their Ears with Snow or have plunged as we may so say their almost frozen feet into cold Water or Snow And the same Fabricius in the place alleadged relateth That a Noble man of good esteem and reputation told him that when he travelled in those Regions he himself on a time lighted upon one travelling as he was upon the Road whom finding to be stiff with cold and almost dead he caused to be put into a Cart and having brought him into an Iune his Host the man of the house immediately plunged him over head and ears as we say in cold water which was no sooner done but instantly there issued forth from al parts of him a kind of frostiness in such a manner that his whol body seemed as if it had been al over covered with Ice like as with an Iron shield and then he gave him to drink a Cup of Hydromel putting thereinto the pouder of Cinnamom Cloves and Mace upon which he fel into a swear in his Bed and soon after the sick person returned unto his former state and became perfectly wel recovered The Cure When now the said congelation is asswaged and qualified and the cold for the most part extracted and drawn forth or else hath exhaled of its own accord which is known by this that the pricking pain is much moderated if not quite ceased then the part is to be fomented and cherished with sweet Milk made blood warm in which there have been boyled Rosemary Organy Sage the Leaves of Rue and Bayberries It wil be likewise very commodious this being a remedy that is also very wel known to thrust deep into warm Water in which Rape Roots especially those that were formerly congealed and frozen with cold have been boyled the Hands or the Feet Or Take White Wine one pint Allum an ounce boyl the Allum with the Wine and let the part be wel washed therewith the Decoction also of Lupines is good and helpful and after it let the part be anointed over with Honey in which live Sulphur hath been boyled This is likewise very efficacious Take of the Oyl of Bayes two ounces Honey one ounce Turpentine half an ounce Mingle c. Or Take Turpentine unsalted Butter and Mace of each alike and what you please for the proportion Mingle them c. Or else Let the part be anointed with Oyl of Wax If the part be already exulcerated Allum poudered and mingled with a like portion of Frankincense pondered likewise is very helpful and wel approved of a little Wine being thereto added or the Oyl of Roses boyled in a Rape Root or in the Reddish Root made hollow and the pith taken al out and then squeezed and pressed forth Or else let an Unguent be made of River Crabs burnt with Honey and the Oyl of Roses Or Take Rue the Marrow of a Bull the Vnguent of Roses of each as much as you think fit mingle them c. Or Take Wax the fat of a Hog of each an ounce Litharge of Silver or Lead ten drams the rind of the Pine two ounces of Manna thur is one ounce Oyl of Roses a sufficient quantity Make an Vnguent Chap. 16. Of the Tumor Ecchymoma THere is likewise somtimes poured forth blood the Skin continuing stil whol and sound into the spaces of the parts from whence there ariseth an Affect which by the Greeks is termed Ecchymoma or Ecchymosis and by the Latines Effusio Suffusio Sugillatio For an Ecchymosis is nothing else but Chymeon ecchysis that is an Effusion or pouring forth of the Humors to wit the blood into the next adjoyning spaces by reason of the opening of the Veins to wit if the Skin abiding whol the Veins pour forth that juyce which they contain that is the blood as Galen speaketh in his second Book of Fractures Comment 16. and either the orifices of the Vessels gape which happeneth in an Anastomosis or else the blood doth as it were sweat forth and strain it self out through the Tunicles of the Vessels being rarefied which the Greeks cal Diapedesis or else by contusion the Vessels are loosened which chanceth if one fal from an high place or else be oppressed and over laid by the weight of somthing that is heavy lying upon him or else be smitten and hurt with a club stone stump of a Tree or else lastly that by some violent motion and extension a Vessel be broken Then the Skin remaining who the blood is poured forth into the neer adjoyning spaces whereupon the color of the part is changed and at first indeed it seemeth reddish afterward it becometh Leaden colored then yellowish green blackish whereupon it is that Galen in his Book of Preternatural Tumors Chap. 10. and tenth Book of the Composition of simple Medicaments Chap. 9. maketh two species of this Ecchymosis one which by the general name he calleth Ecchymoma when the part obtaineth a middle color betwixt red and black which indeed may properly be termed Pelidna that is of a livid or leaden color and the Affect may likewise be called Livor to wit paleness or wanness the other he termeth Melasmata that is blacknesses which latter are especially familiar unto old persons as often as their Veins are bruised or opened upon any other cause and these happen upon any smal or sleight occasion like as on the contrary Pelidna and Livores befal Children and those that are young and Women and such as are of a white color But now although oftentimes and indeed for the most part the part is not lift up into a Tumor or Swelling but the Blood poured forth doth so insinuate it self into the spaces of the parts that there is no Tumor at all appearing yet notwithstanding somtimes the part doth swell up if there be great store of Blood poured out and this also is now and then wont to happen after Venefection to wit if the whol Vein be smitten or if the Wound that is in the Skin shall be closed up but that which is in the Vein it self left open and unshut For from hence by that Wound that is in the Vein the blood is poured forth for which when there is no issue or passage open the Wound in the Skin being closed up it is oftentimes under the Skin poured out into the whole Arm and somtimes it exciteth also a certain swelling but however it alwaies dyeth the Skin of a Red and livid or leaden colour Ecchymosis But the Affect is various and different and the Ecchymosis ariseth in a different manner since that the blood is not evermore poured forth without the Veins but oftentimes by reason of the great abundance of the Spirits and Blood the Veins and Arteries that are terminated in the Skin are filled full of blood and thereupon the Body becometh coloured as appeareth out of Hippocrates Epid. 2. Sect. 4. in the end thereof where he writeth thus That all diligence and care must be taken that the passion and anger of the Mind may be
beyond Natures intention and hath its production from somwhat that is preternatural and comes to be adjoyned to some one or other part Nor is it of any validity what Rudius here objects That in Tumors which have their original from the humors and those likewise which have for their causes the strutting forth and falling down of parts and such like that there the difference is to be taken from the efficient next and containing cause and that from this cause we may gain excellent artificial and profitable Indications but not so from the consideration of magnitude augmented For albeit they differ in the containing special cause that this is now and then an humor somtimes above and somtimes also an Intestine or Gut fallen down yet in the general cause they agree which is some one thing or other preternatural added unto the part and swelling it up into a Tumor And in every Tumor as it is likewise in al other diseases depending upon the cause containing no profitable Indicacion can be gained or may be expected from this cause no not in those Tumors which have their dependance upon the influx of humors For the general Indication though it be altogether useless is this that the humor which lifteth up the part into a tumor is to be removed but how and by what means this may be effected is wholly left unto the skil of the knowing Artist In the mean time I wil not deny but that those tumors which have their original from the humors may fitly enough be ranked among the diseases that are compounded of augmented magnitude distemper arising from the afflux of matter and a vitiated figure yet however this is not to be granted in al Tumors And hence it is without doubt that Galen hath placed the Tumors one while amidst the Affects of the similary parts as in the twelfth Chapter of the difference of Diseases and assoon again among those Diseases we call organical and this he doth in the thirteenth of his Method and first Chapter Neither is it to be denied That now and then Authors whilst they make mention of preternatural Tumors do not intend al Tumors in general such as are also those that are produced by the falling down of the bowels or by some boney substance sticking out but those in special which are caused by the afflux of humors and these are evermore diseases that may properly be said to be compounded of magnitude augmented intemperies an unmeet figure and most usually also the solution of Unity The Cause The containing Cause of a Tumor as we take it in the general is somthing beyond Natures intent added unto a parâ— which elevates distends and swels it up to a more than ordinary greatness The Difference Now the matter which we say is added being threefold to wit a Humor a Wind and a solid Substance the primary Difference then of Tumors ought to be taken from that which we commonly term the Containing Cause Tumors then are somtimes thus differenced that some are great others not so some external some internal some new others that are of longer standing But these differences are meerly accidental denoting a certain mutation or change and an alteration of the condition but the species oâ— kinds they vary not in the least But the differences specifical and which constitute the several kinds are taken from the matter and the containing Cause which is threefold as hath been said First of al therefore Tumors derive their very being from the humors but these as yet have not obtained any peculiar appellations to be called by but at leastwise are al of them comprehended under the general name of a Swelling yea as some say they are only called Tumors Secondly Winds it shut up in any part distend the same and lift it up into a Swelling or Tumor and this sort of Tumors the Grecians cal Emphysemata the Latines Inflationes by reason of their windy original In the third place now and then somwhat resembling flesh or skin or that is hard and solid as a bone and other such like matter is super-added unto some one part and there causeth a Tumor or Swelling But in regard that these very substances have their original from the humors we will thereupon adjoyn this sort of Tumors unto the first kind And lastly even the very solid parts of the body themselves cause Tumors whenas they change their place together with their scituation and slip down upon some other part which they both distend and elevate neither have these any peculiar names to be known by There are yet some other differences behind From the quality of the concomitant matter some are said to be hot others cold some moist others dry some soft and loose others hard From their magnitude the greater of them are by a general name simply called Tumors the less Tubercula From their scituation that some are internal others external and these again either more deep and profound or else superficial From their figure some of them are said to be broad others again sharp-pointed But now to comprehend al those differences of Tumors under names and to give you the number of them is not very easie to do Galen in the close of his Book of Tumors writes That there was not any one kind of these preternatural Tumors which there he had omitted but that he had spoken of them all and had not left any one unmentioned And out of that Book Johannes Philippus Ingrassias in his Book of tumors first Tract first Chapter and second Commentary pag. 77 hath collected Sixty one Tumors which he reckons up in this order 1. Corpulentia 2. Phlegmone Tumors their number and names according to Galen 3. Abscessus calidus 4. Sinus 5. Fistula 6. Abscessus ex solidis humidisve corporibus that is to say an impostumated matter issuing from solid and moist bodies 7. Atheroma 8. Steatoma 9. Meliceris 10. Anthrax 11. Cancer 12. Gangraena 13. Sphacelus 14 Erysipelas 15. Herpes similiter 16. Herpes Esthiamenos 17. Herpes miliaris 18. Scirrhus 19 Ecchymosis 20. Aneurisma 21. Oedema 22. Phagedaena 23. Vlcus Chironium seu Telepium 24. Scabies 25. Lepra 26. Elephantiasis 27. Exostosis 28. Satyriasmus seu Priapismus 29. Achor 30. Cerion 31. Myrmecia 32. Acrochordon 33. Psydracion 34. Epinyctis 35. Dothien 36. Phyma 37. Bubon 38. Phygethlon 39. Struma 40 Sarcocele 41. Hydrocele 42. Epiplocele 43. Enterocle 44. Entero epiplocele 45. Cirsocele 46. Varices 47 Bubonocele 48. Exomphalos 49. Ascites 50 Tympanites 51. Anasarca 52. Epulis 53. Parulis 54. Thymus 55. Vva 56. Paristmia 57. Antiades 58 Polypus 59. Encanthis 60. Vnguis 61. Staphyloma But Ingrassias himself not content with this number Tumors their number and names according to Ingrassias Tumors of the Head are twenty seven adds unto these one hundred sixty five more to wit of such properly belonging unto the head twenty seven the which in page 301. he enumerates after this manner 1.
Eczesma 2. Elcydrion sive Papilla 3. Sycon that is a Fig or pushes in the head resembling it 4. Exanthema that is an Ulcerous blowing out like a flower 5. Ganglion 6. Hydrocephalus 7. Syriasis 8. Phrenitis 9. Lethargus 10. Typhomania seu agrypnon coma 11. Catochus Pauli 12. Catalepsis seu Catoche 13. Carus 14. Apoplexia 15. Rhia alsabian 16. Sibare 17 Fatera 18. Sekakilos 19. Testudo 20. Talpa 21. Topinaria 22. Lactumen 23. Cornu 24. Alopecia 25. Ophiasis 26. Pityriasis 27. Phthiriasis Those properly belonging to the Eyes and the parts thereof Tumors of the Eyes and their parts 63. sixty three which in page 351. he reckons up in this order following 28. Proptosis Galeni sive ecpiesmos Pauli 29. Taraxis 30. Ophthalmia 31. Epiphora introductorii 32. Chemosis 33. Xerophthalmia 34. Sclerophthalmia 35. Scirrhophthalmia 36. Phlyctaena 37. Bothrion 38. Coeloma 39. Argemon 40. Epicauma 41. Encauma 42. Myocephalos 43. Melon 44. Clavus Pauli et Aetii 45. Clavus introductorii Celsi 46. Hypopyon 47. Onyx that is Vnguis a Nail 48. Hyposphagma 49. Achlys Aetii 50. Nephielion Aetii 51. Vla or Nephelion 52. Leucoma 53. Sebel 54. Bothor Avicennae 55. Hymene panastasis 56. Nyctalopia 57. Anthracâ—sis 58. Carcinoma 59. Synchysis 60. Mydriasis 61. Proptosis Pauli 62. Ptylosis 63. Madarosis or Milphosis 64. Pladarotes 65. Emphyspma 66 Symphysis or Ancylosis 67. Eutropion 68. Laâ— ophthalmos 69. Trachoma 70. Sycosis 71. Tylosis 72. Dasyma 73. Pachytes 74. Barytes 75. Hydatis 76 Psocophthaâ—mia 77 Truhe 78. Thalazion 79. Porosis 80. Litâ—iasis 81. Alanâ—isac 82. Sude Avicennae 83. â—arcosis 84. Lupia 85. Mydesis 86. Pustula Abenzoaâ—is 87. Scleriasis 88. Anchilops 89. Aegylops 90. Epinyctis Plinii And 〈◊〉 these he mentions many more in other parts Tumors in all other parts of the Body 97. to the number of ninety seven and in this following order he sets them down 91. Auritus 92. Parotis 93. Pherea 94. Ozaena 95. Sarcoma 96. Theluâ— Albuc 97. Alharbian Avicennae 98. Chaisum Arabum 99. Haemorrhoides Arabum 100 Batrachos 101. Glossomegethos 102. Ancyloglosson 103. Aphtha 104. Cynanche 105. Paracynanche 106. Synanche 107 Parasynanche 108. Gongrona 109 Folium 110 Bronchocele 111 Alhadal 112 Dionysisci 113. Hypopion 114 Jonthi or Vari 115 Montagra 116 Ephelis 117 Ignis sylvaticus 118 Noli me tangere 119 Buttizaga 120 Gutta rosacea 121 Sparganesis 122. Chondriosis 123 Trichiasis 124 Gynaecomaston 125 Pleuritis 126 Peripneumonia 127 Phtoe 128 Althahalop 129 Napta 130 Cyphosis or Cyrtosis hybosis 131 Lordosis 132 Scoliasis 133 Coeliacus 134 Aurys Rasis 135 Colica 136 Hâ—os 137 Condylomata 138 Haemorrhoides 139 Marisca 140 Hepaticus 141 Cachexia 142 Altherel Bellunensis 143 Thelegi 144 Altherbel Bellunensis 145 Splenicus Aureliani 146 Nephritis 147 Lithiasis 148 Satyriasmus Pauli 149 Cercosis 150 Mola 151 Nymphomegethos 152 Kion Hippocratis 153 Seliroma Pauli 154 Arthritis 155 Podagra 156 Cheiragra 157 Ischias 158 Lupia Guidonis 159 Tophi 160 Cornua Avicen 161 Ancylosis or Ancyla 162 Paâ—onychia 163 Pterigion Celsi 164 Condya 165 Perniones 166 Gemursa Plinii 167 Dentes muris Bellunensis 168 Alliathan 169 Lupus 170 Dactilia Haliab 171 Malum moriuum 172 Terminthos 173 Emphysema 174. Phlyctaena 175 Turmusios Avicen 176 Impeâ—go 177 Essere 178 Palmos 179 Clavus 180 Calli. 181 Aegritudo bovina Abenz Albuc 181 Dracontium 183 Syrenes or Pedicelli Guâ—don Argelatae 184 Variolae 185 Morbilli 186 Rubeola 187 Crystalli 188 Exanthemata 189 Ecthymata Fernel 190 Hidroa or Sudamina 191 Epinyctis Romanorum 192 Bothon lenes 193 Ganglia 194 Seps Hippocr 195 Spina ventosa 196 Bubasticon Vlcus 197 Hypersarcon 198 Cacoethes 199 Sepedon 200 Nome 201 Therioma 202 Herpes Esthiamenos Celsi 203 Herpes ecthiomenos Avicen 204 Thymion Celsi 205 Ignis sacer Celsi 206 Cerion Pauli 207 Paratrimmata 208 Aposirmata 209 Zerma 210 Rancula 211. Spina 212 Morsus Diaboli 213 Patursa that is Morbus Gallicus 214 Scopuli 215 Tincosati 216 Pinitae 217 Spili 218 Tusius Aviceâ—â— 219 Eparma Hippoc. 220 Rosboth 221 Cunus Rasis 222 Albothir Albucasis 223 Nakir Albuc 224 Alchalan Abenz 225. Arcella Abenz 226 Rosulae sataritiae So that the number of all the Tumors recited by Johannes Philippus Ingrassias amounts unto two hundred twenty six But that Entities should be multiplied in this manner without any cause is altogether unfitting For as al the affects which are here reckoned up under the name of Tumors are not properly to be accounted Tumors besides that one and the same Tumor is somtimes repeated under different names So again Ingrassias having not at this time compleated the remaining Sections of his Works concerning Tumors it is not sufficiently apparent what Tumors he would have us to understand under some of these names Now for the truth of this that I may give you an instance or two of what hath been said he reckons up among Tumors Sinus and Fistula Vlcus Chironium and divers other Ulcers But before or since Ingrassias who hath there ever been that hath taken the liberty or made so bold to enumerate among the Tumors that are properly so called such as are these following viz. Lethargus Typhomania Catochus Catalepsis Carus Apoplexia Lordosis Coeliaca affectio Colica Affectus hepaticus Splenicus and other such like Affects which relate either to Symptoms or the kinds of other Diseases rather than unto Tumors And in very truth many of the Tumors wherewith this Catalogue is stuft are not peculiar kinds of Tumors but only differences of their species according to the parts affected Tumors their Differences Now therefore we conceive that there are two main Differences especially to be heeded in Tumors one whereof ariseth from the variety of Causes and the other is by reason of the parts affected We have said before that the conteining cause of a tumor is threefold a Humor a Wind and a solid Substance Again the humors are various much different to wit Blood Phlegm Melancholy a black humor a waterish and wheyish humor and divers other thin excrements as also mixt humors and matter into which other humors degenerate and likewise malignant humors From the Blood there is caused an extraordinary Corpulency which the Greeks call Polysarcia and an Inflammation Their Cause containing There are likewise that refer a Gangrene a Sphacelus unto an Inflammation in regard that an Inflammation somtimes degenerates into them But because that a Gangrene and Sphacelus do very often proceed from other causes without an Inflammation and have not alwaies a Tumor to accompany them and are of neerer alliance unto Ulcers very usually degenerating into them we wil therefore treat further of them anon when we come to speak of Ulcers But with more right it is that unto an Inflammation we refer an Erysipelas or Rosa as it is commonly termed Bubo Furunculus Phyma Phygethlon Parotis Carbunculus Paronychia Perniâ—nes Ecchymosis as afterward from the special Explication of these Affects wil
further appear From Choler is produced Herpes and its differences From the Pituitous or Phlegmy humor proceeds Oedema From the Melancholly humor Scirrhus From black Choler Cancer From the watry humor Hydrocephalus Hernia aquosa But of the wheyie humor and the thin excrementitious matter called Ichores from which various less swellings by the Latines called Tubercula do arise there is a very vast difference and oftentimes these ferous and wheyie humors as likewise the salt and cholerick humors are mingled with other and from hence originally proceed divers Wheals or Pushes in the â—kin as to instance Psydrasia Vari Sudamina Spinyctides and Terminthi Essere Arabum Elcydria Scabies Lepra Graecorum Vitiligo Impetigo and Lichen Crusta Lactea Achores Favi Tinea with many other of the like Nature Moreover from the humors there is derived also a certain peculiar kind of tumors yet nevertheless differing from those we have hitherto made mention of in a twofold respect The former difference lies in this that it proceeds not from one single humor but from more to wit Phlegm I mean such as hath other humors Melancholly or Choler mixt therewith yet notwithstanding so that the cause conjunct may not any longer be said to be an humor but some other matter generated from out of those humors The later difference consists in this that the aforesaid matter is included in some one peculiar Membrane Tumors of this sort are Strumae and Scrofulae Bronchocele Ganglia Nodi Melicerides Atheromata Steatomata Testudo Talpa and Natta Out of the humors likewise where you are to understand such humors that degenerate into another matter take their rise and original those tumors which the intelligent Artist cals Polypus Pamela sub lingua bernia carnosa Verrucae Fungi and others the like There are moreover tumors that have their very being from malignant humors and these are Variolae Morbili Lepra as the Arabians or Elephantiasis as the Greeks name it Tumors Venereal of different kinds Bubones and pestilential Carbuncles From flatulency or windiness are derived Emphysemata as the Grecian Authors or Inflationes as the Latines call them and all other flatulent tumors whatsoever From the solid parts lying out of their proper places arise Hernia in the Cods and Navel when the Intestines fal down thither Epiplocele And hitherto also is to be reduced Aneurisma a tumor that hath its original from an Arterie dilated as in like manner Varix being a tumor from a dilated Vein From the Bones proceeds that which we term Exostosis and from the Vertebrae or turning Joynts of the Back when they stick out is caused Gibbositas like as in other parts also tumors arise when disjoynted or broken Bones slipping out of their own place happen to fal down thither But now those tumors receive various appellations by reason of the part affected of which enough hath been written already in its due place And moreover as concerning divers of these Tumors this is to be taken notice of that very many and that in most Countries have indeed been not a little infested by them and that they have been likewise as ordinarily cured of them but yet notwithstanding what the German Italian French Spanish and other names of several Nations are and unto what names of the Grecians Latines and Arabians they may fitly answer is not alwaies manifest which very thing hath exceedingly perplexed and puzled the studious Physitian in his perusual of Authors And of this also Johannes Philippus Ingrassias who took a worlâ— of pains in comparing together and explaining the Greek Latine and Arabian names extreamly complains as wil appear by what he writes in his Book of tumors Tract 1. Chap. 1. page 220 after this manner I cannot but exceedingly admire and withall greatly lament the so great unhappiness of our Age in the which we are evermore infested with divers and almost innumerable kinds of Diseases and day after day are sadly afflicted especially more with this kind of Tumor he here speaks of Dothien or Furuâ—â—â—lus by reason of an unwholsome and corrupt kinâ— of Dyet insomuch that questionless the Affect â—s most perfectly known but as for name it hâ—th none other than what is as obscure and as ambiguous unto most men as that of Epinyctis and Psydâ—acion so that hence we find it a business of the highest difficulty to discover the proper head of the Disease and the Method of curing it either in the Latines or the Greeks and Arabians themselves writing in the Latine Tongue Of the signs Diagnostick Prognostick and of the indications and Cure of Tumors in generall some there be that are wont to assert many things But in truth there is but very little that can be said as concerning Tumors in this manner that is generally considered but what for the most part is agreeable to certain species of them of all which we wil now speak in order and particularly in the Chapters following Chap. 2. Of Tumors arising from Humors in general THat kind of Tumors which is caused by the Humors is found to be most frequent and usual and therefore we wil treat of it in the first place The primary and nighest cause hereof is a humor elevating and raising up a part beyond Natures intention unto a greatness more than is ordinary Which said humor having for the most part a certain excess of qualities adjoyned wiâ—h it and thereupon becomes either hot or cold or moist or dry derives that quality unto the part affected the which quality since it differeth from the temper of the grieved Member must therefore necessarily excite in the same an unequal temper and hence it is that an intemperies or distemper is concomitant with a Tumor The Causes Now of the humors that cause these Tumors there is great diversity For both the Natural and preternatural humors whose differences we have already spoken to in their proper place excite Tumors hereunto belongs the matter that is wheyey and waterish filth and corrupt matter and all things else into which the humors degenerate and which are to be found in Tumors and yet are not in the number of the parts of the Body of which there is great variety Galen in his second Book to Glauco The variety of such things as are often found in Apostems and seventh Chapter writes that in Apostems there have been found to be substances conteined like unto Stones Sand Shels Wood Mud or Slime the filth of Baths the dregs and lees of Oyl together with many other such like resemblances And in his fourteenth Book of the Method of Physick and twelfth Chapter he further informs us that in Tumors have been discovered substances resembling Nails Hairs Bones Shels and Stones And that Worms also may be found in Tumors frequent experience testifieth Fallopius with others have seen such Tumors and I my self have more than once beheld the like Nicolaus Remigius in his third Book of the worship of Devils and first Chapter writes that
again forced unto some other parts until at length it come unto the weakest which is not able to expel these transmitted humors so that being here left they cause a Tumor For it cannot be that a Tumor should be caused by the matter transmitted and sent from divers places unless we grant as needs we must that there is a part which sends them a part receiving them and the passages by which the humors flow The parts do then transmit when the vigorous faculty by the quality or store of matter is incited to expulsion For unless the faculty were provoked it would never attemp this expulsion and unless it were strong and vigorous it could never effect it And this is likewise much furthered by the external causes exciting the fluxion to wit Heat which attenuates and dissolves the humors and cold that by constriction presseth the parts together and thereby causeth the greater afflux of the said humors Notwithstanding unto these two may be added also a third cause of the defluxion and that is a certain 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or violent issuing forth of the humor it self as usually it doth appear in persons that have the Dropsie where we find a water through its own weightiness descending into the Feet and Cods which motion notwithstanding is wont to cease in the night time but this would not be if the humor were expelled by Nature and not rather as in truth it is forced down by its own gravity Now as for the humors flowing together from elswhere the parts receiving they are received by such parts as are feeble and through their weakness altogether disposed for the reception of a fluxion For evermore the more vigorous Members send away that which is superfluous unto the weaker The weaker Members we account such as either have contracted a certain debility in their very first formation or being afterward hurt do contract unto themselves a kind of preternatural constitution or else they are such as Nature her self makes and intends for weak and so framed and constituted that they may the more easily receive the excrements of other parts such are the skin and the parts loose and porous For Nature that she might the better preserve the principal and more noble parts from Diseases hath purposely ordained in mans body some certain parts weak and feeble that so the principal parts oppressed and burdened with Humors might into them empty whatever is superfluous and burdensom and these as we have said are the skin and glandulous or kernelly parts And hence it is that the Heart transmits the peccant humors unto the Arm-pits the Brain sends them behind the Ears and the Liver thrusts them forth to the Groyns The parts ready to receive are al those that have any connexion with the part that transmits the humors and which have the passages through which the humors are conveyed alwaies patent and open but as for waies whereby to expel and drive them forth they are either none at al or otherwise such as are exceeding narrow and over streight or else lastly these passages are so scituated that they lie directly under the parts transmitting so that the conveyance of Humors unto them from the abovesaid parts is render'd the more facile and easie As for the waies and passages through which the humors run the passages by which the tumors flow they are either such as lie hid or else such as are open and very manifest For whereas the whol body is confluxile that is to say apt and ready to flow together hence it is that the humors have their fluxion out of one part into another by these occult or hidden passages So the Whey as we may term it being gotten in great abundance into the Abdomen or Cavity of the Belly commonly called the Paunch by these privy Passages descends into the Cods and the Thighs and lifts up the said parts even unto a Tumor or swelling the same which likewise very often happens in other parts Somtimes the humors assembled together betwixt the Skul and skin of the Head descend thence along under the skin into the inferior parts but very seldom and rare it is that from hence any tumors are produced But most an end those humors which excite and raise tumors flow through passages that are patent enough the Veins and Arteries But that we may briefly come to speak of the differences of Tumors arising from Humors the differences of tumors whence they are taken although very many of these differences are accidental yet notwithstanding those by which the tumors proceeding from humors are truly and properly distinguished among themselves are taken from the variety of the containing Cause or the Humor as an efficient cause producing the Tumor Now the Humors are divers Blood Choler Flegm Melancholly black Choler Choler adust and Whey From which likewise various sorts of Tumors are excited and caused And then again one while the humor exciting the tumor is as we use to say simple and sincere from whence also the tumor proceeding therefrom is said to be a pure tumor or assoon again divers humors concur to the making up of one Tumor and from hence the Tumors which we term spurious that is such as are improperly so called take their Original The Signs Diagnostick It is easily known whether the Tumor proceed from the falling down of any part and if this be not the Cause we may then safely conclude that the rise of it is from the afflux of humors unto the part affected But now whether or no the Tumor takes its beginning from congestion or rather from fluxion may by this be discerned to wit that those Tumors which are caused by congestion or the storeing up of humors are a longer while and by degrees arriving at their perfection neither take they up so much room in the part nor lastly was there any the least preceding cause or sign of a defluxion But now if the tumor be generated from a fluxion it wil be discerned by the presence of the contrary signs And certainly if so be there were not in the grieved part any foregoing pain or heat it manifestly shews that the said fluxion is caused by a transmission and not by means of an attraction like as on the other hand a preceding pain or heat of the affected part argues the Tumor to proceed from the attraction of humors For the Signs whereby to discern and understand the times take this advertisement viz. That the beginning of it is then when the part first of al is perceived to be distended and stretch'd forth The increment or growth when as the part appears now to be elevated into an indifferent big swelling and when the Symptoms that accompany al sorts of Tumors are evidently augmented The state or heighth of it is when the swelling and with it together al the symptoms are at their highest pitch The declination is then when both the bulk of the swelling and all the
any further enquiry thereinto we wil therefore make the more accurate search after thereby to find out the Cause of an Inflammation in this manner following There would be no Tumor at any time generated in any part of the Body were it not that either its substance as it were boyling over with heat is poured out or that from without some new substance makes its approach For there are but two only causes to be assigned of the augmentation of the bulk and quantity in any thing whatsoever For either the radical moisture through an internal or external heat is resolved into an aery substance which as it is wel known requires a far greater space room for dilatation then formerly it had or else as we said before some new substance is extrinsecally from some other place superadded thereunto Now therefore of necessity it is that one of these two causes must be present when as in that hot and burning Tumor which we commonly call a Phlegmone the part is lifted up into a greater bulk than is ordinary or agreeable to the intention of Nature But now that the fervency and boyling up of the natural moisture or the effusion thereof is not the Cause appears by this because that every thing that is poured forth and converted as it were into spirits when it is cooled it assumes again its pristine quantity and as we may so express it puts off and laies aside the Tumor as by common experience it is most apparent But as for the parts inflamed let them be never so vehemently cooled yet wil they never return into the former state and condition nor ever cast off the Tumor or Swelling Furthermore if by reason of the effusion of the part and its conversion into spirits a Tumor should be caused in the part inflamed then necessarily upon the incision of the part the spirit should appear which yet as we see is nothing so but that rather there follows an effusion of Blood and the whole place by its colour and the looks thereof seems altogether full of Blood It remains therefore that the accession of some new substance is the cause of a Phlegmone But now that this new substance is the Blood appears from hence to wit that the Phlegmone is exceeding red both within and without Now this red colour is only proper unto and inseparable from the Blood Blood the nighest cause of an Inflammation for there is nothing that waxeth red in the Body beside the Blood and the Flesh which later notwithstanding viz. the Flesh cannot by any means be the cause of a Phlegmone For if the increment of the flesh were the cause of an Inflammation there would be indeed a Tumor or Swelling in the part yet so as notwithstanding the internal heat should remain sound and in an healthful plight without the least distemper and that also it should not in the least vary its pristine nature when as in no one thing that is augmented according to its substance the heat may properly be said to be heightned and encreased so far forth that the increment of the substance and quantity should any way differ from the change or alteration of the qualities But now the case is otherwise in a Phlegmone wherein the colour is changed and the heat grown to be more intense the said colour evidently demonstrating not only the quantity but likewise the quality of the substance Moreover that the Blood is cause of a Phlegmone may be manifestly evidenced by this that the place in the greatest Inflammations especially which now and then happen in Ulcers appears and seems all bloody round about which certainly would never be if blood were not the cause of the Inflammation Furthermore that Blood is Cause of the Inflammation that generating of the Inflammation which happeneth in Wounds doth evidently demonstrate For in new and fresh Wounds the Blood its true at the first flows forth but then afterward being compressed and kept in either by the hand or else with Ligatures or Medicaments that stop the issuing forth of blood or else lastly being suppressed and staid of its own accord it is then reteined either in the Orifice or Cavities of the dissected Vessels and there it is compacted and so wrought that it grows together like as clotted blood useth to do and there by a continued heaping up of the blood abundantly flowing thereunto it lifts up the part into a Tumor or Swelling and causeth an Inflammation An Inflammation what it is Since therefore the Conjunct Cause of an Inflammation is proved to be the Blood preternaturally flowing thereunto it is no hard matter thence to collect that an Inflammation is a preternatural Tumor of the fleshy parts as Galen in the place alleadged takes and understands the name of Flesh arising from the preternatural afflux of the blood and that therupon it must necessarily be hot red extended and accompanied with a kind of renitency or resisting property pain and pulsation or beating The manner how an Inflammation is bred But now that there may not be left to remain any the least obscurity about the nature of an Inflammation we will here add the manner also how a Phlegmone is generated and this we wil do out of Galen who in his Book touching the unequal Intemperies Chap. 3. hath in these words described it it is saith he a hot fluxion or flowing the which when it hath seized upon and seated it self in some muscelly part at first the greater Veins and Arteries are fil'd up and distended and next after them the lesser and so it is carried on untill that at length it arrives even at the least of them In these when the matter of the fluxion is forcibly impacted and cannot therein be any longer conteined it is then transmitted unto the outward parts partly through their own Orifices and partly by a percolation as it were and straining or sweating out of it through the Tunicles and then the void spaces which are betwixt the most principal parts are filled full with the fluxion And so all those parts or places are on all sides very much heated and overspread Those parts or Bodies are the Nerves Ligaments Membranes the Flesh it self and before al these the Veins and Arteries For whereas the Veins and Arteries run along unto each particular part by the which is received both nourishment and vital Spirit so long as the blood flows in a due measure and just proportion and is conteined within those its receptacles the part is not wont to suffer any Inflammation at all but then only when at the length the blood is overcopiously and all on a huddle emptied and poured forth into the substance of the part by the Veins and Arteries By which very thing also a Phlegmone is distinguished from other fluxions in which the matter is diffused without the Veins into the whole substance of the part and there doth distend and dilate it For in a Phlegmone although all the
parts are as I may so say embrued with blood yet notwithstanding there is a certain order observed to wit that some of the parts should sooner receive the fluxion and others of them not til afterward until that at length all of them come to be replenished and distended by the humor Now this kind of order wholly depends upon the natural distribution of the greater Vessels conteining the blood For whereas the Veins and Arteries when they first of all make their entrance into the aforesaid Vessels are evermore the larger and by how much the deeper they are distributed thereinto so much the less they are all this while there ariseth no Inflammation unless it so chance that the blood be emptied forth into those smallest Veins and again happen to fall out of them And this that hath been said manifestly appears unto those that by an exact and accurate inspection take a right view of those very little and almost imperceptible Veins that are branched forth and extended unto that Tunicle of the Eye which Oculists usually call Adnate or Conjunctive For these indeed do evermore convey blood unto the Eye for its nourishment and yet notwithstanding whilest that the Eye is free from distemper they are so exceeding smal that they can hardly be discern'd by the sharpest sighted Eye But then so soon as the Eye is inflamed those slender Veins are preternaturally replenished with blood then they shew themselves and become very conspicuous And it is most agreeable to truth that thus it should be also in al other Inflammations whatsoever they be But as yet there is no Inflammation present albeit the lesser Veins are even filled up with blood until that at length by and thorow them the blood be derived into the remaining substance of the parts which may be done two waies For in the first place the blood is emptied forth by those very smal and most inconsiderable orifices of the Veins by which the Veins do as it were gape open themselves into the surrounding substance of the part that so thereby the blood may through them the more easily drop forth for nutrition or nourishment Moreover likewise it strains and sweats through by the Tunicles of the Veins for even the Tunicles of the Veins are in like manner so framed by nature that they are not without their pores through which if not the blood it self yet certainly the ferosity or wheyiness thereof and its thinner part is exâ—udated or sweated forth by a kind of percolation From what hath been hitherunto spoken the distinction of the conjunct cause from the cause meerly antecedent in an Inflammation is sufficiently apparent For the blood which we have asserted to be the cause of a Phlegmone doth in a double respect take upon it self the virtue and Nature of a cause For either it is the next conteining and conjunct cause of which we have hitherto discoursed to wit as it hath already flown into the part and is irremovably impacted therein so far forth that it actually elevates that same part into a Tumor or else it is the antecedent foregoing cause to wit The antecedent cause of an Inflammation as by reason of its abounding in the body it hath a power of slowing into and by its influx of lifting up the part into a Tumor or Swelling The which antecedent Cause in an Inflammation like as also in other Tumors fals again under a twofold consideration to wit either in regard of the Affect simply considered as it is to follow upon this cause which it hath a power to excite although as yet it hath no being in the body And so a Plethory which is an extream and overgreat fulness of good and laudable blood is very frequently present in the body albeit an Inflammation doth not instantly ensue thereupon Or else secondly it is considerable as preceding and foregoing the affect that already hath a being and is already actually existent in the Body to wit when as the Blood now floweth to the exciting and augmenting of the Tumor Which to speak truth is more rightly stiled the antecedent cause then was the former since that this latter hath respect unto an effect already present but the former relates only unto an affect which hapneth in the future time But this antecedent cause that it may flow together unto the place affected it is thereunto moved and stirred up by other means whilst that it is either transmitted from some where else or else attracted by the part it self for those very causes we have hitherto been treating of and explaining But now for those Causes which we commonly term Procatartick The remote Causes more remote and primitive they are such as either conduce to the breeding of a copious and a plentiful blood as do al meats of good and much juyce an easie and idle kind of life and other such like requisites Or else they are such as render the blood more acrimonious and sharp as do all things that cause heat al acid and tart aliments wrath watchings stirrings and exercises in the extreme or else such as excite and stir up the blood to move unto the part affected as doth the overgreat heat of the part pain proceeding from a wound from a fall from contusion or beating from a fracture from disjoyntures and the like causes or else the weakness and imbecillity of the part affected receiving compared and considered in reference to the vigour and strength of those other parts which transmit the abundant store of hot blood unto the aggrieved part Notwithstanding an Inflammation never happeneth to be generated by a leisurely and gradual storing up of blood but it is evermore bred by a sudden and thronging affluence and influx of the said blood For although it may so chance that some kind of Humor may sensibly and by degrees be collected in some one part which being heaped up as aforesaid may afterward begin to excite a certain kind of pain in the part yet notwithstanding al this an Inflammation is never produced until such time as the pain gives cause sufficient that a more plenteous store of blood should forthwith and very easily make its approach Notwithstanding we are to take notice That although the Blood be the containing and antecedent Cause of an Inflammation yet notwithstanding we say that a Cacochymy or a depraved ill digestion and more especially sharp and cholerick humors are the prime and principal cause that the blood be moved unto the part affected in those Inflammations which are excited without any apparent cause as Wounds Contusions and such like For so it is That when Nature is twinged and pulled by such like Humors and yet notwithstanding is unable altogether to expel them out of the body to the end that she may free the principal parts from the danger impending by reason of them she assays to thrust them forth unto the external and less principal parts the which when it is not able to accomplish
about it The Prognosticks In an Inflammation there are two things that it mainly and principally behoves us to presage to wit The termination of an Inflammation Which is threefold its event or termination and then the exact and punctual time of the said termination Now the Event is said to be good when Nature overcometh the matter that breeds the Inflammation which hapneth when either the Tumor is resolved and the matter insensibly exhaled which is the best kind of solution of an Inflammation or else when the matter is suppurated and turned into that which we term Pus being a thick and purulent matter Or otherwise secondly The event may be said to be evil or if ye wil worst of all when Nature doth not overcome and master he peccant matter which hapneth when the Inflammation if it be external suddenly vanisheth and retires back to the internal parts or when the natural heat being overcome and extinguished the Member thereupon becomes putrified and seized upon by a Gangrene insomuch that if it be not forthwith cut off ruine and death it self threaten the whol body Or else in the third place there follows a Neutral Event as some cal it which is absolutely evil when the Tumor is hardened and when upon the resolution and discussion of the thinner parts the more thick and gross parts remaining behind the Inflammation degenerates into a Scirrhus But now which of these events is to be hoped for or expected may probably be guessed at by comparing together the vigour and strength of Nature with the matter that causeth the Disease For if the matter be not overmuch not thick not over deeply scituated not shut up under a hard and thick skin if the body be not greatly impure and Nature be strong then a resolution and an evacuation by an insensible transpiration may be hoped for But if the matter more abound be more than ordinary thick be contained in a deeper place than usually and be pent up under a thicker skin then a suppuration is to be expected That the matter is retreated unto the inward parts may be conjectured by this token to wit When we perceive the Tumor to be diminished albeit there were no repulsive remedies administred and applied to drive back the matter That the extinction and overthrow of the heat is neer approaching may be presaged by this whenas the heat redness of color pain and the pulse or beating is lessened the Tumor notwithstanding still remaining touching which more hereafter when we shal come to treat of a Gangrene But then lastly an Inflammation for the most part then degenerates into a Scirrhus when the matter is over viscous and clammy and hard therewithal and when the Natural heat being strong and vigorous forthwith even in the very beginning of the distemper remedies that discuss and dissipate over forcibly are thereunto applied which said remedies disperse and scatter the thinner parts thereof and leave the thicker still remaining That the time of the Event may be known The times of an Inflammation it is requisite that the times of the Inflammation be first of all known and they are likewise heedfully to be observed by us upon our knowledg of them in relation unto the Cure For unless the times of an Inflammation be well known and considered we may soon run our selves into an Error whilst we administer and apply Remedies that are any waies improper or incongruous unto any one particular of those several times Now then Inflammations like as all other Tumors and Diseases have four times or periods its beginning encrease state or perfection and its decay or declination It commenceth or begins when the parts are replenished with blood and when the swelling pain and stretching out are encreased this we cal the augmentation The state or perfection is then when the Tumor Distension Pain and all the other symptomes are most vehement and in the heighth of their extremity And lastly the declination is then said to be when the matter generating the Tumor is diminished and the pain heat together with the other symptoms are become more remiss and gentle or otherwise the matter is converted into Pus or purulent matter But the truth is these times are some while shorter somtimes longer and the Inflammations are somtimes sooner and somtimes more slowly terminated For as Galen tels us in the sixth Book of the Aphorisms Aphor. 49. that which is of a thinner substance is in a shorter space digested and that which is thick or tough requires a longer time for its digestion but that which is thick and viscous requires a far longer time And that Inflammation which hath seated it self in the fleshy parts is terminated according to the period of acute Diseases to wit fourteen daies for the substance of the flesh is more soft and permeable by reason of its thinness But the substance of the Ligaments Tendons and Nerves being more thick and hard and thereupon with greater difficulty receiving the fluxion for the same cause also doth with more difficulty discharge it self therof and hereupon the Inflammation in those parts is the longer time ere it attain unto its state and perfection and is not so soon curable but yet notwithstanding the Cure is in this case seldom or never prorogued beyond the term of fourty daies if both the Physitian rightly in al points discharge his part and likewise the patient be in al things willing to submit The Indications and Cure Whereas the containing cause of an Inflammation is the blood which hath preternaturally i. e. beyond or besides Natures intention flown in unto the part the Cure is effected if that blood be removed out of the diseased part and then great caution be had that it thenceforth flow no more unto the part affected that so by this means as wel the containing as the antecedent cause may be wholly taken away For whenas the affect cannot possibly be removed without a first removal of that which causeth it and the case so standing that the causes ought to be taken away in the very same order that they follow one the other in therefore we say that the Fluxion must first of all be extirpated The Cure of a fluxion or flowing of the blood Now this intention may be accomplished if care be taken to prevent the bloods abounding in the body and that that which is there in great plenty flow not unto the part affected The benefit of blood-letting in an Inflammation and this with most safety and speed is to be effected by opening a Vein For by this Venesection or blood-letting the great store of abounding blood is diminished and the same is likewise drawn back from the aggrieved place hence it is that there is an exceeding great benefit arising from and following upon this opening of a vein in an Inflammation so that it is seldom or never to be omitted if the strength of the patient wil permit it to be done And indeed hardly can
the beginning of the distemper it ought to be attempted from a far off but afterwards from the affected parts themselves Now what kind of remoteness and what sort of longitude he understands is explained in his fifth of the Method of Physick Chap. 3. A Revulsion saith he ought alwaies to be carried downward in those affects which are upward and upward evermore in those that are below and moreover also the Revulsion ought to be made from the right side unto those on the left and again in like manner from those unto these and semblably from those places that are internal unto such as are outwardly scituate and on the contrary from these unto those For when as the main scope of Revulsion is not to evacuate those humors which are already conteined in the part affected but those rather that are flowing thereunto and seeing it respects rather the part sending the blood than that which receives it from these premises it necessarily follows that questionless this is required in every revulsion to wit that it should by all means procure a motion contrary unto that which flows that so it may not any longer be moved unto the part affected and for this cause the revulsion must not be ordain'd either from the grieved part or from that next unto it but rather from the opposite yea and so far forth as possible it may be from the places most remote from the affected part And hence also it is that every opposition doth not constitute a contrariety neither hath every kind of opposition any place in a Revulsion but those oppositions alone which Galen in the before alleadged third Chapter of the fifth Book of his Method of Physick recites to wit upward and downward from the right side parts unto the left from the places that are within unto those that are external and so on the contrary Yet if there be only but a very smal inconsiderable distance we cannot safely nor conveniently draw back from the parts more inward to those more externally scituate but then only when the distance is greater But that opposition which is from before and behind or according to the fore parts and hinder parts hath no place in this kind of Revulsion which is so called singly and absolutely For neither if any affect shal chance to be in the backward part of the Head are the Forehead Veins forthwith to be opened by way of revulsion since that may not be done without manifest danger during the continuance of the Plethory and flowing of the humors But enough hath been said of Revulsion in the fifth Book of Institutions Part 2. Sect. 1. Chap. 18. But that we may in few words contract whatsoever hath there more at large been spoken Revulsion twofold and whatever else may be said upon this subject it is in the first place to be taken notice of that Revulsion is twofold one which is accomplished together with the evacuation of the humor such as is that which is effected by Blood-letting and Cupping-Glasses with Scarification the other which is wrought without the evacuation of the humor such as is that which is performed by Frictions or Rubbings Ligatures and Cupping-Glasses without Scarification This latter is never to be practised but when the Revulsion is to be made unto the parts most remote since that if it be instituted in the neer adjacent parts then the humor which is only stirred and not totally evacuated may without any difficulty or resistance rush upon the affected part And it is very rare and scarcely ever known that this kind of revulsion hath place or any thing to do in an Inflammation which requires a manifest sensible and suddain evacuation of the blood Furthermore Revulsion by opening of a Vein as for what concerns Revulsion which is effected by opening a Vein this one thing at least is to be observed which if it be wel heeded many intricate controversies touching the thing now in question may be determined to wit that the utmost endeavor must be used that a contrary motion may be procured unto the blood and that as much as possibly may be drawn back unto that Fountain from whence it flows And since that the Liver is the Fountain and Sourse of the blood and that the greatest store of the blood is conteined in the Vena Cava or great hollow Vein nigh about the Liver we must do our utmost that the blood which flows into the inflamed part may be drawn back towards its Spring-head yea also if it be possible unto the opposite part yet notwithstanding so that the blood which flows may be retracted and drawn back And therfore in every Revulsion this at least is to be wrought that the blood may obtain such a motion as that by it the part affected may not be injured by its immoderate conflux but that it may rather be again recalled from the diseased part But how this may be effected in every part here to declare unto you would be a business too tedious besides we have already elsewhere spoken to this very point in our treating of particular affects Revulsion when to be ordained after what manner And by what hath been said as I conjecture it is sufficiently apparent how and in what manner a revulsion is to be ordained in case of an Inflammation so that there wil not be any great need that we should add much as touching the right and due administration thereof For whereas revulsion is then only suitable and proper unto the Humors when they flow and unto them alone and not unto those which have done flowing and have seated themselves in the part affected it is hence manifest that it ought to be instituted and appointed in the very first rise of the distemper Notwithstanding this is not so to be understood as if in the first appearing of an Inflammation we were instantly to put revulsion in practice for if either there be no great store of blood or if its rushing in upon the part be not over violent and impetuous Medicaments that drive back and derive will be sufficient But then only is Revulsion to be put in practice when there is great plenty of blood and a more than usual violent and forcible rushing thereof unto the part affected and according to the greater or less proportion of this abundant blood and the more or less vehemency of its motion so answerably ought the Remedies and Medicaments that are prescribed for Revulsories or drawers back to be ordained so much the more or less strong and forcible But now that Revulsion which is made with an effusion or emptying forth of the matter must needs be greater than that which is made without it But amongst all the Remedies which we term Revulsories or drawers back the most prevalent and efficacious is the opening of a Vein which said Venesection doth more effectually or less strongly draw back accordingly as the Veins that are opened be greater or less The greater
be contained in the intervening middle spaces And in his second Chapter of a Tumor he thus writes It is saith he by Physitians found to be expedient in the case aforesaid not only to discuss by the means of heaters but likewise sensibly to evacuate at least some part or portion of the blood it self by making scarifications in the Skin But here then we are to know that great heed and circumspection ought to be taken and had whether or no the matter may be turned into Pus as we term it being the snotty fetid matter ensuing upon maturation For if we may probably hope for the said suppuration then the above mentioned scarifications have not any the least place But then on the other hand if the matter may not be changed into the said Pus or matter and that notwithstanding likewise there be little or no hope that possibly it may be wholly discussed or scattered by the application of Medicaments then in this case both Scarifications and Cupping-glasses may nay ought to be administred For these two are a very effectual and prevalent Remedy for the evacuation of the matter whatever it be that sticks and is deeply scituated and which seemeth forthwith to be in the ready way of conversion into a Scirrhus And therfore they are by no means to be administred in the beginning or first appearance of the Inflammation but at length after that the body is sufficiently emptied and that the Phlegmone is at a stay that so there may be further cause to fear that a new fluxion should be excited by that pain which originally proceeds from scarification and then only when we have a purpose to extract that which remains over and above after the use of other convenient Remedies Yet notwithstanding Scarification hath place only in those parts which in other cases likewise are fit to undergo and suffer the said Scarification For if an Inflammation happen unto any part unto the which in any other case scarification ought not to be administred I conceive that there wil be found no man so rash and unadvised as that he dare be so adventurous as after a Phlegmone for the evacuation of the residue of the matter to apply Cupping-glasses and administer scarifications unto the part affected But very rare it is that scarifications are admitted and allowed of for the use and purpose aforesaid But the safest and most usual way of curing an Inflammation is that the matter which hath flown in unto the part be discussed by the Medicaments before propounded But if thereby it may not be effected Suppuration we must then have recourse unto some other means for the curing of the Phlegmone and that is by Suppuration Now all this that hath been said must be understood as spoken of a pure and simple Phlegmone But if the Inflammation be not pure but that it rather decline unto the nature of an Erysipelas or an Oedema or a Scirrhus then those Medicaments that are proper and convenient for these and such like Tumors are to be intermingled with the other yet evermore with this Proviso that such of them as relate unto the Phlegmone be alwaies predominant The Cure of an Inflammation degenerating into an Impostume The generation of an Impostume If therefore there be no hope that the Inflammation may be compleatly cured by the helps and means hitherto propounded which will appear from the more intense signs of the Inflammation to wit grievous pain that encreases day after day a manifest Pulsation or beating and an evident discernable extension or stretching out of the part then we ought instantly to use our utmost endeavor that the matter that is the cause of the Inflammation may with all possible speed be concocted and brought unto suppuration that is converted into Pus For neither can the matter yet unconcocted and as yet not turn'd into matter be in a due manner evacuated and then again if any one open the inflamed part before the said Pus be compleated he shal thence draw forth nothing and shal encrease and add unto the Malady rather than relieve and cure it But if that same part shal be opened the purulent matter being already elaborated and thereby brought to a due perfection then all whatever is superfluous in the inflamed part may most commodiously be evacuated And therefore we conclude that the matter is first of al to be concocted and so far forth as possible may be digested by the native radical heat For although that matter which is conteined in a Phlegmone can never be so far forth concocted and elaborated that it may be rendred any waies useful and profitable to Nature and in any sort fit to nourish the parts Yet notwithstanding since that there are therein certain qualities which are to Nature very offensive and burdensome those may be taken away and a certain kind of equality and moderation of the qualities may be instituted and a separation of the corrupt humors from those that are good and such as are meet to nourish the Body may be wrought which said elaboration of the humor is here termed concoction and suppuration And when that that is superfluous and corrupt in the part inflamed is separated from what is useful good and serviceable and that the vitious qualities are now hereby corrected and amended and the very proper substance of the blood it self shal be changed into an equal whitish and smooth matter and gathered together into its proper and peculiar place so that now without any difficulty at all it may upon the opening of the part be evacuated then and not til then the Pus is said to be now already perfectly concocted and that same collection or gathering together of the snotty filth termed Pus or matter into some one particular place is by the Grecians called Apostema and by the Latines Abscessus with us in English it is named an Apostem or Impostume as hath been said before in the first Chapter Now that concoction in mans Body is Natures work alone the which by the help and assistance of the native heat digests the humors takes pains with them and as it were leads them along until it hath brought them unto that perfection which they ought to receive which said heat if it be strong and vigorous then we use to say that the Pus or matter thereby bred is good and laudable and it is as we may find in the first Prognostick Tom. 42. white equal smooth and not very sâ—â—nking and noysom But if the innate heat be weak then it wil be quite and clean contrary unto what was in the former case And therefore the Physitians office is and his main care must be to cherish or preserve and encrease the native or natural heat in the inflamed parts that so by means of it the generating and breeding of the said Pus may the better succeed and the more easily attain unto its perfection The innate heat is conserved and augmented if
Butter or with the fat of an Hog or with some other fit Digestive But if the hole be not wide and large enough it may very easily be dilated to wit if either a little piece of Spunge or Gentian root or Rape root dry be put thereinto For these things aforesaid when they are filled full with humidity they are then dilated and so consequently widen and enlarge the hole The Spunge is thus to be prepared the Spunge is to be wel soaked in the white of an Egg twice or thrice throughly shaken together then afterwards let it be close squeezed together on all sides and then let it be leisurely dried in the shade a smal portion of this when it is dried is to be taken and put upon the Ulcer But in regard that the crustiness thereof wil not fall off in a few daies time and that all this while the Pus or filthy corruption unless it stick immediately under the Skin is detained and imprisoned in the Impostume for this very cause if there were no other it is by far the safer way to open the Impostume with an Iron The Impostume being now opened whatever the way of opening it hath been the Pus or matter is to be evacuated but yet this needs not evermore to be wholly all at once or altogether For if the Impostume be great and contain much Pus within it neer unto the Arteries and Veins the whole matter and filth ought by no means to be evacuated all at once lest that together therewith much of the Spirits be likewise evacuated and dissipated and so by this means the sick Person should be caused to faint and swoon or be debilitated and weakned but rather the corruption is to be emptied forth by some and some especially if the Patient be weak or a Woman with Child or in case the Patient be a Child or lastly if the sick party be very aged When the Pus is evacuated if either pain manifest it self or else any reliques of the matter not suppurated appear in the circumference and it be so that the Pus it self be not wel and perfectly ripened then the pain is to be mitigated and more especially the remainder of the matter is speedily to be converted into the said Pus by some concocting Medicament which they commonly call a Digestive And such is that which is made of the Oyl of Roses and the Yelks of Eggs for it greatly mitigates the pain and helps forward the generating and breeding of the Pus so often mentioned Or Take Turpentine one ounce one Yelk of an Egg the Pouder or Dust of Frankincense one dram Oyl of Roses three drams mingle them wel together Likewise the Emplaster Diachylon simplex is very profitable in this case When this is once accomplished even while the concoction doth yet appear we must come to those things that throughly cleanse and purge it for neither can there flesh be bred nor any conglutination by drawing together the Lips of the Impostumated part be made unless the part be first cleansed Which to effect Take Clear Turpentine one ounce Honey of Roses six drams the Yelk of one Egg let them boyl together a little and afterward add of Saffron one scruple and a little quantity of Barley meal If there be need of a greater cleansing you may then add the juyce of Smallage As Take of crude Honey Barley meal of each alike one ounce of the Juyce of Smallage half an ounce Saffron half a scruple and mingle them If yet there be occasion for a more forcible cleanser there may be added of the Vngueut Egyptiack as much as wil suffice Centaury the less and round Birthwort is here likewise very useful As Take the juyce of the lesser Centaury two ounces Smallage one ounce Honey three ounces let them boyl together and after add of Barley meal and the Vetch Orobus of each six drams when they are taken from the fire add of Turpentine one ounce of the Pouder of the Flower-de-luce root one dram mingle them The Impostume being throughly cleansed such Medicaments as breed cause flesh are to be administred Now of what sort these are Galen in his third Book of the Method of Physick the second third and fourth Chapters teacheth us at larhe and we have likewise declared them in our Book of Institutions As for example Take Frankincense Mastick of each half an ounce Colophony two ounces Oyl of Roses and Honey of each as much as is sufficient let them be mingled Or Take The greater Comfrey one handful Betony Saint Johns-wort Hors-tail Grass of each half a handful boyl them in Wine and bruise them wel out of the mash of them squeez forth a Juyce and add of Frankincense and Mastick of each one ounce half Dragons blood an ounce Honey and Turpentine of each a sufficient quantity boyl them until the juyce be consumed and make an Vnguent Or Take Myrrh Aloes Sarcocol of each an ounce Honey six drams White Wine as much as wil suffice boyl them to an indifferent thickness When the Ulcer is filled up with Flesh then those Medicaments which we cal Epuloticks that is such as bring to a Scar are to be administred of which we have in like manner spoken in our Institutions such as are the Emplaster Diapalma or Diachalciteos de minio of Vigo and others which are every where known Chap. 6. Of the Sinus in the Tumor BUt it oftentimes so happeneth that although the said Pus or snotty filth be emptied forth of the Impostume yet notwithstanding it becomes again replenished from whence it comes to pass that the adjacent Skin doth not close fasten and grow together with the Flesh that is underneath it but there is a certain cavity or hollowness left to remain and at length there ariseth a certain difficulty if not impossibility of cementing and conjoyning the skin with the Bodies lying underneath which affect the Greeks cal Colpos and the Latines term it Sinus to wit when the enterance into the Impostume and Ulcer appears narrow enough but the deeper and more profound part thereof diffuseth it self into a breadth The Causes Now for the most part the Causes of this Sinus are Impostumes or Suppurated Tumors over-slowly opened or not wel cleansed For the corruption if it be longer deteined in the deep place than it ought to be acquireth a certain kind of sharp corroding quality and there causeth divers winding passages and turnings such like as we find in Coney-borrows and so unto the part in this manner affected there flow together from the neighboring parts yea from all the whole body such excrements and such humors as superabound from whence afterwards it chanceth that this kind of Sinus or windings to and fro can very hardly be conglutinated and filled up with Flesh The Differences But now of these Sinus there is an exceeding great diversity for they differ not only in the dimension of quantity that one should be less and shorter and another
tels us of another far more easie and compendious course that he himself had found out and discovered in curing Apostems newly opened whereby on the third or on the fourth day at the furthest all the aforesaid Cavity of Apostems might be remedied and perfectly cured by drawing together what was divided which operation we cal commission and conglutination of the Impostume so that nothing should be left gaping beside the opening or incision place which was made by Art to the end that thereby the Pus might flow out and be pressed forth and that al this should be effected without any the least danger to the sick party without much if any pains and labor or any other difficulty Now his way and method of Curing was as followeth If the Tumor or Apostem be great then saith he in the first place let it be opened in the best manner that may be so that the little finger may be put into the orifice and that thereby al the Pus that is contained within the Impostume may be permitted to flow forth and may likewise be thence expelled by a gentle compression of the place it self The Pus being once expelled and evacuated let the mouth of the Sinus be stopt with a Tent and then an artificial Pillow or Cushion being laid and fastened down thereon let it so remain without removal until the next day following The day following the Ligature being loosened let the Ulcer be purified and carefully cleansed from al the Pus if haply there be any left remaining underneath After this is done let a Pipe or smal Cane of Lead be put into the orifice the which let it be as big and large as is the Orifice it self and let it reach even unto the Cavity or hollow place but let it not by any means be forced any further Upon this let the Basilick Emplaster spread upon a Linen Cloth be imposed in the which also the pipe may be contained that it fal not forth yet nevertheless leave a hole at the very Orifice of the Leaden Pipe or Cane Afterwards on either side of the Cavity let there be put triangular Pillows or Cushions of which before on either side one so that al the hollow space may be filled up with either Pillow c. But let the Orifice of the Sinus in which is the Leaden Pipe be left free and open neither let it be stopt up by the aforesaid Pillow nor any waies obstructed by the Ligature or binding that so al the Pus that lieth underneath may be throughly purged out afterward let the place covered by the Pillows be rolled about with a Swathband so that it may be without the least pain and let it be so ordered that the Ligature may begin at or from the bottom and tend toward the orifice that so by this means al the Pus or filth that is within may be forced toward the Orifice and through it may be pressed forth The Sinus thus bound about is to be left in this manner until the day following on which the Ligature being loosened we ought by making strict enquiry to find out how much of the Cavity remains that so we may be throughly certified Whether or no the aforesaid Pillows or Cushions did touch upon the places For al those places which were subjected by the Pillows c. wil al of them be found conglutinated and fast closed together The which when we have discovered the Pillows are again to be tied and fastened after the same fashion as they lay before and so they are to continue until the next day But now if so be that any of the Humor or of the Pus seems to be left in any place this as before is to be pressed forth with the Pillows fastened by the Swathband together with which the gaping place doth coalesce and joyn close together In this manner so soon as the parts are closed together let the Pillows be removed and then let there be imposed upon the Ulcer a Linen cloth spread over with the Authors Leonine Emplaster or such other like Plaister as suppose the Emplaster Diapalma and you may not forget to wipe and cleanse it six or eight times every day But yet notwithstanding as touching this way and manner of curing the Sinus and Cavities it is first to be taken notice of that this same doth succeed most happily in Apozems newly opened and in them only for as for an old Sinus where all is not wel within and which almost declines unto callous Ulcers and Fistula's the former way and manner of curing it is far better and safer Moreover this is likewise to be observed that we ought wel to look whether or no there remain any relicks of the indigested matter spread thorow-out the part which easily comes to be known by some apparent Tumor or Swelling as also by its redness of colour For otherwise and as long as any thing preternatural sticks in the part agglutination as we term it or closing up of the Orifice is not to be expected neither is it to be so much as hoped for And therefore be sure that the Pus it self be likewise cleansed and purged in the best manner that possibly you can Thirdly This also is to be heeded to wit whether or no the place may conveniently enough be rolled about with Swath-bands and likewise whether the aforementioned Pillows or Cushions be streightly fastened and tied down close enough that so they may both compress and keep down the severed and disunited parts and also press forth the Pus or filthy snot-like matter For if so be that the Swath-bands gape and that the Pillows press not down the part as they ought then neither is there any Pus pressed forth nor doth the part coalesce and meet together Chap. 7. Of the Tumor Erysipelas or Rosa THat Tumor which the Greeke cal Erysipelas but we here of this Country commonly Rosa from its rosie color is altogether to be referred unto and so to be accounted in the number of the Tumors that take their original from the Blood All the Latines Celsus only excepted who retains the name Erysipelas term it Ignis Sacer we in English call it St. Anthonies fire or this Ignis Sacer the Poet Lucretius makes mention in his sixth Book The Body all at once with Vlcers brand grows red As 't is when Ignis Sacer hath the whol ore-spread This Tumor is most an end by Physitians ranked among the Cholerick But yet there is ground and cause enough of doubting from what humor it derives its beginning and Pedigree For Galen himself seems now and then to stagger and not alwaies to stand to what he had spoken concerning it For in his second Book to Glauco and first Chapter he expresly writes that the most thin and hot Blood or Choler together with Blood to wit when both of them are hotter than is behooful is the Cause of an exquisite Erysipelas and there he determines that meet pure Choler
and Chap. 8. maketh a twofold sort of this Tumor differing according to the Nature and quality of their Causes The one he deriveth from cholerick blood the other from a salt and nitrous Flegm but this more rare Others there are that assert that this kind of Tumor doth arise from an exhalation or vapour of hot fervent Blood or else the admixture of the Cholerick and Salt humors The Causes Whosoever knoweth and understandeth the Nature of serous wheyish humors wil not deny that such like Tubercles may possibly be excited from serous or wheyish humors being such as are sharp and easily moved and likewise such as without much ado vanish and are discussed Which appeareth and may be confirmed even from hence that this Malady may be and is removed especially by Venesection or blood-letting which said Venesection doth chiefly and principally qualifie and allay that extream and fervent heat of the serous and wheyish part of the blood Yet notwithstanding the itch that is somtimes greater and somtimes less likewise teacheth us that there is not one alone difference of this wheyish humor but that somtimes this said whey is more mild and moderate and somtimes again more sharp and hot somtimes thinner and somtimes thicker as likewise thus much which I my self have very often observed that these Tubercles while the the Patients are in a hot place they then break forth and appear and that when they expose themselves unto a cold Air the Essere then vanish and as soon again on the contrary to bud forth in the cold Air and to vanish in a hot place the former whereof seemeth from hence to happen to wit because the humor is very thin and moveable and therefore is instantly driven in again by the cold ambient Air but the latter because the Humor is not altogether so movable and thin but somwhat more thick which for that very cause cannot transpire in a cold Air but in a hotter Air it wil transpire or breathe through But this wheyish and thin Humor is for the most part generated from the fault of the Liver which from some preternatural cause is disposed to generate and breed this humor Now that said Humor waxeth extreamly hot from the Causes Procatartick as they cal them that stir and move the blood And this happeneth likewise in the Winter time and in cold Regions rather than in hot Signs Diagnostick It is easily known by those notes and marks that are above mentioned to wit there somtimes goeth before an Ulcerous Lassitude and then there break forth in the whol body itchy Pustules as if the party had been pricked by Bees or stung with Nettles The Prognosticks 1. These Tubercles vanish of their own accord within a very short space although there be no course taken for the curing of them and they are not suppurated neither doth there issue forth of them any humidity at al. And if this should somtimes so happen yet this chanceth rather by reason of the scratching of them and also from the vehemency of the Itch which is extream troublesom to the sick persons than by means of the Tumor 2. Somtimes these Essere go before Cholerick Feavers and therefore such as are very frequently molested and grieved with these Tubercles ought not in any case to neglect the Cure lest that they fal into Feavers and some more grievous Disease The Cure For the most part there is no need at al to administer Topicks but if the fervent heat of the Blood and Humors be by Venesection and the administring of Medicaments that alter qualified and kept under the Tubercles wil then soon vanish and the smoothness and Natural color will forthwith return unto the Skin To wit in the first place a Vein is to be opened and so much of the blood drawn forth as the state and condition of the body requireth And afterwards if there be any need at al thereof the Cholerick and wheyish Humor is to be drawn forth by Tamarinds Myrobalans Rheubarb afterward let there be administred the Juyce and Syrup of Pomegranates Ribes Syrup de Agresta or Varjuyce Whey with the Emulsion of the four cold seeds and the like Milk tart and sowr c. It is likewise very requisite to put the sick person into a Bath of warm Water Let his Diet likewise be cooling and moistening Chap. 27. Of Scabies or Scabbiness SCabies or Scabbiness ariseth likewise from adust matter as doth also the Itch that is as it were a certain Praeludium and forerunner of Scabbiness and the like Affects Now Scabies by the Greeks and Latines is called Psora an Affect sufficiently known in the which there is not only present some kind of foulness and deformity of the body but a distemper also even of the very Skin together with a swelling and exulceration from whence it is that the actions of the Skin are likewise hurt But more especially in the Scabies or Scabbiness the top and utmost part of the Skin is affected insomuch that out of it as Galen tels us in his fourth upon the Aphorisms and the 17. Aphor. there is some such like thing cast forth that beareth a likeness and resemblance with the casting of Serpents From whence it likewise differeth from the Itch for in the Itch there is only a roughness of the Skin in which there is nothing that fals off notwithstanding the scratching whereas in the Scabies there is not only a roughness of the Skin but likewise a distemper with a swelling from which by scratching the bran-like bodies are easily and readily separated and together with them divers Ichores likewise and filthy purulent Excrements The Causes But what the Cause of the Scabies is in this Authors seem not so wel to agree Galen in his Book of Tumors Chap. 1. 3. tels us that Sabies also and Lepra are Melancholick Affects and likewise in the seventh Sect. Aphor. 40. that Cancers Elephantiases Lepra's and Psora's are al of them Melancholy Affects and the same he also tels us in other places But Avicen in the seventh Book of his fourth Tome Tract 3. Chap. 6. writeth that the matter of Scabies is the blood with the which Choler is mingled and that converted into Melancholy or salt flegm and with him the other Arabian Physitians agree But the very truth is that although in the Scabies the humor be not alwaies one and the same yet in every Scabies there is some kind of mixture of the adust and melancholy hot and dry humor And furthermore there is one sort of Scabies that is moist another that is dry The moist in the which there sloweth forth a certain matter that is moist and withal rotten filthy and purulent but the dry is that in which there is but little or none of the aforesaid matter cast forth And concerning this latter it is that Galen seems to speak as being such wherein that melancholy humor doth more superabound But Avicen and the rest of the Arabian
Physitians understand hereby al kind of Scabies whatsoever Now albeit the next cause of Scabies be a humor sharp and salt yet notwithstanding Avicen doth not altogether absurdly assert that blood is the matter of the Scabies For seeing that Scabies is an Univerversal Affect of the whol Body it cannot therefore easily proceed from any other humor unless that blood be likewise therewith mingled and yet notwithstanding the blood cannot properly be said to be simply the cause of Scabies to wit so long as it retaineth its benign and tempeperate Nature For whilest it continueth benign and good it can in no wise excite and cause the itching neither yet those Ulcerous Tumors or Swellings Wherefore before such time as the blood can possibly produce and breed the said Scabies it must of necessity be corrupted and other humors that are sharp and biting there with mingled And true it is indeed that yellow Choler is sharp and corroding but then it scarcely floweth in so great abundance or is of that thickness as to excite such like Tumors But black Choler and salt Flegm are Humors very fit and most apt to produce the said Scabies For these Humors being thick hot and dry and withal biting and corroding if they chance to be thrust forth unto the Skin there they stick fast in it and there they excite a hot and dry distemper an itching a swelling and an exulceration But now as for the primitive Causes and more especially for the generating and breeding of those salt biting and sharp humors the kind and ordinary course of Diet that is kept doth exceedingly advance and further the same Meats to wit of a bad juyce and that afford an unwholsom and corrupt aliment such as are salt sharp and that are easily corrupted And hence it is that the poorer sort of people who live upon these kind of unwholsom corrupt meats are most frequently infested with the Scabies or Scabbiness as likewise Children and yong people in general in regard that these are altogether careless and heedless in their Diet whereupon they contract great store of excrements that being retained in the outward part of the body are there corrupted and so they get an acrimonious quality But then from these bad and naughty meats those sharp and salt humors are the more easily bred if there be present a hot and dry distemper of the Liver And hitherunto likewise relateth the uncleanness and nastiness of the body to wit when there is altogether a neglect in the keeping it sweet and clean and if the foulness and impurities of the Skin be not duly washed off or the garments not shifted and changed often enough whereupon it is that filth and impurities sticking in the superficies of the body do not permit so free a passage forth unto the excrements and by this means the said excrements acquire a certain acrimony and so corrupt the other humors The Scabies ariseth likewise somtimes after a Crisis and after Diseases both acute and those also that are of a long continuance to wit when Nature expelleth forth unto the Skin those naughty and depraved humors which it is not able any other way to discuss and evacuate And lastly Congium is likewise accounted and reckoned up among the principal causes of Scabies which cause Galen also acknowledgeth in his first Book of the Differences of Feavers Chap. 2. and Book 4. of the Differences of Pulses Chap. 3. For in the Superficies of the Skin of those that are Scabby there is a certain viscous and clammy moisture gathered together which being either by the Apparel oâ— by some other means communicated to the body corrupteth the humors therein after the like manner and produceth the like Affection and that especially in these bodies that are now already disposed unto the Scabies And indeed the humid or moist Scabies is the more contagious in regard that in this there is generated more of the aforesaid viscid and clammy humidity The Differences Some there are that reckon up very many Differences of Scabies as that one is new another old and inveterate and that one seizeth upon the whol Body another upon the Hands only and the Thighs but the main and special Difference is that which is taken from the Difference of the Humors that one ariseth from a black and melancholy humor and this is called a dry Scabies in which although there be a concurrence of other humors yet notwithstanding the greatest part thereof is of this last mentioned humor from whence it is that out of the parts affected with this Scabies either there is nothing at all sent forth or if there be any thing issuing our it is thick dry and the Ulcers themselves as likewise the prints and footsteps as we may so term them of these Ulcers are wan and pale and somtimes black another is humid and moist in which there aboundeth a salt flegm out of which there plentifully floweth forth much moist filth and corruption that is thin and subtile sharp and now and then likewise it wil be thick Signs Diagnostick The Scabies or Scabbiness is an Affect very wel known and it may easily be discerned as may also its Differences and from those signs and tokens especially that we but even now mentioned And yet notwithstanding those signs do now and then vary and are somthing changed according as the aduition of the other humors is greater or less Prognosticks 1. Now although the Scabies be in this respect troublesom to wit in regard of the foulness and deformity that it causeth in the Skin rather than that it bringeth with it or threateneth any other danger nigh at hand and that in youth it oftentimes preserveth and likewise freeth from other Diseases yet notwithstanding it is not alwaies secure and safe For if it be of any long continuance it may and somtimes doth turn into the Lepra or Leprosie and in Ancient persons it is contumacious and stubborn and hard to be cured 2. And among the several species and kinds of them the dry is more difficult in curing than the moist And therefore whatever kind or sort it be of it is not at any hand to be neglected but by a due and fit Cure even for the very deformities sake if there were no other cause speedily to be taken away and removed Of the Scabies retiring inwardly That Scabies that hath its rise and original not from any contagion but from some internal default of the humors for the most part breaketh forth as it were critically and ariseth from some internal vice of some one or other of the Bowels in which so soon as any vitious humors are generated they are immediately by Nature thrust forth unto the outward part of the body the which motion if Nature be not able to perfect and accomplish it or in case she be by Medicaments administred unseasonably hindered in her operation divers Diseases are from hence excited Many Diseases proceeding
or Guajacum Wood. To cleanse Galen in his sixth Book of the making of simple Medicaments doth especially commend a Myrepsick Suppository which in regard that it hath a very strong astringent power if Vinegar be therewith joyned having laid aside and put off its astringent power and virtue will excellently well discharge the office of Cleansing and deeply penetrating in all affects of the Skin Sulphur is here likewise very commodious by reason of its abstersive Virtue The rest of the Remedies are specified in the precedent discourse of Scabies And more likewise which may very fitly be here made use of shall be said below in Chap. 4. where we treat of the Elephantiasis Chap. 29. Of Vitiligo or Leuce and Alphus WHereas in the former Chapter we told you that the Lepra of the Greeks is by the Arabians called the black Albaras for the Arabians mention two kinds of Albaras the one white the other black and that the white Albaras of the Arabians is the same with Leuce of the Greeks and seeing that Leuce is a Species of Vitiligo we therefore judg it fit to subjoyn Vitiligo unto Lepra of the Greeks Vitiligo The truth is there be some that strenuously dispute whether or no Leuce and Alphus and the like Evils that we shal anon propound do belong unto Diseases or else unto Symptoms and they scrape together out of Galen divers places in which he seems to assert now this now that now one thing and then another But since our purpose in this Book is to treat both of the Diseases and likewise of the Symptoms of the extream parts we wil not therefore scrupulously dispute hereof Let it suffice that we give you notice of this that if the recess from the Natural state whether it be in the distemper or in the Organical Constitution be so smal that it hurteth no action it is then no Disease but only a symptom and hâ—â—herunto are to be referred the changed colours of the Skin For although in our former Books we propounded the Diseases and Symptoms of the parts severally and assunder yet notwithstanding it could not here fitly be done in regard that somtimes the same Affect according to the greatness of the recess from the Natural state is one while a Disease and another while a Symptom only Now unto the word Vitiligo from whence soever it be derived there is no general Greek word to be found that answereth unto it but it conteineth under it these three Affects Leuce and both the Alphus to wit the white and black For so Celsus writeth in his fifth Book Chap. 26. about the end thereof There are saith he three Species of Vitiligo Alphus where the white colour is somwhat rough and not continued so that there seem to be as it were certain smal drops dispersed And somtimes it creepeth broader and with certain intermissions Melas differeth from this colour in regard that it is black and like unto a shadow other things are the same Leuce hath somwhat like unto Alphus but it is more white and it descendeth deeper and in it there are white hairs soft and tender as wool or down feathers All these creep but in some faster in others more slowly But Galen as we have already said hath no common name under which to comprehend Leuce and Alphus but he propoundeth them as divers Affects in his second Book of the Causes of Symptoms and the second Chapter Among the Arabians we meet with the word Albaras which they divide into white and black not as one and the same Disease into its Species but as a word into its significations For different Affects they are and Albaras nigra or the black Albaras is nothing else than Lepra of the Greeks and the Impetigo of Celsus But Alba or the white the Greeks term Leuce which appellation Celsus doth both keep and maketh it a Species of Vitiligo Like as Pliny also maketh mention of the white Vitiligo in his Book 18. and Chap. 15. and in his Book 31. Chap. 10. But of Nigra or the black in his Book 22. and Chap. 25. For there is no word or name to be found among the Latines that may answer unto the Species of Vitiligo to wit Leuce and Alphus To wit Physitians do thus stile Leuce as Galen writeth in his third Book of the Causes of Symptoms and Chap. 2. from the Colour imposing the name thereon For look what kind of flesh Locusts have and so likewise almost al kind of Oysters the like hereunto have they also that have their Skins fouled and defiled with Leuce But Alphoi are so called from the Greek word signifying to change to wit because the colour of the Skin is changed and yet notwithstanding not of the whole Skin but up and down here and there great spots arise throughout the Skin and for the most part in the Body also And the truth is their generation as Galen there tels us is of the like kind to wit from a vitious nutriment Yet notwithstanding under these the whol flesh is not vitiated but only in the very superficies and top of the Skin there are as it were certain little scales fastened thereupon and the truth is that Alphi or the white arise from a flegmatick but the black from a melancholly Juyce And yet they are not true and right scales but there is a certain kind of roughness perceived in the Skin together with the change of colour For in this the black Alphus differeth from the Lepra or the black Albaras of the Arabians that in Albaras Nigra or the black Albaras there are both excoriation and scales whereas in the black Alphus there are neither Morphaea Alphus is likewise called Morphaea without all doubt from Morphe to wit because the colour of the Skin is changed into white and black Celsus hath used the Appellations of the Greeks in distinguishing the several species of Vitiligo and he hath named the first Species Leuce or Leuca but Alphus he calleth only by the single name Alphus and the black he stileth Melas But now this change of colour as wel in Leuca as in Alphus doth not only consist in the Skin but is extended likewise unto the Hairs and as Celsus in the place alleadged writeth in Leuca there are white Hairs such as are like unto the soft and tender Hair in new born Children and the white Alphi likewise as Paulus Aegineta tels us in his fourth Book and Chap. 6. produce white Hairs and the black Alphi black Hairs And Johannes Philippus Ingrassias in his first Tract of Tumors Chap. 1. P. 142. assureth us that he had more then once seen even old Gray-headed Men that have had some part either of their Beards or of their Eye-brows black like as it is in young Persons that are altogether black to wit when Melas is become inveterate or that there be present the black Alphus and yet notwithstanding all this while the part affected with the
is but seldom that it happeneth in these parts The Causes That it hath its original from a blow or from hard labor Paulus and Aetius teach us which is indeed to be understood of the evident cause But how these evident causes come to produce those Tumors is not so evident and manifest Vulgarly the greater part determine that they arise from a dull sluggish thick flegm or else from Melancholy But others assert and that more rightly that by means of some fal by reason of extension or of some extraordinary hard labor and over working by al or any of which either a Nerve or a Tendon is too far extended or likewise according to the Membrane even as is were broken the nutriment of the Nervous part doth as it were sweat forth and adhere neer about the Fibres and the substance of the same Nervous part and so becometh changed into this substance by reason of the formative faculty of the said parts and then covered with a peculiar Membrane After which manner if the Periostium be opened even in the Bones their nutriment is turned into a boney knot as Platerus giveth us to understand For look as it is in Trees if their Rind or Bark be wounded or in any other manner opened Nature sweating forth the aliment suffereth it not rashly to diffuse it self al abroad but changeth it into a knot so in like manner albeit the Membranes that wrap about the Bones or Nervous parts may be broken yet Nature permits not the aliment rashly to flow abroad through the open passages but from thence under the Skin formeth a Tumor included and shut up in a peculiar Membrane But now that Ganglion that Platerus describeth happeneth not from the default of one only Nerve or Tendon but chiefly in those places where there is a concourse of Tendons Ligaments and Nerves and especially about the knee either when those parts by reason of their overgreat motion are very much exercised or else while Wounds are in curing For if the juyce of these parts to wit of the Tendons Nerves Membranes and Ligaments shal chance upon the occasion of the aforesaid Causes to flow forth abroad out of the said parts and shal withal begin to be luxuriant and to abound and shal likewise adhere unto the Fibres of the same parts it is then changed into such a like fungous or Mushrom-like matter which oftentimes overspreadeth the whol joynt and is thereupon by the Germans called Der Gliedshevva And yet notwithstanding it may likewise so chance that a vitious humor abounding in the body may flow in into such a like weak part and may be mingled together with the said thick juyce that nourisheth these parts and may through that open passage flow together with it unto the aforesaid parts and may there augment the Tumor Signs Diagnostick This Tumor is bred in those parts that are not covered with much flesh but only by the Skin and therefore it lieth not hid very deep and it is now hard now soft now greater now less and somtimes it is in bigness equal unto and many times greater than an Egg it is void of al pain and yet notwithstanding if it be forcibly pressed together it then manifesteth a certain kind of dul and stupid sense it may be thrust and moved unto the sides but neither forward nor backward That Ganglium which Platerus describeth is a Tumor for the most part arising in the Knee soft without pain and of a different color from smal beginnings somtimes encreasing to so great a bulk and magnitude that it comprehendeth the whol joynt from whence it chanceth that the sick person can neither stand upright no go straight neither is he able in going to tread upon the ground or at least as it were only on tiptoe Prognosticks 1. This Disease is of long continuance and oftentimes lasteth for many yeers and accompaninieth the sick parties even unto their dying day 2. Those of them that are in the very junctures of the joynts impede and hinder the motion of the whol Member 3. The Ganglium likewise that is neer about the Joynt unless it may be taken away by Medicaments is altogether incurable For it admitteth not of Section or cutting in regard that it may easily happen that by Section a Nerve Tendon or Ligament may be hurt The Cure Universal or general Remedies having been first premised it is requisite that the Tumor be mollified and discussed or if this cannot wel be done that it be suppurated or cut out Therefore if Ganglium or Nodus the Knot be recent and new and the little Bladder within which it is included be yet tender we must then in the first place do our endeavor that the said bladder may be broken And therefore the Tumor is to be rubbed with the hand so long until it wax hot and become softer and afterward let it be close pressed together with some thin plate or some other solid thing so long that the bladder may be broken and that the matter therein included may be thereby dispersed And therefore let a thin plate of Lead be imposed upon the place affected and bound close upon it with a Swathe which is not to be removed until after ten daies Others there are that first of al anoint the Tumor with Ammoniacum dissolved in the form of an Emplaster and then after they apply a thin plate of Lead Oribasius made use of this that followeth Take Ceruss Pitchy Rosin old Oyl Ammoniacum Galbanum of each one ounce Wax four ounces mingle them c. Or Take Aloes and Myrrh of each six drams Litharge of Gold one ounce Ladanum half an ounce Ammoniacum the Fat of a Calf and of a Fox of each six drams Oyl of white Lillies two ounces Wax as much as wil suffice make an Emplaster Or Take of unslaked Lime the Fat of a Goose of each one ounce Ammoniacum half an ounce Turpentine one ounce mingle them c. Or Take of the Emplaster Oxycroceum one ounce the Mucilage of Marsh-mallow seed and Fenugreek seed of each half an ounce Galbanum Sagapenum and Ammoniacum dissolved in Vinegar of each three drams Rosin six drams white Wax half an ounce Mingle them and make an Emplaster Or Take Gum Ammoniacum Bdellium Galbanum dissolved in Vinegar of each one ounce and half Oyl of white Lillies of Camomile of Bays the Spirit of Wine of each half an ounce the pouder of the Flowerdeluce Root and live Sulphur of each half a dram mingle them and make an Emplaster If the Ganglia give not way unto these Medicaments we must then betake our selves unto those Remedies that cause suppuration As for Example Take the Roots of white Lillies and Marsh-mallow Roots of each an ounce and half the Root of Fern one ounce fat dried Figs in number ten the Root of Squils or the Sea Onion one ounce the Flowers of Melilote and Elder flowers of each one smal handful boyl them in the Broth of a
of theirs since that those who are affected with the Elephantiasis are not made hereby ever a whit the greater unless haply we have respect not so much unto the greatness of the body in such as are thus affected as unto the greatness of the danger of death thereby threatned to wit that look as the Elephant is the greatest of al the four-footed Creatures even so among diseases this appeareth to be the greaâ—est and an Affect almost remediless and incurable touching which thing Macer in his Book of the virtues of Herbs and Chap. 15. speaketh unto the same purpose Or else this Malady is so called because that creeping along upon the Thighs it causeth them to become as are those of an Elephant rough and unequal or else because that among other Diseases this is exceeding vehement strong and violent like as is the Elephant or otherwise it is so called and this indeed seemeth to be the most true and genuine reason thereof because the members the skin of those that are affected with this Disease are rendered tumid and swoln scaly rough and rugged ful of swellings and unequal like unto the skin of Elephants Galen in his Book of Tumors Chap. 14. writeth that this Malady when it first beginneth is likewise called Satyriasmus in regard that the face of those that are afflicted with this Disease is rendered like unto the face of the said Satyres For the lips of such as are troubled with Elephantiasis are thereby made thick and the Nose swelleth and thereupon it seemeth as if it were pressed down the Ears become flaggy and much wasted the Jaw bones are colored as it were and overspread with a certain kind of redness and in the Forehead there appear here and there Tumors or Swellings like as if they were certain Horns although there be others indeed that think the Satyriasmus to be so called even for this very cause that in the beginning of this Malady the sick parties are extreamly libidinous and lustful like as are the said Satyres And yet notwithstanding Aetius in Tetrab 4. Serm. 1. Chap. 120. out of Archigenes rendereth another kind of reason of this resemblance and that indeed different from the former to wit because the Cheeks and face in such as are thus affected are lifted up together with a certain redness and the Chin it self is dilated upon the Convulsion as it were of the Muscles of the Jaws even as we see it likewise to befal those that laugh in a certain kind of likeness and resemblance unto the Pictures of Satyres which Coelius Rhodiginus in his 19. Book of the reading of Antiquâ—ties and Chap. 25. conceiveth to be â—o called from the Greek word Seserenai because that these Satyres sing and sport themselves with their mouths wide open and gaping and their lipâ— drawn forth like unto those that laugh A d there are some that give us a thâ—â—â— reâ—son and ground of this appellation to wit b cause thâ—â— those who are affected wiâ—h thiâ— Elephantiasis are like unto Satyres in their propension unto Venery and lustfulness It is likewise termed Leontiasis either in regard that this Malady is inviâ—â—ible like as the Lyon or else because as Aetius hath it in Tetrab 4. Serm. 1. Chap. 30. the forehead of the sick person is with a certain swelling rendered and made more loose after the resemblance of the flexile skin of the Lions Eye-brows or else because the breath and the very spiriâ—s of such as are affected with this Malady do even stink like unto the breathing of Lions and their very excrements also or else because those that are affected with this Disease have a most filthy and terrible face insomuch that like as do Lions they strike a terror into those that come suddenly and unawares to behold it This Malady is by our Physitians called the Malady of St. Lazarus because that such as are Elephantiack do so abound and are ful of Ulcers like as was that Lazarus the beggar of whom there is mention made in the Evangelical History Luke Chap. 16. Now this is a very sad and grieâ—ous Malady and as it were an Universal oâ— Cancer of the whol body whereupon it comprehendeth under it many more sorts and kinds oâ— Diseases For fi st of al there is present magnitude augmented and a â—â—â—lling up and down in the body especially in the external parts whose beauty feaâ—ure and 〈◊〉 likewise is hereupon corrupted there is likewise present a hot and dry distemper by which the parts are so exulcerated and corrupted that as length they fal off Celsus in his third Book and Chap. 25. thus describeth the whol Idea of this Malady The whol Body saith he is affected so that the very Bones likewise may in a manner be said to be vitiated and corrupted The highest and utmost parts of the body have in them both spots and swellings that stand thick and close one by the other The redness of these parts is by little and little converted into a black color The top of the skin is unequally both thick and thin hard and soft and is exasperated by certain scales the body waxeth lean the mouth the calves of the legs and the feet swel and are puffed up When the disease comes once to be old the fingers and toes are quite hidden under the swelling there ariseth also a light and gentle Feaver that easily consumeth and wasteth the sick person that is already overwhelmed with the aforesaid evils and mischiefs The Causes The containing cause is black Choler and this not without malignity diffused and spread abroad throughout the whol body Now we find touching the generating of this humor viz. black choler a long and tedious dispute among Authors and we find them holding divers and different Opinions In this the truth is they al agree that this humor is generated from the adustion and burning of other humors but then in this they differ viz. from the adustion of what humors this proceedeth Avicen in the third Section of his fourth Book Tract 3. Chap. 1. seemeth to have comprehended them all whiles he mentioneth five Species or kinds of this humor The first is that which proceedeth from the Blood the second that from the melancholly humor the third that which is from the adustion of bitter Choler the fourth that which ariseth from Flegm burnt the fift and last that that proceedeth from the thick and hot part as being very apt to be burnt of the Chyle as to Instance from all salt Flesh Fish and the like But although it cannot be denied that there is here in this case an adustion of humors present and that salt humors are the cause of this Malady yet notwithstanding since that there are very many other Tumors and Ulcers that have their original from adust humors here therefore the very specifical cause is altogether to be sought for which notwithstanding cannot easily be explained but it consisteth in an occult i. e. an hidden and secret Malignity But
an extream troublesome palpitation and beating of his Heart For the removal of this great Distemper there were many Remedies prescribed and administred not only by my self but likewise by the most expert Physitians of our Vniversity there All which when they could not in the least prevail over this contumacious and head-strong Disease by reason of the Patients continuing and persevering in his accustomed ill course of Diet he grew the worse thereby and after some few months were passed in the which by the advice of the Physitians he took no Physick at all for they were willing to commit unto Nature a part of the Cure of this Chronical Affect he began to complain of that part that lieth under his left Shoulder-blade The place of his grief being lookt upon and throughly considered there appeared unto me a notable Tumor soft unto the touch and attended with a beating and when pressed down with the Fingers it was then seemingly wholly hid and non-apparent but these were no sooner taken off but forthwith it returneth as before In short the Disease having gotten deep rooting being now become incurable our Patient within a very short time after departed this life But now that we might get the truth and certainty both of the nature and constitution of this Disease as also of the Cause thereof we dissected that part that was affected with the Tumor out of which there issued forth great store of Blood unsavory and stinking as it was all which Blood being wholly evacuated and throughly cleansed there appeared the prime and principle Artery under the Heart having its original from the great Vein in its ascending up into the Head exceedingly dilated and extreamly torn This Vein descending downward creepeth along through the Region of the Intercostal Muscles the Blood that flowed forth of it being heaped up in the spaces of the Muscles and in tract of time putrefying and corrupting had so vitiated and marred the Vertebra and Rib of that place that it seemed unto us altogether rotten and putrefied And therefore say we some other way and means of the generating of this Tumor is to be sought and found out The Author of the Book of the Medicin Definitions defineth Aneurysma by the relaxation of an Artery And so likewise Fernelius in the seventh Book of his Patholog and Chap. 3. asserteth that Aneurysma is a dilatation of an Artery ful of spiritful blood but all this while they do not express the manner how this is done Neither is it ever a whit credible that Aneurisma is caused by the dilating of both the Tunicles of the Artery but only by the widening of one of them For the Atteries have indeed a double Membrane one external which is slender thin and soft having of straight Fibres very many but of oblique ones very few and of transverse ones none at all the other internal which is close thick and hard having transverse Fibres but wanting straight and oblique ones And therefore if the Internal Tunicle be either broken by extension as easily it may be in regard of its hardness or else if it be opened by Section it doth not easily Cement and close together again because it is hard but now the external Tunicle in regard of its softness doth easily and soon grow together again and because it is so soft and wanteth both oblique and transverse Fibres it is thereupon extended by the Blood and the vital Spirit seeking their passage forth in an imperious and violent manner and so this kind of Tumor cometh to be excited in the which the force and the impetuous violence of the blood and the vital spirit may be discovered by the very touch Neither is that which Platerus objecteth of any weight or moment to wiâ— when he tels us that upon the alone bare Section that he saw made in the skin that covered over the Tumor the blood forthwith at first hid it self but then instantly sprang forth amain and this oftentimes saith he is in so great abundance that it cannot by any one use he what means he wil be any more stanched but that it issueth forth in greater abundance insomuch that the whol stock of Blood being almost spent it hath oftentimes brought a sudden Death upon the sick Person But indeed if we should determine that the Aneurisma proceedeth from the dilatation of these Tunicles of the Artery this Objection would then carry some weight along with it But in regard that according to the truth of the matter we have already asserted and determined that an Aneurysma ariseth from the dilatation of the exterior Tunicle alone of the Artery the internal being opened either by Section or by Rupture we cannot therefore by any means grant that the Arterial blood lieth hid under the whole Skin but because the external Tunicle is extraordinarily extended it cohereth and sticketh so close unto the Skin that it is extended together with it and is in a manner so become one therewith that it is almost impossible to cut the Skin without cutting the external Tunicle of the Artery And so then the result of al that hath been said wil be this to wit The nighest cause of Aneurisma That the proxime and nighest cause of Aneurysma is the opening of the interior Tunicle of the Artery and the dilatation of the external Now it is very frequently opened by Section when unexpert Chirurgeons instead of a Vein open an Artery or when at least together with the Vein they cut through the Artery that lieth under it Now if this at any time happen the external Tunicle in regard of its softness and neer alliance with the Tunicles of the Veins very easily and soon closeth together again but the interior by reason of its hardness remaineth open from whence through the patent and open place the Blood and vital Spirit endeavoreth to break forth and by this means distendeth the external Tunicle and causeth this kind of Tumor The same may likewise happen if the internal Tunicle of the Artery be broken either by the violent and impetuous motion of the Arterial blood or by any violent external cause and the overgreat distension of the Artery the external Tunicle that is more apt for extension being al this while safe and sound But now Whether or no that pulsation of the Arteries of which Platerus maketh mention in his Tract touching the palpitation of the Heart and touching which out of Fernelius and Ludovicus Mercatus we have already treated in the fourth Book of our Practice Part 2. Sect. 3. Chap. 9. may or ought properly to be referred unto Aneurysma I very much doubt For whenas the Membrane of either Artery is then whol and entire it seemeth rather to be an Affect in the Veins of kin to the swoln and distorted Veins that we cal Varices than this Tumor Aneurysma of which we are now treating Signs Diagnostick The Aneurysma is easily known and discerned from Ecchymosis because that in Aneurysma the color
Part 4. chap. 4. of the Inflation of the Liver ibid. Part 6. Sect. 1. chap. 3. of the Tympany ibid. Part 6. Sect. 2. chap. 4. of the windy Rupture ibid. Part 9. Sect. 1. chap. 7. of Satyriasis and Priapismus ibid. Sect. 2. chap. 3. of the Inflation of the Womb Book 4. chap. 10. of the Inflation of the Head Tract of Infants Diseases Part 2. chap. 6. Touching those Tumors that arise from the soft parts when they are removed out of their own proper places we have likewise spoken of them in special and first of all of the falling down of the Vvea in the first Book Part 3. Sect. 2. Chap. 25. of the Hernia of the Intestines Book 3. Part 2. Sect. 1. Ch. 6. of the Umbilical Hernia ibid. p. 10. Ch. 2. of the falling forth of the Womb and the Uterine Hernia B. 4. Part 1. Sect. 2. Chap. 16. and 17. And moreover as touching the Scorbutick Atrophy Of the Atrophy in general we have written sufficiently thereof in its proper place But now whereas we have in the general spoken of the augmentation of magnitude in the whol body and in general above Chap. 4. those things therefore which may in general be further spoken of the Atrophy we think it nor amiss to subjoyn them here in this place When the Body is not nourished so much as it ought to be Certain peculiar Species of an Atrophy but is diminished and lessened by reason of the denying of food unto it this may indeed in the general be called an Atrophy But yet notwithstanding the peculiar Species of an Atrophy have likewise their peculiar names That which proceedeth from the Ulcer of the Lungs is properly called Phthisis and Tabes that is from an Hectick Feaver is named Marasmus and Marcor And that which happeneth without these causes is called in general an extenuation of the Body We here in this place use the word Atrophy in a general signification and under it we will comprehend all and every preternatural Extenuation of the Body by reason of the defect of Nutriment But now an Atrophy is twofold Atrophy in general what it is the first is of the whol Body the other of some one particular part as of the Arm the Foot c. The Atrophy of the whole in general so taken is a preternatural extenuation of the whole Body by reason of its being frustrated of its food and its being denied its due and requisite Nutrition The Causes As touching the Causes of an Atrophy this in the first place is to be taken notice of viz. that the Cause that invadeth the whole body is either in its own quality and disposition according to Nature or else it is preternatural And then likewise that which is Natural or according to Nature is the Marasmus as we cal it in old age and in aged Persons For there was never yet that living Creature born or brought forth than was not obnoxious to old age and which in old age did not wither and consume away But since that this Atrophy cannot by any Art whatsoever be prevented we wil therefore in this place speak only of that Atrophy which happeneth preternaturally unto some Bodies alone and not unto all in general But now whereas there are two things that concur and are necessary unto Nutrition 1. By reason of the Nutriment to wit Nutriment and the nourishing faculty in both these likewise the Cause of Nutrition diminished and consequently of an Atrophy is to be sought after In regard of the Aliment the body consumeth and wasteth away by reason of its either defect or vitious quality which we may cal its pravity For if there be not dayly as much of this Aliment again taken into the body as is every day insensibly discussed then the body wasteth But if there be indeed a sufficient store and stock of blood treasured up in the Veins yet notwithstanding this is vitious and naught and either it is not at all attracted by the parts or if it be attracted yet can it not be assimilated The body is extenuated and pineth away in the defect and want of Food and Nutriment when in place of that Substance that is dayly wasted and diffused by an insensible transpiration and exhalation there is no other Nutriment or at least not a sufficient store thereof substituted and supplied Now whereas the blood is the proxime and nighest Nutriment of the whole body there the Nutrition is especially hurt through the defect and failing of the blood Now the blood faileth first of all in regard of some default and error in the first Concoction when there is not a sufficient quantity of Chyle from whence the blood ought to have its original generated and bred in the Stomack and this may happen unto such as are sound and in perfect health by reason of a dayly and continued scarceness of Food and their frequent spare Diet but it happeneth in such as are sick and unhealthy when by reason of the want of appetite it being now much dejected and weakned they are averse from all kind of Food and refuse to make any or else when by reason of their Disease they are fed with but little Food and that likewise not much nourishing Which may also happen if the Food that is taken in be presently sent and driven down into the Guts either Crude or Raw or else turn'd into Chyle and so is by the Belly ejected without its ever coming unto the Liver The same may likewise happen if by reason of any Disease whatsoever in the Stomack its Concoction being thereby much weakned the Chyle that is generated be either but little in quantity or that which is as bad or worse imperfect and not sufficiently elaborated Moreover Nutrition may be hindred because of the hurt of the sanguifying faculty to wit when by reason of something amiss in the Liver or Spleen the blood that is generated is impure and not good and this cometh to pass in the Cachexy Leucophlegmatia Tympany the Dropsie Ascites the Scorbutick atrophy and the long lasting Scabbiness Now as for the Causes of Sanguification they have been already in the third Book of our Pract. mentioned and explained From whence it happeneth that albeit there be a sufficient quantity of Food taken into the body yet notwithstanding there followeth no Nutrition and this again happeneth for two Causes to wit because either there is no aliment appointed by Nature for the nourishing of the parts or if there be any appointed for this purpose yet notwithstanding it cannot be rightly assimilated There is no aliment appointed unto the parts either because the Chyle is not so exactly elaborated in the Stomack that it may be converted into good blood or else because although the Chyle be sufficiently and rightly elaborated in the Stomack yet by reason of some fault in the Liver it is not converted into good blood or else because that although there be Chyle generated
in the Stomack and that accordingly blood be bred in the Liver yet it is oftentimes discussed and wasted by some certain Causes such as are overmuch exercise Watchings Cares Griefs and Diseases which melt away dissolve and discuss the aliment so that there is too great an evacuation hereof by the Belly by Sweats and by the flux of Blood and such likewise are immoderate Rest Meats and Medicamens that dry excessively Fevers especially such of them as are acute and Malignant But the Nutriment is not rightly assimilated by the parts in regard of some vitious quality it hath in it by reason of which it cannot be assimilated by the parts and so likewise the Nutrition may be frustrated by some external error or else by reason of the Object to wit because the Blood is such that it cannot by the nourishing faculty be perfectly overcome and assimilated But now in regard of the faculty there is not a sufficient Nutrition â— In regard of the nourishing faculty by reason of some defect and want of native heat and radical moysture For Nature maketh great use of this Native heat as of the next instrument in nourishing And this especially happeneth by reason of the preternatural affects of the Heart and principally its heat and driness whether it be that the Heart be primarily affected as it is in the Hectick Fever or else that it suffer through some default of the neighboring parts as it happeneth in the Ulcer of the Lungs For whereas the nourishing faculty as we said erewhile maketh great use of the innate and Native heat as its principal Instrument in reteining Concocting agglutinating and assimilating and it being so that the innate heat is cherished by the heat that floweth in if the temper of the Heart be not right and as it ought to be then the heat that floweth in and consequently the innate heat likewise wil be much amiss and not rightly tempered and so it can be no fit Instrument of the nourishing Faculty And that that Hectick Feavers do but slowly and sensibly bring to pass this the burning and melting Feavers accomplish in a very short time by the heat whereof not only the aliment and substance of the body is consumed and melted away but likewise the temperament both of the Heart and also of the whol body is converted into that which is more hot and dry The same happeneth by reason of over hard labors cares long continued diseases and in general al causes that are able to consume the Radical moisture and weaken the Native heat Now this Atrophy happeneth especially in the softer parts The subject the fat and the flesh and indeed the fat is first of al wasted and then afterward the flesh is likewise extenuated But now as for the harder parts such as are the Membranes Cartilages and especially the Bones although these may also in the like manner be dried yet notwithstanding they cannot possibly be so extenuated and diminished that thence the whol body should decrease And hence it is likewise that the said extenuation and Atrophy of the body doth appear especially in those parts in which there is much fatness and where there are more or greater Muscles as in the Eyes and Temples The particular Atrophy The Atrophy that happeneth in the parts is various It happeneth oftentimes privately in the Limbs the Arms and the Thighs And hither belongeth the Atrophy of the Eye The causes thereof which are the same As for the Cause of the particular Atrophy like as the Causes of the Atrophy of the whol body consist in some one principal Bowel whose action is necessary for the nutrition of the whol Body or is indeed universal and such as may exsiccate and dry the whol body so in like manner the particular Atrophy of any one part hath a private cause or at least such a one as belongeth unto that particular part Yet notwithstanding the Causes are the same as of the universal Atrophy to wit the weakness of the Nutritive Faculty The weakness of the Nutritive Faculty and the defect of Aliment The Faculty is hurt when the part is over cooled and left destitute of its proper heat For if this happen the part can neither attract nor retain not alter nor assimilate the Aliment Now the part is refrigerated and the heat decayed and rendered dul and unfit for action not only from the external Air as also from cold water but likewise it may proceed from overmuch rest in the Palsie or else from the streightness of the passages through which the Spirits flow in The defect of nutriment The Nutriment faileth especially by reason of the narrowness of the passages through which it floweth unto the part that needeth it And this happeneth for the most part from external causes when the Veins that carry the blood unto the part for its Nutriment are pressed together by the bones when they are loosened and out of joynt or else from some certain Tumor that is nigh unto it or by the brawniness and hardness of the flesh or else lastly when the Veins that convey the Nutriment are cut in sunder See likewise Galen's Book of Marcor a Species hereof arising from an Hectick Feaver Signs Diagnostick The extenuation of the whol body as likewise of some one particular part thereof is visibly apparent to the sight so that there wil be no need of many signs For if the whol body be greatly wasted by an Atrophy then the Face fals away and becometh lean the Temples fal down the seat of the Eyes is rendered hollow and deep the Nostrils become sharp and such kind of Face because that Hippocrates describeth it in his Prognosticks they commonly cal an Hippocratical Face Al the Ribs are conspicuous the shoulder blades and the Chanel bones stick out the Neck is extenuated and the Larynx or the top of the cough Attery buncheth forth the Belly falleth down the Buttocks become withered and weak the Thighs Arms Hands and Feet are emaciated and grow lean But in regard that the Atrophy hath its dependance upon many and several causes they are therefore al of them to be inquired into that so the Cure of them may the more rightly be proceeded in And therefore enquiry must be made whether external Causes to wit tasting cares grief over hard labor and the like went before If we find no such thing we are then to make enquity into the internal Causes to wit whether there be present a Hectick or any putrid Feaver or whether there had not been one a little while before and likewise a discovery must be made touching the Stomach Spleen and Liver in what state and condition they are for by the Diseases of the Bowels it may easily be known what the Cause of the Atrophy is Prognosticks 1. By how much the more the Atrophy is but recent and newly begun by so much the more easily it is cured but by how much the longer it hath
and the very natural flesh it self wanting and that Ulcer is no simple and single Disease but a Compound one such as is conjoyned with magnitude augmented There may likewise together with an Ulcer be conjoyned divers other Diseases a Distemper an Inflammation an Erysipelas an Excrescent Flesh and other Diseases which yet notwithstanding belong not unto the Essence of an Ulcer but may be taken away the Ulcer stil remaining the essence whereof doth consist only in the solution of Continuity together with some kind of diminution of the part affected The Subject of an Ulcer is a part soft or fleshy The Subject the word Flesh being here taken in a large acceptation viz. not only for the Musculous flesh but for that likewise that comprehendeth the flesh of which the Intestines the Bladder and other of the Bowels consist and herein lieth the difference between it and the rottenness that is in the Bones The Causes The neerest Cause is any matter whatsoever it be that hath in it any corroding quality which comprehendeth under it not only the sharp humors that are bred in the body but likewise all those external Causes that have in them a corroding power such as are corroding Medicadicaments and poysons for it is false that which some assert that the very same Ulcers arise only from internal Causes since that experience teacheth us that the very same Ulcers may be excited also from external Causes And so Galen himself being witness in his fourth Book of the Method of Physick and Chap. 9. it is most apparently known even by experience it self that by the Fire scalding hot water Oyl and other the like fervent juyces in burnings and scaldings they are not Wounds that are excited but Ulcers like as also Medicaments and Poysons that cause putrefaction and burning excite Ulcers And so poysonous and contagious vapors breed Ulcers like as Scabbiness by contagion and infection breedeth Scabbiness to wit whilest the Contagion that is imparted and communicated unto the Skin corrodeth it And in the very same manner the vapors that are drawn in by breathing from the Lungs of Phthisical Persons do exulcerate the Lungs and by contagion do breed a Phthisis or Consumption And in the like manner upon the very same ground Venome and Venereal Poyson being rub'd and chaf'd into any body or by any means communicated thereunto infecteth and exulcerateth the same Neither is it of any weight or moment that Eustachius Rudius endeavoreth to reduce such like Ulcers as these rather unto Wounds then unto Ulcers For by this means he confoundeth altogether the Difference that is betwixt Ulcers and Wounds in regard that Ulcers Wounds do not differ only in this that Ulcers are evermore with a loss of some of the substance whereas Wounds may be without any such loss but likewise in that Wounds arise from some Cause that either cutteth into the part or pricketh it or breaketh or bruiseth it but these to wit the Ulcers proceed from a Corroding Cause whether it be external oâ— whether it be internal And this is also manifest in Medicaments that putrefie for who can deny that to be an Ulcer that is excited from the Juyce of Spurge from the which said Medicaments that Contagion that is in Scabies the French Pox and the Phthisis or Consumption differeth but very little For although as Rudius there Objecteth we do not deny that such like Poysons have likewise in them a power of infecting the humors which being corrupted may afterward also promote these Ulcers yet notwithstanding we say that all power whatsoever of corroding is not to be denied unto this very Contagion it self although afterward when the corruption of the humors happeneth in the body the increase of the Ulcer be thereby much promoted and furthered The Differences The Differences of Ulcers some of them are Essential others of them only Accidental The Essential are those that are taken from the very form of the Ulcer from the Subject and from the efficient Cause thereof Those that are taken from the form of the Ulcer are drawn from its figure its magnitude and the like For some Ulcers are great others but smal some of them long others short some of them broad others but narrow some straight others again oblique wreathed in and fistulous some of them equal in which the flesh in all the parts of the place affected is equally wasted others unequal in which there is a greater part of the flesh consumed in this place and a less portion in another place of the same Ulcer From the part affected some Ulcers are said to be External others Internal some sleight and superficial others of them profound and deep and they may be in this or in that part The Differences arising from the Causes shall he shewn in the next following Chapter wherein our purpose is to treat of the Causes of Ulcers But now the Accidental Differences of Ulcers are those that are taken from such things as are without the Nature Constitution of the Ulcer and they are such as are taken from the scituation of the Ulcer or else from their time viz. that some of them are Recent and new others of them old and inveterate And hither likewise there may not unfitly be referred those Differences that are taken from Causes accidental and such as are not common unto all Ulcers to wit that some Ulcers are joyned together with a fluxion but that others of them want the said afflux that some of them are pure others of them sordid and soul corroding eating up and Creeping along For these Differences depend upon the Causes And hitherto likewise belong those Differences that are taken from the Accidents and Symptoms of the Ulcers to wit that some of them are altogether void of pain others of them accompanied with a pain an itching pricking and burning some of them easie to be cured others difficult and rebellious by the Greeks called Dysepulota some of them benign and favorable others such as have contracted a most pestilent and malignant quality And hither likewise are to be referred those Ulcers that they commonly call Chironia and Telephia And yet nevertheless besides these Differences that may be properly called such there may yet some others be given that are improperly so called and such as may rather be termed the Complications of Ulcers with other Diseases then Differences and such like Differences are these to wit that some Ulcers are conjoyned with Pain a Distemper a Phlegmone a Callous or Brawny Flesh a Gangrene a Cancer Worms and the Rottenness or Corruption of the Bones And the truth is the Differences and Distinctions of Ulcers are drawn from the Springs aforesaid But it being a truth likewise that some of the sorts of Ulcers are taken and drawn from divers and several Fountains that so we may not treat of Ulcers without any Method I conceive that our Discourse touching these Ulcers will be most Methodical if we handle them in the
Groins and Tumors in bodies that are plethorical and cacochymical For the matter flowing down unto the ulcer in the Hand or in the Foot those very parts themselves likewise being become more loose and weak do first of al receive and drink it in 21. The ulcers of the Thighs are for the most part hard to be cured and especially if they be cherished by any distemper and default in the Spleen for then the thick and melancholy humors that flow unto the ulcer do hinder the Cute thereof 22. Ulcers that have continued long and are now become inveterate are not to be cured without much danger unless the body be first of all carefully purged and a good course of Diet be observed of which very thing Gulielmus Fabricius in his third Century and Observ 39. giveth us an instance in a certain man who having had an inveterate ulcer cured in his left Thigh by an unskilful and immethodical Empirick after some few months was surprized with a Pleurisie in his left side upon which he died and that during his sickness he spit forth just such stuff and excrements as before were wont to flow forth of the ulcer See likewise Ambrose Parry in his seventeenth Book and Chap. 51. touching Pus likewise from an ulcer in the Arm evacuated by the Urine The rest of the Prognosticks shal be handled in the special differences of the ulcers Indications Since that the Essence of an ulcer consisteth in the solution of unity and the diminution of the magnitude of the affected part the solution of unity sheweth that union must be endeavored and that which is lost and diminished indicateth its own restauration to wit the ulcer as an ulcer is to be filled up with flesh and united and then shut up with a Cicatrice But then when the ulcer is conjoyned with its cause that either excited the ulcer from the very beginning or else if in the Cure it obtain the Nature of that cause without which the ulcer had not been the said cause is then first of al to be removed But then it is requisite likewise that the temper of the part affected as also the blood that floweth thereto be such as it ought to be but if there chance to be any thing amiss in these it is to be corrected touching which we shal hereafter speak further in the special differences of Ulcers If therefore that Humor that excited the ulcer be stil present it is to be evacuated for in every affect in which the cause is stil present the Cure is evermore to be begun from the removal of the Cause And moreover because that in the beginning there wil alwaies fal forth some of the blood without their proper vessels and because that oftentimes together with it other vitious humors in the body flow thither lest therefore that which stâ—cketh in the pores of the parts should putrefie and breed an Inflammation this blood is to be concocted and changed into good and laudable Pus From whence likewise it is that Galen in his Book of the times of the whol Disease and Chap. 3. writeth that ulcers have their peculiar times and that in the beginning there iâ— thrust forth a thin inconcocted and waterish Sanies which in the augmentation by the help and benefit of concoction becometh thicker and at length in the state is changed into Pus that is good and white And therefore in the beginning of an ulcer it wil be requisite to use Concocters which they commonly cal Digestives And furthermore the filth and impurities which are wont to be generated in an ulcer in regard that they hinder the curing thereof are to be wiped clean away So soon as the ulcer is cleansed the Cavity thereof is to be filled up with flesh and at the length the ulcer is to be shut up with a Cicatrice There is yet nevertheless likewise regard to be had unto the parts affected For in the ulcers of the external parts the green iust of Brass burnt Brass Vitriol Antimony and the like have their place which nevertheless are by no means to be admitted of in the internal parts If likewise the part be so constituted and framed that it may give a passage unto other things like as the Gullet doth the Medicaments are then so to be ordered that they adhere unto the part Those parts that are endued with an exquisite sense wil not admit of sharp Medicaments which those parts that are of a more dul sense wil wel enough sustain touching which we shal speak here and there in the particular ulcerâ— But now how an ulcer may be filled up with flesh Galen teacheth us in his third Book of the Method of Physick and Chap. 3. To wit unto the generating of flesh there are necessarily required the efficient Cause and the matter The efficient is Nature which as it doth in the whol body so likewise in each particular part doth attract and draw so much Aliment as is necessary and there she retaineth it concocteth applieth and assimilateth it The matter is a pure and sincere blood that is generated from meat and drink But because in every concoction there is generated a twofold excrement one more thin that insensibly exhaleth or else is discussed by Sweat the other more thick the same likewise happeneth in the generation of Flesh in the Ulcer and if they be left remaining in the part they wil moisten it and hinder the generation of Flesh And therefore these Excrements in the Ulcers are to be clean wiped away and dried up And this is that which is so frequently commonly alleadged out of Galen in his third Book of the Method of Physick and Chap. 4. and in his fourth Book of the Method of Physick and Chap. 5. and in other places here and there where he saith that every Ulcer requireth exsiccation And Hippocrates in the beginning of his Book of Ulcers thus writeth That which is dry saith he commeth neer unto that which is sound but that which is moist cometh very nigh unto that that is vitiated And so the Cure of an Ulcer it is indeed the work of Nature that restoreth the flesh that is lost from the Blood flowing unto the part and bringeth a Cicatrice over the Ulcer being silled up with flesh The Physitian he only removeth those impediments that are an obstacle to Nature in her operation whilest he cleanseth away the Excrements and drieth the Ulcer and when he doth this he is then said to generate Flesh and to introduce a Cicatrice The Cure At the beginning therefore if the body be plethorical or Cacochymical then the abundance of Blood is to be diminished or the Body evacuated lest that the humors flow yet longer unto the part affected And withall let there likewise be a good and wholsome Course of Diet appointed unto the Patient that so there may no more of these bad humors be generated in the Body And for all those things likewise that we call not natural there
thin there is no unsavory and stinking smel neither in the Vlcer nor in its Tumor There is no Inflammation the pain is but little and moderate nothing creepeth therein and therefore it bringeth along with it no great danger yet however it is not easily cured There it somtimes a thin Cicatrice brought all over it but this is again soon broken and the Vlcer renewed It happeneth most especially in the Feet and in the Thighs The same Celsus seeing that he maketh no mention of Telephian Ulcers it is not to be doubted but that he thought them to be the same with the Chironia as likewise Paulus Aegineta doth when in his fourth Book and 26. Chap. he thus writeth Inveterate Vlcers saith he and such as hardly admit of a Cicatrice some cal them Chironia as though they needed a Chiron himself to heal them others there are that cal them Telephia because that Telephus continued long troubled with such a like Vlcer Those that think that both the Chironium and the Telephium Ulcers consist not so much in their corrosion as in this that they are both of them malignant and contumacious so that they are wont to continue with the sick persons even unto their old age these dissent from Galen who in the second Book of the Method of Healing Chap. 2. and 14. of the said Method Chap. 17. thinketh that Phagedaena consisteth in erosion and that Chironium and Telephium are a species hereof Where we must know as Galen acquaints us in his Commentary upon the sixth of the Aphorism Aphor. 45. that al Ulcers that become greater and worse the Ancients called al these Ulcers Phagedaenae and if in this manner we take Phagedaenae then Chironia and Telephia may be called a Species or lâ—nd of Phagedaena But there are some certain of the latter Writers that have endeavered to distinguish them giving unto each of them a proper and peculiar appellation and some of these they cal Chironia others of them they term Telephia and a third sort Phagedaenae So that Phagedaena being taken for a corroding Ulcer is one while the Genus of Chironium and Telephiuns Ulcers and another while a certain determinate Species of a corroding Ulcer differing from Chironium and Telephium which to wit besides the skin eateth through the flesh it self and yet nevertheless is not altogether so malignant as Chironium or Telephium or the Cancer To wit Telephian Ulcers are the same with Chironia so called from Telephus who was a long time afflicted with such an ulcer And what Galen in the fourth Book of the Composition of Medicaments according to their kinds Chap. 4. hath written touching Chironia to wit They cal saith he those Chironian Vlcers that are not meanly and indifferently malignant or contumacious but such as are so in the highest degree The same is likewise to be taken and understood of the ulcers Telephia The Causes Now such like Ulcers have their original from a Melancholy humor having some though not much black Choler mingled together with it Signs Diagnostick Such like Ulcers are known in that they have their lips il colored and for the most part they are red and itching and although the Ulcer be never so lightly and gently handled or wiped yet there is a pain perceived the parts lying round about it swel up and the Ulcer is from day to day dilated and not only the skin but the flesh likewise that lieth under it is eaten through Prognosticks Every sort of these Ulcers is Contumacious and hard to be cured as we told you before The Cure As touching the Cure Universals being premised and the body emptied of the vitious humor and a fit course of Diet prescribed there are to be applied unto the Ulcer Medicaments that are compounded of such things as are cold and dry astringent and withall Dicussive and such are Plantane Nightshade the tops of the Black-berry or Dog-berry bush the Flowers of Roses Cypress Nuts Pomegranate flowers and rinds Mastick the bark of Frankincense burnt Lead Litharge and the like And therefore in the first place let the Ulcer be washed and fomented with this or the like Decoction Take Plantane one handful Flowers of red Roses Pomegranate flowers and Cypress Nuts of each half an ounce Myrtle berries Pomegranate rinds Sumach of each three drams Alum burnt half an ounce boyl them in Water and wash the Vlcer wel therewith Or Take the Juyce of the Bramble Plantane Nightshade Shepherds-staff of each four ounces the whites of six Eggs Alum four ounces destil them in a Leaden Alembick Let the Ulcer be washed and fomented with this Water and let the parts likewise that lie neer unto it be anoynted over with some Defensive After the Ulcer is thus washed let the Unguent Diapompholyx be laid thereon as also the white Camphorate Unguent and the Unguent de Minio Or Take Tutty prepared half an ounce burnt Lead Ceruss washed of each an ounce let them be wel mingled together in a Leaden Mortar pouring in unto them by little and little the Juyce or water of Plantane and make hereof a Mass afterwards add of Bolearmenick three drams Oyl of Roses and Wax of each as much as will suffice and make an Vnguent More of these like Medicaments shal be declared in the Chapter following Chap. 15. Of the Ulcer Phagedaena Phagedaena what it is ANd because as we have told you there is likewise mention made of Phagedaena among the Ulcers we shal therefore here in this Chapter explain it and shew you what it is It is so called from the Greek word Phagein from its Eating and this whether Tumor or Ulcer hath received its name from eating through and corroding because it eateth through the parts lying neer unto it And indeed it is properly an Ulcer But yet nevertheless in regard that the Lips of the Ulcer strutting forth with black Choler are lifted up into a Tumor it is therefore by some referred unto Tumors and there is mention hereof made by Galen in his Book of Tumors Chap. 14. But we wil treat here of it among Ulcers But yet nevertheless as touching its name this is to be noted that it is not alwaies taken in one and the same signification For somtimes as Galen tels us in Epidem 6. Comment 3. Text 37. Phagedaena signifieth an appetite unto and eating of much meat and hence by the Author of the Medicinal Definitions it is defined to be a Constitution in which Persons having an appetite unto much Food and devouring much thereof are not able to retein and keep it but when they have cast it up they again desire more and in this manner it is also defined by Aurelianus in the third Book of his Chronic. Chap. 3. So that Phagedaena being taken in this manner and in this sence is nothing else but that we cal the Dog-like appetite And therefore Pliny in his Book 20. Chap. 5. 13. and in his Book 30. Chap. 9. and Book 35. Chap. 13.
cold is made soft and flaggy so that it yieldeth unto the touch when it is pressed by the fingers which yet nevertheless after it is throughly dried becometh black wan and altogether deadned and it yieldeth a noysom and stinking savor like that of a dead Carkass and the skin if it be taken up with the fingers seemeth to be separated from the flesh lying underneath it And here Ambrose Parry adviseth every Physitian that when he hath discovered by these signs that there is a Gangrene and a Sphacelus he no longer defer the doing of what is to be done neither suffer himself to be deceived by the motion some whereof is oftentimes stil left remaining even in a mortified and dead Member For in a Sphacelus the corrupted parts are moved not by the motion of the whol and entire Muscle but because the Head and no more of the Muscle is yet whol the which while it is moved it doth together with it draw the Tendon that is inseparable from it and the tayl likewise thereof although it be now wholly dead and without any true and proper motion And these signs that appear in a perfect corruption and Sphacelus are stil the same in every one of them whatsoever the cause be that it draweth its original from whether it be from cold or from a poysonous quality or from transpiration hindered or from an extraneous heat or lastly from the defect of Aliment unless it be in this only that such like Symptoms in a Sphacelus that hath its original from an occult cause and such as is poysonous as for example the Delirium or dotage the Syncope and the like are greater and more grievous But in a Gangrene and mortification that is but yet now beginning there is observed a diversity of the signs and symptoms according as the Gangrene hath its original from divers and different causes For in a Gangrene that ariseth from cold there suddenly appeareth an acute and pricking pain and a redness in the part which soon after is changed into a black color and the heat that was in the part is extirguished and there is perceived a coldness and stupidity with a certain kind of horror as it useth to be in Quartan Agues And moreover in a Gangrene that proccedeth from a poysonous and malignant humor in the body which Nature thrusteth forth unto the external parts there is present a continual Feaver and a strong conflict of Nature with the Disease from whence the Syncope Dotage and the like have their original and such a Gangrene as this ariseth for the most part in the external Members and the extream parts thereof as for instance the great Toe of the Foot with a certain Pustule or Bladder under which there is present a black spot which oftentimes is suddenly derived into the whol Leg and Thigh But that Gangrene that followeth upon great and extraordinary Inflammations that proceed most usually from the hinderance of Transpiration is known by this That the fresh and flourishing color that is wont to appear in Inflammations is turned into that which is pale and wan that beating pain which before did infest now ceaseth the sense is become dul and there arise very great Pustules that are ful of a thin ichorous excrement like unto that that cometh from the washing of raw flesh Which appear almost the same when the Gangrene hath its original from an extraneous heat If lastly the Gangrene seize upon the part by reason of the want of Aliment or through a dry distemper then there is present neither pain nor inflammation nor swelling but rather a leanness and the body is immediately cooled and this Gangrene happeneth for the most part in those places of the body that are the utmost and extream as for instance the Ankles and Toes But when at length the Pustules arise and the part becometh pale and wan then the pains likewise appear and the Feaver is excited But if the Gangrene happen by reason of hard tying and Ligatures then the part swelleth and it distended and there arise greater Pustules ful of a thin excrement resembling the washing of raw flesh but the evident Causes we may easily learn and understand from the sick person himself Prognosticks 1. That the Gangrene is a Malady very dangerous is sufficiently manifest unto every one For unless it be speedily cured it degenerateth in a very short time into a Sphacelus and the part becometh altogether dead For this cause therefore there is not any the least delay to be made but help is to be afforded with al possible speed which may be done with less difficulty in a body that is as yet young strong and vigorous where the vital spirits are as yet entire and especially where the Muscles and Nerves are as yet unhurt 2. But that Gangrene which is with an afflux of poysonous humors and an occult quality is more difficult to be cured than that which is without any such afflux for there are but very few that recover of such Gangrenes 3. There are Gangrenes that are yet more dangerous and these are they that begin in the moist parts for the innate heat is sooner suffocated in such parts by the great store of humors abounding therein 4. And for this cause it is that the Gangrene that ariseth in Hydropical persons is likewise very seldom cured but most usually it degenerateth into a Sphacelus and that which ariseth from the Antecedent Cause is likewise ever more dangerous than that which hath its original from the primitive Cause in regard that in the former the Bowels are more affected 5. But a Sphacelus is yet far the more dangerous Malady For the part that is taken with the Sphacelus can no way be restored and made sound again but it is forthwith to be cut off and separated from the part that hath life which if it be not speedily done then the sound parts that lie neer wil likewise be infected and the putridness wil at length creep into the rest of the body from whence there wil be extream danger of present death before which there usually precede Dotings Watchings the Syncope Convulsions Ructures and Belchings Sobbings and a cold Sweat breaking forth over all the Body and some of them die while they ate yet speaking and others of them die being as it were oppressed with sleep The Cure The Cure of the Gangrene that it may be rightly proceeded in first of al regard is to be had unto the Dyet and the Antecedent Cause if it be present in the body before ever we come to Topicks Most Physitians prescribe and command a Diet that is cool and drying which albeit that it be most true of that Gangrene that is accompanied with an afflux of Humors and followeth great Inflammations yet nevertheless the Diet is somtimes also to be varied according to the variety of the Causes as anon in the species or several kinds of Cure we shal further shew you And so also
a wollen Cloth be wee therein and so imposed upon the place affected it hath likewise been happily and successfully administred in the Gangrene of the Cods of which we have spoken above Take Vitriol one ounce the tops of the Oake one handful Frankincense half an ounce Camphyre two drams Vrine two pints and half boyl them to the Consumption of a third part and then strain them But the Aegypriack Unguent is not alone to be applied but upon the Unguent that Cataplasm is also to be imposed which resolveth drieth and hindreth putrefaction such an one as Johannes de Vigo in his second Book first Tract and seventh Chapter describeth and commendeth and which many other Physitians and Chirurgeons now a daies likewise make use of And all these are to be applied blood-warm and they are so long to be continued untill the putridness be removed But if the Malady wil not yield unto these Remedies then we are to have recourse unto those that are stronger to wit Causticks such as those Trochisques of Andro Polyidas Musa and Pafio which dissolved in Vinegar and Wine may be imposed upon the part Many indeed do here commend and prefer Arsenick before all other Remedies but Gulielmus Fabricius doth and not without good Cause reject and altogether disallow of it in the Cure of a Gangrene as that that not only hath in it a Septick and putrefying faculty and a quality of melting the flesh as it were but that likewise produceth very great and grievous Symptoms vehement pain Dotings Syncope's and the like the malignant vapours being communicated unto the principal part It is therefore more safe to make use of an actuall Cautery as that which hindereth and preventeth putridness drieth and corroborateth the part This is also much commended Take Mercury dissolve it in Aqua fortis when it is dissolved precipitate it the Oyl of Tartar after it is precipitated wash it Or Mercury alone dissolved and mingled with the Water of the Trinity Flowers and wollen Cloaths wet in this Liquor may be imposed on the part The Crust in what manner soever it be produced is to be taken away by those Medicaments that have been above declared in the first Part and Chap. 13. touching a Carbuncle Neither are we to wait so long til Nature shal altogether have separated the Corrupt from the Sound but the highest part of the Crust is with the edge of a Knife or a Penknife to be cut even unto the sound part that so there may be a way made for the Medicaments unto the deeper parts and the rest that are corrupted For if we expect until the Crust shal be freed of its own accord it may possibly happen that under the Crust a new putridness may be contracted The rest of the Cure is in the same order to be proceeded in as is fit to be done in Ulcers Fourthly If the Gangrene happen from overmuch heat A Gangrene from too much heat then a Cold Diet being prescribed and the hot humors being duly qualified and evacuated if the Malady take its original from an internal Cause the Member affected is to be scarified and then washed with such a Decoction as this Take the Water of Endive Sorrel Lettice Nightshade and Vinegar of each one pint Syrup of Sorrel two pound of Lupines half an ounce Water Germander half a handful Salt three ounces boyl them till a third part be consumed After this the Aegyptiack Unguent and the Cataplasm but even now mentioned is to be imposed and the rest which were before prescribed are speedily to follow Where notwithstanding this is to be observed that unless in case of urgent necessity we must not have recourse unto the actual Câ—utery lest that hereby to wit by the power and force of the fire the extraneous heat which is the Cause of the Gangrene be augmented Fifthly and lastly If the Gangrene arise from the defect of Aliment and Blood and Spirits A Gangrene by reason of an Atrophy in the part and chiefly in truth if it be by reason of a Driness and an Atrophy necessaâ—ry Nutriment being denied unto the part then meats that are hot and moist easie of Digestion and such as generate much and good blood are to be given unto the sick Person and outwardly the body is likewise to be moistened with Oyntmentâ— of sweet Oyl or with Oyl of sweet Almonds and all things are carefully to be avoided that exsiccate and dry the body And unto the part it self that is already affected with the Gangrene the Aliment is by all manner of means to be attracted And therefore here there is no place left for Defensives in regard that they shut and stop up all passage of the blood and Spirits unto the part affected And therefore we are not only to anoynt the part affected and the other members with the Juyce of Earth-worms which is made of the said Earth-worms first washed in Water and then in Wine so put into a great Vessel with good store of the Oyl of sweet Almonds Violets and melted by a gentle and moderate heat over hot Embers and afterwards strained which is a sprecial and soveraign Remedy in the Atrophy and extenuation of the parts but the part affected is therwith likewise gently to be rubbed and chafed unto which also Cupping-glasses not scarified are to be applied But it wil be most fit and requisite if there be already present a putridness to administer those things that do alike both attract and resist putridness such as are Salt Water boyled with Water-Germander Liquid Pitch with the meal of Lupines of the bitter Vetch Orobus Myrrh and the like But if the Gangrene hath already made any progress the part is then to be scarified and the Aegyptiack Unguent and that likewise that is compounded of Pitch and those other things a little before mentioned are to be laid thereon A Gangrene from the interception of the blood spirits Moreover If the Gangrene happen from the interception of the Blood and the Spirits likewise whatsoever the Cause then be that thus intercepteth the blood and the spirits it is immediately to be taken away as if the said interception be from the binding of the part it is forthwith to be loosened and withal those Medicaments that resist putridness as likewise those that discuss that that is corrupted such as are those that are made of the Meal of Beans of the bitter Vetch Orobus of Lupines Aloes Water-Germander and the like are to be imposed And if the Gangrene hath already gotten unto any heighth the place is to be scarified and those other things that are required in al Gangrenes are to be done If an astringent and repelling Medicament be the Cause the said Medicament being removed the heat is to be recalled by Frictions Lotions and Anointings And so we must also proceed in the Gangrene that hath its original from other Causes that intercept the Spirits For the Cure of the Gangrene
arise thereupon the Trunk or Stump of the part that hath been cut assunder yea and the Neck likewise and all the Spinal Marrow is to be anoynted with those Medicaments that are otherwise also wont to be applied unto affects of a Nervous Nature made of Sage Rosemary Marjoram Rue Lavender Dil Camomile St. Johns wort Bayberries the Oyl of Earth-worms the Oyl of a Fox Turpentine and the like We must not here pass by in silence the Scoâ—butick Gangrene The Scorbutick Gangrene touching which we have already spoken something in the third Book of our Practise Part 5. Sect. 2. Chap. 4. Which most usually beginneth about the extream part of the Foot with black and purple spots and a little after this there appeareth from hence a crusty and Gangrenous Ulcer dry and yielding forth neither the thin Excrement Sanies nor yet the thicker which we term Pus and then one or other of the Toes beginneth to die and then there appear red lines and purple spots upon the juncture of the Foot according to the length of the Leg. I have my self seen some examples of this Disease But both this Gangrene and Sphacelus differ from that Gangrene and Sphacelus that are both of them wel and commonly known and that in many things For that Gangrene that is so wel and commonly known hath its original for the most part from Causes that are manifest and apparent and there alwaies floweth forth of the Member that is dead in such a like Sphacelus a stinking and waterish humor the Member becometh soft and putrid and it sendeth forth from it a grievous and noysom stench like unto that of a dead Carkass and it creepeth much in a very short time and most commonly it soon destroyes and kils the man that hath it But now the Scorbutick Gangrene almost ever appeareth and invadeth the person without any manifest cause creepeth forward but very gently and slowly and doth not destroy the person therewith affected until after a long time for I knew a Noble-man that lived above three months but a certain School-Master I saw that lived above six months notwithstanding this Malady The part affected with this Gangrene is altogether dry so that there floweth out of it nothing at al and when the corrupt part is taken away by the Iron although a red flesh offer it self unto the view yet nevertheless that same red color is withal somwhat dark and blackish and the day following it likewise is even found to be dead also and there is here no stink at al perceived that offendeth And moreover so soon as ever the Malady hath first of al seized upon one of the feet only then presently after without any manifest cause at al there begin to appear in the other Leg and Foot also certain spots and blemishes of a red or purple color and then likewise not long after this one or other of the Toes of that Foot becometh wan and leaden colored and in a very short time it is found to be quite dead and at length most commonly the party as it befel that Noble person before mentioned being taken either with the Apoplexy or with the Epilepsie upon the first approach thereof dieth And yet notwithstanding this Malady somtimes invadeth suddenly to wit when the peccant humors are by wrath terror or the like Cause first disturbed and then afterwards thrust down suddenly and as it were in a moment unto the Toes and first of al to some one of them only after the very same manner as the Erysipelas or Rosa is wont suddenly to arise and this humor in regard that it hath in it a very bad and destructive quality or else hath received it from some affect of the mind causeth that part that it seizeth upon instantly to die and hence it is that by some this kind of Gangrene and Sphacelus is in special called Syderatio whereas otherwise the Gangrene is wont in the general also to be termed Syderatio Now this said humor seizeth upon the Tendons most usually from whence there arise most terrible and intolerable pains that torment and grieve the sick person both day and night which said Tendons in regard that they do not so easily and soon putrefie as doth the flesh hence it is that this Gangrene likewise or repeth on so slowly that somtimes unto the external view it is a whol months space in overspreading one only joynt and ere it seize upon another albeit that within almost al the Tendous of the Foot are already infected and this Malady continueth somtimes a quarter of a year before it kil the person and it is seldom or never cured in regard that this depraved humor hath insinuated it self more deep than usually into the Tendons and therefore cannot be so easily taken away So a certain Noble person that had otherwise a Cacochymical and foul body and was subject unto the Erysipelas upon a fear and terror Nature then suddenly thrusting down the vitious humors unto the little Toe was surprised with a Gangrene which afterwards by little and little overspread likewise al the rest of the Toes and almosâ— the whol Foor with extream great pain upâ— which after the space of three months 〈◊〉 died Of this kind was that Gangrene also with which a certain Citizen here about thirty yeers of age was taken in the month of January 1633. He first of al complained of a pain in his left Arm neer unto the Elbow which he making light of the pain descended unto his Hand and it was presently taken with a cold Tumor or Swelling and at length became suddenly overspread with a purple color so that now there appeared manifest signs and tokens of mortification and a Gangrene Yet notwithstanding upon the administring of fit and proper Medicaments of which we shal speak more hereafter his Hand had its natural color again restored unto it and the swelling vanished away so that there was nothing further to be seen but only in the very tip of the little Finger the Scarf-skin appeared to be somwhat wrinkled upon the opening of which here flowed forth a little of an humor and the Skin underneath appeared pale and so the very tip of the finger was taken with a Gangrene which yet nevertheless without any diminution of the Joynt was cured In the curing whereof we found this one thing wel worth our observation that from the said finger most sharp and exquisite pains were extended into the whol Hand insomuch that the sick person was even afraid to betake himself unto his bed but that rest and sleep he took was in the night time as he sate When his finger likewise was handled by the Chirurgeons the pains that he felt were so great that he could not endure the least touch the feet moreover swelled much and his face was somthing more swoln than usually Neither indeed wil any man that is not a stranger unto what is done in the practice of Physick admire that some vitious
Womb from the pollution of the blood and the corrupted seed and that it did consist and was nourished in the Womb of the Mother or that this Maiden being then but an Embryo in the Womb of the Mother while it yet lay therein suffered somthing from the nauseousness and vomiting of the Mother and from affrightment befalling her or from some grievous Affect that she lay under He conceiveth moreover that the Mother might be affrighted and terrified upon the sight of some Sepulchre or that she happened to come in place where they were anointing some dead body or that she took conceit and a loathing from the putrid and stinking Excrements that flow from such as lie in child-bed or else that she was some way or other greatly affected by these and the like accidents You may read more hereof in the alleadged Epistle of Libavius And another Example of the stink of the whol body the same Libavius hath in the following Epistle where he writeth that he wel knew a certain yong woman that after she was married and living in Wedlock while she had her Courses had such a stink coming from her as never Jakes had worse and that during this time her Husband lived very discontentedly as one much afflicted therewith THE FIFTH BOOK THE THIRD PART SECT II. Of things amiss in the Hair and Nails Chap. 1. Of the Nature of the Hairs AFter the faults of the Skin we wil and that not unfitly subjoyn those things that are amiss in the Hair For the Hair is fixed in the Skin neither is it any where else to be found but in the Skin Neither indeed are the Vices of the Hair to be passed over in silence in regard that even these are although ignoble yet parts of the body For as no man can wel deny That the Nails the Hoofs and Horns of al living Creatures and likewise that the Feathers in Birds are parts of their body and that none can wel say that a Peacocks Tail and al the various Feathers in Birds that are of so many several colors I say as none can wel affirm that these Feathers affording so great variety are a thing meerly excrementitious and not parts of their body so likewise it is in no wise to be denied that the Hairs are also a part of the body And this we are sufficiently taught by the conformation of them by their various figure and their different colors The same is likewise proved by the use of them and so also by their diseases touching which we shal speak hereafter and especially that we cal Plica Polonica And lastly That very effective and conformative power that the Hair hath as wel as other parts as we shal by and by shew you cleerly demonstrateth the truth of this And the growing of the Hairs again after their being cut doth not in the least prove that they therefore are no parts For both the Nails and the Hoofs the Claws of Lobsters and in certain bruit Beasts the Horns after they are shed and fallen off yet they grow forth again and so do likewise the Teeth in Men and Women We are indeed vulgarly but erroneously taught That Hairs are generated when from the heat of our bodies fuliginous and thick vapors are out of the third Concoction elevated in the parts of our body and are driven unto the pores of the Skin in the streight passages whereof whiles they stick they are there conglutinated until at the length the pore being filled up other vapors coming underneath drive it forward and these vapors are likewise followed close by other vapors and after them by more and so in the end they are thrust forth out of the pore and the hair is formed which afterward the like vapors succeeding and thrusting forth the hair and agglutinating themselves unto the root thereof it thence cometh to be prolonged But now if the Hair should be generated in this manner The breeding of the Hair a reason could not then be given why hair should not alike be bred in al parts of the body and in those parts where they are bred why there should be in some places more store thereof in some less and why some of them are alwaies growing when others grow not at al. In the Neck and Face there grow no hairs naturally but in the Head and Cheeks there are great abundance of them as also in the privy Parts in the Armpits Eyelids and above the Eyelids on the Eye-brows The hair in the head and beard is ever growing and is continually lengthened out but those hairs that are in the Eyelids ever keep at one and the same length and moreover they evermore remain straight And furthermore no cause could at al be given wherefore men only should have Beards and that women should not likewise have them whenas notwithstanding women have on their heads most usually the longer hair Moreover the hair is by Aristotle in his third Book of the History of living Creature Chap. 12. distinguished into that which is bred toegther with us such as is the hair of the head eyelids eyebrows and that that is afterwards bred to wit such as at length ariseth in process of time as age comes on of which there could no cause at al be rendered if according to the vulgar opinion the hairs had their original out of those vapors that break forth And therefore there is some other cause of the hairs original to be sought for in the discovery of which Galen hath also been very curious and taken great pains insomuch that he here taketh occasion which otherwise he doth but very seldom to make mention of the wisdom power and goodness of Almighty God the Author and Framer of al things and he hath here endeavored to examine his Omnipotency and Wisdom in this particular and to confute Moses as we may see in his eleventh Book of the use of the Parts Chap. 14. But if we seriously weigh the matter we cannot by any means grant that the hairs are bred only from the excrements or the vapors exhaling out of the body and sticking in some certain places but we are rather to determine that they are generated from the formative we may term it the pilifique or hair-breeding faculty for the causes a little before mentioned And that the hairs are generated not only from some kind of fuliginous vapors but from a matter that is far more solid and neerly allied unto the matter of the Nails and Horns we are taught even by this that the hairs are not easily corrupted but are even after death preserved a long while whol and entire Touching which Gabriel de Zerbis relateth a History in his Book of the Anatomy of Mans Body in the Title of the Anatomy of the Hair fol. 15. in these very words At Rome we both saw and touched saith he the dead body of a Woman buried in the way called Appia just opposite unto the why where Cicero was buried and
Species of the shedding of the Hair as we shal hereafter shew you As for Baldness in the first place look what Patos that is to say the falling down of the Leaves is in Trees the like is baldness in Animals yea also in the very Trees themselves whereupon Aristotle in his sixth Book of the generation of Animals and Chap. 3. writeth Men saith he of all living Creatures are mostly subject unto baldness and they evidently become so sooner then any other Creature whatsoever Which kind of Affect is in a manner general For of Plants likewise some of them have allwaies green Leaves others of them lose their Leaves The like Affect is baldness in those men unto whom it happeneth that they should be Bald. For whenas by little and little some now some then both the Leaves and the Feathers and the Hairs all off when this same Affect shal happen universally then it receiveth these words Baldness falling of the Leaf and shedding of the Feathers And Columella in his fourth Book of Husbandry Chap. 33. saith that the young and tender Chesnut Tree that is infested by Mice and Moles doth oftentimes become bald Now baldness in a man is a certain smoothness Baldness what it is or defect of Hair in the fore part of the Head taking its original from the want of Aliment And this most commonly chanceth naturally in the progress of yeers but yet nevertheless unto some it happeneth preternaturally which is thereupon to be accounted preternatural and vitious The Causes Touching the Causes of Baldness Physitians do indeed very much differ in their Opinions But if we wel weigh the manner how Hairs are generated in the Head the business in Controversie wil not seem at all difficult For whereas both the matter and the Aliment is sent and supplied unto the Hairs from the Brain more especially therefore we say indeed that the defect of the necessary Aliment is the neerest cause of this shedding or falling off of the Hair yet nevertheless this Affect proceedeth oftentimes from the Constitution of the Brain to wit if it become more dry then is meet Hippocrates tels us the same in the sixth of his Epidem Comment 3. Tit. 1. where he thus writeth the Consumption of the Brain and by reason thereof baldness c. Where as Galen tels us in his Comment upon the place by the Consumption of the Brain that diminution thereof is to be understood that happeneth unto old men from its extraordinary driness For if the Brain once become extreamly dry then there will be nothing superfluous therein remaining that may suffice for the nourishing of the Hairs And Aristotle teacheth us the same who in his fifth Book of the Generation of living Creatures Chap. 3. writeth that baldness is caused from the scarcity of the moist heat and fatness that is to say of the moist Aliment For there is in old People an excrementitious humidity that is rather too much abounding then any want thereof And indeed as we have already said baldness is natural unto the most because that in the progress of their yeers and as old age comes on the Brain in every one becometh more dry then is meet but yet unto some this baldness happeneth in their Youth and green yeers to wit unto those that from some preternatural or violent cause have their Brains overdried before the time which Causes may be many The Chief and most principal of them al is the immoderate use of Venus that powerfully drieth the Brain Whereupon it is that before the use of Venus none groweth bald Neither are Eunuchs bald at all in the sixth Sect. of the Aphorisms Aphor. 28. in regard they lose not neither cast forth any Seed and so the like may be said of Youths and until they attain unto ripeness of yeers Women likewise are seldom or never bald and yet nevertheless Albertus Magnus testifieth that he saw two Women that were bald in his nineteenth Book of Animals Chap. 6. in regard that their Constitution is naturally more moist and therefore the Brain also in them is not so easily and soon dryed and because that Women eject not such store of Seed as the Men do The Brain is likewise overmuch and oversoon dried by too much Watching Study and Cares As for that opinion of Actaurius who in the first Book of his Method Chap. 5. assigneth overmuch humidity for the Cause of baldness if any one hath a mind to reconcile it with the opinion of Hippocrates Galen and Aristotle he cannot more fitly explain it then by saying that the defect of Alimental humidity is indeed the Cause of Baldness and yet notwithstanding that excrementitious humidity causeth that this baldness happeneth so much the sooner and more easily after the very same manner that Leaves of Trees fal off indeed by reason of the want of necessary Aliment and yet nevertheless they fal off sooner and faster if any adventitious and Accidental humidity Rain or the like happen Signs Diagnostick The very Truth is that baldness of self appeareth sufficiendy unto the Eyes But yet nevertheless in what respect it differeth from the other species of the falling away of the Hairs we shal now explain unto you This Baldness we now speak of differeth from the Apolecia and the Ophiasis or Area in this that these Vices are fleeting from place to place neither in them do the Hairs fal off from any certain parts of the Head whereas baldness happeneth evermore in the fore-part of the Head But from the falling off of the Hair in special so called this baldness differeth because that in the shedding and falling of the Hair the Hair al generally or at least the greater part of them here and there up and down throughout the whole Head fal off but in baldness this falling of the Hair is only in the fore part of the Head Prognosticks 1. Baldness indeed in it self bringeth no danger at all but that it causeth that the Head lieth the more open to be hurt by the externall injuries of the Air and that it is as it were the forerunner and sign of the hastening of our Mortall Nature towards her dissolution and yet notwithstanding it causeth a great deformity and unsightliness especially if it happen early in the time of Youth and that that is resented and disliked by the most of those that behold it and it is reported that Caâ—us Julius Caesar the Emperor famous both for his learning and likewise for his warlike exploits could so il brook and bear the baldness wherewith he was affected that after his making triall of very many Remedies to no purpose it was at length granted unto him by the Senate that he might perpetually wear the Lawrel who if he were now at this day living might easily cover his baldness with a Coveting of Hair made of other mens Hair we in England cal it a Perriwig which is now adaies in very great and common use 2. But that baldness that ariseth
is that these Medicaments that even now we named and those that we shal hereafter further mention do not al of them generate hairs only by their manifest qualities and by taking away the Causes of the falling off of the hair but that they likewise produce hair by some occult quality that is in them such like Medicaments are therefore especially to take place in the production of a Beard not where there hath been a shedding or falling off of the hairs of the Beard but where they never as yet grew It is also wel known that it much conduceth unto the speedy growing of the Beard if the first soft hairy down upon the Chin be often shaved off by which means the Aliment is the more abundantly allured and drawn unto the Roots of the hair For the furthering and hastening of the Beard these following Medicaments are likewise commended Take Oyl of Dill Oyl of Spike of each five ounces the tender Sprigs of Southernwood two handfuls Squils three drams the best Wine three ounces let them boyl until the Wine be consumed and then use it Or Take Oyl of Garden Pinks and sweet smelling Spike of each three ounces Oyl of Roses four ounces of Cloves one dram of Ladanum two drams sweet smelling Wine two ounces Let them boyl al of them unto the consumption of the Wine Add of Musk one scruple and mingle them Chap. 3. Of the shedding of the Hair ALthough as we have already said al shedding of the Hair may be termed a Defluvium or falling off yet nevertheless use and custom have so far prevailed that the shedding of the Hair here and there in the Head in al or most parts thereof is in special termed a Defluvium or falling of the Hair so that they fal not only in one place but either they al fal off throughout the whol head or at least they most of them fal away in most parts of the Head The Causes There is not one Cause alone of this Defluvium of the Hair but the Causes are many to wit Either the want of Aliment or the pravity of the humors corroding the roots of the hair or the thinness of the skin not admitting the aliment of the hair The two former Causes have their place in those that are Phthifical in whom if the hair fal off this cometh to pass as Galen tels us in his Comment Aphotism 10. Sect. 5. because there is here both the greatest defect of Aliment and somtimes also the corruption of the humors The same happeneth for the most part in malignant Feavers such especially of them in which the Brain being withal affected the sick persons are seized on by a Delirye or Dotage For even in these Feavers also the sick parties are greatly extenuated and there is wanting unto the body a necessary aliment and the depraved humors likewise lie gnawing at the roots of the hair and eat them asunder The hair also falleth off in those that have the French Disease by reason of the pravity of the humors which somtimes happeneth likewise unto those that have drunk poyson and it is reported for a truth That whosoever toucheth the Salamander his hairs wil shed and fal away Bun somtimes also the hair fals off by reason of the thinness of the skin and this happeneth unto Women and especially in the Summer time And hence it is that those who travel out of Germany into Italy or other hot Regions find now and then this shedding of their hair for by the heat of the Ambient Air the Skin is made thin and it chanceth also that the matter out of which the hair ought to be generated doth withal transpire Signs Diagnostick The Defluvium or falling of the hair that is in special so called is easily known by the continual shedding of the hair But it is distinguished from baldness the Alopecia and Ophiasis because that in Baldness the hair fals off in the fore part of the head only but in Alopecia and Ophiasis the hair fals from al parts of the head and the head alone but then in this Defluvium the Affect we now speak of the hairs fal off in al parts of the body equally one while more and another while fewer of them But from what cause it is that they fal off may be known from the causes that went before For if there went before any sickness that was in it self apt to consume the aliment of the Body it is then credible that the shedding of the hair proceedeth from the scarcity of the Aliment But if vitious malignant and depraved humors excite and cause any disease it is then an argument that the falling of the hair proceedeth likewise from the pravity of the humors If lastly there went before causes rarefying the skin it is then probable that the said Defluvium of the hair proceedeth from the thinness of the Skin Prognosticks 1. Among al other the species of the shedding of the hair this Defluvium in special so called is most easily cured unless the cause be such as is not to be removed For the skin hath not as yet contracted any preternatural disposition that is difficultly cured And therefore it is that the Defluvium or falling of the hair that happeneth after acure and malignant Feavers is easily cured when the Feaver being healed there is an Aliment again supplied unto the body and the hair that is already fallen off is for the most part restored without the use of any Medicaments 2. But in the Consumption such a defect of the Aliment and such a vice of the humors cannot by any means be amended And therefore in this case there is not only no cure to be had for this shedding of the hair but the sick persons die also And therefore in such as are in Consumptions the falling of the hair is a sure and certain sign of Death approaching as in the fiftth of the Aphorisms Aphor. 11. 3. If the hair fal off by reason of the skins thinness it may then by the use of thickness be restored without any great difficulty The Cure The shedding of the hair is cured by taking away the cause upon which if dependeth If therefore the hairs fal away from the scarcity and want of Aliment it sheweth us that we must use our endeavor that there may be sufficient aliment bred in the body and that that which is bred may be drawn unto the skin of the head If this Defluvium be from the depraved humors and these be supplied from al parts of the body they are then to be evacuated but if they lie only at the roots of the hair they are then to be discussed If these humors be of a poysonous Nature as in the French Disease we ought then to meet with and oppose that poyson If the Affect proceed from the thinness of the skin the skin is then to be thickened If therefore this Defluvium or falling of the hair arise from the want of Aliment we ought then especially to
take care that by appointing a due meet course of Diet there may be generated sufficient store of good blood But for the drawing of this unto the place affected frictions are more especially to be made use of Yea indeed almost before the use of any Topicks the frictions or rubbing of the head are to be administred as Galen teacheth us in his first Book of the Composition of Medicaments according to the places Chap. 2. For Friction doth both attract the Aliment unto the head and also strengthen and thicken the skin If this falling of the hair proceed from the pravity of the humors then universal purgations if need require being first premised the head is often to be rubbed and discussives are to be administred but yet let the Discussers be moderate especially if there be a concurrence of an abundant aliment left that by the excessive and overmuch use of them the aliment be likewise dissipated and the skin rendered over thin and therefore Ladanum is very fitly mingled together with the Unguents If the Defluvium depend wholly upon the thinness of the skin then we ought to apply those things that condense and thicken the skin Galen commendeth especially Ladanum the Oyl of Mastick and the Oyl of Myrtle mingled together Or else let Ladanum be dissolved in Wine and so made use of And Ladanum is also very fitly administred in almost every falling off of the hair But in regard that it is of too thick consistence in it self to be anointed with it is therefore to be dissolved in somthing that is liquid Wine or Oyl and indeed such an Oyl is to be made choyce of that may satisfie and answer the cause But seeing that Unguents and Oyls are troublesom unto many who wil not endure that their heads should be anointed with Oyntments or Oyls therefore for these we must provide Lotions for the head that please them better which are to be made or Southernwood Maidenhair Golden Maidenhair Mastick Roses Rosemary Ladanum And we must here again repeat what we gave you notice of about the end of the foregoing Chapter to wit That there are some who appoint and not without good reason such kind of Medicaments to be made for the recovery of the hair that do not only by a manifest quality take away the cause of the shedding of the hair but such as also by an occult and peculiar faculty do conduce unto the breeding of hair and such as these are only known by experience And these are al the Capillary Herbs Southernwood Reed root sharp-dock root the root of the greater Bur Asarabacca Ladanum Honey and Water destilled from it Bees beaten together with the Honey-combs or the pouder and ashes of them aâ— also of Wasps Flyes Moles Mice the Land Urchin Bears fat and Serpents fat Of which there are made many Compositions As for instance Take the Rind of the Reed root burnt Bees ashes of each two drams Southernwood burnt one dram Ladanum two drains Honey half an ounce Oyl of sweet Almonds and Bears fat of each as much as wil suffice and make a Liniment For the shedding of the hair after sicknesses this following is found to be good Take Maidenhair Southernwood Golden Maidenhair of each half a handful the Leaves of Myrtle of Roses and of Wormwood of each two pugils boyl them in a sufficient quantity of common Oyl and red Wine until the Wine be wasted then strain and squeeze them hard Take of the aforesaid Oyl four ounces Ladanum one ounce Mastick half an ounce and mingle them according to art Or Take Root of the Bur-dock six ounces Maidenhair three handfuls Southernwood one handful Pour thereunto as much white Wine as wil suffice and let them be destilled in a bladder Vnto what is thus destilled if you please you may add the Water of Honey Or else let the Roots of the Bur-dock be boyled in Ley and the head washed therewith Chap. 4. Of Alopecia and Ophiasis Alopecia THat which is called Alopecia and Ophiasis is a peculiar kind of the falling of the Hair Alopecia is so termed from Foxes because that this kind of shedding of the Hair is familiar unto them But Ophiasis is so called from its figure Ophiasis because that the bald and smooth parts destitute of their Hair and writhed seem like unto Serpents It is common unto both these Affects that in them the Hairs fall off areatim as they term it and hence it is likewise that this Malady is in the general called Area And Celsus in one and the same Chapter treateth of Area Area Alopecia and Ophiasis Now the name of Area is imposed upon this Affect from Country Garden-plats For as there the Beds or quarters are distinct and in certain places only and as these Beds when they are void of Plants are Naked and bare so it is likewise in these Areae for here in certain places the Skin appeareth smooth bare and slippery These Affects differ only in their figure For Alopecia hath no certain figure but as Celsus saith is dilated under any kind of figure But the Ophiasis creepeth up and down writhingly like unto a Serpent and one while being extended from the hinder part of the Head it creepeth along on both sides the Head even unto the Ears the breadth almost of two fingers and as soon again being carried beyond the Ears it creepeth forward Serpent-like even unto the very Forehead it self And moreover there is in the Ophiasis far more hurt and danger in the Cause thereof so that not only the roots of the Hair but even the Skin it self also is eaten and gnawn thorow to wit as far as the roots of the Hair reach The definition of Alopecia and Ophiasis And so Alopecia and Ophiasis may be thus defined that they are a falling off of the Hair after the aforesaid manner areatim having its Original from a corrupt and depraved humor gnawing assunder the roots of the Hair The Author of the Book of Medicaments soon provided referreth the Alopecia and Ophiasis unto those Affections that vitiate and marr the Colour of the Hair But we are to know that this is not proper unto the said Areal falling off of the Hair but that this change of Color in the Hair doth either precede the Alopecia and Ophiasis to wit when from a vitious Nutriment the Hair first becometh white but afterwards they fall off or else the colors of the Hair are changed after the Alopecia and Ophiasis For when after the Areae Hairs are again bred they are then either white or yellow like as it is in Horses after that the hair is fallen off by reason of some Ulcer caused by attrition or gauling there is wont in the place thereof to appear and grow again white hairs which happeneth from a vitious Nutriment and the weakness of the Skin And of this Celsus gives us notice in his sixth Book Chapter 1. to wit that the Ophiasis is extended unto the Hair
and dressed up her hair somwhat long as her custom was with warm ordinary Spring water But upon the very first pouring on of the water all the Locks of one side of the Head as it were all besmeared with Birdlime become on a sudden so intricate and intangled that afterward as long as she lived they could by no means wit or device be extricated and severed as formerly but continued thus in long entangled Locks very frightful to behold even unto her dying day And this we conceive to be wrought meerly by Witchcraft But I think this to be very rare and that this Vice proceedeth from some internal Cause we are taught even by this that in those places Bruits likewise are taken with this affect But now what kind of humor that is we shall find it very difficult to explain Very many there are and indeed the most who refer the Cause of this malady unto a certain viscid and slimy humor But these fal short of the truth For in many bodies and many Regions likewise these viscid Clammy humors are generated which yet notwithstanding produce no such Disease For neither may these pains of the Limbs Convulsions and other Symptoms be referred only unto a viscid humor neither can any reason be rendered why this matter should be thrust forth only unto the hairs and unto no other parts But what the Nature of this humor is the nourishing of our body and the generating of other Diseases may in some measure instruct us For although all the parts are nourished by the blood yet nevertheless as divers Plants do from the same Earth attract each one of them that Aliment that is proper and familiar unto them as Hippocrates testifieth in his Book de Natur. human Text. 31. even so likewise one of the same Mass of blood contained in the Veins every one of the parts attracteth unto it self that Nutriment that is most familiar unto it It happeneth moreover that if the blood be less pure that excrementitious aliment is carried more unto one part then unto another And this is plainly to be seen even in the Joynt-Gout Arthritis where that same serous wheyish matter salt and tartareous or cal it how you please is carried more unto the Joynts then to the fleshy parts A proof of this we have likewise from the stone Osteocolla which is very fitly administred in the fractures of the Bones where we find that the very bones themselves attract unto them the said Stone so that it is by experience found that from the overmuch use thereof there have grown forth Callous substances extraordinary great and unsightly of which see Gulielmus Fubricius in his first Century and Observat 91. And therefore I am of Opinion that in those places where this Disease is Epidemical the fault is in the Genius of the place and in the Waters which flow down from the mountains of Hungary into Polonia and in Bisgoia if this Disease be likewise familiar in that Region from the Alps which supplieth unto the hair an abundant Nutriment but unto al other parts of the body such an aliment as is altogether unuseful and which is worse very hurtful which when Nature expelleth unto the hairs the rest of the body is thereby freed from all other grief whatsoever and the hairs alone become vitious And I am the more confirmed in this my Opinion by what was related unto me by the aforesaid Illustrious Lord Count Nicolaus Sapieha that he knew a Boor in Polonia that by bathing Cured such as were troubled with this Disease by the use of which the first seven daies the sick persons became very hairy all their body over the hairs breaking forth in all parts which upon continuing the use of the same Bath for seven daies more fell off again and so the Diseased persons recovered their health And indeed that some Waters have in them an extraordinary and admirable virtues will every where appear unto us in the Writers of Naturall History So in the Alpes Styria and Carinthia by the fault of the Water the Tumors Bronchocelae and Strumae we cal this last being a swelling in the Neck the Kings Evil the former being a swelling in the throat are Natural and as it were bred together with the Inhabitants the vitious matter being thrust forth unto the Glandules in the Neck and into no other places And yet nevertheless I would not have it thought that I do hereby altogether exclude the Air which it must be confessed hath likewise a very great power in altering our bodies and it causeth that in these or those Regions and bodies these or those humors are generated Although it be likewise true that the said Air hath not this power from it self but that it receiveth the same from whose vapors that are lift up and raised from the Waters and out of the Earth which the Water washeth upon and passeth through And for this reason it is that this Malady is not general and Universal throughout the whole Kingdom of Polonia but only familiar unto some certain places thereof in regard that it alwaies spreadeth and rageth there and yet is not from thence dispersed into any other Regions and this Disease Hercules Saxonia acknowledgeth to be Endemick but he wil by no means have it to be Epidemick as we may see in the tenth Book of his Practice of Physick and Chap. 7. of Plica But we have already told you in the second Book of our Institutions Part 1. Chap. 11. that he did not wel understand and therefore could not rightly describe unto us the Nature of a Disease Epidemick and Endemick Now the said Matter is carried unto the hair not as some would have it in the form of vapors but together with the blood it self which as it is of all other parts so it is likewise the Nutriment of the hairs as we told above in the tenth Chapter Which appeareth even from hence that the hairs in the Plica if at any time they be cut they yield forth blood That notwithstanding what hath been said there are now and then some certain persons even in the neer neighboring Regions that are likewise troubled with this Disease this may possibly proceed either from the natural neer allied Genius of that place or else from the Parents For look as Arthritical persons beget the like so also it is not impossible but that those which are affected with the Plica may transfuse into their Issue a vitious disposition unto the generating of the same Disease and Experience teacheth us the truth of this The Son of the aforesaid Lord Count Sapieha when he was six yeers of age had at the first some few intangled Locks of hair among the hairs on his head and the same hath also happened unto others I knew a Souldier an old man that had a Plica in the hinder part of his Head who being demanded as touching the Cause of the Disease for he was a German and horn at Thuringia
unto my remembrance a certain Drink no doubt at the first brought thither out of Polonia that was much in use in my Country in the City Vratislavia and it is made of Bears-breech the vulgar cal it by the common Polonian name Barsiez or as the Germans pronounce it Barkech which those that are Feaverish and especially the great Drinkers after their excessive Cups the day before use in their broths and in their ordinary Drink to asswage their chirst Now it is made in this manner The Leaves of Bears-breech dried are boyled in a sufficient quantity of Water that the Decoction may get only a yellow and not a purple color Unto the Decoction there is added a little Leaven or Breâ—d twice baked made of the Pounder of Bears-â—â—ch with the sour Leaven of fine white Bread â—â—d then for some certain daies set in a warm place where it gets a boyling heat and fermentation until such time as it hath contracted a caste somwhat tart and sour But now whether or no this kind of Drink hath a power of doing any thing toward the expulsion of the matter in this Disease we are to consult with Experience And it is their part who live in those places to make publick those Medicaments that use hath taught them to be fit and profitable that so al their Experiences being conferr'd together there may at the length be composed a Method of Curing this Disease But in regard that the Plica hath some symptoms common with the Scurvy such as are the pains of the Limbs Cramps and the like and that the aforesaid illustrious Count Nicolaus Sapieha was affected with both those Diseases I think it not amiss therefore here to place the History of his Disease which wil add some light unto what we but even now spake touching the Plica and to what we have likewise before in the third Book of our Practice written concerning the Scurvy The History of the Disease of that Generous and Illustrious Lord Count Nicolaus Sapieha Earl of Coden Chief Standard-bearer of the great Dukedom of Lituania c. This Illustrious Count without doubt contracted this his Disease of the Plica in his own Country from the same common cause from whence the vulgar have it but as for the Scurvy he got it from the many Errors by him committed in his Dyet during his various troublesom Journeys throughout almost al Europe and from the Quartan Feaver that followed upon the same For when in the heat of Summer as himself related the story unto me he had travelled over the Pyrenean Mountains out of France into Spain and in this his Journey had drunk good store of Wine out of bladders that was corrupt and ful of Vermin the Autumn following in Spain he fel into a Quartan Ague The long continuance whereof having made him impatient and being quite tired out with the tediousness of a Methodical Cure he committed himself unto a certain Soldier for Cure who took some certain Cups of the strongest Spanish Wine and into the same he puâ—s the pouder of al sorts of sweet Spices and this Wine he gave him to drink not only to satiety but even to Ebriety until he had made him almost drunk by which be kindleth within him a continual Feaver which indeed lasted not long and quite took away the Quartan but yet nevertheless imprinted such a Dyscrasie in his Bowels and humors that shortly after the Scurvy followed thereupon With which being grievously afflicted at home in his own Country and yet notwithstanding so that he could not wel tel what the disease was he made a Journey unto Padua and there he committed himself for Cure unto the most Eminen Physitians of that University But yet he recovered not that health and strength that he had expected and hoped for and thereupon he is sent back again home into his own Countrey with this following Consilium which we may term a Direction Advice or Counsel The Advice of that most Famous and Eminent Doctor Johannes Prevotius Chief Professor of Physick in the University of Padua TOuching the manifold Diseases that this Noble person lieth under it is neither my purpose at large to treat of them since that I am not ignorant that they have already been discoursed of by some of the most Eminent Physitians in their long and learned Disputes neither indeed wil either the state and condition of mine own health not yet sufficiently confirmed permit the same nor likewise the health and safety so much desired by this illustrious person for whom I conceive that help and assistance is far more requisite than word â—nd tedious Discourses I shal therefore with al brevity state and determine the whol case and ingeâ—â—â—ly declare unto you my Opinion touching the same not that I may interpose my Judgment in opposition unto the Opinion of these grave and learned men but that I may in some measure gratifie the request of this eminent person and if I may any waies possibly be serviceable unto him in procuring his health that I may not in the least be wanting in the discharge of the Duty and Office of a Christian It seemeth therefore unto me that this illustrious Lord is disaffected with a twofold kind of Diseases the one of them most manifest depending upon Causes that are commonly known and confessed the other occult and secret the Causes whereof are as yet obscure neither seem they hitherto to be sufficiently expressed by any There is manifestly appearing a Catarrh of matter that is thick tenacious white oftentimes insipid and tastless and very rarely sharp and biting flowing and falling down unto the parts of the mouth and somtimes also unto the stomack There is moreover an exetraordinary pain of the lower belly returning afresh after long intervals and Cassations with an astriction and costiveness of the belly and a certain grievous and painful sense of extension and stretching about the Region of the Navel of the Hypochondria especially the left and somtimes also of the Loyns which indeed is wont in great part to cease upon the plentiful Evacuation of the Wind and a snotty kind of Excrement that comes from him To these we may add the Nephritick distemper and want of rest and sleep this latter being indeed very familiar and frequent with him for he usually passeth many whol nights together without sleep and the former to wit the distemper of the Kidneys hath now of a long time sorely troubled him with a redness and heat of his Urine and excretion of sand and gravel with his water The causes of al which Maladies it is most manifest that they are derived from the evil constitution of the internal Bowels and the excrements of several sorts from thence arising For the Brain being overmoist not without much weakness of the innate hear contracted by reason of a great wound he received in it at Paris engendereth much flegm there being added unto al this in a special manner the consent of
that they contract these Clefts especially about the Joynts yet nevertheless this same happeneth somtimes likewise unto the Feet It may be Cured most speedily and most conveniently by this Unguent Take Litharge of Silver Myrrh and Ginger of ech alike parts bruise and pouder them very small and so with Virgins Wax Honey and common Oyl as much as wil suffice make an Vnguent unto which for the rendering it the more grateful to the smel Musk and Ambar may be added THE FIFTH BOOK THE FOURTH PART Of WOVNDS Chap. 1. Of the Nature Causes and Differences of a Wound AMong the external preternatural Affects of the Body and such as are obvious unto the senses there remain Wounds Fractures and disjoyntings of which we will now speak in order And First of all as touching a Wound that it is a solution of Unity in a part Bone and softer Cartilage is without al doubt and controversie But yet nevertheless it is sometimes taken largely and somtimes in a more strict sence Celsus taketh it in the largest sence of all whn in his fifth B. and sixth Chap. he thus writeth That Wound saith he is far worse and more dangerous which it caused only by a Bruise then that which is made by incisiom and dividing the part so that it is also far better to be wounded by a sharp and keen edged Weapon then by that that is blunt It is taken in a large acceptation when it is attributed unto all kind of solution of Unity made by any sharp instrument whether this solution be made by pricking or by cutting like as Galen in his Sixth B. of the Meth. of Physick the first and following Chap. calleth the pricking of the Nerves the wounding of them It is taken strictly when it is distinguished from a pricking that a wound is the solution of Unity in a soft part made by a Cut from any keen and cutting instrument but a pricking is that solution of unity that is caused in a soft part by a prick from an instrument that is cutting By which it appeareth that the solution of Continuity in a soft part is wider and broader then a Wound whether it be made by cutting or by pricking For Unity may also be dissolved in a soft part by a thing that is not sharp but only hard and heavy and this may be the Skin either appearing whole or even broken likewise which happeneth in those Wounds that are inflicted by Bullets from Guns Moreover also the Unity of the soft part may be dissolved by extension which in special in the similary parts is called Rupture but in the Compound Apospasma to wit when those fibrous Ligaments and Threads by which the parts are fastned together the one to the other being broken the parts themselves likewise become broken A Wound what it is By all which it appeareth that a Wound is the solution of Unity in a soft part caused by a cutting and sharp instrument But if as Guido in the Second B. of his Chirurgery and Fernelius in the seventh B of his Meth. of Physick Chap sixth rightly admonish us the Wound become sordid and foul and that some thing be by the Pus or filthy corroding matter eaten away from the substance of the wounded part then the Wound passeth into an Ulcer or certainly we may very well say that an Ulcer is conjoyned with the said Wound The truth indeed is that Rudius in his B. of Wounds and first Chap. doth impugn this Opinion but al to little purpose For neither is it absurd as he without Reason thinketh that one Disease should be changed into another or that one should be added and Joyned to another The Wound and Ulcer they are both of them the solution of Unity in the soft part buâ— the Wound is made by section of cutting alone whereas the Ulcer is caused within it by Erosion and therefore it is that in an Ulcer there is somwhat that is lost from the substance of the part If therefore in a Wound of any part somthing shall be Eaten away and consumed from the substance of the flesh it is then altogether to be granted that now there is likewise present even an Ulcer also Which nevertheless is not so to be taken as though so soon as ever on the fourth day the Pus or filthy corrupt matter doth begin to appear in the Wound that then likewise an Ulcer may be said to be present For that said Pus proceedeth from the blood that is shed forth without the Veins or some Aliment that sticketh in the Capillary Veins and spaces of the parts neither is there then any thing Eaten away from the substance of the part But if there be so great an abundance of the Pus gathered together whatsoever the Cause thereof be that somthing be Eaten away from the substance of the part then it cannot be denied but that there is an Ulcer likewise present seeing that there are then present all things that are required unto the Essence of an Ulcer and in this Case the Cure is no longer to be ordered as in a single and simple Wound but as in an Ulcer But since that a Wound is to be accounted in the number of Diseases there may be enquiry made and that upon good grounds what actions they are that are hurt thereby Unto which it may be rightly answered that all the Actions of the said part and the severall uses thereof unto which the part is destined are hurt by the Wound whether that part perform those actions either as a similary or as an instrumental part That the Organical Actions may oftentimes be hurt by a Wound to wit when the part destined for motion is Wounded cannot be denied â—t being a thing so manifest since that the wounded Member can no longer be moved in a due and right manner As likewise the Vein that is cut assunder can no longer convey the blood unto the part for the nourishment thereof neither a dissected Artery the vital blood and spirits or a Nerve the Animal Spirits But indeed the truth is that the temperament of the part is not next of all and immediatly hurt by the Wound but yet never the less it is mediatly hurt to wit when the Vessels being cut assunder and the blood poured forth the heat of the part is withal dissipated and the influx of the Blood spirits and heat flowing in this last being so necessary and requisite unto the temperament of the part is altogether hindred For all which Causes the attraction of the part the Concoction the Nutrition and the expulsion is hurt And from hence it happeneth that the temperament being changed there are more Excrements generated in that part then otherwise were wont to be And from thence also it proceedeth that the Pus is not presently generated in the very beginning of the Wound but afterward to wit about the fourth day when the heat of the part that was dissipated is again restored The Use is
or no being Cured and his Wound healed he be likely to undergoe and suffer the hurt Action of some one or other of his Members For so oftentimes it happeneth that some Tendon being cut asunder the motion of some part is wholly lost and that the Brain being wounded the Memory or Rational faculty is thereby hurt and Moreover whether the wound be likely to be Cured in a short or whether it wil take up a longer time But on the other side if the wound be altogether incurable whether it be Mortal and such as is likely to hasten Death or else whether it be not more probable that it will degenerate into some long continuing Ulcer And Lastly it must be foretold likewise whether the Changes and Alterations of the Wound will be for the better or for the worse and when these Changes wil be Now in the first place it must be diligently explained What Wounds are Deadly and what Wounds are not so For indeed this Question is of very great Moment and therefore most diligently and exactly to be weighed and known by the Physitian For whereas oftentimes the lives of some men are much hazarded and endangered when they are brought before the Magistrates in the publike Courts of Justice by Reason of Wounds they gave unto others and that oftentimes the Judges desire the Physitians Opinion touching the same great Care and a diligent Endeavour ought to be used that the Physitian give so true a Relation and so distinctly deliver his Opinion touching the quality of the said Wounds that the innocent may not be condemned nor the Guilty acquited But in the first place we are to know that not every Wound which hath Death following it is to be called a Mortal wound but that alone which in its own Nature bringeth Death Now such like wounds are twofold For Mortal or Deadly as Galen in the 5. B. of the Aphor. Aphor. 2. and Aph. 18. teacheth us is somtimes taken and understood of those wounds that are of necessity deadly and somtimes again of such Wounds as are so for the most part as Hippocrates speaketh and such as by Reason of which as the same Hippocrat maketh the limitation in the 18. Aphorism 6. Sect in Coacis or his tract of Playsters those that are wounded almost or for the most part die like as Galen in his 5. B. Aphor. 2. writeth that Deadly is to be taken for that that is dangerous and is oftentimes terminated in Death But the Question is here especially of the former kind for that wound that hath been at any time Cured in others cannot be taken for a wound simply Mortal and Deadly But we shall afterward tel you when it is to be taken and accounted for Mortal or not Mortal And therefore Secondly Wounds cannot be accounted simply Mortal whereupon the supervening of most grievous Symptoms which said Symptoms notwithstanding do not alwaies and necessarily follow upon the reception of these like wounds the wounded person dieth as when in the Wounds of the Joynts and the Nervous parts an inflammation Deliry and other Symptoms happen or that by Reason of a Cacochymy lying secretly in the Body a feaver is kindled upon occasion of the Wound And it is altogether most true that many things often fal out that render Wounds incurable which in their own nature were curable Like as neither are those to be accounted for Wounds simply Mortal the Curing of which is long protracted by Reason of which it at length happeneth that the Wounded person perisheth by a slow and lingring Death the same that happeneth when the Lungs being Wounded an Ulcer and the Consumption follow thereupon or the Thorax or Stomack being wounded which oftentimes after a long space of time become the Causes of Death unto the wounded person For whenas it hath been observed and known that these like Wounds have been healed in others they cannot then be accounted for Wounds simply Mortal But those Wounds are only to be reputed simply Mortal which in the space of a few hours or daies do necessarily bring Death unto the sick person and cannot be cured by any Art And therefore we are to distinguish between Wounds Mortal and Wounds incurable For all Mortal Wounds are incurable but all Wounds that are incurable cannot be said to be Mortal For Wounds incurable as we have told you are al those that though they cannot indeed be cured yet notwithstanding they are not suddenly the Cause of Death unto the wounded person since that although they cannot be healed yet nevertheless the sick person may after this live not only many Weeks but even yeers also And such a like Wound was that which Mathias Cornax in his Epistle Responsory unto Dr. Aegidius Hertogh and Julius Alexandrinus in his Annotations upon the sixth Book of Galen his Meth. of Physick Chap. 4. have described unto us For when as a certain Bohemian Boor as he was hunting received a Wound in his Stomack with a broad hunting spear it could not possibly be consolidated but yet in tract of time the lips of the wound became hardn'd by a certain Callousness growing over them so that the wounded person survived for many yeers after and by applying of an instrument he could at his pleasure evacuate his stomack And now in the next place let us see what Wounds they are that we may account to be simply Mortal or Deadly And now whereas Death happeneth upon the defect extinction of the Native heat and that the Native heat may in a twofold manner be extinguished either sensibly and by degrees as it is in a Natural Death and long continued Diseases as the Consumption and the like or else suddenly and violently the latter way it is that Wounds are said simply and necessarily to bring Death unto the wounded person to wit a violent one Now the innate heat is extinguished either because the vital spirits are dissipated or because they are suffocated And therefore all Wounds that are Mortal and of necessity cause a sudden and violent Death either they suddenly suffocate the vital spirits or else they dissipate and corrupt them But in regard that the Heart is the Store-house of the vital spirits and the Native heat first of all therefore the Wounds of the Heart of all others do especially and most speedily bring upon the Wounded Person a violent Death And the very truth is as Galen writeth in his 5. B. of the places affected and 3. Chapter if the Wound penetrateth unto the ventricle of the Heart especially the left the wounded person of necessity dieth suddenly but if the Wound penetrate not so far as unto the ventricle of the Heart but that it consist in the substance thereof the man may then indeed live for a while but yet nevertheless he must necessarily die this violent Death Secondly It is of necessity that the man die if some Vessel be wounded in that part of the Lungs that are next unto the Heart and
miraculous unto many men as well Courtiers as Citizens And thus this Boor in the space of a few weeks by the use of fit and convenient remedies administred unto him by that most expert Chirurgeon without any further sickness and trouble alwaies eating wel and drinking and sleeping as somtimes he told me himself by the blessing of God and the liberal Charity of many people toward him in his low and poor condition contrary unto the determinate assertion of Physical Aphorisms fully recovered his wonted perfect health and soundness and not long after he married a Wife But those wounds of the Stomack are especially mortal that are inflicted upon the superiour orifice thereof in regard that it hath those considerable Nerves that arise from the sixth Conjugation of the Brain and thereby obteineth a very neer consent with the Brain and Heart so that it being wounded most grievous Symptoms may very easily be excited And Benivenius in his tenth B. of the hidden Causes of Diseases that are curable Chap. 110. reporteth that a certain Fuller with one blow of his fist upon the Stomack of a young Man smote him so violently that he immediatly died thereof Eightly The wounds of the smal Guts The Wounds of the smaller Guts are by Hippocrates accounted and reckoned up among those that are Mortal And more especially the wounds of the Jejunum or hungry Gut among al the wounds of the Intestines are especially Mortal by Reason of the greatness of the Vessels and the almost Nervous substance of the Tunicle of that Gut from whence for the most part there follow great torments and pains of the Intestines Sobbings and Faintings as is to be seen in the Histories related by Valleriola in his 2 B. Observat 8. and 9. And indeed the wounds of the smaller Guts are then most especially incurable when the said Guts are wholly cut assunder in a transverse manner since that the Lips thereof standing wide one from the other cannot possibly by any means be Joyned and made to grow together But now the wounds of the thicker Guts are less dangerous and especially if they be not great and that oftentimes such like wounds have been Cured appeareth from the many extant Observations of Physitians which Schenckius in his Observations hath Collected Ninthly VVounds of the Liver Hippocrates likewise accounteth the wounds of the Liver in the number of such as are Mortal which yet nevertheless wanteth a limitation For Aegineta hath truly told us in his 6. B. and 28. Chap. that the Liver having been wounded and a part thereof cut away yet that the wounded person may be preserved And Gemma relateth in the first B. of his Cosmocrit and 6. Chap. that a Spanish youth a great part of whose Liver brake forth by the wound of the right Gut was yet notwithstanding Cured And Bertinus also in his 13. B. and 7. Chap. writeth that a Noble person after a wound inflicted neer about the Region of his Liver and a smal part of the substance thereof drawn forth and cut off yet escaped and became sound again And the same hath likewise been observed by others Guilhelmus Fabricius in his 2. Cent. Observ 34. relateth that a certain Helvetian thirty years old in a Duel was with an Helvetian Sword hurt in that part that is opposite unto the Liver and that he received a very great wound one span long and that hereupon there was taken from him a good big piece of his Liver And yet nevertheless this Man notwithstanding the superveising of most grievous and violent Symptoms by the blessing of God was perfeâ—â—ly recovered And Matthias Glandorpius in his Speculum Chirurgic Observ 34. Page 160 hath a History of a youth dangerously wounded in his Liver who yet nevertheless recovered perfect soundness And yet notwithstanding we say that they only recover who have the superficies alone or the substance of their Liver only wounded without any hurt at all of the great Vessels For if there be wounded any one of the greater Vessels the wounded person cannot possibly escape and by reason of the large effusion of the Blood the Man before that the wound can be Sodered and Agglutinated dieth And of these some indeed for a very short time have their life protracted but others of them die in an instant or at least in a very short space For as Hippocrates in his 5. Epidem telleth the story a certain person having had a dart thrust into his Liver immediatly the colour of a dead Carcass was dispersed all his Body over his Eyes sunk in his Head a difficulty of breathing together with an aestuation or sudden vehement passions followed after this and the same day he died Another Boy being strucken upon his Liver by a Mule died the fourth day after and before his Death he was troubled with a short and thick breathing neither understood he any thing but all the while until he died lay under a feaver Wounds of the spleen Tenthly The Wounds of the Spleen are almost of the same Nature and alike dangerous as those of the Liver For if only the Parenchyma of the Spleen be wounded without any hurt of the Vessels the wounded person may possibly escape But if the Vessels of the Spleen be wounded such like wounds are not only dangerous but also deadly and Mortal For seeing that the Spleen hath stâ—re of Veins and especially of Arteries these being wounded by Reason of the great effusion of Blood and Dissipation of the Spirits the wounded person must of necessity perish VVounds of the Bladder Eleventhly The Wounds of the Bladder are likewise found in Hippocrates his Catalogue of Mortal Wounds But yet nevertheless here also a distinction is requisite For a smal wound is soon sodered together by the intervening of flesh as Galen in the 6. of the Aphorism Aph. 18. and Experience teach us But if the whole Bladder chance to be cut quite through which wound Hippocrates calleth Diacope the Wound is then yet more dangerous And indeed that is most especially perillous which is inflicted at the very bottom of the Bladder and the Nervous paâ— thereof for by Reason of the sharpness and extremity of the pain the inflammation following thereupon and the continual feaver the party dyeth soon after But as for these Wounds that are inflicted at the Neck of the Bladder which is fleshly they are Curable as we are taught even by the Cutting of the Stone And yet nevertheless it hath been observed that the Bladder wounded even in the very bottom thereof hath likewise been Cured the truth of which we have confirmed unto us by those examples we meet with in the Observations of Schenckius For the whole Bladder is not altogether Nervous but the Exterior Membrance thereof is more fleshy whereupon Hieronymus Fabricius ab Aquapendente and Spigelius account the said Membrane for the Muscle that shutteth the Bladder But it is very rare that such a like wound of the Bladder is
most grievous Epileptick Convulsion which in the space of â—our or five hours ended his life And I my self also remember a certain Student stout hearted enough otherwise Who being by a Chirurgeon to be let blood in my presence and at my command as the Surgeon was about according to the custom to bind his Arm and began but to move his Instrument toward the vein he fainted away and fell from the seat wherein he was sitting before ever the Lancet was put neer unto his Arm whenas Nevertheless he had neither fever nor any other Disease that might any waies cause and occasion this swounding of his Eightly and Lastly an Inflammation following upon a Wound may render that Wound Mortal if it be internal For indeed an Inflammation doth not necessarily accompany Wounds yet notwithstanding because that in internal Wounds those Medicaments cannot possibly be administred that were wont to be applied in external if any internal part especially if it be more Nervous and of an exquisite sense shall chance to be wounded then a pain is excited and thereupon an afflux of Humors and from thence an Inflammation a feaver a Gangrene and other Evils do arise that destroy the Wounded person within a very few daies And from hence it is that the Vulgar do likewise in Wounds observe the seventh and the nineth day because that within these daies those Symptoms are wont to supervene and in these daies to bring the greatest danger unto the sick Party Some there are that add yet another Cause to wit the influence of the Stars And so Franciscus Vallesius in his Comment upon the 95. Text. B. 4. of Hippocr his Epidem saith that the Malignant Aspect of the Stars and Constellations is the Cause why light and very sleight Wounds are oftentimes likewise rendered Mortal And the very same Quercetan also tels us in his Third Chap. Touching Wounds made by Guns and that for this very Cause the Wounds of the Head are for the most part wont to be Mortal at Ferraria and Florence But this Cause is not to be admitted of neither can there any Reason be easily rendered why at Ferraria the wounds of the Head should be mortal and not so in the neer neighbouring Rhodigium or Bononia And from these Fundamentals no doubt it is that Civilians likewise take upon them to pronounce what Wounds are of themselves and in their own Nature Mortal and what not Nicolaus Boerius in the place alleadged N. 18. propoundeth six Conjectures from which it may be Collected that the Wound was not Mortal of it self but that it was made such by Reason of some accident happening thereupon The first is if the Wounded person died not until a longer time after then wounded persons are wont precisely to prolong their Lives The Second is this if there were present no dangerous Symptoms in the beginning of the Wound or if there were any present and remained for a while the sick person notwithstanding was not much the worse for them but that he was able to perform all kind of Actions in such a manner as they are not able to do that are mortally wounded For if he shall appear to be in a fair way of Recovery and then afterward die it is to be beleeved that he died upon some other Cause and not from his Wound All which notwithstanding are to be understood only of a Wound that is not of it self Mortal The third Conjecture is if the sick person in the Course of his life were not so ordered as wounded persons ought to be but that he exposed himself unto the cold Air addicted himself unto excessive drinking were often distempered with passions of the mind immoderate Anger frequent affrightments and overmuch addicted to Venery The fourth if the Physitians were of opinion and that they adjudged the Wound not mortal who as men experienced in their Art ought to be beleeved The fifth is if the wounded person had no Physitian with him or if any were sent for unto him he was one altogether ignorant and unskilful which is al one as if he had had none at all Which yet nevertheless as hath been said is only to be understood of a Wound not simply mortal in it self For if a Wound be in it self mortal albeit there were no Physitian sent for yet nevertheless we are not thence to collect that the wounded person might have been cured The sixth and last Conjecture is if the wounded person be of a strong Nature For in this Case if due care be taken in the preserving of the said Natural strength and vigour the sick person very seldom miscarrieth But if the Wound being not mortal the wounded person die and that in a short time we ought to collect that he died not of his wound but that he died from some other Cause as we said before And this is the Judgment of all Physitians in general touching Wounds both mortal and not mortal But yet there ariseth another Question among the civil Lawyers to wit whether the person that inflicteth the Wound may be found guilty and condemned of Homicide For these do not only as Physitians weigh and consider the quality and Nature of the wound but the minde and intention also of the party wounding and other Circumstances likewise touching which we may see more in the Books of these Civilians The Rest of the Prognosticks Now although that out of what hath hitherto been said may easily appear what is to be foreknown and foretold touching the event of wounds yet nevertheless we think it not amiss here to add somwhat more as touching the premises For although that other Wounds besides those we have already spoken of do not indeed suddenly destroy and kil the person yet nevertheless some of them are far more dangerous then other and even of these some are more easie some more difficult to Cure And this in the first place is to be learnt from the very substance of the part For the fleshy parts of all other are most easily brought together and sodered again the rest as the Veins Arteries Nerves Tendons and Membranes with more difficulty They may be united and made to grow together again but it will be more slowly Galen in his 1. B. of the Seed and 13. Chap. tels us than himself saw the Veins in the Head and those both many of them and great ones also grow again and in his 5. B. of the Moth. of Physick Chap. 7. that he saw an Artery also united Secondly from the Action and Use of the part For the more Noble the part is in regard of its more necessary Use and the Action that it performeth for the good of the whole Body so much the more dangerous are the Wounds of that part And those parts likewise that are in continual motion will not be brought to grow together again but with much difficulty And the more exquisite likewise the sense of the part wounded is the more easily upon its being Wounded
Nerves ANd moreover the Wounds likewise of the Nerves Tendons and Ligaments are for the most part of such a Nature that somthing in the Curing of them may fal out that is peculiar and proper to them alone And first of all as for what concerns the Nerves as also the Tendons for what we shall speak touching the Nerves may likewise be applied unto the Tendons they are of another Nature then the flesh and therefore also as we shall afterward shew you they require other Medicaments then the wounded flesh doth and furthermore they have a very quick and exquisite sense as the Tendons likewise have and thereupon if they be hurt they bring great Pains and Convulsions Now the Wounds of the Nerves are twofold to wit Pricking and Incision according as the wounding Instrument inflicteth the Wound either by a Prick or a downright Cut. Signs Diagnostick Now the Wound of the Nerve is known first of all from the Consideration of the wounded place and from Anatomy which acquaints us with the Nerves that are in every Member and how they enter and are Scituate in them For which cause it is likewise to be considered whether the wound be in the Heads of the Muscles or in the ends of them and whether the wound be above upon the Joynts or else in the very Joynts themselves for if it be in the Heads of the Muscles it betokeneth that a Nerve is wounded but if it be in the ends and neer the Joynts it is a sign then that a Tendon is wounded And moreover from the vehement pain that immediatly after the receiving of the wound infesteth the wounded person unless the whole Nerve be cut assunder transverswise or over thwart For the Nerves have a very quick and exquisite sense and therefore when these are prickt there instantly ariseth in the wounded part a vehement pain and upon this an inflammation and so the Brain being drawn into a Consent oftentimes Convulsions and Deliries are excited But now the Tendons although they are not endued with a sense altogether so quick and exquisite yet nevertheless even these they being not wholly void of sense and feeling when they are pricked there are also pains and from thence Convulsions excited Prognosticks 1. All Wounds in the Nerves are dangerous by reason of that exquisite sense they have and their Consent with the Brain And yet notwithstanding a Wound by pricking is more dangerous then that that is made by cutting as afterwards we shall shew you 2. The Wounds of the Tendons are less dangerous then those of the Nerves 3. That Convulsion that happeneth upon a Wound is Mortal as we find it in the 5. Sect. Aphor. 2. Which is to be understood of the Wounds of the Nervous parts And yet notwithstanding the Greek word Thanasimon and the Latine Lethale as Galen explaineth it in his Comment do not here signifie that which of necessity and evermore bringeth Death but only that which is very dangerous and oftentimes causeth death 4. Those that with their Wounds as suppose those of the Nerves have conspicuous Tumors those are not greatly tâ—oubled with Convulsions neither with madness but those in whom the said Tumors suddenly vanish if this be done in the hinder part unto such Convulsions and the Tetanus do usually happen but if it be on the forepart that these Tumors vanish then there wil befal them madness a sharp pain in the side an Empyema and Dysentery if the Tumors be of a Reddish coâ—our Sect. 5. Aph. 65. 5. Yea what we find in the 5. Sect. Aphor. 66. and Which we have above alleadged touching wounds in general hath place here more especially to wit if the Wounds being great and dangerous there shall no Tumor be seen to appear it is then a very ill sign For in no kind of wounds are Inflammations more easily excited then in the wounds of the Nerves And therefore if there be present any Cause and occasion of a fluxion and yet nevertheless a Tumor shall not happen thereupon it is then a sign that either the matter is driven to some other place by repelling Medicaments and so deteined in the more inward and deep places and parts of the Body or else that they are by Nature her self thrust unto some other place 6. And yet notwithstanding there oftentimes appear no Tumors at all in such kind of Wounds to wit if the Physitian take away all the Causes of fluxion or if that Nature her self shall allay and asswage the violence of the Humor And there is alwaies ground of good Hopes if even unto the seventh day there shall follow no evil thereupon for it is a sign that Nature hath appeased the motion and the impetuous violence of the Humors touching which Galen in his third B. of the Composit of Medicam according to their several kinds and 2. Chap. thus writeth If unto the fifth or even unto the seventh day of the Disease there be neither Phlegmone so much as appearing and that there be altogether a freedom from pain and that the sick person feel no extension and stretching in the part affected he shall after this time be safe and secure 7. The wounded Nerves do very easily likewise conceive a putridness since that they have in them but a weak heat and are of a very dry Nature and so may be easily hurt by those things that are moist whereupon it is that Water and Oyl are enemies unto the Nerves Neither is that putridness and Corruption conteined in the wounded part alone but it is likewise communicated unto the neer neighbouring parts yea and oftentimes also unto those parts that are more remote Whereupon it is that the hand being wounded or but the Finger only the pains are wont to appear in the Arm and Shoulder and that the Leg being hurt there are wont to be in the Thigh not only pains but also Impostumations and that the Malady is imparted not unto one of the sides alone but even unto that also that is opposite Yea and in the whole Body likewise the Humors are corrupted whereupon feavers pains in the sides and Dysenteries are wont to be excited And that which we are here to give you notice of and not to pass it over in silence there are not evermore present signs that betoken an Inflammation or putridness yea and oftentimes there are likewise present no vehement pains but that very often secretly and suddenly the Convulsion invadeth the wounded persons For the vitious matter being thin and depraved is hiddenly carried by the Nerves unto the Brain as we see that this is done in the Epilepsie or Falling-sickness a poysonous Air ascending unto the brain from the extream parts without any notable pain in those parts by and through which it passeth Of which thing we meet with many examples and how that the wounded persons without any pain and Inflammation have been suddenly surprised with a Convulsion and have instantly died thereupon And therefore in the Wounds of
doubt these poor Flies are more likely to obey his Commands then the Stars There is Another who tels us how we may make a Seal with the Figure of old Father Saturn digging up the Earth with a Spade which say they ought to represent unto us the Planet Saturn and this Seal if any one shall carry about him in his left Boot and why not I pray as well in his right Boot or on his Arm he writeth that it will then so preserue a man that he shall suffer no hurt at all from his Horse and moreover that it wil speed and hasten the hard labor in Child-bearing Women And moreover how and from whence will they be able to prove that those strange and uncouth Characters that are to be seen in Corn. Agrippa Paracelsus and others are the Characters of certain Stars And not Characters only but even other Figures also They paint Saturn in the likeness of an old man with a Pruning Hook Sythe Spade or Plow-share They paint or Picture Jupiter like a King with a Scepter in his Hand Now what agreement is there between these Figures and those Planets which they Represent And what I pray may the Reason be that the Planets communicate their virtues and influences unto Metals only if they be engraven and inscribed with these Figures and not with others And who was the first that taught us that this Star taketh a delight in this kind of Character and that Star in another kind of Character different from the former And the Reason is the same for al other Figures touching all which they ought to prove unto us that these are the Figures of certain Stars And moreover besides these Characters what mean they by so many Words which they not only pronounce in the framing and fashioning of these Seals but they are likewise engraven and imprinted upon these Seals as we may see in Paracels his B. Archidox Magic and in the Seals of Arnold de villa Nova But others there are that endeavour to free themselves and clear the controversie by saying that individuals when they begin to be under some determinate Constellation they then receive a certain admirable faculty of operating or of suffering over and beside that they have in special or from the species But let this be granted yet notwithstanding it cannot be said that the precious stone or Metal do then begin to have their being when they have these Characters engraven upon them for they were and had their being before and indeed their substance was likewise individual and according also to their own opinion the Astral Spirit virtue insinuateth it self into that substance wherewith it hath a Sympathy For there is to wit between natural substances themselves a certain occult and secret familiarity and Sympathy but yet no such thing between Natural Substances and Artificial Figures But others are of this opinion that the Figure is not indeed the principle of operation but yet notwithstanding that it conduceth very much unto the said operation For the conception of a deformed Figure in the minde of Man or Woman we see what sadness it produceth unto them and on the contrary what Joy and cheerfulness the conception of a fair and delightful Figure and representation causeth in their Minds and Countenances And by the Instruments of Artificers according to the variety of the Figures so are the operations various some of them by the Saw and some others of them by the Hatchet or Axe But neither is there any thing of weight or moment in this that they alleadg For I demand what Beauty or Deformity there is in these Images and Characters And whereas fair things delight the minde while they are seen and lookt upon how I pray can these things delight the mind of a Man when they are carried and worn about him covered and seldom look'd upon And what do those various Names and indeed oftentimes such as are altogether unknown to us confer and add unto the fair and pleasant conception before mentioned And as for the Instruments of Artificers the Figure indeed maketh much unto the operations which are by a local motion but nothing at all unto those operations that are wrought by alterations for in these the Figure doth nothing at all neither can it and precious Stones if they have any natural virtues at al in them they put forth these their virtues under any Figure whatsoever it be And Galen writeth as touching the Jasper stone in the place above alleadged that he himself had found by experience that the virtue thereof was stil one and the same with or without the Figure of the Celestial Dragon or the sign Scorpio Neither yet are there any other that hitherto have been able to bring any the least shew of probability for the virtues of these Characters and Seals And how indeed could they possibly render any Reasons and give us the causes of such their absurd Tenets whenas they write that these Seals do not only expel and drive away Diseases but that some of them wil likewise make a Man gracious unto al Men whatsoever and that others of them will procure for a man knowledg Wit and Memory others the favour of Princes others victory in War and Civil Causes others good fortune as they cal it in Hawking Hunting Fishing and Merchandising and that others wil make friends to stand faithful unto them others advance a Man unto the highest Honors and preferments and that there are some of these Seals that wil make a Man Master of his with whatsoever it be and I know not what other things that these Seals are able to accomplish for him that weareth them Rodolphus Goclenius the younger taketh here a great deal of pains and troubleth himself exceedingly in his Magnetick Synarthrosis and at length he distinguisheth between these Seals and those whose Authors are said to be Ragael Chael Terel Hermes Salomon these he rejecteth but there are others of them that he commendeth to wit those Seals that are framed and fashioned under some certain position and concourse of the Stars and receive naturally all their virtues from the influence of these Stars and from the Connexion and Continuation of the Natural Causes without any impiety or Superstition at al. But now what this Connexion of the Natural Causes is and in what manner these Seals and Images receive their virtues from Heaven these things he no where telleth us neither doth he sufficiently explain himself only he saith indeed that these things are very clear and sufficiently manifested by Experiments But the very same may be said by Chael Ragael and the rest of the Magitians in the behalf and for the Justifying of their Seals also And who is there that now adaies knoweth not that even by such like Seals very many have been made inviolable and not to be hurt by any Weapons And therefore the Question is not here what may be done but the Question is only from what agent these things
for if it be fallen to the fore part the Arm is extended and cannot be bent in the fore part there is seen an unusual Tumor but in the hinder part an unusual Cavity things contrary to these do happen if it be luxated in the hinder part to wit the Arm is crooked and can by no means be extended the Tumor appears in the hinder part but the Cavity in the fore part A Luxation to the outward part makes also a bunching out in the outer part but a bosom in the inner part but on the contrary if the Elbow be fallen to the inward part there is an eminency less then should be in the inward part and a Cavity in the outer part If the Radius follow the Elbow 't is known by the same Signs but if it only depart from the Elbow without a Luxation a gaping and disjoyning shews it the place is hollow and 't is easie to find a bosom with the Finger Prognosticks 1. The Elbow as it doth not easily fal forth by reason of its firm and fast coarticulation with the Shoulder and its plenty and strength of Ligaments so being fallen forth it is hardly restored 2. The Elbow luxated unless it be most speedily reduced doth not only bring divers and dangerous Symptoms to wit a most exceeding pain Inflammation Fever Convulsion but sometimes also Death 3. Of all Luxations which happen in the Gibbous part of the Elbow the most dangerous and painful is that which is to the hinder part Paulus Aegineta de re medic l. 6. c. 115. 4. When the Bone of the Elbow is divided from the other Bone it is not easily restored for neither do two bones which are joyned together when they once gape easily return to their ancient place but it must needs be that the Bones being so divided the part becomes swelled and the bones are quickly compast with a Callus The Cure The Elbow being imperfectly luxated or subluxated to the fore part is most easily restored by moderate extension and only bending of the Arm but a perfect Luxation is harder to be reduced and requires greater provision for first there must be extension made and that obliquely lest the high brow of the Elbow hurt the head of the Shoulder by two Servants one of which must draw the top of the Shoulder upwards but the other the Elbow downwards either with their Hands only or if need be with Reins then some round body must be placed by the brawny part over which afterwards the Chirurgeon bending his Arm and suddenly forcing the Elbow to the hinder parts may restore it into its place Hippocrates 3. de fractu affirms that he hath somtimes cured the Elbow luxated to the hinder part only by a sudden and continued extension of the Arm which if it suffice not convenient extension being made the Elbow must be driven inwards The Elbow fallen forth to the outer or inner part is most easily reduced if extension being made it be forced from that part into which it is fallen into the contrary The same manner of reducing is to be observed in replacing the Radius if it hath followed the Luxation of the Elbow but if it be only departted from it it must be prest with the prominent parts of the Hands and the Arm must be reduced to the natural figure it being reduced convenient Medicines must be applied and it must be bound up fitly as was said in general before c. 7. Chap. 8. Of a Luxation of the Hand and its Fingers HEre by the name of Hand we understand the Wrist and After-wrist but the Wrist is joyned with the Elbow bone and Radius by a Diarthrosis whenas there is a manifest motion but with the After-wrist whenas there is no manifest motion by a Synarthrosis or doubtful articulation the Metacarpium or After-wrist is joyned again with the bones of the Fingers by a Diarthrosis because the round heads of the four bones of the After-wrist do conspicuously enter the superficies of the first bones of the Fingers lightly hollowed and after this manner also the bones of the Fingers themselves are joyned one to another The Differences Whence we may easily collect that the Wrist may be luxated into all four parts to wit the fore the hinder and to the sides all the bones of the After-wrist indeed are luxated inwards and outwards but the falling of the two middle bones to the sides is hindred by the two extream bones that have respect to the little and Fore-finger the which two only may fall forth to that side which is free from bordering bones The bones of the Fingers again are luxated four waies to wit inwardly outwardly and to the sides The Causes The Cause of the Luxation of the Wrist After-wrist and Fingers as of other luxations is some violent Motion Blow Fall Perversion and Contorsion Signs Diagnostick The Signs of all parts of the Hands luxated are almost common for whether the bones of the Wrist After-wrist or Fingers be luxated to the fore part a Tumor appears as that place in the fore part and the Fingers cannot be bent If they be fallen to the hinder part a Tumor also is perceived in the hinder part and the Fingers by reason of the compression of the Tendous and Nerves going to them cannot be extended But if a Luxation be made to the sides a Tumor appears in that part into which the fall is made and a depression into that from which the Joynt is fallen The Prognostick The Luxation of these parts is not dangerous whenas they may easily be restored into their place The Cure The bones of the Wrist into what part soever they be luxated may be without any extension at all reduced into their place after this manner let the Hand of the Patient be placed upon a Board or Table and that with the palm downward if the luxation be to the hinder parts but with the back downwards if it be to the fore parts afterwards let the Chirurgeon most strongly force the luxated Joynt to the contrary part either with the palm of his Hand in more tender bodies or with his Heel in bodies that are stronger The same rule is observed in replacing the bones of the After-wrist and Fingers except that some servant holding with one Hand the Fingers with the other Hand the Arm doth make a light extension the bones being reduced Medicines that hinder an Inflammation and strengthen the Joynts must be applied and the part must be conveniently bound up and placed Chap. 9. Of a Luxation of the Thigh THe Thigh-bone the longest and greatest in the Body of Man at its upper part with its head sufficiently great thick and exactly half Globous is not only most exactly half joyned by an Enarthrosis to the bosom of the Hip sufficiently large and deep to receive this head but also is most strongly united to it by a most firm Ligament arising from the bosom of the Hip and implanted into the narrow
bosom of the head of the Thigh to the end that the Thigh might by so much the easier and more readily be bowed extended moved to the sides and turned about and not easily slip forth The Causes The Causes of a perfect Luxation of the Thigh are the same as of the Luxation of the Shoulder to wit external and violent a fal a blow or some other violent and indecent extension and distorsion of the Thigh but the causes of an imperfect Luxation are the humors flowing to this joynt and by degrees thrusting it out of its seat The Differences But this joynt fals forth to four parts the former hinder but seldom whenas the brow of the Cavity in this part is higher to the outer and inward part most often whenas at that place the brow is lower and somtimes the Thigh admits of a Subluxation from an internal cause whence when Paulus Aegineta lib. 6. de remed c. 118. writes that the Articulation of the Hip doth only suffer a Luxation and not a Subluxation that is to be understood of that only which is from an external and violent cause for we see oftentimes that by a flux of humors some have the Ligaments in the Thigh relaxt and mollefied that they cannot retain the head of the Thigh-bone firmly in its Cavity whence follows a certain Subluxation Signs Diagnostick the Diagnostick signs of a thigh luxated to the fore part If the Thigh be luxated to the fore part a Tumor appears about the Groins whenas the head of the Thigh leans to the Pubes the Buttocks on the contrary by reason of the Muscles contracted with the Thigh to the Pubes seem wrinkled the Urine is supprest by reason of the compression of the bladder by the head of the Thigh the external Thigh can neither be bent nor brought to the Groin whenas the head of the Thigh is in the very bending place the man is also in pain if he be forced to bend his Knee by reason of the former Muscle which ariseth from the bone which belongeth to the Loyns for that is comprest and being retcht is lift up by the head of the Thigh and whenas it can be no further extended it resists otherwise it equals in length the whol sound Thigh to the Heel for the Thigh going forth of its Cavity comes to the fore part and a little lower by which it comes to pass that the Thigh hurt equals the length of the sound one which especially fals out so at the Heel the Toes of the Foot cannot easily be extended nor turned to the ground whence in walking the Patient is compelled to tread only on the Heel But in them who at strong age have this joynt fallen forth into this part and not restored they when the pain ceaseth and the joynt is accustomed to be contained in that place into which it is fallen can forthwith go upright without a staff and wholly upright for by reason of the inflexibility of the Groyn they use the whol Thigh more straight in going than when it was sound somtimes also they draw their foot upon the ground whenas they cannot easily bend the upper iunctures which are at the Groyn and Knee although they walk upon the whol foot but in those at whose render age this joynt fallen forth is not restored their Thigh-bone is more diminished than that of the Leg or Foot but the Thigh is little diminished only the flesh every where is abated especially at the hinder part to the hinder part If the Thigh-bone be luxated to the hinder part there are contrary signs to those mentioned to wit The Head of the Thigh being fallen to the Buttocks is discovered by a Tumor about those parts both by the sight and touch the Groyns on the contrary appear more loose the affected Thigh by reason of the compression and distension of the Muscles compassing the head of the Thigh cannot be extended and 't is rendered shorter than the sound one the heel doth not touch the ground whence the Patients can neither stand nor go but fal headlong backwards because the body slides to that part and the head of the Thigh being out of its proper place is not directly opposed to under-prop the body yet the man may bend his Thigh if he be not hindered by pain for whenas the head of the Thighs is by force with its whol neck expelled into the great Muscle of the Buttocks which extends this Articulation this Muscle admitting the head of the Thigh fallen forth is most of al tormented whenas 't is distended and prest under it and of necessity must be seized on by an Inflammation but in process of time when this Muscle is freed from an Inflammation and contracts a certain glutinous humor that part of it which toucheth the joynt grows to a Callus and the Knee is bent without any pain moreover the head of the Thigh being luxated to the hinder part the Thigh and Foot appear moderately straight and do not incline much one way nor other But when in ripe age the Thigh-bone fallen forth is not restored when the pain is ceased and the joynt accustomed to be turned in the flesh the man indeed may walk yet he is forced to bow very much towards the Groyn when he walks and that for two reasons Because the Thigh is rendered much shorter and the heel is far off from touching the ground for if he try never so much to stand on that foot leaning upon no other thing he wil every where fal backwards but if in tender age this joynt luxated after this manner be not reduced the Thigh-bone is made short and the whol Thigh is spoiled and is less increased and made slenderer being for no use To the outer If the Thigh be luxated to the outer part it is known by these signs Between the Anus and Cod there is seen a Cavity and leanness on the contrary in the buttocks a certain Tumor the Thigh by how much the head of it is fallen forth to a higher place is rendered shorter the Knee with the Leg looks inwards the Heel toucheth not the ground whence when the Patient would walk he goes only a tiptoes And if in those of ripe age this Joynt be not restored but the flesh into which the Joynt is fallen grows callous and the pain therefore ceaseth they may go without a Staff and therefore when they use their Thigh in these the flesh is less offended but they to whom in tender age this misfortune happens require a diligent care for if they be neglected the whole Thigh becomes unprofitable and is little increased the flesh also of the whole Thigh is more abated then in the sound one Lastly a Luxation of the Thigh to the inner part is known this way to the inner the Thigh is longer if it be compared with the other and that for two reasons for the head of the Thigh sticks to the bone which proceeds from the Hip upwards
bent and moved Prognosticks Whenas this Articulation is more loose the Patel Bone may easily be restored to its seat The Cure That the Patel bone may be reduced into its seat let the Patient stand firmly upright upon a place but let the Chirurgeon with his hands force the Patel Bone from that part into which it is fallen to that from whence it is fallen when the Bone is restored to its place fit Medicines must be laid upon it and the hollow of the Knee must be filled up with Bolsters that the Thigh cannot be bent then a hollow piece of the figure of the Patel Bone must be placed about it especially on the side to which it fel that the Patient may not bend his Knee When there is no more danger lest the Parel Bone fal out again let the Patient by degrees accustom to bend his Knee again Chap. 11. Of the Knee Luxated THe Knee may not only be Subluxated but it may suffer a perfect Luxation and truly oftentimes fals to the inward and outward part seldom to the hinder part but seldomest of al to the fore part and not unless from a most violent cause in regard that the opposition of the Patel Bone doth hinder it The Causes This Luxation also happens from blows fals jumping vehement running and an uncomely extension or contraction and distorsion of the Legg Signs Diagnostick To what part the Knee is Luxated is easily known for in the side to which the joynt is broke forth a bunching out but a Cavity in the side from which it is departed is discoverable both by the sight and touch its figure is depraved the Thigh is extended and cannot be bent whence the motion is necessarily depraved or wholly lost Prognosticks 1. The Knee if it be compared with the Elbow the joynt in the Knee by reason of its manner of juncture oftener fals out and is easier reduced For the structure of the Bones with which both joynts are contained is more straight in the Elbow more loose in the Knee besides many processes and many bosoms joyned to one another do every where bind up the joynting of the Elbow but in the Knee the bunchings forth of the Thigh are cast into the smal Bosoms of the Leg. 2. For the same cause a Luxation of the knee is less dangerous nor doth an Inflammation easily happen for whenas an Inflammation ariseth from the force with which the bones are expelled and reduced again and the pain arising from hence because in the Knee the joynt may fal forth and be reduced without any great force there is no fear of an Inflammation The Cure The Knee luxated to the inward and outward part is not hard to be restored by moderate extension made either with the hands in a new Luxation and childs body or with reins in a Luxation not so late and stronger bodies and with forcing the bones with the hand into the contrary part from which they sel But a Luxation made backwards is commodiously restored if the Patient be placed with his Face on a Bench and some servant put a Linen Globe into the hollow of the Ham at what part the Bone sticks forth and strongly force the bone fallen forth towards the fore parts but let the Chirurgeon take hold of the lame Leg with both hands and of a sudden so bend and bow it that his Heel touch his Buttocks A Knee Subluxated by none or very little extension made and forcing it to the contrary part is reduced into its place When the Bone is reduced which is known by the free exten sion of the Leg and comparing it with the other Knee convenient Medicines must be laid upon it and binding up must be ordered and the Patient must forbear going til there be no more fear of a new Luxation Chap. 12 Of the Distraction of the Bracer THe Bracer adheres to the greater Bone of the Leg and as it was said in the former Chapter above to the Knee below the Ankle but 't is drawn from the great Bone three waies to wit To the fore part and both sides The Causes But this Divulsion comes from those Causes from which we said the Knee was luxated especially when walking in a slippery place the foot is not firm but dubiously is wrinched inwardly or outwardly the same may be by a fal from on high or by a blow Signs Diagnostick A Tumor appears in the part to which the Bracer is distracted and is discovered by the sight and touch and motion is hurt The Prognostick The reducing of the Bracer is easie The Cure For by the hands of the Chirurgeon it may easily be compelled and brought back into its seat by forcing it into that part contrary to its fal afterwards convenient binding up must be ordered putting bolsters to that part to which the Bracer is fallen and rest for some weeks must be commanded the Patient til the Ligaments are confirmed again Chap. 13 Of a Luxation of the Foot and its Bones and of the Toes BY the word Foot we understand al that part of Mans Body reaching out from the lower part of the Leg to the very ends of the Toes which contains divers Bones after divers manners joynted together and united by Membranous Ligaments to wit The Ankle the Heel the Ship-like Bone the Tarsus Metatarsus and Bones of the Toes of the Luxations of al which we should now speak but because the Bones of the Tarsus Metatarsus and Toes are here united almost after the same manner as the Bones of the Wrist after-Wrist and Fingers are to one another they are subject also to the same Luxations have the same causes are known by the same signs and are reduced the same way but the ship-like bone may suffer the same things as the Bones of the Tarsus it is not worth our labor to add much of these but those things which are said of the bones of the Hand may also be applied to these Luxation of the Ankle and Heel Some things only we shal add of the Luxation of the Ankle and Heel whenas no Bones in the Hand do answer unto these The Differences The Ankle joyned with the greater and lesser focil by a Ginglymus may be luxated perfectly and imperfectly to every part to wit The outward inward fore and back part But the Heel lying under the Ankle is often moved indeed more forward and backward but seldom to the sides The Causes The Luxation of these parts is from a violent fal a blow or some other inconvenient distorsion of the Foor But in particular the Heel is luxated and pulled from the Ankle if one leaping from on high do fal and stick heavily upon the Heel or in dancing doth insist much upon the Heel The Signs Diagnostick The Ankle if it be fallen to the outward part the lower part of the Foot is turned inwardly if to the inward part there are contrary signs if it be luxated to the fore part the broad Tendon
of the Head alone but that Alopecia may be extended even unto the very Beard also The Causes The Cause of both these Maladies is a depraved and sharp humor of eating assunder the roots the Hair of whatsoever kind it he But for the most part notwithstanding this Malady iâ— caused by a salt flegm adust or putrified Whereupon Galen in his Book of the differences of Symptoms and Chap. 4. writeth that these Vices follow a depraved Nutrition of the Skin of the Head But that one while the Alopecia another while the Ophiasis is excited and that the Hairs do sometimes constitute a strait and direct Area and sometimes that that is winding and writhed the Cause of this is the great abundance and the quality of the matter For if there be an extraordinary great store thereof and it be likewise thin then it equally and alike eateth through the Hair in the more and greater places but if the Matter be less and mingled with a thick humor then there followeth an unequal and writhed Defluvium or shedding of the Hair because that the humors being unequal and mingled do not flow right forward but creeping along obliquely they gnaw assunder the hair The more remote Causes are the heat of the Liver and Head and especially the fault of the first and second Concoction by reason whereof salt and sharp humors are generated which although it may happen in every age yet nevertheless it happeneth more especially in Childhood and Youth and it followeth the Affects Tinea Achores and Favi by reason of the Causes that we mentioned in the Diseases of Children And somtimes likewise External and Malignant Causes make very much for the generating of this Disease among which Galen in his first Book of the Composit of Medicam according to the places Chap. 2. reckoneth up Mushroms because that they make very much for the generating of vitious and corrupt humors And hither likewise belongeth the poyson of the French Disease in regard that this also eateth through the roots of the hair which other poysons may likewise do Signs Diagnostick We have already before told you in what respects this falling of the Hair differeth from baldness and that shedding of the Hair that we call Defluvium But Alopecia differeth and is known from Ophiasis by the very figure of the Area and because that in the Alopecia the hair only falleth off without any hurt as all of the Skin But in the Ophiasis there is not only a falling off of the hair but likewise an excoriation of the Skin And the very color of the skin is also changed and in some it appeareth more whitish in some more pale and in others more black and if it be pricked there floweth forth a serous whitish blood Touching the difference between Alopecia and Ophiasis Celsus in his sixth Book and Chap. 4. hath these words That Area saith he that is termed Alopecia is dilated under all kind of Figures and it happeneth in the hair of the Head and in the Beard But that which from the likeness of a Serpent is called Ophiasis beginneth from the binder part of the Head and is not extended above two fingers in length it Creepeth on both sides the Head even unto the Ears and in some unto their Foreheads also the former of these in all Ages but this latter only in Infants But Alopecia and Ophiasis differ from Tinea in this because that in Ophiasis the Excoriation of the Skin is superficial and when it is cured the hair groweth again But in Tinea the excoriation and Ulceration is more deep and the skin is oftentimes so corrupted that the hair never groweth again As for what concerneth the signs of the Causes the Skin it self sheweth what kind of humor it is that offendeth which that it may be the more exactly known the hair that remaineth behind is to be shaven away and the Skin to be gently rubbed there are other signs also that wil instruct and teach us what kind of humor it is that aboundeth in the body The hairs likewise that grow anew by the various colour that they have according to the Nature of the peccant humor wil shew us what humor is the Cause of this Malady Prognosticks 1. Alopecia and Ophiasis although they bring not much danger along with them yet nevertheless they cause a great deformity and among the Romans those Slaves that were disfigured by the said Area and especially by the Alopecia were sold at a far lower rate then other Slaves And in our daies also these Areae in regard that they cause a suspition of the French Pox are therfore accounted very disgraceful unto him that is affected therewith 2. But whether the Ophiasis or the Alopecia may be soonest and most easily cured it is a great question among Authors and they herein much differ Celsus and Avenzoar are of Opinion that Ophiasis is more easily cured then Alopecia And on the Contrary Alexander in his first Book Chap. 2. and Serapio in his first Book Chap. 1. teach us that the Alopecia is more easily cured then Ophiasis But Celsus seemeth to speak only of the Alopecia of Infants which in the course of yeers and change of age is of it self oftentimes cured But if Alopecia and Ophiasis be such as are grown to maturity or likewise in one and the same age be compared the one with the other then the Ophiasis seemeth to be altogether the more difficult to be cured in regard that it hath its original from a matter more thick and far worse then the former and such as doth not only eat assunder the roots of the hairs but likewise even the very Skin it self which is never done in the Alopecia 3. Yet notwithstanding by how much the longer either of these Maladies hath been and continued by so much the more difficult is the Cure thereof and by how much the less while they have continued by so much the more easily are they cured 4. If by Rubbing the place become red there is then hope of Cure the sooner it is thus the more easie the Cure but if it wax not red at all then there remaineth no hope at all of any Cure 5. That kind of Areae is also the worst that hath made the Skin thick and somwhat fat and slick or slippery in all the parts affected 6. Alopecia and Ophiasis that proceed from the Leprosie are altogether incurable and that that hath its original from the French Disease is not to be Cured untill the Disease it self be Cured 7. There then shines forth some hope of a Cure to follow when the excremities of the Areae that are neerest unto the remaining hairs do again begin to send forth other hair For then those parts that are nigh unto the sound have the less receded from their Naturall State and so consequently will the sooner again return unto their Natural State and begin to produce hair The Cure If a Vitious humor abound in the whole body