affectus or Distempers of the Feet The Contents A cruel Pain cured by a Cautery I. The Sweat and Stinking of the Feet is to be cautiously stopt II. I. A Woman for five years together was taken two or three times a day with a very cruel Pain in the Soal of her left Foot it rose from a thick Flatus mixt with tough Phlegm a weakness of the part accompanying with heat redness hardness Many Remedies being used in vain at last an actual Cautery is affixed to the Pained Part after the falling off of the Eschar there flow'd for fifteen days a virulent Matter in great plenty Zacut. prax adm p. 2. obs â—â—t and the Patient was freed of her Pain II. Seeing Excrements are collected about the Extremities of our Bodies the Hands and Feet as the most remote from the Heart more naturally or plentifully than in any other parts of the Limbs so that our Hands grow dirty and our Feet are almost crusted over with virulent and stinking Sordes we must be very careful not to hinder the usual defecation there Wherefore such as pull not off their Boots or Shoes when they go to sleep do great injury to their Feet And those consult ill for their health who to hinder the stinking of their Feet put in their Shoes Myrtle Leaves Filings of Iron c. For as the Arteries endeavour to discharge themselves of their Excrements in these parts so when the Defecation as I may call it is hindred any way the Veins are made to absorb the same together with the Arterial Blood which is carried back to the Heart by means of the Circulation and wants still to be defecated Simon Paull quadr bot Penis affectus or Diseases of the Tard The Contents A Caution in cutting off part of the Tard when it is gangren'd I. We must not after Section use an actual Cautery to stanch the Blood II. The abuse of Cathereticks in rooting out of Caruncles III. Cautions about taking away a Caruncle IV. The Penetration by Rushes is dangerous V. A Caution in putting up a Catheter VI. How a Caruncle may be consumed without injuring the Urethra VII Quick-Silver and Precipitate safely cure a Caries of the Yard VIII The Cure of a Crystalline Bladder of the Glans IX The Vlcers of the Glans are to be handled gently X. The Cure of a Phimosis XI When the Prepuce grows to the Glans they are to be very warily parted the one from the other XII How a Node of the Yard is to be cured XIII The Cure of a Phimosis and Paraphimosis when caused by a wholsom Coitus XIV The Cure thereof when gotten by a Clap. XV. Coolers and Repellers are not to be used in the beginning XVI The Cure of a Paraphimosis in Infants XVII I. IF any Portion be to be cut off from a Gangren'd Yard we ought presently to put into the Vrethra some Pipe or a Wax Candle for Pissing otherwise all that which remains of the substance of the Yard retires within the Body so that thereby the Urine cannot pass forth The Erection of the Yard perishes by the Incision Walaeus meth mod p. 157. for the Spirits can no longer be retained in the Nervous Bodies II. When the Yard is cut off an actual Cautery for stanching the Blood is very dangerous both because it obstructs the Urinary Passage and also is apt to cause an Inflammation in the Bladder and Circumjacent parts I order my Servants to take care of stanching the Blood by holding continually one after another Stupes to the part wet in Water and Vinegar Hildan cent 3. obs 88. and besprinkled with an astringent Pouder III. To root out Caruncles in the Vrethra many do too boldly put up Wax Candles besmeared with Corroding Medicines by the over great biting whereof I have not only seen loss of substance in the Vrethra H. a Moinichen obs 17. but also a Gangrene which infected not only the Perinaeum but also the inside of each Thigh and consumed these parts with a foul Mortification to the destruction of the Patient ¶ A Noble Person being troubled with a Caruncle from a virulent Gonorrhoea when the Surgeon had injected with a Syringe a sharp Liquor into the Urinary passage there presently arose a great Pain whereupon followed an Inflammation and a Fever his Urine was quite suppress'd Hildan cent 4. obs 54. and he died in a few days IV. The original of a Caruncle in the Yard is sometimes to be attributed to a Gonorrhoea in the inflammatory stiffness whereof the Chord as the Vulgar call it being broken in Copulation or to speak more artificially the Membrane of the Vrethra being torn which is contracted and mâ—de shorter by force of the Inflammation and Tumour after a large Hemorrhage such as is usual upon those strainings and violent tearings there remains an Ulcer out of which by degrees there arises a Fungus namely a Preternatural Tumour and Disease in the Urinary Passage that cannot be safely and certainly rooted out any other way than by such Medicins as consume it by immediate contact Those Spongy Thymus's use to run with a Purulent Matter which has generally been taken for a Gonorrhoea by such as have less accurately consider'd the source of this Malady Hence there appear Threeds of Pus floating in the Urine part of which Matter I think also to flow from the Prostates which have been afflicted a long time by an Intemperies not wanting Malignity destructive of the Natural Heat and injurious to all the Functions I cured a Nobleman that had been afflicted fifteen years with such a Caruncle Considering diligently all the difficulties but especially his delicate Nature the most exquisite sense whereof reputed even the easiest Chirurgical Remedies for the cruellest Torments I put mine hand to the work and having premised Universals I consumed the whole Caruncle with little pain by an often repeated application of a Catheretick by a Wax-Candle it was pretty hard and three Fingers breadth long possessing almost half the length of the Vrethra The nearness of the neck of the Bladder gave me no small trouble when I came to the end but especially that small Tubercle which by a gaping mouth gives passage to the Seed into the Vrethra whose bulk being increased by an afflux of Humours would have impos'd upon an unskilful Artist and persuaded the further use of eating Medicines But take this as a Secret from me in the Cure of a Caruncle That 't is better cured by delay than haste As often as the lips of the Ulcer swell being irritated by Medicines Theodor. de Mayerne tract de Arthrit p. 145. they fall again by the application of Lenients and which is strange the most pertinacious obstacles vanish of themselves in a few days V. Because it happens sometimes in a suppression of Urine that there are found a great many Caruncles that hinder its passage and the application of Medicines if neither Baths nor Anointings
may draw down the humours more powerfully from the Jugular Veins Nor need want of strength be much feared which is here oppressed not wasted As for cooling the body Gr. Nymannus Tract de Apopl p. 217. and thickning the humours for which some reject bloud-letting it is of no moment for in the Apoplexy nothing is more necessary than Revulsion and Turning the Matter away from the Head and we must especially labour to doe it presently which Indication bloud-letting quickly answers Wherefore we may hope for more benefit from translation of the Morbifick Cause than we need fear damage from cooling of the Body II. After the universal Plenitude is abated by letting bloud in the Arm the Parts especially affected are to be relieved for which purpose the best means is opening the Jugular Veins out of which by reason of their bigness the bloud runs freely which by stagnation oppressed the Brain and by this discharge the Lungs are less oppressed and when less bloud comes to them they easilier deliver what they contain to the Arteries and left Ventricle of the Heart and the Current of the bloud being render'd more free Coagulation is hindred Obstructions are opened and the Animal Functions are by degrees restored Concerning opening of them Experience seconds Reason and these Veins may with more ease be opened Fr. Bayle Tract de Apoplexia c. 11. because in this Disease they being swelled there is no need of Ligature which in this case might doe harm and therefore after opening of them must not be too strait but Emplastrum Galeni must be applied to the Orifice III. When there is no Plethora but great store of sharp humours i. e. much sowre Melancholy or its Exaltation hath caused the Apoplexy which foregoing pains do shew Hippocrates bids us use Fomentations before bloud-letting nor without reason for when the Veins are inflamed dried and straitned and the bloud by degrees coagulates if we withstand these things by emollient heating and attenuating fomentations the bloud will run more freely and with its rapid motion will wash what was beginning to coagulate from the Capillary Vessels dilated and softened if presently after the Fomentation or in the very use of it a Vein be opened Otherwise it is to be feared the thinner part of the bloud may come away by bloud-letting while the thicker and what begins to coagulate stays behind which will hinder the effect of the Purge which should then be given The Head especially should be bathed seeing in it there is the greatest danger from Coagulation and next the Hypochondria But both Fomentations and bloud-letting should be used in the beginning of the Disease while the spirits are yet elevated Ideâ— IV. There is scarce a Practical Physician but advises bloud-letting in an Apoplexy caused by bloud But I question whether it be proper in every Apoplexy as the excellent Nymannus thinks For he in favour of his Hypothesis which takes every Apoplexy to be caused by Obstruction of the Sinus's is very large in commendation of bloud-letting which Hypothesis since it does not hold true in every Apoplexy as I have proved the like and perpetual use of bloud-letting may be questioned It 's evident when the Vertebral and Carotid Arteries are filled with fibrous bodies that bloud-letting avails little And those Apoplectick persons are in the same Case who have the Torcular stopt seeing it cannot wholly be obstructed except by some such like body Nor likewise will bloud-letting be convenient when Serum is gathered in the Ventricles and Cavity of the Skull since by it the immediate cause is not removed but the strength otherwise spent is more weakned In an Apoplexy where a Vessel is broke there is no hope both because a quantity of bloud poured into the Ventricles and Basis of the Brain cannot be got back by Art and because while it stays there it is coagulated In that which is caused by Serum gathered in the substance of the Brain what good bloud-letting does it is by accident namely as it abates the Turgescency of the bloud and Serum Therefore this alone will not remove the Apoplexy but we must also use things that spend and evacuate the Serum which moistens the medullous substance But bloud-letting in an Apoplexy caused by a sudden Obstruction of the little Arteries is good in many respects for first the preternatural violent motion of the bloud is stopt which often is the occasion of this Obstruction and it runs in less quantity to the Brain for instance when the bloud is taken out of the Arm no small portion makes to the Arm by the Axillary Veins that so what was taken away may be supplied Then the bloud hastens from the whole body and from the brain towards the Heart to assist it thus depauperated and spoiled by bloud-letting Wepferus Exercitat de Apâ—plexia p. 218. And the heart eased of the burthen wherewith it was loaded both before and in the Paroxysm disperses the bloud as it returns more chearfully in better order and in quantity more usefull to the brain which forceth and washeth out what caused the Obstruction and Trouble in the medullous substance and drives it into the Capillary Veins adjoyning to the extremities of the Arteries V. Bloud abounding in the head cast a full-bodied young man into an Apoplexy with Trembling loss of Speech and Ratling three most dangerous concomitants of this Disease Tulpiâ—â— c. 7. lib. 1. Observâ—â— Wherefore speedily to abate these violent Symptoms he was immediately bled in the right Arm but not bleeding so freely as his extremity required the same Lancet was used to his left Arm and when both had continued bleeding for some time his Ratling evidently abated he took his breath better and quickly was cured VI. Cupping with Scarification should be applied not to the shoulders and back as the Arabians advise because there is no remarkable Vein that reaches the Brain But they should be stuck near the Jugulars and under the chin if possible Rondâ—lâ—â—us For these Topick Remedies should be applied not onely upon the Veins that reach the part diseased but upon the next and largest if the constitution of the Part will permit it VII A large Cupping-glass may well be applied to the top of the Head seeing it draws the bloud out of the Sinus of the Dura Meninx opens Obstructions and raises the subsiding Brain With which opportune Remedy Fracastorius remembred how he had once cured a Nun at that very time when he himself being seised with a small Apoplexy Horstius in Probl. made signs by putting his hand to his Crown that he would have the like remedy applied but they that were by not understanding him and his Disease increasing about night he died VIII A Man of Threescore fell down drunk and contused the hind part of his head but his Skull was whole and he was taken with a true and violent Apoplexy While all despaired I tried to cure him I shake
Veins which with Hippocrates is a general name both for them and Arteries when a great quantity of this Moisture is gathered it runs by other passages and when it stops in any part of the Body there a Disease is contracted I therefore conclude with Hippocrates that the Gout arises from filthy diseased steams or from a flatuous Ventosity upon which if any Humour follows it was the Vapour that made way for it And not onely Hippocrates but more modern Physicians have held That the Gout comes from Wind. Guainerius and Matthaeus de Gradibus were of that opinion Also Guido de Cauliaco a stout Voucher of the 4 Humours tells how â—e read in the Pope's Canons that the Gout aroâ—e from Vapours That Royal French Surgeon Paraeus was of the same judgment Several eminent Physicians hold Vapours the cause of the Tooth-ach Bastard-Pleurisie Colick Epilepsie and of Fits in Women so that they are called Vapours in English And I question not but many Diseases differing onely in Name and Place are of the very same nature with the Gout especially all those into which the Gout and they mutually degenerate Furthermore the China Physicians say Our Bodies are governed by 3 things i. e. by the innate Heat the radical Moisture and Spirits which they hold to be the Vehicle of the Heat and the Lungs from which they begin the Circulation of the Bloud to he the Elaboratory of the Spirits Upon the temper or distemper excess or defect conjunction or separation good or bad constitution of these 3 things they reckon life and death do depend And they wholly ascribe the Gout to noxious Spirits or Vapours These Vapours are as different as the several Parts and Humours in the Body that cause them Their material cauâ—es are first Meat and Drink thence come various Humours from each of which a different Vapour ariseth Their efficient causes are chiefly the Stomach which as it is strong or weak hot or cold full or empty breeds a different Vapour and then all parts of the Body where there is any concoction fermentation ebullition or effervescency of Humours may breed different Vapours Administring causes are all the six nonnatural things He that would be better satisfied let him reade Fienus de Flatibus That it is a malignant Vapour the Vehemence and intollerableness of the pain do prove Nor do several Authours deny it especially Galen who assigns good reasons for it Because the Gout never comes to Suppuration Because this Vapour causeth more intense pain than any Humours while they suppurate Because it creates no trouble in any part by which it passes except the Joints Bâ—t which is of greater moment the Cure proves it for whilst in the Gout men are burnt with Moxa sometimes Wind hisseth out of tâ—e Burn. And if it be kept open like an Issue an ichorous filthy malignant matter weeps out of it which stinks most offensively All grant thâ—t the Periâ—steum is a very sensible Membrane Now this Vapour doth not torment it on the out side but it insinuates it self between the Bone and it and so parting the delicate and extreme sensible Membrane from its Bone and distending it causes a raging pain And the Tumour lying so deep no wonder it cannot break prison till way be made by a red hot Iron or by the milder Burning of downy Moxa This Vapour the cause of Diseases extends it self as far as any Periosteum enwraps a Bone And so the Gout may come under as many denominations as it hath Parts to afflict The Learned Languages have Christened onely three the Hand Gout Gout in the Feet and the Sciatica for all which England can afford no more proper name than Gout in general or what it borrows from other Languages As for the antecedent Cause of the Gout I cannot impute it to any particular part But I think whatever Part or Humour therein contained is apt to breed a Vapour from that same part the Vapour may be carried to the Heart by the Veins and so from the Heart communicated to the Limbs and Joints by the Arteries Which is the Reason that several are troubled with Fevers Swoonings Palpitation of the Heart and infinite other diseases when this Vapour is not cast off to the out-parts But with some the Gout is reckoned a good sign of long life This Circulation of the Vapour is a reason also that the Pains remove from the Feet to the Hands and from any one part to another And the Vapour being cast off by the Arteries might be the reason why in Ventosities the Ancients approved of Arteriotomy beyond Phlebotomy and does indicate that the burning with Moxa should be where the Arteries beat most which is not duly observed by the Chinois and Japanois If the Part be so strong as to return the Vapour by the Veins or if any one be so much an Empirick as to repell it to the Heart it proves often Tragical Wherefore I do caution all Practitioners not to use Repellents by any means PART II. The Diagnosticks A Physician can no more direct his Remedies without observing the Symptomes of a Disease than the Master of a Ship can steer his designed Course without observation of the Stars and his Compass and a competent knowledge of the Shelves on a dangerous Coast Therefore we should reckon as much of the knowledge of the Symptomes those especially called Pathognomick which live and die with the Disease as we would of the Cure it self Impediment in Motion and Pain are inseparable signs of the Gout which spring grow up come to a pitch decrease and vanish with it sure tokens of an inward latent Pain that rarely is observable by the eye With which we rank the Swelling of the Veins and the violent beating of the Arteries for Signs and Symptomes always concomitant to the Gout because we find them by experience The Pain of the Gout is a piercing distending throbbing deep continual and bitter Pain each of them a certain sign of the Periosteum's being afflicted It is piercing because a Membrane of a most delicate sense is â—urt Distending because the Blower up of the Gout separates raises and stretches it Throbbing because the Authour of this Disease passes the Arteries and makes the bloud move inordinately while it is forced into the part affected it must be deep because in the Membrane about the Bone Continual because the Vapour pours in continually into the pained part as long as it hath any matter to supply it And then it must be sharp because while it abounds in quantity and malignity the Vapour cruelly and violently molests fills separates and distends a membrane of most exquisite sense nay and sometimes dissolves continuity as the violence of the Pain doth argue The other Symptome is Impediment in Motion of the same nature and degree with the former which happens not through any fault in the Member but onely in the Periosteum And this difficulty of Motion appears and disappears with the Gout And these two
the body but it flows back slowly from the Heart and Diaphragm for the Veins are crooked and the place is dangerous and apt for a delirium and Madness by reason these parts are replete and a Shivering with a Fever takes them which they call Wandring Fevers And these things being thus she is mad because the heat is increased and she is timorous and afraid because of Darkness she suffers strangling and prefocation because of compression about the Heart her mind being sad and anxious because of the badness of the bloud draws on mischief And I add that the whole body is not onely cacochymick but moreover rendred cachectick as appears from the vitiated colour of the whole languishing of the Strength swelling of the Eye-lids and Feet But Hippocrates seems to intimate that it is possible this Disease may come not onely from the stopping of the Menstrua but from the retention of the Seed when he asserts that Virgins are cured when either they lye with a man or their Menses come especially if the Virgins be of a hot and moist complexion and of a good habit That the Patient may be rid of this Fever it is necessary that the mass of bloud be purified and be reduced to a more laudable state Therefore First The cleansing of the Stomach and first ways must be premised Secondly The Obstructions of the Mesentery and Lacteal Veins must be opened Thirdly The Cacochymie of the whole venous kind must be taken away Fourthly The Cachexy that is beginning must be provided against Fifthly The Menstrua must be solicited by opening Hystericks And lastly The Bowels must be strengthned As question cannot be made concerning Bloud-letting since it offends in quantity substance and motion so we must act with caution in the present case concerning the quantity for the bloud is already degenerated into a Cacochymy and although Hippocrates teach that the cure of this Disease is taking away Bloud yet he orders this to be done before the whole Body be Cacochymick and while as yet it is not altogether so Cachectick Wherefore in a tedious and confirmed oppression he 1. de morb mal 10. purges the belly upwards and downwards because a Cacochymy is not taken away by bleeding but by purging Hence after a copious Diarrhoea a Maid 4. Epidem recovered The place must be the right jecorary Vein that Bloud may be drawn but not drawn downwards before the obstructions of the Womb be opened and the Veins be made pervious for then the Saphaena may be opened onely upon the account of the Bloud 's motion In the mean time an Issue must be made in the Hip. For emptying the Stomach a Potion with Manna clarified or Lenitive Electuary with Tartar For the preparation of the first ways Oxymel simplex with Mel Rosarum simplex of each 1 ounce and an half Cinnamon Water half an ounce Mix them for one Syrup and so for five more then let either of the said Medicines be repeated Then the obstructions of the Mesentery and Lacteal Veins must be cured with attenuants aperients and evacuaters A preparative may be thus made Take of juice of Cichory clarified 2 ounces Juice of Borage 1 ounce Tartarum vitriolatum 10 grains Decoction of Cichory Borage Endive Cinquesoil Parsley Agrimony 5 ounces Mix them for a Syrup To which may be premised about 2 ounces of dilute Oxymel in which she may continue ten days and about the middle of the time let this be given her Take of Pilul de tribus cum rhab. de Hiera cum Agaric each 2 scruples Electuary Lenitive six drachms mix them Make a Bolus And when ten days are over Take of Elect. Cathol 4 drachms Rosat Mesues 2 drachms Pilul de tribus one drachm mix them Make a Bolus Upon which when an hour is over let her drink Broth altered with Barley or Barley-water The Cacochymy must be taken from the Bloud by Epicrasis by preparation and frequent purging Nor must the little Fever be feared for in this case we must ply the Cause making very small reckoning of the Fever And we must insist 12 days on the preparation but a Purge must be given every fourth day Take of Decoct Epith. Mesues 6 ounces or if she had rather have a Bolus Take of Extr. Sennae 1 drachm black Hellebore half a drachm Lenitive Electuary half an ounce mix them Make a Bolus Upon which let her drink clarified Whey because Hellebore has in it a very hot quality When these three Purges are taken we must not believe the whole venous kind is defaecated from impurities wherefore Purges must be repeated which have also an opening faculty they must be prescribed in form of a Syrup 2 ounces of which must be given every day in half a Glass of White-Wine persisting in the use of it for twenty days Then we should take care of the Cachexy and things that purifie the fleshy parts and defend them from ill humours should be given that is Diaphoreticks sensible Evacuaters and insensible Digestives To which intention sweat might give satisfaction some convenient Decoction premised or the continued use of Viper Powder But because our chief intention ought to be to open the Veins of the Womb to provoke the Menstrua and purge the whole Body by those ways that are proper and usual to Nature therefore lest the humours should be diverted from the Centre to the Circumference setting aside the Intention we must first make use of aperient Hystericks and things that provoke the Menses For the opening stubborn obstructions of the Womb the use of Steel is usually extolled by all men especially of potabilis M. D. whose virtue that it may come to the Womb wants a vehicle Therefore let a decoction be made which may have the faculty to doe that and to dry the whole body Take of the best Sarsa 1 ounce fat Guaiacum root of Gentian wood of Saffafras each half an ounce distilled water of Cichory Maiden-hair Motherwort each 1 pound mix them make an infusion for 24 hours Then let them boil to the consumption of half Keep the Colature for 2 doses to be given early in the morning to which 10 drops Chalyb Pot. M. D. may be added and a spoonfull of Savine-water or 5 drops of its Oil. Also the opening of the Veins must be procured outwardly not by Pessaries or Injections but by things applied outwardly by making a fomentation and applying it with a large Sponge to the Region of the Womb anointing afterwards with Oleum Lilior alb Aromatizat Insessions also in medicated Waters are good Things to stop the hysterick symptoms may be Treacle-water with Water of the whole Citron Oil of Amber to 2 drops in Cinnamon-water middle aged Treacle or Triphera without Opium with water of Pennyroyal or Motherwort Then the great Antidotes will strengthen the Bowels Treacle-Salts Salt of Wormwood Mint Joh. Raim Fortis Tract de Febr. p. m. 42. Let Wine for Meals have Rosemary Guaiacum or Sassafras infused
taken away in less quantity if Putrefaction prevail in a larger And so especially if it arise from a morbid apparatus and putrid humours gathered within the Veins and that chiefly if there seem to be or to be imminent an Inflammation of some of the Inwards which often happens But Bloud must be let betimes For if the Disease have made any progress and the Malignity be diffused into the whole mass of Bloud it does not onely doe no good but also greatly weakens Nature so that most Authours think Bloud must not be let when the fourth day is past Yea and seeing at different times they are of a different nature arising from a different degree of Malignity we must observe diligently what emolument Patients receive from Bleeding For some sort of Continents wherein the Putrefaction is more intense and the Malignity more remiss do abate much by Bleeding But others whose Nature consists in Malignity onely in a manner are made more pernicious by breathing a Vein Concerning the time and intervalls for repeating Bloudletting observe that if the Disease proceed slowly Bleeding must not be accelerated for the strength is spent before its time and will not be able to hold out the whole Disease Therefore as the Disease moves so Bleeding must be celebrated sooner or later Riverius V. It is determined by the wise Judgment of Doctors that when Purple-spots appear in the beginning of the Disease and at those days when Bleeding uses to be celebrated if a sufficient quantity of Bloud have not been taken away before even at that time Bloud may be taken away in a moderate quantity without any imminent danger Seeing that Eruption which is in the beginning of the Disease is not Critical but Symptomatick arising from the exceeding Ebullition of the Bloud and the ferment of malignant and putrefying humours And therefore Nature's motion which at that time is not cannot be hindred For if when the Body is plethorick and sends out a thick and red Urine you do not let bloud on the score of Spots appearing Nature will scarce be able to conquer so great a quantity of Humours and there will be danger lest they fall upon some inner part and breed in it a pernicious Inflammation yet at that time Bloud must be taken away with greater caution and in less quantity not that the Veins may be very much emptied whereupon a retraction of the Humours from without inwards might succeed but onely that their too great fullness might be removed which being taken away the Veins do not attract new Bloud but they fall flat and grow a little strait that they may be the better able to contain and rule the Bloud that is left in them and so the motion and expulsion of Nature to the superficies of the Body is helped For Nature being eased of part of her burthen wherewith she was opprest expells the rest more easily Which is well known to us in our practice whilst often on the same day we open a Vein in acute Fevers yea sometimes within a few hours after Bleeding we observe plentifull Sweats and those critical and wholesome to break out Yea and although Nature were strong enough to rule all the redundant Bloud seeing in Plethorick Bodies the Bloud is usually thick and by such efflorescencies onely the thinnest portion of the Bloud exhales the thicker Bloud remaining would onely putrefie more and more and would render the Disease far more dangerous Yet I think it most advisable a little after Bleeding to apply several Cupping-glasses to help the motion of the Bloud outwards In short if this happen in the beginning of the Disease and before the fourth day at which time there can be no critical Eruption if no relief follow upon it but all Symptoms rather grow worse bleeding should in no wise be hindred If after the fourth day a great quantity of Spots break out the Patient be better and Symptoms abate instead of Bleeding several Cupping-glasses with Scarification may be applied that Motion may be promoted outwards And what has been said of Bleeding understand it of bleeding in the Arm which immediately abates the Quantity Sometimes notwithstanding opening the lower Veins is very beneficial if the strength be not able to bear farther bloud-letting It is beneficial especially to Women even beyond the time of their natural Purgation It is good also where a translation of the humours to the Brain is feared Opening of the haemorrhoids also with Leeches does good which is done with little loss of strength revulsion in the mean time being made from the inner bowels Idem it is good especially for Melancholick persons VI. This generous Remedy ought to be administred immediately in the very beginning of this Disease that is while strength is good and before the corruption and poison is got into the Bloud Yea I prefer this one thing that there is no Fever in which relief is deferred with greater damage nor perhaps is there any one Fever which more deceives ignorant Physicians For when Bleeding is deferred the Bloud being already corrupt I have observed that the cure is rendred almost impossible by reason of the great weakness which appears all on a sudden before the height of the Disease Parthermore if any Disease can deceive a Physician this is the principal because this Fever at the beginning appears so mild both in heat and in all its accidents that ignorant men slight it But then afterwards signs of Death appear all on a sudden for which reason it is necessary that the Artist be experienced Augenius carefull and Learned VII I think Bleeding in the lower Veins is far more beneficial than in the upper especially if the Menstrua be stopt or the usual bleeding of the Haemorrhoids suppressed for in these latter cases it has no difficulty But if they be wanting I have observed in these Fevers it is far safer to breathe a Vein in the Leg or Foot For if it be the best way to draw the Poison from the Heart no safer way can be thought on than to draw to the lower and weaker parts But some may say the abundance is not evacuated with that celerity out of the lower Veins as out of the higher I answer 1. I cannot easily admit that because if I be not mistaken the Veins of the Legs and Arms are equally distant fom the Vena Cava 2. Suppose there be a difference it is exceeding small but the utility for the foresaid Causes Rolfinccius is far greater VIII Aquapendent says he will propose a Paradox that evacuation by the Haemorrhoids conduces more to the cure of Malignant fevers than Bleeding in the Arm. He subjoins a reason for the greater branches of the Vena Cava wherein the peccant matter lies may so be emptied And I add that while they draw from the sedal Arteries it is very likely the Heart is wonderfully relieved thereby Idem IX opening of a Vein may be omitted when the strength
be free from that infection 5. This powder was used with great success in the Plague and is given by many but erroneously as a common cure for Fevers Take Sugar-Candy 3 drachms Ginger 2 drachms Camphire 1 drachm Mix them The dose 1 drachm in Water and Vinegar in which Tansie has been boiled especially when the season is not hot ¶ I could also prove the efficacy of this Electuary by good witnesses it is made also of Camphire Take of Scordium 3 drachms Tormentil White Dittany Zedoary Gentian Angelica Cloves each 1 drachm Saffron Camphire each 2 scruples Mix them Make a powder sprinkle it with Water of Carduus in which are dissolved of Treacle 2 drachms and with Syrup of Juice of Carduus and of Scordium make an Electuary The dose 1 drachm or more in Carduus-water ¶ Nothing is better to preserve children from the Plague than Bole-Armenick with a little Tormentil and Citron-pill powdered which may be strewed on their Meat ¶ In a Pestilential fever the following Water is a truely royal Medicine and is highly commended Take Spirit of Malmsey-wine eight times distilled 8 Measures put to it of root of Tormentil Serpentaria each 1 ounce Angelica Zedoary each half an ounce Citron-peel Cinamon each 1 drachm let them stand 3 days in a glass stopt and in a warm place then these things being cast away and strained out first pour this Elixir again into a glass and let these things tied up in Linen be put into it Take of fresh Sperma Ceti Ambergrise best Rheubarb each 2 drachms Musk half a drachm let the Vessel be well stopt keep it One drop of it in Summer time is taken with Sugar of Roses for preservation to those that are infected one ounce may be given with Water of Carduus Benedictus Scabious or Scordium adding 1 drachm of this Powder Take of Hartshorn Unicorns-horn each 1 scruple Terra sigillata half a drachm Pearl Emerald each half a scruple Camphire 7 grains 5 grains of Bezoar-stone may be added and every 3 hours 1 scruple of this powder may be given with Water of Water-lily Sorel c. and when the Patient has taken it let him Sweat ¶ I have learned by certain experience that to pour some Spirit of Malmsey-wine upon Amber and keep the Glass close stopt and every morning to take a few drops with Bread Crato is an excellent preservative from the Plague 5. Elixir Alliatum is reckoned a great Preservative from the Plague it is made thus Take twenty heads of Garlick cleansed bruise them put them in an Alembick pour to them rectified Spirit of Wine till it stand four inches above distill it in Balneo by cohobations always putting in new Garlick in the last distillation add of Camphire tied in a rag and hung in the nose of the Alembick 1 drachm distill it as before ¶ There is a most secret virtue against the Plague in the herb Milfoil whole with its Flowers Deodatus with which onely the Buriers use to guard themselves in the greatest Plagues 6. A compound Oil is made of Scorpions and is much celebrated amongst Chymists it is commonly called Oleum Clementis it shews wonderfull effects in Poison and in all Pestilential Diseases reviving them that are half dead which Oil I highly commend in this case if the Arteries Pet. Salius Diversus and the region of the heart be anointed onely with it 7. A Salt is made of the ashes of a burnt Toad with Water of Carduus Benedictus or Meadow-sweet The dose half a drachm in Carduus Benedictus Water for a Sweat in the Plague which it powerfully promotes Faber and it is very good to cast the Plague out thereby 8. I take Earth-Toads and hang them up and dry them in the Air then I lay them on a hot Tile to make them dry I powder them but first I anoint the Pestil and Mortar with Oil of Scorpions that the Powder may not get into my Nose and hurt my brain with its poisonous quality I take of this Powder 1 ounce sowre Leven 4 ounces the best Treacle 1 ounce leaves of green Rue 1 handfull I mix all these things well with Honey and apply it to the Bubo twice or thrice a day This Plaster draws the Poison out of the body wonderfully to it self a whole Toad dried Guilh. Frabricius and applied to a Bubo does the same 9. This is a most noble Bezoardick Tincture Take of Mistura simplex 3 ounces Berries of the herb One berry 3 drachms Scorzonera-Root 4 scruples Make an Infusion and digest them J. Mich. Febr. The Dose 1 scruple to 2 scruples 10. Hier. Fabricius I especially commend Flammula Jovis to be applied to a Bubo because it draws much and raises blisters by which the Poison is purged out 11. This Plaster is commended above all others for Swellings and Pestilential Buboes Take a Frog and a Toad dried powder them add thereto of Gum Opoponax Frankincense each 2 ounces Galbanum 1 ounce Serapinum 4 ounces Bdellium 3 drachms pour to them Rose-vinegar what is sufficient boil and dissolve the Gums add of Camphire Oil of Sulphur each 1 ounce Fry them in a Frying-pan into the form of a Pultess and apply it hot to the Swelling repeating it every six hours ¶ This is very good to anoint Carbuncles Take of Vnguentum Basilicon 1 ounce fat of Vipers 1 ounce extract of Scordium 3 drachms Treacle 2 drachms Juice of Lemons Oil of Scorpions each half an ounce Mix them Make an Unguent Anoint the Carbuncles ¶ Above all other things which by experience are found good to preserve from the Plague Vitriol is the thing To the stronger sort it may be given to 1 drachm dissolved with Honey and Water for the weak it is prepared with Rose-water and ground very fine at least four times and so half a drachm of it may be given with Wine or Honey ¶ In a Malignant Spotted Fever this Cordial-water of mine is most excellent Take of Juice of Goat's Rue Sorrel Scordium Citron each 1 pound Mix them Add 1 ounce of Treacle Infuse them in warm Water then distill them in Balneo The dose half an ounce morning and evening ¶ This is a most excellent Powder which preserves from and cures the Plague Take of White Vitriol it is first powdered and infused in water then it is dried and this is done three or four times adding a little Camphire of White Dittany Tormentil-root each 2 drachms Make a Powder Rod. à Fonseca The Dose is 1 drachm in Water of Plantain or Roses or Sorrel 12. This Powder of mine was very good Take of Root of Dittany Tormentil Bole Armenick prepared Terra sigillata each 3 drachms Roots of Gentian Butter-bur Tunica each 2 drachms red Sanders 1 drachm shavings of Ivory Citron-Pill red Coral Bone of a Stag's heart Root of Zedoary each half a drachm prepared Pearl both the Behens each 2 drachms Amber Unicorn each half a
taken stops all Bleeding Stockkerus 12. If a red-hot Iron be held under the Nose as it bleeds so that the vapour of the Burnt-bloud may ascend to the Nose immediately the Bleeding stops Willis Haemorrhoides or The Piles The Contents Their excessive Bleeding must not be rashly stopt I. Where bloud must be let when they are stopt II. When they run excessively bloud may be let in the lower Veins III. Whether they should be opened with a Penknife IV. Whether in curing haemorrhoids of a long continuance all of them must be suppressed V. The cure of their too much running by bloud-letting VI. In whom they may safely be suppressed VII Scarifications Cuppings Ligatures c. do not stop them when they run too much VIII Not onely bloud but a puriform matter sometimes runs out of them IX What such bloud comes X. Whether the thick and black humours which they void do come from the Spleen XI Whether Tying Cutting and Burning be proper for their excessive running XII Whether an old Flux must be let alone or stopt XIII An excessive one stopt by searing XIV The body must be exactly prepared before they be stopt XV. They are painfull from all bloud and not onely from melancholick XVI The cure of painfull and distended ones by compunction XVII The cure of latent ones XVIII Sharp Clysters are bad to provoke them XIX The pain cured by an easie Medicine XX. Eased by opening a vein in the little Toe XXI The pain of the blind ones ceasing by an Issue made below the Knee XXII When they are painfull we must abstain from violent Purgers XXIII Why remedies must be varied XXIV Narcoticks must sometimes be made use of XXV The cure of them excrescent easie and safe XXVI The cure of Tumid ones without pain and inflammation XXVII Pain must be eased variously XXVIII XXIX The Flux is often provoked by Medicines of Scammony and Senna XXX Tamarinds and Syrup of Roses are suspected XXXI How we must purge in an excessive flux of them XXXII We must abstain from Rheubarb XXXIII We must not accustome our selves to them XXXIV To stop them a decoction of Sarsa is excellent And derivation to the Womb. XXXV The Abuse of Clysters hurtfull for such as are subject to the Piles XXXVI Vnguents not proper XXXVII Medicines I. I Remember when I had the most Illustrious Ann Countess of Waldeck of the family of the Duke of Cleves under cure for a most grievous and tedious Flux of the haemorrhoids and when I saw that her strength was wasted and her spirits spent and so that she was in great danger I stopt them But though she was refreshed the first day thereby yet she was wonderfully oppressed on the following days and she began to swell and puff up about her heart When I was called on the sixth day I was forced to open the veins and make the haemorrhoids bleed again nor could I with any security close them till I had provided for the body by gentle Evacuations and for the Liver with other things that are alterative and corroborating Solenander Therefore here we must act dexterously lest we leap out of the Frying-pan into the Fire II. Because oftentimes there is no less danger when they are too much stopt than when they run too much especially in such whose custome it has been to be purged that way at set-times and we must have a care they be not stopt longer than is convenient therefore it is proper to let Bloud in the inner veins of the Legs about the inner Ankle or in the veins under the Ham for by opening them the suppressed Piles are provoked according to Galen l. de V. S. But if the Body do not appear very much oppressed nor any danger as yet seem to be feared from the suppression of them yet it is good to provide for and to take care of Mens health lest some Disease breed by their being too much stopt It will doe good sometimes to open a vein in either Arm for so you will prevent the necessity of the haemorrhoids the cause that is of that Flux being in some measure removed and you will abate Nature's pains in bringing them at certain times Idem and you will avoid some inconvenience which may happen ¶ For the cure some teach that according to Galen a vein must be opened in the Foot because the opening of this vein provokes the haemorrhoids In which matter the Physician must not be too hasty a plenitude of Bloud continuing because by this Bleeding the Bloud often falls with such violence upon the lower parts and especially the part affected that a worse Disease follows and hence I have seen in such a case great Inflammations and sometimes Gangrenes also have followed Wherefore the plenitude remaining not the lower but rather the upper veins must be opened And this must be observed especially when there is an intention onely to allay pain and not to provoke the haemorrhoids for where no intention is to provoke them it is safer in every case to open the upper veins and the rather if we have a mind to stop them P. Salius III. In a preternatural running of the Haemorrhoids although a Vein must be opened in the Arm because the Fluxion which tends to the Head may be drawn back by opening a Vein in the Legs so that which tends to the Feet or Anus by opening a Vein in the Arm. For if the Bloud run impetuously by the Arteries to the lower parts and a Vein be opened in the Arm the Bloud cannot chuse but be carried with less violence to the lower parts for want of Bloud that is if a good quantity have been taken by venaesection And since it has an easier exit where a Vein is open the Bloud must necessarily run by those Arteries rather which are soonest drained by the opened Vein than by them out of which into the Veins there is not so ready a passage and so the Bloud which before ran by the Arteries downwards when a Vein is opened in the Arm and the course changed must needs tend upwards to the Arm by the branches of the upper Arteries Yet we must observe if there be an Inflammation already in the Haemorrhoids then we must bleed rather in the Leg than in the Arm because in this case we have not so much regard to the humour affluent as affluxed which wants evacuation and derivation Bleeding by venaesection will then be convenient when the excessive Flux of the Haemorrhoids proceeds from redundance of Bloud in the Mesaraick Veins for though Bloud do not then run out of them by opening a Vein because these Veins no where reach to the Skin yet because the Vena cava being in some sort exhausted of the Bloud by it draws Bloud out of the Mesaraicks by the means some evacuation of it is made thence also by revulsion and especially by plentifull bleeding in some patent Vein in the Arm or Hand Or also
Septalius lib. 6. animad 117. forbids Diureticks in the Palpitation of the Heart if thick Blood offend because they exhaust the Serum of the Blood and make it thicker But when it arises from a warry and serous Humour there is nothing that can more easily conquer the violence of this Disease VII Although we must presently relieve the Heart as a principal part by such things as have a singular virtue to encrease its strength and to discuss the malignity of the Vapours such as are most sweet sented and Aromatick things which by their Balsamick virtue defend the innate heat of the Heart and by their heat discuss and waste the Vaporous Matter Yet if the Womb be the cause of the Palpitation we must abstain from them the Diseased Constitution of the Womb forbidding it For such things presently cause Fits and then the Palpitation is greater For when the Brain is refreshed with sweet sents by the sympathy which is between it and the Womb if this be morbid the latent Vapours are raised which fly to the principal parts especially to the Heart Therefore we should rather fly to those things which have the faculty of discussing that vapid Substance such as some fetid and strong smelling things which by their inimicous quality excite the expulsive faculty to cast out what is noxious Besides they have a virtue to attenuate and violently to dissipate as appears in Castor Galbanum Asa faetida and the like Sennertus VIII If the Palpitation come from Wind Electuaries and other Compositions must have no Syrupus de Pomis in them Rondeletius for Apples keep their windiness to the third concoction as Avicenna writes IX A certain Valetudinary Prince when he had been a long time most grievously troubled with Palpitations of the Heart could find relief by no Medicines A young Physician coming in tells how he found in some Writings of the former Age that a certain kind of Worm sometime breeds in the Heart which by taking a Clove of Garlick Evening and Morning may be killed which Remedy was neglected and accounted despicable But at length when the Disease had killed the Prince his Body was opened a white Worm with a very sharp horny snout was found sticking to the Heart which the Physicians took and put alive into a Circle drawn on the Table with juice of Garlick J. Hebenstrein l. de Peste it crept about and about and was wonderfully tormented but would not touch the Circle At length being overcome with the sent of the Garlick it died within the Circle X. A Noble Matron of Newemburgh 35 years old had been troubled with the Hypochondriack Disease for ten years She was taken with so violent a Palpitation that one would have thought her Heart would have broke her Ribs and leaped out of her Breast When I was called I presently ordered an Emollient Glyster to be given her because she never went to Stool but upon meer necessity This was succeeded by a Carminative one Afterwards an Epitheme was applied of Treacle Confectio hyacynthina and Alkermes without Amber or Musk. Then the following Potion was given her Take of Water of Balm Carduus Benedictus each 1 Ounce Orange-flower-Water half an Ounce Cinnamon Water 2 Drachms Syrupus corticis Citri made according to Zwelfer's Correction and of Betony Flowers each half an Ounce Oyl of Citron rind 2 Drops prepared Pearl 5 Grains Saffron 1 Grain In two hours time it left her and never returned again XI This must be reckoned in the Palpitation which comes from heat and abundance of Blood we must neither use hot things lest the effervescence be increased nor cold ones lest when the efflux of Vapours is stopt the Palpitation grow more violent For it is sufficient to use temperate Mercatus strengthning and odoriferous things XII Issues are very good in the Palpitation of the Heart as I have happily experienced Which since they may be made in divers parts of the Body if the matter falling from the Head cause the Palpitation as Hippocrates says it is best to make Issues in the upper parts and in this case I use to advise an Issue in the right Arm. Mercurialis But if it be essentially in the Heart or come by consent with the lower parts it is much better to make an Issue a little above or below the Knee XIII In this sort of Disease we must insist long on Medicines Ferdinandus Hist 12. for after six months or a whole year the Disease uses to return as I have known several Wherefore we must always be doubtful of it and not be overjoyed because it ceases for a month or two XIV Joh. Praevotius in a years time cured Baron K. of a Palpitation of the Heart Rhodius Cent. 2. Obs 40. and of all the Arteries in manner of an Aneurism from retorrid Bile with drinking of Whey and bathing in fresh Water Fernelius mentions this Pulsation Path. lib. 5. cap. 12. XV. Since the Causes are various the Cure must also variously be insisted on For what some hold that these Remedies which are vulgarly called Cordials do refresh the Heart and are thought to help it as it is laboring this is repugnant to Reason and to ordinary Experience Since therefore we have declared how the Palpitation of the Heart proceeds from some fault in the Blood or in the Arteries that are joyned to the Heart and have shewn the divers ways of affecting both of these an apt method of Cure must be accommodated to every sort of that Disease 1. Therefore if the Disease proceed from some fault in the Blood the primary Therapeutick intention must be to exalt the Blood that is too watry and unfit for Accension and Fermentation to a better crasis and to exalt and increase its active Principles that are depressed or diminished For which purpose Spirituous Medicines also Saline of all sorts Sulphureous and especially Chalybeates are proper Here also we may prescribe such things as are used in a Leucophlegmatia Pica and a cold Scurvy 2. The Palpitation of the Heart which is more frequent and much more violent comes from the Cardiack Arteries and then their fault is either an Obstruction or a Spasmodick Affection The first Disease is usually continual and often incurable especially if it comes from Consumptive Lungs or from a Tubercle at the Roots of the Arteries or some bony Excrescence whereby they are half stopt up or compressed Which causes if at any time they be there and can perfectly be known it would be in vain to endeavour to remove them But rather this only must be done we must give the Patient some ease by an Hypnotick to prolong a miserable Life a little further Nor is it also improbable that the Arteries are in a great measure filled by Polypous Concretions that are used to breed there and sometimes within the Ventricles of the Heart and therefore the free and total exilition of the Blood is hindred As the
be opened III. IV. Whether it may be done even to swooning IV. It is to be done where there is a Bone under the Artery V. Before an Artery be opened in the Head we must see whether the fluxion be not by the subcutaneous vessels VI. Whether it be more effectual than opening of a Vein VII If an Artery be cut with an hot Iron let the falling of the Eschar be retarded VIII I. ALthough this kind of Remedy is almost obsolete in these times of ours yet it is a very powerful and profitable one and void of all danger for only by ligature the efflux of the Arterial Blood is hindred in the lesser Arteries nor is the Plaster proposed by Galen necessary viz. of bole Armene Frankincense Mastich and hares wool made up with the white of an Egg which yet those may make use of for the greater safety that are fearfull of this opening The Temporal Artery is opened as in Phlebotomy and six ounces of Blood may be taken that spurt◠out with violence after which lay on presently your plagets and let them remain tyed on for four days By the use of this we have cured the fiercest hemicrania or Head-ach and never found any danger in this opening of Arteries ¶ In vain sayes Paraeus Laza◠River Pract. lib. 1 cap. 16. has arteriotomie been suspected as if there were danger that the Blood could not be stopt or the orifice heated up again because of the hardness of the Artery and the continualness of the pulse and for fear of an aneurism but this is the opinion of men that fear all things safe For we must distinguish between the larger Arteries which are to be shunn'd by the Physician for the aforesaid dangers and the smaller in the cutting whereof there is no fear of danger Yea of a larger Artery Galen lib. de s m. cap. 23 sayes that if it be quite cut through it may be closed with a cicatrix without an aneurisma and that doing so has often taken away the danger imminent from a flux of Blood for it is clear that when it is wholly cut asunder both ends being pull'd back on each side one retires upwards and the other downwards and this happens indeed to the veins also but moderately but to the Arteries more than to the Veins And of the difficulty of the coalition he saith thus in the same place The Nature of an Artery does indeed plainly shew the difficulty of its hard coat 's conglutination yet the difficulty is not such as is altogether invincible for it is not so dry and hard as a bone or gristle yea it is far softer and more carnous than these and therefore there is less reason to despair of uniting it after it is cut especially where it self is small and the Body of the man whose it is soft by nature II. The manner of Arteriotomy deliver'd by the Ancients is so severe and dangerous that there is none of the Moderns but is displeased with it yea it had been wholly cast out of the number of Remedies if the pity and diligence of latter Physicians had not invented other wayes Surgeons were wont to tye a string about the Neck but seeing the straiter binding thereof is very troublesome it is better to make this ligature under the Arm-holes Let this be so strait that the jugular Veins and Carotid Arteries may manifest themselves the one by its swelling and the other by its beating then press the arterie with your finger a little lower down than you intend to open it and having open'd it which must be done with a slow but steady and strong hand let it bleed as much as you desire When the operation is over sprinkle an adstringent powder upon the wound then lay a folded linnen cloth upon it and upon that a plate of Lead Barbette Anat. Pract. c. 10. tye both these on with a fit stay and it will be healed up in five or six dayes III. What Arteries may be cut The first is the Frontal that runs along the middle of the fore-head and is commonly divided into two above but in the middle has one single notable trunk this is frequently cut by the Aegyptians in an inveterate Head-ach The second is the Occipital or the Artery of the puppis opposite to the former by the Lambdoidal suture and is opened in the same distempers with the former Thirdly the Temporal Arteries are very safely cut in most diseases of the Head By my advice an implacable pain in the left side of the head was taken away by cutting of these Fourthly Galen mentions the opening of the Arteries behind the Ears lib. de cur rat per s m. c. 22. and Paulus lib. 6. c. 4. commends it in the vertiginous and such as have a fluxion upon their eyes But sayes Galen 3. de loc aff c. 8. it is manifest that all have not been cured by the benefit of this Remedy for some Arteries that are larger than these ascend to the Brain from its basis through the plexus retiformis by which 't is probable such distemper has been caused a vaporous and hot Spirit being carried through them and filling the Brain And it may be also that an unequal intemperies of the Brain may produce such a Spirit Fifthly the opening of that Artery that runs betwixt the thumb and fore-finger that is famous for Galen's praises is good in the pain of the hypochondres there where the Liver is joyned to the diaphragm Septalius lib. 6. animadv 171. and 172 calls it a most wholsom help in palpitation of the heart Alpinus lib. de medic Aegyptior 2. cap. 12. testifies that the Aegyptians cured all the pains of the internal viscera by opening this Artery Sixthly the cutting of the Artery that is near the Ankle is believed to help in the Sciatica None dare on purpose cut an Artery near the Cubit for although an Artery cut by chance by a Surgeon that should have open'd a Vein was healed up again by * Gal. 5. Meth. Med. cap. 7. Galen's advice yet the same Physician lib. de cur rat per s m. cap. 23. judges such apertion to be dangerous for fear of a gangrene or an Aneurisma Rolsinc Met. Med. lib. 4. sect 3. c. 2. IV. Whether may we Bleed by an Artery even to swooning We have Aëtius an asserter of the affirmative Tetrabib 2. serm 3. cap. 9. de arter sect We must cut the Artery sayes he not aslant but a cross even to the bone and most exactly scrape the Membrane that cloaths the Skull and let it bleed even to swooning in such namely as are robust and in whom the pain is vehement for thus you shall destroy the Symptome c. Galen favours it also l. de cur rat per s m cap. ult where he relates how upon the cutting of the Artery betwixt the thumb and fore-finger the Blood issued out so abundantly that it came to near a pound which evacuation was followed by a
pain heat and fuga vacui or the avoiding vacuity To pain indeed as it depends upon its causes an hot intemperies and a solution of continuity springing thence this debilitates the part and makes it unable to repell the Humours from it whence the tyed part swells But there is a far other reason of this swelling Ligatures upon the Arms stop the motion of the Blood that is flowing out at the Nose not because they attract upon the score of pain or heat but because they retard the Blood that is received from the Arteries and is a returning to the heart by the Veins from passing so speedily to the right ventricle On this foundation the vertue of Ligatures rests whilst they are made upon a sound part they hinder the Blood from flowing back by the Veins to the affected part in any plenty Rolfinc Meth. Med. p. 442. so the affected part is freed from the influx Narcoticks See Hypnoticks before Nephriticks Cysticks or Medicines for the Stone See Book 3. Calculus Renum or the Stone in the Kidneys and Book 15. Renum affectus or Diseases of the Kidneys The Contents They respect either the resolution of the Coagulum it self I. Or the Saline Acrimony and irritation of the genus membranosum II. Or the opening of the ways III. Nephriticks and Cysticks are the same IV. Nephriticks are not to be confounded V. Resolvers hurt when a Saline Acrimony offends VI. The Reins rejoice in moisture but not excessive VII Where Topicks are to be applied VIII Refrigerating ointments scarce cool because of the oyl IX Hot dissolvers of the Stone many times do hurt X. I. IT being presupposed 1. that the Material cause of the Stone is a dry concretion that in a Natural state is voided with the Urine or a Tartareous Salt consisting of an earthy and Saline matter although a viscous Humour may also concur 2. That the Blood of calculous persons add of Gouty and Hypochondriacal abounds with such Saline and Tartareous Coagulables we say that Nephritick Medicines are both such as resolve and such as mitigate and such as drive forward and so they respect 1. the resolution of the coagulum it self or the sliminess or muddiness of the Blood tending now out of the Vessels separated in the Kidneys and Bladder but not expelled whether it offend by its plenty or Nature her self fail in her expulsion and the earthy parts by the access of the saline fixed volatile turn into a coagulum such as are 1. Abstergers both watry and diluting that afford a more plentiful Serum for the draining out of those excrements and are good against gravel when there is a plentiful sediment in the Urine and the stone is a breeding 2. Sulphureous Resolvers that more intimately hinder coagulation and hinder the matter from stopping there whether they be more temperate oily obtunding and taking away Acrimony of Sperma ceti and other Aperients that are good in any obstructions stoppage of Urine stone c. or more active fusing the Blood as it were and precipitating and liquating the Serum into the Kidneys such as are chiefly Remedies of Turpentine which give the Urine a Violet smell which is a notable testimony that their vertue reaches hither the oyl of Amber c. 3. Saline Resolvers whether Acid inciding and deterging as Acidum Tartari acid mineral Spirits especially Spirit of Salt or soaty and earthy alkali's obsorbing Lyes which are of avail either through their Salt which they keep retir'd or from their notable vertue of absorbing saline Humours as Crabs-eyes the Salts of plants the tincture of Tartar c. whence belong hither most of the more generous Aperient Diureticks and Lithontripticks From hence it appears why Acid and Lixivious Medicines also are good in the stone namely both of them resolve correct glutinosity and destroy a preternatural coagulum likewise other things that take away grumescence or clodding and resolve coagulation which also are good when clods of Blood stop about the Bladder II. Or 2. they respect the saline acrimony and irritation of the genus Membranosum and are temperating moistening cooling absorbing whether the parenchyma and Membranous and Nervous passages be hurt by an acrimonious caustick Salt as it is common upon taking Cantharides to have all the harm accrew to the Kidneys and Bladder alone or from the weight and sharp corners of the coagulated Stone Such are 1. those things that are common as it were to both temperate and demulcing aqueous Remedies not Saline Sweet and Mucilaginous as Gum Tragacanth Gum Arabick the pulp of Cherries and Cassia Raisins Sebestens Conserve of the flowers of Mallows commended by Amatus Fernelius's Syrup of Marsh-Mallows c. 2. Things also that are partly oily and watry as sweet Milk Emulsions of the cold Seeds Which as they ease the Symptoms that are caused by Cantharides so they do in a special manner demulce and ease the ways that are torn by over stretching as it were and by accident they cure nocturnal pollution help the Strangury that springs from a serous acrimony 3. Precipitants whether they be withal Styptick as in pissing of Blood and other laxities or Nervine as Cinnabarines the more temperate specifick powders so also steel Remedies belong hither hence Heurnius upon Hippocrates's aphor 6. 6. where when he had said that the pains and Diseases of the Reins and Bladder-in general are hard to cure he commends experimentally in an Ulcer of the Kidneys the juice of steel that is steel Wine made of the filings of steel macerated in sweet and strong Wine 4. Acids correct a bilious Acrimony if it be present as red Liver-wort whence according to Hippocrates lib. de locis Acids both cause the Strangury and help it And these as we have already intimated are good for Bloody Urine diabetes nocturnal pollution heat of Urine yea in the stone it self and we must also have great regard to the pains which are as it were the tyrants of indication 5. Hither belong even Opiats also which being mixed with resolvers are very useful in the Stone not indeed as if they resolved primarily or as if they cleared the wayes but because they give rest to Nature III. Or 3. They respect the stopping and clearing of the ways not so much by driving forward as loosning that way and leave may be given to the departure of the unwelcom Guest such as are internal and external emollients and paregoricks lubricaters and moisteners especially oily things chiefly Oil of sweet Almonds likewise Chamomel the Decoction whereof resolves withal whence the Flowers thereof in Pottage give present ease in the Cardialgia or Pain at the Stomach the Colick Stone also fat Broths for they give by so much the presenter Ease by how much they resolve the more withal thus the Oil of sweet Almonds with the juice of Lemons is a Secret with some Hither belongs that place of Walaeus m. m. p. 4. In Pains of the Stone says he whether you
bones You need not fear the acrimony for our Euphorbium does not inflame the adjacent flesh But I would have a Seton first used which is of such moment that I have observed in several persons an inveterate lachrymal Fistula could scarce be cured without the help of this Fabricius Hildanus cent 6. observat 3. Nor would I have any thing attempted before the Seton have run for some time and have drawn to it the Matter which fell upon the Fistula II. There is another Aegylops often bred of a tough humour like gelly inclosed in a bladder which cannot be cured without opening the Tumour with a knife or a potential Cautery and taking away of the skin Enchiridii med pract p. 88. and then lest the Ail return a burning hot Cautery must be applied to cause an Eschar which when it is fallen off some beaten Allum mixt with Turpentine may be applied till it be perfectly healed ¶ Because this Swelling cannot be cured with Medicines alone it must be taken hold on with a pair of Nippers and cut round the bottom with a knife Scultetus tab 31. armament yet so that the whole spungy Caruncle be not cut off which is not unfitly called The Bridle of Tears for upon taking it away a perpetual efflux of them or an incurable Rhyas doth follow III. A Matron about thirty years of age after frequent inflammation of the Eyes and Head-ach had a Lachrymal Fistula arose Hildanus cent 4. oâ—s 19. and was cured by the help of a Seton IV. Sometimes there are cancrous Ulcers in this part which cannot be cured except the part be burnt and the Veins and Arteries especially be burnt thoroughly and to the quick Enchiridion med pract p. 89. For so the cure will be most safe without fear of relapse because when these Vessels are burnt there can be no more new Defluxion V. In the burning an Aegylops I should with the more approved Physicians prefer an actual Cautery before that they call Potential But why do they order it to be of Gold rather than of any other matter For one would think it might commodiously be made of Iron nay perhaps more commodiously seeing there is an astringent Virtue confest to be in Iron a quality very requisite in this case Again Gold if it be violently heated melts if indiffereâ—tly it is to no purpose Yet Johannes Montanus a great Physician chuseth Gold or Brass in his Counsels Plempius Ophi◠〈◊〉 mogr. l. 5. c. 3. by reason the burning is greater and the Scar deepr than the tender particles here exposed can endure VI. All the difficulty in the Cure is about Repressers and Suppuraters for either of them seem to incurr the hazard of a Fistula that indeed by repelling the humour to the Parts within and this by putrifying Nevertheless both must be done sometime of Necessity When the Defluxion first begins and the corner of the Eye ailed nothing before repressers are convenient for if this place never ailed any thing before the Parts underneath are strong therefore Repulsion should be made to the sides rather than directly under But if in the process of the Disease an Inflammation arise in this case Repulsion is no way convenient Sometime we must use Suppuraters when Nature hath already begun the Suppuration and the Humour is Sanguine and in great plenty when Suppuration cannot be avoided Saxonia prael pract part 1. cap. 20. which when made though but imperfectly the Abscess must be opened Medicines especially made use of by eminent Physicians 1. Take of Fine Honey Aloe Hepatica each 2 ounces Myrrhe 1 ounce Saffron half a drachm Water 2 pounds Boyl them over a gentle fire to half Petrus Bayruâ— de med hum corp malis l. 3. c. 26. let a new little Sponge be put in the hot decoction wring it out wrap it in a fine rag bind it to the place and you will see a wonderfull effect as I have often experienced 2. I never found any thing better than what follows Take of Aqua vitae mel Rosatum each 1 drachm Myrrhe 2 drachms Mix them Chalmeâ—â—us enchri â—hirurg l. 3. c. 20. make a Liniment wherewith the part must be anointed morning and night 3. Take Garden Rue which Fullers use beat it very fine and apply it it cures this Ail excellently well It is very biting at the first but it will presently grow easy Alex. Trall l. 1. c. 23. and which must be admired it leaves either no Scar at all or no disfiguring or remarkable one behind it 4. Services bruised and applied are reckoned a singular Remedy Arnold Weâ—kard thesaut pharmacop l. 1. c. 4. Agonia or Pangs of Death How persons at the point of Death are to be Revived WHen Physicians perceive the Hippocratical Signs of Death they bid adieu to their Patients lest they should expoâ—e themselves their Art and their Medicines But they should not be given up but all means rather should be used which have any possibility to prolong life For I have known several at the point of death who have been given over by the Physicians and yet have recovered by inconsiderable means I will give you my opinion freely In the Heart which is the last that dies the vital Spirits are extinguished divers ways I. By the excessive heat of the Bloud Cooling Potions and Epithemes to the Breast relieve such persons II. Others die when there is not a sufficient Affluence to the heart to continue the Circulation 1. If new Chyle pass not to the Heart either by reason of Expulsion of the Food by Dysentery Vomiting or some fault in the vessels of the Mesentery or if it pass not by the proper ways Transfusion of man's or Calf's bloud would do good in this Case 2. If the Bloud which should be carried back by the Veins do clot and congeal and this it does variously in various Diseases in the Phthisick deep Consumption and Fevers the Lympha or usefull Serum is wanting in the bloud A warm bath which dissolves the Coagulation relieves such for a time In Tartarous Diseases as the Scurvy c. the Bloud wanting Spirituous Parts is made tough and thick such Patients begin to die at the extreme parts warm baths also and spirituous Potions which hinder Coagulation do help such In such when they are dead the Arteries are flaccid and the Veins do strut III. The motion of the bloud is choaked by suffocating Catarrhs inasmuch as the Lungs through which the Circulation of the Bloud is made out of one Ventricle of the Heart into the other and the Vessels of Respiration are choaked by a cold Viscidity Let the sick Persons be laid on their side that the Phlegm may run out at the mouth apply a hot Pultess to the Throat and hot sand to the Head and Neck Because Apoplectick persons die of such Phlegm stopping up the Ventricles of the Brain Cupping the head and blistering the neck signify little if
over intervening concerning which Spots Practioners doubt whether they come symptomatically or critically I indeed sometimes have observed that by reason of the quantity and quality of the bloud and corrupt Serum which Nature was not able to correct have appeared unhappily and portended Death it self I have also observed them to break out critically as well as the Small Pox and Measles which were kindly But these forementioned Spots in Malignant fevers are the effects of a very bad Cause as it argues so great a corruption of the bloud in the live Body that the Fermentation causes such a diacrisis or apocrisis in the mass of bloud as that the volatile Salt it self appears Simon Pauli D grâ—s de Feb. M â—â—gâ— Sect. 52 5â— which is naturally apt to pass subject to subject and is by consequent a poison which acts in its whole substance and this is the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or morbid excretion of Hippocrates XXV Lest any one should accuse us as if we were ignorant of the methodus medendi because when they that are sick of a Malignant fever with a hot and dry Intemperature and that notorious enough to the touch indeed gentle and kindly we presently fly to Sudorificks Diureticks and finally to Salts and I add that I willingly allow him this although it be not universally true that all these things are hot as to our last refuge when the Fever requires cooling things I will here introduce Hofmannus his reason namely why Diseases of hot Intemperature are cured with hot Medicine fetched from his de Medicam Officin lib 2. cap. 128. Because it holds good not onely in the Venereal Disease whose cure he treats of in the forecited place but in Malignant fevers and many other Diseases called Occult and in such as wherein the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 of Hippocrates which word many understand amiss is said and believed to be In that place after Fallopius he inveighs against them who granting Guaiacum to be bitter and biting and therefore hot and dry yet would have it most temperate and as like our Body as any aliment because they observe that some grow corpulent upon the use of this Wood. By which contradiction some being constrained saith Hofmannus have held that this wood cures the Pox indeed whether it depend on hot humours or cold by propriety of substance or some occult property and other Diseases joined with it by manifest qualities But indeed they are very much deceived For if it be thus when it cures the Pox it self does it lay aside its manifest qualities They will not say so I hope Therefore these Problemes still remain undiscussed Why Hot fights with Hot and Dry with Dry And if it be such in adjunct Diseases why is it not in the root it self But is it hot and moist perfectly and does it nourish more than gelly Broth of a Chicken Then this is sure Guaiacum is hot and dry and how does it drive away a Disease that is hot and dry It is by discussing and wasting the hot and dry humours I add that they appear such or are really hot and dry because of the Salt wherewith the bloud of Persons infected with the Pox does without all controversie most exuberantly abound for certainly this Plague of theirs is contagious which is cooling by accident So Rheubarb cocls by purging such humours but it does it not indifferently and without the Laws of Method without which those who have tried it have been greatly hurt Yet does it noâ—rish For they take the Body of it It nourishes not at all for since aliment is a passive Word that is is a thing which is conquered who can believe that so hot a Medicine can be conquered and turned into the substance of the thing nourished Yet People grow fat upon it You kill me for I said but now it was done by accident the hot humours being discussed and the obstructions of the Bowels being opened which hindred the generation of Bloud But how bad a Logician are you in that you distinguish not what is of it self and what by accident c. But this is the summ of the matter that the Venereal Disease a hot and dry one is cured with a hot and dry Medicine by accident and that indeed by a simple Decoction of Guaiacum Which we must affirm is done likewise in a Malignant and Spotted fever while we use Sudorificks Diureticks and Salts in particular namely that sharp and hot things are good for them by accident why Because while in it no crisis or but an imperfect one intervening the Salt in the mass of bloud being now made fixt in the hands or feet or rather in the Anastomoses of the Veins and Arteries of the said parts far distant from the Heart hinders the free circulation these Salts render it volatile which being either attenuated or made volatile and discharged by the benefit of Circulation by sweat or being more fixt and as it were in fusion by the Urinary passages it does again freely doe its duty which being procured the bloud is truly cleansed and as it were ventilated not onely in the said Fever but in other malignant and contagious Diseases hereupon Health is procured and the Malignity dispatched But when in this acute Disease and in a Malignant fever Nature receives no assistence then at length whatever upon the ceasing of the Fever or fermentation in the mass of bloud is corrupt and remains Idem ibid. breeds divers imposthumes and swellings in divers parts XXVI And as there is extreme danger in purging in Malignant fevers so it is well known that those Medicines which are commended against Fevers and those commended against poisons are diametrically opposite one to another and why Because some Antifebrile Medicines have been found out not by Indications but by Empiricism And since the manner of the corruption of our bloud in Fevers and especially in Malignant and Spotted ones varies and as it were eludes the industry of Physicians hence it usually falls out that both Agues and especially Malignant and Spotted fevers when we come to them we call Antifebrile and Specifick Medicines are so hard to cure that they are cured rather by chance than reason And the Cause besides that I brought from the corruption of the bloud is this for that there is no Fever without fermentation or ebullition Therefore if for example's sake Nutmeg Alume Powder of Tormentill Antefebrilis Crollij prepared of long Oyster shells with Wine Vinegar Pearl Coral Bezoar stone Pretious Stones and the like be given to People in Fevers it sometimes happens that the Fever ceases and Why Because that Ebullition is stopt by them just as we find that the heat of the Stomach is stopt by the alone use of simple Chalk powdered But if you weigh these simples in the Balance of Reason you will find it very likely that they act what they do act by drying and by their earthy parts for they are in an
Method of curing Poisons consists in Alteration by Medicines which either in quality or in their whole substance are opposite to the poison It is my advice that we especially observe these two ways of curing virulent Diseases and poisons while we cure Pestilential fevers Because seeing all Poison of its own genuine property does first of all affect the heart the House and Fountain of life and then is on a sudden dispersed through all the Bowels and habit of the Body What is more necessary than that you should first of all give assistence and relief to the heart by those Alexipharmacks which either in their quality or whole substance resist the destructive poison of the Plague But if a Bubo break out in the Groin an Imposthume in the Arm-pits or a Parotis behind the Ears about the Emunctories of the Brain Heart or Liver or in the mean time a Carbuncle bud out in the Arms or Legs then as in poisonous wounds you must hastily apply Medicines to the place affected which may draw out the venome and scarifie the Abscess before maturation or open or burn it with an actual or potential Cautery if the Patient fear fire which by their heating and burning virtue not onely attract noxious humours but also often open gatherings made by them But whether beside these things the noxious humours of this Disease be to be evacuated by Bleeding or Purging is not yet determined But seeing the cause of the Disease is mixt with the Bloud in the Veins What hinders but that after ten or twelve hours from the taking of the Alexipharmack and when the Sweat is ended and the Spirits refreshed we may breathe a Vein in the same side in some proper place under the abscess or Carbuncle age and strength concurring seeing Phlebotomy not onely draws out the infected humours but also opens obstructions and abates the heat of the Fever Nor need you fear the revulsion of the humours inwards when the Abscesses are covered with strong attractive Medicines which resist revulsion Wherefore Galen and Paul advise to begin the cure of a Carbuncle with Bleeding till one swoon yet exclusively which I do not disapprove But whether strong Purges in the cure of this Fever be so convenient I cannot easily say because they do but the more disturb the noxious humours and disperse them through the whole Body and draw them again inwards and waste the strength and they participate also of a poisonous quality and use very often to cause a Bloudy-flux and Loosness which is usually otherwise peculiar to this Fever and for the most part is a mortal symptome wherewith all that were taken in the long Plague of Rome who could not be helped by Bole Armenick died as Galen 3. Epidem relates But if the obstructed Belly do not void it Excrements who will disswade the use of a lenient Clyster And if the Disease have passed the state that the reliques of the Disease may be extirpated a Purgative Medicine of Rheubarb Agarick Cassia Tamarinds Manna can doe no harm as those strong ones Diagridium Coloquintida c. seeing they savour of Poison can do no good I have cured several who were given over for dead in this Plague by this method If before the beginning of the Disease one went little or not at all to stool then I procured one by a Suppository or a gentle Clyster afterwards I gave a Sudorifick Alexipharmack which according to the age and strength might provoke Sweat for two or three hours or more I applied Epithems to the Heart And if an Abscess or Carbuncle arose I presently applied Plasters to draw out the Poison Then about six or seven hours after Sweating but the strength first refreshed by some Broth I opened some convenient Vein But every day after the taking of the Alexipharmack both morning and evening I gave some alterative Potage which might both in quality and whole substance resist the poison of the Disease and also strengthen the Heart such as are made with juice of Lemons Citrons Oranges Sorel and Wood-Sorel with a little Vinegar and Sugar And in the declension of the disease if the appetite were languid I first Purged the Bloud from the reliques of the Contagion by Medicine that the Body might safely be nourished Last of all I ordered the Chirurgeons not to hasten the healing of the Sore or Carbuncle Joh. Langius lib. 1. Epist 18. and I charged the Cooks to give the Patient his proper Meat and Drink at the time prescribed By which way of cure a vast number of sick people recovered ¶ Hence it is evident they are under a mistake who being content with Alexitericks onely do give them to every Age without method relying onely on Experience And that all method should not be rejected seeing a Pestilential fever has not onely one Indication of Cure but two or three For the Fever requires cooling the Putrefaction requires alteration evacuation c. IV. Men are of quite different opinions whether Bleeding be convenient in the cure of Pestilential fevers some approving others disapproving the opening of a Vein in the Plague But neither opinion taken simply is reckoned safe by Peter Salius for he finds in either what he may deservedly disapprove They that judge we must proceed onely by Alexipharmacks in the cure of a Pestilential fever wholly rejecting Bloud-letting they he says have regard onely to the pernitious quality but they slight the putrefaction or fermentation rather of which nevertheless in such cases most reckoning should be made for except you remove it the Fever which is putrid cannot be removed and you will scarce be able to cure this unless you abate the quantity that causes and upholds obstructions and which is grievous to Nature Wherefore we must indeed give Antidotes to infringe the base infection yet we must likewise doe our endeavour to take away the Putrefaction whose cause we shall then try to remove when we shall attempt eventilation by exonerating Nature and diminishing the matter But their opinion says he who have admitted and commended Bleeding in a Pestilential fever I am afraid has been broached to the destruction of Mankind For he reckons this to be an Axiome of eternal verity That a Vein should never be breathed upon the account of a Pestilential Affection Or Bloud-letting must by no means be admitted in a Pestilential fever But seeing sometimes Nature must be eased of her Burthen and the body must have vent he shews another way besides cutting a Vein whereby we may satisfie this Indication without loss of strength that is by application of Leeches to the Haemorrhoid Veins or by scarifying of the lower parts I indeed think that opening a Vein in a genuine and simple Plague is for the most part hurtfull because by frequent experience it is oftner found to doe hurt than good in Pestilential fevers and I judge that those remedies that are instead of Venaesection may more properly be used in the simple Plague But I do
not wholly disallow Venaesection it self in the Plague joined with a Fever or in Pestilential fevers themselves For when the body is plethorick and the strength is oppressed or the loss thereof is imminent from the plenty of bloud or when a Fever is joined with the Plague or a Pestilential fever it self afflicts a Man sometimes a Vein must be opened especially in those that are used to it when nothing in its stead seems to suffice but it must be in the beginning by and by after Alexipharmacks are given and when their operation is onely over And here I fully approve of J. Palmarius his advice cap. 23. Where he thus determines about bleeding In a Plague which is complicated with a putrid constitution where there are the Head-ach want of Sleep Tossing Thirst a dry Tongue an ill Pulse great Heat about the Heart and other Symptoms proceeding from the heat and putrefaction of the humours If the Veins be turgid with plenty of humours bloud ought to be let more or less as the fullness of the Vessels Age the Season of the year the habit of the Body and the violence of the Symptoms will bear So the strength be good and the Physician be called in the beginning of the Disease and it be taken away in much lesser quantity than in other Fevers And according to the same Palmarius the bloud must be taken from the Foot or Leg if a Bubo be protuberant in the groin or in any part below the Loins But in the Arm if in the Jaws or Arm-pits or in any other part above the Kidneys or even in the Loins themselves and that always on the same side As it is well advised by the same party that we must abstain from bloud-letting whenever a Pestilential fever affrights us with lowness of strength or fainting Besides whatever simple and legitimate Plagues do shew no signs of putrefaction in the Urine or in other excrements as those which have no Fever joined with them these Palmarius being judge abhor bloud-letting how cruel soever the Symptoms be In the Plague therefore A. Deusingius l. 5. de Peste cap. â— as the Plague bleeding does no good But as there is imminent danger from the quantity of bloud while strength is good and other circumstances do not hinder it must be diminished V. Whether in the time of a Pestilential fever bleeding be proper for preservation Almost all Writers shew that a Plethory quoad vires because this is it from whence there is imminent danger of corruption must be taken away by bleeding But this opinion is not convenient always and in every place But it may be of use with this distinction In a wholsome Air in Spring and Autumn it may be admitted but not in the midst of Summer or Winter nor in very hot or cold Countreys or Constitutions On this hand the body is too much cooled on the other hand too much spent and it is not then safe to evacuate sound bodies If the state of the Air be pestilent bloud-letting must never be practised because of this plenitude for it very much exhausts the Spirits and stirs the humours and the inspired Air more easily impresses its pestilent action and the Disease if it come is conquered with more difficulty because the strength is spent by bloud-letting For as when Men have drunk poison after bleeding it more easily penetrates and is more difficultly overcome In like manner they that are well who admit of bleeding in a pestilential Air more easily receive the bad quality of the Air are worse and escape with more difficulty Besides such a Plethora may easily be exhausted by a more spare and thin diet by loosening things and cleansers of the bloud But they that have taught that when bloud abounds a Vein must be breathed were either mistaken if they spake of this plenitude or they were superfluous if their discourse was of plenty of good bloud Both because a pestilential fever does not impend from this and because it is good to abound in bloud because Life depends especially on it Which if it so redound as to distend the Vessels although bleeding be proper yet it is not our case because hereon not a pestilential fever but bursting of the Vessels extinction of the native heat c. does usually follow And although a Plethory quoad vires in a pestilential Air be not to be taken away by bleeding yet considering the causes hereof we sometimes admit some diminutions of it as if it be superfluous on account of the Diet or of some evacuation uppressed For this reason in Women I commend bleeding in the lower Veins which because it spends the strength less than in the upper Veins it may without any impending danger both relieve nature and provoke the Menses I say the same of them that have the haemorrhoids stopt or any accustomed haemorrhage suppressed Pet. Salius Diversuâ— c. 20. lin de Feb. Pâ—st To which evacuations nevertheless I should never descend without a new and urgent indication ¶ Although letting of bloud do not draw out the Infection yet I confess in curing and preventing a putrid pestilential fever it does a great deal of good if it be seasonably used but in a contagious one which is caused by inspiration of the seminary seeing all hopes of safety consists in preserving the strength we must consider again and again lest any thing be done rashly Crato and without reason VI. Oribasius advises not to bleed in the cure but to scarifie the Legs which according to Alpinus is customary with the Aegyptians where the Plague is commonly endemical This may well be done when we would make a general evacuation for the bloud will run out plenteously amongst them the fleshy part of the three Muscles of the calf of the Leg is cut with a Razour in a streight line 4 or 5 pretty deep wounds are inflicted and they have a care that they do not close for a long time so the filthy corruption is discharged And that place is so far from the heart that it is not so sensible of this injury This also may very well be done if a Carbuncle fix near the region of the heart and if you think bloud ought to be let but if it seize other parts remote from the heart the next place to the Swelling must be bled If Carbuncles or Buboes appear in the Groin the lower Veins are opened If one appear in the Neck a Vein in the Forehead must be cut or the Veins in the Nose must be opened Or the Jugulars must be opened or one under the Tongue and Cupping-glasses must be set to the Arms and the Neck deeply scarified From the foresaid reasons yet trust experience I durst almost infer this Maxim A Malignant Tumour arising of it self if it precede a pestilential fever does in its beginning and while the strength is good admit of large bloud-letting in the Vein next it that the poisonous matter may be exhausted and
the fear of a future Fever prevented But yet if the Stool or Urine have no sign of putrefaction a Vein must not be breathed though the Symptoms be urgent But if this Imposthume follow the pestilential fever Phlebotomy will doe hurt Therefore before there is a pestilential fever we may bleed Yet seeing the Plague comes from contagion Heâ—rnius â—â—de jâ—â—ribuâ— because of the poisonous putrefaction already conceived I should think we should abstain from bloud-letting VII Bleeding is very prejudicial to them that are sick of the Plague and it is very dangerous also for them that would be preserved from it The poison often lurks for some days weeks or months in the body out of the Vessels before it shew it self by the use of Medicines that stir the bloud But if by Venaesection you draw it to the heart it behoves you to inquire whether or no the diminution of the bloud spirits and strength through your means be not the cause why the Heart is suffocated and is not able to chase away its enemy Physicians indeed who deserve credit and are well versed in their art do say that cautious bleeding and celebrated at the beginning has ever been the chief of Antipestilential means But they that in these cold Countries imitated them P Barbetâ—e de â—â—ste p. 1â—3 soon left it off yea our Countrey Physicians are now wholly silent as to bleeding VIII The Circulation of the bloud tells us that all poisonous and bad humours which are either thrown off by Nature it self or come from abroad should immediately at the very first moment be drawn out from the Glandules and the Skin it self by means of attractive Medicines lest that in the space of a small time all the bloud be infected and the heart it self be oppressed and suffer violence This may sufficiently shew how dangerous it is to breathe a Vein and Purge the body in a Pestilential and Venereal Bubo yea and in all venemous wounds on the contrary how necessary it is to draw out the peccant matter by the help of sudorifick and attractive Medicines Idem And therefore that the doctrine of the Circulation of the bloud is of great use in the Art of Physick IX Purging in a Pestilential fever is suspected both because of the lowness of strength and because a Loosness and that a colliquating one quickly happens But we must note that it is not always so But when it is whether it be colliquating or because nature attempts to discharge the peccant matter Physicians are not of one opinion For the most indeed think Purgatives may be given but such as leave an astriction behind them Others judge otherwise and aright for since in this case it is either the humours themselves or the solid parts that are colliquated the colliquated matter does not require vacuation by Medicine seeing Nature discharges it of her self nor is it indicated by what is to be colliquated since such evacuation should rather be stopt nor yet as if I thought it should be stopt by Astringents because if it be altogether bad it would doe more harm kept than voided but I should recommend it to Nature while the Physician opposes the causes of colliquation But if the flux be not Colliquative but Nature onely attempts the excretion of the peccant matter by stool then it will either be Symptomatick and the matter crude and bad or critical and the matter concocted If Symptomatical it will either be moderate or too much from whence loss of strength may be feared If moderate it must neither be promoted nor hindred for there is no cure of Symptoms by themselves If too much it must be stopped with such things as respect the peccant matter and the present Disease But in Pestilential fevers wherein the Belly is not loose some would Purge others not Of them that would some presently in the beginning of the Disease others not till the matter is concocted They that doe it in the beginning some doe it in the matter turgid others when it is quiet Again some use gentle Purges others violent They that purge in the beginning when the matter is quiet fear lest it become turgid and seize some principal part They confirm it from Galen 5 method 12. Who writes that they who recovered of the Pestilence which was abroad in his time some of them vomited all of them were loose They add that a crisis must not be tarried for which comes in the state or declension for as Galen 2 Aphor. 13. says Most crises end in a recovery unless the state of the Air be pestilential They produce also the experiments of them who in long Pestilences have recovered Men innumerable by giving strong Purges in the Beginning and Encrease They that think Men ought not to Purge are perswaded thereto because immediately at the very beginning there is a great decay of strength and because Colliquation is joined with it or an internal Inflammation in which a Purge does a great deal of harm Therefore the most famous Physicians Greeks and Arabians do not mention one word of Purging Others add that all the motion of the matter is to the skin and must not be drawn inward In this difficulty we would first of all observe this that there is a manifold difference in these Fevers The first is taken from the form for one Pestilential Fever is simple another mixt The simple one is that which without the Putrefaction of other humours has its rise from some poisonous putrid matter The mixt when other humours also do putrefy The second from the subject for the poisonous quality is either in the spirits whence comes a pestilential Ephemera or in the Humours and it is humoral or in the solid parts and it is Hectick The third is from the matter for the poisonous quality may reside either in choler phlegm melancholy or bloud and they keep the periods of those humours The fourth is from the place of the matter whence some are continual others intermittent The matter of the Continual some is in the Veins other in some determinate part For according to Galen we have Malignant fevers from the Brain being affected And such also as come from the Membranes containing the Brain and from the Lungs and Heart The fifth from the degree of putrefaction and venemous contagion since in most Fevers there is much putrefaction and but little poisonous contagion in some on the contrary In some both are great in some both are little The sixth is from the Symptoms for some are quiet so that they shew not themselves at all others make the Patients very restless especially inwardly Some are colliquating the Belly others abounding in Urine Some are with Spots others without These things granted we say 1. We must not purge in a Pestilential Ephemera and Hectick unless there be a great Cacochymie with fear lest the Infection should spread thither 2. We affirm that all matter is not turâ—id for we see it
observed But if in the declension of the Fit the Swooning cease as it most frequently happens the Stomach being first strengthned some minoration of the crude matter must be procured first by Clysters and then by Vomiting if the Patient be inclined to vomit In the mean time Attenuants and Concocters may be given that a gentle Purge may be given afterwards if not on the fourth day at least a little after But such Fevers as these require an experienced or at least a very cautious Physician Fortiâ— IV. Sometimes Swooning Fevers occur which have their name from Swooning which seizes the Patient together with the Fever They are owing to the pancreatick Juice but such as by its stagnation has acquired a volatile rather than a sharp Acidity there being in the mean time but little Bile or very sluggish wherefore without delay it penetrating the Heart by the lacteal Veins does not onely break out every way and cause a cold Sweat but it also immediately so coagulates the Bloud that sensibly for a time it does not pass and therefore no Pulse can be observed till the accession of this exceeding nocent Juice ceasing the Bile begins by degrees to prevail and the Patient seems as if he were risen from the dead That the Swooning may be prevented I commend this Mixture to be taken by one spoonfull at short intervals Take of Mint-water 2 ounces Aqua vitae Matthioli 1 ounce or Take of Tincture of Cinnamon half an ounce Oil of Cloves 6 drops Sylvius de l. Bâ—ë Syrup of Scurvy-grass 1 ounce Let it be given a few hours before the Fit Febris Symptomatica or A Symptomatical Fever The Contents Many Fevers that are reckoned Symptomatical are essential I. A vernal Symptomatical from an occult Inflammation of the Thoracick parts II. I. WE must take good notice which is of great moment in practice and is observed but by few that all Fevers are not perpetually Symptomatical which are joined with Inflammation of the parts but some of them are essential to which the foresaid Inflammations use to succeed For it usually happens that after the Bloud corrupt or full of bad humours has caused a Fever it is disturbed by Nature and as hurtfull to it self is expelled to the weaker parts or such as are fit to receive the humour whereby an Inflammation is produced in them which does not cause the Fever but is rather succedaneous to it Thus we may frequently observe in our practice that in the beginning People are sick for a day or two before a Pain of the side and other signs of a Pleurisie appear Thus many on the third or fourth day fall into a Phrenzy thus all Arthriticks almost before they are taken with a pain swelling and inflammation in their Limbs use to be ill for a day or two of a continual Fever Thus they that are taken with an Erisipelas have a Fever for some while before it appears The disposition of the Urine shews as much which in such Inflammations manifestly bewrays marks of putrefaction contained in the Veins for at the beginning it appears crude but in process of time it shews signs of Coction daily increasing Very corrupt Bloud also is taken out of the Veins which things would not be if such Fevers were onely Symptomatical Riverius or simply depending on those Inflammations II. In the Spring-time especially towards the latter end of Spring and the beginning of Summer a sort of Fever uses to invade at that time which although it want the pathognomick signs of a Pleurisie or a Peripneumony yet it is as a Symptome in respect of some Inflammation lurking about the spiritual parts for there is no pain of the side no great difficulty of breathing wherefore suspecting it to be a bare Fever I sometimes inclined to treat my Patients in the same method as I used to doe in curing Fevers Nevertheless afterwards I reckoned with my self that this season of the year was unfit for producing Fevers which run into continuity for of themselves they do as it were part into pieces and place themselves among the intermittent kind or they turn to Pleurisies and such sort of Inflammations moreover also I took diligent notice of the Bloud that was let in this sort of Fevers and it looked just like the Bloud of Pleuriticks I also observed a redness in the Cheeks and a certain propensity to bleed at the Nose though a Vein had been opened before besides I found a little cough and some obscure pains in the vital parts sometimes These things therefore well considered I was at length persuaded that I must proceed in the same method in this case as I had often used in the Pleurisie with singular success and it happily succeeded as I desired Febris Synochus Putris or A Putrid Continent Fever The Contents The Fever must presently be suppressed I. The heating of the Bloud must be prevented II. Nature's motion about the Crisis must be attended III. How we must prevent the Symptoms IV. What Diet in the Declension of the Fever V. When the Crisis is imperfect what must be done VI. When the case is desperate the Patient must not be given over VII The Diet must not be too thin VIII I. WE must endeavour to suppress the Fever immediately at the first coming and to stop the Inflammation of the heated Sulphur to which Venaesection especially conduces for by this means the Bloud is eventilated and the hot particles overmuch agglomerated and then next to burning are dissipated one from another just as Hay that is apt to take fire if it be exposed to the open Air its burning is hindred Moreover a spare Diet must be insisted on in which nothing spirituous or sulphureous must be used Let the Bowels and first ways be rid of the load of excrementitious matter wherefore Clysters will be of use and sometimes Vomits and gentle Purges by which sometimes seasonably used and with judgment the Fever is extinguished at the very beginning Wâ—lâ—iâ— de Fâ—br c. 11. when the Fewel is withdrawn But if notwithstanding this method the burning spread farther and take the sulphureous particles of the bloud more and more every day let care be taken as much as can be that the deflagration proceed without much disturbance II. Wherefore when the Fever is in the increase if the bloud be too effervescent and distend the Vessels much with a strong and vehement Pulse if Want of sleep Phrenzy or the Head-ach be very violent let Bleeding be repeated again and free transpiration as much as may be procured Wherefore let the Patient keep himself for the most part in bed let his Diet be spare of very thin aliment Also let his Drink be small and plentifull that the boiling bloud may be diluted with a more copious Serum Clysters are safe and convenient enough But let Purgatives and Diaphoreticks and things that disturb the bloud much be as industriously avoided as the blowing of the Wind when a House
bloud taken from him by opening a Vein Upon which that very day revulsion of the putrid humour being made from the Skin to the greater Veins by Venae-section he was taken with a Malignant fever which killed him on the fifth day For in such Diâ—eases I do not let bloud Martianus com in 〈◊〉 loc or in a very small quantity both for the reason above-said or because a Cacochymie prevails rather than a Plethory III. A certain Physician cured grievous Itches successfully which were despaired of by others onely by giving a powder made of equal parts of Sarsa Rheubarb and Senna in Broth for 40 days and anointing the body onely with Vnguentum è succis For such Diseases being near of kin to the Pox do in a manner require the same cure as formerly J. B. Montanus did advise Others commend the like powders as N. Massa p. 1. Ep. 30. does also commend decoctions of Purgatives mixt with â—udorificks whom others do follow though Rondeletius Sennertuâ— and Chalmetaeus disapprove of such Medicines who never used them because they are inconvenient and dangerous by reason of contrary motions which Ballonius reckons may be compared to purging in the Dog-days Vâ—lschius Obs 84. l. 1. Epidem p. 41. Yet experience shews they are usefull IV. A Boy ten years old was afflicted with the Itch which ouzed out an ichorous matter A cold season coming on it was suppressed and the filthy matter was turned upon the Lungs which caused a horrible Asthâ—a Pachequus ad Riverium obs 53. which ceased immediately as the Wind turned to 〈◊〉 South V. Galen 14. meth c. 17. speaking of the Ringworm says that if but a little excrement be repelled to a principal part it does no little harm because this is dissolved by the bowels speaking there of a Roman Matron's Ringworm which would never have been cured by a Medicine of Sea wrack had not Galen by stealth put a little Scammony in her Whey which she drank The reason was because there was a great fluxion to the Part. Repellents therefore before evacuation of the Excrement always doe harm Sanctorius de Remed Inv. c. 15. except in a case where it is but small VI. Leeches did a Melancholick woman a great deal of good in a St. Anthony's-Fire which ate her Leg by drawing the hot and adust bloud from the next veins which till then did constantly supply the stubborn Sore And the bloud being voided what remained was easily cured by Bread soaked in Water onely Tulpius l. 4. obs 13. VII One by reason of heat in his Liver was a little troubled with Pimples in his Face who being about to Marry a second time drove them in with some Medicines A little while after he was taken with the Gout Pâ— Salmuth cent 2. obs 35. then with a Palsie in both his Arms and in a short time he died VIII Sometimes redness of the Face comes from abundance of bloud that is carried by the great vein which is in the middle of the Forehead and flushes on a sudden all over the Face and strikes in again but presently returns An Illustrious Countess sent for me on this account and while she was discoursing with me the Bloud immediately flushed out of that vein all over her Face I observing that great vein in her Forehead to be full of bloud perswaded her to let it be opened I ordered her hair to be shaven a little above the commissura coronalis upon the vein leaving a little hair on her brow under the shaven place that it might not disfigure her face and I ordered a ruptory Medicine to be applied to the vein in the shaven place and I told the Chirurgeon that he should not let it lye on above one hour but he let it lye on two and when it was removed it bloudied all the Chirurgeon's face the effusion was so violent who ought to have pressed the vein from her Nose to the Wound that the bloud which was in that part might have been evacuated and then should have applied a defensative upon the place But he being affrighted immediately stopt the Wound and bound it and the bloud which was in the foresaid place fell down to the Nose which swelled upon it but was cured by applying a Plaster When the Wound was cured Bayrus Pract. l. 7. c. 3. and the Vein that was abscinded stopt she was free and her flushings vanished IX Whether are Spaw-waters good for a red Face and for pimpled and copper-nosed Drunkards I Answer Because these Pimples or Pustules do for the most part depend upon immoderate heat of the Liver and these Waters do greatly heat the Liver as is evident in Hydropicks Cachecticks and such as labour of the Suppression of the Menstrua whose Liver is acknowledged to be cold and we have seen abundance of people cured by heating it with these Waters it is certain that if any Man drink these Waters any considerable time he will go away from the Spaw with a far redder and more Pimpled Face than when he came thither as I have observed in several But because these Pimpled Drunkards do always in a manner from the adustion of their Bloud in the Liver contract an obstruction of the Mesaraïck vessels sometimes more sometimes less Heer p. m. 156. they may safely drink the Spaw-waters about ten days namely that when the obstruction is removed by these opening Wells the Liver may be reduced to its temper by the help of cold things X. Our business must be to carry off by the Centre for to drive out the excrementitious humours of the whole Body to the circumference by Hydroticks in a particular not an universal cutaneous Disease does appear to me not very proper For the crusty affection which seizes a peculiar and ignoble part may become universal all the body over Fortis XI There are two constitutions of Diseases one whose essence subsists in facto not depending any more on a preceding cause From this as also from the procatartick cause no indication for remedies can be taken because it is vanished Another whose Being depends upon the generation of a preceding and efficient cause As the venome communicated by the bite of a mad Dog and diffused all over the habit of the body lies hid a long time till it have infected the nature of the Heart and Bowels then the caninc madness quickly shews it self in the Hydrophobous In like manner the impurity of the menstruous bloud of which the bowels of the Embryo are concrete that the foetus may be nourished with the purer part of it lies hid several years within the bowels till by its contagion and ebullition with the bloud it produce the Small Pox and Measles Hence it is manifest that those Diseases whose Being does not any more depend upon a preceding cause and whose matter does not any farther lye deep in the body mixt with the bloud in the heart and veins but is entirely
cast out to the external habit of the body by the strength of Nature neither stand in need of Purging nor Bleeding unless some portion of the Matter or disposition contrary to Nature do still remain in the body Wherefore Hippocrates 1. aph 20. advised well Things that have had a Crisis and that have had a good Crisis we must neither meddle nor make with them either by Purges or by irritating them any other way but we must let them alone And we find these entire excretions of the noxious humour do for the most part happen in such Diseases as arise with an ebullition of the bloud such as a Fever with Buboes an Ephemera the Sweating Sickness St. Anthony's Fire and children's Exanthemata And it is manifest that this ebullition is made in the bloud as in Juices and new Wine by reason of watry and crude or putrid Excrements For since three kinds of Excrements are contained in the Juices of all natural things one Earthy which in Wine is the Lees another Aerial which answers to the flower or top of the Wine the third Watry and crude which fermenting by time and heat causes an ebullition in the humours and juices Thus since Children's bowels are nourished by and concrete of the Mothers bloud which because of Womens idle living and the weakness of their heat is more watry and less concocted than it should Who is there that does not think the tender body of the Child must be infected with the contagion and filth of it and that it must abound with superfluities Which things when they grow hot in the mass of bloud or in the heart with a febrile heat then Nature like working Must throws off these dregs to the external parts of the body where they become Exanthemata Thus also the bloud in the Liver or Veins fermenting with the Putrefaction of either Choler expells its filth to the ambit of the body whence come Buboes in the Groin and Erysipelata Serpigines Carbuncles and Inflammations in other parts And when the Body by a Crisis is perfectly purged of noxious humours which the Urine the Serum of the bloud being made like to healthy peoples urine does indicate then it were needless for us to purge the bloud either by bleeding or a purgative Medicine but the said exanthemata relicks and symptoms might then rather be easily cured by outward remedies or fomentations Like as in that long Plague which raged at Rome in Galen's time In those saith he lib. 5. Meth. who were to escape death black Pustules which they call exanthemata broke out thick all over the body And it was clear to any one that saw it that this was the relicks of the bloud which had putrefied in the Fever which Nature had cast out to the skin like ashes But saith he there was no need of Medicines for such exanthemata because they went away of themselves Thus also I have above an hundred times seen an Itch and oedemata in the Legs that have risen after a Crisis of other Fevers but especially of Quartane-Agues go away of themselves without any help of Medicines But if then either bloud had been let or a Purge given there had been great danger lest by those veins whereby the matter of the disease had been driven out it might have been drawn back again to the inner bowels For a hungry Stomach can fetch back the Aliment trasmitted to the bowels and limbs by the same ways and can draw other humours out of the bowels into its cavity But since this foul asperity of the Skin vulgarly called the Itch does arise of impure cholerick bloud or adust or faeculent mixt with the liquour of salt Phlegm such as the Liver produces through its dyscrafie or often of meats and drinks of a bad juice which Nature does not throw off all at once but by degrees with the Aliment of the body without any ebullition of the bloud to the parts of the body and infects and alters them with its contagion whence it comes to pass that the successive regeneration of it depends not onely upon the dyscrasie of the Liver as upon an internal antecedent cause but oftentimes upon an obstruction of the Spleen whose office it is to purge the bloud and upon the contagion of the Parts Therefore here it is necessary not onely that the bloud be purged by opening a Vein and giving purging Physick frequently but also that the intemperature of the Liver and obstruction of the Spleen be corrected and opened And then after the Body has thus been well purged it will be worth the while to dry the habit of the Body also with Sudorifick Potions of Treacle or Sulphureous Baths or with Ointments made of Mercury and so you may rid the outer parts of the Plague of this infection which they had taken And seeing the Pustules and Itch of a new Pox have commonly a great affinity with other Exanthemata which the remedies common to them both do argue and since beside the external causes of contagion both of them depend upon the internal infection and filth of the corrupt bloud and humours Who I pray even after the Pustules are driven out to the Superficies of the body will deny Langius Ep. 15 16. lib. 1. that evacuation of bloud by Phlebotomy and Purging is of great moment in the cure of either of them XII Angelica N. had been several years troubled with blackness in her fingers with a little corruption and parting of the Nails She was of a cold constitution heavy and dull The blackness was taken away by Tobacco smoak and Ointment thereof Severinus Med. eff p. 159. for that year But when it returned the next it was quite taken away with a fume of Cinnabor so that it never came again XIII Sometimes Sweating of the Feet does miserably torment Women which they endeavour to stop For which Disease I can easily tell them a speedy remedy D. Panarolus Pent. 3. Oâ—s 16. namely if they put some powder of Myrtle in their Linen Socks But let them have a care they do not fall into worse diseases as I have often seen This excretion preserves from many Diseases and should rather be promoted than checked ¶ A Noble German following the Count of the most Serene Prince advised with a Physician about the sweating and stinking of his Feet The Physician orders him to wear Socks dipt in Red-wine wherein Alume was dissolved and prescribes him Pills of Aloes and other things and an Electuary of drying and diaphoretick Medicines which might keep the body safe from putrefaction and superfluous humidity The Socks gave great and present help for the Soles of his Feet were so thick that no sweat could get out afterwards But the Pills and Electuary did not answer the Physician 's end In a few Months some small faintings and unusual giddiness followed The Count of the most Serene Prince came to Geneva in the year 1674 and he desired a remedy of
Warm bloud of Animals is given to People in Dysenteries for a Clyster Or things that violently cause a Crust whether actual or potential Willis saw a most violent Haemorrhage stopt with the Vapour of the bloud falling upon a red hot Iron So Cauterization by rosting the Bloud and crisping and closing the Vessels is the last Remedy You may refer hither the Sympathetick Powder the bloud dropping upon which causes this astriction but it is onely in a slight case Or they respect the free passages of the bloud Wherefore Aperients do improperly and mediately stop bloud because they restore the Circulation of the bloud when hindred as we often find them very beneficial in a too violent flux of the menses and in other Haemorrhagies Idem VI. To divert the tendency of the bloud from the Nostrils it is sometimes convenient to open a Vein in the Arm or Foot For the more bloud is carried by the Arteries to the place of Venaesection the afflux to the Nose will be the less Yet this administration does not always so much good but that a quite contrary effect sometime falls out the reason is because the Vessels being suddenly but not sufficiently emptyed do take back again the incongrous humours before thrown out stagnating within the Pores whereby the bloud is immediately put into a greater eruptive turgescence Willis That Venaesection in the Foot is more effectual than in the Arm for stopping an Haemorrhagie at the Nose I have learned from a late Example and that repeated Last March in the year 1681. A Man about thirty years old cholerick and lean had had a Quartane-ague from the preceding autumnal to the vernal Aequinox A double Tertian followed this with tension of the hypochondria and of the whole abdomen and a pertinacious Bleeding rebellious to all Remedies Bloud was let in the Arm and other things done and nevertheless he bled still after application of glutinous things it ran into the Mouth which he spate up concrete in abundance His strength seemed to fail what with the foregoing Fever and the loss of Bloud his Face fell and grew pale But because the heat about his Heart was troublesome his Pulse full and strong and the Bloud came out with violence I ordered the most tumid Vein in his Foot to be bled out of which the bloud came full stream a little after he fell into a sweet Sleep which he wanted before because his Ague-fits came in the evening and he continued in it till night afterwards his Bleeding and Ague both left him he being rid of both by means of Bleeding in the Foot I had prescribed him some opening Pills for his remaining obstructions which he did not take because within a few days by the use of a good Diet there appeared no signs of any so that in four days after his Bleeding he was perfectly well Another Instance offered it self at that same time in a young Man whose name was Frederick Servant to the Family of the Illustrious Counts of Waldeck he was hypochondriack and he had been sore handled by a Quartane-ague all the Winter When the cold season abated which lasted till the latter end of April he bled at the right Nostril I ordered his right Salvatella to be opened out of which the bloud came full stream his Bleeding at the Nose not abating The bloud being received in linen clothes appeared florid not like to washing of flesh and ichorous I also ordered a Vein to be opened in his right Foot and about seven ounces of bloud were taken from thence in Pottingers which gave evident signs of corruption Store of bloud also ran into the Vessel wherein the water was which the Chirurgeon could scarce stop after he had untied the fillet The event was the same as in the former case for both his Bleeding and Ague were stopt Hence you may gather what the nature of the humour is that causes a Quartane-ague which onely the power of the returning Sun is able to conquer The febrile Fire does lye as it were raked up in the Ashes which by the accession of such a blast breaks out into a flame but an innocent yea a salutary one which feeds on and consumes onely its own fewel leaving the solid parts and the other humours untouched It was my hap to observe this in the foresaid Frederick's Lord the young Count Waldeck who had patiently and obstinately endured a Quartane-ague from the preceding August He had a wonderfull Antipathy to all sort of Physick At length as the Spring came on when signs of a Cachexy and Leucophlegmatia appeared in his countenance when he made little Urine which had a large tartareous settling in the bottom of the Chamber-pot I told him he was going into a Dropsie He being affrighted admits of Pills from which he was less abhorrent than from other Medicines made of massa Pilul de Sagapeno Camilli Mercurius dulcis and Tartareae Bontii and a laxative Ptisan to drink after them which brought abundance of filthy stuff away and the Ague which of a simple one was become a treble one at length was a single one again and within a few days quite ceased Yet the third day after his Ague went quite off he was taken with a Diary which ended in a Crisis by stool urine and sweat together which was followed by perfect health That is by this last and gentle Burning all the febrile matter blazed out But this by the way VII Letting of bloud is the chief among revulsory Remedies but it ought to be drawn with a large hand and a broad hole All Men in a manner bleed at a small hole and in a small quantity reckoning that Revulsion is better made so But that a contrary motion may be communicated to the bloud it must be acted by a more violent motion because the more violent draws the weaker Therefore at the larger hole and the faster the bloud runs so much the sooner is the profluent bloud drawn from the Nostrils So that oftentimes a violent Bleeding at the Nose without a Plethora Riverius has been instantly stopt by Venaesection celebrated in this manner ¶ Whether must bloud be let all at once or at several times I think if it be let all at once it will doe the Patient more good for Rolsinccius cens 2. lib. 3. when the bloud gushes out of the open Vein all at once quicke◠Revulsion is made of the bloud that would run out at the Nose VIII Galen 5. Meth. and many who follow him apply Cupping-glasses to the region of the Liver which that it cannot be done without danger the following History does prove A certain Courtier labouring under a violent Bleeding at the Nose made use of a Chirurgeon who among other Remedies set large Cupping-glasses to the region of his Liver The bloud indeed stopt but an Inflammation of the Liver followed I think cold Medicines should rather be applied to the Liver and Spleen according to Hippocrates
Hand to keep one open which yet he does not mention lib. de Haemorrhoid wherefore they have Revellents Incrassaters and Astringents in suspicion as if they thought it were an easie matter to stop this evacuation But because I have observed in my Practice that strong Remedies did little good and gentle ones none at all I use all the Apparatus of Medicines to suppress it yet so as it be not moderate periodick of thick and melancholick Bloud nor troublesome to the Patient because from such the Patient rather finds relief than detriment Of which excellent Doctrine not I but Galen is the Teacher who 4. Aph. 25. says that for Bloud to be voided upwards whatsoever it be is bad but to bleed downwards by the Haemorrhoids is good when black stuff is voided that is when the Man's nature gathers abundance of such humour Otherwise we must not rashly accustome our selves to evacuation by the Haemorrhoids For either excess is accounted dangerous Fortis cons 100. cent 2. both when Bloud is voided above measure and when it is totally stopt VIII It ought to be observed that they are in a gross errour who in an excessive Flux of the Haemorrhoids from the Vessels being opened do set Cupping-glasses to the Back-bone and several ways draw from the Hips to the Neck or Shoulders thinking by these means the Bloud will be retracted Whereas by these means granting the circulation of the Bloud more Bloud is drawn to the place affected and the Vessels are opened by increasing the Flux of Bloud in the greater Vessels which being afterwards quickned at the Heart Frid. Hofmannus increases its Flux in the Arteries ¶ Scarifications Cuppings Ligatures Frictions although they be proper for Revulsion in other Haemorrhagies wherein the Bloud comes out of the Branches of the Vena cava yet here since they can neither exhaust the Bloud out of the Vena cava nor derive it from the Mesaraicks to any other place they will doe little good IX Fernelius lib. 6. de Part. morb Symptomat c. 10. has observed which I also have observed that sometimes there comes out of the Podex without Pain or Bloud some mucous or whitish Filth which some mistake for Pus He thinks it is as it were the Slime and Dregs of melancholick Bloud which the sedal Veins do void a long time commonly after tedious melancholick Diseases and hard riding Platerus writes that this comes the same way as Womens Whites That like as in Women Nature rids her self of that white matter by the menstrual Veins so here she does it by the haemorrhoidal of a matter not unlike the white tenaceous Menstrua Sâ—â—nerius X. These Veins are not all of them of one sort as has hitherto been believed by many but some are internal arising from the Porta others external from the Cava to which the haemorrhoidal Arteries are joined by which the humours to be evacuated are carried Onely the internal were known to the Ancients commended as in splenick and melancholick Diseases and as if they might be opened about the Podex or Leeches might be applied to them whereas no Branches of the Porta that lies within do reach the Skin which may be cut They differ 1. In their original for the internal come from the Porta sometimes from the splenick Branch whence comes the Vas breve The external from the hypogastrick Branch of the Cava 2. In insertion for the internal are inserted into the substance of the Intestinum rectum The external into the musculous substance of the Anus 3. In number the internal is one the external three 4. In the qualities of the contained Bloud the Bloud of the internal is thick and black of the external thin and red 5. In their use the internal empty the Porta and help obstructions of the Spleen the external do empty the Cava and Liver by accident but primarily the great Artery and the Heart yea their evacuation cures sanguine Diseases of the Head Breast c. which Hippocrates also mentions in his Aphorisms hence the internal are said to cure a Cacochymie the external a Plethory 6. In profusion of Bloud the Flux of the internal is not so plentifull of the external so great sometimes that Death or grievous Diseases do follow 7. In evacuation of the external there is no pain or griping in the Belly sometimes also no pain in the Anus which in evacuation of the internal do afflict 8. Arteries do not accompany the internal Veins the external Veins descend to the Muscles of the Anus with the Arteries Tho. Bartholinus libello 1. ca. 4. therefore these are more rightly called haemorrhoidal Vessels XI We often see thick and black humours evacuated by the Haemorrhoids that run spontaneously But we must know that this Bloud comes not from the Spleen but from the Plethory of the whole Body into these Veins and is discharged as into the more ignoble parts where if it tarry it may easily fall into corruption and putrefaction so that it looks like a sort of Imposthume Walaeus Met. Med. p. 86. and these Haemorrhoids seem to be a kind of Varices XII Hippocrates lib. de Vict. acut and lib. de Haemorrhoid propounds Tying Cutting and Burning saving one open which operation as being very laborious and exceeding dangerous is grown obsolete in our times Yet Massoria says he once saw this operation the History whereof it may be usefull to describe because from thence the manner of operation and the event will appear Fridericus Corsicus had been ill first of a Pain then of an immoderate Flux of the Haemorrhoids And when he had tried many Remedies in vain he at length betook himself to Padua where the Physicians by common consent resolved that the Bloud must be stopt by manual operation A Neapolitan Chirurgeon who professed that thing was called The Haemorrhoids were cut tied and burnt The sum of the operation is this First they conveniently bind the Man then they excarnate the extreme heads of the Haemorrhoids how many soever they be and gently separate them from the Intestine then with a certain proper strong Needle with a Thread they perforate them all almost to the end and tye them strait and sew them when this is done they clip off the part of the Veins which is above the Suture and fear it with a red hot Iron Truly a very painfull and tiresome Work what with the Ligature Section and the Burning A Fever and great Pain came upon Frederick but the Chirurgeon using some of his own Remedies he in a few days was free from his Fever Pain and Haemorrhoids to the admiration of many But it must not be omitted that he being over confident of himself did not onely omit Bleeding and Purging but kept no good Diet and the next year he died of a pestilential Fever Wherefore Hippocrates his Rule Aphor. 12. 6. must be observed that one Haemorrhoid should be kept open Unless according to Aetius the Patient
admirably discuss the pain of the Haemorrhoids Riverius 6. Rolfinc Leaves and Flowers of Toad-flax excell in a singular Prerogative to stop pain 7. Ointment of Figwort is good Sennertus ¶ The dropping of a rosted Eel is good For excessive running of the Haemorrhoids 1. Galen's is the most excellent and onely Remedy of Aloes Frankincense and the white of an Egg made as thick as Honey Don. ab Altomari mixt with Hare's Down and applied 2. This Medicine never failed me which is made of Steel old Sugar of Roses Claudinus and Powder of Sea-Wormwood 3. Let the Haemorrhoids be washed with the Patient's Urine for it dries wonderfully and eases pain ¶ This has been tried in several Take of Powder of Bayberries dried in the shade one drachm Cortilio drink it in white Wine every third day in the morning for three times 4. I have known the running of the Haemorroids successfully stopt onely with Housleek-water Hofmannus For the Suppression of the Piles Among things that open the Haemorrhoids I must give the preheminence to the greater Centaury root if the bloudy juice be squeezed out of it and a Syrup made with Sugar The Dose 2 or 3 spoonfulls in a morning ¶ To open the Haemorrhoids let an Onyon be hollowed and some Oil of bitter Almonds be put into it rost it in the Embers Anoint the Haemorrhoids with the juice when squeezed out Crato For the Swelling of the Piles Powder of Mullein given in Milk or in some other Liquour Sennertus is very good to waste the swelled Piles also its Juice or Syrup may be given Hepatis Affectus in genere or Diseases of the Liver The Contents The conditions of Medicines proper for the Liver I. A new way of administring Hepatick Medicines II. When Rheubarb is the Life of the Liver III. Chymical Oils are Enemies to it and the Stomach IV. It is heated by strengthening the Stomach with outward applications V. Atonia Hepatis or Want of Tone in the Liver Whether Almonds and Pistachio's be proper in a cold one VI. The Cure of an Epatick Maid extenuated and dried up VII Hepatis Inflammatio Tumores or Inflammation and Swellings of the Liver The differences of Inflammatory Tumours VIII Plentifull Bloud-letting is proper IX To what places Cupping-glasses must be applied X. When Purgatives are proper XI Whether they should be mixt with meat XII Of Liquids which are most convenient XIII Internal Repellents what such they should be XIV Wind oftentimes deceives us in appearance of a Schirrhus XV. We must have a care how we use Saccharum Saturni XVI Emollients hurt a Schirrous Swelling XVII Emplastrum de Cicuta takes away the Schirrus XVIII Hepatis Intemperies or An Intemperature of the Liver In a hot one we must not abuse cold things XIX What we must doe if it be with Bile XX. Two generous Remedies in a hot one XXI In a hot Intemperature it is good to drink when Concoction is finished XXII Hepatis Obstructiones or Obstructions of the Liver When Bloud must be let XXIII We must purge quickly XXIV How we must purge XXV Whether Rheubarb be always proper and how XXVI We must have a care how we use Diureticks XXVII Things that dissolve Tartar must be added to deobstruents XXVIII The abuse of Aperients does harm XXIX They ought to be given in a large dose XXX Obstructions of the hollow part must be opened before those of the Gibbous XXXI When Rheubarb must be used in Substance and when in Infusion XXXII Cautions in the use of Aperients XXXIII About Sugar XXXIII Hepatis Ulcus or An Vlcer of the Liver Cured by opening the side XXXIV Hepatis Vomica or An Imposthume of the Liver It may safely be opened XXXV I. THESE ought to be the Prerogatives and Conditions of things which cleanse the passages as well in a hot as cold intemperature 1. Because of the narrowness of the ways they must penetrate as Cyperus Schoinanth Saffron Iris. 2. They must open as Horehound Aromatick Wormwood Pistachio's root of Parsley 3. They must concoct and mollifie as Raisins Figs sweet Pomegranate Wine Rhenish small Wine 4. They must be abstersive as Honey Sugar 5. They must strengthen as Agrimony Wormwood Schoinanth Rue Spike 6. They must preserve from Putrefaction as Cassia lignea Calamus Aromaticus Cinnamon Myrrh Amber Lignum Aloes Rhodium and all sorts of Spices 7. They must dry moderately as shavings of Hartshorn Ivory 8. They must be specifick as Rheubarb Wolf's Liver Raisins Mat. Martini de morb mâ—sent Flesh of Snails 9. They must also be astringent correct Malignity and not easily corrupt II. The proper way to take things inwardly is the Mouth The virtue is carried with the chyle to the Heart and after to the Liver The Moderns have an Invention to infuse some hepatick Liquour into some Vein opened in the Arm It is held that by this way the Vein being closed and tied the Medicine communicates its singular strengthening faculty to the Parenchyma of the Liver being carried to the Heart and out of the right Ventricle by the great Artery into the Hepatick Artery Rolfinccius and so to the Liver III. Rheubarb is indeed the life of the Liver but to a hot Liver it is Death Riolanus because it is hot and dry to the third degree IV. Let no man wonder how it comes to pass that many do not onely find no relief but sometimes hurt from Oils Chymically prepared as also from Decoctions But let him take these true Reasons from Hofmanni prefat in Lib. de Medic. Offic. Distilled Oils which they commonly call Essences are so plainly Enemies to the membraneous Stomach indeed by consuming its radical moisture and to the Liver and other Bloud Viscera by heating or to speak more plainly by raising an Inflammation S. Pauli Quadr. Botan p. 225. that some have contracted to themselves a perpetual thirst others a bilious Cachexy and some a hot Dropsie V. The Lobe of the Liver that lies upon the Stomach is heated by hot Ointments before the Stomach it self which I admire indeed how it has always passed unobserved by famous Men in their practice Fortis VI. Altimarus denies that Almonds and Pistachio's are good for cold Epaticks 1. Because things that are easily corrupted cannot be proper for them 2. Because they are oily but a cold constitution of Liver is very much hurt by these things because Obstructions which are usually joined with them are encreased by such a quality 3. Because they are readily converted into Bile On the contrary the affirmative must rather be defended with Savanorola who prescribes Almonds among other convenient Medicines 1. Because Almonds especially bitter have a faculty to extenuate and purge the thick and viscid humours of the Liver Gal. 2. de Alim fac c. 22. and 30. Where the same is affirmed of Pistachio's 2. According to Dioscorides l. 1. c. 136. de Mat. Med. they and
and an Oedematous one X. The Physician must labour to know an internal one XI Vnguents are not very proper XII I. AS 1. All the bloud is carried by the Arteries from the Heart to all and each of the containing parts of the body both for their vivification nutrition and increase and for the separation of all the humours or contents usefull and useless some way or other from the rest of the mass So the same after this multifarious benefit multifariously conferred on both bodies being residuous and surviving but deprived of some part of it self or effoete is again carried by the Veins from all and each of the same containing parts to the Heart there to be renewed by the mutual mixture of various concurring parts and by their effervescence and vital rarefaction afterwards 2. And this reciprocal flux and reflux of the bloud is called now the Circulation of the bloud 3. But the Bloud is sometimes hindred in its reflux when it either stagnates and stops in its Vessels and Passages or is poured out of them whether it be into the Substance of the adjoining parts or into the Cavities of the body or whether it happen out of the Body 4. The Bloud stagnates in its Vessels either through an excessive Plethora called ad Vasa or as to the Vessels or by reason of their narrowness caused either by their compression or obstruction 5. The Veins are compressed so as to hinder the reflux of the Bloud sometimes by hard tumours adjoining sometimes by bands about the parts which straiten both the Veins and Arteries 6. The Veins are stopt sometimes by the Bloud it self or Phlegm coagulated and concrete in them sometimes though rarely by a Stone bred in them and increased by degrees 7. By Veins I understand as most do the cavernous substance of each part by which the Bloud for the most of it passes out of the Arteries into the Veins 8. The Bloud is coagulated both by the extreme cold of the Air or Water affecting the Parts very much and by powerfull astringent or austere Medicines communicated to the Bloud either inwardly or outwardly and congealing it 9. Phlegm is coagulated in the said Vessels by the same causes but most frequently by the cold of the Air Water Drink or of other things suddenly seizing the parts that were hot before either inwardly or outwardly thickning and curdling the Phlegm especially the viscid which has by some cause or other been dissolved in the small Gut and carried thence into the Bloud and dispersed every way with it 10. Where note the more causes concur and the more peccant they are so much more easily quickly and plentifully is the said Phlegm dissolved and carried to the Bloud 11. And the Bloud stagnating in the said Vessels and gathered by little and little distends them more and more and so indeed that sometimes they burst or afford a passage for it some way or other upon which there happens then an effusion of the bloud out of its vessels whether it stick in the substance of the adjacent parts or be gathered in some adjoining cavity of the Body or be all poured out of the body 12. The Bloud as yet inclosed and remaining in the capillary vessels and it may be also in the sinuous substance of any part intermediate to them or poured out of its said usual passages but open and patent into the porous substance whatever it is of the parts themselves and especially the carnous or membranous or into their interstices and gathered in a moderate quantity at least does of it self presently grow hot and produces a troublesome sense of Heat in the sensible part and being by degrees corrupted it uses to turn into pus or sanies Wherefore the first mutation is called an Inflammation as the latter is called an Abscess or Imposthume 13. And I think the Bloud grows hot or breeds an Inflammation inasmuch as its spirituous and more volatile and subtile parts which used to temper the acid and saline ones presently begin to vanish when it stops in its distinct vessels or in any other place that is stagnates Upon which both of them being made more sharp do fight one with the other and raise a hot effervescence by reason of the oily parts of the bloud and by little and little so corrupt the bloud that it turns to pus which varies according to the variety of the corrupt bloud Sylvius de le Bâ—◠¶ For the Cure therefore of the Inflammation and of the Abscess that would then follow it is requisite 1. That the Compression or Obstruction of the vessels be removed 2. That the motion of the stagnating or stopping bloud be restored 3. That the Bloud poured out of its vessels may if possible be removed thence before its suppuration 4. If it cannot be removed and so suppuration cannot be hindred that it may be maturated and promoted 5. That discharging the pus when bred may be hastned 6. That cleansing and consolidation of the Ulcer may quickly be finished As to the first Indication and Obstruction see Tit. de Pleuritide BOOK XIV where one thing should be added concerning Externals that volatile Salts may be here used outwardly with great success if at the time of using they be mixt in a small quantity with Fomentations Cataplasms Unguents c. For the second Indication Sudorificks are good as by their help the bloud is not onely made more fluid but moreover it is actually put in motion being more and more rarefied by the volatile Salt that is in Sudorificks And Venaesection inasmuch as the next bloud comes into the room of that which is let out and so more room being made for all the bloud it moves both quicker and stronger wherefore that which stagnated and stopt first in the Vessels now that the Plethora is removed stops no more but renews its interrupted motion For the third Indication these things given inwardly hinder the coagulation of the bloud Crabs-eyes Antimonium Diaphoreticum Mummy Sperma Ceti Galbanum Sagapenum Opium c. The Part affected may be anointed with Vnguentum Martiatum de Althaea compositum or any other Aromatick May Butter and Butter prepared with the Juice of aromatick Plants adding sometimes aromatick Oils distilled Among Plasters this de Spermate Ceti is highly commended Take of white Wax four ounces Sperma Ceti two ounces Galbanum dissolved in Vinegar one ounce Mix them Make a Plaster or Sparadrap Which not onely preserves the Bloud in all external parts of the Body but Milk also in the Breasts from Coagulation yea it dissolves and discusses it if but gently coagulated The fourth Indication is satisfied by emollient and maturating Medicines But when pituitous and viscous Humours are mixt with the Bloud sometimes the Bulbs of Onions Squills c. must be added to them sometimes Bdellium Galbanum Ammoniack and the like liquid Stirax Wax Turpentine and Honey Where a great Heat is in the inflamed part and the Patients cannot
Diagnostick of this is very difficult so I think the Cure of it is no less rare When there is suspicion of it Saline Medicines especially seem to be of use and such of them must be given as are endued with a Volatil or Acid Salt And the same things must not be given together but these for some space of time and when they will do no good others may be tried 1. Spirit of Sal Ammoniack compound with Millepedes or distilled with other Antasthmaticks 3 Ounces The Dose from 15 Drops to 20 thrice a day in some Julep or appropriate Water 2. Spirit of Sea-Salt or Vitriol impregnated distilled and often cohobated with Spirit of Wine and Pneumonick Herbs 3 Drachms The Dose from 15 Drops to 20 in the same manner 3. The Palpitation of the Heart is often a Convulsive Affection and is usually produced by the like cause and way of efficiency whereby other Hypochondriack and Asthmatick Diseases are usually produced The Cure whereof must in like manner be attempted by Antispasmodick Remedies c. Willis Saxonia mentions this last sort Praelect Pract. parte 2. cap. 1. It must be observed says he that it is caused by some fault in the Nerves alone nothing appearing amiss in the Brain Breast or Muscles Which I observed in my Brother whom I perfectly restored by the use of Treacle only applied to the beginning of the Spinal Marrow XVI The Trembling of the Heart which they commonly call the Passion of the Heart is a Disease distinct yea quite another from the Palpitation of it For in the Trembling the Carnous or Motive Fibres seem to be affected by themselves and the Morbifick cause does not in this as in the other Disease consist in the Blood or in the Arteries of the Heart The trembling of the Heart may be described to be a Spasmodick Convulsion or rather a Trepidation of it wherein the Motive Fibres do very quickly make only semicontracted and very speedy Systoles and Diastoles but abrupt and as it were half strokes so that the Blood can be brought into the Ventricles of the Heart and carried out only by small portions The formal reason seems to consist in this that the Animal Spirits belonging to some certain Muscles do start restless out of the Tendons continually into the Flesh and return and so in a perpetual vicissitude they repeat their Excursions and Recursions in the mean time when they are only exalted with small Forces so that they do not fill up the Carnous Fibres and they stay in these Fibres only a short time and although they make sometimes frequent efforts yet they are weak insomuch that the Members and Limbs are not moved out of their places by the Muscles so perpetually agitated and the Heart during its trembling how quickly soever shaken yet it is scarce able to drive the Blood about as is plainly manifest from the little and as it were tremulous pulse and a decay of all strength As to the Conjunct and Procartarctick Causes whereby namely the Muscular Spirits are made so instable or acquire this Desultory Faculty it seems that some Heterogeneous and Elastick Matter having past the Brain and Nervous Ducts then is carried into the Muscles and the Tendinous ends of them where mixing now and then with the Spirits it irritates them so that they can be quiet no where but run hither and thither continually and in the mean time they either omit or do not strenuously perform their proper Offices The cause of the trembling of the Heart is commonly laid upon the Spleen for it is vulgarly supposed that foul Vapours are by this parts being obstructed or otherwise amiss sent to the Heart which seising of it make it so shake and tremble yea as if it were in a cold fit This Opinion has gained some credit because Hypochondriacks or Spleneticks are found to be very subject to the Cardiack Passion But the reason why they that are reckoned Splenetick and Hysterick are so commonly troubled with the Passion of the Heart is the great affinity and intimate communication between the Splenetick and Cardiack Nerves so that not only the affection of one Part does draw another easily into consent but if at any time Spasmodick Matter falls upon the Branches of the Nerves belonging to the Spleen or Bowels in the lower Belly it seldom misses but the same in like manner scises those that belong to the Heart As for the method of Cure to be followed in the Cure of the Passion of the Heart because it is a Disease meerly Spasmodick therefore not Cardick but rather Cephalick and Nervous Medicines are indicated which yet according to the Temperament and Complexion of the Patient must be hot or moderate and sometimes of this sometimes of the other nature That I may comprehend the business in short three sorts of Medicines use to do the most good in this Disease Testaceous Chalybeates and things endued with a volatil salt Therefore first of all provision being made by evacuating the whole Medicines may be prescribed Idem which shall seem to be most useful Medicines especially made use of by eminent Physicians 1. Let a Man take this Potion inwardly which I have seen do good to a miracle Take of Water of Boragè 5 ounces Syrup of Borage 1 ounce Julep of Roses Cinnamon Water each half an ounce dissolved Pearl 2 drachm◠dissolved Gold 1 drachm Crato Mix them 2. Spirit of Balm alone cures the Palpitation of the Heart when the Body is purged Take of Regulus of Antimony 2 ounces the best Gold 2 drachms Melt them in a Crucible then reduce them to Powder add of red Coral Pearl each 2 drachms Mix them through a Sive Add the like weight of the best Nitre Burn them in a hot Fire for three hours Powder them very fine Wash it in sweet Water Put it into a Glass retort with the best Spirit of Wine and distil the Spirit cohobating it three or four times upon the Powder So it is prepared for an excellent Bezoardick Powder which in virtue excels the Bezoar-Stone The Dose half a drachm with Water of Carduus Benedictus Fabe◠Meadow-sweet or Balm It is given to drive out in Palpitation of the Heart Malignant Fevers and the Small Pox. 3. For the Palpitation of the Heart I ordered the following Bag to be applied to the Heart Take of dry Balm 4 handfuls the Cordial Flowers 1 pugil shred them grossly Make a Bag. When it was applied to the Heart the Palpitation ceased to a miracle There is an admirable virtue in Balm both taken inwardly and applied outwardly I took green Balm and Borage bruised them a little laid them upon a hot Tile sprinkled them with a little Rose Water and Vinegar and applied them to the Heart Forestus and the Palpitation of it ceased to the admiration of all Men. 4. The Juice extracted out of Weather's Hearts strengthens the Heart wonderfully Take the Heart of a Weather or a
the prescript of Nature If an Acute Disease happen in the middle time two things are to be considered One whether the Morbifick Matter be contained and rivetted in one particular part or be dispersed through the Veinâ— the other whether the Woman have had sufficient Purgation or no. If the Disease be caused by a dispersed Matter as in Fevers and the Woman be not perfâ—ctly cleansed the lower Veins are to be opened because both the Morbifick Matter will be lessened and the natural Flux provoked But if she be sufficiently purged and the Disease be strong and the natural Evacuation be not sufficient for the Disease the lower Veins are likewise to be opened in this case and so much Blood is to be taken as may make both Evacuations amount to as much as the Disease requires as Galen teacheth 9. meth 5. If the Fever be very high and there be a great burning let that be done which we shall by and by advise to be done in a Disease from Matter fixed and putrefying in some particular place In a particular Acute Disease as a Pleurisy Peripneumony Quinsy c. we must note whether the Fluxion be only a beginning so that the Disease is only imminent or beginning and but a very small quantity of Blood is as yet collected in the part For then the lower Veins are to be opened that Revulsion being made to the most distant opposite parts that preposterous motion of the Humours may be restrained But if the Fluxion be already made and the Inflammation bred in a great part and the Inflammation be very high whether the Woman be sufficiently cleansed or no the upper Veins are presently to be opened on the same side with the part affected because such Evacuation draws Blood out from the said part But if the lower Veins should be opened which are neither near to the part affected nor can draw from it both the Faculty will be injured by the Evacuation and the Matter that is fixed in a particular part will not be diminished And so you shall either draw forth almost all the Blood to revel the Morbifick Matter from the part affected or the Woman shall be killed by the Disease before sufficient Revulsion be made Nor must we fear lest by letting Blood in the upper Veins the Blood should be drawn back from the Womb because in those cases the upper parts abound with Blood and though much be evacuated yet the Veins are not so emptied as to be compelled to attract new Blood from some other place Yet for the greater caution it will not be unprofitable before Blood be let to make Frictions in the Thighs and then to make painful Ligatures in their middle which must be kept tied till Blood be let and loosed a little while after and after that apply Cupping-Glasses to the same parts or at least repeat the Frictions hereby we may procure an Evacuation of the offending Matter and a Conservation of the Natural Flux The same is to be done in burning and violent Fevers because though the Matter be dispersed yet the burning is only about the Heart and Viscera so that it cannot be extinguished so well by the opening of a small and remote Vein as of a near and large one such as the Basilica of the Arm is This method of Cure is not only fitted to Childbed Women but may be adapted also to other Women taken with an Acute Disease and having their monthly Purgations If the Disease happen in the end of Childbed the same is to be done as in the middle the same Conditions being observed this being noted that the more the Woman is distant from the beginning the safelier may the upper Veins be opened but the nearer she is thereto even in the middle time we must do it with the greater premeditation and if the Disease be not urgent and her Natural Purgation be plentiful let us abstain wholly But if the Purgation be too little Laz. River lib. 15. c. 24. ex Petr. Sal. Divers de affect part c. 23. we ought to open the lower Veins to make up the due quantity And if the contrary shall happen let that be observed which we said was to be done in an urgent Acute Disease II. The use of Purgation in Childbed Women taken wi h an Acute Disease shall be concluded in the fo lowing Theorems While the Lochia flow naturally Purgation is never to be administred for there is danger lest Nature should be diverted from her work But if her Natural Purgations become preternatural and disorderly we must consider whether they offend in quality or quantity If they offend in quantity and that too little and the Womâ—n be either not at all or not sufficiently purged after that all Remedies that are proper for promoting this sort of Purgations have been used in vain and the Morbifick Matter appear concocted eight ten or twelve days being past from her delivery according to the greater or lesser urgency of the Disease she may be purged wiâ—h some gentle Medicin wholly abstaining from the more violent Iâ— the Lochia offend in quality so that the Fluxion look white or be of some other preternatural colour the Matter being concocted Purgation shall be administred safely towards the â—later end oâ— their lying in But this is always to be observed in general the longer the Ch ldbed Woman is distant from the day of her delivery the safelier may a Purge be administred and on the contrary For Experience has taught that Women who have their Purgations supprest if after the seventh or ninth day they fall into a loosness are generally recovered But if a Diarrhoea happen on the first days viz. the first second River or fourth they generally dye III. In a Fever following the suppression of the Lochia let cooling Alteratives be given let Women praâ—tle what they will which yet must neither be acid nor astringent The Whey of Asses Milk the Juice of Endive or Succory Clarified Fortis tract de morb mul. p. m. 106. the distilled Waters of Endive Succory Borage Maiden-hair IV. Rondelelius taught that the Pouder of the dried Secundine being drunk in a convenient Liquor did presently allay the After-pains And because Brutes use to devour it they are therefore free from those pains as he knew by Experience in his lâ—ttâ—e Bitch from which having taken away the Seâ—undine Pâ—â—erus 〈◊〉 â—om 2. p. m. 524. he said he observed that these pains did also supervene V. A certain Childbed Woman exposing hâ—r self to the Winds and Air too unseasonably fâ—ll into intolerable pains and could not be recovered At length there came an old Midwife who called fâ—r three Nutmegs grosly bruised then she set an Eartâ—en Pot under the sick Woman with live-Coals in it and presently sprinkled the Pouder of the Nâ—â—mâ—gs thereon bâ—dâ—ling the Woman so place the â—or tâ—at was set under her that she might receive into her Womb the smoak or nidour of the Pouder through a
Millepedes that is either in form of a dry Pouder or of a distilled Liquor seldom fail of success for such recall the superfluities of the Serum from the Head and Nerves and carry them to the Urinary Passages Gentle Purges are also good as is a decoction of an old Cock and other things appropriate to an Asthma See the Section following Willis XXI Of all the dire Symptoms of Scorbutick Persons difficulty of Breathing and straitness of the Breast coming by Fits are the worst I think they for the most part arise either from a sudden stagnation of the Blood that is just growing grumous in the narrow passages of the Lungs or from a Convulsive irritation of the Nerves which serve the Organs of Respiration In the first case there is an exceeding distention of the Lungs and thence as it were an immobility with a sublivid redness in the Face a dimness of sight swooning a low weak intermitting Pulse accompanied with despair of the Patients recovery But in the later case the Pulse of the Heart and Arteries is not very irregular the Party is troubled with a dry Cough together with an anxious straitness about the Heart and deep sighs stopping the Breath For when the Blood because of its thickness stagnates in its Circulation through the strait passages of the Lungs such things are proper as by powerfully attenuating inciding and moving it do restore it to a requisite fluidity and to a more expedite Circular motion 1. Carminative Clysters for Revulsion 2. Blood-letting where there are signs of a Plethora for so when the Blood is diminished the rest will more easily be attenuated and will pass the straits of the Lungs with a quicker motion 3. Hot Thoracicks mixt with Antiscorbuticks of the same virtue Tincture of Saffron Elecampane Castor Elixir Proprietatis Confectio Alkermes Flowers of Sal Ammoniack Benzoin Volatil Salt of Vipers Horse-dung Spirit of Sal Ammoniack A spoonful either by it self or in some convenient Vehicle in a small but a repeated Dose for these do excellently keep off the Fit by keeping the Blood from Coagulation For it is found by Experience that Coagulated Blood is dissolved by a Volatil Salt diluted with Water and besides Volatil Salts there is not any thing found fit to prevent or dissolve this Coagulation For a Scorbutick Asthma from a Convulsion of the Pneumonick Nerves See the foregoing Section Antispasmodicks promise a Cure which are experienced to have the faculties of dulling suppressing and discussing this irritating acrimony of the Humours or Vapours For this these things are cried up Spirit of Sal Ammoniack Hartshorn Soot Castor Spiritus Lavendulae compositus mixt with appropriate Liquors and taken in repeated draughts while difficulty of Breathing is urgent Castor also Galbanum Asa foetida and their Tinctures drawn with Aqua Raphani compos or Lumbricorum But in such a shortness of Breath which threatens to choak the Patient there is no more present Remedy See Charleton Section XII than a few grains of Laudanum Opiatum dissolved in good Canary Wine and infused till the Tincture is extracted and a spoonful of it given now and then Rheumatismus or a Rheumatism See Febris Rheumatismi comes Book VI. and Lumborum Affectus Book X. The Contents The excellency of Blood-letting I. When Purgations must be prescribed II. The benefit of Diureticks III. Sudorificks are not proper at all times IV. We must take care to strengthen the parts V. Cured in a young Man VI. I. BLood must be let every day at the beginning till the Disease and pains abate Nor is it any matter if you Bleed for ten or twelve days or for more since it is peculiar to this Disease for the Patient not to be weakened by Bleeding Therefore it is my custom when I prescribe Bleeding so often to add this restriction that it be continued every day till the pains be abated or the strength be much wasted and when no decay of strength arises upon it Patients do freely admit it The condition of the Blood causes this Tolerance which comes out always very putrid Experience shews the benefit since by repeated Bleeding the Disease which in its own nature is long is often conquered in a short time Besides a large Haemorrhagy supervening often cures it Riverius II. Purging in the beginning increase and state of this Disease gives no relief yea it does harm As it happens in all Inflammatory Diseases But in the declension it is necessary and must often be prescribed and with gentle Medicins that the Cacochymie restagnating in the Body may be carried off If gentle things be insufficient wholly to eradicate this Disease which is often contumacious we must if there be no Fever have recourse to stronger things I have always cured this Disease when other things could not do the work by giving about twenty grains of Mercurius dulcis six times sublimed with ten grains of Scammony or Resin of Julap Idem ¶ One Clyster made of Emetick Wine cured a Woman of this Disease Idem III. In Rheumatick Diseases when a bad and sharp serous Matter bred by a hot intemperature subservient to Sanguification is discharged into the External habit of the Body with a wandring pain of the Bones and with a sense of heat and heaviness all over the Body and sometimes also into the inner parts Diureticks are very good to dry it up and that by Hippocrates his advice lib. de Humor Do not shut up says he the dissolved Humours within but dry up the superfluous and when you have a mind co carry them off or otherwise it is best to use Attenuants because so you may more easily purge them by Stool or by Vrine than if you had restrained them and kept them in by Astringents And by Galen's consent 15. Simplic 13. By Diureticks says he the Blood is not only attenuated but is melted and separated just as in Milk in which what is serous and thin is separated what is thick is curdled and exactly united Frid. Hofm IV. Sudorificks as well as Purgatives do no good but much harm in the beginning increase and state Ordinary Physicians experience this who mistaking it for a true Catarrh and being tired with the contumacy of this Disease have recourse to these things whereby the Disease is doubled and the pains are increased But in the declension Generals premised and when there is no Fever Riverius they do much good V. After sufficient Evacuation yea at the very time of Evacuation we must endeavour to strengthen the principal Parts and the whole Body And these Strengtheners must be cooling by reason of the hot intemperature of the Liver the original of a Rheumatism There is great store of them I shall propound four that are very effectual and not ungrateful 1. Tincture of Corals two ounces whereof may be taken two hours before Breakfast in the morning those days when no other Medicins are used 2. Conserve of Hips which is grateful to
intention consisting in a due constitution of the Pores is commonly performed only by outward administration Willis VI. An old Man 72 years of Age was in the year 1657 very ill of a Diaphoretick Sweat so that he was all over in it almost Night and Day and what ever he eat or drank he immediately perceived it pass out at the Pores of the Skin The Cause of this Disease was abundance of serous Humors complicated with the Scurvy which were gathered in the Mass of Blood by a depraved and vitious fermentation in the Organs designed for Sanguification which did not transmute the acid Salts of the Meat into volatil Salts The Disease had lasted 3 Months before my Advice was taken but it was quickly cured by me only with Ivory without Fire and an Emulsion made of the four greater cold Seeds and Cichory and Bugloss-water giving now and then Jalap and Crystall of Tartar Forbearing Wine Sowr Meats and other things that breed Scorbutick Blood He lived until he was fourscore and three years old Hofmannus Suffocatio or Suffocation or Strangling The Contents Bleeding is often convenient I. Fear of Suffocation from the Lungs distended with Wind. II. How they that are strangled with an Halter may be recovered III. By what means they that have been Suffocated in the Water have been brought to Life again IV. The Cure of those that are Choaked with Smoak V. With the Steam of Must VI. With the Veins too full of Blood VII With Worms coming into ones Throat VIII With the swelling of the Thymus IX With poysonous Mushromes X. Men may be taken with Fits like Hysterick ones XI An easy Remedy in fear of Strangling XII 1. FOr them that are Strangled or Choaked the suffocating Humor having recourse to the Throat either because the Blood is forcibly carried to the Heart or Brain whether it come from the Womb or from some other Place Bleeding is never amiss in this Symtome that is if you find the Pulse strong and the Veins full Bleeding is also good when it comes from drinking cold Water as Diascorides advises for Bleeding is not convenient because the Water is alwayes hot or because Infectious but because there is much in the Veins Bocallus II. Sometimes Wind distends the Lungs so violently that it causes Suffocation unless help be given by opening the Breast by Paracentesis which is often done at Paris to the great advantage of the Patient and the ease of the Breast though no Water run out but Wind break out violently Hippocrates calls them 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 whose Breast is distended with Wind. Riolanus III. Anne Green a lusty young Woman about 22 years of Age was tried for killing her Child and hung on the Gallows for half an hour Her kindred who stood by that she might be dispatched of her punishment by a speedy Death some of them beat the poor Wretch on the Breast others hung on her Feet and others lift up her Body that as it fell down again it might draw the Halter closer She was reckoned by all People to be Dead and was taken from the Gallows The Physicians waited for the Body to dissect it but Dr. Petty and Dr. Willis who were to dissect it observing her to breathe altered their Minds and consulted how they might save her Life They directed all there Care to procure the free and accustomed Motion of the Blood Therefore forcing open her Mouth they poured in Spirits and Waters which in a small quantity do very efficaciously strengthen the Heart They diminished the quantity of Blood which would otherwise have been burthensome to the oppressed Heart and took at several times repeated in all to the quantity of 20 ounces that the Heart might when eased of the abundance of Blood more easily and readily distribute the rest into the whole Body and might the more eagerly draw to it self that which stagnated in the Veins or moved too dull They laid Cataplasms round her Neck and anointed her all over with Oyls and hot Spirits that the Bruises might be discussed and that the Blood might pass more freely to the Head by the Carotides and repass by the Jugulars They ordered Clysters full of Spices to be given her both that they might get out the Excrements which perhaps might be troublesome to the Guts and might prove more prejudicial to other Parts and that they might quicken the Motion of the dull Blood in the mesenterick Vessels Upon this she first scratched her Hands by and by she could open her Eyes and move several Parts and was able to Cough Afterwards being further helped by the dexterity of the Physicians she could understand the by standers talk observe and laugh She found a Pain and numbness in the bruised Parts and in a few dayes time she was well and was able to go about her Affairs Wepferus IV. A Girl not three years old fell into a Vessel full of Soap-water and being full of it she seemed to Breathe her last she slept profoundly rattled and scarce drawing any Breath was quite Choaked such a murmuring Noise coming upon her as is usual in People that are dying I was called and I ordered that a Decoction of Barly unhusked Liquorish and Figs should continually be poured in a little warm and when she had Vomited gently and had cast up all the Soap-water and freed her in a few hours from Suffocation her Mother if I had not hindred her had given her Rhenish Wine which indeed is amicable to Nature but it might not only have easily carried the poysonous Matter in the Soap to the Heart but it might easily have raised an inflammation and a Fever In the year 1577. when a great many Boyes and Girles had got upon an old rotten Bridge to see a Soldier that was fallen into the Water The Bridge broke and a great number fell into the Water and were in danger of their Lives to whom when I was called they all escaped by taking a Decoction of Chamaemil Flowers in Beer by which we made them sweat in Bed which I did to several others and they all recovered Forestus My Son Frederick Bonet 20 Months old she that tended him having left him was walking over a Pit full of new quenched Lime and being thrust by one about his own Age he fell into it She who had the care of him coming immediately jumped into the Pit threw him upon the edge of it and she her self could scarce get out by reason of the deepness of the Pit and softness of the Lime She immediately poured some Wine that happened to be in the way into his Mouth when he breathed not at all but seemed as one dead by means whereof he vomited the Water and some signs of life appeared By and by lest the Acrimony of the Lime wherewith his whole Body was smeared should hurt him she cut the Girdle wherewith his Clothes were tied and put him naked into a Pale of Water and
Paeony water Rod. à Fonseca he will find no better Remedy F. Hofmannus 3. Three drachms of Seed of Columbine is good in a Vertigo 4. Van Helmont sayes he cured himself of a Vertigo with Sulphur of Vitriol 5. Silk worms dried and powdered and strewed on the Head Mercatus wonderfully strengthen the Head in a Vertigo 6. Marcellus has a Medicine which I have experienced Take Mysi and beat it to powder steep it in Vinegar and so steeped apply it in manner of a Cataplasm to the Temples and behind the Ears for it has an excellent virtue to disperse Vapors Mercurialis which cause a Vertigo Eustachius Rhudius 7. Some say that the juice of black Betes applied to the Temples quickly cures a Vertigo 8. In a Vertigo by Sympathy coming from an hot cause this is a most excellent Remedy Take of Fumitory 1 handful Dodder of Time 8 drachms Myrobalans citrine 2 drachms pulp of Tamarinds 1 drachm Endive Cichory Purslain each 1 handful Raisins 6 drachms let them boyl in a sufficient quantity of water to the expression add of juice of Quinces juice of unripe Grapes each 3 ounces pulp of Damascens boyled in the former decoction and passed through a sieve 1 pound Let them boyl to a moderate consistency then add of Cassia new drawn 6 ounces pulp of Tamarinds 3 ounces Species ditragacanth Santal each half a drachm Sugar what is sufficient Mix them and make an Electuary The Dose from half an ounce to 6 drachms every or every other day before Supper ¶ In a Vertigo caused by obstructions of the Brain this is an effectual Remedy Take of powder of Staves-acre 8 grains Mysi 1 drachm Pellitory of Spain 1 scruple yellow Wax 1 ounce Saxonia a little Sugar Make it into a Masticatory Vesicae Affectus or Diseases of the Bladder The Contents When it is full of Excrements whether we may purge I. In an Inflammation of it or the Kidneys what Vein should be first opened II. Whether Cupping-Glasses may be applied III. In the Vlcers of the Bladder how injections may be made IV. They must have but few astringents in them V. What such their matter should be VI. Cured by Spaw waters VII The efficacy of Balsame VIII Medicines 1. GAlen is reprehended by some because 7. method cap. ult he says that the Bladder is purged by the Guts if it be full of Humours For say they what other way is there from the Bladder to the Guts than by the Ureters Kidneys and a thousand Maeanders in the Veins But it were ridiculous to imagine purging by so many turnings and to leave the streight and common way Yet let not Galen be blamed who several times opens the causes of this transfusion and commends Hippocrates his judgment That all things have a common conflux and transpiration Do you think that the distribution of the Aliment is made only by wayes conspicuous But there are many parts which have no conspicuous wayes to them If any part be starved it snatches what it can get the Veins from the Arteries and these from the Veins by sweating through the pores of the Veins therefore the Guts may take from the Bladder and it from them When any part has a Humour fell into it out of pain or weakness does it not receive excrements from every hand In a Loosness of the Guts is it safe for the Bladder to abound with excrements which cannot commodiously be purged by their own way I think not for when this way is stopt they might come violently upon the Guts But if upon these occasions something may be transfused out of the Bladder into the Guts why may not something far more easily be drawn by the strength of the Medicine through the pores of the coats Galen 1. de fac nat sayes that if an earthen Vessel full of water be set in a heap of Wheat the Vessel will be drawn dry and so bulk and weight will be added to the Wheat and this is done by the Wheat 's drawing the moisture through the thick Vessel And how much a more powerful attractive vertue in all probability is there in Physick than in Wheat And how much more convenient is the Coat of the Bladder for transfusion than an earthen Vessel Which if it have nothing else it has wayes of drawing nutriment which very same ways may serve to draw a Medicine Wherefore by what ways the Bladder receives nourishment by the same it may remit the excrements wherewith it abounds But the Bladder does not receive nourishment by the Ureters which only carry Serum but by Veins and Arteries And if it be difficult to you how the juice that is extravasated in any cavity should be resumed into the Vessels I suppose it has not been your fortune as it was Galen's to cure the jaundice with once purging Vallesius or to evacuate the water between the Peritonaeum and the Guts by stool II. From one that was ill of an Inflammation in his Bladder I immediately took 3 ounces of very foul Blood from his right foot I bled him in the foot both because he had been let Blood in the Arm formerly for an Ague and also because Galen in several places orders Bleeding for parts ill above the Kidneys in the Arms for the parts below the Kidneys in the foot You will ask whether must we always let Blood in the foot for parts below I answer that when the body is very plethorick and strong and in the bginning of an Inflammation it is no absurdity to bleed in the Arm and then presently the same day in the foot for although Bleeding in the Arm be a great revulsive yet because it does it but slowly for it is far from the place affected Epiphanius Ferdinandus Hist 19. therefore I advise to let Blood first in the Arm and then the same day in the foot ¶ Riverius first orders the Basilic Vain to be opened twice thrice four times or oftner if there be strength sufficient till the fluxion cease which is known by the abating of the pain this revulsion being made he will have the lower Veins opened also for derivation ¶ Walaeus meth med 98. agrees with Ferdinandus In what place saith he must we bleed for revulsion sake whether near or at a distance My opinion is when the part affected is above the Heart it is convenient to bleed an upper Vein but if the place be below the Heart open a Vein below III. In an Inflammation of the Bladder Altimarus and Mercatus after Bleeding and Fomentations if they be not sufficient order a Cupping-glass with Scarification to be applied to the region of the Pubes Salius contradicts this fearing lest the Inflammation should be thereby exasperated But he need not fear it other things as well universals as topicks being premised Horstius For the matter being softned and prepared is by this means diminished by derivation IV. In Ulcers of the Bladder injections must not
arise And I use to reject these Medicines because they do little good and constant Practice and Experience has taught me better which I use with great success and benefit to my Patients For they are such as do not at all draw the humors yet gently repell them nor cause any Inflammation but rather resist the poysonous quality in the beginning and avert the power of the poyson and its communication from the Heart and other principal Parts XXIII At the first visit these two things especially are immediately to be considered by the Physician and upon these two all his Pains must be spent that is the poysonous quality and conflux of the humors Nor let any man object that in the beginning regard should be had to burning contusion attrition of the part and the bleeding For I answer that this Wound is not simple but complicate and therefore we must first fall upon that which is most urgent And therefore we must begin the cure with poyson wherein consists the greatest danger of losing life the fluxion must be stopt and other things which may increase Putrefaction infect the Spirits and cause other Symptomes and in the second place we must look after Pain Inflammation and Bleeding Therefore the poysonous quality must be resisted immediately Now all Authors agree that in every wound where there is suspicion of poyson attractive Medicines must be used immediately at the beginning and things that evacuate by the part affected Therefore we ought either to scarify the wound or apply cupping-glasses or do both together But I commonly with good success always cut the Wound open the part a little and make incision that the Blood may run out and the poyson may be dissipated together with the Blood and this dilatation or opening of the wound is very necessary both that extraneous bodies may easily be got out and also that the Sanies and superfluous Humours which breed in bodies affected with these wounds may be conveniently purged and also the cavities and Sinus's of these parts may be prevented which otherwise usually happens through the unskilfulness of Surgeons Besides I clip away some part of the torn flesh which operations indeed I use instead of Sacrification Then also I apply a cupping-glass to the part if there be one at hand to take away the poysonous quality and when these things are done I presently apply some things to the wound that I may prevent the poisonous quality and flux of Humours and if at any time there be an Haemorrhage I take some Yolks of Eggs with a little of the White for the White alone applied does a great deal of harm but when it is mixt in a small quantity with other things it loses that astringent and emplastick faculty to which I add oyl of Turpentine St Johns wort Euphorbianum oyl of unripe Roses adding a little Terra Sigillata oriental bole Armenick Scordium powder of Tormentil root and Myrrhe for these things are violent resisters of poyson and putrefaction as also Galbanum Bdellium c. draws out the poyson Idem Ca. 19. in which Medicines Tents and Pledgits are dipt XXIV After we have provided for the wounded part we must then take care of the whole Body And in this case we ought to breathe a Vein for this is the best Remedy of all universals For though Bleeding may seem not at all convenient in Gun-shot wounds which have a poysonous quality joyned with them because thereby the said quality is drawn into the inner parts of the body and therefore to the principal parts with great peril of life For in applying Cupping-glasses and Scarifications to the wounded part the intention is not only to evacuate the virulence by the part affected but by revulsion to attract it that it penetrate not deep or infest the principal parts Bleeding by opening of a vein is altogether contrary to this intention for it does not evacuate or expell the poysonous quality but rather gathers and draws from the part and circumference to the centre Yet I answer that when it is said A Vein must not be opened in poysoned wounds this must be understood of Poyson from the whole substance and not of a poysonous vapour Besides a poyson from the whole substance quickly creeps to the heart and other principal parts but an halituous poyson is not so soon communicated to the principal parts We have an example in the bite of a mad dog because sometimes many days and months pass before a hydrophobia comes so in Gun-shot wounds the Poyson is not communicated presently and much less when Blood is let quickly for Blood-letting is very good in Gun-shot wounds for revulsion sake and draws no virulence inward because in the beginning the venemous quality poysonous Vapor is not so penetrating of it self unless it be so attenuated by the heat and spirits as to infest the heart come to the principal parts especially when its passage is hindred by scarification and application of drawing Medicines Wherefore alwayes in these wounds as well as in others Blood must be let by opening a Vein to prevent a defluxion of Humours and especially of bad juices after which if the wound be inflamed bad Symptomes usually happen as great pains Erysipelas Grangrene Idem especially if there be a Cacochymie in the Body XXV Yet Blood must be let on this condition that when topical Medicines are applied a vein may be opened for so it may do good but never harm But large Bleeding cannot be approved of and herein the greatness of the wound must not be so much regarded as the plenitude of the Body Idem a gentle purge or Clyster being premised XXVI The next day and the second visit before the wound be looked on the body must be cleansed and to this purpose we must prescribe some gentle Medicine but not a strong purge because in a poysonous quality which comes from without violent purging is not so well approved of by Physicians Galen 4. m. m. affirms that purging is not only proper in plenitude but especially in abundance of bad juices and in a great Disease Therefore in these wounds it is very proper to give some gentle Medicine Which is approved of also by Hippocrates l. de vulner For Purging by the Belly is good for most wounds because bilious thin and serous Humours are purged for such Humours might easily flow to the wounded part and cause Inflammation Pain c. Idem XXVII Some put Butter in their Digestive Medicines in the beginning yet I ever abstained from the use of it for it greatly corrupts putrefies and relaxes the part Plazzonus but here we must alwayes prevent putrefaction and corruption XXVIII Some prefix the seventh day as a set bound for Digestives Others go beyond this time tarrying for the separation of the putrid flesh that encompasses the Lips of the wound unless what has been already suppurated be removed by abstersives But I think the set
of a middle nature consist of these mixed and are divers The External are either moisteners and restorers of the Serum as in melancholy where for instance a decoction of the leaves of Lettuce is in use or being of thin parts do penetrate or are refrigeraters and repellents as in Hemorrhagies deliriums where Acids are also good c. or are discussers and evacuaters as sternutatories apophlegmatisms or anodynes as unguentum alabastrin populeum or strengtheners as lixivium sapientiae c. oyl of peaches Idem V. There lies a great deal in the right administring of these and it is to be noted 1. in the manner of administring Such as alter violently and leave an harm behind them are either to be omitted or to be used more sparingly Thus the too odoriferous dull the Head especially where the Head akes and is affected by Vapours whence Styrax Saffron Myrrhe also it self and Coriander not prepared molest the Brain and by consequence all things that are too vaporous and endued with a preternatural Sulphur do easily disturb the Spirits and though indeed they shut the pores yet they are to be used warily whence also Opiats belong hither which being given more heedlesly and frequently especially in Children do weaken the Head and render it muddy So likewise very cold things are to be shunned for although the Brain do bear well enough repelling frontals yet care is to be taken that its tone be not vitiated seeing all cold things are Enemies to the Nerves In like manner it is never safe to heat and dry too much for thereby the Spirits are enraged and the pores are too much dilated thus by the confectio anacardina some have been made mad So in Topicks which is Heurnius's caution meth ad pr. l. 2. p. 118. we must use those sparingly that manifestly astringe to which hot things are often added that the rest may penetrate 2. Neither moistening nor too liquating and hot things are to be used in Catarrhs and where the Brain is filled with Humour hence in Catarrhs washings of the Head yea and baths also have no place at all and some have been observed to lose their Smelling quite thereby So those that use hot things as the oil of Amber whether inwardly or outwardly to anoint the Scalp in Catarrhs by melting the matter and precipitating it into the Vessels they often cause a Fever and other greater mischiefs 3. Also Salts whether alkalis nitrous or acids are less convenient in Catarrhal affections for they make the Serum the more fluxile whence it easily finds a way to the more noble Parts which holds in general also of the other Parts 4. Acids are good where the Pores are too full or the Humours and Spirits too enraged and unbridled as in soporous affections Madness c. but they are not so good where the Nerves and Membranes are weak as in the Palsie and worse yet in watchings Idem where they are to be avoided VI. Cephalick spirituous waters as also Aquae aureae vitae and Elixirs are not so very safe especially when they are taken on an empty Stomach and as Crato said they have proved the Waters of Death to many for they hasten forthwith to the Viscera Joh. Jacobus Wepferus cons ms pro Nephritico they harden the Glandules amongst which the Brain is one they hasten the Dropsie and Apoplexy as I have sometimes observed in Monasteries amongst the Confessors Chirurgia infusoria the manner of its Administration and Benefit IN our time has been brought to light an Operation of Infusion or a new Clysmatick or sort of Clystering when through an opened Vein by putting a small Pipe into the Orifice there is injected by the help of a Syringe or Bladder some Liquor that is either nourishing altering Cardiack or Purging which passing to the Heart and afterwards marching through the Arteries and all the habit of the Body produces the same Effects but in a shorter time as if it had been taken in at the Mouth and let down into the Stomach This Artifice was afterwards amplified by making a transfusion of the Blood of one Dog into the veins of another Dog yea the Experiment was tryed in two Men into whose Veins being emptied to some Ounces was transfused the artcrial Blood of a Lamb who were also better thereupon Another manner of transfusing Blood was invented out of one man into another Joh. van Horne microtechn Part. 1. Pag. 218. ¶ J. Jac. Sacks writes thus concerning the same to the famous J. D. Maj. Of what moment the Circulation of the Blood is says he the most skilful Industry and Experience of the Experimental College in England does notably teach which hath found out that Purgers without ever putting them to the Mouth do exert their vertues by the help of the circulated Blood A Pipe is made of the little Bones of Larks thighs of the shape of those Pipes that are fitted to an Oxes Bladder for injecting Clysters A purging or other altering Liquor is put into a small Bladder especially that of a Carp then a vein is cut in the Hand Arm or Thigh with a small hole and the Liquor is poured into it out of the aforesaid Pipe being thrust into the hole pressing the Bladder lest the Blood spurt out of the Vein instead of the Liquor 's entring into it When the Liquor is poured in the Orifice is closed and tyed up Thus within an hour the Blood is impregnated with the purging Liquor and communicates the vertues thereof to the Heart by means of the Circulation and an happy Purgation is effected The transfusion of Blood out of a mangy Dog into a sound was performed by M. Thomas Coze as the Transactions of the English Society in the year 1667. p. 75. relate it Whereupon there followed no alteration in the sound Dog but the mangy one in the space of Ten or Fourteen days was perfectly recovered Dr. Richard Lower in his Treatise of the Heart p. 190. delivers the Method that is to be observed And the way of preparing the Vein in Man is shewn in the said Transactions from Dr. Edmund King p. 246 c. Many things are objected against this Transfusion but this chiefly that there is a great difference betwixt the Flesh we feed upon and the Blood that is transfused immediately into the Veins that that undergoes great alteration but this not To which I answer That of the three primary Digestions of the Aliment the first that is performed in the Stomach is of no great moment in respect of the others that are made of the chyle and Blood in the Heart Liver and all the Parts that are capable of nourishment And although Blood poured in fresh undergo not the first concoction that is made in the Stomach yet it undergoes the other two through many Circulations that are performed by the natural Blood and therefore there is no absurdity to hinder why it should not be transformed into man's substance D.
be emptied I add that whilst they draw from the Hemorrhoidal Arteries 't is very like that the Heart will be wonderfully helped thereby Rolfink de febr p. 274. See §. 3. Hepaticks or Medicines for the Liver See Hepatis affectus or Diseases of the Liver The Contents They respect either its Vessels Ducts and Pores I. Or the Choler which is either to be restored II. Or temper'd III. Or its tone IV. What and how sweet things help V. How Steel-Remedies profit VI. The too much use of Aperients is hurtful VII Astringents have not place always VIII The abuse of Syrups hurteth IX I. HEpatick Remedies respect either its Vessels Ducts and Pores in the concrete respect being likewise had to the Lymphatick Vessels and Gall-Bladder or the Choler which it separates and transcolates or its tone fibres and parietes or Parenchyma Aperients do chiefly respect the Ducts for this Bowel is principally and above all others subject to Obstructions because of the very numerous Vessels that it has so that the chief Hepaticks are Aperients Hither belong also Diureticks which unless there be withal an over dry intemperies or if there be such of them as are more dilute are most agreeable to the Liver Thus to repeat only a few 1. Bitter things are profitable that cleanse cut and attenuate the clamminess of the choler 2. Others of thin Parts whether Aromaticks as calamus Aromaticus Spicknard c. or Acids as red Liverwort Mineral Spirits 3. Absorbents Lixivials and especially Steel Remedies And these have a notable use in Obstructions in a too mucilaginous choler Jaundise Dropsie Cachexie and the like II. Moreover those that respect the Choler do either restore it if it be sluggish and defective or bridle it when it exceeds and is impetuous lessen it when it abounds and mitigate it when it boils and burns as it were Those that restore the Choler are 1. Partly contrary to those that restore the Ferment of the Stomach and are for the most part the same which encrease the heat of the Stomach namely Sulphureous Balsamicks as all Aromata or Spices likewise spirituous as Wine and its Spirit 2. Partly the same being endued with a volatil and simple and with an oleous acrimonious Salt as Mustard Erysimum or Hedge-Mustard Water-cresses which are like a spur to it for Choler consists chiefly 1. of Oleous Sulphureous Bâ—lsamick Parts 2. of volatil Saline both which are immersed in a little watry mucilage and limited with watry Particles Hither belong also sweet things which encrease choler and that by contributing partly mucilaginous clammy parts whence also the same are said to breed Obstructions partly Sulphureous also if they happen upon an hot and dry Body And these are good in an Anasarca as also partly in an Ascites a serous Cachexie loose Tumours and where in other cases there is need of rarefaction of the Blood for such things as then more intimately rarefie the same do exalt choler They likewise profit the Phlegmatick that have no gall as it were III. Having hapned to mention sweet things we must see why Galen 8. de Comp. Med. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 writes that Raisins are familiar to the Liver in their whole substance and why the same thing is not equally attributed to sugared things That familiarity of Raisins with the Liver gave foundation to the Electuary of Raisins in Riverius that notably strengthens the Liver The reason may be because they temper the fluxility and sluggishness of the choler and kindly moisten withal which sugared things do not do IV. And the choler is temper'd and bridled when it exceeds both by accident by certain openers as Preparations of Succory where note that some things are called coolers which yet are hot as we may see by these mention'd inasmuch namely as they loosen the stoppages and cleanse gently withal partly evacuating Cholagogues and also per se by 1. Diluters thus when choler offends the Whey of Goats Milk with a little Cinamon c. is good whether the anima of Rhubarb be taken with it or the clyssus of Antimony be dropt into it both which I use with success hither belong mineral Waters Potions c. Now these very Diluters are a vehicle to Aperients whence note that in the Jaundise such Aperients as dilute more and in the Dropsie such as dry more profit most And those very Aperients that are diluters withal do set the lympha at liberty and make its motion free and withal restore the Serum which is and is called the bridle of choler 2. Bitter things which both cleanse and open the Pores of the choler so that it is hastened more to the Guts and evacuated the vertue of Wormwood Aloes and Rhubarb is known 3. Acids hither belong acidum Tartari red Sanders or the red Liverwort of Dresden because these do tame and blunt the Sulphureous part of the choler and fix and enervate the volatile Saline 4. Earthy and absorbing Remedies especially the Nitrous and Alkaline thus also lixivial Salts themselves belong hither likewise Shells Corals Perles species and Pouders c. likewise Nervines themselves or Cinnabarines which I have found profitable in Diseases of the Liver and I have happily cured a stubborn Pain of the right Hypochondre with Tetters breaking out all the Body over with these especially For it is to be noted what Experience testifies that earthy Medicines do precipitate and absorb both choler or cholerick Humours and also acid and even serous Humours whence we cannot absolutely conclude that wheresoever Alkaline Medicines profit there an acid offendeth for Experience witnesses that the earthy profit in many Patients and Diseases where by the consent of all an acid offendeth not but the choler regurgitates and is frothy which they dissociate inhibit and bridle in its preternatural motion V. Lastly The tone and fibres of the Liver are strengthned both by 1. Moderate Astringents whence it is a common opinion among Practitioners that it delights in Astringents 2. Absorbers especially Steel ones and the vitriolated that are made of these 3. Correcters of any excessive temper but chiefly a moist and consequently a loose Hence Mercurials also and Mercurius dulcis in particular is greatly commended by which with a Bezoartick Steel Remedy Sennertus writes that one was cured who was given over in a Dropsie that on no other account than because Mercurius dulcis makes the Serum fluxile whence it opens Obstructions cures Loosness by diverting the Serum another way and thence evacuating it by convenient ways c. Thus Antimonials likewise are good inasmuch as they notably precipitate and dry discussing the superfluous Humours VI. So Steel-Remedies do chiefly perform this whence there is a caution given concerning their use by Gul. Gilbert in his Book of the Load-stone 1. cap. 15. who sayes that Steel is granted in loose Livers and moist Maladies because it dries also in the Green-sickness over-grown Spleens namely where moisture abounds but he denies it greatly in
is found in it unless some error be committed in Diet or a mans constitution decline more or less from a perfect State of Health Now if any one do attentively consider all the Humours in the Body that are to be confounded with the Blood as also the proper qualities of each he will easily come over to us and will grant that their strictier union with the Blood is owing to an Acid and therefore to the Pancreatick juice or Lympha ill affected On the contrary that their looser Union with the Blood and so the loosning of the stricter is to be hoped and expected from a sal lixivium and especially a Volatil and so from a bitter and therefore from Choler when it is more powerful and has the dominion Daily experience confirms how true these things are which I have now said seeing it may be known to any who observes those things which cast the Healthful into divers Sicknesses and increase the same and on the other hand which restore lost health to sick Persons that the concoction in the Blood is hindred by the Vertue of Acids but such as are excessively so and that the same is promoted and obtain'd by the help of Aromaticks and in particular of bitter things or volatil Salts but such as are more temperate See concerning the signs of crudity from Vrines loc cit § 14. The watry Urine which is a sign of crudity that is of deficient concoction in the Humours of the Blood as often as it continues and a Spontaneous concoction by Nature is expected in vain so often is it to be promoted by Art and that by Medicines that kindly temper all acrimony of the Humours but chiefly the acid whence the too intimate mixture of the Humours in the mass of Blood uses to proceed and such as will loose again their over-strict union The fixed Sulphurs of Minerals and Metals being exalted to their greatest Perfection do above all other things gently temper all acrimony of the Humours even the acid also Next to these are volatil oleous Salts and to these Aromaticks by the vertue of which being prudently used exceeding even imagination in many things there is not only obtained such an effervescence of subcontrary Humours in the small Gut and Heart as is most agreeable to Humane Nature but the preternatural concretion and union of the two acrimonious Humours being first moderated by them is dissolved again in the Blood I declare from Experience that these things are to be esteemed of great moment in Physick Idem § 78. and 79. IV. Trallianus l. 5. cap. concerning a Diary Fever from Obstructions does not grant oxymel for preparing the Humours that are thick through adustion but that are thick through crudity For the things that are thick through adustion are made thin if you dilute them with liquids thus dirt is made thin by mixing it with water and choler made Vitelline or like the yelks of Eggs by assation by a cold and moist Potion becomes thin and liquid but the things that are thick through crudity or the admixture of a thick Humour such as is vitelline choler in a bastard Tertian are made thin by heating things that attenuate the thickness of the substance and incide the clamminess thus we incide and attenuate viscid and thick Phlegm by Oxymel and Honey of Roses V. When the whole mass of Blood offends in quality we may change it also with external Alteratives Wal. m. m. p 94. Epithems and washings of the hands witness this VI. There are some Practitioners that always alter and never Purge That we may know whether Alteration ought to be made we lay down these Rules 1. All alimentary Humours ought to be alter'd when they abound 2. And the excrementitious Humours 1 which are so mixed with the mass of Blood that they cannot be separated 2 In burning Fevers in the greatest heat and motion of the Blood the vicious Particles are so exactly mixed with the good Blood that they admit of no separation whence it is absurd to intend to Purge in the augment or state of these Fevers 3 When excrementitious Humours so abound that they cannot be drawn out without present danger of life 3. Those excrementitious Humours refuse alteration that are severed from the mass of Blood Idem p. 102. VII Let none trouble himself in vain with thinking as many do who are moved more by Reason than Experience that all Medicines can be taken safely only when the Stomach is empty of Meat seeing I have found the contrary true in many especially as to Medicins that alter and correct the Humors For I have observed a thousand times that Alteratives namely the gentle for such only I would have Physicians to use have been used with greater benefit of the Patient a little before or after Meals yea at them than at other times Nor is reason contrary to this experience for so the vertue of the Medicine does kindly mix and insinuate it self not only into the Saliva in the Stomach but also into the Ternary of Humours that flow together in the small Gut yea int◠all the Blood also and all the other Humours in the right ventricle of the Heart and in all the Arteries and Veins whereby the desired amendment and correction of one or all of them is the sooner Franc. Sylv. Pract. l. 1. c. 34. § 102 more easily and happily performed VIII Thick Humours cannot flow and they are either tough or slimy or dense The sliminess of the Humours is known from the Urine when some white stuff sticks closely to the Chamber-Pot The thickness of the Humours is corrected by acid and hot things whence in many Fevers all we give is to no purpose unless we mix hot things therewith Yea it may chance that when a Physician has not been able to cure a long Tertian prescribing to his Patient nothing but tedious cooling Apozems an old Woman coming bids him take a draught of Wine to comfort himself Walaeus m. m. p. 104. and the Patient is recovered IX Preparation is always necessary before purging except in two cases 1. if the matter be turgid 2. if it be thin such as is the cholerick and serous which easily yield to any attracting Remedy But it is questioned whether thin Humors be to be prepared that is incrassated for the Humours cannot be evacuated unless they be concocted but concoction incrassates as Aristotle 4. met teacheth Concoction says Avicen is a certain adequation and reduction to mediocrity if therefore thin Humours be to be concocted they are to be reduced to mediocrity and therefore to be incrassated Besides thin Humours easily elude the vertue of the Medicine which working by compressing the Vessels thin Humours will be apt to escape But on the contrary thinness of the Humours is requisite for evacuation for thin Humours pass out of their own accord and resist not attracting Medicines as Galen teacheth 3. progn 23. and in other places We must say that
by the fault of the too thick matter than from weakness of the faculty I think it most adviseable to use Purgers Wherefore if flatus be generated in the Stomach or other part through weakness Mercat de Ind. Med. l. 1. c. 6. I think it safer to use strengthners and discussers than Purgers LI. The ingenious diligence of some hath invented a conjunction of Narcoticks with Catharticks for though it be confessed by all according to Galen's opinion that sleep stays all evacuations except those of sweat and the Seed and that Narcoticks hinder the operation of Purgers and therefore are a present Remedy for an hypercatharsis yet it is found out by experience that after a gentle sleep caused by a Narcotick the innate heat beeing collected in that time there follows a most successful exclusion of Humours by vertue of the Cathartick joyned with the Narcotick Alex. Dâ—od Valetud 17 ¶ In a vehement pain of the Stomach Aelidaeus in Forestus mixes purgers with Narcoticks that the pain may both be allayed and the offending matter withal expelled Take of Diaphoenic half an ounce Philonium Romanum two scruples with the water or decoction of Chamomel make a potion Also in the Colick Riverius prax l. 10. c. 10. prescribes this Take of the best Aloes a drachm of Laudanium Opiat four grains of Diagridium six grains mix them and make pills to be given at a convenient hour they allay the pain in an hour and afterwards evacuate the Humours LII A Sudorisico-cathartick Diet-drink is a decoction that provokes sweat and withal evacuates by stool It is an invention of Modern Physicians and hardly used a few years ago yet not invented without the hope of very great benefit seeing by the help hereof the thinner part of the Humours being resolved by sweat the thicker that remain which otherwise use to restagnate stubbornly in the Belly and other parts P. Morellus Meth. praescr fâ—rm rem s ct 1. c 13. See a List â—f Appr vers in Velsâ—hâ—us 's Sylloge obs 84. are by this means profitably eradicated withal Nor need any exclaim against divers and contrary motions for the natural heat that is the instrument of the excretive faculty together with the expulsive bears it self indifferently to all motion or situation and when the Medicine twitches or draws rises up to the expulsion of the morbifick matter by all the ways that are open as experience confirms LIII Some deny that Lenitives ought to be mixt with Purgers for instance Cassia with Agarick because Lenitives are toto genere less powerful than Purgers and of a slower operation therefore some first give Lenitives alone and then Purgers by themselves namely with such a distance of time betwixt as they think may bring them to work at the same time But they are deceived For those Medicines that are only Lenients seeing they do not purge but by their slipperiness and glibness carry down the Humours have no proper time of operation but if there be any other thing joined with them that may excite the Belly quickly to excretion Emollients pass by speedily if not slowly therefore being mixt with Purgers according to the vertue of these they will pass through quicker or slower and they will go before softning the ways and by their slipperiness gently drain forth what the Purgers shall attract Valles cont l. 9. c. 4. which was the only benefit that was expected from the mixing of these together LIV. Purging is hindred either because the Medicine is not dissolved because of its solidity or because the natural heat especially of the Stomach is so weak as not to put it into act or from the same weakness the expulsive faculty is not strong enough to move the Humours Hence is a reason gathered why Elective purgers that are strong and given in a large dose sometimes purge less than those that are weaker for the stronger the Medicine is the stronger it requires the Natural heat to be whereby it may be deduced into act There is another reason why many Purgers and given in a large dose sometimes work less than a few namely because they are overwhelmed by the multitude of Correctors and Alteratives that are mixed with them for every menstruum designed for extraction draws out as much as it can and so it ought to be proportioned and specifick with respect to the matter to be drawn forth So that though for instance you infuse a whole ounce of Senna adding many Correctives and Alteratives you will have a less effect than if you drunk an infusion of two drachms only in wine Hoefer Hert. Med. l. 8. c. 2. understand this of infusions and extracts for nothing acts beyond the bound of its activity LV. A late way has been invented by some Moderns of injecting Purgers into the larger Veins and communicating them to the Heart and whole Body by means of the circulation P.I. Sachs hath given us the experiment and manner of administration in his Oceanus Microcosmicus through a pipe made of Larks bones the one end fitted to an oxes Bladder the other inserted into the vena mediana or some fair Vein of the Foot is a purging liquor poured in by squeezing the Bladder when the liquor is injected the hole is stopped thus the liquor is communicated to the Heart and a purgation follows in a little time LVI Bertrandus Rezius in Sâ—ler c. 129. transfused into his Wise the force and vertue of a Medicine with his Seed I remember that the same happen'd to a Noble Man at Orleance in France who lying with the Wench that brought him some gruel an hour after he had taken Physick insinuated inâ—o her the efficacy of the Medicine so that she was purged violently ten times upwards and downwards 1. Dan. Horst obs Anat. 10. LVII Purgations as they are sometimes necessary so where they are frequent they bring danger f r by them the Body is used not to be nourished and for this reason it will be infirm seeing infirmity is most obnoxious to all Diseases Celsus l. 1. c. 3. Besides these things which Celsus writeth Purgers drain moiâ—â—uâ—e from the Body whereby the Body is wasted and old age is hastenâ—d and the Belly also becomes costive through dryness Wherefore Galen 3. aphor 15. If any one fearing lest many excrements should be heaped up in his Body do use Purging twice or at least once a Month besides that he will bring his Body to an evil custom he will also weaken it c. And Avicen l. 1. f. 3. doct 2. c. 1. Physick purgeth and inveterates Which is chiefly true of the stronger Medicines that they used in that age and that many use in ours whilest they take Antimony c. Nor signifies it any thing what some say that they take only a few grains Because seeing it is necessary that the Medicine be such as to overcome the inward heat and not to be overcome by it for then it would not purge it is
violence But being taken with an Apoplexy a few hours after she died Her Body being opened there were hardly to be seen four ounces of Blood remaining So that it is hardly consonant to reason that from so small a quantity of Blood so strong and frequent impressions should be made upon the inner Nervous coats of the Heart and Arteries as to put these Vessels upon driving the Blood about so rapidly And therefore it is very likely that the Heart and Vessels themselves impelled the Blood the Blood it self not concurring thereto We may likewise infer that from the vehemence of some passions of the mind joy anger c. the Channels of the Blood do of themselves promote its motion because the lucid and sense-causing Spirits being moved more than usual do rush more vehemently out of the Brain into the Nervous Channels those perhaps especially that send branches into the Heart and the Vessels that spring from that Bowel whereby it comes to pass that the constrictions of the heart become more frequent and vehement Gautier medic Nivortensis in Merc. am an 1681. In such a case as this it were rashness and imprudence to fly to Venesection and to order it as often as we would do in inflammatory diseases XIII Because the Blood that is poured out at the Nose appears florid and saturated with a splendid redness it is commonly believed to be more pure and sincere than the rest The reason given is because it is poured forth by very slender Vessels which 't is said admit not the thicker Blood But the whole Mass of Blood together with all the humours it consists of is percolated at least in the Liver as all agree which the Physicians that defend the old Hypothesis ought to have noted who likewise teach that the thicker Blood is evacuated by the Hemorrhoids and issues out of the Capillary Vessels If they say that those small Vessels are widened by the turgent and more vehemently fermenting Blood why say they not the same of the Vessels of the Nostrils Besides that Blood which flows out of the Hemorrhoids is sometimes no less bright and red than that which runs out of the Nose Therefore neither the saturate redness of the Blood nor the smalness of the Vessels out of which it issues evince that that Blood is purer than the rest We shall easily find a reason of its deep redness if we observe what happens to the Blood as to its colour as it flows out in this or that manner out of these or those Vessels The Blood that flows out of an Artery being cut is caeteris paribus more bright and red than that which flows out of a Vein Likewise the Blood from whencesoever it flow that destils out by drops is redder than that which issues forth in a full stream by a large Orifice Blood let forth into a broad Bason looks very red If the same be received out of the same Vein into a narrow and deep Vessel it inclines more to black Lastly If the Blood that is let out of its Vessels be received in a cold place it becomes more ruddy if in an hot one more black Thus the Blood that flows out of the internal Hemorrhoids if it be retained in the streight Gut looks more black but more red if it issue forth presently unless some special cause hinder From these things it is evidently gathered that the Blood when it is suddenly cooled becomes more red when it cools by degrees or leisurely it is more black Now it cools the sooner when it issues out but in a small quantity because a little is less able to resist the ambient air than much is It is sooner cooled when it is received in a large or wide Vessel than when in a narrow and deep From these the rest appear Therefore the reason why the Blood that flows out of the Nose looks more red is not because it is purer but because it is suddenly cooled What the quickness or slowness of cooling can do towards variety of colours we may observe in Steel when it is temper'd for if a bar of Steel that is red hot be moved very swiftly through the cold Air it puts on a reddish colour if not so swiftly a colour that inclines to yellow if yet less swiftly it looks blue if very slowly it receives the natural colour of Steel For like as Bodies that are very hot are cooled quicker or slower are the insensible particles of which they consist disposed on this or that manner and they diversly modifie the light which they reflect in which modification does their colour consist Not only the quickness of cooling makes the Blood of a more saturate colour but also the motion of the particles of the Air which by licking as it were the surface of the Blood and depressing the particles that jet out make it more smooth dense and slick and so makes its redness more bright through the greater reflexion of the light Thus Red wood looks redder when it is smoothed and polished by some convenient instrument From the same cause the Blood that was blackish in the top of the Vessel if it be exposed to the Air acquires a more saturate and splendid colour namely because it s dispersed and eminent particles are depressed and compressed into a dense skin which reflects more light than the same Blood when its particles were loose and less cohering because then a great deal of the light did penetrate into the interstices of the parts Fr. Bayle probl med 2. and was not reflected at all and the rest falling upon soft parts was reflected but weakly XIV From the precedent problem it is easily understood that a sudden mutation from heat to cold and the appulse of the Air are the cause of the redness where the Blood that is poured forth shineth Hence it follows that as often as the Blood is red it has undergone the greater and more sudden change which happens two ways either because the Blood is hotter or because the ambient Air is colder Wherefore in an equal temper of the ambient Air other things being also alike a notable redness of the Blood is a sign of its notable heat therefore a florid redness of the Blood is not a certain token of malignity Yet if horrible Symptoms accompany a Fever such as none but a notable putrefaction can produce and yet a putrefaction of the Blood cannot be deduced from its colour those grievous Symptoms are to be referred to some malignity Idem XV. To prove that the Elements of the Blood are the four vulgar humours to wit Blood so called in specie Choler Melancholy and Phlegm some take an argument from the variety of colours in the different parts of the Blood when it is cold in a Poringer for they affirm that that which is florid in the uppermost part is choler which because it is fiery gets a top through its lightness that which is next under this is Blood
the part affected Whence Galen 6. aph 36. has noted that our great Master used always to let Blood out of the Arms for diseases above the Liver but for those below out of the Legs and Ankles a reason whereof is given by Celsus l. 2. c. 9. Nor am I ignorant says he that some say that Blood is to be let at the greatest distance from the part affected for so the course of the matter is averted and that which already oppresses the part is called forth But this is false for Bleeding first exhausts the nearest part and the Blood therefore follows from the remoter parts because it is first let forth of the nearest but as soon as it is stopt it comes no longer from afar because it is drawn Hippocrates has confirmed that same precept lib. de loc Sect. 2. v. 285. where speaking of all evacuation he says But diseases are to be drawn forth by that part which they are nearest to or by the nearest outlet Which at length he hath more particularly expressed even in the evacuation that is made by Medicins Pains above the Midriff that need purgation intimate that they should be purged by Vomit but those below by Stool But for prevention of those diseases that have been used to invade often Hippocrates's opinion is that Blood should be let at the greatest distance from the part affected Of which he gives a double reason namely 1. Lest there be a great change made on the suddain in that part which is used to be ill For by such change the humours being for the most part moved and the part it self further weakned fluxions towards it are excited whence the accustomed Diseases are raised Which Precept many Gouty Persons not observing whilst they will Bleed or Purge for prevention they often raise those pains that were quiet 2. Another reason is that by Venesection made in distant parts the custom may be removed by which the humours used upon any occasion to flow upon the part accustomed to be affected By which it is clear that the Revulsion which is made from the remotest parts is not good in the Cure of present Diseases unless one would stop Symptomatical evacuations Pr. Martian comm in cit loc pag. 17. for then Revulsion is to be made accoâ—rding to the advice of Hippocrates 6. Epid. 2. 5â— We must revel if the humours run whither they should not ¶ The several kinds of Revuâ—sion profit and gratifie diversly For to Revel to the Origin is usual in those Diseases which rise from some peculiar Member Traction to distant parts is good for those which are fed by the whole Body But Tractions to contrary Parts are profitable for both Namely to a part that is Contrary to that from which and to which the matter flows Mercat de ind med l. 1. c. 4. where it is discoursed more at large of revulsive and derivative Bleeding And moreover it has this use peculiar to it self that it is most beneficial for prevention Nature as I said being called off to that part which is contrary to that to which she inclined Nor matters it that the same Veins are to be opened both in prevention and Cure seeing this Revulsion is owing to the motion and custom of the humours rather than to the Disease and Humour XXV Some make the Kidneys the Centre of the Body as to its length but this is better referred to the Heart Walaeus p. 81. It is better to Bleed on the same side with the part affected the Reason is in the Arteries not in the Veins XXVI If the Blood be observed not to Circulate as it should do by the Pulse's not being full enough but little and from anhelous Respiration I think bleeding altogether necessary And these two indications that are taken from the Pulse and Respiration I would recommend to the diligent observation of every one seeing they are of great Consideration in many Diseases as to Bleeding I say a little and an oppressed Pulse yet soft as also a laborious and anhelous respiration are the chief signs and indications of the Blood 's stagnating about the Ventricles of the Heart and threatning danger of suffocation Sylv. de lo Boe prax l. 2. c. 22. §. 73. XXVII Hippocrates's Precept Aph. 22.1 of purging in a turgency of matter is not observed in ordinary practice but when there appears an Orgasm of the humours we rather fly to bleeding as more safe and so we the more easily prevent the moved humours from rushing into some Noble part River pract l. 17. c. 1. which if they were more exagitated by a Purge might be the more readily precipitated into it ¶ We may gather from Galen that bleeding may be allowed in a turgency of the humours Which that it may be understood I premise these things 1. That the turgent humours are not always Cholerick but sometimes Sanguineous Blood here being taken for a fervent humour resembling Choler And such Bloud is Turgent because it is moved very quickly and easily so that I believe acute Diseases arise from it as they do also from pure Choler Whence many dangers threaten because it may very easily run into the Principal Parts 2. I premise that in a Turgency of the humours there may also concur sometimes other Reasons for Bleeding as some fault in the Sanguineous matter the greatness of the Disease the Strength of the faculties and a Youthful Age. 3. But if purging be compared with Bleeding in a Turgency of the humours the former doubtless is more to the purpose and more profitable but the latter is safer And because according to Hippocrates 1. Epid. a Physician ought to endeavour so to profit as that he may do no harm withal therefore Bleeding may be sometimes used in the room of Purging If you object That Purging draws only bad humours but Bleeding all so that one cannot be substituted for the other I Answer 1. that Turgent humours that are different from the nature of Blood are also evacuated by Bleeding as being in motion 2. That Bleeding is not always substituted but only sometimes If you object again That where Bilious humours are turgent and such as differ from Blood the Blood it self does not offend and therefore it is not proper to substitute Bleeding I Answer That in such a turgency of humours Bleeding is not to be substituted indiscriminately but only where there is a most vehement Fever which rather requires a friendly Venesection than offensive Purgers which are hot and apt to induce a Fever Now that a violent Fever requires rather Bleeding than Purging is not doubted Whence I draw these conclusions 1. If the humours be mixed with the Blood without doubt Bleeding is proper as appears by the faultiness of the Blood that is let forth 2. If the turgent humours be different from the nature of Blood but there be present an high Fever strength of the faculties a youthful Age I approve of Bleeding and so
very crooked towards the point Sever. Med. Eff p. 67. I use daily to practise this Piece of Surgery both ways XCI If the Orifice in Venesection be too strait it must be widened as in stoppage or constipation that must be removed which stops or constipates But to amend the straitness there is greater skill and pains requisite than if the Vein had not at all been medled with because the Blood is presently diffused betwixt the Skin and the Vein and driving the Skin higher separates it from the Vein Assoon therefore as the Skin about the Orifice rises into a Tumour it must presently be gently pressed by your left Thumb that the violence of the running Blood may be mitigated and the rising Tumour depressed then draw off your Thumb gently so far as till the Orifice appear and you have room enough for the Launcet and the hand you hold it in then put the Launcet gently and warily into the first Orifice which make as wide as it ought to be But in this operation we must take heed that the Skin alone which is usual be not widened without the Vein for then both the pains and pain would be to no purpose Put the Launcet therefore moderately into the capacity of the Vessel it self and enlarge the Wound as much as is sufficient If the efflux of the Blood be hindred from the recourse of the Skin it is gently to be drawn back to the same place in which it was when the Vein was cut that the division of it and of the Vein may hit together and it is to be held there till the Blood have issued out as you desire Leon. Botal de §. 11. ¶ But it happens also that the Skin or rather all that which lies above the Vein sometimes covers the orifice in the Vein when yet the same was not removed out of its place and that happens when the Surgeon thrusts his Launcet over slopingly into a vain that lies deep and lifts not up its point but draws it out again the same way he thrust it in In this case to make the Blood flow if the Vein be cut wide enough the Skin is to be raised up by putting a slender probe or the head of a pin under it or the Vein is to be lightly deprest with the same probe or pin till the Blood shall have flowed out to your liking for by this means the vein being thrust from the Skin or the Skin raised from the Vein the Blood gains a passage Idem §. 12. XCII When a fillet is tyed about any member and the Vein that uses to be found in that part does not appear but something that is round is felt deep under the Skin of which you doubt whether it be a vain or not presently loosen the fillet and if it be a Vein it also growing lax will fall down and be no longer perceived by your finger till you bind the member again but if when the fillet is loosened that which you touched feels as it did before when it was tyed then use not your Launce◠for it is not a Vein but a tendon or the Head of a muscle or something beside a Vein And the Arteries beat where they are whereby both their situation and depth become manifest to even a meanly experienc'd Artist Idem §. 19. XCIII Patients often ask what Vein of the Arm they should have opened because they have heard something of the distribution of the Veins in the Arm one of which they allot to the Head another to the Liver a third they make doubtful profitable to both the cavities Belly and Head Physicians introduced this opinion before Anatomy was so well cultivated as now it is and many adhere to it still But it is certain seeing all the Veins of the Arm spring forth of the same Branch that they evacuate from the same parts And that which is allotted to the Head empties no less from the Liver than that which is called Basilica though the Cephalica because sometimes it receives a little Branch from the Head is believed to profit more in the Diseases thereof yet both do equally help the Diseases of the internal viscera and do equally withdraw Blood out of the Vena cava and 't is to no purpose to pitch upon one more than another for they all draw Blood from the same fountain Of this opinion are Vesalius Anatom l. 3. c. 8. Bauhin in Theatro Fallopius Bartholin Horstius tract de Scorbuto and others Primiros de vulg err l. 4. c. 26. ¶ If the rule of late dogmata be consulted the circular motion of the Blood takes away the choice of Veins there is no prerogative of order amongst them all the Veins enjoy a common fate The Blood always ascends by the trunk of the Vena cava and changes not its course upon the opening of the Veins of Arm or Foot but that which flows out issues from that part of the opened Vein that is below the orifice that is made in it and that Veins's twigs in the extremities of the Hands and Foot do again receive the Arterial Blood Therefore the parts affected are not emptied directly No fruit can directly be expected from the opening of a Vein in the Arm or Foot viz. of the Cephalica in Diseases of the Head though it be joyned by a particular Branch with the external Jugular or of the Basilica in Diseases of the Breast as the Pleurisie though the same be joyned to the Thoracica in the Arm-pits Rolfinc c. 15. l. de febr ¶ 'T is all one which Vein you open so it be plain yet this caution should be used That if the lower parts be ill a lower Vein be opened if the upper an upper The Kidneys they otherwise place for the center of the Body as to its longitude but this is better referr'd to the Heart Walaeui m. m. p. 80. Bleeding on the same side with the part affected is better than on the opposite the cause lies in the Arteries not in the Veins XCIV Hippocrates 5. aph 68. propounds the opening of the fore-head Vein but the Body is to be diligently purged first otherwise it may become hurtful seeing it is a local Remedy A man of thirty years old being troubled with a long Head-ach and Epileptick fits by the advice of a Barbar suffered himself to be let Blood in that Branch of the Vein of the fore-head which in some bends a little to the left side without any preceding preparation of the Body But what came of it His eye in that very moment lost its motion and became fixt unmoveable and shut an Inflammation arose in it the pain in his head increased Hild. Cent. 5. obs 18. and at length losing his speech he was with great difficulty recovered by the Physicians of Basil XCV The Ischiadick Vein which is found in the outer ankle ought not to be cut but with the strictest and fullest knowledge of
because no Passion is made by what one is accustomed to Hence those erre who in laying on Cerecloths say that they are to be kept so long upon the Part as till they fall off of their own accord Besides they are of a contrary opinion to Galen and Avicen who unanimously say that neither internal nor external Medicines are to be rendred customary to Nature XI 'T is a great errour when malactick Plasters are made of Galbanum Ammoniacum Opopanax Rosin and the like and are diluted with much Vinegar for so they attenuate incide Hollerius discuss and not mollifie XII The use of Fomentations is sufficiently famous amongst Topicks which are made of some Liquor or Decoction of many Simples which several include in a Bladder but the same are made unprofitable by that means for the vertue of the Simples passes not through the Bladder into the Body but the heat only operates whence if some part be only to be heated such Fomentation does good let the Liquor that is included be what it will as also for easing Pain and digesting Humours But if obstructions be to be dissolved Primiros de vulg err l. 4. c. 46. or something be to be mollified 't is better to use either linen or wollen cloths XIII Anointings that are very oily do obstruct and stuff the Pores unless a little spirit of Wine be added or before the anointing rub the Part with a Squill newly cut through the middle to make the Medicines penetrate the better Fortis XIV A Person falling out of his Chariot divers Accidents superven'd such as use to befall Persons bruised and amongst them the motion of his Arm was much impaired For fear he should quite lose the use of it his Spine is anointed with strong Ointments and hot Plasters are also applied upon which he fell into a Fever from which yet he is soon freed by leaving off those Topicks He said he perceived the heat very sensibly to proceed from the Medicines namely in the great Vessels that run that way After some Weeks they fall again to Topicks and the Fever returns again whence 't was thought fit to abstain from those stronger and to use an appropriate Water Phil. Salmuth Cent. 1. Obs 79. by which he was cured XV. This is to be esteemed for a most certain Proposition That never any Powder is to be sprinkled upon any Part unless it be first anointed or wet with some clammy Liquor that the Powder may be made to stick on except in the Head where the Hairs sufficiently retain the Powder that is sprinkled amongst them Thus for Bruises of the Limbs we use astringent Powders in the beginning to hinder a Fluxion and those not only in the bruised Part but in the neighbouring Parts also but first of all we anoint the Part with some astringent Oil as the Oil of Roses Myrtles Quinces c. Pouders may also be kept on if the white of an Egg strongly beaten be smeared over the Part. Rondelet p. m. 977. XVI The use of the cutaneous Veins comes all to this that what Blood remains over and above the nutrition of the skin and subjacent Parts may be carried back by them to the larger branches and trunk of the Cava Hereby the vertue of Topicks applied to the Wrists transmitting their Particles and Atoms through the Pores of the skin may be communicated to the Blood yea to the Heart it self Some Veins have that great vertue and power that they can communicate to the Heart the deadly poison of things laid to the skin by stealth though never so slightly Rolfinc dissert Anat. p. 1034. This poison is carried to the Heart by the Veins which carry back the Blood to the Heart ¶ Those Physicians are not to be heeded as being more subtil than skilful who reject the use of all Ointments Plasters and Liniments because it does not seem probable to them that fat and oily things can penetrate through the Skin Fat Membranes and Muscles of the Abdomen that encompass the contents But though this seem improbable or at least difficult yet daily experience witnesseth that internal Diseases of the Abdomen or Belly are daily cured only by the use of Ointments and Liniments Now though the laudable effect of Oils and oleous things may suffice to prove their penetration through the skin and other parts yet the ways also may be determin'd by which oily things may penetrate even to the inner Parts of the Belly namely the Pores of the skin from which there is a passage to the Vessels and consequently to the Heart For seeing all the Parts of the Body are made up of various Particles like natural Minima and therefore of Atoms joyned and wrought together it is not probable seeing they are diversly shaped that they are so exactly fitted to one another but that there is every where a passage through them for fluid Bodies and especially for such as are volatil which Hippocrates also observed when he pronounced the whole Body to be pervious and any one may observe that views either the Bones Gristles or other Parts and notes them to be porous especially when he considers the same with magnifying-glasses and compares them with things made by Art linen or wollen Cloths which though never so close yet are pervious withal for he will acknowledge and conclude that there are every where Pores Sylv. de le Boë Prax. l. 3. c. 3. §. 105. sometimes larger sometimes straiter in all natural things XVII Many are often deceived in outward Alteratives as Ointments Plasters Cataplasms c. whilst they let them lie longer than they should upon the parts affected and see not that custom makes Topicks like to the heat of the parts and when they are made like have no further power to alter And the reason is most manifest because all Alteratives alter only so long as they are unlike Hence Galen 3. de temp says that when Lettuce is assimilated it does not cool Aristotle 1. Sect. Probl. 46. being to shew why custom takes away the vertue of Alteratives asks why Cataplasms ought to be changed To which he answers As those things which we commit to the Stomach if they be Medicines in tract of time are no longer Medicines but Aliments in like manner Cataplasms that one has been long us'd to do not do their office What the Philosopher says of a Cataplasm Sanctor m. V. E. l. 4. c. 13. is to be understood of all Alteratives inward and outward XVIII Let Refrigeraters be moderate endued with that faculty rather in power than in act for things that are actually cold do condense the Pores incrassate the Humours and fix the Blood in the inflamed part Rhases used the clarified juice of Endive Fortis consult 86. Cent. 2. which we also may give to four Ounces in a Decoction of Mallows Violets and Barley XIX Though Oils made by infusion may seem by their unctuousness to obstruct the