act contrary to the rules of nature and have unnatural effects The one again being either alimentary proper for life and growth of the body the other excrementitious more proper for cleansing its sinks and channels As the Humour is so also is generally seen its Colour for as Blood is of a pure florid rosy colour so doth it give colour to the Muscles It is this that graceth the cheeks by affording them a a share of its redness and as it is made of Chyle and Blood so also doth it send forth its white and red and by how much the red exceedeth the white by so much are the Muscles more red than the Skin Choller is citrine and yellow thin and griping and as the four Humours do work man into a good humour so this burneth him into a passion it gives a lively paint of its colour in the Jaundies Flegm is white and washy and so are they that have too much of it being very cold and subject to Oedematous Tumours Dropsies and Agues Melancholy is black and masketh the whole body with an Ashy colour this is long and tedious in executing its office it being the most heavy an dsad part of the blood but at length bringeth forth the terrifying Scrophula Corroding Cancer Scirrhous Tumours Quartane Agues and the like and we daily find when it hath hatched them up to any growth it is very long if ever before it be made to part with them Besides these there are two others one a serous Humour which serveth as a vehicle to the blood ordered by nature for thinning it that it may pass to its smallest capillary vessels Part of this is sucked up by the kidneys where having made a short stay it maketh its further progress into the bladder and there remains whilst it be loaded the which being therewith filled is let out as useless and unprofitable Besides these comes Wind taking its circuits and turns and in our bodies is occasioned and bred by ill digestions crudities and wind the former making watery Tumours whilst this maketh slatuous Tumours But that we may well understand the foundation of these Humours let us examine from whence they are bred and whence they come 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or Blood as it is the cheifest and of the greatest service for life so ought this to take the preheminency in our discourse It is made from the temperate part of chyle in the stomack sent through the small guts into the milky vessels in the mesentery whereby nature hath ordained it a Receptaculum commune being here planted by Divine Providence as a bag for reserve for the most part full from whence passeth this chyle along the great Artery just by it untill it reacheth the Subclavian vein from thence it marcheth into the right ventricle of the heart by the vena cava and from hence is carried into the left ventricle of the heart by the Arteria venosa from the lungs and is there elaborated and made pure blood sweet of taste and florid in colour mild and benign This sanguification is a similar action and performed by assimulation and therefore taketh this chyle aforesaid as its subject matter for this assimulation and as they dewell together so do they assimulate together and this is done by process of time never passing to the liver as the Ancients dreamed for the chyle seldom or never reacheth it This blood as the vital liquor is sent through the whole body by its veins and arteries as its proper trunks and channels And although at its first appearance it sheweth it self pure and free yet hath it alwaies these three Humours adjoined to it as three several substances as Choller Flegm and Melancholy distinguishable one from another not only in taste sapour or colour but also in their effects for as Galen observeth lib. de natur homin the melancholy humour is acid choller bitter blood sweet and flegm having little or no tast and out of those being benign and pure is bred Scirrhus Erisipelas Phlegmon Oedema It is hot and moist which are the two species of its natural and unnatural temper and as Gal. lib. de Atra bile cap. 2. it is of a very red colour in its humour and is made of the best of juices and so bred from the best of tempers made by a temperate heat and those are its natural tempers As of its unnatural its proper substance is changed as its thinner part converted into Choller as Gal. 2. de Differ where he saith the thinner part is converted into yellow choller whilst the thicker turneth into melancholy Next to this is choller called by the greeks 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 it being a humour hot bred out of the thinner and hotter part of the chyle and blood It hath but few spirits somewhat of Sulphure in it most of Salt and Earth It s parvity of spirits are evident in that it is of its own nature bitter neither hath it in it any great quantity of Sulphure for if we view its masse carefully it being neither Oleaginous or pingued neither doth it soon take fire yet it taketh Sulphure in it being principally exalted by adustion whence it bred this bitterness and although its salt excelleth in quantity yet doth it not gain preheminence It s flegmatick watery substance doth enlarge its liquid faculty its earthly parts thickeneth it and gives it the body it bears its heats and driness are sufficient signs of its being an enemy to the radical moisture and so unfit for nutriment that it is declared by all to be excrementitious This heat is the manifest cause of its bitterness made by a perpetual digestion of the blood thus milk unless oft times stirred in its boiling soon burneth and turneth bitter and as from heat and motion do colours change from white into red as Quinces being pale by boiling gain a red colour and chyle turned into blood by circulation and heat so also choller is as readily discharged of its first taste by adustion and perpetual digestion As to its uses Aristotle will grant it no waies useful Coryngius and some others do as much cry up its value offering that it serveth to warm the liver and to help digestion Helmontius calls it the balsom of the blood deduced from the liver to the mesentery but this is contrary to Anatomy for Anatomy teacheth that this humour is carried out from the liver not brought into it but onely sucked up by the Parenchyma thereof as through a strayner Others there are also as Zerbus amongst the rest that offer that if the bladder or gall be removed from the liver the substance of the liver would soon be dissolved and melted And to conclude this it s most proper use is to render the excrements fluxile The third is Flegm by the Greeks called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and this also is of two sorts natural and not natural The natural humour is cold moist crude in substance white in
understand their diversity of times Hence also are we to consider the largness or smalness of a Tumour and its species without the knowledg of which we cannot be said to understand the curative method its causes which are conjunct with the disease the circumjacent parts and the symptoms which do follow either from the nature or cause thereof and lastly the signs And when we have thus far arrived we are to consider the four great Tumours in general as Phlegmon it being as our first to treat of it proceeding of blood the Son of nature generated for the treasure of life Secondly of Erysipelas arising from choller the fury of the gall Thirdly of Oedema coming from Flegm the proper instruments of the joynts Fourthly of a Scirrnus bred of Melancholy the lumpy and terrene masse of the rest Of every of these are bred various Tumours according to their various shapes and changes but of these in their proper places CHAP. V. Of the Vniversal way of curing Tumours HE that will undertake the curing of Tumours ought well to understand his curative scopes and intentions and the well timing of Tumours is a very great matter here And here may we expect a Tumour either already made or in its making And hence ariseth a double intention the one prohibiting Fluxion whilst the other cure is wrought by discharging the matter already flown because removing of causes do hinder Fluxion If this happen from Plethory breathing of a vein is very proper whilst in a cachochymick body purging is as useful When a Tumour doth proceed from Fluxion we are to begin our cure from the matter flowing and hence cometh our first intention and this is performed by Repellers Revellers and Interceptives save onely in these seven cases set down as our seven cautions by Galen First when the matter doth flow to the Emunctories or glandulous parts secondly when a venenate matter floweth for this sends it more inwards and so poysoneth the heart Thirdly when this matter floweth Critically not crossing Nature in her own way Fourthly when Fluxion is excited in a Cacochymick body Fifthly when the part to which this matter maketh its Flux is weak and its heat but mean Sixthly when there is vehement pain for here is more need of anodynes and then seventhly when this Fluxion is near some principal part And as touching these curative scopes we are first to probihit its Origination and by this means to hinder its augment secondly to understand the quality of such things as are to be applied for as Galen saith 13 Method 16. we do destroy the breed of a Tumour if we well understand its cause and this being ablated the Tumour is soon seen to vanish Fluxion and congestion are the two cheif causes of Tumours the first offending either in Quantity or Quality and so with violence doth seize suddainly upon any member either by reason of its loosness or weakness Congestion being when a Humour is gathered into a part gradatim by reason of this weakness of the digestive and expulsive faculties CHAP. VI. Of Phlebotomy its manner of Operation and where it is most properly performed IN this Discourse we have many things do offer themselves to our consideration As when there is a fulness Evacuation is in use and here is to be let out as much as is necessary If there be a Plethory Quoad vires here it is to be repeated And as touching the part which is to have the lancet exercised on it whether from above or below this also is to be minded and regarded because Derivation which Evacuation from the adjacent part doth not agrees in the beginning of the cure because this would make the Fluxion larger and the Attraction to the part affected greater And if we will make Revulsion aright we ought well to understand the place of Fluxion that we may happily revell in the opposite part Thus if the right kidney be hurt we open a vein in the left arm in Tumours of the groin vena Poplitis And if any may question our meaning between the upper and lower parts Galen himself giveth them this answer All the parts above the navel including the Liver and Stomack are called the upper parts and thus have we one part of the vena Cava called the ascendent Trunk the other below these are properly called the lower parts This knotty difference between Repulsion Revulsion and Derivation is not very easily untied I shall thus endeavour to loosen it Fluxion arising from Expulsion showeth expulsion if it followeth from the quantity of matter this is either to be revoked or evacuated and hence ariseth this twofold intention Revultion and Evacuation This being out another thing is to be observed the matter that slows hath three places one from whence it floweth the second whither and this is to the part affected and thirdly through what parts before it arrives hither These being found out we are to consider how to discharge this matter and thereby prevent its further spreading secondly we are to prevent the Fluent matter which hath got passage into the channels that it flow not to the part affected and so run this also into a Tumour And the well consideration of these may well make us use study where and when to make this Revulsion and where to make evacuation And in both of these we are to observe Hippocrates Rule that all be done secundum rectitudinem and this is to be performed two waies as by comparing the left with the left and the right with the right for with these there is held a proper consent Thus the Liver vein hath a rectitude with those veins which ascend up to the head Thus upon an immoderate Flux at the right nostril by applying a cupping glass to the Region of the Liver the Flux doth suddenly stop if the left by applying one to the spleen doth work and perform the same effects Galen hath also two species of Revulsion the one from the upper parts to the lower from the right to the left the second not so exact which we use when the matter is much and threatens danger Galen also in diseases of the upper parts doth revel by opening the upper veins as in Tumours of the head he doth order the Cephalick vein to be opened and Falloppius saith in a Squinancy he hath breathed the left arm and the Humour presently vanished and in some cases this is very proper In Tumours of the Axillaries being venenate if we should open the lower veins we must consequently draw its venome inwards to the heart and vice versa if we should open the upper veins in a pestilential Bubo we may well make a free passage for the pestiferous matter to make its address to the heart which is not onely a great fault in the Chirurgion but also as unhappy to the Patient And thus have I shown some of its benefits I now come to teach the young Chirurgion how he is to use his
thereof twice in a day within three daies perfectly recovered CHAP. XXV Of a Cancer AND because this is a Tumour doth happen very frequently in our Art and proves an enemy both very powerful and painful that we may understand the right way of dealing herewith it generally happening in the Brest let us first consider the Brest it self and its parts The Brest according to our Countryman Wharton is said to be framed of a glandulous spongeous Parenchyma not divided into distinct conglobated Glandules but is rather to be accounted a conglomerated Glandule but in a Scirrhus and in a Cancerous Tumour they appear knotty It hath Veins Nerves Arteries and Lymphaducts and a porous Cavity its Veins and Arteries come from the Subclavians it hath its Nerves from the fifth pair and from other Originations Lymphaducts are here very frequently scattered and as touching its Porosities or porous Cavities these do serve for its Excretion or its excretory uses they being more large in the Brest then in the common Ductus which is opened with many small Foramulaes their general use is to prepare the Milk fit for the Infant and for the making this there is held a great controversy some holding the Blood to be the Prima Materia hereof whilst others do contend as stoutly for the Chyle to be its Origination The first is not to be defended for if Chyle be to be made most properly into Blood it may very properly be accounted retrograde for Blood to turn into Chyle And such as do stand up for the Chyle to be the onely substance of the Milk they do offer this as their assertion that the Chyle doth immediatly pass through the Milky vessels into the Brest or that it is there received into the Veins and thence effused through the Thoracick Arteries into the Brests and that they have a power or faculty to separate the Blood from the Chyle and to dispose it through the Mammillary vessels into the Body and this they call Milk but the way or passage which should conduct this to the Lactiferous vessels is not yet arrived at Our worthy Wharton's opinion is that Milk is peculiarly a nervous Juice not properly constituted for the substance of the Milk but also for carrying a double Matter with it as being both Chylisick and Spermatick and these two do breed the greatest part of the Milk not immediatly sent from the Ventricle to the Brests by the Milky vessels but carried by or through the Ductus chyliferus into the Subclavian thence circuled with the Blood through the Ventricles of the Heart and so passeth through the Thoracick Arteries and in time of the Mother giving milk it is refunded into the ample capacity of the Brests and there do separate the Sanguineous part from the Chyle and do reduce it through the Mammary Veins into the Meditullium of the body And this he offereth as the cheif matter or substance of Milk and the most proper nutriment for the Infant And since we daily see the young sucking Babe is nourished by alluring this Milk from its mothers Brest by her Nipple it is very necessary that it should contain in it such a substance as may give it satisfaction And as the more noble part thereof doth come from the Succus nervosus so also ought it most properly to be derived from hence for the Infant 's nutriment but thus much as touching Milk We arrive now to that which nearer concerns our enquiry which is the tract of a Cancer and this by the Greeks is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by us a Cancer from the resemblance it hath with a Sea-Crab For as the one hath expanded claws and feet in several places being of a livid or cinerish colour so also is this Tumour of a round Figure of a livid Colour and sticketh or adhereth so close to the part affected as a Key to a Door or a claw of a Crab in its griping having in it by some reported to carry in it exalted Veins but this is more fabulous then true for not in four of a hundred as Falloppius observes can you see them thus apparent It carrieth with it a train of horrid pain and heat shewing it self to view both cruel and horrible it ariseth from black Choler As Tagaultius supposed it ariseth from the Fecies of Blood but this is onely his opinion for this doth more properly frame and make a Scirrhous Humour and that which to the whole body doth make an Elephantiasis to a private or particular part doth also frame a Cancer and where this black Choler is sharp and hot it maketh an Ulcerate Cancer and by reason of its thick Juice it can neither be repelled or discussed for as it slighteth and contemneth the company or acquaintance of mild Medicines so also doth it like Lard or Oyl turn into a flame rage and fury by the applying of any strong or vehement Medicine The Causes of this Atra bilis are many for first in the Liver is bred this natural melancholick Humour which is called the Fecies of the Blood and hence ariseth a Scirrhus so this Atra bilis is made up of the adustion of the other Humours and without flattery is the worst of all the rest and as it groweth more putrid sharp and malign it doth more speedily violently and painfully create an ulcerated Cancer Sometimes it ariseth from a hot intemperiety of the Liver which burneth it and by this burning is bred Atra bilis Sometimes as Galen saith cap. 10. lib. 2. ad Glaâ—c from weakness and intemperiety of the Spleen it being made incapable to attract this melancholick Humour in so much that it is kept up and burnt up in the body Sometimes it happeneth from a suppression of the Menstrues Outward causes may also affect this as a thick and viscous Diet as Onyons Leeks Beans and the like It may arise in any one part of the Body sometimes it doth throw it self forth into several places but the Brest being a soft loose part is most subject to its Tyranny and receiving the impress of its malitious stamp Sometimes it happeneth in the parts of the Face Nose Lips Mandible and Tongue Sometimes in the Inguens and Thigh a lively example of which I had in a Gentlewoman my Patient in Norwich when I writ this Another reason that a Cancer doth soonest grow acquainted with the Brest before any other part is in respect of the great consent that there is made between the Breast and the Womb by the Veins through which this thick and feculent Blood is sent and dispatched and for the same reason is it that there have been seen so oft times Cancers of the Womb. At its first touch it doth appear hard in respect of its thick Humour it is of a livid Colour and the more malign the Humour is the more livid the Colour of the Tumour is and then painful for here is made
a Dilatation of the Veins in the Testicles conglomerated in manner of Varices and these as Celsus and Paulus write are either the Veins of the Scrotum or those in the Membranes of the Dartos or those which do nourish the Testicle and therefore Celsus adviseth if the Rupture be in the Scrotum you are to apply thin and sharp Instruments to the Veins and with these the Veins are to be cauterized and there to be most cauterized where most variced or twisted The general Curative Method here is the same to that prescribed in curing of a Scirrhus the Intentions here are three to repell the flowing Humour to discharge and dry up that which hath already slowed and to astringe the dilated Vessels Now Astringents do satisfie these two scopes for as being cold and restringent they repell the fluent Humour as being drying they dry it up and by its Astriction do also bind up the dilated Vessels And for this Affect Balaustians Red Roses Pomgranate Rinds Juice of Hypocystus Bol. Armen Dragons Blood Mastich Olibanum Glue Amber and the like these or any or some of these mixed with the White of an Egge and a little Vinegar may very well be used here but if these do no good come to the use of Incision or Caustick and here are we to be very careful in onely cauterizing the parts where they are thus twined or twisted together after which done remove the Eschar then deterge and digest it But if the Veins of the Dartos be tumefied you are to make your Incision in the Groin and the Membrane is to be drawn through there with the Testicle and after this separate the dilated Vessels from the Coat either with your Fingers or a convenient Instrument then tie up the Vessels and cut them off under your Ligature then repose or reduce your Coat and Testicle And if the Rupture be in the Erythrois or Tunica vaginalis and either two be dilated proceed in the same Method as in the Dartos but if it be between the inward Coat and the Testicle it self make your Incision in the Inguen draw out the Vessels amputate the Testicle and cauterize the parts And this is Paulus his Method and Distinction As touching Hernia Humoralis take this brief Description of it It is framed out of a Confusion of many Humours in the Scrotum or between the Coats which enwrap the Testicle Oft times also it is seen to be bred in the proper Substance of the Testicles You are to cure this as you do the former And thus much of Ruptures CHAP. LXIII Of a Venereal Bubo WE arrive now at the Inguens where we may meet with these four following Tumours Bubo Venereus Pestiferus Phyma Phygethlon of each of these in their order These Glandules have their proper names as well as others and hence is it that they are called Bubones by us in England called the Popes eye in veal and mutton They are held to be eight in number and very large There is held to be a great commerce between the Nerves and these Glandules for it is very credible that the Nerves do conveigh somewhat hither as their excrementitious succus and also do send hither any nerveous quality that at any time doth perplex them but they do not unload themselves into these as into their excretory ports but into their adjoyning vessels and hence it is that they are placed at the greater division of the vessels neither is it less probable that they take somewhat from hence as a nutritive juice the which being allured by a similar attraction of the Glandulous substance the Lymphaducts to pour out their Lympha here and by the benefit hereof these Glandules do separate one and leave the other And this is confirmed by their sweetnes and delicacy they having a familiarity with the nutrive Succus And the reason they are so large and numerous is because the Crural Nerves had need to have such large Organes for discharging their superfluities We come now to their Diseases with the Affects these being either simple or not malign Tumours or pestilential or venereal Tumours The Causes of all which may be reduced to two The first being the hindrance of the Circulation of the Blood and hence ariseth a Tumour by reason of the continuity and impetuous afflux of the Blood from the heart through the Arteries and by reason of its making no reflux from these through the Veins An evident example we have hereof in Contusions of the Glandules and in their Obstructions A second common Cause ariseth generally from the Nerves themselves spitting forth their superfluous Humidities being either here vitious in Quantity or Quality now these are 2 common causes Every special Tumour hath its specifick causes differences and thus if these superfluities only err in quantity or quality as in viscidity thicknes or the like it frameth a simple Tumour If from a malign quality there ariseth a Tumour being of the same nature as malign and thus being either venereal or pestilential it occasioneth a venereal or pestilential Tumour We are now to enquire of the efficient causes of this venreal Bubo and this poyson oftimes is communicated to the Liver and hence is sent into the Inguens as its proper Emunctuories and hence ariseth these venereal Buboes The cheif matter of which they are bred is of a part of thick cold and viscid Humours which may wel be perceived by the hardnes whitenes ilnes of pain and colour of the Tumour Sometimes they arise from a hot sharp cholerick Humour with a great pain and a conjunct heat and these make them so oft to run into Ulcers being both virulent corroding As to the cure never-use digestives lest the thinner part being resolved the thicker excrement lyes and encreaseth inwards much less Repellers for these do drive the virulent matter inward and therefore Attractives and Suppuratives here only do take best place The Tumour being made ripe open it with a potential Cautery As touching the cure of the whole body neither purge bleed or keep any order of dyet Make your orifice not very large but so as you may lodge in it a pretty handsome large Tent for discharge of this peccant Matter you may keep it open for 20 or 30 dayes according to the greater or lesser quantity of Matter This being discharged we may both prescribe purging bleeding and a good order of dyet It being discharged cleanse it well fill up with flesh and skin it And thus may you cure the kinder sort of a Venereal Bubo but if it proves more rebellious then instead of Suppurating Medicines we should come to the use of Cupping Glasses every other day and after these to apply Diachylon cum gummi mixed with black Soap and these will maturate the most rebellious Buboes and having brought it thus deterge the Ulcer by keeping it a long while open and freed of its peccant Matter then fill up with flesh and
living beyond the fourth I shall conclude this Chapter with this History related by Petrus Bayrus lib. 20. cap. 8. of a Woman which had a Pestilential Tumour bred behind her Ear and he being sent for about eight hours after it was perceived it grew into a large Bulke in that time with much pain the pain afterwards began to cease but the Venome descended to the Heart and did horribly trouble and vex it neither could she beleive herself to live an hour being by his directions ordered to smell to Vinegar and Rose-water after this she was bled on each Cephalick first Breathing a Vein on the contrary Side then on the distempered Side Then was there applyed a large Ventose to the Part affected with a deep Scarrification reiterating its application And when there was drawn near half a pound of Blood by this Ventose the Patient began to find her self somewhat better and to have some hopes and found manifestly that the Venome receded from her Heart by these Frictions Odours Cordial Powders and Potions and the like that by Divine Blessing and help of these Remedies she perfectly recovered Hollerius saith live Oysters being applied to Pestilential Buboes do attract all the Venome from them CHAP. LXV Of Phyma and Phygethlon IN cap. 1. lib. 2. ad Glauc Phyma is said to be a Tumour in a Glandule which encreaseth with some Vehemency and hasteth to Suppuration for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 agrees with all sorts of Tumours arising out of the Earth and these happen not only in the Inguens but very oft in the Axillaries for these Glandulous Bodies being very loose are the most apt to give Entertainment to all strange Appearances Fluxions and Tumours particularly in the Groins because of their depending Site strong Motion and humid Redundancy After here having prescribed a convenient Dyet and the general Method which we have already shown you in a Bubo we are to apply Digestives to the place affected and then Suppuratives and the Tumour being by these made ripe we are to discharge the Matter either by Caustick or Instrument and the rest of Cure perform as you have already directions in curing of a Bubo Phygethlon is an Inâ—lammation and part of Erysipelas or an inflamed Erysipelas and this you are to cure by Phlebotomy Purging and Diet. As touching the affected part you had better apply Digestives than Suppuratives because this Tumour hath a mixture of Choler and hence it is that Galen lib. 6. Simpl. doth praise Atriplex and the Leaves of Garden Mallows and a cold Cerate and is at length to be cured with mild Discussives Lusitanus Cent. 6. Curat 82. telleth of a young Gentleman troubled with a Phygethlon under his Axillary the which did spread to a very large bigness in process of time it grew soft and livid and so proceeded with Pulsation that both Physician and Chirurgion conjectured Matter to be lodged in it and therefore by a general consent it was opened but the Success was miserable for it was scarce opened but the Blood flew out impetuously with a great noise of Spirit upon which the Patient presently dieth with his inclining downwards and he speedily departed this miserable Life CHAP. LXVI Of the Hemorrhoides HEmorrhoid is a Compounded word 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifies Sanguis and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 fluo and this is a Flux of Blood The Veins of the Anus onely gain the place of their dwelling and being or they are Tumours encompassing the Veins of the Anus excited by the great inâ—lux of Melancholy Blood resembling somewhat of a species of a Varix Some of these at certain times do open themselves and so do discharge and exonerate the Blood others there are that onely tumefie Some are hidden others more manifest Such as flow they pour out almost all Blood mixed with a yellowish Serum which is as a Vehicle to make its more speedy exit and by its acrimony does make a more speedy opening of the Vessels Such as do not flow do either lodge in some small Bladders and by some called Vesicales and these are made by the influx of Flegm and Serum resembling Grapes from whence they are called Vvales from the efflux of Bloud being laudable in quality but bred by a copious Redundancy They are different in their Magnitude some being large others small in their multitude some having many Orifices others few in their Figure some narrow some broad in their Colour some being of a blackish colour others more red in their Place some being in the Anus others in the Sphyncter others bordering upon the right Gut in their Constitution some being mild others more cruel and painful These Hemorrhoides arise as both the ancient and modern Anatomists allow from the Splenetick branch deducing its issue from the Porta produced downwards towards the Rectum and then carrid backwards to the Coccix and there to be inserted and propagated But from the Vena cava there are two Branches produced from the Os sacrum or Coxendix and sent to the Anus the one from the right the other from the left part the which are disseminated through the Muscles of the right Gut and Anus and do there constitute these Hemorrhoidal Veins here pouring forth their Blood and this is confirmed with good reason for the rectitude of the Vessels the Blood flowing downwards by its weight must necessarily fill its Vessels and being girt up or constringed being thus filled by the Muscles does make way for this Apertion And to give a better light to the well ordering and curing of both sorts let us make an exact Anatomical Inquiry about these parts These Hemorrhoidal Veins again have an Artery belonging to them to feed them this Blood first coming from the Porta to the Anus for from the great Branch of the Porta is this carried to the Spleen and thence through the Mesentery is it sent to the right Gut These Veins are onely two arising from the Cava and the Porta for this cause because these serve as do the other Veins of the Body for nourishing the parts with Blood and thus are the parts of the Anus nourished therewith This was a thing unknown to the Ancients and therefore it is necessary that the Melancholy Blood should this way be discussed for by this Passage onely is Melancholy best discussed and the Schirrus of the Spleen cured Besides these these also are by nature as Scavingers to cleanse the feculent Blood and make a sound Body and when therefore she cannot perform these we make our speedy address to Phlebotomy and the Evacuations thus made we daily find to yield great comfort and ease to the troubled Patient Besides these not being kept open a man having a great quantity of Melancholy Humour lodged in him the whole Body will hereby be less capable to undergo any other Method which may be prescribed And lastly in Malign Fevers being lodged in the larger Vessels and there putrefying the Blood
Lancet and prepare himself for this Operation First let him make a pretty strict bandage a little above the elbow of that arm which he intends to bleed not too strict because he will very seldome hereupon but meet with obstruction in bleeding the Artery being too close girt that it cannot discharge it self into the vein And as to his Lancet let him make his apertion a little sloping or upon placing it a little obliquely let him get his Lancet into the vein and so lift it up not penetrating too deep lest he commit those errours which daily are acted by ignorant Pretenders and Quackes who oft go so deep as that they prick an Artery and so cause Aneurisms and pains Let the Orifice that you make be neither too great or too small the first endangering the Division of the vein whilst the second runs it into a Tumour Here also is he to judg of the goodness or badness of the Blood and so according to his judgment may take away more or less and also considering the necessity of the disease the strength of the Patient and the quantity and quality of the Blood The veins which are generally opened are these the Frontal vein one under the Tongue the Cephalick Mediana and Basilick but of every of those in their order and as necessity requireth The Frontel vein is most properly opened in infirmities of the Face and in pains of the Head Two veins of the Temples opened in continual Head-ach in distillations of the Head and Eies The veins under the Tongue in Anginaes Apoplexies pains of the Teeth the Jugulars good in preventing suffocation Squinsies Asthmaes Dyspnaea and the like The three in the Arm the first being the outward or Cephalick this may safely be opened in distempers of the head as Mania and other hot passions The second Mediana so called in respect of its Scituation being made both of the Cephalick and Basilick vein in opening of this vein is made a general evacuation of Humours this oft times opened in pains of the breast and Pleurisies The third is Basilica or Hepatica by some called Axillaris this dischargeth those parts which are beneath the Neck as the Brests Sides Liver Spleen and Pleurisies And this note of the three in all sicknesses and times except in time of Pestilence That vein is to be taken which is most full and large In the Feet also are three veins Ischiatiea Saphaena and vena Poplitis these or some of them are generally opened in Obstruction of the Monstrues in bringing them down pains stoppings swellings and the like I shall conclude this with these directions In an Apoplexy open the Cephalick vein if this appears not open the Mediana In a Lethargy open the Frontal or Cephalick vein In a Squinsey those under the Tongue In a Pleurify the Basilica and here bleed while the Blood doth change its colour In diseases of the Lungs vena Axillaris or Mediana In inflammations of the Liver Basilica or Hepatica In obstruction of the Spleen the Basilick or Hemorrhoidal veins In diseases of the Womb the Sciatick vein In restraint of Menstrues Saphaena In pains of the Hips first open the Basilica then the outward malcolus below CHAP. VII Of Evacuation of matter erring in Quality IF a Tumour or Fluxion happeneth in respect of matter not onely erring in Quantity but also in respect of Quality that this may be discharged we are to consider two things First whether this matter may be altered as if hot cooled c. Secondly to remove the subject matter hereof and in the first if Plethory Phlebotomy is proper if less Pharmacy is most convenient And herein are we to observe these two Rules that the matter may first be educed or sent forth being contrary to the true genus of the part and then if it doth still remain to alter it The most proper way to deal with this is by our later writers found out which is by discharging the body hereof by purging Medicines which do work both quickly and safely ordering the strength of the Medicine according to the vigour and strength of the Patient and herein also are we to mind the motion of the Blood for if it doth move to the eies this is to be revelled first by Cupping-glasses without Scarrification Secondly that the parts ought to be rubbed for the better thinning the Humour thirdly frictions which are proper for revelling from the Center to the Circumference And Galen nameth the last when parts are obstructed we ought to obstruct with Medicines but these are tedious painful and troublesome Our later Writers have found out better means and methods as by washing with warm water which doth revell by opening the pores another sort is by vesicatories and these are in great use in Apoplexies Rheumatisms or Distillations the third and last is an actual Cautery and Fontinels and Setons very much in use in our times And in all these we are to observe that Revulsion doth take its indication from that part from whence the Humour sloweth not from the Humour flowing and this being known we are to understand the parts which we are to revell CHAP. VIII Of a Tumour the part affected drawing to it self Preternatural Bodies THE greatest occasion or cause of attraction in a Tumour of a preternatural body is cheifly to be attributed to Laxity and Intemperiety of the part and pain This Intemperiety is therefore first to be removed by running it into a better temper And this may be executed with oyl of Roses Violets and the like having fine linnen rags dipt therein and so applied and these are oft to be repeated to prevent inflammation For this use also Vnguent Rosatum Refrigerans Galeni Populcon Album Camphoratum If pain occasioneth this we are here to give ease by Anodynes according to Galen 13. Meth. 1. and if any preternatural bodies offend discharge them either by Medicine or Instrument if pain cometh from venome cure this as you do venomed bodies and herein also are you to consider the times of the poyson for the longer it hath got room and entrance the deeper doth it imprint its venomous Qualities and Effects In this case Venice Treacle Methridate and the like are very good Spirit of Wine here also is very proper And thus are we to vary our methods according to the variety of our Objects In venenate distempers in cold poysons we use hot Medicines and in hot poysons on the contrary cold Medicines as Rue Frogs Scordium and the like commended by Dioscorides Galen doth furnish us with many pleasant stories of poyson and amongst the rest he doth offer that if any be bitten with a Scorpion if the same Scorpion be taken opened and applied to the part affected it draweth out its own poyson This generally being here observed that before you apply any Medicine to the poysoned part you first well foment the part with a hot and sharp Lixivium and when the place beginneth to