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
got into the Scrotum or its Coats the which we shall thus endeavour to discharge by outward Medicines as Fomentations Oyls Unguents Emplasters Cataplasms and the like neither here using Caustick or Incision For Fomentations you may use these â„ž Origan Calamenth Puleg an M. ss sem 4 Calid major sem Vitic Bacc. Laur. Juniper sem Cumin an Ê’ij fl Melilot Chamomel an pug ij Sal. Ê’ij coquantur in s q. vini albi ad 3 partis consumptionem Or this â„ž Lixiv. Barbitonsor iij. Cumin Bacc. Laur. an â„¥ ij fol. Laur. Rorismarin Rosar rubr Meliss Menth. Majoran an M. j. Sal commun â„¥ iiij with this bathe the part affected with a Sponge Or this â„ž Acet fortissim ij in quibus coquantur rad Pyreth Staphis ac Bacc. Juniper Laur. Cumin an â„¥ ss fol. Laur. Haeder terrestr Salv. Thym. Rorismarin an pug j. bathe also with this the affected part or with this â„ž sem Cumin Bacc. Laur. Rut. Chamomel Bacc. Juniper Absynth an â„¥ i. misce fiat Fomentum cum aqua vino mixta Oyls for the same are these â„ž ol Rut. Laurin an â„¥ iss ol Petrol â„¥ i. ol Spic Terebinth an â„¥ ss misce Or â„ž ol Chamomel Rut. an â„¥ i. ol Aneth Nard an Ê’iij spirit vin Ê’ij Cer. q. s fiat Vnguentum Or â„ž ol Castor Rut. Euphorb an Ê’vj Vnguent Martial â„¥ ss misce Or for Cataplasms take these â„ž sem Cumin Bacc. Laur. sem Sesel Rut. an â„¥ i. stercor Bovin j. Sulphur viv Cumin an â„¥ ij mel q. s fiat Cataplasma Or this â„ž Farin Fabar. â„¥ iiij sem Danc. Cumin an â„¥ ss Bacc. Laur. Juniper an Ê’ij fl Chamomel Melilot Rosar rubr Lavendul an pug j. Salpug iss cum vini albi q. s fiat Cataplasma Or â„ž Farin Fabar. ss sem â—â—nugraec cumin an Ê’ij sem Apii Rui. an Ê’j fl Chamomel pug ij pulv Rui. Absynth Scord. Rosar rubr ad Ê’ss câ—quantur omnia in vino albo q. s fine addendo Oximelit Scillitic q. s fiat Cataplasma Empl. de Bacc. Laur. is here also very good or this mixt Emplaster â„ž Empl. de Melilot de Bacc. Laur. de Ran. cum Merc. an Ê’iij nitr Cumin Sulphur Calc viv Sal. an ℈ j. ol Laur. Cerae q. s fiat Empl. Benivenius cap. 81. Abditor writes of a Person of Quality who having his viscera and Stomach so filled with Wind that it proved very troublesome to him and when the part was compressed there was perceived no exition and hence not onely the Bowels and the Brest but the Scapulaes also were extended with incredible pain and the Spirits very narrowly conâ—ined all convenient and proper Medicines being prescribed and used without any effect the third day the Gentleman dieth the dead Body being dissected the Intestines and the other viscera were seen to be much swelled and puffed up with wind and in the left Ventricle of the Heart was found a hard Callosity equalling the largeness of a Nut and these two were generally held to be the onely Causes of his Death CHAP. LXI Of Sarcocele or Hernia carnosa THis is a Tumour contra naturam which is generated about the Testicles out of a Scirrhous Flesh or it is a Tumour bred out of the defluxion of thick Humours which are collected between the Coats of the Testicles and they there not assimulating there oft times grows as it were a Hyposarcosis oft times Varices accompany the Tumour and these are very troublesom and these Humours being thick and viscid bred from Flegm and Melancholy as they breed Scirrhous Tumours in other parts so also do they generate a hardness in these It is known by its Hardness Asperity Inequality and Indolency It ariseth from Melancholy it having a sublucid colour If it ariseth from Flegm it does not differ from the colour of the Cutis If it ariseth from burnt Melancholy it hath a pricking pain and the Tumour is inequal in some places soft in others hard If the Tumour be not confirmed cure it as you do a Scirrhus by using Emollients then Discussives but the last seldom does any good here But if these fail you are to come to Section but if it be Cancerous attempt nothing Matthiolus affirmeth that he hath absumed a Sarcocele by the onely using of Pulvis Radicis Anonidis being taken for many moneths But if it yields not to Medicine Incision is the next remedy and this way or method is not void of danger the Testicle being either left in or taken out And by the way we are to consider that if any fleshy substance grows about the Coats or Testicles this is wholly and absolutely to be taken away in this case for more safety the Vessels are therefore to be drawn out and tied and afterwards incised and cauterized for to leave any part hereof does more represent the ignorance of a Quack than knowledge of an Artist for no Son of Art will give the advantage of a new growth whenas he may well prevent any appearance of the same by a careful managing of his Operation and taking care of preventing all accidents for a small quantity but left remaining will soon run up like a rank Weed to a great bulk and this in a short time grows worse and worse If the Tumour be not very hard the Chirurgion comprehending the whole Tumour that is the whole tumefied Substance in the Testicle every way encompassing it let him make his Incision even to the Tumour above the Scrotum then abduce the Testicle from the Scrotum drawing a strong Needle and Thread through the middle Process above the Region of the tumefied Testicle and then drawing it back again through the same part of the Process then tie both of them these being performed cut off the whole Process the Testicle being concluded with it It being ablated apply a Repercussive Medicine and strengthen the neighbouring parts with convenient rollings and bolsterings and heal up your Ulcer as you do others Fabritius Hildanus tells a very pleasant story of a young man who embracing his Mistress in Veneral Ceremony he being near ready to eject his Spermatick succus was prevented of his intended purpose by a Messenger which rushed in unawares by opening the Chamber door and disturbing him in his pursuit on which his Sperm receded and was retained Upon which a pain seized on his Groin his Testicles tumefied and the pain began to be remiss in his left Testicle and the Tumour vanished and returned to its former state but about the right the Tumour continued the which in process of time turned into a great fleshy Rupture and he being called to the Patient amongst other Physicians in consultation saw not onely Flesh about the Testicle concreted but found it also extended with serous Humours so that it equalled near the largeness of a Childs Head CHAP. LXII Of Circocele or Hernia Varicosa THis is nothing else than