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
is not therefore contained in one Bag as the former but is lodged between two Coats And when it is in the Head it doth contain in it a Matter resembling Sewet a large Basis and doth not yield to the touch when it is in other parts it is seen to contain in it Matter much like Fatt more like this than Sewet neither is its colour there so white It is generated as is Sewet by reason of the Intemperiety of the place or by reason of ill Blood They are scarce ever cured but by manual operation If the Vesicle be broken and you do not draw all out it will leave either a Fistula or a foul Ulcer As touching its Cure in respect of its hardness broad Basis multitude of Sewets it is only to be handled as other Abscesses this Sevum is to be wholly separated from the Pericranium lest the Abscess do make a fresh return Here may you make a cross Incision if it be large and take care of touching the Vesicle lest you make a faetid smell and ulceration This being performed press out your Cistus cut off the branch that fed it and have a care that the least particle remaineth not this being done cleanse it and use your greatest care to produce a Cicatrize There was a Gentleman who was troubled with a Steatoma in his Inguen weighing near forty pounds his whole Body redounding with pituitous Blood a good and thin Dyet being prescribed ordering him to abstain from all viscid and thick food as Milk Cheese and the like and prescribing him a Honey-drink in which Ginger and Time were boyled and outwardly applying such Medicines as may discuss this Flegmatick matter as Fomentations and the like being every Night and Morning repeated and preparing the Humour with Oxymel of Squills and then by intervals ordering him to take some of these Pills of Aloes Rosatae ℈ 5. Troch de Agaric ℈ ij Turbith gummos Ê’ss Squinanth rad Asar an gr 5. ZZ ℈ ss Cinamom ℈ i. Rhabarb Ê’ss Troch Alhandul gr 15. cum Oxymelit Scillitic q. s fiat massa pillul â—rum dosis a ℈ ij ad Ê’i And this Oyl being outwardly applied as â„ž Ol. Philosophor Latern lss Thur. Mastich gum Arabic Terebinth venet an Ê’iij pistentur per alembicum distilla fine distillationis addatur Sal. ex ciner Cerr iterum distilla quod pro usu reserves By these this great Tumour was dissipated and digested this you may read of in Langius Epistol 4. lib. 3. CHAP. XXXII Of Meliceris THIS Abscess hath a Matter contained in its Cistus much resembling Honey and is thus by Aetius described It is an Abscess enclosed in a Nerveous Coat containing a Matter like Honey wanting pain having a round Figure easily yielding to the touch and the finger being taken off it doth as speedily turn into its former condition The cause hereof is a mixt preternatural Humour And although every Abscess contained in a Bag hath Matter going along with it yet are these divided into four Modes or Forms hence in a Meliceris because it is soft and thin its Flegm is mixed with a greater quantity of Choler than in an Artheroma or Flegm out of which is made this Meliceris This is to be cured three ways by Digestives Causticks or Amputation As touching the Septicks or Causticks we have already treated in Steatoma we shall here more properly treat of Digestives the which because they do discharge this Matter perporos cutis they ought to be powerful and strong and to exceed in their vigour more than in those Abscesses which are enclosed in Bags Whence in small and moist Melicerides a Decoction Pulegii Calamenthae Hyssopi Melissae made and applied hot with a Sponge is here accounted very proper but if stronger be required you are to make a stronger Lixivium in which boil the aforesaid Herbs and apply it to the part affected or for the same you may use this of Aetius which he hath in his 15th Book â„ž Sal. armoniac Spum argent li. Cer. Terebinth Galban Opoponac an â„¥ i. Rubric Synopic â„¥ .vi. Acet heminam misce Or this â„ž Diachyl Ê’ 12. pul Irid. Ê’ij misce or Diachyl cum gummi to which may be added a little powder of Ireos Emplastrum Alexandrinum here also is much commended thus made â„ž Sal. Armoniac Litharg Cerus an Ê’i Galban Opoponac an ℈ iiij Sem. Sinap â„¥ ss Ol. veter â„¥ iiij Cer. Terebinth an Ê’i misce fiat Emplastrum If this Method succeedeth not we are to come to the use of Suppuratives And of these some may serve for the prohibiting the egress of Vapours and not only obstructing but also keeping in the inward native Heat others do not only obstruct but do also heat and by the calefying quality do rarefie and thin the parts of the same qualities should our most proper Medicines be framed as this of Rhasis â„ž Farin Sem. Lin. Ê’ij Faenugraec â„¥ ss pulv Sem. Caul Ê’i Mucilag rad Alth. q. s fiat Empl. In the last place I take crude Figs and beat them in a Mortar and to these I add a Snail and beat with them and order this Medicine to be laid on and so kept on until it falleth off of its own accord After you have made it fit to open discharge the Matter as I have directed you in the other two Chapters then apply Digestives convenient Detersives Sarcoticks and Epouloticks Amongst all these three Tumours I must acquaint you that it is not very frequent for the putrid Matter to exalt it self in these Tumours of the hairy Scalp and therefore Causticks are the most proper Instruments to occasion this but here not to be used Langius lib. primo Epistol 38. Writeth of a Woman who having an Ulcer in her Matrix had also a Meliceris accompanying it and when it gave the greatest hope to the Chirurgion of its consolidation a new Ichor began afresh and forced it self out she being thought to be bewitched by good Prayers and divine Ejaculations the Woman had her Ulcer spontaneously consolidated and cured CHAP. XXXIII Of Psydracium THIS is a yellowish sharp Pustle out of which if it be pressed cometh a Moistness according to Celsus Galen seemeth to place it sometimes amongst the Tumours of the Eye-lids sometimes he will have it a Tumour of the Head It is called Psydracium either because it is seen to appear sharp in the Head or else because it doth contain in it a great quantity of a waterish humidity These do arise from mixt Humours and by how much the whiter they are this shows they have more Flegm in them the harder come from Choler and the sharp and small from Water The Cure is to be performed by moderate Coolers and Discussives Coolers as for allaying and tempering the heat of Choler and Discussing in respect of Flegm here also are to be observed a good order of Dyet a good respect to the habit of Body to keep it
Alb. graec Ê’j colaturae 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 adde Sacchar Saturn ℈ ss Sal. Prunell ℈ i. Or this Cataplasm â„ž rad Alth. Lilior albor an â„¥ j. Nid Hirundin no. j. Ficuum Dactylor an no. iiij Caepar Ê’vj coquantur ex aqua Hord. colaturae adde farin Tritic. sem Lin. an â„¥ i. Faenugraec Alth. an â„¥ iss vitellor Ovor. n. ij Croc. Ê’ij ol Chamomel â„¥ ij misce fiat Cataplasma Galen doth report of one troubled with a Squinancy after having used many proper Remedies and these failing this at last recovered the Patient he ordered the Excrement of a Boy well dried and powdered and mixed Honey therewith and with this he anointed the Jaws of the Patient and in the space of half an hour the Abscess did break and the man was restored to his perfect health Aetius cap. 5. lib. 6. saith that Agarick doth suck up hidden Abscesses and doth draw them outwards And Jacobus Dovonetus apolog lib. 3. cap. 2. writeth that having a young Gentlewoman much troubled with a Squinancy he cut a little Agarick in pieces and put them into a Decoction made of Marshmallows Figs with a little Ginger and a fourth part of Wine and Water to which he added a little syrup of Marshmallows this Potion he gave to the Patient and ordered her that she might not swallow it but hold it for some time in her mouth she following his directions whilest he was but discoursing with another a great quantity of white Matter came out at her mouth and after this some putrid this being discharged she came to her perfect breathing and got off from her Fever and all other bad Symptoms and perfectly recovered CHAP. XLVIII Of a Tumour of the Tonsils THese Tonsils are by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 amongst the which is reckoned the Columella And Nature hath placed two Glandules at the root of the Tongue much resembling in figure and shape an Almond and therefore by some these are called Amygdals And before we proceed any further in this Discourse let us take a more curious view of them and see for what uses they were framed and then if being either hurt tumefied inflamed or ulcerated how they ought to be cured They are as it were framed out of a cold concreted oleaginous and malleous Substance save onely that it is thicker and more firm they being of a yellow colour soft in touch but in being boiled hard spongeous and porous They have belonging to them Veins Nerves Arteries and proper Cavities Veins and Arteries from the Jugulars Nerves from the third and fourth pair Each hath its proper Ductus allowed it opening into the Mouth and very many small Glandules dispersed from thence about the whole Root of the Tongue Through all those Foramulaes is our mucous Substances expressed and thence disposed through the Root of the Tongue Their Uses are various as being first the chief Organs of Tasting for the same Membrane which covereth all the parts of the Mouth doth also take this Glandule into it Secondly it is the Excretory Iustrument for its office is to separate the Mucous or Pituitous Matter which falleth from the lower part of the Brain especially through the Nerves of the third Pair and so to refund this into the Fauces and Mouth Thirdly this moisteneth and keepeth soft the Jaws Larynx Tongue Oesophagos and maketh the Tongue so voluble and the Oesophagos the better capable to perform its office of Deglutition Fourthly in plentiful Catarrhs of the Brain the Nostrils being obstructed they do imbibe into their spongeous substances the Matter which might otherwise have been disposed the other way And lastly they help towards the Concoction of the Ventricle by their Fermentative Faculty for these with much ease do contract Acidities which is the great Agent in Fermentation and its chief cause All these are worthily allowed by the curious hand of Dr. Wharton in his Book De Glandulis Now if this Saliva be spent or consumed by violent Fevers the Patient does soon begin to grow impotent and weak unless the Tongue and Mouth be kept moistned by some cooling Decoction or other for these Glandules are planted in a hot and moist place and therefore the sooner subject to Inflammation Into these also with Blood do flow a pituitous Matter crude and viscid and this being condensed by Cold does elevate them into a Tumour Aetius telleth us it may happen in a young body by drinking too much sharp Wine and by eating very often of too sharp Meats With these Glandules do frequently their neighbouring Glandules of the Larynx joyn in Tumour and then the Patient is ready to suffocate It is very apparent both to sight and to feeling This eminent danger may be both prevented and resisted by Purging and Phlebotomy Cupping glasses Vesicatories applied to the Neck and Shoulders then wash the Mouth and Throat with this Gargarism â„ž Rosar rubr Plantag Balaust an Ê’i summitat Papaver Myrtin an â„¥ i. Bol. armen ℈ i. fiat Gargarisma Or this â„ž fol. Plantag acetos Hyssop an M. i. gran Sumach â„¥ ss Cort. Granator Rosar rubr an pug i. fiat decoctum ad lbi in quo solve syrup Moror â„¥ iss Lap. Prunell Ê’iss misce Or â„ž fol. Salv. Plantag Rosar rubr an M. ss Cort. Granator Balaust an pug 1. Santal rubr Bol. armen an ℈ i. Betonic M. i. coquantur in aqua fontana ad lbi colaturae adde syr Myrtin Sambuc an â„¥ iss Sal. Prunel Ê’i misce These Trochischs are also very proper to moisten the mouth and parts with and also to allay Heat and Inflammation â„ž Spec. Diatragaganth frigid Diapapaver an Ê’i Bol. armen praepar ℈ ij Amyl succ Liquirit an ℈ Sacchar candit Ê’ij cum syrup Papaver erratic q. s fiant Trochisci to be dissolved in the mouth Or this â„ž Aqu. Prunel Plantag Rosar rubr an â„¥ iiij fol. Rosar Cort. Grantor Balaust fol. Plantag Ophiâ—gloss an Mss sem Cydonior Ê’i coquantur omnia simul colaturae adde syrup Diainor â„¥ i. Granator q. s ad aciditatem To the outward Region of the Neck apply this Cataplasm â„ž rad Alth â„¥ i. Scabios Sambuc Rosar rubr fl Chamomel Melilot an M. ss sem Alth. Ê’iss coquantur ad mellis consistent pistentur his adde farin sem Lin. Foenugraec an â„¥ ss ol Rosar Aneth Chamomel an â„¥ i. misce fiat Caplasma Pills proper for purging the Patient may be these â„ž Pil. aur ℈ i. Extract Panchymagog Croll ℈ ss ol Cinamom gutt ij Diagrid gr i. cum syrup Rosar q. s fiant Pil. A very convenient Electuary may be this â„ž Stercor canin alb aq Rosat lot pulv Ê’iss Sacchar Rosat â„¥ ss syrup Violar Moror an â„¥ i. ol Amygdal dulc recenter extract â„¥ ss pulv Irid. ℈ i. spec Diatragagant Ê’ss ol Foenicul Ch. gut ij misce fiat Electuarium Dodonaeus Observ cap. 16. telleth of a
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
amicable Hand and if you give it the time of a Survey play not the part of a Waterman who Dum aliud proponit aliud supponit Let every man study his Art quietly and peaceably that he may profess it openly and confidently then may be expect it to have it guarded with the Lion and Crown and encouraged by Royal Charters and Princely Privileges I hope this Tract will meet with a Gentlemans Charity whose Soul is drawn out to his Fingers ends who can pardon an imperfect Draught and where he meets with too deep Shadows can with a light Hand and finer Pencil lessen its darkness It may be well reckoned amongst Vulgar Errors in our days wherein the Mists of Ignorance are very plentiful the Evening of Knowledge appearing but through a small hole and the dark Clouds of Folly obstructing our Light of Reason and hence is it that the Light which we enjoy is so variously refracted by the glittering Vices of our times and looks much disfigured by the Glasses of Humour and Fancy If this may answer expectation I am happy if it be disliked by such who rather do measure another mans actions by number than by either order or weight I am not troubled knowing it to be a common failing of some to be tempestuous in Temper and troublesom either in Judgment or Desire as to hate any thing they cannot themselves perform or yield or lend a good look to another mans Labours because they were not christned by their Name be they never so lawful good advantageous or honourable To these and such others I offer this as a Conclusion let us all study to be quiet and peaceable and to do our own business for publick and private good to work with our own hands such things as may gain afair repute and good name here and a happy reward from Heaven hereafter then shall our present actions smell like the Rose and Eternal Bliss shall crown our end And as I have in this Tract studied to be profitable to thee so let thy endeavours be to help others From my House in Norwich Nov. ult 1677. Vale. To the Author Mr. JOHN BROWN SIR SInce you were pleased to honour me with a sight of your Chirurgical Endeavours in this Work I must in justice return you my Thanks and Commendations due unto it for though the same Subject hath been handled by others yet have you made so good a Collection out of Approved Authors and so well disposed and set down the Nature and Cure of Tumours together with apposite Historical Observations that the same may become of very good use especially unto younger Chirurgious unto whom you chiefly designed it and therefore I wish you happy success herein and also in all future Endeavours unto which Art and Industry shall enable you Your Loving Friend and Servant THO. BROWN To Mr. John Brown Chirurgion of Norwich on his Treatise of Tumours SIR YOV have taken great pains in these your Collections which having exemplified with so many very pertinent Observations I do encourage you in the Printing of them they will be of great use and instruction to all such as have not had the opportunity of consulting the many learned Authors quoted by you which most imployed in Armes and Sea-service cannot be accommodated with Sir I am Your Affectionate Servant KNIGHT Reg. Chir. Principal To his Ingenious Friend Mr. John Brown upon his Treatise of Preternatural Tumours SIR HAving with great delight perused your Indusrious Discourse and careful Studies in this your Treatise of Preternatural Tumours I must in gratitude and civility return you my just Acknowledgment due unto it How lively you have examined their Causes Signs Presages and Cures no Son of Art but will acknowledge with thankfulness and with what admirable Historical Observations you have adorned your Book I need not to acquaint the Reader All that I shall and in justice ought to adde your Care and Ingenuity shewn herein may challenge a kind Opinion from the worst of those who may pretend any disgust against your Sedulous Endeavours which is the perfect Vote of him who is SIR Your assured Friend and Servant ROB. DANIEL To his Worthy Friend Mr. John Brown Chirurgion in Ordinary to the Kings most Excellent Majesty on this his Learned and Elaborate Treatise of Chirurgery WElcome my Friend upon this mundane stage Learn'd Artists very scarce are and the Age Abounds with Dolts which doth its ills enrage We wanted one that would our Griefs declare And proper Medicines for them prepare And thank our happy Stars we have them here If Agues or Cut Fingers formerly Being cur'd could raise men to a Deity What 's then thy due that cur'st each Malady Cheap in those cloudy times were Deities And little skill would purchase such a Prize But Physick now doth look with Argus Eyes Yet thy great Soul is such thou canst appear Before the Presidents and Censors Chair Thy Work being perfect what hast thou to fear Were fam'd Hippocrates alive to write Those Books which first gave Greece her Physick sight He from this Work would humbly borrow light For having this learn'd Book men need no more Of useful things it is a bounteous store And doth provide a Salve for every Sore Thanks then dear Friend for this thy worthy pains Cure but all Worms too in Fanatick brains And Immortality shall be thy Gains JOHN GADBURY Student in Physick and Astrology The Names of the Authors concerned in this Tract of Tumours Paulus Aegineta Albucasts Avicen Aquapendens Aetius Banister Berbert Bayrus Bauhinus Benivenius Cornelius Celsus Crooke Cordaeus Calmetaeius Columbus Dodonaeus Jacobus Dovonetus Gabriel Falloppius Fabritius Hildanus Fabritius de Aqu. pend Forestus Galen Guido Gesner Osualdus Gavelchoverus Hippocrates Haliabbas Hercules Saxoniae Hollerius Jubertus Laurentius Lusitanus Leonellus Montanus Ocavus Oratianus Jacobus Oetheus Guilielmus Placentinus Ambrosius Paraeus Rhasis Read Rondeletius Ronsius Rogerius Johannes Schenkius Johannes Tagaultius Johannes Vigerius Johannes Vigo Vesalius Whartonius AN INTRODUCTION TO CHIRURGERY AMONGST all the liberall Arts which the wise Creator hath made and bestowed on mankind there is none extant that carry more excellency and dignity than this of healing Considering either its Origin or Antiquity its splendor of Invention its honour and excellency nobility and vertue its subject and learning benefit and necessity constancy and firmness with its liberality and charity As touching its Origin and Antiquity It came into the world almost in the same day with man for soon after his Birth was this sought out as both reason and history makes good it being generally our lots either sooner or later to make use hereof for as soon as we leave our mothers womb we grow subject to receive the vapors of a putrid air and winds and do thereby exprome diseases and sicknesses as well as upon a further growth we share in others arising from meats and drinks Can we either live well or act any thing to purpose without health Are there not many
Lancet and prepare himself for this Operation First let him make a pretty strict bandage a little above the elbow of that arm which he intends to bleed not too strict because he will very seldome hereupon but meet with obstruction in bleeding the Artery being too close girt that it cannot discharge it self into the vein And as to his Lancet let him make his apertion a little sloping or upon placing it a little obliquely let him get his Lancet into the vein and so lift it up not penetrating too deep lest he commit those errours which daily are acted by ignorant Pretenders and Quackes who oft go so deep as that they prick an Artery and so cause Aneurisms and pains Let the Orifice that you make be neither too great or too small the first endangering the Division of the vein whilst the second runs it into a Tumour Here also is he to judg of the goodness or badness of the Blood and so according to his judgment may take away more or less and also considering the necessity of the disease the strength of the Patient and the quantity and quality of the Blood The veins which are generally opened are these the Frontal vein one under the Tongue the Cephalick Mediana and Basilick but of every of those in their order and as necessity requireth The Frontel vein is most properly opened in infirmities of the Face and in pains of the Head Two veins of the Temples opened in continual Head-ach in distillations of the Head and Eies The veins under the Tongue in Anginaes Apoplexies pains of the Teeth the Jugulars good in preventing suffocation Squinsies Asthmaes Dyspnaea and the like The three in the Arm the first being the outward or Cephalick this may safely be opened in distempers of the head as Mania and other hot passions The second Mediana so called in respect of its Scituation being made both of the Cephalick and Basilick vein in opening of this vein is made a general evacuation of Humours this oft times opened in pains of the breast and Pleurisies The third is Basilica or Hepatica by some called Axillaris this dischargeth those parts which are beneath the Neck as the Brests Sides Liver Spleen and Pleurisies And this note of the three in all sicknesses and times except in time of Pestilence That vein is to be taken which is most full and large In the Feet also are three veins Ischiatiea Saphaena and vena Poplitis these or some of them are generally opened in Obstruction of the Monstrues in bringing them down pains stoppings swellings and the like I shall conclude this with these directions In an Apoplexy open the Cephalick vein if this appears not open the Mediana In a Lethargy open the Frontal or Cephalick vein In a Squinsey those under the Tongue In a Pleurify the Basilica and here bleed while the Blood doth change its colour In diseases of the Lungs vena Axillaris or Mediana In inflammations of the Liver Basilica or Hepatica In obstruction of the Spleen the Basilick or Hemorrhoidal veins In diseases of the Womb the Sciatick vein In restraint of Menstrues Saphaena In pains of the Hips first open the Basilica then the outward malcolus below CHAP. VII Of Evacuation of matter erring in Quality IF a Tumour or Fluxion happeneth in respect of matter not onely erring in Quantity but also in respect of Quality that this may be discharged we are to consider two things First whether this matter may be altered as if hot cooled c. Secondly to remove the subject matter hereof and in the first if Plethory Phlebotomy is proper if less Pharmacy is most convenient And herein are we to observe these two Rules that the matter may first be educed or sent forth being contrary to the true genus of the part and then if it doth still remain to alter it The most proper way to deal with this is by our later writers found out which is by discharging the body hereof by purging Medicines which do work both quickly and safely ordering the strength of the Medicine according to the vigour and strength of the Patient and herein also are we to mind the motion of the Blood for if it doth move to the eies this is to be revelled first by Cupping-glasses without Scarrification Secondly that the parts ought to be rubbed for the better thinning the Humour thirdly frictions which are proper for revelling from the Center to the Circumference And Galen nameth the last when parts are obstructed we ought to obstruct with Medicines but these are tedious painful and troublesome Our later Writers have found out better means and methods as by washing with warm water which doth revell by opening the pores another sort is by vesicatories and these are in great use in Apoplexies Rheumatisms or Distillations the third and last is an actual Cautery and Fontinels and Setons very much in use in our times And in all these we are to observe that Revulsion doth take its indication from that part from whence the Humour sloweth not from the Humour flowing and this being known we are to understand the parts which we are to revell CHAP. VIII Of a Tumour the part affected drawing to it self Preternatural Bodies THE greatest occasion or cause of attraction in a Tumour of a preternatural body is cheifly to be attributed to Laxity and Intemperiety of the part and pain This Intemperiety is therefore first to be removed by running it into a better temper And this may be executed with oyl of Roses Violets and the like having fine linnen rags dipt therein and so applied and these are oft to be repeated to prevent inflammation For this use also Vnguent Rosatum Refrigerans Galeni Populcon Album Camphoratum If pain occasioneth this we are here to give ease by Anodynes according to Galen 13. Meth. 1. and if any preternatural bodies offend discharge them either by Medicine or Instrument if pain cometh from venome cure this as you do venomed bodies and herein also are you to consider the times of the poyson for the longer it hath got room and entrance the deeper doth it imprint its venomous Qualities and Effects In this case Venice Treacle Methridate and the like are very good Spirit of Wine here also is very proper And thus are we to vary our methods according to the variety of our Objects In venenate distempers in cold poysons we use hot Medicines and in hot poysons on the contrary cold Medicines as Rue Frogs Scordium and the like commended by Dioscorides Galen doth furnish us with many pleasant stories of poyson and amongst the rest he doth offer that if any be bitten with a Scorpion if the same Scorpion be taken opened and applied to the part affected it draweth out its own poyson This generally being here observed that before you apply any Medicine to the poysoned part you first well foment the part with a hot and sharp Lixivium and when the place beginneth to
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
so suddenly run into Uucers if not suddenly and well cured In its Cure are we to prohibit its Ulceration for it soon exulcerates if not well cured And here we are to begin with purging and cleansing the Body from these Humours by Pil. Coch. Aggregativ Sine Quibus and the like and by Diaphoreticks to dry up this moisture the part affected is to be discharged of this Serum and prohibiting suppuration And therefore to Children troubled with such a Disease you may use such a Medicine as this â„ž Aqu. Marin vel aqu fontan in quâ imponatur Sal M. j. in his coquantur herbae Saliv Rosar rubr Absynth an M. ss cola In this you may dip Sponges and apply them warm to the affected part and afterwards lay this Plaister-wise Take Figs being boiled in Water to the form of a Pultice and apply them If you require stronger Medicines â„ž Alumin Roch. Calcanth ust an part aequal sqam Aer dupl Glut. in Aceto diluatur cum reliquis imponatur If it be exulcerated apply Ceratum Citrinum Sem. Lin. trit cum aqua Let it be deterged with the pulp of Figs to which may be added a little burnt Alume and skin it with Desiccativum Rubrum or Diapompholigos There was a Minister of forty years of Age who was much perplexed with a Scirrhous Tumour at the great corner of his Eye the largeness of a Chesnut being of a livid colour intertexed with many capillary Veins The Body being well purged and a good Dyet ordered and being let Blood on his left Arm the same side where this Tumour possessed the Tumour was extirpated with a pair of cutting Forcipes After which was applied the white of an Egg mixed with Rose water then following were applied Anodine Abstersive and very drying Collyriums oft timeâ— repeating the Purgations and Administring cupping Glasses to the Neck and Scapulaes and to the Forehead was applied this first being Anodine and afterwards this second being very drying The first was this â„ž Mucilag sem Cydonior Plantag cum aqu Rosar extract Lact. muliebr an â„¥ ij Camphor Croc. an ℈ ss misce apply iâ— warm The second this â„ž Aâ—u Plantag Rosar an â„¥ iij. Tuth praeparat 〈◊〉 ust praeparat Ceruss lot an 〈…〉 fiat Collyrium By the benefit of these and observing his prescribed Direction he was perfectly cured CHAP. XXXVIII Of a Cataract I NOW proceed to Tumours of the Eyes and under this Head I shall comprehend Suffusio Hordeolum unguis Oculorum and Encanthis Suffusio or Cataract by the Greeks is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and this is an affect of the Eye whose cause is as it were a concreted glassy Humour gotten between the Cornea and the Chrystalline Humour clouding it and obscuring its Species of Objects sometimes covering the whole Pupil whilst at other times it is seen only to cloud but half thereof And according to it s more or less spreading it doth either in process of time wholly abolish or partly diminish the sight And as Platerus doth observe it groweth in length of time to the thickness and hardness of an excocted Egg. It is oft times made by a concretion of a Flegmatick Humour bred either between the Coats of the Eye or its Pannicles or Spots It ariseth also from an influx of Humours or is occasioned by some outward Action as a Blow or Fall or thick and fumid Vapours arising from the Stomach and so getting into the substance of the Brain are from thence sent and diffused into the Eye and at length do there contract its concretion It may arise also out of weakness and cold Celsus lib. 7. cap. 7. saith that there is a space or distance between the Cornea and the Vvea and in this empty space as he does imagine lodgeth this Cataract or Suffusion and there takes its Origination Paulus lib. 6. cap. 21. saith that a Suffusion is a Concretion of an idle or sedentary Humour in the Cornea near the Pupilla but this carrieth not so full a measure of truth as the former Galen 10. de usu partium cap. 1. 4. offereth that this Humour doth grow between the Cornea and the Crystalline Yet Fabritius ab aqua pendente doth affirm that in the three persons which he hath couched and that in all People which he hath seen use the same Operation the Needle hath been applied backward under the Vvea before the Suffusion would appear and therefore it is probable as he mentioneth that behind the Foramen of the Vvea this Humour should consist because if it did grow in its Circumference it could not be dilated Where this Cataract is confirmed and comes to maturity we may with ease perceive the thin Membranes visited with a strange Species of a thin clouded Pupil variously coloured according to the diversity of Humours as sometimes with white or black or blewish yellow red or green and by these or any of these the Eye is oft times clouded and deprived of its sight If it do possess half the Pupil it takes away but half but when it creeps and overcasts the whole it doth cause perfect blindness It s Cure is to be begun with a good order of Dyet and convenient Medicines and Instruments artificially prescribed and applied Abstaining from Wine and such hot things as may disturb the Brain Shunning flegmatick Dyet and such as is of a flatulent and pituitous Juice If the Patients Bread have some Fennel-seed put into it it will be so much the better for this is generally reputed not only to help the sight but also is very advantagious for dissipating of cloudy Vapours Bleeding Purging Frictions are here very useful Masticatories chewed in the Mouth are proper Cupping Glasses and Vesicatories applied to the Neck and Shoulders are here also very requisite for Derivation Pills and Potions for purging the Head of these flegmatick Tumours are wonderfully helpful For Purging Means or Methods take some of â„ž Pil. Sine Quib. ℈ i. Pil. de Cynogloss ℈ iss Ol. Faenicul gutt iij. cum syr Betonic q. s fiant pillulae Or these â„ž Alo. optim â„¥ ss Turbith gummos Hermodact Agaric recent trochiscat an Ê’ij Diagrid Ê’i ZZ Caryophyllor an ℈ ss Croc. Sal. gemm an gr vij pulverisentur cum Syrup de Staechade q. s fiat Massa pillalar hujus sumat à ʒss ad ℈ ij c. A potion for the same â„ž Sen. â„¥ ss sem Anis Caryophyllor an Ê’ss fol. Menth. Betonic an M. ss Summitat Thym. Paralys Anth. an pug ss coquantur ad â„¥ iiij colaturâ infunde Agaric recenter troch ℈ ij Cinamom Ê’ss misce fiat potio For outward Medicines there are innumerable by most Authors already mentioned amongst the best of them all may be reckoned this very oft times used by my self with good success â„ž Succ. Haeder terrestr Chelidon Bellid an â„¥ ss Aqu. Rosar albar. â„¥ i. pulv Sacchar condit albissim Ê’ss Mix these and being made lukewarm let the
it does continually flow An Imbecillity of the Testicles does give another great suspicion hereof Another Cause amongst some is attributed to Coition with a Menstruous Woman Oft times it happens by overstraining the inward parts a thing very frequent in snch who being in their Drunken fits do act beyond their power of Reason If the Seed therefore which is thus thrown forth be pure and is not in any respect tinged with any strange quality and is void of all fetid smell this either does shew and express a plenty thereof or a weakness of the Retentive Faculty or Convulsion of the Spermatick Vessels But if it be accompanied with any other vitious Humours and furnished with thin ill Juices and appears with another colour strange to its own proper nature and yieldeth a smell which sheweth no good Concoction this first of all does calefie and by its acrimony does corrode pricketh and invadingly ulcerateth And this Ulcer does much differ from that which exerciseth it self in the Bladder and thus may with ease be distinguished where the Neck of the Bladder is ulcerated the pus or Matter does as it were compactly precede the Urine it self and the pain between making water is most mightily sharp about the ulcerated part On the contrary the Bladder it self being ulcerated there is no pain felt nor Matter pissed forth secreted by the Urine but cometh along with it The Urine does yield a strange strong smell where the Bladder is affected with an Ulcer When the Urinary passage is ulcerated the Yard is very painful and heavy and bendeth downwards An Uâ—â—er contracted in the Neck of the Bladder or in the cavity of the penis unless it be both speedily and knowingly cured does convert it self into preternatural Caruncles by which the Urinary passage is obstructed For as out of most pure Blood the best Flesh is generated so also vicious Juices enwrapping or keeping company with the Ulcers there is oft times seen a spongious Flesh to grow and breed And therefore when we have arrived at the sure knowledge that this unnatural Guest hath made his entrance into these quarters which we may speedily find out by the search of a Candle and to gain advantage of this Disturber of the Humane peace we ought if Plenitude be a main wing of its vigour to discharge this by Evacuation And here let the Patient use a thin Diet if the Juices be sharp and thin thicken them so as that they may give strength to the Spermatick Vessels if we do here find or meet with any weakness strengthen them And for clearing this Method observe with me these Curative scopes First loosen the Body with emollient Clysters made of Mallows Violets Pellitory Lettuce French Barley and the like adding thereunto Cassia in the end After this breathe the Basilick Vein 〈◊〉 the right Arm. These two being premised let the Thighs be washed with a Decoction of Red Roses French Barley Violets red Poppies and the like Let the Kidneys Spine and Testicles be cooled with this â„ž Vnguent Rosat Refriger Galen an â„¥ j. ol Violar â„¥ ss pulv Rosar rubr Santal Citrin Spod an Ê’j Camphor grâ—iij Acet Rosat gutt aliquot As to the part affected deterge it first with a Decoction of French Barley in which have been put some Mel Rosarum this being made lukewarm is by a Syringe to be injected into the Yard Then produce a Cicatrice with this following â„ž Aqu. Rosar Plantag an â„¥ iiij Sacchar candit â„¥ j. Ceruss Lithargyr aur Alumin Roch. an Ê’iss Camphor ℈ ss misce fiat injectio Trochisci albi Rhasis do here also very well but if you have a mind to dry more powerfully adde to the former a little Aegyptiacum Shun all strong Diureticks which may force or drive the Humours to the ulcerated parts and such things are especially to be used which have a quality in them to lessen the pain For this purpose Lac Amygdalatum is very good A Hyposarcosis in the Neck of the Bladder or in any part of the Urinary passage may be collected out of the great difficulty of Urine the which comes not onely out by drops but by forcing and endeavour to perfect this So that sometimes upon a great straining while the Patient makes water he hath a Laxity joyned with it Neither can that Urine come right which hath its passage obstructed by a Carunculous Flesh Neither doth it easily come forth unless it be compressed with the Hand Oft times there is seen such Obstruction that unless the Catheter be called in use there 's no coming forth of Urine to be expected There is a twofold Method in curing of a Caruncle of the Yard the one is performed by Instrument the other by Medicine A Fomentation for this purpose may be this â„ž fol. Malv M. j. rad Alth. Ap. Faenicul an â„¥ iij. sem Lin. Cydonior Foenugraec an â„¥ j. fl Chamomel Staechad Melilot Puleg Origan an pug ij Caricar pingu â„¥ iss coquantâ—r omnia usque ad radicum dissolutionem cum hoc foveatur radix penis Or else dip Sponges herein and apply them to the part affected After it is thus fomented it is to be absterged with such an Unguent as this â„ž Vnguent Dialth Agrip. Oesyp Butyr an â„¥ j. ol Amygdal dulc Lilior albor Chamomel an â„¥ ij Ammoniac â„¥ iss Succ. Ap. â„¥ iij. Mucilag semin Foenugraec rad Alth. Lin. an â„¥ ij boil them all untill the consumption of the Juices then adde the Fat 's and strain it off and to the strained Matter adde a little white Wax Here also are you to make use of searching Candles made of white Wax And for this Affect a Leaden Probe is excellent good for that whereas besides that it is an Anodyne so also hath it a very drying faculty When these fail we come to the use of a Catheter but this without a very respective care and steddy hand does very often occasion strange Hemorrhagies and so thereby doth frequently bring fear both to the Physician and the Patient But should such a Flux as this appear this may with ease be stopped by injecting into the Passage with a Syringe some Plantane water and Rose water to which the White of an Egge should be added Here also are you to mind how upon applying your Candle what part thereof is either bent or bruised or compressed for upon this part is to be applied your Medicines you intend to use and for this purpose Philips Emplaster is reputed to be a most excellent and sovereign Medicine in this Affect because it healeth the adjacent parts and keepeth them whole and safe but that which grows with the Ulcer it taketh away without pain This is its description â„ž Aerugin Auripigment Chalcat Alumin Roch. an â„¥ ij his adde Acet acerrim perfus inter duos marmoreos fiat pulvis subtibissimus exponantur Soli. Then put it into fresh Vinegar again after dry it as formerly let this be done for 8
crooked Needle you are to make a Suture according to the length of the whole Dilatation in the dilated Vagina drawing a thick and strong Thred the inward Vessels of the Seed inwardly remaining safe and entire through the Coat is to be agglutinated without extraction or hurting of the Testicles then let the Patient be put to Bed and after this apply such things as are agglutinative then induce a Cicatrice and keep your Patient well trussed The fourth and last Method is performed the Emperical manner and this is with Extraction of the Testicle a way very useless and dangerous It is thus repeated by Paulus cap. 65. lib. 6. The Patient being placed with his Head downwards the Intestine being reduced part of the Abdomen being compressed by an Assistant and the Patient being bound make an oblique mark in his Groin after this make a deep Incision so that the Testicle may come forth with the Spermatick Vessels the which the Chirurgeon having in his hands let him separate all the Coats and draw forth the Testicle through the same Orifice all the other parts being taken aside with small Hooks let them be sown together or tied after this above the place tied take them off and with an hot cauterizing Iron being there instantly ready cauterize the mouths of the Vessels hereby hindering all Flux besides which you will find the parts sooner agglutinated the which being done they leave a long Thred remaining applying Digestions inwardly After this they make a Cavity in the Scrotum and there applying a Digestive they use Butter to which they adde Frankincense the Yolk of an Egge and a little Turpentine then they study the generation of Flesh with Basilicon Aureum Vnguentum de Betonica or the like and induce a Cicatrice with dried Lints and Unguents Diapompholigos Diapalma Desiccativum rubrum c. I shall conclude this Chapter with a History of Hildanus who writes of a Gentleman which for many years was troubled with an Intestinal Rupture distended by Wind having a great pain of his whole Belly continual Vomiting Watchings Restlesness adjoyned to it for whom this Clyster was first administred â„ž Rad. Alth. Malv cum toto fol. Violar Parietar fl Chamomel Melilot Sambuc an M. j. sem Fenugraec Lin. contus an â„¥ ss sem Anis Foenicnl Caru Cumin an â„¥ j. incidantur contundantur omnia postea indantur in sacculo ejus magnitudinis quâ totum Scrotum cooperiri possit the which being sown up boil it in twelve pounds of Water Take of this Decoction lbj in which dissolve of Electuar Diacatholic â„¥ j. Vitel. Ovor. n. ij Butyr recent ol commun an â„¥ iij. misce fiat Enema After the Bag being pressed out apply it to the Scrotum and this repeat very often by dipping it into the Decoction and so pressing it out and applying it warm Within half an hour after the Clyster was injected there was administred the same Decoction by which the Scrotum began to grow lax and the Patient being put into his Bed with his Head placcd supinely or downwards and his Feet upwards his Intestine was reduced and for keeping it in its place he applied to the Scrotum this following Restringent Bag â„ž Rosar rubr Absynth vulgar prunor sylvestr Caud equin fol. salv Mosc Quercin an Mss Cort. Querc â„¥ ij sem Foenicul Anis an â„¥ j. incidantur contundantur postea indantur in sacculo which is to be sowed up and boiled in red Wine and afterwards applied The day following he prescribed this Purge â„ž Rad. Foenicul Petroselin Gramin Polypod Querc an â„¥ ss herb Agrimon Veronic Cuscuth an M. ss sem Anis Foenicul an Ê’ij fol. Senn. mundat â„¥ ss coquantur ut colatura redeat ad â„¥ iiij in quibus solve Electuar Diacatharm Diaphaenic an Ê’iij aqu Cinamom Hordeat â„¥ ss misce After this was applied Emplastrum ad Herniam and a convenient Truss and by these Helps and Remedies he was perfectly cured CHAP. LVII Of Epiplocele or Hernia Omentalis THis 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 so called by the Greeks from Epiploon or Omentum may happen in either side of the Scrotum and may not very easily be reduced This Rupture is occasioned by the Dilatation of the middle Coat onely not because of the Peritonaeum being rent by reason no great part of the Omentum descendeth it being annexed to the bottom of the Ventricle Colon and Spine This therefore is chiefly generated by the Coats Dilatation especially the Omentum being armed with Fat which gives a more easie cause to this Relaxation and Dilatation although not to its Ruption Signs of an Omental Rupture are these the Tumour is always the same unequal to touch soft and slippery in respect of its Fat it lieth more in the Os pubis than in the Scrotum and is small in Tumour Its Curative Scopes are two to reduce the Omentum inwards which is performed by the Hand and to hinder its exition and this is done by Pharmacy And because this Dilatation generally is occasioned by Moisture or the Fat relaxing this Rupture therefore Restrictives are the most proper Medicines in this place required and here take Aquapendens his Emplaster â„ž Alo. Malicor in vino austero elixat succ Hypocystid Thur. glutin fabror an partes aequales gluten passo incoquatur ad integram dissolutionem post teratur in mortario caeâ—era addautur As touching the rest this Cure dissereth not much from an Intestinal Rupture and therefore Trusses Caustick or Incision may upon occasion be used observing Celsus Rule lib. 7. cap. 25. If a small part of the Omentum descend this may properly be reposed but if a great part this is to be burnt or dealt with so that it falleth off yet this is not to be attempted very readily because this Rupture is seen very often beyond expectation cured I shall shut up this Discourse with two or three pleasant Histories very convenient for this purpose and matter Hollerius relates of a pious youug man who died Ileous from a Prolapsion of the Ileon with the Omentum into the Scrotum the which Body being diffected the Ileon was wholly found gangrenated by reason of Inflammation which was conceived to be by this Prolapsion Columbus lib. 15. Anatom writes he saw above a pound of Omentum in the Scrotum Jacobus Oetheus lib. Observat propr writes of a young Gentleman who having been troubled with an Inguinal Rupture and the Intestines oft times falling into the Scrotum he at length found somewhat else fall into it also it being no part of the Intestines but the Omentum which swelled the Scrotum at this rate and the Signs hereof were he had neither Cholical Pains nor Motions nor Fever nor Obstructions of the viscera That part of the Omentum which was lapsed by application of convenient Fomentations Emplasters and Ligature to the part affected they were well reposed the Patient soon felt ease and in process of time
living beyond the fourth I shall conclude this Chapter with this History related by Petrus Bayrus lib. 20. cap. 8. of a Woman which had a Pestilential Tumour bred behind her Ear and he being sent for about eight hours after it was perceived it grew into a large Bulke in that time with much pain the pain afterwards began to cease but the Venome descended to the Heart and did horribly trouble and vex it neither could she beleive herself to live an hour being by his directions ordered to smell to Vinegar and Rose-water after this she was bled on each Cephalick first Breathing a Vein on the contrary Side then on the distempered Side Then was there applyed a large Ventose to the Part affected with a deep Scarrification reiterating its application And when there was drawn near half a pound of Blood by this Ventose the Patient began to find her self somewhat better and to have some hopes and found manifestly that the Venome receded from her Heart by these Frictions Odours Cordial Powders and Potions and the like that by Divine Blessing and help of these Remedies she perfectly recovered Hollerius saith live Oysters being applied to Pestilential Buboes do attract all the Venome from them CHAP. LXV Of Phyma and Phygethlon IN cap. 1. lib. 2. ad Glauc Phyma is said to be a Tumour in a Glandule which encreaseth with some Vehemency and hasteth to Suppuration for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 agrees with all sorts of Tumours arising out of the Earth and these happen not only in the Inguens but very oft in the Axillaries for these Glandulous Bodies being very loose are the most apt to give Entertainment to all strange Appearances Fluxions and Tumours particularly in the Groins because of their depending Site strong Motion and humid Redundancy After here having prescribed a convenient Dyet and the general Method which we have already shown you in a Bubo we are to apply Digestives to the place affected and then Suppuratives and the Tumour being by these made ripe we are to discharge the Matter either by Caustick or Instrument and the rest of Cure perform as you have already directions in curing of a Bubo Phygethlon is an Inâ—lammation and part of Erysipelas or an inflamed Erysipelas and this you are to cure by Phlebotomy Purging and Diet. As touching the affected part you had better apply Digestives than Suppuratives because this Tumour hath a mixture of Choler and hence it is that Galen lib. 6. Simpl. doth praise Atriplex and the Leaves of Garden Mallows and a cold Cerate and is at length to be cured with mild Discussives Lusitanus Cent. 6. Curat 82. telleth of a young Gentleman troubled with a Phygethlon under his Axillary the which did spread to a very large bigness in process of time it grew soft and livid and so proceeded with Pulsation that both Physician and Chirurgion conjectured Matter to be lodged in it and therefore by a general consent it was opened but the Success was miserable for it was scarce opened but the Blood flew out impetuously with a great noise of Spirit upon which the Patient presently dieth with his inclining downwards and he speedily departed this miserable Life CHAP. LXVI Of the Hemorrhoides HEmorrhoid is a Compounded word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifies Sanguis and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 fluo and this is a Flux of Blood The Veins of the Anus onely gain the place of their dwelling and being or they are Tumours encompassing the Veins of the Anus excited by the great inâ—lux of Melancholy Blood resembling somewhat of a species of a Varix Some of these at certain times do open themselves and so do discharge and exonerate the Blood others there are that onely tumefie Some are hidden others more manifest Such as flow they pour out almost all Blood mixed with a yellowish Serum which is as a Vehicle to make its more speedy exit and by its acrimony does make a more speedy opening of the Vessels Such as do not flow do either lodge in some small Bladders and by some called Vesicales and these are made by the influx of Flegm and Serum resembling Grapes from whence they are called Vvales from the efflux of Bloud being laudable in quality but bred by a copious Redundancy They are different in their Magnitude some being large others small in their multitude some having many Orifices others few in their Figure some narrow some broad in their Colour some being of a blackish colour others more red in their Place some being in the Anus others in the Sphyncter others bordering upon the right Gut in their Constitution some being mild others more cruel and painful These Hemorrhoides arise as both the ancient and modern Anatomists allow from the Splenetick branch deducing its issue from the Porta produced downwards towards the Rectum and then carrid backwards to the Coccix and there to be inserted and propagated But from the Vena cava there are two Branches produced from the Os sacrum or Coxendix and sent to the Anus the one from the right the other from the left part the which are disseminated through the Muscles of the right Gut and Anus and do there constitute these Hemorrhoidal Veins here pouring forth their Blood and this is confirmed with good reason for the rectitude of the Vessels the Blood flowing downwards by its weight must necessarily fill its Vessels and being girt up or constringed being thus filled by the Muscles does make way for this Apertion And to give a better light to the well ordering and curing of both sorts let us make an exact Anatomical Inquiry about these parts These Hemorrhoidal Veins again have an Artery belonging to them to feed them this Blood first coming from the Porta to the Anus for from the great Branch of the Porta is this carried to the Spleen and thence through the Mesentery is it sent to the right Gut These Veins are onely two arising from the Cava and the Porta for this cause because these serve as do the other Veins of the Body for nourishing the parts with Blood and thus are the parts of the Anus nourished therewith This was a thing unknown to the Ancients and therefore it is necessary that the Melancholy Blood should this way be discussed for by this Passage onely is Melancholy best discussed and the Schirrus of the Spleen cured Besides these these also are by nature as Scavingers to cleanse the feculent Blood and make a sound Body and when therefore she cannot perform these we make our speedy address to Phlebotomy and the Evacuations thus made we daily find to yield great comfort and ease to the troubled Patient Besides these not being kept open a man having a great quantity of Melancholy Humour lodged in him the whole Body will hereby be less capable to undergo any other Method which may be prescribed And lastly in Malign Fevers being lodged in the larger Vessels and there putrefying the Blood