the Impostures subtilty and power of the Devil But as for the manner how such things may be either generated in the Body or covertly conveyed into it is not my purpose here to determine I therefore proceed to dispatch what I have further to deliver touching the rest of the causes of Tumors that take their rise and original from the humors So then Tumors how caused by congestion or the heaping together of humors as for what concerns the causes remote be they what they will for their kind they may easily be known if we do but enquire into the manner how Tumors come to have their first being and withal take notice from whence and after what sort or by what means that humor which hath rightly gained to be stiled the containing Cause comes into the part affected Now therefore that humor which is the nighest and containing Cause of a Tumor is either insensibly and by degrees heaped up in the part or else altogether as in a heap which the Grecians express by the word Athroos flow into it The matter is gradually and by little and little gathered together in the part affected primarily and most especially by reason of somwhat amiss in the member to wit when either the concoctive power is grown weak and therefore cannot as it should digest the nutriment but generates more excrements than it ought to do or else when the expulsive faculty doth not cast out all the excrements as it ought to do and this may come to pass either through its own weakness or otherwise because the way by which those excrements should be ejected is not sufficiently open And again a humor is likewise then heaped together in the parts whenas the food it self is naught and unwholsom for hence it happens that either so great abundance of excrements are caused that the expulsive faculty cannot cast them al forth or else that they are so thick that Nature cannot easily expel them But upon what causes these causes do depend hath been already declared in its proper place nor is it requisite that we should at large repeat what hath been spoken Only in a few words take this That the weakness of the faculties wholly depends upon the intemperies or distemper of the parts and the decay of their native heat The passages are obstructed by overmuch and thick matter which happens to be condensed by the vehemency of cold Meats of an ill juyce produce store of excrements Now what these meats are Galen gives us to understand in his Book touching meats of a good and evil juyce A Humor then flows to some part this being in truth the more usual cause of Tumors when either it is drawn by that same part tumors how caused by an afflux How by attraction or transmitted unto it from some other place Attraction primarily proceeds from heat caused either by overmuch motion or from the heat of the Sun and Sun-beams from the fire or lastly from any sharp Medicine taken in For the parts so soon as they are heated by these causes draw unto themselves humors from the rest of the body although there be not therein any excessive store of humors and yet I deny not but that the more the body abounds with humors the greater is the store of them that is attracted Moreover Pain likewise frequently enough excites Tumors by attracting the humors unto the part aggrieved Yet we say not that pain of it self draws the humors but that this is done by some other means and commonly it is said to draw for these three causes First because Nature while she attempts to relieve the suffering part sends in an extraordinary supply of blood and spirits to the part in pain and this she doth with an endeavor more than usual so that by this means she over fills and hurts the parts she intended to succour Secondly the grieved part by this time grows hot from that abundance of blood and spirits transmitted thither by Nature and hereupon fals to drawing more than before by reason of this adventitious heat And lastly pain weakens the Members Now the Members once weakned if they attract not yet they readily receive and in the least resist not the matter flowing in upon them from several parts Secondly A Tumor is caused by a defluxion when as the humors are transmitted unto some part although they be not drawn by that part For whereas there is in every part a faculty not only of attracting al things familiar and agreeable unto it but also of expelling and casting out whatever is superfluous and burdensom hence it is that being stir'd up and provoked by the excess or offensive quality of the excrements and humors it expels and thrusts forth unto some other part whatever is useless or at least burdensom unto it Where if it be not digested or evacuated by transpiration it is thence
again forced unto some other parts until at length it come unto the weakest which is not able to expel these transmitted humors so that being here left they cause a Tumor For it cannot be that a Tumor should be caused by the matter transmitted and sent from divers places unless we grant as needs we must that there is a part which sends them a part receiving them and the passages by which the humors flow The parts do then transmit when the vigorous faculty by the quality or store of matter is incited to expulsion For unless the faculty were provoked it would never attemp this expulsion and unless it were strong and vigorous it could never effect it And this is likewise much furthered by the external causes exciting the fluxion to wit Heat which attenuates and dissolves the humors and cold that by constriction presseth the parts together and thereby causeth the greater afflux of the said humors Notwithstanding unto these two may be added also a third cause of the defluxion and that is a certain 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or violent issuing forth of the humor it self as usually it doth appear in persons that have the Dropsie where we find a water through its own weightiness descending into the Feet and Cods which motion notwithstanding is wont to cease in the night time but this would not be if the humor were expelled by Nature and not rather as in truth it is forced down by its own gravity Now as for the humors flowing together from elswhere the parts receiving they are received by such parts as are feeble and through their weakness altogether disposed for the reception of a fluxion For evermore the more vigorous Members send away that which is superfluous unto the weaker The weaker Members we account such as either have contracted a certain debility in their very first formation or being afterward hurt do contract unto themselves a kind of preternatural constitution or else they are such as Nature her self makes and intends for weak and so framed and constituted that they may the more easily receive the excrements of other parts such are the skin and the parts loose and porous For Nature that she might the better preserve the principal and more noble parts from Diseases hath purposely ordained in mans body some certain parts weak and feeble that so the principal parts oppressed and burdened with Humors might into them empty whatever is superfluous and burdensom and these as we have said are the skin and glandulous or kernelly parts And hence it is that the Heart transmits the peccant humors unto the Arm-pits the Brain sends them behind the Ears and the Liver thrusts them forth to the Groyns The parts ready to receive are al those that have any connexion with the part that transmits the humors and which have the passages through which the humors are conveyed alwaies patent and open but as for waies whereby to expel and drive them forth they are either none at al or otherwise such as are exceeding narrow and over streight or else lastly these passages are so scituated that they lie directly under the parts transmitting so that the conveyance of Humors unto them from the abovesaid parts is render'd the more facile and easie As for the waies and passages through which the humors run the passages by which the tumors flow they are either such as lie hid or else such as are open and very manifest For whereas the whol body is confluxile that is to say apt and ready to flow together hence it is that the humors have their fluxion out of one part into another by these occult or hidden passages So the Whey as we may term it being gotten in great abundance into the Abdomen or Cavity of the Belly commonly called the Paunch by these privy Passages descends into the Cods and the Thighs and lifts up the said parts even unto a Tumor or swelling the same which likewise very often happens in other parts Somtimes the humors assembled together betwixt the Skul and skin of the Head descend thence along under the skin into the inferior parts but very seldom and rare it is that from hence any tumors are produced But most an end those humors which excite and raise tumors flow through passages that are patent enough the Veins and Arteries But that we may briefly come to speak of the differences of Tumors arising from Humors the differences of tumors whence they are taken although very many of these differences are accidental yet notwithstanding those by which the tumors proceeding from humors are truly and properly distinguished among themselves are taken from the variety of the containing Cause or the Humor as an efficient cause producing the Tumor Now the Humors are divers Blood Choler Flegm Melancholly black Choler Choler adust and Whey From which likewise various sorts of Tumors are excited and caused And then again one while the humor exciting the tumor is as we use to say simple and sincere from whence also the tumor proceeding therefrom is said to be a pure tumor or assoon again divers humors concur to the making up of one Tumor and from hence the Tumors which we term spurious that is such as are improperly so called take their Original The Signs Diagnostick It is easily known whether the Tumor proceed from the falling down of any part and if this be not the Cause we may then safely conclude that the rise of it is from the afflux of humors unto the part affected But now whether or no the Tumor takes its beginning from congestion or rather from fluxion may by this be discerned to wit that those Tumors which are caused by congestion or the storeing up of humors are a longer while and by degrees arriving at their perfection neither take they up so much room in the part nor lastly was there any the least preceding cause or sign of a defluxion But now if the tumor be generated from a fluxion it wil be discerned by the presence of the contrary signs And certainly if so be there were not in the grieved part any foregoing pain or heat it manifestly shews that the said fluxion is caused by a transmission and not by means of an attraction like as on the other hand a preceding pain or heat of the affected part argues the Tumor to proceed from the attraction of humors For the Signs whereby to discern and understand the times take this advertisement viz. That the beginning of it is then when the part first of al is perceived to be distended and stretch'd forth The increment or growth when as the part appears now to be elevated into an indifferent big swelling and when the Symptoms that accompany al sorts of Tumors are evidently augmented The state or heighth of it is when the swelling and with it together al the symptoms are at their highest pitch The declination is then when both the bulk of the swelling and all the
daies together by reason of the vehement pain of the Patonychia could not sleep not take any rest at al the skin being shaven off he findeth under the skin in the very tip of the finger a spot of this bigness O in the which there was contained scarcely one smal drop of the Ichorous excrement The spot being opened thereto applied Cotton dipt in Aqua vitae wherein there was Treacle dissolved and about the whol hand and wrist a linen cloth after it had been first wel soaked in vinegar and water doubled and wrapped the pain immediately ceased insomuch that the very next day following the finger was fully and perfectly healed But the same Author addeth further that this incision ought forthwith in the very beginning to be made because that otherwise by the concourse of the Humors there wil be excited an Inflammation and Swelling and so the flesh lying underneath yea and even the bones also wil be in danger of being eaten through For the Skin in that place is of an extraordinary thickness so that the matter of the Paronychia which in it self is malignant when it can by no means exhale it then acquireth the greater acrimony and poysonfulness and the finger also yea and the whol hand by reason of the vehemency of pain is swoln and blown up and this incision very little or nothing availeth unless that the matter be first concocted and converted into Pus Chap. 15. Of Perniones or Kibes THere is also found a peculiar kind of Inflammarion which they term Perniones the Greeks cal this Affect Chimethlon and Chemeithlon from the Greek word Cheimon in regard of their appearing in the Winter time only And it is such a kind of Inflammation as in the Winter time ariseth in the heels and on the toes and fingers I once likewise saw a Noble-man that had such a kind of Inflammation on the very tip of his Nose The Causes Now this kind of Inflammation ariseth from the Winters cold whilest that by it not only the part is weakened and made more apt to receive but that likewise from the pain there is caused an attraction of blood unto the part Yet notwithstanding this is worth consideration how it cometh to pass that he who hath in the Winter time undergone and suffered some notable cooling of the extream parts should yet notwithstanding be wel and altogether insensible of it during the Summer and the Winter following again and thus to continue for some yeers and until the Malady be wholly removed and taken away by cure should be so sensible of an extream itching pain and swelling in the part that was over cooled as aforesaid and that although in the Summer time he felt no ill instantly in the very first entrance of the Winter the Malady should again get head and return and an itching be again felt in the part affected al which argueth that there was some strong impression left behind in the part For those that are thus greatly cooled do not only suffer a bare alteration but that there is likewise somthing that is substantial communicated unto the part affected appeareth even by this That Apples and Eggs when they are frozen if they be cast into cold Water there is then an Ice taken out of them so that it outwardly sticketh fast unto them like unto a crust and then these Apples and Eggs return again to their former Natural state whereas on the contrary if they be put into warm Water they become flaggy turn black and are corrupted which notwithstanding could not possibly happen if there were only a meer and simple alteration and therefore we may conclude that by the pain that afflicteth the part there is blood attracted to the part affected that exciteth and causeth the Inflammation Signs Diagnostick There went before a guarding and preservation of the extream parts of the Body against the injuries of the external Air that was but weak and sleight and not sufficient to maintain a due warmth in them and thereupon an undue cooling befalleth them there is likewise an itching and a pain that is not only once and after that the sick person hath suffered a refrigeration from the external Air perceived but although it cease in the Summer time and Autumn yet notwithstanding about the beginning of Winter it again returneth the part waxeth red and swelleth up and now and then also it is exulcerated Prognosticks This Tumor to tel you the truth hath in it no danger at al yet notwithstanding if the Malady be not speedily â—â—â—ed it wil prove tedious and of long continuance and this pain wil for many yeers be grievous and troublesom unto the Party thus affected and somtimes likewise the part is wont to be exulcerated The Preservation Lest that the parts should be hurt by the external cold it is requisite that in the Winter time they should be sufficiently fenced and provided for against the injuries of the aforesaid external cold Air. And more particularly lest that the feet be hurt it wil be expedient to wear Legharnesses as they cal them or linen Socks wel moistened in the Spirit of Wine especially in that part of them by which they cover the feet But seeing that it cannot wel be that al the parts should be sufficiently kept from and defended against the cold yet notwithstanding lest that any one after he hath for a while been in the cold Air should suffer any dammage the refrigerated parts are not first of al to be altered with the contrary quality but rather we ought to do our endeavor that the cause which hath insinuated it self into any part may be removed and taken away And therefore as it is commonly wont to be done in the cold Septentrional Regions and of which as of a thing very wel known Gulielmus Fabricius takes notice in his Treatise of a Gangrene and Sphacelus Chap. 10. the refrigerated part is not to be put close to the fire neither are those things that are hot to be imposed thereon for if this be done the coldness or indeed rather the cold Atomes retained in the part being by this means thrust down into the deeper parts of the place affected a most intollerable pain happeneth thereupon to arise yea and somtimes also a Gangrene is produced and excited but the cooled part is to be wel rubbed with Snow that so by its like the coldness or cold thing may be extracted out of the affected part after the same manner as Apples or Eggs being frozen and cast into the coldest water are restored unto their pristine Nature the extracted Ice sticking fast without unto the rinds of the one and shels of the other And for this very reason the Inbabitants of the abovementioned Northern Regions when they have been travelling do not accustom themselves to enter into Stoves or Hot-houses or so much as to draw neer unto any fire until they have first throughly rubbed their Hands Nose and the extream parts or tips of
Barley Lentiles Beans of each one handful Arnogloss or Lambs Tongue two handsuls Pomegranate flowers Roses the grains of Myrtle Sumach of each half an ounce Let all except the Barley be grossly poudered and then boyl them in Wine until the Barley be soft and make hereof a Cataplasm Or Take the Rinds of the Pine tree burnt and washed a dram and half Ceruss three drams Frankincense one dram Goats fat six drams Oyl of Myrtle two ounces Wax at much as wil suffice make herewith an Vnguent But if we have a mind to dry more than ordinarily we may ad the prepared file-dust of Iron the flower of Brass and Lime washed This is likewise commended Take the spume or froth of Silver half an ounce the juyce of Leeks and Beets of each sive ounces Mingle them c. Hieronymus Fabricius writeth that with very good success he made use of this following Remedy Take the juyce of Tobacco three ounces green or Citron-coloured Wax two ounces Rosin of the Pine tree an ounce and half Turpentine one ounce Oyl of Myrtles as much as wil suffice for the making and forming of a soft Seoer-cloth But if the Ulcer be already putresied we must then betake our selves to the Remedies that are stronger and more forcible such as are the little sweet Bals of Andro Musa and Polyidas a for example Take Litharge and Ceruss of each two ounces the Rinds of Pomegranates half an ounce Myrrh one dram Frankincense a dram and half the flower of Brass and Allum of each a dram and with the Oyl of Myrtle and Waie a sufficient quantity of each make an Vnguent But if these wil not serve the turn and that the Ulcer and putrefaction creep further and become broader we must then have recourse unto the stronger sort of Remedies They refer likewise unto choletick Tumors those that we cal Phlyctaenae Impetigines Lichenes Sudamina and Epinyctides But because that these little risings or swellings proceed not from pure Choler but from Choler mingled with serous and salt Humors we wil therefore treat of them below with the rest of the Tumors of this kind Chap. 18. Of the Tumor Oedema LIke as those Tumors that we have already hitherto handled have their original from hot Humours so there are likewise some certain peculiar Tumors that arise from cold Humors and in the first place Oedema that hath its original from Flegm For although Hippocrates and other ancient Physitians under the name of Oedema understand al other Tumors whatsoever in general yet notwithstanding those of latter times by Oedema do understand some one certain kind of Tumor only and this they specially term Oedema being a Tumor that is lax or loose soft without pain yielding unto the touch and compression of the singers having its original from thin flegm or else from the more cold and moist part of the Mass of blood The Causes The containing Cause of this Tumor is that flegm that is contained in the blood to wit if it be so increased that it irritate and stir up the Expulsive Faculty For then Nature being stirred up and provoked thrusteth forth the matter out of the greater Vessels unto the less and expelleth it from the more noble parts unto the weaker until at length it be received and retained by the most weak and infirm part The cold and heavy Humor it self likewise very often by its own weight tendeth downwards and also unto the extream parts And thereupon it it that although the Oedema may be excited in al parts whatsoever of the body yet notwithstanding it chiefly and more especially ariseth in the Hands and the feet as it evidently appeareth in Persons that are Hydropical Cachectical and Phthisical in regard that those parts are more remote from the fountain of heat But now this Oedema is not suddenly generated but by degrees and by little and little For why the Humor is thick and therefore altogether unfit for any speedy and sudden motion Galen in his second Book to Glauco and third Chapter determineth that the Oedema is caused by a Pituitous or flegmy substance or else by the Spirits when they are ful of vapors and such a like Tumor or swelling happeneth in dead Carkasses From which place as likewise from the 14. of his Method of Physick Chap. 4 Johannes Philippus Ingrassias in his Book of Tumors the first Tome page 113. endeavoreth to prove a twofold kind of Oedema the one from thin flegm the other from a vaporous spirit and that to wit the former he asserteth to be a Disease and the latter a Symptom only that followeth upon Phthisis and the water betwixt the Skin one species of the Dropsie and the Cachexy But yet although it be not to be denied that Carkasses in the very first beginning of there putrefying and as it were a certain kind of fermentation swel up in some sort yet that in the Cachexy or Phthisis the Oedematose swellings of the Feet should in this same manner be caused I cannot easily beleeve in regard that such a like putridness doth not then happen but it is far more credible that such like Tumors are caused from a serous wheyish Humor abounding in the body and descending unto the Feet and there abiding and sticking fast as in a part more cold than the other parts of the Body And be it indeed granted and admitted that in the similar parts there may be some kind of slatulent Spirit collected and that it may lift up the part into a Tumor yet notwithstanding this Tumor is not properly Oedema but is rather to be termed Empneumatosis or Emphysema And albeit such a like Tumor is by Galen in his 14. Book of the Method of Physick Chap. 4. called a Symptom yet we say that Galen then useth the name of a Symptom in the general for every Affect preternatural that followeth another But if we wel weigh and consider what this Tumor properly is we affirm that it is altogether and in al respects a Disease in regard that it is magnitude augmented and for the most part an impediment and hindrance unto men in their walking And although such an Oedema doth not indeed requite a peculiar Cure yet notwithstanding it is not for al that to be razed out of the number of Diseases and placed among the Symptoms For those Diseases that simply depend upon other Diseases require not any proper and peculiar kind of Cure but those being removed these likewise are taken away But now that very Humor that is the cause of Oedema is generated by an error and default in the sangnification touching which we have spoken in the third Book of our Practice third Part second Section and first Chapter The Signs Diagnostick Oedema is known in this manner The Tumor is soft and loose and if it be pressed down with the singer it easily yieldeth and giveth way by sinking and so there is a little pit and print of the singer left behind For the moist
three Humors viz. Choler Flegm and the Melancholy Humor And indeed the upshot of the whol Controversie is this That these Affects do arise from a Salt and nitrous flegm with the which there is mingled one while Choler another while Blood and somtimes likewise a Melancholy Humor In special Psydracia as for what concerneth Psydracia the Author of the Book of Medicaments that are easily provided unto Solon thus defineth them viz. That they are smal Efflorescencies made in the Head like unto those Bladders that rise high in the superficies And Alexander Trallianus in his first Book and Chap. 5. and Paulus Aegineta in his fourth Book and Chap. 3. following the aforesaid Authoâ— have reckoned up Psydracia amongst the Affects of the Head and thus they define Psydracia Psydracia are certain smal eminencies like unto little Bladders or Pustules those that we cal Phlyctanae spread up and down upon the surface of the Skin Yet notwithstanding that Author of the Introduction unto Galen ascribeth Psydracia likewise unto the whol body when he saith in his 15. Chapter That Psydracon is commonly so called because that it is an Efflorescence all over the Body and about the white of the Eye somwhat red in the top thereof The Causes The Cause of this Tubercle is a humor mingled together of Blood Choler and a salt and nitrous humor The Signs may easily be gathered out of the descriptions already delivered neither do the Psydracia threaten any danger at all The Cure They are cured by these following Compositions as Al. Trallianus in his first Book Chap. 5. and Paulus Aegineta in his third Book Chap. 3. teach us Take the Spume or Froth of Silver and Ceruss of each half an ounce Alum and the Leaves of Green Rue of each two drams these being well bruised and mingled together with Vinegar and Oyl anoynt the part affected therewith Or Take Rue and Alum bruise them well with Honey and impose them upon the Head after it is shaven Chap. 33. Of Strumae and Scrofulae THere is moreover another kind of Tumor which is not excited simply from a humor poured forth into the external parts of the Body or diffused through them but a humor in which the matter that is the cause of the Tumor is in a peculiar Membrane concluded and shut up and the humor that exciteth this kind of Tumor is changed into almost another kind of Substance Among these Tumors in the first place we are to account Strumae and Scrofulae and indeed touching Strumae in the Neck or the Kings Evil as we commonly call it and Bronchocele we have already treated in the second Book of our Practise Part 1. Chap. 25. where we have likewise written much of Stumae in general And yet notwithstanding here in this place likewise there is somthing more in general to be spoken touching the same in regard that as we shall by and by shew you they do not only seiz upon the Neck but also upon divers other parts But although this kind of Tumor may not unfitly be referred unto a Scirrhus yet notwithsanding they are not called by this common name but these Tumors are called Choirades or Scrofulae the appellations being taken from Swine that are more frequently troubled with this Malady And yet notwithstanding Paulus Aegineta in his sixth Book and Chap. 35. rendreth another reason of the name to wit from the Rocks Chaerades For Chaeras is a black Rock in the Sea that is rough and somewhat eminent so that it seemeth like unto a swimming Hog unto which Rock indeed by reason of the roughness of the Tumor this Disease may be resembled But yet some there are that seem to make a Difference betwixt Scrofulae and Strumae when they write that Scrofulae are hardned Tumors and such as are included within a certain Membrane in the Glandules or kernelly parts the which if they be generated out of the Flesh then they are to be called Strumae but most Physitians reject and approve not of this difference For Strumae are a Scirrhous Tumor of the Glandules VVhat Scrumae are as Galen defineth it in his 14th Book of the Method of Physick Chap. 11. and such as is shut up in a peculiar Membrane For the Glandules or Kernels are the Subject of Strumae and the truth is they arise most commonly in the Neck both the fore part and the hinder part thereof and yet somtimes likewise in the Arm-holes and the Groins Meges a certain Chirurgeon of whom Galen also maketh mention in his Book of the Method of Physick the last Chapter hath also observed that these Strumae often arise in the Paps as Celsus writeth in the fifth Book Chap. 18. And we have told you before in the third Book of our Practise Part 3. and Chap. 5. that Strumae have been likewise somtimes found in the Mesenterium If this Affect appear in the Throat then by a peculiar name they call it Bronchocele Bocius and Hernia Gutturalis This is a great and round Tumor of the Neck between the Skin and the rough Artery in the which there is included somtimes Flesh and another while a certain humor like unto Honey or Faâ— But yet notwithstanding these Scrofulae differ from other Glandulous Tumors and that first in the number because that in Scrofulae there are very many Kernels that swel up and one dependeth upon the other in the superficies of the Skin like unto Grapes that hang down from one and the same Bough and moreover because that Scrofulâ— have deeper Roots then the other Glandulous Tumors The Causes But now these Strumae have their original from a flegmy humor and likewise according to others from a Melancholly or else from a humor mingled of Flegm and Melancholly whereupon it is that such as are Flegmatick Melancholly Gluttoinous that are wont to eat meats that are cold moist and to drink cold waters are most especially troubled with these Scrofulae And hence it is that in certain Regions where the Inhabitants make use of Crude and snowy waters they are all of them for the most part afflicted with the said Strumae But now these Strumae are generated not suddenly and all at once but by degrees one after another and first of all the matter floweth in unto one Glandule in the which there is excited a Tumor soft and loose and then unto another in which there is in like manner excited a soft Tumor which in a short time is hardened until at the length there hang down from the place affected many Glandules as it were so many Boughs or Branches Aetius in Tetrab 4. Serm. 3. Chap. 5. out of Leonidas tels us of a twofold manner of the Generation of these Strumae where he thus writes These Strumae saith he are a Flesh somwhat white easily encreasing and growing conteined in a Membrane and in brief they are Glandules hardned that arise in the Neck under the Arms and in the Groyns where the
Diagnostick Ulcers with the afflux of humors are known First by the Tumor or Swelling that appeareth not only in the lips but likewise in the neet adjoyning parts And then next of all from the pain which is very grievous and troublesome unto the sick Person especially if the Nervous parts be affected Thirdly from the great store of excrements which is far greater than what it was wont to be proportionably according to the magnitude or bigness of the Ulcer And lastly albeit there be likewise administred all things that are necessarily required unto the Cure thereof yet we find the Cure of them very difficult in regard that the flowing humors hinder the Cure Prognosticks 1. All Ulcers as we said but now with an afflux of the humors are very hard to cure in regard that from the afflux of the humors the Ulcer is rendered moist gains growth and increase thereby swelleth up and the pain is likewise hereby xcited 2. But by how much the asslux of the humor is greater and by how much also the humor that floweth thereto is the worse by so much the more difficult will it be to Cure the Ulcer The Cure First of all therefore in regard that the Ulcer cannot be cured unless the Flux be removed therefore the Flux it self with all its Causes is to be taken away and thereupon whether in the whole body or else by the default and something far amiss in the Liver or the Spleen the vitious humor be generated the generating of it is to be hindered and prevented and so much thereof as is already flown in is in a convenient manner to be prepared and evacuated touching which very thing we have already elswhere spoken at large Moreover lest that the humor should flow unto the affected part it is to be drawn back intercepted and driven back Among the Revulsive Aids and Remedies in the first place we esteem and account of Issues that are made in the contrary part because that the Humor that floweth unto the part affected they evacuate and empty it forth by some other place And these Issues are indeed oftentimes very necessary in old inveterate Ulcers For when Nature hath been now of a long time accustomed to evacuate the vitious humors by the exulcerated part if the ulcer be altogether closed and that there be any of the vitious humors heaped up there it may easily then come to pass that these humors regurgitate and flow back again into the Veins and so rush into some more noble part but al this may be prevented by a Fonticle or Issue But the aforesaid Defensives do intercept which are to be imposed above the exulcerated part in the sound part toward the root of the Vessels in those places where the Veins being bigger do appear more conspicuously which said Vessells through which the humor floweth they strengthen and shut up and withal drive back the humor And they are formed out of those Medicaments that are dry and astringent such as are Bole-armenick Dragons blood Flowers of Red Roses Pomegranate flowers the Rinds of Pomegranates Myrtle Allum with the white of an Egg Oyl of Myrtle Oyl of Roses autere or sharp Wine astringent Waters Out of which Cataplasms or other Medicaments are prepared But then unto the part affected it self Repellers are to be applied that so the Humors that do as yet fluctuate in the Vessels of the affected part may be repelled And therefore the exulcerated part or the parts neer unto it are to be washed with Allum Water the Water or Decoction of Plantane of Roses of Pomegranate flowers the Roots of sweet Cyperus Cinquefoyl and the like but the neer adjacent parts are to be anointed with the unguent of Bole. And in the middle of the Ulcer there is a drying Pouder to be laid on of Litharge Tutty Lead Corals Bole-armenick Chalcitis the white unguent of Rhasis and unguent Diapompholyx In a word the Sarcoticks ought here to be stronger than in the simple ulcer that is not pestered with this flux that so they may throughly dry up the humor that sticketh in the pores of the parts and yet nevertheless they must be such as are without any mordacity at al that so there may be no pain excited As Take Turpentine one ounce the Suet of a Bull half an ounce burnt Lead an ounce Tutty prepared half an ounce Mingle them c. But yet nevertheless if the matter be crude and biting some Frankincense is to be added to further the Concoction of the humor Touching the form of the Medicaments this is to be observed that they be not of a moist consistence not Oyly and fat in regard that they do more loosen and moisten the part as Galen tels us in his first Book of the Composition of Medicaments Chap. 6. and in his fourth Book of the Composition of Medicaments Chap. 1. 13. And yet nevertheless we are not alwaies to persist in one and the same kind of Medicaments For it oftentimes so happeneth that what did once or twice do good may afterwards the humor being any waies dried up prove prejudicial and hurtful by exciting a morâ—dication or biting and there the Medicament is then to be changed and one more gentle to be administred in the place thereof After that the ulcer is filled up with flesh the Cicatrice is at length to be brought over it by Epuloticks Guido in his Tract 4. Doct. 1. Chap. 2. upon such ulcers as these adviseth us to lay on a thin Leaden Plate with a hole bored through it For Lead being thus beaten into a thin Plate cooleth and therefore is of special use in such like ulcers if a fitting Ligature be added in regard that it presseth forth the humor out of the part affected and hindereth the influx thereof into the part exulcerated Chap. 5. Of the sordid putrid and corroding Ulcer THe moist ulcers that are accompanied with an afflux of Humors are for the most part thereby made sordid and soul such as the Greeks cal Rupara to wit if that thick and snotty excrement which in special they cal Sordes flow forth and putrid if the said excrement breath forth a grievous and noysom smel like unto that of a dead Carkass For sordid and putrid ulcers as Guido in his Tract 4. Doct. 1. Chap. 3. telleth us differ only in degrees viz. in this That the one is such in a greater the other in a less degree For if the excrements of the ulcer be simply thick and sordid then we cal it a sordid ulcer but if they likewise receive a putridness insomuch that they putrefie and corrupt the flesh that lieth under it and also the softer parts so that there breath forth from thence a noysom and unsavory vapor then it is called a putrid ulcer The Causes The nighest Causes of this ulcer are depraved humors malignant and such as receive an extraneous and moist heat and putridness And indeed these humors either they flow unto the part affected
cold is made soft and flaggy so that it yieldeth unto the touch when it is pressed by the fingers which yet nevertheless after it is throughly dried becometh black wan and altogether deadned and it yieldeth a noysom and stinking savor like that of a dead Carkass and the skin if it be taken up with the fingers seemeth to be separated from the flesh lying underneath it And here Ambrose Parry adviseth every Physitian that when he hath discovered by these signs that there is a Gangrene and a Sphacelus he no longer defer the doing of what is to be done neither suffer himself to be deceived by the motion some whereof is oftentimes stil left remaining even in a mortified and dead Member For in a Sphacelus the corrupted parts are moved not by the motion of the whol and entire Muscle but because the Head and no more of the Muscle is yet whol the which while it is moved it doth together with it draw the Tendon that is inseparable from it and the tayl likewise thereof although it be now wholly dead and without any true and proper motion And these signs that appear in a perfect corruption and Sphacelus are stil the same in every one of them whatsoever the cause be that it draweth its original from whether it be from cold or from a poysonous quality or from transpiration hindered or from an extraneous heat or lastly from the defect of Aliment unless it be in this only that such like Symptoms in a Sphacelus that hath its original from an occult cause and such as is poysonous as for example the Delirium or dotage the Syncope and the like are greater and more grievous But in a Gangrene and mortification that is but yet now beginning there is observed a diversity of the signs and symptoms according as the Gangrene hath its original from divers and different causes For in a Gangrene that ariseth from cold there suddenly appeareth an acute and pricking pain and a redness in the part which soon after is changed into a black color and the heat that was in the part is extirguished and there is perceived a coldness and stupidity with a certain kind of horror as it useth to be in Quartan Agues And moreover in a Gangrene that proccedeth from a poysonous and malignant humor in the body which Nature thrusteth forth unto the external parts there is present a continual Feaver and a strong conflict of Nature with the Disease from whence the Syncope Dotage and the like have their original and such a Gangrene as this ariseth for the most part in the external Members and the extream parts thereof as for instance the great Toe of the Foot with a certain Pustule or Bladder under which there is present a black spot which oftentimes is suddenly derived into the whol Leg and Thigh But that Gangrene that followeth upon great and extraordinary Inflammations that proceed most usually from the hinderance of Transpiration is known by this That the fresh and flourishing color that is wont to appear in Inflammations is turned into that which is pale and wan that beating pain which before did infest now ceaseth the sense is become dul and there arise very great Pustules that are ful of a thin ichorous excrement like unto that that cometh from the washing of raw flesh Which appear almost the same when the Gangrene hath its original from an extraneous heat If lastly the Gangrene seize upon the part by reason of the want of Aliment or through a dry distemper then there is present neither pain nor inflammation nor swelling but rather a leanness and the body is immediately cooled and this Gangrene happeneth for the most part in those places of the body that are the utmost and extream as for instance the Ankles and Toes But when at length the Pustules arise and the part becometh pale and wan then the pains likewise appear and the Feaver is excited But if the Gangrene happen by reason of hard tying and Ligatures then the part swelleth and it distended and there arise greater Pustules ful of a thin excrement resembling the washing of raw flesh but the evident Causes we may easily learn and understand from the sick person himself Prognosticks 1. That the Gangrene is a Malady very dangerous is sufficiently manifest unto every one For unless it be speedily cured it degenerateth in a very short time into a Sphacelus and the part becometh altogether dead For this cause therefore there is not any the least delay to be made but help is to be afforded with al possible speed which may be done with less difficulty in a body that is as yet young strong and vigorous where the vital spirits are as yet entire and especially where the Muscles and Nerves are as yet unhurt 2. But that Gangrene which is with an afflux of poysonous humors and an occult quality is more difficult to be cured than that which is without any such afflux for there are but very few that recover of such Gangrenes 3. There are Gangrenes that are yet more dangerous and these are they that begin in the moist parts for the innate heat is sooner suffocated in such parts by the great store of humors abounding therein 4. And for this cause it is that the Gangrene that ariseth in Hydropical persons is likewise very seldom cured but most usually it degenerateth into a Sphacelus and that which ariseth from the Antecedent Cause is likewise ever more dangerous than that which hath its original from the primitive Cause in regard that in the former the Bowels are more affected 5. But a Sphacelus is yet far the more dangerous Malady For the part that is taken with the Sphacelus can no way be restored and made sound again but it is forthwith to be cut off and separated from the part that hath life which if it be not speedily done then the sound parts that lie neer wil likewise be infected and the putridness wil at length creep into the rest of the body from whence there wil be extream danger of present death before which there usually precede Dotings Watchings the Syncope Convulsions Ructures and Belchings Sobbings and a cold Sweat breaking forth over all the Body and some of them die while they ate yet speaking and others of them die being as it were oppressed with sleep The Cure The Cure of the Gangrene that it may be rightly proceeded in first of al regard is to be had unto the Dyet and the Antecedent Cause if it be present in the body before ever we come to Topicks Most Physitians prescribe and command a Diet that is cool and drying which albeit that it be most true of that Gangrene that is accompanied with an afflux of Humors and followeth great Inflammations yet nevertheless the Diet is somtimes also to be varied according to the variety of the Causes as anon in the species or several kinds of Cure we shal further shew you And so also
be taken But if the Contrary shall happen then the strength of the Medicament is to be augmented either by mingling a greater quantity of the old or else by the admixture of the newer Euphorbium for that mixture that hath in it a triple proportion of Wax is the strongest that which hath a five-fold quantity of the said Wax the weakest and the mixture having but a quadruple proportion of the Wax is in a mean betwixt both Galen as we may see in his third B. of the Compositâ— of Medicaments according to their kinds and 2. Chap. mentioneth likewise other things that are to be made use of as live Sulphur unslaked Lime washed Arsenick Sandarach Pompholyx the scourings of Brass Chalcitis or red Vitriol burnt But in all these he had only a regard unto their drying faculty and he would only have the Medicaments to be so made and Compounded that they might be able to cal forth and consume the Excrements out of the Wounds of the Nerves But unto me as I told you before it seemeth far more probable that such Medicaments are to be made choice of that may withal Corroborate and Augment the Native heat of the Nerves which of it self and especially in the wounded Nerves is very weak And therefore this latter Age hath found out Medicaments that are far more safe both such as are prepared by the Chymical Art as also such as are brought unto us out of other Countries yea and such as are very ordinary at home among our selves and such as do their office without causing any pain that is easily brought upon the Patient by the use of those stronger Medicaments that the Ancients made use of and which may be safely applied whether the Nerve be naked and bare or whether it be covered whereas in the Nerve that is bare all those Medicaments of the Ancients cannot be made use of with any safety such as are these Balsam of Peru the distilled Oyl of Rosin Turpentine and the Rosin of the Fir-Tree Wax Oyl or Balsam of St. Johns wort the spirit of Wine Gum Elemi Gum Tacamahaca and Gum Caranna All which obtain that faculty which by Galen and the Ancients is propounded and have in them no Corroding quality at all and withal obtain a Balsamick virtue as those of our times term it which those other of the Ancients are void of and they do not only consume the Excrements but they likewise greatly strengthen the Native heat of the wounded part and are all of them very agreeable and suitable unto the Nerves Caesar Magatus in his second B. of Wounds 5. Chapter mentioneth these several forms following Take Ammoniacum Opopanax Sagapenum dissolved in hot water Propolis and Turpentine of each half an ounce Oyl of thin parts two or three yeers old in which Earth-worms have been boyled one ounce and half Mingle them and make an Vnguent Or Take Cleer Turpentine the exsudation or tear of the fir tree of each one ounce Tacamahaca half an ounce Caranna two drams Balsam of Peru three drams Propolis six drams our oyl of St. Johns wort one ounce Mingle them and make an Vnguent Or Take Sagapenum Opopanax Propolis of each half an ounce Tacamahaca three drams the destilled oyl of Turpentine or the sweat of the fir tree one ounce Sulphur that hath not come neer the fire one dram and haâ—f Mingle them and make an Vnguent Or Take Tacamahaca Opopanax Propolis the sweat of the Firtree of each two drams Artificial Balsam six drams Mingle them and make an Vnguent Or Take Artificial Balsam our oyl of St. Johns Wort of each half an ounce Burning water which the Latines call Aquâ— ardens or the water of Balsam three drams and mingle them Or Take Diachylon with Gums one ounce Tacamahaca Caranna Sagapenum Propolis Rosin of the Pine Ship-pitch of each three drams Artificial Balsam half an ounce Euphorbium two scruples Mingle them and make a cerot Or Take The oldest Leaven one ounce and half Doves dung or Brimstone one dram Aqua Ardens or Water of Balsam as much as wil suffice that the Medicament may have the consistence of Honey and so mingle them Or Take Oyl of Turpentine or the sweat of the Fir tree one ounce Sagapenum Propolis of each half an ounce Euphorbium one dram mingle them And if the Medicament that is layd on be of a thin substance or as the Chymists speak volatile which may easily be dissipated then we are to mingle therewith all Turpentine and Gum Elemi or else we must impose an Emplaster of Gum Caranna Tacamahaca dissolved in the compound Oyl St. Johns wort The Diet. There is likewise regard to be had unto the diet The Air in which the Patient is most conversant ought to be somewhat more warm then ordinary since that the Cold is an Enemy unto the Nerves as in the fifth Sect. Aphoris 18. And therefore likewise the Wounds of the Nerves are not over often and without very great cause to be uncovered and when they are uncovered a Candle nmst be lighted and a pan ful of hot coals must be in a readiness and this new binding up must be hastened and performed with all possible speed Let the sick person abstain from wine The affected part is softly and gently to be placed and kept in quietness For as Celsus saith in his fifth Book and Chapt. 26. the best of all Medicaments is Rest and quietness and to move and walk unless for such as are sound is altogether unfit and improper Yea moreover we have two histories that tells us that Laughter may bring very much danger and damage in the wounds of the Nervous parts These Histories we find taken notice of by Guilhelm Fabricius in his first Century Observat 23. Let Anger likewise and the passions of the mind be avoyded And let the patient at this time abstain from Venery that which is of all other things most hurtful unto him as we are sufficiently taught by the history of that young man in Guilhelm Fabricius his first Cent. Observat 22. who being now almost perfectly wel and recovered dyed upon this very cause and no other Chap. 16. Of the downright Wounds of the Nerves as also of the Ligaments by Cutting But now if the Nerve or Tendon be wounded not by pricking but by a downright cut we are then to look whether the wound be long waies or whether it be transverse and overthwart and then whether the Nerve be wholly cut assunder or else be but only in part Wounded and how much of the skin lying over it is divided Signs Diagnostick The pain if the Nerve be Wounded by a Cut but not wholly divided and cut assunder is not so great as if it be Wounded by a prick and yet nevertheless for the most part it is even great enough But if the Nerve be wholly cut assunder there is then no pain at all felt but yet nevertheless the sense and feeling or else the motion of the part into which the Nerve