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
have already writ of Tumours from whence we shall derive this method in our beginning of Tumours first acquainting you with the name of a Tumour then its essence and causes then its difference and symptomes its signs and presages and after these its universal cures both as touching general and particular Tumours Of each of these in their Order CHAP. II. Of the name of a Tumour IT hath its name from the Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifies inflammation or extutuberance and hence by Celsus and Avicen a Tumour is said to signifie a preternatural extuberance and by Galen is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Tumor praeter naturam by the Asiaticks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 as it were a condensed or conglobated matter by the Arabians Apostema which by the Greeks signifieth an Abscess which is a substance converted into Pus or as Aqua pendens calls it an eminency of the body this I call a preternatural disease in which some parts of the body are indecently extended being hereby unfit for performance of their proper action Hippocrates doth christen all Tumours with the name of Oedema Galen appearing somewhat doubtful and incertain doth sometimes reckon this amongst diseases of the similar sometimes amongst the Organick parts Haliabbas is of his Opinion Guido defines an Aposteme a disaffection composed of three sorts of diseases aggregated into a bulk And Avicen thus expounds them ill complexion ill composition and a common solution of Continuity which is found in every Tumour Tagaultius after Guido defineth an Aposteme to be an Inflammation made in a member beyond its proper nature and form Falloppius holdeth a preternatural Tumour to be a Disease in magnitude and therefore simple and onely consistent in a great extention Fabritius de Aqua pendente offereth a preternatural Tumour for the most part to be a compound disease and taketh its denomination from that which hindereth action Read calls it sometimes a Disease sometimes holds it to be a light Affection for the most part incident to the Organick parts encreasing their quantity by superfluous humours Or if you please after all these you may take a preternatural Tumour to be a material Intemperiety dissolving the Union of the parts and sometimes hurting them in magnitude figure and sight CHAP. III. Of the Causes of Tumours A Tumour is said generally to have four causes attend it as a Material Efficient Formal and Final cause By Guido the first is called the conjunct cause The second when Nature frameth any part so weak as that it is not able and strong enough to keep the excrements of other parts out of its territory A third cause when any part of its substance is too rare or loose the fourth is a natural Humidity with exemplification of the part Another cause may be said to be the Site of the part for the upper parts are said to be less capable of receiving humours than the lower part Falloppins offereth six heads as so many Observations of Tumours The first when it begins to putrifie it spreds and extends it self speedily and suddenly groweth into a lump or masse Secondly there are Humours which â—ake Tumours and these are either 〈◊〉 or preternatural Thirdly when some parts change and remove themselves 〈◊〉 of their proper places into other 〈◊〉 strange places as you 〈◊〉 in Ruptâ—â—â—â— and Dissocations A fourth is such â—â—mours as are bred of waterish 〈◊〉 as Hernia Aquosa Ascitis and the like A fifth when vapours wind and the like either naturally or preternaturally do frame a Tumour And the sixth is that which maketh the body unnatural to it self as Sanies Excrements and the like But to bring this discourse of Falloppius to one head you may find six Humours generally in our bodies of which are generated these six Tumours as out of Blood Choller Flegm Melancholy Wind and Water Phlegmon Erysipelas Oedema Scirrhus Pneumatocele Hydrocele Besides these we have Insects and other Animals that very oft times are the occasions of Tumours as Falloppius once observed in a Maid who having a large Tumour about the Inguen the Chirurgion in his presence opening the same saw it filled with Worms Amongst the primary causes may well be reckoned Air for out of its Contagion ariseth many Tumours Secondly Contaction as a cold Stone may occasion a Tumour and for this Falloppius brings in another story of a Woman who sitting upon a cold stone was afflicted with a cold Tumour And a third may be solution of continuity and this proveth either occult or manifest thus after fractures we oft times find large Aposâ—emes to appear and what was the occasion of Luxation is very oft also the occasion of Tumours as too much contracting or binding of a part may occasion a Tumour as Gangrene biting of Beasts taking of offensive things inwardly these being sufficient matter for Humours to breed from If a Humour do suddenly excite a Tumour this is its evident cause and the cause hereof is either Congestion or Fluxion The one when bred carried in the part onely whilst the other maketh its further progress by Fluxion as Aqua pendens observeth And therefere as he adviseth we ought well to consider the part mit tant and the part recipient for the matter doth not move it self but is moved by some other as by the part mittant per 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and by the part recipient per 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The mittant part ought first to be strong and able to expel the supersluities as the attractive is made by the part recipient And this bringeth me to the inward causes and here sometimes the matter is hedged into one place so that it cannot make its exit Another may be its passage out of one place into another and this is properly called Fluxion a Fluendo from thus â—lowing and as intemperiety is the cause of pain or solution of Continuity so also is this intemperiety made either by outward or inward causes CHAP. IV. Of the Differencies of Tumours THE true Differencies of Tumours by Aqua pendens are generally taken from these two Fountains as from Humours and the depending parts and from these two do arise the cheif intentions in Tumours Falloppius doth offer seven things which belong to the Differencies of Tumours First a disease when it receiveth more or less Secondly the material cause hereof diversified and then are its Species and Differencies diverse Thirdly when the efficient cause when manifold doth draw many species to it The fourth is the Fountain of accidents which followeth the disease The fifth the time which is the cause of all the differencies of Tumours The sixth the subject of the Tumour And seventhly the motion of the disease for it is as its owner and moveth as he moveth Besides these are we to consider of the times of diseases for some are short some long some quick others slow and therefore are we well to
divine assistance that can maintain and keep up our sorts and castles from the assailing batterings of wounds and contusions c. and by him also may herbs and roots seeds and berries gums and fruits be made capable instruments to banish the enemy having once made its entrance It 's by his Art the swelling bubbles of scalding water are disperst the burnings of gun-powder allaid its pain removed and its black marks fetched out It s by his Art dislocated Articulations and fractured bones are brought into their right form and order old ulcers and fistuales dilated mundified incarned and cicatrized Herniaes and Stones bound up and drawn forth and since these and many more are committed to his care and charge what skill knowledg fathoming of diseases and judgment ought he to have and be furnished with to undertake this task Take with me this as a short character of a good Chirurgeon he being a man both honest and careful in his art prudent and provident for his patient expert and skilful for defending himself well learned and educated for discourse with others well exercised and practised for the help of both He ought to be well furnished with books these being as so many safe Pilates to conduct him in his unknown way and to keep him off from the shelves and rocks of mistakes and errorsin his Art Adorned with learning for this makes him appear as a Sun whilst others less literate shine but as smaller Stars this conducts him to the tree of knowledg whilst others can onely boast of their impudence and ignorance it is this gives life to his practice chearfulness to his study and security to his conduct And as we seldome see a wise man gain knowledg from a fool so is it as rare to gain awise medicine from an ignorant block He ought to be well exercised in Anatomy for hinc discimus artem rectissime operandi securitate incidendi It being as the cheif pillar or basis on which Chirurgery planteth its foundation this is the great magazine from whence she fetcheth her richest treasure of knowledg It is the knowledg of this which bringeth Honour to his name Praise to his practice Worth to his skill Plenty to his wisdom Gain to his industry Reason to his judgment and a great measure of success to his undertakings hence he learns how and where to make right oblique and transverse incisions by this he finds out the Origination of the nerves the trunks and channels of the veins and arteries here may he find the difference between a nerve and a vein a Tendon and a Muscle a vein and an Artery a Bone and a Cartilage These may well convince their utility necessity and profit in Chirurgery He ought to be well read in Physick by which he may as well gain the knowledg of removing the cause as the discharge of effects and this gives a great light to the well timing of diseases for outward medicines are very oft applied with little success when they are not conducted with a cunning hand and a solid judgment Besides these a Physician is not alwaies at hand to defend the Chirurgion or to assist him which should upon necessity put him upon this excellent study which gives life to his knowledg by teaching him to eradicate the growth of a distemper It is his best friend at Sea and as great assistance in the Wars in helping him to pull down fevers in frightning agues in curing scurvies in discharging Itches in allaying Calentures and in bringing life vigour courage and health to his dying weak faint and sick Patients He is to be armed with Instruments both great and small the greater for greater uses whilst the smaller he carrieth as daily companions but of these you shall read more at large with their figures elsewhere The knowledg of Medicine is also very proper for him and a main wing of his Art it is by this that he can draw and heal dry and close up repel and resolve digest and suppurate attract and emolliate escharioticize and ease pain some of these being proper in Tumours whilst others are more useful in Wounds and Ulcers but of these also in their order And when a Chirurgion hath purchased all these thus furnished adorned armed educated and experienced there remains yet somewhat to add to his excellency as a quick sight having an eie pointed upward to fetch down a blessing upon his practice a nimble wit to apprehend every advantage that he may get from his Seniors a pleasant countenance to call chearfulness into the Patient's cheeks a couragious spirit in things which he well understands and are safe but as wary in matters of danger prudent in his presages courteous in his behaviour chast temperate not given to too much wine or venery Charitable to the Poor for conscience and charity as well as to the Rich for fame and profit furnished with undauntedness in amputations and Lithotomy having a steddy hand to act with evenness and without trepidancy a hawks eie sharp and clear to look into the distemper dexterous at his work He that is thus furnished may well assure himself he is in a happy estate of knowing how to remove solution of continuity restore union separate parts unnaturally joined remove superfluous bodies and then supply nature in her defects taking this as his guide 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 CHAP. II. Of Humours SInce daily experience showeth that out of Humors Tumours do take their Originals our present task shall be to treat of the matter of Humours of what they are how made and how many they are what good and mischief they do and then show you their Introduction in one Scheme their general Division and then arrive at Tumours themselves To understand the nature and essence of a Humour is and ought to be the work study and care of a Chirurgion as well as a Physician there being no disease with matter which is not framed of a confused mass of Humours It his hence that all Tumours Wounds Ulcers and Fistulaes and their differencies have their acknowledgments and distinctions the which is the only cause which makes both Physicians and Chirurgions run presently to the tempering of the Blood that is to the correction of those Humours which are the occasion of these Tumours By Physicians a Humour is taken for a thin and liquid body flowing and cruising in our body Tagaultius doth call them more properly Humours which are juices made by the Liver in the sanguinary mass for its nutrition and thinning of the blood all over our body All these are Choller Flegm and Melancholy adjoined to the Blood scattered and sent into our veins and arteries the which the variety of their colours and consistence will make good as Galen hath it lâ—b Natur. Human. Of these some are natural some not natural Those called natural because so ordered according to nature for keeping defending sustaining and nourishing the life of man Those counted otherwise which
grow red to apply your other Medicines as for example â„ž Fob Absynth Scord. Rut. Angelic Hyperic Salv. Agrimon Veronic au M. j. Rosar Rubr. m. ss Scabios Menth. Meliss an p. ij coquantur omnia in Lixivio q. s colaturae adde Spirit vini lbj with this foment the part and then may you use such proper and mundifying Medicines as are most requisite as â„ž Vrguent Basilicon Buâ—â—r recent au â„¥ ss Ol. Amygdal Dulc. â„¥ j. Theriac Andromach â„¥ j. cum Vitel. Ovor. nov ij misce fiat Vnguent Or this â„ž Pulv. Mirrh Alo. Aristoloch Rot. Irid. Florentin Angelic an 3j Theriac solut in aqu vitae 3j cum mel q. s fiat unguent Or this â„ž Pulp Caricar â„¥ iiij Ferment act â„¥ j. Sinap 3iij Sal. gem torrefact â„¥ ss Sal. commun torrefact 3j Sapon moll Theriac an 3j Vitellor ovor no. iij. Ol. Lilior alb q. s fiat Cataplasma Or this Emplaster of Falloppius â„ž Pic. naval â„¥ j. Sal. nitr â„¥ ss Sem. Sinap 3ij Caepar Allior sub prunis coct an â„¥ iij. Assafaetid Sagapen an 3iij Stercor Columbin â„¥ iss Aristoloch rotund Dictam Cretens an 3j Ol. Lilior q. s fiat Empl. If all these fail apply live Pigeons opened to the part affected and if these do not answer expectation make a speedy address to the actual Cautery Another cause hereof is loosness of the passages the which unless they be stopped do make a Tumour as if an Humour do flow out of several parts of the body into one particular part unless this be altered it is very easily raised up into a Tumour if this happeneth with an Intemperiety we are to mix restringents with coolers as thus in Fluxes of the Head take this for a defensative â„ž Pulv. Rosar rubr Myrtillor Balaust Gallar Mastich Sang. Dracon Bol. Armen Oliband Santal omnium an 3j Ol. Rosar q. s Cer. alb parum Acet rosat â„¥ ss misce coquantur omnia ad aceti consumptionem his addere possis albumin Ovor. no. j. vel ij Or this â„ž Pulv. Santal omn. Sangu Dracon Bol. Armen Pic. Colophon an 3j his adde Empl. Diapalm â„¥ j. Acet 3j misce fiat Empl. And these are proper Medicines here and by Galen called strengthening as well as restringent Medicines because they strengthen by compression as Gal. 2. ad Glauc 14. And having thus passed over the general Indications arising from the matter of a Tumour and its curative scopes as Phlebotomy and Pharmacy we come now to treat of the four times of Tumours CHAP. IX Of the four times of a Tumour and first of its beginning THE knowledg of these times are very proper for our Diagnosis Prognosis and Cure They are four in number Beginning Augment State and Declination That time most properly called the Beginning when a part begins to tumefy thus if a Tumour be made in a recipient part Expulsion and Repercussion is the Intention and this Repercussion is nothing else but Illision and Impulsion of the Humour which floweth either from the whole body or some part thereof into the affected part This Repulsion is a double motion from the part hurt and from another part sending to this hurt part And here we are to advise that when members are loose and soft then are we to strengthen with Medicines of a contrary affect that is with such Medicines as are compact and dry Gal. 14. Meth. cap. 17. saith that pure cold things do repel as cold water and he there adds that others which are not cold yet are restringent as Mint Roses Wormwood and the like and these he saies do repel these for the most part are to be used in the beginnings of Tumours but not alwaies in every kind of Tumour For experience teacheth us that in Pestilential or Venereal Buboes if in the beginning we should apply repelling Medicines we should send the peccant matter to the heart In these six cases apply no Repellers in the beginning as if it be bred by a venenate matter and repelling here you soon do shut up the doors of life If the matter be critical yet this doth not alwaies deny Repulsion for in a violent Fever in which it happeneth that the matter doth send it self to the membranes of the brain in this critical case the Fluent matter is to be repelled lest otherwise the brain becometh inflamed And then when this Tumour happeneth either in a Cacochymick or Plethorick body When the matter sloweth to the emunctories we are not to repel as Galen adviseth 6. de Comp. per loc cap. 2. Then when the part into which this Tumour hath got footing groweth weak as Galen also hath it Meth. 13. cap. 7. And lastly when pain and exasperation of the part is present for then Anodynes are more proper as Galen citeth 6. de Comp. Medic. these I have formerly shown you in the differencies of Tumours but this being their more proper place to bring them into I have also here given you their brief repetition and in all other causes we may and ought to come to use Repellers in the beginning of Tumours Avicen speaking of repelling Medicines ordereth us not alwaies to use one sort or kind thereof but in cold cases to use hot Repellers and in hot cases to use cooling Repellers Now if pain ariseth in the beginning and draweth somewhat of Humour to it here are you to use mild Repellers these being of a sufficient capacity to lenify the parts being stirred up by pain Such are Lettuce Purslain Trifole Nightshade Endive Violets and Plantane these being endued with a waterish moisture do much better in this case than such which are two astringent And out of these may you frame many sorts of Medicines by adding thereto Oyl Water Vinegar and the like And of these may you make stronger or weaker Medicines as occasion may require as â„ž Malvar Parietar Plantag an M. j. coquantur in aqu fontin contusis adde farinae Fabarum Hor dei an â„¥ iss Pul. Rosar rubr â„¥ ss Ol. Chamomeli â„¥ iiij cum decocti praedicti q. s addendo fl Chamomel Melilot in pulv a Ê’j fiat Cataplasma tepide admovendum CHAP. X. Of a Tumour in its augment THE Augment of an Inflammation or Tumour as Gal. hath it cap. 4. lib. de Morb. Tempor is when the Influx hath ceased and the part affected Tumefies more than it did formerly And the reason hereof by Aquapendens is because the blood prolapsed out of the vessels doth necessarily grow hot and putrify whence the blood is poured out and converted into a Spirit Aâ—â—cen saith that the Augment is then most properly to be so called when the Tumour encreaseth so that it is extended We may know when Tumours have arrived at their Augment by their causes and Symptoms by comparing its times and therefore here our intention is two-fold for that some part hath already made its Flux and other part is still to
make and this requires two scopes to remove the compacted matter and that we take away the cause hereof We have already discoursed of Repulsion we more properly in this place and time speak of Digestion or Discussion This Digestion is an Evacuation of a thin matter gathered in a part by insensible Evaporation procured by the natural heat encreased by proportionate Medicines And this is said to be performed four waies for first the Humour is to be made thin then resolved into a Vapour afterwards drawn from the Center to the Circumference and lastly expelled or thrown forth by the pores of the Skin and these therefore do show that the proper Medicine to be here used is to be a Digestive a Medicine hot and dry in the third degree and of thin parts Of these Digestives some are mild some strong some simple others compound Of the simples are Dill Rue Chamomile Ammoniacum Galbanum white Lillies Lupines Fenugreek and the like Such as are stronger are Time Origanum Mint Pennyroial Hyssop and the like Of the strongest sort are Sulphur vivum and Chalk c. Of the compounds â„ž Malv Dialth Absynth Lilior Albor. an M. i. coquantur in aqu fontin q. s colaturae adde Pulv. Rosar Rubr. Ê’ij Pulv. Absynth Puleg Fl. Chamomel Melilot an Ê’ij farin fabar Lupinar Hord. an â„¥ iss cum ol Chamomel â„¥ iij. misce fiat Cataplasma Ever observing this that according to the strength Age Temper and Constitution of your Patient you endeavour to regulate and order your Medicines If the former will not serve you may make use of this Empl. â„ž Farin Fabar. â„¥ i. Farin sem lin Ê’ij Empl. de mucilaginib â„¥ i. Melilot â„¥ ss Pulv. Sem. Cumin Absynth a. Ê’i cum Ol. Chamomel q. s fiat Empl. Or this â„ž Fol. Mal. Alth. Violar an M. i. Rad. Alth. Irid. Lilior Alb. an â„¥ ss fl melilot Chamomel Aneth an p. i. Cumin â„¥ i. Bacc. Laur. Ê’ij Croc. ℈ i. cum Adipe Anatis Anserini Butyri recentis ol Lilior an â„¥ i. M. fiat Catapl Or this of Aquapendens â„ž Myrtillor Lactuc Solan a. M. i. Puleg Calamenth Hissop an M. ss coctis in aqua contusis adde Farin Faenugraec â„¥ iij. Pul. Betonic Chamomel an â„¥ i. ol Anethi Chamomeli a. â„¥ iij. cum decocto praedicto fiat Cataplasma CHAP. XI Of a Tumour in its State THEN is it properly said to be in its State when it can reach to no higher degree the beginning of this State doth carry with it some rellish of the Augment and here therefore are Anodynes and Digestives proper being equally mixed In its middle you are to mix more of the Digestives and at last to use Digestives altogether It is in this state that the matter is very near digested and converted into Pus And these have sharp Symptoms attend them for while this pus is making there are Fever and pain as two inseparable companions that go along with it these in its declination taking their leave with the Tumour And this we are to observe that when nature digesteth we ought to help her forward in her designs But a Tumour is very oft times seen to terminate into many other diseases and herein we are to consider the Pulsation if it hath been long if pain be not diminished when the heat endures then is its transition to be expected and where any one of these are it is an evident sign there is matter at hand against which we must be prepared and so mind the symptoms as Pain Tension Hardness Heat for these are toublesome companions and then are we to assist nature in the discharge hereof taking away their causes which is to be performed by Medicines as this or the like â„ž Ol. Chamomel Rosar a. â„¥ iij. farin fabar pul fl Chamomel an â„¥ ij Hyssop â„¥ iss Sapae dulcissim â„¥ 10. misce fiat unguent Or this Catapl â„ž Lapath Parictar Chamomel Melilot an Mâ—ss Rosar Rubr. pug i. fl Melilot Chamomel an p. i. farin Hâ—rd pug iij. cum s q. aquae fontinae fiat Catapl Or this â„ž Fl. Chamomel Melilot an pug ij Herb. Chamomel M. i. Coquantur omnia cum Radic Lilior Albor. â„¥ iiij simul contusis adde farin faenugraec â„¥ ij ol Aneth Chamomel an â„¥ ij Vini albi q. s fiat Catapl CHAP. XII Of a Tumour in its Declination WHEN all the former Symptoms do abate and cease then we generally hold we have arrived at the Termination and here according to Gal. cap. 1. lib. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 we are to use purely Digestives or Discussives and these are to be so much the stronger the declination of the inflammation being in its progress And in this part these two Cataplasms are very proper â„ž Hyssop Origan an M. i. coquantur in vino albo simul contusis adde Ol. Lilior Albor. â„¥ iiij Pulv. Puleg Absinth an â„¥ ss Farin Faenugraec â„¥ iss misce fiat Cataplasma Or this â„ž Alth. Malv an M. i. fl Chamomel Melilot Rosar Rubr. an pug i. Rad. Lilior Alth. an â„¥ i. Sem. Lin. faenugraec an â„¥ ss Ficuum pingu no. 10. furfur farin hord tritic an pug ij contusa coquantur in aqua ad mellis crassitudinem fine addendo ol Chamomel Axung Porcin an â„¥ iss misce fiat Catapl CHAP. XIII Of a Tumour tending to Suppuration THE true waies and methods of curing Tumours we have already shown but it oft times doth happen that a Tumour doth tend to suppuration that is the influxed Blood is converted into pus or matter whence doth arise another method of curing And here Galen doth propose two waies which are performed either by Digestion or Concoction but the first is the best for these two things follow concoction two much generation of this matter and an Abscess made hereof into another place In respect of its generation its long in curing in respect of the Abscess the Inflammation oft times doth run it self into another disease as oft times into a Gangrene as Jubertus observed in the wife of Rondeletius As touching the efficient cause of Purity or Matter Gal. offereth lib. de inaequ intemper cap. 3. that in an inflamed part there is found both a native and an extraneous heat the first preserving the part and doth administer such things to it as belong to its health and welfare the other Extraneous ariseth from the influxed Blood prolapsed out of the vessels and there putrifying this being contrary to the former and so doth destroy and pull down or extinguish the natural heat The first matter is thick laudable white equal well tasted but if the other prevail it appears livid red or black thin inequal grumous The Tumour offers it as a sign of its tending to suppuration by its intenseness and when the inflammation is great and the pain vehement and doth daily encrease and when pulsation joins with
shall I conclude this Chapter of pestilential and not pestilential Carbuncles CHAP. XXVII Of Epinyctis PAVLVS and Celsus do write this to be a very bad Pustle having in it an ashy or black Colour about which doth grow a vehement Inflammation with nocturnal pains joined to it The parts affected herewith are the outward parts of the body which may easily be perceived by the Humour imprinting its Colour wherever it taketh It is made of burnt Blood The Pustles arise of their own accord with a reddish Colour somewhat tending to a lividness sometimes to a blackness They are most commonly seen in young Children and aged Persons they bring no great danger without they be ill treated There is three Intentions required in this Cure a good order of Diet being cold and moist a discharge of the peccant Matter and here both Bleeding and Pharmacy are conveniently to be prescribed according to the age and strength of the Patient and then in applying convenient Medicines to the affected part As â„ž Vnguent Basilic â„¥ ij Vitell. 〈…〉 2 Axurg Huma Caprin an â„¥ ss ol Rosar Ê’iij Croc. ℈ ss misce fiat Vnguent Or this Unguent â„ž Vnguent Rosat â„¥ ij Vitell ovor no. i. Cer. all parum Acel paul fiat Vnguentum This use if Inflammation if you be to mundify use Vnguentum Aegyptiacum or ex Apio fill up with Aureum or Basilicon and skin it with Diapalma or Desiccativum Rubrum A Wine-Merchant being troubled with black and sublivid Pustles about which was a vehement Inâ—lammation and nocturnal pains when as he could receive no ease or benefit by other things prescribed him by the advice of a Woman he was ordered to anoint them with oyl of Juniper by the help of which he rested very well and had more ease by this than he could ever obtain by all his former Medicines both inwardly taken and outwardly prescribed and at length was hereby perfectly cured CHAP. XXVIII Of Herpes Miliaris and Herpes exedens THIS by Avicen is called Formica It ariseth from a cholerick Humour and when as this cholerick Humour is made preternaturally thin and hot it frameth Herpes exedens or that Disease by Celsus called Ignis sacâ—r by Avicen Formica corrosiva because by its corrosion it doth spread it self This preternatural Choler mixing it self with Flegm it formeth that Herpes which hath many small Pustles in the skin like to Millet or Hyrse-seed and thence is called Herpes miliaris And since as we may apparently find that there are two sorts the one from Choler mixed with Flegm the other arising from a dust Choler our present discourse shall onely reach to the first the latter more properly ought to be reckoned amongst Ulcers The Signs of the first are many small Pustles like Millet-seed in the upper part of the Cutis and arising from the mixture of Flegm then they encrease in their number the former growing old and when they are opened or rent the Matter which cometh forth from them is between Sanies and Pus partly reddish being somewhat of a mixt Colour between red and white All the Causes may be related to those of an Erysipelas save onely that this Tumour is made from a redundancy of preternatural Choler an Erysipelas coming from natural Celsus doth propose that as Ignis sacer hath little danger so amongst such creeping Diseases its very hard to cure for sometimes there is an Intemperiety of the Liver which may be another Cause of this difficulty This cure may be performed by having a respect to the whole habit of body and since it doth not much irresemble an Erysipelas I do commend you thither to â—etch convenient Medicines both inward and outward which may do you great service in this Cure The second sort Herpes exedens is so called from Erodendo for it doth not onely erode the Cutis but doth also depopulate the subject Flesh Celsus Cap. 28. de sacro igne lib. 5. doth describe its nature when he saies it is made with an Exulceration of the Cutis not very deep large sublivid inequally planting its self in the extream parts As often therefore as we see an Ulcer to grow and increase and to make small Ulcers and many small Cavities penetrating no further then the Cutis this we may properly call Formica Corrosiva It is to be cured with Cholagogicks as the former and whereas it is a Disease arising from a preternatural hot and sharp Choler proceeding with Putredness Phlebotomy is no waies proper here for it very oft times doth arise from Cacochymy purging with Senna Damask Roses and the like in Whay or good Cassia Manna or â—eâ—itive Electuary or a Decoction of Sarsaperilla China and Guaiacum And as touching the part affected these are very proper here to be used â„ž succ Tabasc â„¥ iij. Cer. Citrin â„¥ ij Resin Pin. â„¥ iss Terebinth venet â„¥ i. ol Mirtin q. s fiat Ceratum molle â„ž Camphor â„¥ ss Album ovor no. iiij succ Plantag Solan an â„¥ i. Plumb ust Ceruss alb Lithargyr aur an Ê’ij pulv Troch alb Rhas sine Op. Ê’i ol Rosar â„¥ iiij Pomat â„¥ ij fiat Vnguentum With this let the Patient be anointed three or four times in a day Or this â„ž succ Plantagin Lapath acut Solan an â„¥ i. succ Polygan â„¥ ij Lithargyr aur â„¥ i. Tuth praeparat Antimon an â„¥ ss Alo. citrin Ê’iij Cer. alb ol Myrtill ol Rosar an parum misce fiat Vnguentum both for deterging and drying up of the Ulcer I shall conclude this Chapter with this History of a young Gentleman who was burnt from his foot to his knee but very slenderly that it did scarce hurt the Cutis coming to an Emprick who from the first used Empl. ex Argilla Bol. armeny with the whites of Eggs mixed with the Juices of Nightshade and Housleek dipping clothes therein and applying them to the part affected the pain which was but small grew into a great degree by the use of these he became vexed with a Fever disquiet and afflux of Humours to the affected part and Inâ—lammation of the whole Thigh even to the Hip and at length a Herpes exedens correpted the whole Thigh so vehemently that some Chirurgions thought to have made Amputation but at length was thus cured having first prescribed him this Potion â„ž rad Scrophular Cort. interior rad Frangul rad Polypod an â„¥ ss Herb. Fumar. Cuseuth Scabios an M. ss fol. senn Ê’iij misce fiat Decoctum in aquâ ad â„¥ iiij in quibus solue Conf. Hamech Ê’ii syr Rosar solutivar â„¥ i. misce fiat potio the day following he was bled in the Basilica of the same side the Herpes was and the Humour prepared with a purging Apozeme against Melancholy already prescribed in a Scirrhous Tumour The body being thus prepared we arrived at Topicks and here because the Cutis was already made hard by the use of cold
Medicines formerly applied by this Quack there was first used this Emollient Fomentation two or three times in a day with which the part affected was fomented ℞ rad Bismalv cum Tot. Lapath acut Screphular an ℥ ij fol. Malv Violar fl Melilot Sambucin Melilot an M. i. sem Faenugraec ℥ ss coquantur in aquâ ad 3 partis consumptionem The part affected being herewith near half an hour fomented cover the parts with this Catapl ℞ farin Fabar. Lupinor an lbss sem Fenugraec Lin. an ℥ ij rad Alth. recenter coct cribrat ℥ iiij pulv fl Chamomel Rosar Melilot Absynth an ℥ i. misce fiat Cataplasma With this being applied for fourteen daies and the Fomentation continued the hardned Skin grew soft the Pain allaied the ichorous Matter which flowed out of the Ulcer was prepared and brought to a fair Digestion after this was sprinkled upon the Ulcer Precipitate in pouder being washed in Plantane and Rose-water and over these applied this Empl. ℞ Empl. de Mucilaginib Diapalm an ℥ iiij De Ran. cum Mercur. ℥ i. Alumin ust Calcanth an ℥ ss ol Rosar q. s fiat Empl. molle And about the end this Unguent ℞ rad Scrophular Lapath acut cort Frangul an ℥ iiij succ Fumar. Scabios Acet an lbi Pinguedin Porcin lbij. conquassentur Radices cum succis ad eorum consumpt coquantur colentur colaturam serva ad usum ℞ hujus pinguedinis colatae lbi pulv Alumin Vitriol opt farin Lupinor bacc Laur. Ciner fuligin an ℥ iss Argent viv extinct ℥ ij Theriac ℥ i. fiat Vnguent in mortario With this anoint the whole Leg keeping his Body open with Conf. Hamech c. CHAP. XXIX Of a Gangrene and Sphacelus A Gangrene is that which doth feed on the flesh and poysoneth it and imprints a strange unnatural Quality in it By the Greeks it is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from the verb 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is Exedere But there are more essential Definitions hereof by some it is said to be a change from a natural to a preternatural Colour and by these it is called Mortificatio Galen doth call a Gangrene the beginning of a Mortification in the part affected the which doth so trouble and infest the neighbouring parts that without the best of Medicine be applied by a very skilful hand it does speedily run it self into a Mortification Inflammation by him also is accounted as a very great Instrument hereof and here beginneth a change of Colour decay of Sense a turning to Mortification We more properly allow and decree it the beginning of a Mortification and that it very oft times happens the which I have very frequently found in my practice experimentally to follow or succed large Inflammations and thereby do corrupt the soft parts as the Muscles Cutis Veins c. A Sphacelus is worse than the former for under this name we may comprehend Syderatio Putrefactio Corruptio and Mortificatio 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by the Greeks is held to be a most intense Disease so is a Gangrene by the Arabians A Gangrene is a Disease consequent to the effect not to the cause Sphacelus is a Disease exeding and compressing the parts It is a perfect Syderation and Mortification for a Member being corrupted with a Sphacelus is found plainly cold and dead While the member is in a dying posture and not quite dead it is called a Gangrene this for the most part remaineth in the upper superficies and doth onely possess and affect the Muscles and soft parts in a Sphacelus not these onely but the Bones themselves become affected In a Gangrene the Skin groweth red by reason of its companion Inflammation in a Sphacelus it first groweth pale then livid and afterwards black In a Gangrene you have no very ill smell in a Sphacelus never expect a good smell In a Gangrene your greatest design must be to prevent the spreading of the Humour and if it hath got place to prevent its growth in a Sphacelus its lost labour then to act or treat any other waies than by Amputation for there is no hope of bringing a dead part to life It gains its Name of Syderatio from that of Plants being a proper passion of them when they lose their natural moisture the which doth afford them their full growth and beauty this affect is called Syderatio as if they were struck by the Stars The immediate Causes of a Gangrene are three Intemperiety of the part when the transpiration of the Spirits are obstructed and when both the Heat and Spirits of the part are suffocated Sometimes it cometh by cold and then is to be discharged by heat in Gun-shot Wounds it doth frequently happen by reason of large Contusions it is sometimes also bred by the carelesness of Physicians who in the curing of an Erysipelas in the beginning do order and prescribe cold things so being in Act and Power that they are made capable to destroy the natural Heat oft times by defluxion of Humours or venenate Pustles which are left uncured sometimes out of immoderate Driness other times arising out of the Interception of the vital Spirits and very often out of Obstruction in the beginning of the Nerves And since there is a Mortification and Extinction of life and Destruction of the native Heat let us consider which way and out of what universal Causes this may happen Mans innate Heat cannot be supported without a radical Moisture and its Spirits justly and in their order implanted in all the parts of his body so that consequently upon hurting or offering any injury to this radical Moisture its Spirits also will be resolved dissipated and consumed and therefore first there is an Intemperiety occasioned out of the vehement alteration of the manifest Quality Secondly out of the occult Quality a malign and virulent Substance is contracted in the Body and thirdly the Parts are thus mutually affected with an Interception and Suffocation of the vital Spirits As to the first Galen doth observe and offer that every thing is kept preserved and propagated by its natural Heat and Temper so that nothing can alter or destroy this sooner than a contrary preternatural Temper and Heat thus a Gangrene doth happen after a long and tedious continuance of an Inflammation made either by Affluxion or Congestion of some sanguinary or cholerick Humour the natural Humour being dried up by the preternatural It may arise secondly either from a concomitant Malignity either brought outwards to the Body by the biting of some venemous creature or by adhibiting of Septicks In a hot Intemperiety the Pain and Pulsation which formerly were concerned with the Pulsation is much more remiss and the red Colour of the Inflammation doth begin to change into a Lividness here also do arise Pustules filled with an ichorous Matter these being all Forerunners of its tending to Mortification and both Heat and
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
a Dilatation of the Veins in the Testicles conglomerated in manner of Varices and these as Celsus and Paulus write are either the Veins of the Scrotum or those in the Membranes of the Dartos or those which do nourish the Testicle and therefore Celsus adviseth if the Rupture be in the Scrotum you are to apply thin and sharp Instruments to the Veins and with these the Veins are to be cauterized and there to be most cauterized where most variced or twisted The general Curative Method here is the same to that prescribed in curing of a Scirrhus the Intentions here are three to repell the flowing Humour to discharge and dry up that which hath already slowed and to astringe the dilated Vessels Now Astringents do satisfie these two scopes for as being cold and restringent they repell the fluent Humour as being drying they dry it up and by its Astriction do also bind up the dilated Vessels And for this Affect Balaustians Red Roses Pomgranate Rinds Juice of Hypocystus Bol. Armen Dragons Blood Mastich Olibanum Glue Amber and the like these or any or some of these mixed with the White of an Egge and a little Vinegar may very well be used here but if these do no good come to the use of Incision or Caustick and here are we to be very careful in onely cauterizing the parts where they are thus twined or twisted together after which done remove the Eschar then deterge and digest it But if the Veins of the Dartos be tumefied you are to make your Incision in the Groin and the Membrane is to be drawn through there with the Testicle and after this separate the dilated Vessels from the Coat either with your Fingers or a convenient Instrument then tie up the Vessels and cut them off under your Ligature then repose or reduce your Coat and Testicle And if the Rupture be in the Erythrois or Tunica vaginalis and either two be dilated proceed in the same Method as in the Dartos but if it be between the inward Coat and the Testicle it self make your Incision in the Inguen draw out the Vessels amputate the Testicle and cauterize the parts And this is Paulus his Method and Distinction As touching Hernia Humoralis take this brief Description of it It is framed out of a Confusion of many Humours in the Scrotum or between the Coats which enwrap the Testicle Oft times also it is seen to be bred in the proper Substance of the Testicles You are to cure this as you do the former And thus much of Ruptures CHAP. LXIII Of a Venereal Bubo WE arrive now at the Inguens where we may meet with these four following Tumours Bubo Venereus Pestiferus Phyma Phygethlon of each of these in their order These Glandules have their proper names as well as others and hence is it that they are called Bubones by us in England called the Popes eye in veal and mutton They are held to be eight in number and very large There is held to be a great commerce between the Nerves and these Glandules for it is very credible that the Nerves do conveigh somewhat hither as their excrementitious succus and also do send hither any nerveous quality that at any time doth perplex them but they do not unload themselves into these as into their excretory ports but into their adjoyning vessels and hence it is that they are placed at the greater division of the vessels neither is it less probable that they take somewhat from hence as a nutritive juice the which being allured by a similar attraction of the Glandulous substance the Lymphaducts to pour out their Lympha here and by the benefit hereof these Glandules do separate one and leave the other And this is confirmed by their sweetnes and delicacy they having a familiarity with the nutrive Succus And the reason they are so large and numerous is because the Crural Nerves had need to have such large Organes for discharging their superfluities We come now to their Diseases with the Affects these being either simple or not malign Tumours or pestilential or venereal Tumours The Causes of all which may be reduced to two The first being the hindrance of the Circulation of the Blood and hence ariseth a Tumour by reason of the continuity and impetuous afflux of the Blood from the heart through the Arteries and by reason of its making no reflux from these through the Veins An evident example we have hereof in Contusions of the Glandules and in their Obstructions A second common Cause ariseth generally from the Nerves themselves spitting forth their superfluous Humidities being either here vitious in Quantity or Quality now these are 2 common causes Every special Tumour hath its specifick causes differences and thus if these superfluities only err in quantity or quality as in viscidity thicknes or the like it frameth a simple Tumour If from a malign quality there ariseth a Tumour being of the same nature as malign and thus being either venereal or pestilential it occasioneth a venereal or pestilential Tumour We are now to enquire of the efficient causes of this venreal Bubo and this poyson oftimes is communicated to the Liver and hence is sent into the Inguens as its proper Emunctuories and hence ariseth these venereal Buboes The cheif matter of which they are bred is of a part of thick cold and viscid Humours which may wel be perceived by the hardnes whitenes ilnes of pain and colour of the Tumour Sometimes they arise from a hot sharp cholerick Humour with a great pain and a conjunct heat and these make them so oft to run into Ulcers being both virulent corroding As to the cure never-use digestives lest the thinner part being resolved the thicker excrement lyes and encreaseth inwards much less Repellers for these do drive the virulent matter inward and therefore Attractives and Suppuratives here only do take best place The Tumour being made ripe open it with a potential Cautery As touching the cure of the whole body neither purge bleed or keep any order of dyet Make your orifice not very large but so as you may lodge in it a pretty handsome large Tent for discharge of this peccant Matter you may keep it open for 20 or 30 dayes according to the greater or lesser quantity of Matter This being discharged we may both prescribe purging bleeding and a good order of dyet It being discharged cleanse it well fill up with flesh and skin it And thus may you cure the kinder sort of a Venereal Bubo but if it proves more rebellious then instead of Suppurating Medicines we should come to the use of Cupping Glasses every other day and after these to apply Diachylon cum gummi mixed with black Soap and these will maturate the most rebellious Buboes and having brought it thus deterge the Ulcer by keeping it a long while open and freed of its peccant Matter then fill up with flesh and
part affected was applied Emplastrum de Cicuta and this Clyster was administred â„ž Rad. Alth. cum Tot. fol. Violar Malv Parietar Mercurial an M. j. fl Chamomel Melilot an M. iss coquantur in aqua s q. ad tertiae partis consumptionem in j. colaturae solve Benedict Laxativ â„¥ j. Mel. Mercurial â„¥ ij ol commun Ê’iij Sal. pug j. misce fiat Enema The next day was ordered this Apozeme for digesting of this Melancholy Humour â„ž Herb. Lapath acut Rad. Polypod Q. Petroselin an â„¥ j. Herb. Agrimon Veronic Cuscuth Fumoterr summitat Lupul a. M. j. fl 3 Cordial an pug j. Liquirit Vvar passar Rhaharb Rapontic an â„¥ j. sem Faenicul Anis an â„¥ ss coquantur in aqua fontana s q. ad tertiae partis consumptionem hujus colaturae accipe j. syrup de Fumoterr Epithym an â„¥ ij Aqu. Cinamom â„¥ iss misce fiat Apozema pro tribus dosibus to be taken for three mornings Afterwards was prescribed this Purging Potion â„ž Decoct praescript â„¥ viij in quibus infundantur macerentur Rhabarb optim Ê’ij Senn. mundat â„¥ j. in dimidia parte hujus Decocti solve Diaturbith cum Rhabarb Ê’j syrup Rosar Solutivar â„¥ j. misce fiat Potio Empl. de Cicuta was every day renewed and afterwards he took this Purge â„ž Confect Hamech Ê’iss Extr. Cort. Esul ℈ ss aqu Cinamom â„¥ ss misce fiat Potio After this the Tumour began to lessen and then was applied this Emplaster â„ž Empl. Diapalm â„¥ ij pulv Mastich Rosar rubr Myrtilor Radic Symphyt major an Ê’j cum q. s ol Rosar fiat Emplastrum After this he applied a small Knot oft times doubled and this was joyned to the Ligature and this was for repressing the Tumour and for dilating or throwing out of the coagulated Blood and by these Remedies and by Gods blessing he perfectly recovered the use of his Arm. CHAP. LXVIII Of a Paronychia and Pterygion IT s place and seat is generally at the Fingers ends here it fixeth it self and from hence does it send forth its pains It s Figure is longish somewhat Oval It is a Preternatural Tumour apostemated small and scarce perceivable beginning at the Fingers ends arising from a hot venenate and nitrous Blood and oft times places it self between the Bone and the Periostium At its first appearance it is mild and gentle but afterwards grows fierce and troublesom causing pains Fevers sometimes a Caries and Putrefaction of the Bones It 's called Paronychia because it is a Distemper 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 marching to the roots of the Nails Fabritius de Aqua Pendente maketh no difference between Paronychia and Pterygion Pterygion is a Hyposarcosis or Excrescence of the Skin and this does not immediately reach the Nail Aeginetta cap. 81. lib. 3. shews the difference where he calls Panaritium an Abscess fixing it self about the roots of the Nail Pterygion to be an Increment of Flesh spreading out of another part of the Nail The Blood of its nature is hot here being kept in and denied a Difflation Redness arising from this great Heat Pain from this Intemperancy and Solution of Continuity by this violent Matter distending and aggravating the nerveous tendonous and membranous parts These are sometimes said to be bred by an inward cause occasioned by a nitrous sharp cholerick venenate fervid and most thin Blood or Humour the which is infixed in the affected part External Causes may be Contusions after which followeth an Ecchymisis of Blood under the Cutis or between it and the tendonous parts or between the Bone and Periostium this Blood being putrefied large Inflammations increase and Pain and other Symptoms appear The Generation of this nitrous Blood is to be hindered and that it may not flow is to be intercepted and revelled and that which hath already flown is to be weakened by Repercussives or Suppuratives but of these in their order Revulsive Medicines are such as are to be applied to the opposite part and these are hot and attracting amongst which may be reckoned Scarrification Friction Vesication and the like Interceptives commonly called Defensatives have a Stiptick Faculty shutting the Mouths of the Vessels and by the Coldness and Stipticity they thicken coagulate and hinder the Flux of Blood Of either of these you may find various in my former Tracts Of Repellers these are Cold Moist and Restringent and do repell the inâ—â—uent Blood and hinder its coming to the part affected So long as you have any hopes of repelling an Humour follow this freely where this is not to be done come to the use of Suppuratives Take this one for all in this place most proper â„ž Pulv. rad Bismalv Consolid Major an â„¥ ss sem Lin. Foenugraec an Ê’iij Malv Alth. an mj Plantag Hyosciam an mss Vngul Rosar rubr mj Farin Hord. Lol. an â„¥ iss fl Melilot Chamomel au pug ij pulv Gallar Melicor an Ê’ij Bulliant simul in lacte vaccino vel aqua fontana Caepar Sub. cinerib coct â„¥ ss fine addendo Ol. Rosar Myrtin an â„¥ ss Lilior albor Chamomel an â„¥ i. Vitellor Ovor. nâ— Croc. ℈ ss misce fiat Cataplasma Fabritius Hildanus useth a decoction of Cows milk here wherein were boiled Mellilot flowers Chamomel flowers Quinch-seed and Lin-seed and so Fomented the part after which he opened the Skin the which being opened dropped one or two drops of a reddish thin Substance this being discharged he applies a little Venice Treacle which was dissolved in Aqua vitae and with this the pain soon vanished The Incision being made we are to Mundify the part with Mel rosarum unguentum ex Apio or Aegyptiacum For this use also Precipitate is very good Glandorp is fearful of using these sharp Medicines these being very subject to cause Pain and so he prescribeth Anodyne Mundifiers as Oyl of St. John's Wort affirming that this doth both Digest and Mundify the compact Matter lenify the Pains deterge and incarn Very oft a Caries of the Bone follows a Paronychia and here most drying Medicines are most proper as Falloppius his Powder â„ž Pulv. Rad. Peucedan Irid. an â„¥ i. Euphorb ℈ i. misce As curing a Pterygion Having already acquainted you that it is nothing else but a Hyposarcosis about the Nail and this sheweth its own Indication which is to ablate the superfluous Flesh and for this cause Vnguent Egyptiacum or Alumen ustum or Praecipitatum is excellent good Or this â„ž Vnguent Populeon Ê’iss Alumin ust Ê’ij misce Or this â„ž Vnguent Diapompholig Ê’ij Alum ust Ê’i or the like And thus much of those CHAP. LXIX Of Nodes of the Legs THese very often happen after a long continued venereal Disease the which do not shew themselves very speedily but in what plases so ever the lurk in they creat very great and Nocturnal Pains being and having in them a contrary quality to most of other Tumors to bereave the Patient of