Empl. Observat Observat In 6 cases no Repelling Medidicines to be applied in the beginning Cataplasma Here Digestives are most proper Four waies of digestion Catapl Observ Catapl Catapl Observat 〈…〉 Catapl Catapl Catapl Catapl The efficient cause of matter Signs of Suppuration 〈…〉 〈◊〉 Catapâ— Catapâ— A method to find whether a Tumour be ripe enough to open What a Phlegmon is Whence it ariseth Its causes Signs Of the cure of a Phlegmon Four methods according to four times by Guido His diet Observat Electuary Bolus Potio Troch Electuary Clysters Purging potion Revulsion Revulsion Vesicatâ—ries Defensatives Observ Repellers Catapl Unguent Observ Question Answer By several reasons Their use and benefit Catapl Unguent Another Catapl Unguent Catapl Cured by Digestives Catapl Catapl Authoris Catapl Catapl Catapl A History Catapl Catapl Natural Second not natural Quest Answ Third preternatural Its differencies The names of Erysipelas What it is Signs Its differencies from a Phlegmon Praesage Cure The Authors Julep herein Emulsionâ— Bleeding Potion Potio purgans Electuar Pill Clysters Another Another Unguent Unguent Unguent Unguent Catapl Catapl A History Catapl Unguent 〈◊〉 〈◊〉 Chirurgery Electuar Potio A History A History What flegm is It s name It s generation Definition Signs Cause Praesage Pill Pil. Pil A potion Potion Potion Topicks Question Answer Observat Digestive Catapl Catapl Catapl Unguent ex Merâ—â—â— Empl. A History 4 Species of Melancholy Burnt Melancholy made four waies How a Scirrhus is made It s definition Signs Causes Presage Cure Potio purgans Another potion Pills Pills Pills Digestives Emplâ— Empl. Empl. Emple A History A History Signs Presage Cure Pil. Pil. Pill Pill Catapl Unguent A History What iâ— Wind. What a windy Tumour is Causeâ— Differencies Signs Cureâ— Potion 〈◊〉 Pil. Clyster Clyster Troch A Hippocras Wine Pulvis Fomentation Foment Catapl Unguent Catapl Empl Silvâ—â— History What the Brest is The Anatomy of the Brest How milk is made It s name Causes It s subject Signs Presage Cure Apozeme Potion Apozeme Sudorifick decoction Unguent Unguent Empl Unguent History History Caution How an ulcerate Cancer is to be treated A second may Of a Cancer growing at the Eye-tooth Apozeme Potion Potion Gargarism History Signs Signs Causes Presage Cure Unguentâ— Unguenâ— Unguent The Cure of a pestilential Carbuncle Catapl Histoâ—â— Cause Unguent Another A History Signs Causes Presage Herpes exedens Signs Cure Cerate Unguent Unguent History Fomentation Catapl Empl What a Gangrene is What a Sphacâ—lus is The diâ—ference between a Gangrene and a Sphacelus 3 Causes of a Gangrene The universal Causes both of Gangrene and Sphacelus To the first To the second Signs of a Gangrene from a hot intemperiety Signs of its coming from cold 5 Signs of a Sphaceluâ— Cure 1 From the Antecedent Cause 6 Intentions in applying of proper Medicines A particular Cure of a Gangrene coming from Inflammation 1 Intention Unguent Catapl Second Intention 〈…〉 History Oyl Catapl Decoction Digestive Caâ—apl History Cordial History What Artheroma is Observa Care Observ History History It s Cause Cure Empl. History Whence its Name Cure Pil. Pil Catapl its differencies It s Definition Signs Causes Two Species of a Hydrocephalos Presage Cure Decoction Oyl History Unguent Unguent Empl. History History Unguent History Its Causes Digestive Unguent History Three sorts hereof Cure Unguent History Cause Cure â—â—story Cause Signe Cure Pil. Pil Potion A Medicine of the Authors Observ History History Celsus Method Paulus ' s Way History Defensative Collyrium What a Polypus is Cause Differencies Celsus ' s way Paulus 's way What a Glandule is What the Parotides are It s Cure Catapl Unguent Catapl History History History Descriptâ—on of Strumaes Signs Presage Three ways to eradicate them Cure Pil. Pil. Pouder Pouder Aqva Unguent Catapl Catapl Catapl A History Catapl Catapl Catapl Pil. Unguent Empl. Histoâ—y Three species of a true Squinsey Caâ—ses Signs Presagâ— Cure â—argarism Gargarism Catapl History What the Amygdals are 〈◊〉 how made Uses They being the chief Organs of Tasting Cure Gargarism Another Another Trochisc Cataplasm Pil. Electuary History Signs Decoction History Cure History Liniment Empl. Another History Unguent Cataplasm The Causes of a Gonorrhaea Injection A double Method in its Cure Fomentation Unguent Emplâ— History History How the Intestine is to be reposed Cataplasm Unguent Decoction Cerate Empl. Empl. Empl. Apozem Empl. Empl. Histoâ—y Cerate Empl. Anâ—ther Oyl Syrup Electuary Pil. A second Method by Adustion A third Method is Incision The fourth Method History Clyster A Restringent Bag. Purge Signs History Another Another History History Causes Signs Cure Topicks Empl. Fomentation Another Catapl History Foment Another Another Another Oyls Unguent Catapl Another Another Empl. History Signs History Intentions Hernia Humoralis Causes Cure Hist History Causes Signs Presage Cure Unguent Another What Phygethlon is History Their Origination Unguent Another Another Another Another Another History Its Causes A restriâ—gent 〈◊〉 History Apozemâ— Empl. It s Figure what it is Its differences from Pterygion Its Signs Its Causes and manner of breeding Revulsives Interceptives Repellers Catapl History â—â— Pterygian Unguent Catapl History Potio purgans Catapl Unguent Hist Potion Unguen Catapl
the most extreme parts of the body it may very well and properly be here applied and made use of and for which this composition is most excellent ℞ Axung porcin ℥ iiij Pinguedin human ℥ ij Ol. Chamomel Aueth an ʒij Styrac Calamit Benzoin Mastich an ʒss Theriac Methridat an ʒi Argent viv ℥ iss agitentur omnia bene in mortario quibus adde Ol. Spic Salv. granor Juniper an ℈ ss misce fiat linimentum With this you may anoint the part affected or you may apply this often in this case applied with good success by my self ℞ Empl. Diachyl cum gum Paracels an ℥ i. Oxycroc ʒij Vnguent Praescript ℥ ss misce extende super alutam parti admovetor Or this ℞ Empl. de Ran. cum ☿ ℥ ss Pic. Burgund ʒij Taccamahacc ʒiij Empl. Paracels ℥ ss misce pro usu It seldome or never is brought to suppuration by reason both of its coldness and that it for the most part is very far distant from the Fountain of Heat but should it tend that way Empl. Diachylon cum gummi or a Cataplasm made of white Lilly roots Marshmallow roots and the like as you have already prescribed and shown you may do both very well here and be very serviceable A young Maid about eight years of age being much troubled with a Phlegmonous and Oedematous Tumour in the outward part of Her lower Mandible which came to suppuration fearing its fecies would hinder its cicatrice before I could open the Abscess I first tried by Guido's Counsel to resolve it who saith that Apostemes being sometimes suppurated do end in resolution the which was confirmed by Parraeus his experiment who averreth that he cured a suppurated Aposteme by mixing Quicksiver with Diapalma and so applying it and thus I took to an Ounce of Diapalma a dram of Hydrargyrum and applied to the suppurated Aposteme and within four daies it was wholly resolved and for discussing the suppurated matter to the following Conditions are these necessary that the matter be small in Quantity thin and serous occupying the superfificies of the Cutis and not penetrating that it be in a strong and young body happening in the soft parts and a convenient time of the year By the vertue of which Medicine and observing of which method a young Gentlewoman was perfectly cured of an Oedematous Tumour which was but little suppurated upon the Region of Her Loins the largness of the palme of a hand CHAP. XXII Of a Scirrhus OF Melancholy cometh Scirrhus Cancer Vlceratus non Vlceratus Elephantiasis Psoras and others Our late writers do call this Scirrhus Durities because it is a hard Tumour destroying sense lodging in a Member in that Capacity as that it produceth little or no pain or it may be called a preternatural Tumour having no infesting symptome It is by some called Apostema Lapidosum by Avicen Sephiros It is the onely brat of Melancholy and this Melancholy hath a double construction For there is 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or succus Melancholicus 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 atra bilis Between which two there is a vast difference the succus or juice being as the fecies or dregs of the Blood and is drawn from the purest part of it by the spleen the other Black Choler being caused of immoderate heat and burneth the parts and like vinegar being poured on the ground it boyleth and raiseth it self from thence There are four species of Melancholy first when its species are burnt it frameth an illegitimate Scirrhus Secondly when Melancholy is made preternaturally by other Humours it doth take share of their qualities Thirdly when it is made thick by too much cooling or drying of Humours Fourthly when it is mixed with Flegm Blood or Choler then it maketh Scirrhus Oedematodes Scirrhus Phlegmonodes Scirrhus Erysipelatodes There are four waies also shown to the making of burnt Melancholy The first is made of yellow Choler burnt and so representing a yellow sinder and doth burn like it The second is made of thick and viscid Flegm The third is made of burnt Blood which is very bitter The fourth is made of Melancholy Juice being both acid and corroding There are two kinds of Humours which do make this Scirrhus the one being a Crudity as Flegm thick and yet not viscid the second is vitreous matter or a glassy substance of Flegm And hence may we take a Scirrhus either to be exquisite or not exquisite and therefore if Flegm be in a great quantity it shapeth out Scirrhus Oedematodes if Choler be predominant Scirrhus Cancerosus Or if you please a Scirrhus is bred out of a natural melancholy Humour which is cold dry and thick and from glutinous Flegm and hence it may be defined a Tumour hard and indolent a Tumour proceeding from a thick and glutinous Flegm or a natural melancholick Humour It may be known by these Signs it is a Tumour without pain hard to touch if not exquisite it is scarcely perceived Every Scirrhus hath not pain and this necessarily happeneth because it is deprived of sense Melancholick Scirrhous Tumours are generally of a leaden colour but a Scirrhus arising from a Flegmatick Humour carrieth in it the natural colour of the Cutis They take their principal Causes from the beginning of thick and tough Humours and collecting themselves in the parts and that occasioned by evil Diet generating a thick and viscid Humour as by reason of intemperieties of the Liver or Spleen all such causes may be said outwardly to generate thick juices as a cold or dry Air Watchings suppression of Menstrues and the like Expect to do no good on an exquisite Scirrhus for this alwaies is to be suspected If it happeneth about the Joints Knees or these remote parts be not too forward to undertake them If it be exquisite and not turning Cancerous yet it is hard to cure for first the Matter is dried up and then cold and compact and so tedious and that which is lapidous gives no way to Medicine As to the cure the external causes are first to be removed by choosing a thin Air hot and moist free from Fogs and Mists let the Patient shun thick leguminous and cold Diet let his Drink be Wine to help forward Digestion and warm the parts and let him get himself clear of all passions of the mind After this are we to take care to remove the inward causes by preparing the Humour with Syrup of Apples Bugloss Fumitory Hyssop Oxymel Balm and the like This being done we are to purge this melancholick Humour with Senna Polypody black Hellebore Confectio Hamech c. of these or the like may be framed excellent compound Medicines as this Apozeme ℞ rad Faenicul Scorzonar Bugloss an ℥ ss cort Tamarisc Cappar Polypod Q. an ℥ i. sem Anis Faenicul an ℥ iss Citr ʒij fol. Capill vener Scolopendr Meliss Lupul Thym. an M. i. fl 3 Cordial an pug ij Passular
open and by purging it from its Flegm and waterish Humours as this ℞ Extr. Rud. ℈ i. Pil. Coch. ʒss Resin Jallap gr vi misce or this ℞ Pil. sine quib aur Indic an ʒss Resin Scammon ℈ ss misce for two doses The part affected is to be treated with Coolers and Discussives as are Mallowes with Barley Meal and Cicers being made into a Decoction or some of my discussing Cataplasm already prescribed or this ℞ Farin Fabar. ℥ i. Hord. ℥ ij coquantur poscâ ad formam Cataplasmatis in fine ebullitionis adde pulv Rosar rubr ℥ ss post unam ebullitionem ab igne remove tunc misce album vitel Ovor. no. Ol. Rosar parum misce fiat Cataplasma If the Psydracium be ulcerated and a moist Humour cometh from thence apply this ℞ Litharg aur ʒi Ceruss ℥ ss Alumin ʒij fol. Rut. cum Aceto Oleo simul mixt fiat Vnguentum with which anoint the Skin and having well embrocated it with this you may conclude your Cure with this Liniment ℞ Lithargyr aur Ceruss pulv an ʒij Sulphur ʒi Ol. Rosar q. s fiat Linimentum And lastly aqua Scahiosa is by many held to be most excellent here Alome being added to it CHAP. XXXIV Of Hydrocephalos THIS is a proper Tumour of the Head arising for the most part from Water and hence doth it take its name This is a Distemper which doth very oft come into the World with young Infants being either bred with them in the Womb or else so as they are bringing into it It may also be occasioned by a careless or ignorant or unhappy Midwife It may well be called a Cephalick Dropsie for it doth contain in it a proper Waterish substance known by its indolency softness its easie yielding to touch but chiefly from its inundation of Water running out of one place into another in its compression These Tumours do often times vary for in some they are small whilst in others they do appear very large It is a peculiar Disease in the Head of young Children the which ariseth from too much Humidity of the Head for which very Cause they which are much troubled herewith do seldom live long as both Galen Aetius and Paulus do observe This Tumour by Galen in Libr. definitionis is thus designed as being a collection of waterish Humours or feculent Blood in some parts of the Body which doth force it self up to the Head And here is a double meaning to be explained the one whereas he calleth it not only a collection of a Serous Humour but also of a feculent Blood as when the Head Cranium suffers an outward Contusion or Collision and the Veins by this Collision do sprinkle their Blood between the Cutis and Pericrane This Blood here thus putrifying doth make a most soft Tumour and if a serous aquosity were collected the which by dayly experience may well be offered to happen from a Contusion thus happening it may frame a Hydrocephalos Aetius lib. 6. cap. 1. will have that a Hydrocephalos may be generated from a Feculent or bloody Matter the which being changed into a thin substance A second of Galens is that a Hydrocephalos is a collection of an aquous Humour in some part of those Bodies which have a forcing quality towards the Head out of which it may be conjectured that Galen doth offer that Hydrocephalos to be a Disease of some part of the Head not a Dropsie of the whole Head and this is confirmed by Aetius and Paulus who treating of Hydrocephalos do allow four species hereof First when this Humour getteth between the Brain and Membranes Secondly when it lyes between the Membranes and the Skull A third between the Bone and the Pericrane And Lastly when between the Pericrane and the hairy Scalp I have already shown you part of its Signs that it is a Tumour soft in touch whitish in colour indolent turgid much like a Pillow to other parts easily yielding to touch and as speedily filling up its former made vacancy the Finger being removed If it ariseth from a Contusion it doth appear first red and doth carry pain with it as Aetius doth write but being afterwards changed into a thin substance it doth spread it self without pain In those where it happeneth between the Pericrane and Bone they answer plainly the rest for here it is hard in Tumour and very painful by reason of the distention of the Pericrane If it happeneth as sometimes it doth between the Membrane of the Brain and the Skull it will be a Tumour but not yield to compression nor soft to touch Here it maketh the Infant soon to give way to it and to yield up its Ghost Its Causes may be said to be sometimes outward sometimes inward One of the outward may be said to be that which is mentioned by Paulus in Children newly born who had their Heads but ill bound up by their Midwives Another is contusion or collision or ruption of one or many Vessels Another cause is a cold Air or too much Water or thinness of its passages or Vessels out of which this Serum or matter do recide as Aetius hath it or also too cold or waterish Milk which it may suck from the Nurse these may be said to be the inward Causes hereof as when the Brain is too much cooled or the matter being here first collected and hence sent to the Brain Every Hydrocephalos is very slow in its motion as Aetius doth prove Lib. 6. Cap. 1. For it hath a cold Brain inwardly from its beginning arising from its inward Cause and also an outward by and from its outward Cause by reason of its delay and contaction To draw all these to one head there is to be allowed two Species of a Hydrocephalos One in which this waterish Humour is contained and made by an inward Cause that is out of an abundant collection of this serous matter in the Body The second doth not contain the sincere Serum but as it were a mixt feculent Blood the which doth eat it self out of the lacerated Veins arising from Contusion or some other outward Causes As to its Presage Paulus Aetius and Galen do offer that if this Humour be collected between the Brain and its Membranes it is mortal in other parts it may admit Cure by curing its Causes and removing its Effects But here as well as in other parts of the Body the Rules of Celsus and Galen are to be observed every Disease is so much the more dangerous by how much it gets into a greater bulk and bigness As touching its Cure we shall begin with that which is extant between the Hairy Scalp and Pericrane And herewe are to observe that every Hydrocephalos is to be cured by discharging of this waterish substance which is to be performed by purging the whole and cleansing the affected part And with this we are to begin with general Cephalick Purgings in
us it is an Art which informeth with reason how we may cure prevent and mitigate diseases by the help of the hand but it s most proper and essential definition is taken from eradicating diseases by Art and manual Operation for as 〈◊〉 hath it such medicines as are applied to Tumours Wounds Ulcers or Fistusaes cannot so properly be said to be cured by Chirurgery because this health is purchased and procured by help of medicine which was applied But where an Abscesse or Impostume is opened by Incision bones dissocated or fractured reduced by the hand Fistulaes dilated Cataracts couched Cancers taken of by Instrument and the like these may well come under the name of Chirurgery it being from the use of the hand that it taketh its name for it is derived 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 à mann opera and thus Chirurgery quasi 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 As for its subject matter I have already shown man being alone the proper Instrument hereof As to its end it was ordered and framed to repair natures wants to help her necessities to make her curvations right And to its order and method it is divided into Theory and Practice The first teacheth and is called science acquired by demonstration and knowledg of the principles of Art this carrieth with it the precepts of Art The second practice found out by Knowledg and Reason arriving at a greater degree of perfection by manual Operation and this daily experience adds to its lustre and truth It may also be divided into general and special parts These held general as the Articulations or soft parts Those special which teachthe right way of Operation about Tumours wounds ulcers fractures disâ—ocations and the like The scope of Chirurgery directs the Chirurgion to the well knowing and understanding these four parts as to remove solution of continuity to restore union where wanting to separate parts unnaturally united and to supply defects The first is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the joining part the second 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the separating part the third 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the removing part the fourth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the supplying part The first performed by Consolidatives Agglutinatives adducing Luxated bones and curing fractures The second acted by Incision Phlebotomy or Scarrification or Amputation as in wry necks hare lips imperforated Anus and Penis The third is finished by extirpating tumours as Ganglions Cancers Nodes Strumaes Scrophulaes Stones Cataracts drawing out of water from the Abdomen or Thorax by a Paracenthesis Amputation and the like The fourth he supplies in restoring Ruptures into their proper places as in restoring a new nose and bringing the blind eie to its sight And these are to be done Citò Tutò Jucunde suddenly without pain safely without cheat or imposture and pleasantly without fear or fallacy And that the Chirurgion may perform these with honour and repute let him take a turn with me in the several borders of this Chirurgick garden where he may first see what is natural what unnatural what preternatural thereby the better to furnish himself with Indications or Intentions against these or any thereof And the first that offer themselves here are the things of nature for whose end this first intention is appointed and that is health its cause effect its strength and temper all which are to be kept in their order and beatuy These are generally allowed unnatural or preternatural as a disease or distemperiety for this is said to be a praeternatural effect of it self and hurting action by its cause and this may hurt by action hindring it or by accident and then by symptoms which follow a disease as a shadow doth the body There are three general Intentions here requisite The first arising from a preternatural thing taking from its contrary as union from Solution of continuity coldness from heat heat from coldness driness from moisture and moisture from driness ablation from matter exceeding and encreasing from matter diminishing apertion from obstruction and dilatation from angustness astriction from amplification reposition into its proper place from whence it made its recession And as we are to observe this order of contrariety so also are we well to understand it which affect ought first to be cured the curing of which is the principal cause of curing the other and without which no perfecture The second Intention sheweth how we are to keep those parts intire which are placed according to nature and to discharge and expel those that are preternatural and we may understand an incurable disease these three-waies First when the disease of its own nature is incurable as the Elephantiasis or confirmed Secondly when the patient useth not such means as should be proper for his recovery Thirdly when the curing of one distemper threatens another greater and more terrible The third Intention is performed by opportune helps and conveniency use of right and proper medicines and these are either Medicinal or Instrumental Instrumental for living well and keeping a good order as Pharmacy Phlebotomy Emplaisters Uuguents Powders and the like The unguents a Chirurgion should alwaies have in readiness satisfying his common Intentions are these unguent Basilicon to maturate and convert into Pus Apostolorum to deterge and mundify Aureum to incarn and fill up Aâ—â—um to agglutinate and consolidate Dialthaea to mitigate and ease pain Instruments for all occasions large and small some for searching others for cutting for some drawing out extraneous bodies and others for putting or reducing parts into their respective places And these bring me to the Chirurgion himself which is to be the man onely engaged both in their applications and administrations and let us see what person he ought to be how qualified armed furnished and exercised To consider in what chair of honour and esteem a Chirurgion is seated may well require his care and study learning and excellency and since there is such a conjunction of the mind with the body such a connexion and society that they generally take shares of one anothers good and bad fortune as some deliriated with fevers whilst others are blown up with madness by the fury of choller To see the wonderful effects of blood while melancholy acts her innumerable changes in our bodies may well call into admiration the best of mens knowledg our thoughts varying according to the diversity of tempers in our bodies Thus are we troubled with diseases inflamed by anger sweetned by love exhilarated by joy dejected by sorrow tempered by sweetness shaken by fear and to search out the depth of these their originations and causes their diversity of shapes and postures may well require a quick sight to penetrate a powerful wit to search out a well guided reason to consider of He therefore that will enter this stage of Chirurgery must well understand its various scenes and acts for it s he alone guided by the provident hand and
understand their diversity of times Hence also are we to consider the largness or smalness of a Tumour and its species without the knowledg of which we cannot be said to understand the curative method its causes which are conjunct with the disease the circumjacent parts and the symptoms which do follow either from the nature or cause thereof and lastly the signs And when we have thus far arrived we are to consider the four great Tumours in general as Phlegmon it being as our first to treat of it proceeding of blood the Son of nature generated for the treasure of life Secondly of Erysipelas arising from choller the fury of the gall Thirdly of Oedema coming from Flegm the proper instruments of the joynts Fourthly of a Scirrnus bred of Melancholy the lumpy and terrene masse of the rest Of every of these are bred various Tumours according to their various shapes and changes but of these in their proper places CHAP. V. Of the Vniversal way of curing Tumours HE that will undertake the curing of Tumours ought well to understand his curative scopes and intentions and the well timing of Tumours is a very great matter here And here may we expect a Tumour either already made or in its making And hence ariseth a double intention the one prohibiting Fluxion whilst the other cure is wrought by discharging the matter already flown because removing of causes do hinder Fluxion If this happen from Plethory breathing of a vein is very proper whilst in a cachochymick body purging is as useful When a Tumour doth proceed from Fluxion we are to begin our cure from the matter flowing and hence cometh our first intention and this is performed by Repellers Revellers and Interceptives save onely in these seven cases set down as our seven cautions by Galen First when the matter doth flow to the Emunctories or glandulous parts secondly when a venenate matter floweth for this sends it more inwards and so poysoneth the heart Thirdly when this matter floweth Critically not crossing Nature in her own way Fourthly when Fluxion is excited in a Cacochymick body Fifthly when the part to which this matter maketh its Flux is weak and its heat but mean Sixthly when there is vehement pain for here is more need of anodynes and then seventhly when this Fluxion is near some principal part And as touching these curative scopes we are first to probihit its Origination and by this means to hinder its augment secondly to understand the quality of such things as are to be applied for as Galen saith 13 Method 16. we do destroy the breed of a Tumour if we well understand its cause and this being ablated the Tumour is soon seen to vanish Fluxion and congestion are the two cheif causes of Tumours the first offending either in Quantity or Quality and so with violence doth seize suddainly upon any member either by reason of its loosness or weakness Congestion being when a Humour is gathered into a part gradatim by reason of this weakness of the digestive and expulsive faculties CHAP. VI. Of Phlebotomy its manner of Operation and where it is most properly performed IN this Discourse we have many things do offer themselves to our consideration As when there is a fulness Evacuation is in use and here is to be let out as much as is necessary If there be a Plethory Quoad vires here it is to be repeated And as touching the part which is to have the lancet exercised on it whether from above or below this also is to be minded and regarded because Derivation which Evacuation from the adjacent part doth not agrees in the beginning of the cure because this would make the Fluxion larger and the Attraction to the part affected greater And if we will make Revulsion aright we ought well to understand the place of Fluxion that we may happily revell in the opposite part Thus if the right kidney be hurt we open a vein in the left arm in Tumours of the groin vena Poplitis And if any may question our meaning between the upper and lower parts Galen himself giveth them this answer All the parts above the navel including the Liver and Stomack are called the upper parts and thus have we one part of the vena Cava called the ascendent Trunk the other below these are properly called the lower parts This knotty difference between Repulsion Revulsion and Derivation is not very easily untied I shall thus endeavour to loosen it Fluxion arising from Expulsion showeth expulsion if it followeth from the quantity of matter this is either to be revoked or evacuated and hence ariseth this twofold intention Revultion and Evacuation This being out another thing is to be observed the matter that slows hath three places one from whence it floweth the second whither and this is to the part affected and thirdly through what parts before it arrives hither These being found out we are to consider how to discharge this matter and thereby prevent its further spreading secondly we are to prevent the Fluent matter which hath got passage into the channels that it flow not to the part affected and so run this also into a Tumour And the well consideration of these may well make us use study where and when to make this Revulsion and where to make evacuation And in both of these we are to observe Hippocrates Rule that all be done secundum rectitudinem and this is to be performed two waies as by comparing the left with the left and the right with the right for with these there is held a proper consent Thus the Liver vein hath a rectitude with those veins which ascend up to the head Thus upon an immoderate Flux at the right nostril by applying a cupping glass to the Region of the Liver the Flux doth suddenly stop if the left by applying one to the spleen doth work and perform the same effects Galen hath also two species of Revulsion the one from the upper parts to the lower from the right to the left the second not so exact which we use when the matter is much and threatens danger Galen also in diseases of the upper parts doth revel by opening the upper veins as in Tumours of the head he doth order the Cephalick vein to be opened and Falloppius saith in a Squinancy he hath breathed the left arm and the Humour presently vanished and in some cases this is very proper In Tumours of the Axillaries being venenate if we should open the lower veins we must consequently draw its venome inwards to the heart and vice versa if we should open the upper veins in a pestilential Bubo we may well make a free passage for the pestiferous matter to make its address to the heart which is not onely a great fault in the Chirurgion but also as unhappy to the Patient And thus have I shown some of its benefits I now come to teach the young Chirurgion how he is to use his
this Tension and this be large when these signs are at hand use neither repelling Medicines nor Digestives but use your greatest care to assist nature in her progress of suppuration by maturating Medicines that is to prepare the matter and make it fit for expulsion and then to discharge it when we have thus prepared it And that therefore we may procure the Tumour for this suppuration and produce a good and laudable matter we are to encrease this Quantity of native heat by such Medicines as are of a digesting faculty the which ought to be of the native heat with the part These are to be applied from the beginning of the Augment to the end of the vigour Some of these are simple as Marshmallows â—iggs Chamomile Galbanum Bdellium Ammoniacum Hogs lard Goose grease and the like Of the compound may be reckoned Empl. Diachylon cum gummi de Mucilag Flos Vnguentorum or some of these Emplasters or Cataplasms Of which for this use these may be applied very properly â„ž Empl. Diachyl cum gum â„¥ i. De Mucilag Paracâ—ls an â„¥ ss Basilicon Ê’i Croc. ℈ i. cum Vitâ—l Ovor. no. i. misce fiat Empl. Or. â„ž Bdell Ammoniac an â„¥ ss Solventur in Lixivio claro adde Calc viv cum Axung contrit Ê’i Sulphur viv Ê’ss Alumin â„¥ ss mel Opt. â„¥ iss ferment veter Ê’ij misce â„ž Rad. Lilior â„¥ i. Alth. cum Rad. Malv an M. ss fl Chamomel Melilot an pug i. Ficuum pag. iij. sem lin faenugraec an Ê’iij fiat decoctum in vino albo q. s colaturae adde Vitâ—ll Ovor. no. ij Croc. ℈ ss Ol. Cham. Melilot an â„¥ ij misce fiat Cataplasma Or. â„ž Rad. fol. Alth. Malv an M. i. Coquantur pistâ—â—tur ut artis est quibus adde â—arin Tritic. â„¥ ij farin sem Lin. â—eâ—â—graec an â„¥ i. Butyr recent â—l Liliâ—râ— alb Vnguent Dialth an â„¥ iss Croc. Ê’ss vitell ovor no. ij misce fiat Catapl The matter by these orany of these or the like being brought to Suppuration this is to be discharged and this generally is to be performed by Incision or Caustick And before we attempt either of these we are well to understand whether it be ripe enough and this you may thus find out The Tumour at this time seeming by contracting it self to appear less than it was in its state then it draweth it self to a point its hardness is much abated and therefore discussed and by touching it with the finger we find it Fluctuatous the heat and pain ceaseth the part is changed in its colour the Cuticula is shriveled all these being good signs of its Suppuration This not being all drawn out you are to arm your Tents or Pledgets with this or the like â„ž Terebinth Venet. â„¥ i. Mell. Ê’ij succ Ap. â„¥ ss Farin Fabar. Ê’v misce fiat Linimentum After the Application of which apply Diachylon cum gummi or Empl. de Mucilaginibus All these being discharged and the Orifice being well mundified and deterged your next business is by the helps of Sarcoticks to fill up with flesh as Vnguent Basilicon Aureum and the like and then with Epouloticks to induce a Cicatrice as with Vnguent Diapompholigos Desiccativum Rubrum Sanativum or Diapalma And thus have I run through the four times of a Tumour and because a Phlegmon doth bear the greatest share in these four times and orderings I shall be much briefer in its discourse and so proceed CHAP. XIV Of a Phlegmon or Inflammation in General IT is by all Authors granted that a Phlegmon hath its four times and that out of Blood besides this doth arise several other Tumours as a Carbuncle Gangrene Sphacelus Pernio Phyma Phygethlon and several others And here let us first inquire what a Phlegmon is and whence derived It taketh its name 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifieth to inflame This is an Intemperiety not only of the simple but also of the Organick parts as Galen observeth in 13. Meth. Our latter Writers do make two distinctions about the material cause hereof the Blood being either natural or not natural the natural furnished with these conditions being of the same Blood with that which cometh from the Sanguinary mass having in it the four Humours and these Qualities as being hot in action and moist in consistence in colour red in taste sweet the unnatural being denied of these good Qualities and also devested and deprived hereof Thus out of pure and benign Blood ariseth an exquisite Phelgmon if this Tumour hath any other humours annexed or joined to it it occasioneth a various species of Inflammation as having Choller admixed it maketh Phlegmon Erysipelatodes if Flegm Phlegmon Oedematodes if melancholy Phlegmon Scirrhodes Besides these also other accidents belong to Inflammation for if an inflammation doth get into the membranes of the brain it maketh Phrenitis when it creepeth into the Tunica conjunctiva there it frameth Opthalmia when into the Fauces Angina into the Pleura Pleuritis and so into the Emunctuories Bubo Its causes may arise either inwards or outwards Inward causes are Plethory or plenty of Blood and this not having its free passage must necessarily inflame and putrify inflamed heat in the Sanguinary masse and this oft times doth exalt it self into Fevers the part hot and painful doth draw the Blood and this maketh up the Inflammation Outward causes may be said to be Aires which do inculcate and shut in this putrid matter Attrition Attraction solution of Continuity or Luxation these or any of these causing pain and so Inflammation As to the signs when you perceive a Tumour is soon made and doth soon encrease you may properly judge this an Inflammation when the patient doth perceive a great heat and burning arising from this heat the colour of the part Florid and Red occasioned by heat and thinness of parts pain great and a pulsation joined to this pain by reason of its hot intemperiety when any part extendeth it self upon compression aggravation and vellication of the nervous parts and the veins evidently appear which before lay hid when Tension is made by reason of the constipated matter all these are sufficient signs which may pretend to paint out Inflammation I shall follow Guido's method in the cure of Inflammations as first by removing the cause then come to the Inflammation it self and so to the discharging of the peccant matter And for this he propounds four methods according to the four times and whereas a Phlegmon hath a Beginning while the Blood is nowing an Augment when in its Flux it is made hotter a State when it is converted into Pus or Matter and a Declination when the Inflammation is digested resolved and the Tumour diminished So also the four Intentions shall be these first in having a respect to the order of diet secondly to hinder the Flux of Humours thirdly to discharge the Matter and then lastly to correct
with a fever pain watchings blisters and the like she being ordered a cold and moist diet and her body being kept open with Chologogick clysters as oft repeated as occasion required keeping her Room cool by oft times sprinkling vinegar thereon and prescribing her convenient Juleps and Emulsions I applied to the part affected this Unguent â„ž ol Rosar â„¥ ij Cer. flav â„¥ ss Vitellor ovor n o ij misce fiat unguent She being drest three or four times in a day until the pricking pain abated with this unguent afterwards was applied this Digestive for warming and comforting the part â„ž farin Hord. â„¥ i. farin Fabar. â„¥ iij. coquantur in vino q. s tunc adde pulv fl Chamomel Melilot an â„¥ ss Scord. Ê’ i. ol Rosar Chamomel an â„¥ i. vitell ovor no. i. misce fiat Catapl and if any blisters do arise this following unguent is very good and proper â„ž Ol. violar Rosar an â„¥ ij Lâ—â—harg aur â„¥ ss Thur. Ê’ij Ceruss Plumb ust an â„¥ ss succ Plantag Sâ—mpeâ—â—â—â— an â„¥ ss misce in mortario 〈…〉 urgnentum Or this 〈…〉 aur â„¥ ii pulv Alumin Ê’iiss albumin ovor no. i. bene agitatum cum oleo Rosar â„¥ iij. Acet â„¥ i. misce fiat unguent CHAP. XX. Of an Erysipelas in the Face THIS for the most part ariseth from the nose it first growing red then doth swell and then spreads it self and sometimes it doth get into the head and neck The causes which may occasion this may be said to be two being either inward or outward outward as contusions wounds or the like which may be accounted capable enough to excite heat and pain or inwardly taken too much hot wine spice or the like a hot intemperiety of the Liver which doth breed this so plentiful a quantity of Blood a redundancy hereof and a Fluxion of Humours to the part affected The cure hereof is much different from the former and in this we are to make a diligent search as touching its causes happening either by an outward or inward occasion If by an outward this being removed the Erysipelas doth cease if from a redundancy of chollerick Blood which floweth into the face the outward veins are to be opened and hence do arise three intentions in this cure first a cooling of the hot intemperiety of the Blood of evacuating and discharging of this chollerique Blood and thirdly to hinder this Fluxion And these are to be performed by Diet Chirurgery and Pharmacy by Chirurgery in Revulsion by Phlebotomy which ought to be performed in the arm in the same side and here you may bleed plentifully if the patient can endure it if not you may repeat it besides this other Revulsives are good as Cupping-glasses Vesicatories these being applied to the neck and shoulders Pharmacy doth relate to the better tempering the intemperiety and for this you may take these as proper Medinces being very good and useful in this case to be used and administred as â„ž Pulp Prunor. damascinor â„¥ i. Crem Tartar Ê’i Rhabarb Ê’ij Cinamon pulv Ê’ss Santal citrin pulv ℈ ij misce fiat Electuarium cujus sumat patiens q. nuc castaneae omni mane Or this potion â„ž Tamerindor â„¥ ij Prunor Jujub an par no. 5. Passular enucleat â„¥ ss Hord. mundat pug i. sem Melon Lactuc an Ê’iij fl 3 cordial an pug ss fiat decoctum in colaturae â„¥ vj. solve Cass recent extr â„¥ ss pulv Jalap Ê’ss syr Rosar solutivar â„¥ ij misce fiat potio Or this of the Author â„ž rad Petroselin Faenicul Cichor Lactuc incis an â„¥ i. coquantur in aquae fontinae ut colatura redeat ad lb. huic adde vini albi lb. in his simul mixtis stent per noctem in infusione Senn. mundat â„¥ ss Rhabarb Ê’i Polypod querc â„¥ ss sem Faenicul Anis contus an Ê’ij Epithem Ceterach Capil vener an p. j. ZZ Ê’i hujus infusionis sumato â„¥ iiij his adde pulv Jalap Ê’ss Crem Tartar ℈ ij syr Rosar solutivar â„¥ ij misce sumat cum costodia As to his diet which is the third part let the Patient abstain from Wine and instead thereof let him drink Barly water or Julep of Roses or cooling Emulsions such as you have already directed you And thus much of the inward causes As to the outward Applications they ought to carry with them a moderate temper between heat and cold for when heat and pain do urge these do call for ease and mitigation and if pain doth proceed from heat here most properly are we to use coolers without astriction as is the Decoction of Mallows mixed with a little oyl of Violets or Roses in the end we are to use Digestives as we have formerly directed and prescribed And thus much of an Erysipelas getting into any part of the head A country man being vexed with an Erysipelas Phlegmonodes the which being anointed by the advice of a Barber with oyl of Roses for some daies this happening in the arm hence did arise pain inflammation and other symptoms so that at length the whole hand was correpted with a Gangrene the which at last being well scarrified and such convenient Medicines applied as I have shown in my discourse of a Gangrene he afterwards recovered Let this serve as a caution to young Chirurgions that Oyl doth add to the flame rather than extinguish it as Galen doth offer in lib. 5. de Simpl. A Gentlewoman a person of very good Quality had an Erysipelas all over her face the which at length had a Herpes miliaris joined to it in which time the Erysipelas imprinted its marks so as the whole face was marked therewith she being of a plethorick constitution when neither by the advice of Physicians by bleeding purging or application of several external Medicines good could be done after the applying of several Unguents this at last being applied brought her unto her health as â„ž Vnguent de Lithargyr â„¥ i. Hydrargyr extinct cum succ Limon Ê’ss Tuth praeparat Ê’iij Ceruss lapid Calaminar praeparat an Ê’ij aqu Rosar acet Rosar an â„¥ iss agitentur omnia in mortario pistillo plumbeis Of this you may read in Observat 34. Riverii CHAP. XXI Of Oedema AS the former two have their variety of diseases belonging to them so also hath this its various companions bred of and from the same Humour for from Flegm are bred Oedema Artheroma Steatoma Meliceris Nodi in Juncturis Ganglion Leucophlegmatia and the like This Flegm is the fourth part of the mass of Blood that is the colder and moister part thereof and if it so happen that this doth increase in quantity the expulsive faculty being stirred up by the great plenty of this Flegm this doth offer very fair to the generating of an Oedema This Flegm is cold and moist and by some called pituitous Blood And of this there is two sorts one Alimentary the other Excrementitious The first is the
origination hereof by the Arabians called undimia by the Greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 signifies no otherwise then an eminency There are of natural or excrementitious Flegm these three sorts the first being acid so called from its taste the second salt Flegm the third glassy Flegm from its coldness thickness and toughness And if Flegm doth erecede from its nature by admixing it self with Blood it is called Oedema Phlegmonodes if with Choller Oedema Erysipelatodes if with melancholy Oedema Scirrhodes A great matter hereof is a great quantity of Flegm residing in the body cheifly about the extreme parts as the hands knees or feet these being the most remote from the Fountain of heat This Flegm is thrown forth from the greater vessels to the smaller the which being there deteined by the thickness of the Cutis is collected in the musculous parts and there doth form this Oedematous Tumour It is a Tumour soft indolent loose yeilding to the touch generated from a pituitous matter It is soft and loose and these two come from the Humour of thin Flegm indolent for it neither doth make or cause any pain or dissolve unity It gives way to the touch and is a white Aposteme and without heat white being most like its object Flegm without heat being like the matter out of which it is generated which is cold and moist A pituitous Humour redundant in the body is the cheif cause to the which a cold and moist air a flegmatick diet too much sleep and idleness and a cold dyscrasy both of Head Stomack or Liver may help forward to the encrease of its cause And as Galen saith Comm. 46. that out of Fluxion of Humours some are cruel as Chollerick fluxes and burnt Melancholy and others are more kind as this Oedema so this is a tedious and long disease because it is cold the native heat being herein very weak It is oft times soft and without pain and so carrieth the less danger but if it be hard and with pain it is dangerous As touching its cure here ought we first to use proper means by Retraction and Revulsion of the Matter and lessening of it Secondly because it is cold remove its cause by implanting heat and warmth herein Let the Air be warm and dry the Diet attenuating and drying here Wine is good because it doth digest and warm Let his diet be of good and light digestion as Chickens Rabbets Partridges and the like to which may be added all sorts of spices Let his sleep be moderate and let him avoid all passions of mind and venery and observe that he keep a good habit of his body After this let him use such evacuations as may both attenuate open and discharge this Flegm Bleeding here is in no wise to be used unless a Phlegmon do accompany it Fever or the like And for his use these Phlegmagogicks are very proper and convenient as â„ž Alo. lot cum aqu Majoran Agaric trochisc an Ê’i Mastich Cubebar an gr vi Troch Alhandul ℈ ss Cum syr de Betonic q. s fiant pillulae dosis Ê’i Or â„ž Pil. Coch. Ê’ij Aurear. ℈ i. Troch Alhandul gr iiij cum Oxymelit scillitic q. s fiant pil no. 18 quarum sumat 2 omni mane Or if you will â„ž Pil. Coch. ℈ ss extr Rud. ℈ i. Mercur dulc gr 15 ol Câ—ryophyllor gut i. misce sumat mane A potion preparing Flegm â„ž Hyssop M. i. Menth. M. ss Absynth M. ss sem Anis Faenicul Calamenth an â„¥ ss Rosar rubr â„¥ ss fiat decoctum ad lb. colaturae adde Sacchar lb. aromatizetur cum pulv Cinamom Ê’i or this potion â„ž aqu Meliss Bugloss an â„¥ ij in his in funde per noctem Rhabarb Ê’i Agaric trochisc ℈ ij pulv Cinamom ℈ ss ZZ Ê’ss colaturae adde Mann â„¥ ss Cambog gr iiij aqu Cinamom hordeat â„¥ ss misce fiat potio Or if you please this â„ž Electuar Diacatholic â„¥ ss Diaphaenic Ê’ij pul Agaric troch ℈ ss solvantur omnia in aqu Hyssop Rosar damascinar Faenicul an â„¥ i. misce fiat potio cui adde syr de Betonic â„¥ iss And because Oedema is a disease offending partly in quality partly in quantity in respect of its cold and moist quality we are to use such Medicines to the part affected as are warm and dry and in relation to its quantity we are to endeavour its discharge and evacuation And since here is required a double intention here ought we carefully to inquire and examine whether Repellers mixed with Digestives are in the beginning first to be used Galen doth satisfie us cap. 3. lib. 2. ad Glanc that they are to be used as you may find him there using a peice of sponge or linnen rags dipt in Oxycrate to which a little salt is added and so applying it over the part and then ordering it to be rolled up for Repulsion is this roller being dipt in vinegar and the sponge and the water do digest the pituitous Humour But it may be asked how Digestives being hot and dry may or can agree with water which is cold and moist in digestion Galen doth answer this Chapt. 8. lib. 1. that water doth digest and this we may see in the hands and feet of Fishermen who having been much imploied in the water you will find them both corrugated and wrinkled which corrugation is nothing else but the evacuation of that matter which formerly filled up the spaces But should an Oedema happen upon the Tendinous or Nervous parts we are to use little vinegar and for discussion of the matter this may be very proper â„ž fl Chamomel Rosar Mirtin Absynth Staechad a. M. ss Alumin Roch. Sal. commun an â„¥ ss Balaust nuc Cupress an M. i. Salv. Rorismar Squinanth an pug i. coquantur poscâ factâ ex Lixivio coquantur omnia usque ad Ê’ae partis consumptionem in quo madefaciatis Spongiam and this you are to use to the state Or this Cataplasm â„ž pulv Rosar rubr Mirtin Absynth Rorismar Staechad an Ê’ij pul fl Chamomel Melilot an Ê’i misce coquantur cum q. s Hydromelitis fine addendo pulv nuc Cupress Squinanth Balaust an Ê’iij Or this Cataplasm â„ž farin Fabar. mic pan an â„¥ iiij pulv Terrae cimol â„¥ ij sem Lin. Faenugraec an â„¥ j. Bol. armen Ê’i coquantur in s q. Lact. vaccin ad Cataplasmatis formam fine addendo Camphor Croc. an ℈ i. vitell ovor no. ij misce fiat Cataplasma Or this â„ž farin Hord. Fabar. an â„¥ iiij pulv Rosar ru Bacc. Laur. Mirtillor an â„¥ i. pul fl Chamomel Sambucin Melilot Ivae arthritic an â„¥ ss fim caprin â„¥ ij cum vino rubro fiat Catapl fine addendo Sapon nigr â„¥ iij. applicetur bis in die And because Quicksilver hath a very strange penetrating quality allowed it that it can command Flegm from
times doth happen and arise from a weakness of the Kidneyes which are not strong enough to attract this plenty of Serum or may be occasioned by drinking too much Wine for as Galen saith this waterish Humour is the excrement of potion You may know it by its Splendor and Fluctuation if you press it with your Finger and a particular Sign of a waterish Tumour is that it is made with itching occasioned by the saltness which is contained in the Humour Such as cometh from an evil affect either of Liver or Spleen is very bad and dangerous not because of the Tumours but in respect of the principal parts yet they are not so dangerous as windy Tumours The Cure is to be performed by ablating the Causes and if this do arise from two much drinking order your Patient to lessen his quantity and abstain from this course and habit of living and use Driers and if it happeneth from a vice either of the Liver or Kidneyes this is to be corrected Hydragogicks are most proper here as â„ž extr Elater gr iij. Cambog Resin Jallap an gr v. faecul Rad. Irid. gr ii Ol. Macer gutt ij misce fiant pillulae quarum sumat 2 omne mane Or â„ž extr Rud. Ê’ ss Resin Scammon ℈ ss ol Nuc. mosch gutt ij misce sumat cum Custodia â„ž Resin Jalap Scammon an gr vj. Mercur. dulc ℈ ss pulv Jalap gr vj. cum syrup Rosar solutivar q. s fiant pillulae addendo ol Caru Ch. gut ij misce Or these â„ž Troch Alkakeng Ê’ss spec aromatic Rosat Diagalang an ℈ i. Philon. Roman ℈ ss pil de succin ℈ ss Terebinth venet in aquae vitae solut q. s fiant pil quarum sumat 2 or Ê’ omni mane Or this Condite â„ž Cons Absynth Menth. an â„¥ i. Cort. Citr condit â„¥ iss spec Diacalaminth Ê’ij sal Sambuc Ê’i spirit Nitr ℈ ss ol Cinomon gutt v. Macer gutt 10. misce fiat Conditum As touching Topicks the Humour is to be discharged by Digestives and here we ought to rarify the skin that it may with ease come forth and for this purpose this Cataplasm is very good and proper â„ž fol. Malv M.i. farin Lupinor â„¥ i. ol Aneth Chamomel an â„¥ ij coquantur contundantur in Vino albo fiat Cataplasma Or if you be for a stronger you may use this Unguent â„ž sem Sinap sem Vrtic Sulphur Spum mar Aristoloch rotund Bdell an â„¥ i. Ammoniac ol Aneth Cerae an â„¥ ij misce fiat Vnguent Or this â„ž Sal. Nitr Ê’10 Piper bacc Laur. an â„¥ i. ol Laurin â„¥ vi Cer. q. s fiat Vnguent If with these they are not cured they are to be opened and the Ulcers to be mundified with Resine Turpentine and Honey or Vnguentum ex Apio c. then is it to be impleted with Flesh with Vnguentum Tuthiae and dry it up with Pulvis Tuthiae Desiccativum Rubrum Diapompholigos or Diapalma Fabritius Hildanus relateth of a man of thirty years of age very strong and of a sanguine complexion who fell into a Leucophlegmatia that he swelled from the neck to his foot his Optick nerves being obstructed hereby he grew blind Upon ordering the Patient opening Apozemes and giving him preparative Decoctions a great Flux of Blood fell accidently from his Nostrils so that he bled above four pounds and hereby fell into a Syncope but being a little revived after his Flux was stopped and his Faculties beginning to gain a better habit and condition beyond the use of any Medicine this flux perfectly cured him of his waterish Tumour This is occasioned as the Greeks do call it 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from an aluminous salt of the Liver or some other principal part the which by its subtile penetrating quality doth force it self into diverse parts of the body CHAP. XXIV Of Windy Tumours UNTO this windy Commander do belong these several Souldiers as Pneumatocele Tympanites Priapismus Satyriasis and the like This Wind doth carry in it a very strange and wonderful power and force in our bodies and is as it were a certain Lightning scattered through the insensible Trunks insinuating it self into abstruse parts for it reacheth the Bones and doth create very great trouble in our Joints it bringeth greifs between skin and bones and doth ruffle and disorder the whole Man for where it is compact with any other Humours it doth there make both a long stay and doth stir up but many sad Symptoms This sheweth what Wind is whereof are bred these Tumours Let us now see what these Tumours are A slatulent Tumour by the Greeks is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and he that is afflicted with these is oft times girded in his Sides and stretches in his Belly It is oft times caused of Crudities and because it maketh the part thick by reason of the grosness of these Flations it doth oft times make troublesome and tedious work for the Chirurgion Its causes are flatulent Spirits viscid or vitreous Flegm and want of native Heat thus the heat is but small which doth work it self into these Humours and so doth somewhat dissolve them and so doth arise this flatuous Spirit and this being bred doth elevate the part where it once getteth footing because it cannot work its free passage by reason of the density of its parts It is seen to arise in several parts of the Body as well inwards as outwards Here is held by Avicen a double kind of this windy Tumour the one being made by a light Vapour assimulated to Althegeâ—â—um the which is nothing else than a Tumefaction like to a Cachexy this arising from the disaffection of the Liver and there is another Tumour arising from a windy Vapour and this by Avicen is called Inslatio This is bred from Flegm coming from the larger Vessels to the smaller until it hath arrived at the smallest and at the coldest parts It showeth it self apparent in compressing the Tumour with the Finger and you may then see it easily yeild to the touch as doth an Oedema Then upon this compression it maketh a noise for Wind being kept in and being by your Finger prest out from its quarters this never parts from its place without a noise or sound Thirdly it is deteined in a cavity Fourthly as Guido doth offer it appeareth lucid and splendid in its upper part Fifthly it is not alwaies free from pain And lastly being contained in the larger Vessels we daily find the great and many troubles and vexations it brings to mankind As touching the Cure pray observe with me this method wherein we are to observe an Order Mode Time and Substance Order this cheifly consisting in Diet. As touching the Patient's times or eating and drinking that he neither eat too soon or too late between meals or after supper going to Bed and the like or in his bed Mode that he neither eateth more
Carbuncle are these A Pestilential constitution of the Air as in the time of the Plague A slender and as it were an unperceivable Fever and the Patient doth oft-times walk while he falleth down dead Thirdly loss of the natural colour of the Face Fourthly the Tongue doth grow black or yellow Then the Urine thin and troublesome Besides these Liquid and Cholerick dejections Seventhly a prostration of the Appetite and vomiting Eightly much hot or cold Sweats Ninthly a grevious perplexity of Mind Tenthly difficulty of breathing and a raw Urine Eleventhly pain of the Head and Vertigo 11 sometimes deep sleeps sometimes great watchings 12 Syncopes especially when Death doth come to seize 13. the Crust which formerly was cinerish doth now grow blacker and lastly that which was formerly blew is now quite coloured with black The immediate cause hereof is the Fluxion of a most vehement Blood to the part affected which is thus excited by a redundancy of the whole Gal. Com. 12. lib. 3. Epidem doth call the pestiferous the worst The other are also dangerous because they do arise from vitious Humours and do produce a strong Fever The part inflamed doth never suppurate but by the exust Heat and by how much the more the larger and greater in number they are by so much the more tedious and by how much the nearer they get to the Heart or any other principal part by so much the more dangerous If it seizeth on the Membranes of the Brain it causeth Delirium if the Brain it self it proves mortal In the Cure hereof the Fervour of the whole mass of Blood is to be minded and a good order of Diet to be observed and this redundancy of Humours wholy evacuated and this to be done by Phlebotomy And here you may safely breath a Vein until your Patient be ready to faint according to Galen's authority Aphorism 23. Sect. 1. For in a Carbuncle is a very large Inflammation Cap. 1. lib. 2. ad Glauc Here ariseth a great dispute about the most proper place to bleed in for Gulielmus Placentinus will have us bleed on the opposite side for Revulsion and Guido doth join with him Falloppius offereth as there is a double Humour in a Carbuncle â—lowing and already flown so also should there be proposed a double evacuating Method The fluent Humour to be discharged by Revulsion whilst the Flux is to becarried of by Derivation But because as it for the most part happeneth that when the mass of Blood doth flow apart of this melancholick Humour doth flow therewith for this reason also are we to use Pharmacy as by ordering Manna Cassia Diacatholicon Confectio Hamech Electuar è succ Rosar and the like Decoctions made of Scabious Sorrel Cichory will do well here used or appropriated as I have already shown and directed in melancholy Tumours As touching Topicks we are to mind these three things in the part affected as the Crust the Inflammation tending to blackness and the Symptoms about the Crust Paulus will have us here to make deep Scarrification that this melancholy matter may the better be got out and either to apply Sponges or Pledgets dipped in spirit of Wine and Aegyptiacum Niter or Salt to the part these and the actual Cautery are to be used in the great and virulent Carbuncle But if it be not of so great a moment I take two Eggs and boyl them on sinders until the white be hard then I take out the Luteum of the Egg and mix Salt with it and so apply them hot and thus are you to serve it for four daies if it requireth stronger use Aegyptiacum if it yeilds not to these use the actual Cautery and for ablating the Eschar take a little Butter Axungia or Dialthaea or the like let it be deterged with Mel Rosarum Turpeâ—tine or the like Or with this â„ž succ Ap. â„¥ i. Mel. Rosar â„¥ i. farin Fabar. Ê’ij misce fiat Vâ—guentum Or apply to the part this Cataplasm made of Bean meal of Lupines French barly Scordium Ruâ— Wormwood boiled in Oximel resisting putrefaction Upon the Carbuncle apply this â„ž Calc viv â„¥ i. Sapon moll q. s fiat Vnguentum and let it ly upon the Ulcer for two or three hours You need not fear pain for dead flesh is ever void of that and for the removing of the Caustick you may apply this â„ž Butyr non salit â„¥ iss vitell ovor no. ij Vnguent Rosat Basilic Aurei an â„¥ i. Theriac Andromach Ê’ij fiat Vnguent to be applied upon the Eschar and then mundify it with Vnguentnm ex Apio then fill up and cicatrice As touching a pestilential Carbuncle Antidotes are to be given with Scordium Rue and the like in them We are here also to support the Heart against the invasion of this malign Enemy with Cordials as â„ž Aqu. Theriacal â„¥ ss Tinctur Croc. Ê’ij Vin. Hispanic â„¥ ij Spirit Lavendul Aqu. Mirabil an Ê’i Aqu. Angelic Rut. Borag Meliss Calendul Cardu benedict an â„¥ iss Conf. Alkerm Ê’ss cum syr Meliss Caryophillor q. s fiat Cordiale cujus sumat patiens cochlearia 2 vel 3 in languoribus And for defending its adjacent parts apply this Defensative of Chalmaetius â„ž Bol. armen â„¥ ij Terr sigillat â„¥ i. Corn. Cerv. ust Rosar rubr Ebor. an Ê’i Camphor Ê’ij Cer. â„¥ iss ol Rosar lbss Acet â„¥ ij Aqu. Rosar â„¥ i. Albumin ovor no. misce fiat Cataplasma Phlebotomy here is very proper and useful Let the Medicines you apply to the part affected be very potent and attractive having in them an Alexipharmick Quality to which you may add Mithridatum Venice Treacle and the like Cupping-glasses applied here with deep Scarrifications are very beneficial and if you be necessitated unslaked Lime put upon the part will effect the same Riverius observat 9. writeth of one of four years of age who was afflicted with a Carbuncle in the middle of his Forehead with a red Tumour accompanied being black in the middle and the whole Face tumefied to which was applied a Caustick to the black part and for removing the Eschar an Unguent made of Basilicon to which was added some Treacle oyl of Scorpions and the Yolk of an Egg and to the whole Tumour was applied a Cataplasm of Arnoglossus purging and bleeding being afterwards prescribed a Vesicatory to his Neck and a Cordial ordered for supporting of his Spirits with Confectio de Hyacinth c. the Fever abated the Inflammation grew more remiss and every thing did seem mitigated In this case the Vesicatory did perform the greatest part of the Cure by deriving a great part of this virulent Humour And to every Carbuncle I think it very proper to apply it to all the neighbouring parts and not to use Vnguentum ex bolo so generally used in these Tumours because Repellers applied to the Face in its Inflammations are more generally subject to the doing more harm than good And thus
shall I conclude this Chapter of pestilential and not pestilential Carbuncles CHAP. XXVII Of Epinyctis PAVLVS and Celsus do write this to be a very bad Pustle having in it an ashy or black Colour about which doth grow a vehement Inflammation with nocturnal pains joined to it The parts affected herewith are the outward parts of the body which may easily be perceived by the Humour imprinting its Colour wherever it taketh It is made of burnt Blood The Pustles arise of their own accord with a reddish Colour somewhat tending to a lividness sometimes to a blackness They are most commonly seen in young Children and aged Persons they bring no great danger without they be ill treated There is three Intentions required in this Cure a good order of Diet being cold and moist a discharge of the peccant Matter and here both Bleeding and Pharmacy are conveniently to be prescribed according to the age and strength of the Patient and then in applying convenient Medicines to the affected part As â„ž Vnguent Basilic â„¥ ij Vitell. 〈…〉 2 Axurg Huma Caprin an â„¥ ss ol Rosar Ê’iij Croc. ℈ ss misce fiat Vnguent Or this Unguent â„ž Vnguent Rosat â„¥ ij Vitell ovor no. i. Cer. all parum Acel paul fiat Vnguentum This use if Inflammation if you be to mundify use Vnguentum Aegyptiacum or ex Apio fill up with Aureum or Basilicon and skin it with Diapalma or Desiccativum Rubrum A Wine-Merchant being troubled with black and sublivid Pustles about which was a vehement Inâ—lammation and nocturnal pains when as he could receive no ease or benefit by other things prescribed him by the advice of a Woman he was ordered to anoint them with oyl of Juniper by the help of which he rested very well and had more ease by this than he could ever obtain by all his former Medicines both inwardly taken and outwardly prescribed and at length was hereby perfectly cured CHAP. XXVIII Of Herpes Miliaris and Herpes exedens THIS by Avicen is called Formica It ariseth from a cholerick Humour and when as this cholerick Humour is made preternaturally thin and hot it frameth Herpes exedens or that Disease by Celsus called Ignis sacâ—r by Avicen Formica corrosiva because by its corrosion it doth spread it self This preternatural Choler mixing it self with Flegm it formeth that Herpes which hath many small Pustles in the skin like to Millet or Hyrse-seed and thence is called Herpes miliaris And since as we may apparently find that there are two sorts the one from Choler mixed with Flegm the other arising from a dust Choler our present discourse shall onely reach to the first the latter more properly ought to be reckoned amongst Ulcers The Signs of the first are many small Pustles like Millet-seed in the upper part of the Cutis and arising from the mixture of Flegm then they encrease in their number the former growing old and when they are opened or rent the Matter which cometh forth from them is between Sanies and Pus partly reddish being somewhat of a mixt Colour between red and white All the Causes may be related to those of an Erysipelas save onely that this Tumour is made from a redundancy of preternatural Choler an Erysipelas coming from natural Celsus doth propose that as Ignis sacer hath little danger so amongst such creeping Diseases its very hard to cure for sometimes there is an Intemperiety of the Liver which may be another Cause of this difficulty This cure may be performed by having a respect to the whole habit of body and since it doth not much irresemble an Erysipelas I do commend you thither to â—etch convenient Medicines both inward and outward which may do you great service in this Cure The second sort Herpes exedens is so called from Erodendo for it doth not onely erode the Cutis but doth also depopulate the subject Flesh Celsus Cap. 28. de sacro igne lib. 5. doth describe its nature when he saies it is made with an Exulceration of the Cutis not very deep large sublivid inequally planting its self in the extream parts As often therefore as we see an Ulcer to grow and increase and to make small Ulcers and many small Cavities penetrating no further then the Cutis this we may properly call Formica Corrosiva It is to be cured with Cholagogicks as the former and whereas it is a Disease arising from a preternatural hot and sharp Choler proceeding with Putredness Phlebotomy is no waies proper here for it very oft times doth arise from Cacochymy purging with Senna Damask Roses and the like in Whay or good Cassia Manna or â—eâ—itive Electuary or a Decoction of Sarsaperilla China and Guaiacum And as touching the part affected these are very proper here to be used â„ž succ Tabasc â„¥ iij. Cer. Citrin â„¥ ij Resin Pin. â„¥ iss Terebinth venet â„¥ i. ol Mirtin q. s fiat Ceratum molle â„ž Camphor â„¥ ss Album ovor no. iiij succ Plantag Solan an â„¥ i. Plumb ust Ceruss alb Lithargyr aur an Ê’ij pulv Troch alb Rhas sine Op. Ê’i ol Rosar â„¥ iiij Pomat â„¥ ij fiat Vnguentum With this let the Patient be anointed three or four times in a day Or this â„ž succ Plantagin Lapath acut Solan an â„¥ i. succ Polygan â„¥ ij Lithargyr aur â„¥ i. Tuth praeparat Antimon an â„¥ ss Alo. citrin Ê’iij Cer. alb ol Myrtill ol Rosar an parum misce fiat Vnguentum both for deterging and drying up of the Ulcer I shall conclude this Chapter with this History of a young Gentleman who was burnt from his foot to his knee but very slenderly that it did scarce hurt the Cutis coming to an Emprick who from the first used Empl. ex Argilla Bol. armeny with the whites of Eggs mixed with the Juices of Nightshade and Housleek dipping clothes therein and applying them to the part affected the pain which was but small grew into a great degree by the use of these he became vexed with a Fever disquiet and afflux of Humours to the affected part and Inâ—lammation of the whole Thigh even to the Hip and at length a Herpes exedens correpted the whole Thigh so vehemently that some Chirurgions thought to have made Amputation but at length was thus cured having first prescribed him this Potion â„ž rad Scrophular Cort. interior rad Frangul rad Polypod an â„¥ ss Herb. Fumar. Cuseuth Scabios an M. ss fol. senn Ê’iij misce fiat Decoctum in aquâ ad â„¥ iiij in quibus solue Conf. Hamech Ê’ii syr Rosar solutivar â„¥ i. misce fiat potio the day following he was bled in the Basilica of the same side the Herpes was and the Humour prepared with a purging Apozeme against Melancholy already prescribed in a Scirrhous Tumour The body being thus prepared we arrived at Topicks and here because the Cutis was already made hard by the use of cold
Blood do perfectly run to the Center whilst the other parts thereof do suffer Putrefaction It arising from cold doth cause and make a great and pricking Pain Soon after this it changeth its red Colour into Lividness and maketh it most cold afterwards sending the Blood away by its Coldness and dispatching the native Heat and dissipating its Spirits doth make the affected part perfectly void both of sense and motion a horrour and trembling attending it much like the fit of a Quartane Ague There is generally held five Signs of a Sphacelus First the affected part is much more heavy and dull than formerly it was Secondly the Floridness and Redness of the part do turn into a Lividness and Blackness Thirdly the part which was soft in a Gangrene groweth hard in a Sphacelus Fourthly the Cutis being taken up is seen with ease to separate it self from the Flesh And lastly there is no exquisite sense or perfection but a perfect Mortification remains We are if we intend to cure a Gangrene aright to study and find out the Antecedent Cause thereof and from thence to take our first Intention as thus If it happen from a fiux of hot and moist Humours let the Patient's Diet be cooling and drying for purging nothing is more proper here than Chologogicks as Electuarium Diaprunum Diacatholicon Lenitivum Syrup of Roses and the like Phlebotomy is very necessary also to prevent the further growth of Inflammation for opening the passages and making a more free Transpiration but in all sorts or kinds of Gangrenes this is not to be used For in a Cholerick and bilious Humour we are not to attempt it Blood being as the bridle to check and command this Choler In the case of applying of Topical Medicines observe these rules The first is taken from the Cause for if the afflux be cold and flegmatick evacuate more powerfully and warm the Humours with Defensatives The second is taken from the Age of your Patient for in a young body the Flesh and all its parts are soft and tender and therefore are you to order and prescribe milder Medicines than to those of a fuller growth A third ariseth from the Sex a Child being to be treated with more mildness and Gentleness than one of an elder age and a Woman more tenderly dealt with than a Man The fourth is from the Strength of the Patient for you may powerfully exercise your operations on such as are of a good and strong constitution whereas you are more sparingly and tenderly to use such persons as are weak and sickly The fifth ariseth from the part affected for the Eye Mouth Pudenda Anus Vertebre and other such sensible parts are not to be dealt with as you may deal with an Arm or Legg Sixthly the greatness of the Disease is to be much minded and regarded If it be new done and the Putredness not much nor made any deep impression to scarrify the part lightly and to apply Aegyptiacum alone is enough If it be more powerful and do threaten a Sphacelus here is to be made a deep Scarrification and you are to mix Spirit of Wine with Aegyptiacum very hot and often These are your general rules I come now to the prosecution of a particular Gangrene arising from Inflammation and here the first Intention is to be performed by Astringents or Desiccatives as â„ž Bol. armen â„¥ iiij Terr sigillat â„¥ ij Corn. Cerv. ust praeparat rasur Ebor. an Ê’ij Camphor Ê’iij Cer. â„¥ iij. Ol. Rosar lbi Acet â„¥ iiij Aqu. Rosar â„¥ iij. Albumin ovor no. ij misce fiat Vnguentum A Cataplasm for the same is this â„ž farin Hord. â„¥ iiij Bol. armen â„¥ ij pulv Gallar virid nuc Cupress Cort. Granator an Ê’iss Camphor Ê’i cum Oxymelite q. s fiat Cataplasma The second Intention is to revel the Humours and to send and discharge them into other parts And here this Bolus is proper â„ž Cass recentèr extract Ê’ij Electâ—â—r Diacatholic â„¥ ss cum Saccharo q. s fiat Bolus The third Intention is to restore the part to its former health and this is to be performed by evacuating the Blood and other compacted Humours from the part affected and therein concluded And since I have given you the general and particular Method of curing a Gangrene in general I shall still illustrate it with some examples It being a thing of great import as touching the Life and Limb of many a Man And for brevities sake because I do not desire to swell up my book with Tautologies or commit to your reading here any thing you shall elswhere find parallel I will present you with a History of a vertuous maiden Gentlewoman in Norfflolk near Norwich who after a long and tedious Sickness had a very large and great Inflammation seized her Foot the which very speedily spread her Legg and got upwards into her Thigh with a great Discoloration Pain Heat and Fever accompanying My never to be too much esteemed Uncle being sent for to this Lady could not go to her I being by Sir Thomas Brown's order sent for and finding all these already written symptoms upon her consulted with my self and reason what might be the most safe way to quit her from the ensuing danger she without speedy help might fall into with this Method and Almighty assistance I got her loosed from her fears and perplexities which threatned a Gangrene I first anointed her parts affected with this mixture â„ž Ol. Rosar Aueth Chamomel aâ— â„¥ ij Acet Acerâ—iâ—n â„¥ i. misce and having finished this Embrocation I applied to all the inflamed parts this Cataplasm â„ž farin Fabar. lbss farin Hord. Lupinor an â„¥ iij. pulv Rosar rubr â„¥ i. pulv fl Chamomel Melilot Sambuc an Ê’i farin sem Fenugraec â„¥ iij. Croc. Ê’i Bol. armen â„¥ ij Corn. Cerv. ust â„¥ ss Camphor Ê’iss pulv herb Rut. Scord. Absynth Scabios Virg. aur Agrimon Veronican â„¥ iss pulverisentur omnia misceantur cum Vin. Aqu. fontan an q. s his addendo Acet Rosat â„¥ ij coquantur ad Cataplasmatis formam fine addendo ol Rosar Aneth Chamomel an â„¥ ij By the application of this Cataplasm within three or four daies the enemy began to take his leave of her I continued every day anointing and applying this Cataplasm to her After this upon the back part of her Foot a new flux of Humours began to make their incursion and there they made two Ulcers in which were contained a great quantity of thick cold indigested Matter lying very deep and there spreading it self much resembling a Coar or Eschar for the removing and taking away of which I ordered this Fomentation with which the whole Foot was fomented eight or ten times one after another for three Weeks or a Month together â„ž fol. Rut. Scord. Absynth Veronic Meliss Betonic Salv. Hyperic an M. i. Tormentill Chamaedr Virg. aur Laur. Rorismar an
called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by the Latines Ranula it lodging under the Tongue It is occasioned by a moist pituitous gross and thick Substance falling from the Brain into the Tongue much resembling in it the Substance of the White of an Egg being somewhat of a more yellowish Colour And here observe if the party be plethorick breath a Vein under the Tongue and use proper and peculiar Gargarisms for this purpose and anoint it with some restringent Unguents or rather open it with some red-hot Iron Instrument being sharp the manner of which is thus Get a bended hollow Iron-plate which hath a hole in the midst making the Patient to hold open his mouth you must so fit it that the hole is to be just upon the part which you intend to open with the Instrument open the part so as you may hurt none of the circumjacent parts when you are ready to burn it thrust your Thumb under the Patients Chin that you thereby may somewhat elevate the Tumour and hereby you may open with more certainty Being thus opened throw forth the contained Matter after which wash the Patients Mouth with Barley-water and Sugar of Roses and thus may the Ulcâ—r be safely cured Gulielmus Placentinus doth order only Aqua Aluminosa to be held under the Tongue in which hath been boiled a little Myrrh Gesner in Histor animal lib. 2. pag. 51. writes That a Physitian related to him that he saw a Tumour under the Tongue the breadth of two Fingers which hindered the speech and that this Tumour was cured by drawing a Needle through it and afterwards opening it with a sharp Instrument the which being done came out matter from thence much like that of an Artheroma resembling coagulated Milk to the quantity of as much as would fill two hands the which being discharged he ordered the Patient to gargarize his Mouth with Aqua mulsa and sent into the Ulcer of the same by a Syringe and the Body being well purged and by the use of Restringents the Patient perfectly recovered CHAP. XLV Of Strumae and Scrophulae THIS Tumour doth arise with much â—ase from too much fibrosity thickness and viscidity of the nutritive Succus and for this cause only is it that this Juice is so difficultly despersed into all the parts of the Body and therefore must confidently redound in some place and with ease lay its first grounds and Foundations of a Tumour There is held a great difference between Strumae and Scrophulae and by Dr. Wharton in his Book De glandulis the one of these is called by him Wenns the other the Kings evil Scrophula signifying the first and Struma the latter Scrophulae are soft Wenns hard the first pale carrying in them the colour of the Skin the second having a redness turning to lividness Scrophulae soft and not much penetrating Strumae immovable and deeply fixed the Kings-evil swellings generally encrease into a great bulk and magnitude and besides their glandulous Fleshes they do carry in them several sorts of Juices in their little Bags the which do help much forward their growth and bulk It is credible that these concreted Juices are as some rejected Excrements thrown from the glandulous Flesh in its nutrition for these Glandules have no excretory Vessels and therefore necessarily they should carry their Excrements in their Bags And this is one reason of their growth Secondly the Blood effused from hence through the Arteries is more plentiful than that which is reduced through the Veins and hence therefore may there arise another reason of its growth Thirdly The Nerve which keepeth here is but small and that makes them so dull and hence is it that were the parts pricked with Needles the Patient would not much complain of pain Now as touching Strumaes these are not always seen to run into a bulk or magnitude but sometimes they encrease sometimes they lessen and at length do vanish These Tumours do receive their proportion from the reductory Vessel and are discriminated from its first genus here is nothing found besides Nerves Vâ—ins and and Arteries And by how much the Veins are better capacitated and enabled to convey and carry off that which is sent them from the Arteries by so much also are these Strumatous Tumours less capable of running into bulk than such as are Scrophulated And how these Tumours are translated from one place into another I attribute chiefly to the Nerves in their Operations these being most proper Messengers to carry to and fro Now if there be any matter carried to the Emunctuory Vessels or Glandules and be there excerned the Struma doth soon lessen and sometimes doth wholly vanish and is very often seen by applying of Hydrargyrical Mêdicines or Salivation to consume and waste away these having in them a very powerful influence of making the Nerves spit forth their Humidities into the Emunctuory Glandules And hence by Paulus and Celsus these are said chiefly to arise in three places more especially as in the Inguens Axillaries or about the Neck or Throat but most chiefly about the Neck and Throat because here they be nearer the Head their Fountain from whence they draw their flegmatick Matter to their conglomorated Glandules Some of these Strumaes do succeed other Distempers whilst others do breed of themselves Sometimes an outward Cause may occasion them as by applying too hot resolving or too drying Medicines As to their Presage we ought here to consider their different places where they make their abode for these are also either small or great loose or fixt few or many painful or without pain arising from Flegm or Melancholly Some being in the inward part of the Neck whilst others do border on the outward Some terrifying young Children whilst others do lay their impresses on people more aged And by how much they are more movable by so much are they with less difficulty cured yet take them at the best the Chirurgeon will find work enough to get well off clear them with repute Such as adhere to the Bones are incurable there are three ways of eradicating them Either when the Radical Moisture which is carried and reserved in their several Cystuses or Bags is sucked up by the Nerves or the affluxed Blood reduced by the Veins or a free transpiration brought to the part affected The first and main cause of this translation is the Nerve which doth bring and breed the first rudiment of a Struma out of its matter and to help forwards this work both Veins and Arteries are as its Assistants The curing also of these Diseases are very difficult in that most generally such as are troubled with these swellings outwardly they also have them inwardly As to the Cure the thick Lympha is to be incised tempered and evacuated the Glandules softned the Humour if possibly either to be discussed or suppurated and at length if no otherwise to be overcome is to be treated with Escharioticks And
such things as are to be given in either kind of Dropsie this sometimes happening between this and the Erythrois sometimes between the Erythrois and Dartos As touching the Cure all Causes are to be removed the ill Habit of the Body corrected from too much Drink the Patient ought to be prescribed the plenty of this watery Humour to be discharged and evacuated and the whole Habit of the Body amended And for the performance of these Purgatives Diaphoreticks and Diureticks are very proper instrumental Weapons to discharge this invasive companion of which I have already presented you with many in my Tract of Aqueous Tumours As touching outward Applications these ought to contain in them a power to discharge this Water contained in the Testicles this to be performed either by Repellers driving it back or by educing it by the part affected or by Scarrification Hollerius does offer this as an excellent Plaster being made of fresh Cows Dung adding thereto a third part of Bol. Armen and Dragons Blood A Fomentation for the same may be this â„ž Lixiv. Barbitoâ—sor iiij in his coquantur Cumin â„¥ iiij Rut. Absynth Puleg Petroselin Apii an â„¥ ss Sal. j. with this let the part affected be fomented Or this â„ž Cumin Bac. Laur. sem Sesel Rut. an â„¥ j. fiat Decoctum in vino rubro fiat Fomentum Or for this use take this Cataplasm â„ž Stercor Vaccin ij Sulphur Cumin an â„¥ ij Empl. de Bacc. Laur. pulv Juniper Anis an Ê’ij misce cum pauco mellis fiat Cataplasma Or these â„ž Cumin Baccar Laur. fimi Columbin Castor an part aequal coquantur cum oleo Rosarum pauc Cerae First apply your Baths then anoint the part affected and afterwards apply your Caplasms If these fail we are to come to Apertion which may be used two ways either by Incision or Caustick if by Caustick the place is to be cauterized in the place where the Water is and then after it is once discharged a new Collection is to be prevented And here Galen does order the part to be kept open for a long while by placing in a Silver Pipe into the affected part Guido maketh a Seton and keeps it a long while Celsus teacheth the place of Incision saying If it be a Child that is herewith troubled it is to be laid open in the Inguen and the water to be drawn upwards If in one of a greater age this is to be opened in the bottom of the Scrotum and that way the water to be let out taking this as Advice that water is not to be left long in the Scrotum lest by its delay there it does the Testicle injury or hereby there grows a Hernia carnosa The Body being well prepared for your Operation of Incision and a good order of Diet prescribed let the Patient be well placed then in the upper part even to the Tunica Erythrois is the Scrotum to be incised this is somewhat to be separated in its outward part from the Membrane it self And because the Water wholly is contained in this Coat so the Testicle swims therein and lest this Water should descend with a crooked Needle and double Thread the whole Coat is to be apprehended besides the Seminal Vessels and then to be moderately bound and tied after this divide the Membrane in the lower part of the Ligature lengthways and draw out the water or liquor contained within then with a long Tent it being of a moderate thickness being dipt in the White of an Egge to which some restrictive Powders have been added apply it to the side of the Testicle and about the lower part of the Scrotum anointing the Inguens and Abdomen with Oyl of Roses the day following let this Digestive be applied â„ž Terchinth lot Ê’ij Cer. nov â„¥ ss Gum. Elem. Ê’j ol Rosar Amygdal dulc â„¥ ss ol de vitell Ovor Ê’ij dissolve Gummi lento igne cum ol Terebinth Cerâ cum pauxillo Oleorum liquefactis fiat Vnguentum fine addendo Croc. ℈ j. With this let the Tents be armed which are to be put into the Orifice afterwards apply a mundefying Powder to cleanse the Ulcer and keep it open for near two moneths and then close up the Wound with a Cicatrice I conclude with a History of Hildanus who writes of a Commissary 40 years of age a man strong and of a good Habit of Body vexed for many years with a watery Rupture unto whom both many inward and outward Medicines were prescribed and applied without any success and it growing to a great bulk that it occasioned a large Tumour in the Scrotum and proved so painful that the Patient would rather yield to any Method which could give appearance of ease his Body being prepared and a good order of Diet ordered him with administring Purgings and their reiterations with Bleeding c. he being conveniently placed the Scrotum was opened in the upper part of the Coat Erythrois and this on the fore part somewhat separated and because the whole Testicle did swim in water which was contained in that Coat that the water might make no further descent with a crooked Needle and double Thread the whole Coat and Seminary Vessels were moderately taken up and bound after this in the lower part of the Ligature the Membrane was divided lengthways and by degrees was drawn forth some pounds of Water after which was applied a Pledget long and thick enough dipped in the White of an Egge Bol. Armen and the like then was applied the same Digestive I formerly have described and with this were armed the Tents and Pledgets and over these Vnguentum Basilicon and with all care the Ulcer being mundefied digested and filled with Flesh it was skinned and the Patient perfectly recovered Riverius relates another story of a Child of 15 moneths old who was troubled with a watery Rupture in his right side of his Testicle with Matter contained in the Dartos equalling the bigness of a small Egge and this he had almost from his first coming into the world how he received his Cure I will commit you to the Author himself CHAP. LX. Of Pneumatocele or Hernia ventosa THis windy Rupture does happen with and without a Dropsie if with a Dropsie cure the Dropsie and the Rupture will be dismissed if without a Dropsie we are to use Topical Medicines and these ought to be Digestives and purge the Body from the flegmatick and windy Humours and if possibly gain a digestive faculty in the Stomach and these you have already prescribed in Tumours arising from wind This Tumour is known from the former because it is more lucid and red than it the Veins are puffed up and the splendour appears more bright than the former and is suddenly framed and as speedily discharged And having already furnished you with Medicines for discharging the Antecedent Cause we now arrive at the Conjunct Cause which is this flatuous Spirit