the bladder such a position of this part as I once indeed observed in one that was designed to be cut then there is no less need of circumspection as one may see in the example here instanced upon whom the Lithotomist had certainly done his office little to his own credit had he not being frighted with this perverse situation of the bladder in prudence desisted for this Stone was implicated in so perplexed an errour within the contorted bladder that as Anatomy informed me Aesculapius himself could not have got it out without manifest danger of life Nic. Tulpiâ—s lib. 3. observ 5 6. ¶ One man's bladder contained two encompassed so close by its corrugated coats that it was scarce capable of an ounce of liquour besides them X. Although Stones that stick and are fixt can hardly be pulled away and the greater number of these that are troubled with such do dye yet the Cure is not impossible seeing it is observed daily that several such have recovered amongst which I saw one from whom a two ounce Stone was taken Augenius Epist 2. l. 4. inclosed in a bag which rarely happens XI Many Errours are wont to be committed by vulgar Lithotomists in taking out the Stone the First is When they allow the Patient the days next preceding and in the whole course of his Cure to live as he list neither premitting Diet nor Preparation whence many Inconveniences and Death do follow for all things run from a plethorick and cacochymick Body to the place affected Therefore let Diet Preparation and Purging go before c. 2. They think they have done the business when before cutting they have purged their Patient with Antimony Mercurius vitae c. But these violent things debilitate the Strength and native Heat whence the Patient often dies after the operation 3. Some for a few days before the operation give a full draught of a decoction of Rest-harrow-roots or Millet-seed morning and evening to bring the Stone to the neck of the bladder but many mischiefs flow from thence for much humours are carried from the whole to the urinary passages Fabritius Hild. c. 23. de Lithot whence follow after cutting dangerous Symptoms Inflammation Gangreen Convulsion and Death Wherefore onely gentle purgative Potions must be given because if Lenitives do purge also by Urine how much more will strong Purgers which have also a diuretick virtue do it XII Lithotomists when they have got out the Stone often commit many Errours which want rectifying Some think the Wound should be drawn together with one Suture or two that it may the sooner heal but they doe ill 1. Because a Tent cannot be put in as it should nor the bloud gathered in the bladder whence come many Symptoms be got out 2. It is known that after the Stone is got out there often remains Gravel Phlegm clotted Bloud and Matter which not taken out doe much hurt 3. Suppose there be no such things yet it is certain that the bladder afflicted so long does crave time to purge out the gross and viscid Phlegm that it daily breeds but this must needs be done by the open Wound for seeing the urinary passage is long and turning therefore it cannot be voided that way especially when the expulsive faculty is weak II. Many Lithotomists immediately after the operation clap the Patient in a Semicupe in which they boil indeed appropriate herbs and keep him there half an hour for the easing of his pain and heating his body which was cooled by cutting But so there is imminent danger of an haemorrhage the Vessels being opened which is attended with fainting and weakness and is one cause of Death after operation Thus they offend against Aphorism 5. 23. Then after bathing much Vapours ascend another cause of fainting It is the property of the Bath also to draw whence a great quantity of humours is drawn down in a manner violently from the parts above from the Loins especially which were stirred by the operation and other Symptoms follow all the ways and passages being loosned by using the Bath so that all the excrementitious humours flow to that Wound and hinder the healing of it III. Some Lithotomists reject the use of Tents and doe all their endeavour to heal it quickly The Physician indeed should cure quickly but safely also now there is no safety unless the Wound be kept open by the help of Tents for some days after cutting and the bladder be cleared of gravel and phlegm which would grow together again by reason of the heat and inflammation left in the bladder whereupon the latter Evil is worse than the first for a Gangreen doth easily follow IV. The Errour of a renowned Chirurgeon must be remarked who writes that 't is sufficient when the Stone is taken out if the Wound be closed with clean Lint for the Vrine is enough to heal the Wound by its detersion and consolidation wherein it excells if so be he adds that no symptoms supervene And he says well for how will you obviate the Symptoms Pain Swelling Inflammations c. which usually follow wounds joined with confusion But if you would prevent them and Death that would otherwise certainly follow keep the Wound open with Tents which would otherwise so close with the swelling that neither Urine nor the viscid humours bloud nor matter that remained after cutting can run out Besides Urine cannot serve the turn of a Medicine when it has got an acrimony and corrosive faculty from pain and a preternatural febrile heat They that have tried it know that Urine retained is the chief cause of the Symptoms which usually follow cutting for the Stone therefore a prudent Chirurgeon will provide it an easie passage by the help of Pipes and Tents V. Nor is their errour less who make it their business by frequent traumatick Potions to cleanse the Bladder of Impurities Phlegm Gravel c. expecting hence a perfect Cure of the Wound But who can believe that there can pass to the Bladder or bring any benefit when Diureticks though endued with subtile parts cannot according to Galen Art Med. c. 96. penetrate thither VI. There are some who presently after the operation give a little Powder in a Glass of Wine as a singular help and not in the beginning onely but in the whole course of the Cure hoping from thence for an abatement of Pain a Repulse of the afflux of humours stopping of bloud and suppuration But Wine that is hot and sharp by nature will not stop a flux of bloud for which work cold and dry Medicines are requisite and it will not asswage Pain nor promote Suppuration as being hot it rather being fit by its acrimony to enrage than appease a Wound which office is onely granted to hot and moist things Hildanus and those void of all acrimony XIII Authours propose three places by which the Stone may be taken out 1. The orifice of the Bladder as is usual in Women by
will be hindred if the Patient immediately after Meat Morning and Evening swallow 2 or 3 grains of Mastich whole or 1 scruple of juice of Wormwood condensed in Pills For things that heat the Stomach Fortis if they be taken before Meal hurt the Liver XXVII I have learned by Experience that green Wormwood worn within the Shoes amends the cold Intemperature of the Stomach with much benefit in the Noble Lord N. who declared openly and seriously affirmed Greg. Horstius that he found much benefit by treading upon it XXVIII I knew a Man who had a cold Stomach and an hot Liver and had very hot Plaisters and Unguents applied to the cartilago xyphoëides upon which he was taken with an Inflammation in his Liver and could hardly be cured of it If any one desire to enquire the cause let him look upon the Anatomy of the Liver for with its hollow side from the right to the left its covers almost the whole fore-part of the Stomach so that hot Medicines first come to the Substance of the Liver Fab. Hildanus before they come to the Stomach XXIX Wine taken in too great a quantity not fine nor exactly depurated from its Tartar and Lees is very hurtful both because by the continual and immoderate use of it the innate Heat is destroyed and Concoction is hindred in the Stomach especially of Flesh Mayerne de Arthritiâ—e which hardens in that liquor the Liver is hurt a sharp and serous Blood is bred the Brain and Nerves are weakned Catarrhs are caused c. XXX Never give an austere Wine to a dry Stomach for it hurts the substantial Moisture for which nothing is worse than Astringents which feed upon what Moisture there is Therefore in this case store of moist Things must be given Broths Milk almond Milk that the dried Coats may beextended when moistned and so may close well upon the rest of the Meat Saxonia XXXI There is a way fouâ—d whereby the noxious Vapor is taken from the Wine that is by letting it pass through a double glass Instrument the French call it Montevin This way also it is deprived of its superfluous Tartar that is by putting to it some Liquor that has a precipitating Virtue such as Oyl of Tartar by means whereof egre Wine grows sweet a solution of Litharge or Saccharum plumbi made with Vinegar a solution of calcined Crystal by frequent extinctions in Nettle water â—â—yerne and reverberations with acid Spirit of Turpentine XXXII When crudities are bred in the Stomach by reason of Surfeiting it is not advisable as many do to remove it by fasting but it is better the next day betimes to take some delectable food but in a small quantity for Nature being delighted at the approach of new food that is grateful undergoes the work more chearfully and turns what is good into aliment and separates what is bad and crude into excrement by the help of the expulsive faculty 〈◊〉 Wherefore many after a surfeit are taken with a Loosness XXXIII In some People only an heaviness like a Stone with shortness of Breathing show that there is slow concoction I tell such they may safely sleep after Dinner In others there is a certain â—â—â—ctuation or vibration or trembling or palpitation sometimes with sometimes without a rumbling in the Guts and with shortness of Breath â—â—ch may with much more reason sleep after Dinâ—â—r XXXIV Galen 3. de causis Symptom c. 1. shows that an acid corruption alwayes comes from a cold intemperature And 1. de loc aff 1. that a nidorous corruption when it comes from intemperature alwayes follows a hot intemperature yet both these corruptions are caused by external errors The acid indeed by excrements in their own nature acid as acid Phlegm acid Melancholy Or by Aliments offending either in quantity or quality In excess when they suffocate the native heat though it be strong In quality if they are either too cold and moist as thin Wines moist Fruits c. or when they easily putrefie as Milk Ptisan c. or when they are of an austere taste as Services and Medlars which by further concoction are changed into an acid taste And although Galen 7. Simpl c. 8. write that an austere is changed into an acid from encrease of moisture yet it cannot be denied but that the same may be done by excessive heat for he writeâ— that adust Melancholy is made acid by burning heat so in the Summer time austere fruits are turned acid by the heat of the Air. Gather from hence that corruption into an acid in the Stomach is not caused only one way nor by one cause And therefore Trallianus l. 7. c. 16. says well that a corruption to an acid is sometimes caused by a hot intemperature and cured by cooling things Therefore the turning of Milk or small Wine sowre which are moderately hot and do easily putrefie is not caused by a weak heat in the Stomach but by a very strong one which consumes the innate heat of the Milk or Ptisan or any such other Body The case is the same in a nidorous corruption for the meat is so corrupted either by the Aliment or Excrements By Excrements abounding or deficient The abundant are either Cholerick or Melancholick which by their heat bâ—rn the Aliment and turn it into a Nidor The defâ—ct of Humours is defect of Phlegm For Galen 3. de nat facult c. 7. when he mentions things that help concoction as Bile Heat Spirit reckons up the whole substance of the Stomach and Phlegm No man has declared how Phlegm helps concoction but this is my Opinion Concoction in the Stomach is a sort of Boyling this is not done without moisture therefore Phlegm conduces to Concoction as it is a moist matter whereby boyling is made therefore when this fails meats easily turn into a nidor Nor let any one say that Drink serves instead of Moisture for Sagacious Nature hath therefore made the Stomach the storehouse of Phlegm that if drink be wanting the Aliments may not be burnt which they may easily be if but a little in quantity or hot and dry as sharp and aromatick things or if they be sweet as things with Honey in them Saxonia fried things and the like XXXV They are deceived who think depraved concoction pituitous vomit sowre belchings and wind have only a cold cause for oftentimes an hot Liver causes these Symptomes because when this is hot the Stomach concocts badly Neither must cold and moisture be presently blamed nor must we after the manner of Empiricks presently fly to hot things But we must diligently search whether a cold or hot cause waste its strength that it may be opposed by a contrary Remedy When therefore a hot intemperature of the Liver is a cause of depraved concoction it must be opposed by things that cool and moisten the Liver whereto may be added things that strengthen the Stomach with a gentle astriction
their foursquare or sexangular particles for instance they express a manifest sense of cold even upon the Tongue Therefore it is better to call them cold effectively and rather to reckon them among the cold than the hot yea it were better to know their nature more intimately VI. There is a doubt about some bitter Medicines that are reckoned among the cold as Lettuce Cichory Endive Sow-thistle Poppy Sallow by whose example there are some that deny that assertion of Galen That all bitter things are hot as particularly Averroes and Others But the answer is the same as we gave of odoriferous to wit bitter things as such are all hot yet nevertheless some of them are called cold partly because their bitterness is but very little and is subjugated by the abounding moist Parts partly because their effect is equivocal as for example Liverwort is reckoned among the cooling Hepaticks yet it rather performs that by that effect whereby it opens Obstructions absterges Choler c. VII As to the passive qualities moist and dry it is to be noted that the denomination is deservedly taken from the active as being the more worthy whence those that are eminently hot are for the most part dry unless they be substantially moist whence Hofman affirms of Wine that as to its quality it dries but as to its substance it moistens But those which are eminently cold the same saving an exception are most of them also moist We will here repeat our Hypothesis that is proved in another place that there are two alimentary Humours the principal the Blood and the ministring the Serum As therefore the active qualities heat and cold respect and attend the innate heat or blood and the oily and volatil parts of the same so moist and dry Alteratives dispose the Serum the moist are those which preserve restore and increase the Serum the dry those which diminish waste and devour it Nor hinders it that some are actually moist and yet do dry through their prevailing Sulphur for instance and that some are actually dry and yet moisten through a predominant aqueous quality as Gellies c. What we said also of the degrees of heat may be applied here and yet it is to be noted that there are no Humids in an excessive degree unless one will call those so which are such substantially for the same things are predicated also both of those that are potentially such which are indued with watry mucilaginous parts and of those that are actually such which themselves also differ in degrees Thus simple and distilled waters Whey decoction of Barly with Harts-horn Beer and Wine moisten but in different degrees Or respect is had to the coldness joyned withal whence Henbane Poppy Nightshade are said to be moist in the third degree the juice of Lettuce is esteemed poysonous Moist in the first degree are those which are endued with Particles that are weakly watry and mucilaginous In the second those which have the same more evidently But in general the Mucilaginous do moisten more and as it were substantially because they are hardlier dissipated and the watry less because they are sooner dissipated Hence in driness of the Throat and in parchedness and chaps of the Tongue Practitioners use to prescribe the Mucilages of the Seeds of Quinces of Flea-bain with the Syrup of Violets c. Also those that excel in Fat and Oily parts hence there are adstringent oyntments and liniments properly and in their own nature so also succulent green pulpous and carnous things are moist In like manner the oyl of sweet Almonds and Water-gruel are very profitable in that case Likewise in a squalid and withered habit of Body as for example in the Hectick and in an atrophie of the parts besmearings with oyls and fat things also with mucilaginous themselves as the root of Comphrey are more convenient So the eyes also delight in mucilaginous things as the white of an Egg c. Likewise to smooth and demulce in hoarseness diseases of the Lungs Kidneys c. This also is to be noted that driers in the fourth degree are hot also in the fourth degree so cold does modifie moisture heat driness at least for the most part and as preternatural heat requires cold Medicines so preternatural moisture or ichors require drying Dryers are those that have the earthy particles predominant whether alone or joyned with Sulphureous or with acid or some other whence they absorb or dry up greatly and hence for instance chalk ceruss lac lunae pompholix are notable for drying up ichorous humidities So ulcers that will not â—ill up with flesh but are exasperated with Emplasticks are helped by such dry powders as these which I have often seen with happy success sometimes mixing hot things with them as the powder of the leaves of Birthwort and sometimes earthy Hither belong drying and strengthening decoctions and fomentations such as are often used of Alum Nitre Sulphur c. VIII Alteratives are commonly described by those Medicines that are endued with the vulgar faculty of heating cooling moistening drying attenuating and incrassating but these respect not so much the disease as the symptomes Whence Sennertus himself sayes To use refrigerating Medicines at least because of heat Lib. de Febr c. 18. and not first to take away the matter that is the fuel of the febrile heat is to cure the Symptom and make the disease worse Therefore let your Elementary Physicians who respecting only the urgency of the Symptomes inquire of the Patient oâ— those that attend upon him concerning nothing but heat or cold know that such qualities are mere effects of the Diseases and the Morbifick cause or products from the furious Archeus for while it endeavours to expel the strange guest it raises sometimes cold sometimes heat Alteration therefore is a motion as to a patible quality whereby there is caused not another thing but another manner of thing And it is either corruptive or perfective A corruptive alteration is that whereby a former quality is abolished and a worse is induced as is done in the generation of Diseases A perfective is that whereby a new quality is induced for the perfection of another which is meant in this place and we describe it by motion whereby preternatural and strange qualities that deprave or corrupt the ferments of the viscera the mass of Blood and other parts of the Body are abolished by adjuvant altering Medicines and whereby the domestick and natural are corrected and reduced as much as may be to that natural equability and proportion from which they were departed that health may ensue from thence Alteration therefore is a motion because it leads to a more perfect being whereby are acquired qualities agreeable to Nature being repaired by altering Medicines that perfect health may accrew thereby Now by these Qualities we understand not only the first elementary active and passive viz. hot cold moist and dry nor only the second and such as flow from
and not a few into the cholera morbus or Vomiting and Loosness whereas many by cooled fruits are freed from Agues though otherwise they be occupied in Business and Exercises All therefore I think will greatly commend the custom of cooling your fructus horarii by putting Snow to them for if any find his Stomach offended by the coldness of the fruits he may know for certain that he needs them not nor must such an one be advised to eat them hot but to eat either very little or none at all But it is otherwise with Drink for many are offended by cold Drink that nevertheless stand in need of that which is as cold as Ice whence it is manifest that Snow is far more necessary for horary Fruits than for Drink though for this also it be profitable for many during the Summer and a good part of the Autumn but at other times though it may be pleasant to some yet it is hurtful to all And therefore I would both begin and end the use of Snow with horary fruits and in the mean while very much cool the fruits with it and would have every one take as much as he needs according to the nature both of the whole man and also of the Belly alone which nature is either hot or cold dry or moist or some mean between these and according to the Custom and Experience that every one has of his own Body But Drink is not alike convenient for all but for every one his own way consideration being made according to the same scopes Valles comm in 5. Epid. p. 498. for thus many things would be profitable that most now dispraise XXXIII As to Fruits Avicen pronounces generally that they are all bad for Persons in Fevers whom yet all the Greeks oppose Galen 1. ad Gl. grants such in the cure of a Tertian as are easily concocted Trallianus prescribes Peaches both raw and boiled Musk-melons and Melopepones or Cucumbers and chides some Roman Physicians that abstained from Pompions because they bred choler from Gal. 2. de Alim when yet Galen says in that place that Pompions breed the cholera morbus if they be eaten too plentifully Yet he prescribes Pompions an hour before the Fit and also orders the Patient to drink after them a good quantity of temperate Water for much choler being thereby evacuated by Stool or Sweat the Ague has ceased Therefore he adds In every hot intemperies of the Kidneys Liver Stomach Head in a Tertian Ague or continual Fever nothing is better than a Pompion or Cucumber which latter also he prefers before a Pompion because it is altogether harmless Hippocrates himself in Lib. de Affect writes thus of Pompions The Cucumber-Pompion provokes Stool and Vrine and is light and the other Pompion does in some kind cool and allay thirst both of them afford but a thin nourishment and yet no harm that 's worth speaking of proceeds from either Besides the sweetness of Musk-melons and their grateful Scent commend them But we at this day know not what are the Pepones Melopepones or Cucumeres of the Ancients and therefore to come to our own Our Musk-Melons which many esteem for a dainty for their admirable sweetness of taste and smell are yet unwholsom they easily putrefie in an hot Stomach for they are very moist as appears in that from a small root they grow into a great bulk they are presently corrupted by every quality of the Air and they alwayes lie upon the ground whence by eating of them putrid and serous Humours are by degrees heaped up in the Veins whence Fevers or Agues encrease and are lengthened out or if they be not present they are procured so that these are accounted the most unwholsom of all horary fruits What some alledge of their sweetness and grateful odour makes nothing towards their commendation for this ought to be meant of the same kind of meat and not of divers for very many that are most grateful are more pernicious than those that are less grateful But our Cucumbers that use to be eat young and unripe though they cannot be called wholsom yet they ought to be reckoned less hurtful both because they have a kind of sowrness and also because they are corrected with Vinegar and Salt but in the plenty of so many Remedies 't is better to abstain from them than to run the hazard To come to other fruits They are various hot cold moist easily corruptible horary acid sweet fresh dry The hot when the indication is taken from a Fever are wholly hurtful yet in respect to the febrile cause or some Symptom they may be granted as Figs to cleanse or if the Colick accompany The cold are good with respect to a Fever and they profit the Hectick and those that are taken with an Ephemera or a Fever that lasts but for a day but though by cooling they may benefit in putrid Fevers yet in regard of the putrefaction they hurt because they are easily inflamed and boil in a hot and foul stomach which is chiefly to be understood of the horaei such as Straw-berries Mulberries Plums Peaches Cherries Now 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from whence horaeus is derived is the Summer and the Fruits that are gathered in that Season cannot be kept for their great moisture but are suddenly corrupted unless they be dried or preserv'd and all those Fruits that the Latins call fugaces are of a bad juice and windy and when they are corrupted become like to Poisons But the Fruits which may be kept as Grapes Almonds Damsons dried and Prunes may be allowed as also all acid Fruits as Lemons Oranges Pomegranats for they temper the febrile heat allay thirst stir up an appetite hinder the ascent of vapours But yet the too great plenty of acid Fruits is to be avoided because if one take too much of them or unless they be temper'd by boiling as they are wont to be when made into Syrups they breed great Obstructions otherwise they profit very much by cooling inciding resisting Putrefaction Some also of the horaei may be granted because they are corrected by boiling and by putting Sugar to them from which yet if we abstain in bilious Fevers or at least use it sparingly it will be better because it heats and turns it self into choler as sweet things are wont So in an exquisite Tertian Avicen commendeth sweet Pomegranats Prunes the Indian Melon because it loosens provokes Urine allays heat and moves sweat in some manner Fresh Fruit also in some particulars is better than that which has been longer gathered for some Fruits grow musty in time as Almonds Pine-Apples likewise these when they are long kept become oily and therefore are not so fit in acute Fevers because the oily part is easily inflamed and turned into choler and therefore in the Milk which we call Almond-milk we must have great care that the Almonds be not rancid or musty for the fresher they are the better Some boil
Stomach and Liver and absterge the humours And this is a good Powder Take filings of Steel sprinkle them with water of Wormwood or Ash wherein their Salts have been dissolved leave them so long till they contract rust Take of this Crocus 3 ounces burnt Harts-horn prepared half an ounce Magistery of Coral of Pearl each 1 drachm and an half Cinnamon Crystalls of Tartar 1 drachm Sugar what is sufficient to sweeten the whole Make a Powder The dose 1 drachm And this Chalybeate Wine is good especially in a pertinaceous obstruction of the Bowells and suppression of the Menses whence a Cachexy ariseth Take of filings of Steel 3 ounces and an half White-wine 4 pounds infuse them in a Glass 8 days in the Sun or some hot place shaking it often every day Let the Patient take 4 or 6 ounces of this Wine two hours before dinner shaking the Glass and when he hath taken it let him walk for two hours if he be able As often as you pour out one glass you must pour in another till half the Steel seem spent Sennertus then you must add no more Calculus Renum or the Stone in the Kidneys The Contents Signs and the Nature of the Stone I. a. What Vein should be breathed I. b. When a Purge should be given II. Whether Cassia be proper III. Diureticks should not be added to Purgers for prevention IV. Whether strong Purgers be convenient V. Of what things Anodyne Clysters should be made VI. Whether their Quantity must be small VII Whether a Vomit may be given VIII When Diureticks may be given IX They must not be mixt with Food X. The Qualities of Lithontripticks XI We must begin with the milder XII The use of them must be continued XIII They must not be too hot XIV Their Abuse must be avoided XV. The way of making them up XVI Whether Spirit of Turpentine be proper XVII Attenuatives are not always proper XVIII What must be done next when the Stone is got out of the Kidneys XIX Stone in the Kidneys accompanied with vomiting of bloud cured XX. If accompanied with pissing of bloud what must be done XXI Lenient and mollient Clysters are very good XXII Wâ—ether Asses milk be good XXIII Whether it may be given one in an actual consumption XXIV Whether Pease-pottage may be given XXV The use of Astringents does good XXVI We should rather cool the Liver than Kidneys XXVII Coolers especially in old men often doe harm XXVIII Outward Coolers are of no use to some XXIX In prevention Bathing suspicious XXX What such Diet should be used XXXI A Draught of warm Water before Meal is good for prevention XXXII The turning of the Stone into the Gout is safe XXXIII Whether Nephrotomy be possible XXXIV Stone in the Kidneys mistaken to be the Colick XXXV Medicines I. a. GRavel not subsiding in the Urine but sticking to the sides of the Chamber-pot signifies not a calculous disposition but exceeding heat of the Liver Spigelius saith he hath sometimes found the bloud in the Veins full of small Gravel Nor does the subsiding Gravel necessarily indicate the Stone but sometimes the material cause onely of the Stone for many that are free from the Stone do make Gravel yet it intimates a disposition to the Stone Plempius in Institut When Gravel that used to appear is afterwards suppressed and pain is felt and the Urine white and thin it is a sign the Gravel is concrete into a Stone and when it is made with pain and strangury Epiphan Ferdinandus it is a sign of the Stone ¶ Gravel that is bred in the Veins is mixt with the Urine and with the Sediment But what is in the Kidneys Ureters and Bladder presently resides as the Urine is made ¶ Gravel frequently proceeds from adustion of the humours which is bred in the Liver and Veins and sticks to the sides of the Glass nor does it sink to the bottom as that which comes from the Kidneys Besides it breaks with rubbing in ones fingers and appears of a Saline Substance whereas the other neither yields to the fingers nor can it any way be dissolved And finally because this Gravel hath a Saline Substance it is dissolved in warm Urine and no way appears in it while it is yet hot but when the Urine is cold it coagulates and sticks to the sides of the Urinal just as Crystals of Tartar which are dissolved in hot Water do when it is cold coagulate and stick to the sides of the Vessel So that the nature of this Gravel and Crystals of Tartar is very like Riverius I. b. Hippocrates 6. Epid. and in his Book Of the nature of Bones orders bleeding in the Ham. Galen on the contrary 6 Aphorism 36. advises bleeding in the Arm if there be a Plethora and violent pain and the Disease be new and he advises well For if the humours flow from the whole body to the Kidneys such a Remedy must be chosen as may make a Revulsion from thence such as Bleeding in the parts above If the Disease be inveterate or bleeding in the Arm have preceded then it is proper to bleed in the Ham. Leeches also applied to the Seat are very good according to Aphorism 6. 10. II. We must diligently take notice that a Purge must not be given till the Pain be something asswaged For even a strong Cathartick given while the Pain is violent often does not purge because at that time all the parts contract themselves Riverius Pract. l. 14. and do not assist the Medicine III. Some commend Cassia for the Stone but I would caution the carefull Physician that some have found themselves exceeding ill upon using it and have encreased their Disease One complained to me that heat of Urine always followed the taking of it ¶ Petrus Pigray l. 7. c. 4. writes that Cassia agrees very ill with those that are troubled with the Stone Fabr. Hildanuâ— l. de Lithot c. ult ¶ Two ounces and a half of Cassia given one in a continual Fever raised such a flux of Urine that for three days together he made his Urine so hot that every time he made it he thought a red hot Wire had been drawn through his yard IV. Nephritick persons should have some familiar Medicine that may help them to a Stool For those who are loose and troubled with Fluxes have not the Stone and Gravel provided notwithstanding the Purges be not made up with Diureticks I speak this because at this present there are several who use Receipts that purge both by Stool and Urine When there is mention made of Medicines to divert the Matter there is no need of a Diuretick Wherefore they doe very ill who in time of Prevention and for Revulsion's sake do use Cassia for Cassia is both purgative and diuretick therefore not to be used in diverting the Matter Saxonia loco cit and I look on Valeriola to be of this opinion 6. Enarrat V.
Head grow worse Oethaeus apud Schenckium and new Symptomes frequently arise Therefore it is good in all Diseases of the Head to keep the Body open XXV It is very well known that Coriander is given to suppress Vapours arising from the Stomach to the Head Yet some disapprove the use of it because it is its nature to affect the Head nor does it hinder the ascent of Vapours but rather carry them with it self to the Head yea and according to Dioscorides cause Madness But this is if it be immoderately taken which is common to it with Saffron Nutmeg Frankincense c. yet this is no reason that it should be rejected if moderately taken especially prepared For that vaporous and volatile part as Chymists word it that is in the Coriander and which taken immoderately hurts the Head like Poison is fixt and corrected by the Vinegar so that it becomes a proper Remedy to help Concoction Sennertus Pract. l. 1. part 1. c. 2. and clear the Heart and Brain as experience shews XXVI Concerning Quilts and Caps we must take notice that such as are made of very strong scented things do affect the Head and cannot be endured of all people And this is true not onely of Muskified things alone but of all strong smelling things in general though gratefull if they be beyond measure such And they make the Head to ake and cause a turbulent motion in the Spirits for this Maxim holds true here Every extreme Sensible hurts the sense Wherefore I have seen some Wedelius de Med. â—â—t p. 202. especially at the beginning that could not wear these Spicecaps without the Head-ach XXVII Nor yet must the Ingredients be too hot nor too cold and astringent not too hot lest they melt over much dissolve and precipitate the matter into the Vessels which would gladly get out at Nature's High-way thus hath a dangerous Fever come of a Catarrh by unseasonable applying Oil of Amber to the mold of the head We must have a care of Astringents lest the Brain be hurt by powerfull Astriction Idem and the motion of the Humours be stopt XXVIII Caps are most proper in essential Diseases of the Brain They alter and strengthen it that it is not so apt to receive Defluxions and Impurities They discuss both the footy Vapours blended with the Lympha and the abounding serous Humours They intercept especially those that are made of Astringents not so much as the Head is the first Spring and Original of all Catarrhs which nevertheless was the opinion of the Ancients but as at least it is not altogether without fault so the Moderns hold Thus they keep back the shower of a Catarrh Thus they stop the Lympha when it is running into the Pores of the Brain Idem p. 206. and put a stop to all manner of Defluxions Medicines especially made use of by eminent Physicians 1. Tincture of Amber is a Specifick in all Diseases of the Head especially in Weakness of Mind Grulingius l. 1. par â— c. 2. Apoplexy Palsie Epilepsie 2. We have sometime strengthened the Head with this Remedy alone Take of Nutmeg Aniseed Cinnamon Marjoram each 1 ounce let them be bruised grosly put in a Pipe and smoaked like Tobacco morning and evening for it wonderfully strengthens the Brain and purges the Humours C. C. de Heredia p. 130. 3. Levinus Lemnius saith that Lignum Aloes doth wonderfully strengthen the Brain 4. Take of Ly made of Vine-ashes what is sufficient Boyl in it some Marjoram Bayberries Penniroyal Calaminth Basil with the Seed Agarick bruised and tied in a rag 2 drachms Add a third part of Wine to the measure of the Ly Montanus cons 24. Boil all to the consumption of a fourth part press it and strain it and in this Ly with some sweet Soap wash your Head The Head will be wonderfully strengthened by this Washing ¶ Oil of Ladanum rightly prepared dropt into the Ears and sometimes rubbed on the Crown of the Head is a most excellent Remedy Id. cons 40. 5. I reckon this a curious external Remedy for strengthening the Head Take of old Oil-olive Cretian-wine each half a pound of the Wood and Fruit of Balsame each 1 ounce Flowers of Clary Sage and Rosemary each 1 handfull Mix them and let them stand in a Glass 3 days in Horse-dung then distill them For 3 Liquours will come out every one of them of great virtue but the third of most With the first the whole Head being purged before must be rubbed every day With the second and a very small quantity of the third Monardus Ep. l. 17. Epist 1. the Sutures must be anointed and one drop must be dropt into the left Ear once in 3 or 4 days 6. In a cold Intemperature of the Head black Hellebore-root with as much Sugar-candy is an excellent Sternutatory It is Helmont's Medicine and is also good for the Cure of a Catarrh Riverius Prâ—x Med. l. 1. c. 1. 7. In a hot Intemperature of the Head it is good to snuff up cooling Liquours into the Nostrils among which Woman's Milk with Oil of Violets or Water-lily Sennertus prax l. 1. par 1. c. 1. or an Emulsion of Lettuce or Poppy-feeds made with Lettuce-water are commended ¶ Castor is commended inwardly than which among Simples there is scarce another more effectual and powerfull in heating the Brain Also upright Vervain which as they write does discuss above all things and perfectly strengthen the Head especially green yea and dry also with its roots and Mother of Time boiled in Oil. Galen also saith that Sows breeding under a Water-tub are very good if they be boiled in Oil. Idem c. 2. ¶ Also the Medicine called Hippocrates his Treacle is good in Phlegmatick Diseases of the Head it is made thus Take of Wormwood Horehound French Lavender Mastick Rheubarb Groundpine Germander each 3 drachms Hyssop 1 drachm good Agarick powdered the weight of all make them up with clarified Honey The Dose is 2 or 3 drachms in the morning in the decoction of French Lavender or some other Liquour Idem ¶ Wine is very good to strengthen the Brain and rear Eggs with Sugar and Cinnamon if good Wine be drunk upon them as also is Amber-gryse with Sugar taken in broth or a rear Egg. Capitis dolor or the Head-ach The Contents Bloud-letting is not proper for every Head-ach I. One cured by Bleeding in the Foot II. A pertinacious Hemicrania cured by opening a Vein between the Forefinger and the Thumb III. Cured by Atreriotomy IV. By Cupping and Scarifying the Head V. Burning and Cutting the Skin proves sometimes beneficial VI. We must sometimes proceed to Burning VII Whether Issues made in the Head in or near the place grieved be proper VIII Cured by Boring a hole in the Skull IX By Bleeding the Ear. X. With Issues in the Arm. XI With Vesiccatories applied to the Head XII An inveterate Hemicrania
Dysentery from Bile alone what way soever corrupted or made sharper by it self for after the lixivious Salt of the Bile is made extreme sharp then indeed it will any where else as well as in the small guts cause a Gangrene but never an Ulcer for an Ulcer is an effect of an acid not of a lixivial Therefore unless an acid and sharp humour be joined with the Bile it will never cause a Dysentery which onely an acid and sharp humour falling upon the Intestines can produce Hence because the abundance of this acid had its original sometimes from acid Medicines used preposterously and in too great quantity sometimes from the extreme sharpness of the Air in the Month of November these things conduced to its cure 1. The avoiding of the cold and sharp air 2. The use of Medicines that concentre and soak up an Acid as Coral Pearl Crabs eyes Chalk and for the quicker healing of the fretted Guts and Vessels Dragons-bloud Bloud-stone c. 3. The cleansing and healing of the fretted Guts by Clysters made of Cows-milk Venice Turpentine Yelks of Eggs and Honey of Roses given frequently and kept as long in the body Sylvius Append Tract 10. Sect. 296. 772. as conveniently they may that they may doe the Patient the more good For which purpose new Treacle Diascordium c. may be made use of XII In the opening of several Dysenterick persons Bloud has onely been observed in the thicker guts and not in the smaller And why onely in the thicker and not in the small I believe for no other reason than because the corroding humour easily passes from the upper Intestines wherefore no excoriation or corrosion can be caused there as it happens in the thicker especially in the Colon where especially the morbifick humour stagnating because of its turnings corrodes its coats unmeasurably Therefore I judged abstersive Clysters and Spaw-waters very good and I found them so with respect nevertheless to Pâ—naâ—â—lus Penâ—ic 1. obs 9. and not neglecting the morbifick cause XIII In the Bloudy-flux many at the very first use Clysters of a boiled Sheep's-head whereby no doubt the Ulcers grow foul which makes them worse It is better to begin with abstersives and by degrees proceed to astringent and glutinous Medicines for fat are made use of in respect onely of a Symptome that is Pain Galen takes notice of it 12 Meth. When the Stoâ—ls in a Bloudy-flux are very fretting we give a Clyster of juice of Tragum or Goat's Sewet or Ointment of Roses by which means certainly the exulceration in the Guts it self is not cured especially if there be any thing putrid in them but ease is given And this is to oppose the Symptome and neglect the disease for a while In which Discourse not onely they are reprehended that use mere fat things but they that mix Goat's-sewet with other things when there is no pain and they also that think Sewet dries ¶ Augerius Ferrerius Castigat c. 25. reckons Yelks of Eggs among fat things with which and with fat things any Inflammation is increased ¶ Crato in Analogismo gives a caution concerning Sewet that no Physician ever use it without Oil. XIV Astringent Clysters are not so safe as Potions wherefore no man may rashly mix astringent things in Clysters because by the use of them the things that fret the Guts stick closer to them and now and then make the exulceration and the Torment greater Mercatus XV. In all fluxes of the Belly much of the innate heat goes out with the excrements whence it comes to pass that the Stomach is cooled and the concoctive faculty spoiled Nor can it be doubted but that in a Bloudy-flux by frequent injection of cooling Clysters the Stomach also must be much cooled through its continuity with the Guts Which thing the multitude of flatulencies and crudity of Excrements declare Therefore the Ancients in the Bloudy-flux added to their astringents heating and concocting Medicines as Wormwood Mint Castor Mastick c. or such things as might preserve the innate heat from being extinguished with cold things Aug. Ferrerius XVI As a hasty and over-much use of Astringents is hurtfull the flux of the humours being unseasonably stopt and the body made costive whence a perpetual costiveness and driness thereof usually remains so a seasonable use of them is altogether necessary to the end the rheumatick disposition remaining may be taken away and the retentive faculty the weakness whereof upholds the Flux may be strengthned But we must use them upon these conditions 1. According to Crato's advice before the seventh day they must neither be used inwardly nor outward till the Ulcers of the Guts be first well cleansed 2. Sometimes we must chuse cold things sometimes hot according to the nature of the Humour 3. Coolers must be corrected with things that are hot and help concoction for by the continual Flux the heat of the Stomach and Guts is diminished the crudity of the excrements is a sign of it 4. They must be given in a small dose but often first lest the Flux should be staid too soon and that the virtue of the Medicines may more easily be exerted by nature Next lest they should be washt away by the fluent humours before they exert their virtue 5. We must begin with the gentler and weaker sort as Syrup of Quinces or compound Marmalede of Quinces Hartman says we must observe in general that no Flux must be stopt on a sudden except in a Phthisick or Peripneumony XVII We must observe not to use dry things too liberally in dysenterick Clysters such as Dragon's-bloud Coral Trochisci albi Rhasis and de Spodio for they cause greater pain and oftentimes a new Flux But if any Man have a mind to use such things let him chuse Vnguentum album Rhasis Mercatus de in â— câ—t l. 1. c. 31. or Vnguentum ex Pompholyge or such things as are dry and clammy as Bole Armenick Terra Sigillata Starch c. XVIII Some put Opiates in dysenterick Clysters but amiss for Minadous Frid. Hofmannus 〈◊〉 l. 1. c. 10. a Doctour of Padua observed that all those who by the advice of their Physicians used opiate Clysters died The reason is Because Ulcers of the Guts are rendred more putrid and filthy by Opiates XIX There be three degrees of detersive Clysters The first is of such as are made of Wine and Honey with Barly-water and Honey of Roses 2. Gal. 12. Mâ—th 1. Of salt-water with Sal Gem and Honey of Roses 3. Of Brine adding some Aegyptiacum also if the Ulcer be foul and spreading And although the use of Brine may be questioned considering the example of that Physician who cured all dysenteries by the use of Onions and Clysters of brine and killed them with Convulsions for he was without method yet in a spreading and putrid Ulcer not onely Brine but even Causticks are convenient as Galen advises 9 per loca if it be also
negligent and those that look after them put them too soon to their feet it gives great occasion to this mischief in Children and Youths oftentimes the same separation of the head of the Thigh-bone from the neck of the bone happens and it is commonly taken for a disjointing This errour in Diagnosticks often hinders the cure and costs the Patient dear In both cases indeed extension is necessary but it were far better to know the very truth of the matter Rolfinccius and by judgment to comprehend it Convulsio or A Convulsion XL. Let no man wonder that I persuade to Bleeding of young children since Bloud as far as ever I could observe hitherto may as safely be taken out of their Veins as out of old peoples And indeed it is so necessary that without bloud-letting we cannot certainly cure some Symptoms which befall children for example How can we cure childrens Convulsions when they are breeding their Teeth which come upon them in the ninth or tenth month with Swelling and Pain in the Gums when the Nerves are pressed upon and irritated by the Teeth whence these Symptoms arise without letting of bloud which alone is far to be preferred in this case above the most famous Specificks that are yet known Some of which doe harm by their adventitious heat and while they are believed to oppose the Disease by some occult quality they militate against it with their manifest heat Sydenham and kill the Patient XLI It is incumbent on us to prevent Convulsions in children or to cure them as they are beginning For if the former children of the same Parent have been subject to Convulsions that mischief must be prevented in them that are born afterwards by the timely use of Medicines To this end it is usual to give the child some antispasmodick Medicine as soon as it is born some give it a few drops of the purest Honey others a spoonfull of Canary-wine with a little Sugar others a spoonfull of Oil of sweet Almonds others one drop of Oil of Amber or half a spoonfull of Epileptick Water Some within three or four hours after the child is born make an Issue in the Neck then if it be of a fresh colour they draw one ounce and an half or two ounces of bloud from the Jugulars by Leeches having a care that it do not bleed while it is a-sleep Let the Temples and Neck be gently rubbed with such an Ointment Take of Oil of Nutmegs by expression two drachms Ol. Capivii three drachms Amber one scruple Hang a piece of Elk's hoof or Paeony root about the Neck The Nurse must take Antispasmodick Medicines constantly Willis XLII But if an infant be actually taken with a Convulsion because Issues operate but slowly and little it is expedient to make a Blister in the Neck or behind each Ear and unless a cold constitution hinder Bloud must be taken from the jugular Veins by Leeches Liniments must be applied to the Temples Nostrils and Neck and Plasters to the Feet Clysters which may loosen plentifully must be given every day Every sixth or eighth hour specifick Medicines must be taken inwardly Vntzerus highly commends the Gall of a sucking Whelp taken in a little Linden-flower-water A Learned Physician told me that he has known several cured with this Remedy Idem XLIII When Convulsions proceed from difficulty in breeding of Teeth as this Symptome is secondary and not so dangerous so in the Cure our chief and principal aim need not be directed to it but sometimes we may be solicitous for easing of Pain and for removing the febrile intemperature Wherefore both the Patient and his Nurse must use a spare and cooling Diet the Gums where the Teeth are coming out must be rubbed or cut open and when the parts are swelled and pained Anodynes must be applied Clysters and Bleeding are often proper in this case Idem XLIV Sleep must be procured and the raging of the Bloud laid In the mean time Antispasmodick Medicines must be used but temperate ones and such as do not disturb the Bloud and Humours Blisters because they evacuate the Serum that is apt to be poured into the Head often give relief Idem XLV When children are taken with Convulsions neither presently after they are born nor upon their breeding of Teeth but upon other occasions and accidents the cause of such an Ail does usually reside in the Head or somewhere about the parts of Concoction When there is a suspicion of the former as usually it appears from signs which argue that too much serous matter is gathered about the Brain the Remedies beforementioned ought to be given in a little larger Dose Moreover such as bear Purging well may sometimes take a Vomit or a gentle Purge Wine and Oxymel of Squills also Mercurius dulcis Rheubarb and Resin of Jalap are of great use Idem XLVI When the cause of the Convulsion appears to be in the Bowels or when Worms or sharp griping Humours are found to be in fault for the Worms a Purge may be given of Rheubarb or Mercurius dulcis with a little Resin of Jalap Formerly I gave a Boy that was strongly afflicted with Convulsions who was ready to die a Dose of Mercurius dulcis with Resin of Jalap He had four stools and voided twelve Worms and quickly recovered Idem XLVII If we suspect that the Convulsion proceeds from the irritation of the Stomach and Guts by sharp Humours we must either purge or vomit gently or doe both one after the other To this purpose gentle Emeticks must be given of Wine of Squills or Salt of Vitriol if the Patient at any time have an inclination to vomit But if you shall rather think fit to purge an Infusion or Powder of Rheubarb Syrup of Cichory with Rheubarb or of Roses with Agarick must be given And I have often seen the Convulsion cured in children by giving these Medicines in time Moreover in this case Clysters must be given frequently But we must not omit to apply external Medicines Fomentations Liniments and Plasters to the Belly Dentitio or Breeding of Teeth XLVIII Experience testifies that a Hare's Brain is good to breed Teeth for by its coolness it helps to temper the heat of the Gums and by astriction strengthens those parts perhaps it does it by a specifick property but it may be doubted because here a hot attenuating virtue seems rather requisite than a cold astringent one since the coming out of the Teeth would be helped thereby I answer That things temperately cold and moderately astringent do strengthen Nature so that the Heat having thereby got a temper may more commodiously perform its operation Horstius XLIX Strobelbergerus lib. de Dentium Podagra mentions a certain bastard Dentition when some Swellings bunch out in the back part of the Gums when children make a noise and sibilation as they suck the Milk The Physician may be ascertained of this spurious Dentition if he
about the Heart oftentimes the Stomach sympathizes and casts all up that is in it by Vomit Nay I have known in some young Children that this Disease has fallen now and then on other parts and has raised Convulsive motions in the Face Eyes and Limbs and sometimes has proved mortal The Disease is difficult and usually very long in cure The principal indications will be to purge the serous and sharp humours drowning the Lungs out of the bloud and bowels that their tendency to the Brain and sometimes to the Breast may be prevented And to strengthen the Parts that they may not easily admit the superfluities of the estuating Serum To these ends Vomits and gentle Purges are almost always good and sometimes must be repeated Blisters are often usefull yea if the Disease be stubborn an Issue may be made in the Neck or Arm or about the Armpits Drink and liquid Aliment must then be taken in less quantity than usual and instead thereof a Diet-drink of Sarsa China Sanders shavings of Hartshorn and diuretick and antispasmodick ingredients may be used In this case some remedies are cried up as Specificks such as Cup-moss given in Powder or boiled in Milk and so given frequently every day A decoction or Syrup of Castor and Saffron Decoctions of Root of Poeony Misletoe of the Oak and Hyssop have done good to many Water of Black Cherries Saxifrage and Water of Snails distilled with Whey Willis and proper ingredients are often given with success CIII Whether in Childrens Cough may the Breast be anointed The Negative seems probable 1. Because all Anointing stops the Pores of the Skin 2. And the virtue of the Ointment reaches not to the inner parts 3. By rubbing of the Ointment on hot the fluxion to the part affected is greater But I hold the Affirmative because such Liniments have an emollient digesting and dissipating faculty Therefore I answer to the first That Anointing actually cold stops the Pores of the Skin but not that which is actually and potentially hot 2. It is sufficient to help Nature and to promote the discharge of the peccant matter outwardly by occult transpiration 3. It is granted that some attraction is made but it is to the exteriour and sound part Horstius CIV In Childrens Coughs which our Country people call the Hooping Cough Bloud-letting gives great relief Sydenham and far exceeds all pectoral Medicines Varae Tibiae or Crooked Legs CV Oftentimes Children about two years old when they begin to go are crook-legged for which their carefull Mothers take the advice of Chirurgeons and they try to set their Legs and Thighs streight with divers Engines but to no purpose because naturally and of their own accord when they are three or four years old Formius obs 30. the Legs and Muscles grow strong and the Parts return to their natural state Ventris Dolor Tumor Pain or Swelling in the Belly CVI. What remains of the Navel-string after cutting mortifies and in four or five days time falls off of it self And hence unless you put a linen rag three or four times double about the part which contracts great Cold pains in the Belly arise which are ascribed to other causes It is a sign this is the cause for they abate and cease by applying heating things CVII Children are often troubled with inflammation of the Belly from crude Milk which is neither well Purged by Vomit nor Stool It is indeed Crudity proceeding from abundance of Food which exceeds the strength of the Stomach which unless it be quickly prevented degenerates either into tedious fevers or into a loosness reaching and vomiting watching and restlesness There attends this Disease a gentle Fever or celerity of Pulse shortness of Breath a leaden or pale colour of the Face and swelling of the Eyes and Face In which case we must be more solicitous for discharging the abundance than for strengthning the Stomach or alteration I indeed endeavour to diminish the matter by Clysters Suppositories and parsimony of Milk or of other Food If the Disease go not off presently we must not stand dodging but give a gentle purging potion After which I order such things to be applied to the Belly as have a virtue to attenuate incide and make lax what is in the Belly that it may the more easily go off Mercatus CVIII In children yea and in grown people there is often a hardness and inflation of the Belly the cause whereof is the hardness of the Mesaraick Glands and so there is onely passage for the thinner Chyle to the great lacteal Vein upon which the flesh of the Muscles grows limber the Body is rendred heavy and tiresome yea and at length a Fever and Consumption arises I use to remove the Disease by this Liniment without any trouble Take of Vnguent Altb. compos 1 ounce Arthanit Martiat each 2 drachms Oil of white Lilies Chamaemil each 2 drachms Mix them It is good to chew these Trochiscs all the time of the Disease Take of Steel prepared Crabs-eyes prepared each 1 scruple Tartarum vitriolatum half a drachm Lapis Prunellae 16 grains Spec. Aromat Rosat 1 scruple white Sugar 2 ounces Mix them Make Trochiscs Purging in this case must be celebrated onely with Cassia Cream of Tartar and laxative Syrups for the Glands will not bear stronger Purgatives Barbette Vermes or Worms CIX According to Galen's judgment 4. Meth. the principal scope in curing of Worms is to get them out of the Body But because they cannot easily be got out while they are alive therefore it is necessary first to kill them or so to stony them that they cannot resist the Medicines And the things that kill or stony them are all bitter sharp inciding astringent things and sharp and oily ones Mercurialis CX Because these Animals must be cheated and are delighted with sweet things the onely way is always to mix delectable things with such as kill them and therefore they doe very ill who give bitter or sowre things alone for the Worms will not suck plain Poison But if the Poison be mixt with sweet things ludificantur lumbrici as Lucretius says of children and therefore they draw the Poison with Honey and sweet things Wherefore Medicines that are given for the Worms must always be mixt with Sugar Milk Honey or Honey and Water For my children at home I order an Oxymel to be made of the Decoction of Honey the sharpest Vinegar and Wormwood For such an Oxymel admirably preserves children from the Worms Idem CXI In those Medicines that are given by way of Clyster always sweet things must either be given alone or must prevail above the rest The reason is because these Animals being drawn by the sweetness come down to the lower parts On the contrary in Medicines that are taken by the mouth the sharp or bitter things must prevail over the sweet The reason is because if there were more sweet than bitter these Animals might
things because such food is earthy and consequently cannot be fit to nourish Theophrastus 6. de causis Plant. 14. inquiring the reason Why all tasts but a salt one are found in Plants says It it because what is of a salt tast is not fit to nourish For an instance he says Fishes which live in the Sea are not nourished with Salt-water nor salt Juices but either with sweet or acid things or with other things that are found in the Sea wherefore in this regard it is manifest I might very well say that a salt bloud did extenuate and emaciate because it is unfit to restore the parts that are consumed every day The same Plutarch is of the contrary opinion in the same Book qu. 3. vel 4. where he writes that Shepherds use salt to fatten their Cattel Wherefore if Cattel are fatted with salt it cannot be said that bodies must necessarily be consumed by a salt bloud Yea he adds that Apollonius the Physician Scholar to Herophilus used to restore and fatten emaciated Bodies with salt things We must say that salt and salt things may in some sense conduce to make fat and nourish and in another sense to consume and waste principally and of it self to wit for the reasons assigned by Plutarch and Theophrastus since salt things are dry and therefore contrary to aliment for which reason they make bodies dry and are not converted into the lost substance But by accident they may conduce to fatten and nourish to wit by causing an Appetite and which especially happens by carrying the nutriment into the parts If salt things indeed be mixt with other Aliment they are as certain vehicles to carry the aliment to the parts Mercurialis lib. 1. de morbis puerorum and as wedges to fix it there ¶ Pliny lib. 10. c. 73. writes that Salt is given to Cattel to make them drink and so to make them fat II. Another Question arises concerning the course of Diet for Hippocrates lib. de salub Dieta shewing the way how to make fat bodies lean says They must be fed with fat-meats and the reason he brings is because fat things quickly satisfie though they do not fill He subjoyns in the same place If we have a mind to make gross we must take the quite contrary course Rhases Avicenna and almost all the Graecians are of another judgment who advise the eating of fat victuals to make folk fat For a determination we must say That the use of fat things may either be moderate or immoderate and fat Meat may either be a little or very fat The immoderate use of fat things or of things that are very fat are far from fatning because they doe precisely what Hippocrates says But meats that are not very fat and the moderate use of them conduces much to making people fat and of such things must this opinion of the Arabians and Graecians be understood Idem III. And all Diuretick Medicines conduce to carry the Meat to the part for they both open the passages and are as it were Vehicles to carry the juices and aliment to the part Idem IV. So also drinking between Meals is good And they that in general condemn drinking between Meals for emaciated Bodies are much deceived for Galen himself 7. Meth. commended drinking between Meals as good for consumptive Bodies and it is almost always observed that they who use to drink between Meals grow fat Idem V. And those things conduce most to fix the Meat to the parts which do moisten with a certain tenacious and viscid humidity i. e. hot in cold bodies and cold in hot and dry bodies And this is the reason why Rhases and Avicenna commend Popy Henbane and several other things which are very cold for moistning of bodies Upon this account Lucretius says That Goats grow fat with Hemlock to wit because these Animals are hot and dry and therefore their heat and driness are tempered with cold things so that they digest their nutriment For we must not think that Goats or Starlings grow fat onely with Hemlock Nature thereby onely makes way to grow fat Idem ¶ Mercurialis from the common opinion concludes that Popy Henbane c. are cold whereas according to the modern opinion they are hot Now they doe good either by procuring sleep with which it is certain that bodies grow fat or because they thicken the juices that are thin and apt to disperse and so make them stick better to the part For the Medicines see Atrophia BOOK I. Mammarum Affectus or Diseases of Womens Breasts The Contents Things to hinder the growth of them must be applied with caution I. In their Inflammation too violent Coolers and Astringents must be avoided II. They must-be avoided in an Erysipelas III. Over-hot things must not be applied to an Oedema IV. We must be carefull how we use Topicks in a Scirrhus V. Concerning a Cancer of the Breasts see BOOK III. A Swelling from Milk must be cured with Discutients and Repellents VI. A strumous one must not be touched VII An Imposthume must quickly be opened VIII Vlcers in Women that give suck and ly in are difficultly cured IX Abundance of Milk is abated by applying Attenuants X. By setting Cupping-glasses to the Back XI When the Breasts are loaden with Milk they must be drawn XII When we rub the Breasts we must not doe it hard for fear of an Inflammation XIII We must take care that the Imposthumes may be as small as may be when we cannot hinder the breeding of them XIV We must labour to draw them to the Superficies XV. Medicines I. WE must be cautious how we apply Hemlock Henbane and such Narcoticks and they must by no means be applied to such as intend to give suck for they debilitate the innate heat and extinguish the galactopoietick faculty in the Breasts Astringents are the most proper to apply to Maids but for Women whose Breasts are drawn too big by giving of suck Driers and Discutients are most proper whereby the excrementitious moisture remaining is consumed and discussed Sennertus II. When the Breasts are inflamed we must use Repellents at first yet not strong ones by any means lest the Heart be too much cooled or the humour should strike to it but temperate ones R. à Castro with which we must mix things that have a digestive and a discutient faculty III. If an Erysipelas seize one at the first coming of the Disease such a cure must be insisted on as is proper for an Erysipelas and coolers astringents repellents or fat things must by no means be applyed to the part affected but dissolvers giving Sudorificks immediately at the first to the end the more subtile part of the bloud which is inflamed Sennertus may be discussed IV. In an Oedema of the Breasts dissolving and discutient Topicks and also things to strengthen the Parts a little must be used yet we must have a care that we
nothing is more known by experience than that by drinking water the bitterness is increased in their Mouths that abound with too much Choler namely the Choler being diluted floats even to the Mouth and therefore in such Idem thirst will be irritated by Water XXV In the same place Hippocrates speaks thus of water Neither does it quench thirst but encreases it for it is of a bilious Nature as was said before and is naught and very bad for the Hypochondres and does greaty cast down the faculties when it enters into the vacuum and encreaseth the Spleen and Liver when they are scorched and it fluctuates and swims atop for it is of a slow passage because it is coldish and crude That is it is very bad for the Hypochondres because it is very cholerick and encreaseth the cacochymie And if it slide into the vacuum that is there betwixt the Bowels and Peritonaeum it casts down the faculties as in hydropical persons and swell the Liver and Spleen when they are scorched because it passes not through but fluctuates there and swims atop and those viscera swell from the water that abides in or upon them especially when they are hot with much choler which the water increases and it passes not through because it is cold and crude for those things that are such are of slow motion For this cause it neither provokes to stool nor Urine because it stays long and it does some hurt on this account because Nature is without excrements it is 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which term some think is given it because it causes no dejection but I think it rather signifies either the Intestin that wanteth excrement or the food of which no dung is made here it is spoken of water and therefore it signifies that no Dung is bred of water and that for this reason it does some hurt But what can the hurt be that it is without Dung Galen interprets it that to be without Dung is not to cause dejections as if Hippocrates by these words should give a reason why it causeth not dejection but it s not causing of dejections is but a weak argument that it self is without Dung for many things have more Dung and yet cause dejections less than even water as black and thick Wine Therefore I supppose that as he said before that oxymel does greater harm to the Intestin when it is 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is void of excrements because these fence the Intestins so water hurts something because it is without faeces more than it would do if it bred some for these would fence the Intestins But Hippocrates will seem to affirm falsly that it causes no dejections because many mens bellies happen to be loosened by drinking of water but that happens not from any loosening quality that is in the water but because by cooling and moistning it hurts the retentive faculty in the Guts Idem XXVI The ignorant vulgar suppose that all waters are to be boiled for sick persons to make them thinner and purer but the Nature of the thing is otherwise for by insensible halitus or steams what is thin transpires from the waters in boiling and that which is thick remains besides that waters are thereby rendred less grateful to the taste by a certain ineffable and musty relish But they defend themselves with the authority of Aristotle who 4. Meteor teaches That all things wax thick by boiling except water which because it is simple its parts can by no means be separated by boiling as they may in other things that consist of mixture But I question not but if water be long boiled it will grow thick after a sort for it is not altogether pure and sincere so that with making a resolution of it by boiling it cannot be made more sincere and by consequence thicker its aereal and thin part whereby it looked thinner and clearer being resolved For as it is made worse when it is frozen by the strength of the cold so also by the strength of heat which Hippocrates proves l. de aere aq and locis where he says that all waters from Snow and Ice are bad because what is clear light and sweet in them is separated and lost Wherefore it seems to me safer to allow to sick persons very clear pure and long-kept water than to make it perhaps worse by boiling But that I may not seem to depart from the received custom I say those only are to be boiled that have some fault in them which may be amended by boiling Thus we observe that boiling is good for three sorts of faulty waters 1. for the fenny and muddy which Galen commands to boil because when they grow cold they lose their ill savour their earthy part subsiding which before was confused with the whole 2. That water which displeaseth neither by its taste nor smell but by its stay in the Stomach is grievous to it and the hypochondres if it should not be boiled ought however to be heated according to Galens precept as having some fault from the mixture of corrupt air or containing something that proceeds from an unknown cause for that is very well put to flight by the vertue of the fire 3. The last sâ—rt is the crude for as we prepare many yea most other things that are fit to eat in like manner we change some waters also into a better Nature by boiling Mercat de Indic Med. lib. 1. c. 2 Hippocrates calls such untamed as having the sun averse from them and are taken out of wells c. XXVII Seeing Hippocrates 1. de morb mul. sect 2. grants the use of Eggs to Child-bed Women when their purgations flow immoderately it is a plain argument that they have a faculty to stay or stop so that the purgations may be suppressed by them Hence gather that they are unfit in those Diseases wherein 't is fitting that the passages of the Body should be open and wherein the Humours are prepared for an exit And moreover gather that their astringent vertue is not obtained by boiling only seeing Hippocrates in the place quoted uses rear Eggs and not hard ones for astringing So 4. Acut. v. 390. he prescribes Eggs that are not hard but betwixt hard and soft for those who are troubled with a loosness But the indifferent parts which an Egg consists of are to be noted the Yelk whether it be given raw or roasted or potcht does always bridle the motion of the Humours and astringe by incrassating but the white whilst it is taken liquid whether it be boiled till it become like milk or be raw does loosen the Belly for by the vertue of the white potcht Eggs do loosen the Belly in some Hippocrates uses a raw one out of water in a burning Fever 3. de morb because as he says it cools and loosens the Belly Pr. Martian comm in l. c. p. 202. Wherefore those do not well for their Patients in Fevers that throw away
Disease and in process of time see whether the parts of the face grow red when it is thus give light Meat and if there be turgency give her a Purge c. As often therefore as the difficulty of purgation may bring some great inconvenience turgency is required to make the purgation the more easie but otherwise not VI. But we must consider that Nature may be turgent when she is provoked not only by hot thin and malignant Humours but also when by many and cold as Hippocrates teaches l. de morb mul. who rehearses that a Woman may turgere through plenty of phlegmatick Humours whereby it comes to pass that Nature often begins divers evacuations and ceases by and by from her undertaking and being weak and unable desires and points to help whereby notwithstanding inexorable Physicians are not moved but only condemn them as symptomatical and foretel the future danger but do not at all prevent it whereas Hippocrates hath often advised that we must draw that way whither Nature bends Merc. de Praef l. 1. c. 6. which opinion besides shewing of the place that is fit for evacuation insinuates also what Nature who is the Mistress of Physicians would have to be dâ—ne VII Whether turgent Humours be always to be purged off Cardan doubts contr l. 1. tr â— cont 14. because many things hinder such purging viz. continual crudity the use of thick and clammy Meats obstruction tension of the viscera heat and inflation of the Hypochondres Inflammation of the viscera in which cases it is unlawful to purge without previous preparation according to Galen 1. aph 24. yet this opinion is repugnant to Hippocrates and Galen who command to purge a turgent Humour presently without concoction because the putting off purging portends danger to life and then all hope of safety is placed in hastening of purging Indeed when there are many crude Humours in the first ways and the other proposed impediments are present we must purge with great premeditation yet if the Disease be very urgent it is better to use that Remedy than to cast the Patient into danger of his life for the harm that may be feared from Purgers is to be preferred before death as Galen commands 12. meth 1. VIII Hippocrates aph 22. 1. says that crude Humours are by no means to be purged nor must we purge in principiis in the beginnings which is so to be expounded not as if he excluded the beginning of Diseases as the unfittest time for purging as the common opinion is because this is so far from being Hippocrates's opinion that he taught the clean contrary both by doctrine and examples That aphorism is well known In the beginning of Diseases if any thing be to be moved move it then for when they are come to the height 't is better to be quiet and he assigns a reason for about the beginning and end all Symptoms are weaker but in the vigor more strong And speaking more peculiarly of purging lib. de affect vers 29. Concerning the sick we must consider presently in the beginning what thing they have need of and what such things they are as whether they should be purged or you will do some other thing you have a mind to But if omitting the beginning when the Disease comes towards an end you give a Purge the Body being now weakened perhaps being afraid to give any before 't is to be feared you will rather fail than have success From whence we may conclude that Purging is not only not forbid in the beginning but of the two times wherein 't is only permitted I mean in the beginning and declination the former is far to be preferr'd And Hippocrates himself was so observant of this document to purge in the beginning that you will hardly find that he purged in acute Diseases when the beginning was over Thus 4. acut he bids us purge on the 4th day in a burning Fever and after he says that it is to be done before the fifth In the same place he appoints purging on the fourth day in the cure of a Pleurisie In 3. de morb he says that in a Peripneumony we must purge on the first fourth and fifth days In l. de affect v. 267. in a bilious Fever he chuses the 3d. or fourth day for purging at which time he had order'd it a little before in the cure of a continual Fever And 3. de morbis in a Pleurisie he orders the Patient to be purged before he begin to spit thick Phlegm Now by the word beginning we understand not the first invasion of the Disease but all that time that is distinguished from the vigor and from the declination for this was the division of the times of Diseases that Hippocrates used as we may gather from sundry places but he signifies it to us most plainly in that aph In the beginning of Diseases if any thing be to be moved move it then but when they are at the height 't is better to be quiet for about the beginning and end all Symptoms are weaker but in the vigour more strong Wherefore in such acute Diseases as are not very speedily moved the beginning is sometimes extended to the seventh day so that a purge may be given even on the sixth And this I would note lest any because Hippocrates has so celebrated purgation in the beginning of a Disease should think that a Purge is to be given presently at the beginning which I see many do who at the first visit forthwith prescribe a Purge to their Patient often before they can have any knowledge concerning the Nature of the Disease from which importune way of cure many mischiefs use to proceed that afterwards manifest the errour of the Physician while the Disease shews its self to be of the Nature of those that admit not of purging before Bleeding a catalogue whereof Hippocrates makes 4. acut v. 28. If such were under the Law of the Aegyptians they would often be call'd in question for their over hasty purging Which danger that Hippocrates himself might avoid he durst never except in sudden and the most grievous Diseases give a Purge till three days at least of the Disease were over as appears from the above-cited places Yea 4. Acut. comm 4. concerning the cure of a burning Fever he speaks thus If it seem convenient to purge do it not within three days but on the fourth Seeing therefore Purging was so familiar with Hippocrates about the beginnings of Diseases we cannot say that in this aphor he would exclude the beginning of Diseases principally from purging when he said Nor in the beginning but that he meant that even this time Martian comm in dict aphor that otherwise is the fittest of all for purging is inconvenient whensoever there appear signs of crudity IX Then may we give a minorative purge in the beginning of a Disease when the pulses consist of great and small ones or when there is an inequality of
that is naturally cold To which may be added that an agitation being made by such Remedy in the Head an hot Catarrh that is fluxile of its own nature will fall more precipitantly upon the subjacent Parts and thereby will cause great mischief Id m. III. Concerning waters that spring of their own accord it is to be noted that the sulphureous bituminous and aluminous as Galen says l. 6. de ta Valet c. 9. are very bad for hot Heads whether the heat be joined with driness or with moisture I say the sulphureous and bituminous because they incend and melt the Humours and the aluminous because they constipate the narrow Pores m. IV. This also is to be noted that such things are very seldom used in the way of Stillicidium which by moistening may cool yea this is to be understood of cold things in general though they do not moisten but dry as cold thermae or Baths that they are never to be used alone lest the innate heat be extinguished but hot are always to be mixed with them at least in a threefold proportion Idem V. Stillicidia are used to all places that are fit to have liquor fall upon them but they are chiefly convenient for the Head and for the Nervous Parts and Joints The Liver Spleen Stomach c. seeing they are soft Parts and therefore other forms of Remedies may easily work upon them are not to be troubled with Stillicidia save in a stubborn and inveterate Distemper Idem VI. As to the Head some distinguish certain Parts in it for in a cold and moist Catarrh Deafness c. they apply Stillicidia to the coronal suture in a Palsie and Convulsion to the hinder Part of the Head where the beginning of the Nerves is but whilst the Fluxion lasts for otherwise they use to water the resolved or contracted Parts themselves In other inveterate Diseases of the Head such as the Head-ach or Megrim they pour the liquor upon the affected or weak part it self Indeed in my opinion these do not do amiss but yet the vertue of the Stillicidium is always more easily and readily received by the coronal suture Idem ¶ In deafness the Stillicidium may be received very well in the region of the ears and temples for if a mans skull be inspected the Lambdoidal suture appears to reach even to the Mastoides process and the sutures of the Temples appear to coincide therewith so that the vertue of the Stillicidia may penetrate and enter into the inmost Parts of the Ears VII It is administred two ways the one without a Bath and separately from it the other with a Bath so as that the Patient ducking himself in a Bath does withal receive the Stillicidium The first way are almost all Artificial Stillicidia administred and some of late think that Bath Stillicidia are best administred the same way but besides that it seems too troublesom Experience witnesseth that it is not so profitable Idem VIII Whilst the Stillicidium is administring the Patient must by no means Sleep which he uses to be prone to when his Head waxes hot and so a multitude of vapours is attracted to the Brain But those do amiss who keep their Patients awake with loud singing seeing the Head is filled therewith Therefore we must endeavour to do it by talking to them and by other ways Idem IX When the Embrochation is over the part is to be dried and wiped with pretty warm Cloaths and is either to be anointed with some oil of the same vertue with the Stillicidium or to be fenced with something else that may preserve the quality imprinted by the Stillicidium The vulgar apply a Linen cloth to the shaved part of the Head and put a Night-cap over that 'T were better to apply a Cerecloth that is fitted to the Nature and Faculties of the Stillicidium thus Montagnana's Capital Cerecloth of Betony c. will be convenient for a cold Head Idem Stomachicks See Book 18. Of the Diseases of the Ventricle in general The Contents They respect either the heat I. Or the ferment of the Stomach II. Remedies strengthening the Ferment III. Correctors of it when it exceeds IV. What such Externals must be V. Such as respect the beat and ferment both are very well joined together VI. What Stomachicks are bad for an hot and dry intemperature VII In altering we must have a care we do not hurt the other viscera VIII It is not to be overcharged with abundance of Medicines IX I. STomachicks respect 1. the heat which is impaired and wants to be strengthened of which sort are divers Restoratives indeed yet they profit on this general account that they are endued with an oily volatil aromatick and sweet Sulphur which they contain and are 1. Aromatick as aromata or spices the root of Burnet Mint c. 2. Balsamick oils as Amber Balsam of Peru c. for this very Medicine is indued with a Balsamick Acrimony whence Riverius commends it in Vomiting want of appetite c. 3. Things indued with a Volatil Salt especially such as is oily as Pepper Mustard Ginger 4. Spirituous things as wine the Spirit of Wine Mint Juniper Citron pill c. 5. Bitter things as Worm-wood Aloes Elixir proprietatis 6. Carminatives 7. Mild Astringents as Cinnamon Mastich Peptick Powders c. 8. Nervine Cephaiicks as Castor Hore-hound for there is a very great consent of the Stomach with the Brain All these things profit in an Anorexie injur'd chylification belching hiccough pain at the Stomach in which case the oyl of Cloves and Carminatives are the most profitable weak concoction inflation sympathick vertigo and other Symptoms of the Stomach that arise from coldness and generally the same things correct an excessive heat as correct a vitious ferment II. Or 2. they respect the ferment which I call the menstruum of the Stomach Now though those Remedies that contribute towards the restoring of this do much agree and fall in with the aforesaid things inasmuch as they also are indued with a saline Acrimony yet this is to be noted by the way That as those things which abound with a sulphureous Principle and are more Balsamick and oily do more respect the weak heat of the Stomach and invigorate it so saline Medicines do more invigorate the ferment for there are some cases wherein the heat is strong enough and yet the ferment hindered and fetter'd so that concoction cannot be happily performed though it be best that these fellow-causes which stand for one should be both attended together and on this account we must also see that whilst we endeavour to strengthen the heat we do not destroy the ferment which is chiefly done by spirituous things as Brandy III. The sluggish and deficient ferment is whetted and recruited by all such things as are indued either with an acid Salt or especially a volatil 1. All Acrimonious things as common Salt which
transpire as also after rubbings and anointings Comfrey Roots boiled in Spring-water is successfully applied to the Parts in form of a Cataplasm Medicines especially made use of by eminent Physicians 1. Rod. à Fonseca Cons 56. Swines bloud distilled is a singular thing to make one fat Take of Swines bloud 2 pounds distill it in a Glass in Balneo Give 2 ounces of this Water with a little Sugar every morning for 15 days 2. A Water distilled off Swines bloud Hartman prax Chym. de Atrophia and cooling and moistning Plants does a wonderfull deal of good It is made thus Take of Swines bloud 2 pounds rub it between your hands that all the Fibres may be taken away add of the Leaves of Betony Coltsfoot Red-Roses Mallows each 1 handfull Lettice 2 handfulls Melon-seeds excorticated 1 ounce Coltsfoot Water 2 pounds Distill them in Balneo by an Alembick Put to every pound of Water 3 ounces of Manus Christi perlatae Let him drink often of this Water 3. Joh. Stokerus pr. l. 1. c. 60. In an Atrophy of the Limbs Nettle Juice is excellent to anoint the Limbs withall that are extenuated 4. The Virtue of this Liquour is admirable Weikardus Tract Pract. l. 4. p. â—â— 582. Take of Mentha Saracenica Rosemary small Sage Flowers of Cheiri Lavender Lily Convall Roman Chamaemil Spike of each equal parts Bruise them steep them for a Month in Spirit of Wine strain them out very hard keep it and bathe the Limbs with it Aurium affectus or Diseases of the Ears See Surditas The Contents Whether a Vomit or a Purge be convenient in pain of the Ears I. Whether Repellents should be applied II. Whether gentle Medicines must always be used III. Whether Faventinus his Onion be always proper IV. Violent Pain gives way to Purgatives when it will not to outward applications V. Whether Vinegar and Oxyrrhodina may be used VI. Whether Narcoticks may be poured into the Ears VII The Cure of an-Imposthume when broken VIII Things got into the Ear are to be got out and not to be left to Nature IX How a Leech was got out of the Ear. X. General Rules for Cure XI Whether moist things may be used XII How any Liquor may be drawn from the bottom of the Ear. XIII Spirituous Waters are to be-preferred before Oils XIV Medicines I. WHether should we Vomit or Purge in pain of the Ears A Vomit seems better according to Hippocrates Aphor. 4.18 Those pains above the Midriff which stand in need of Evacuation require a Vomit And according to that Precept lib. de loc in hom n. 55. Diseases are to be discharged by the part next to them and to be drawn out by that part that hath a passage nearest each of them In lib. de affect he expresly commends Vomit If pain arise in the Ears it is good to wash in much hot water and to apply a Fomentation to the Ears and if by these means the attenuated Phlegm depart from the Head and the pain cease these things are sufficient But if not a Vomitory Potion is the best Medicine Where you must observe that the seat of Phlegm the cause of the Pain is above and so according to Hippocrates said Rules must be discharged that way But in his Book de locis in Homine n. 20. He commends Purging and condemns Vomiting If by this means the Pain asswage not let cooling things actually cold be poured in and let a Potion be given that purges downwards and not upwards because a Vomit will doe no good But here you must note that the Application of cooling things in this case argues that some Hot Humour is in fault the original seat whereof is below and that Hippocrates consonant to himself purges therefore downwards And do but you consider the Cause you have their directions before you II. Whether should we apply Repellents We must listen here to the determination of Arculanus 9. ad Almansorem Before Repercussion be made let these things be observed The Matter must not have been critically discharged Not be venemous Not furious Not much Not immediately discharged from the Brain Not very tough and thick Not gathered by little and little Not run to the out-part of the Ear Because all these things forbid the use of Repellents besides to repell to the Brain is very suspicious III. Whether must we always use gentle Medicines The excellence of a most exquisitely sensible part and its proximity to a principal part seem to intimate so much Wherefore Galen 7. method doth not cure sensible Parts at once with violent Medicines but by mild ones by degrees Yet he in the violent pains of such parts uses strong Medicines lib. 3. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 as Chalcitis Nitre juice of Onions Goats Urine c. that is when cold and gross humours cause the Pain which are attenuated and heated by the help of such Medicines and the Vapours raised by them are dissipated But he abstains from such things when the pain is the product of inflammation IV. Many Practitioners use Ben. Victorius Faventinus his Plaster of Onions to asswage the Pain of the Ears of whatever cause they come indifferently to the great damage sometime of the Patient especially when the Pain is but beginning and depends on a hot Humour But when the Pain is owing to a cold cause or the Inflammation tends to Suppuration the remedy must be applied with good success Take an Onion rosted in hot Embeâ—s Zecchius consult 62. of fresh Butter 2 drachms Oil of Chamaemil Roses each 1 drachm Saffron 1 scruple apply it warm V. N. was afflicted with an unspeakable Pain in his right Ear he got no sleep and was scarce himself the Humour indeed at first ran but after the Surgeon applied a Plaster and Clothes to his Ear the running stopt but not the Pain A Physician was called and advised Opium upon which he slept two hours and when he waked his Pain returned At length by my Advice he took some Pills of Extractum Rudii Extractum Rhei morning and evening four days one after another he bore the working well when I had removed the Plasters and Clothes the Matter began to run plentifully Then I gave him a gentle Purge of Powder of Jalap 1 scruple sharpened with 5 grains of its Resin and so the Patient recovered in three weeks Another was troubled with a grievous pain in his Ears his Head aked so he could not sleep all night scarce knowing what he did I advised him to lay aside all externals the former was my precedent and presently to take these Pills Take of Extract of Hellebor made with spirit of Wine 1 scruple Pill Ruffi half a drachm Resin of Jalap 6 grains mix them make Pills for 2 doses The first Dose gave him four stools with some alleviation of his Pain The next day he took the second Dose It gave him six stools After Noon his Ear began to run and when it had
of a volatile oily Salt may be mixt with common Medicines I have observed that Vnguentum Martiatum mixt with Treacle is excellent for dispersing and that Emplast Diachyl cum Gummi promotes Suppuration Unless the violence of the Pain be urgent I would not precipitately use Scarification of the Buboes much less Blistering and Cupping But when the Buboes are great and burning and the Patients strength firm I could allow Cupping and Scarifying but never Blistering from which I could never yet apprehend what good could be expected or did ever follow For the pain which is then increased together with the great heat and a kind of Erysipelas can doe the Patients no good who are already sufficiently weakned with the violence of the Disease But by gentle Medicines outwardly applied the sharpness of the Humour is qualified when there is any in the Buboes the Cure at least is promoted by degrees if so be that things convenient inwardly be not neglected by which the Discussion as well as Suppuration of the Buboes may not a little be promoted As soon as the Buboes are suppurated the opening of them must be hastened either with a Penknife or some breaking Medicine though I prefer a Pen-knife Franc. Sylvius de le Bâ—ë Appen ad Prax. Tract 2. Sect. 677. after the Bubo was opened I have put in with good success Balsamus Sulphuris Terebinthinatus Anisatus with Vnguent Basilicon and Treacle for by this means I quickly cleansed the Ulcer Moreover by means of this same Balsam it heals up more happily and quickly if you apply but a little Emplast Diapompholig or some such like to hasten the Cicatrice ¶ I use to treat a Pestilential Bubo in the manner following At the very first I clap on a Vesicatory although the Tumour be of no considerable bigness and neglect Cupping-glasses which I therefore reject because they cause pain and a Fever draw out the good Humours as well as the bad and do yet alter the whole bloud more Within 7 or 8 hours I cut the Blister and apply Emplastrum magneticum arsenicale Certainly its virtue is such in this case that I know not a more noble Medicine as will appear to any one that uses it The Description of it is in Hartman I have experienced these good qualities in it that if it be applied to a hard skin it produces not the least Eschar and in the mean time draws out the Malignant Humours so egregiously that a Bubo as big as a Walnut is taken away in four or five days time But this does not always succeed so quickly and this is the reason why a Blister must be first drawn that the Humours may the sooner be evacuated Nay in robust Bodies it will produce no Eschar unless by help of a Vesicatory not onely the Cuticle but some part of the skin also be first corroded But in children and more tender bodies it is able to raise a Scab of it self without any blistering premised This Scab is the true seat of the extracted Poison wherefore it is found pretty thick and the skin onely superficially corroded which is a thing truly worth consideration For this as I think is the reason why this is sooner separated than any other Scabs raised by Art for in 24 or 36 hours it hath fallen off by the help onely of a Spatula without any precedent Scarification It may be taken away without any or but a very little pain if to your Antipestilential Plaster whatever you use you add a little Vnguent Basilic or Treacle Otherwise this Unguent excellently promotes the falling of the Eschar Take of Virgin Honey Ducks grease each 1 ounce Soot 6 drachms Stratsburg Turpentine 1 ounce Yelks of Eggs N o ij Treacle 3 drachms Oil of Scorpions what is sufficient Mix them and make an Vnguent But if when the first Scab is fallen the Tumour be not sufficiently abated you may raise a second and a third with Emplastrum Magneticum Arsenicale and then proceed as you did before You may heal up the Ulcer with Emplastrum de Minio Barbette Tract de Peste p. m. 191. or some other drying and cicatrizing Plaster but do not make too much haste to heal it lest the Poisonous Humour still remaining in the Body should cause a new Disease or Death at last VII If there be a Venereal Bubo in the groin you must not bleed in the Arm For there would be danger lest the morbifick matter should be drawn upwards I have known some who just upon the appearing of the Bubo after letting of bloud and Purging have fallen into a stubborn Pox if not perpetual But if the Bubo give no hope of Suppuration and several days have past and the Pain and Swelling do not encrease then you may safely let bloud below for the matter is drawn downwards and by the approach of hotter bloud to the Bubo sometimes it is easily suppurated But when you have used Suppuraters a long time Epiphanius Ferdinâ—â—â—uâ— histor 17. if the thing succeed not according to your desire then you may freely breathe a Vein in the Arm. VIII In the same since the Humours want violence of motion there is no necessity of Revulsion but it is rather better to draw all the Humour to the place affected as in pestilential ones that all the force of the poison may expire by the Bubo for when it is otherwise more grievous Symptomes and Difeases spring up Which is the reason that I have always perswaded my self they are in a grievous errour who try to dissolve them for although it be a safer way of evacuation yet in this case it is the cause of much mischief seeing in dissolving them that matter onely vanisheth which is contained within the Bubo Whence it comes to pass when nothing of the peccant matter in the whole body and especially in the parts about the Liver and in the Liver it self is diminished as is usual in suppurated Buboes by which the matter of the whole body runs out and is purged away so that then the Body is more purified that the matter left within causeth falling of the hair Pustules Mercatus de indicat Med l. 1. c. 4. Sore heads and grievous Pains For which reason I reckon it most advisable to endeavour suppuration in all these as a present remedy for this worst of Diseases IX Buboes that are caused by thick tough and cold Humours are ripened with difficulty and require a long time to cure For sometimes when Nature is not strong enough to drive such matter to the outer skin it remains between the Peritonaeum and the Muscles hence it continually sends Vapours to the Liver sometimes it causes large Sinus's and divers symptomes for the matter polluted with this Infection returns to the Liver and infects the mass of Bloud and other parts ¶ A certain person had a Bubo in his right groin who deferred opening of it till the malignant matter fell upon the fourth and biggest Nerve of all
those about him And although I had taken seven or eight ounces of bloud away by cupping yet the next day I order him to bleed again and so in a few days he recovered V. Whether should Wounds of the head be healed by sowing or by regeneration of flesh The best Chirurgeons neglect sowing lest the matter kept in under the sowing corrupt the Pericranium and the skull and so pain and other symptomes follow also for fear of hurting the Pericranium in sowing which in all likelyhood cannot be without hurt when the whole skin is cut And sowing of the Flesh is not properly opposed to generation of Flesh nor is the cure by agglutination and future the same thing for the agglutination of the skin of the head which requires a long time can never be without generation of flesh which generation of Pus doth precede wherefore it is necessary that new flesh should grow in the room of that which turned into Pus Sennertus Let the Chirurgeon therefore make it his business first to close the lips of the wound by binding applying necessary medicines and let him leave the rest to nature VI. Whether when the Skull is fractured under the whole skin should this be cut Vidus Vidius reports that Perusinus a famous Chirurgeon did by long practice observe that more of those are saved who are cured without cutting by lenient and drying Medicines than of those whole skin is cut and their bone laid open and herein he shews that there is a vast difference between a fractured skull bare and one covered with the skin For if the skull be uncovered if it be left without cutting the humour that falls upon the Membrane of the Brain cannot be discussed by the heat which expires and therefore putrefying it kills a man But when the skin is whole the heat expires not therefore it can digest the Sanies and solidate the Bones which we daily see in other fractures that are covered with flesh and skin This opinion may be allowed of if onely a small quantity of bloud be poured under the Cranium if no broken bone prick the membranes and if the broken skull compress not the Brain But if there be store of bloud if the corruption of the parts underneath by the Pus be feared if a membrane be prickt or compressed by a broken bone according to Paulus Celsus and most Chirurgeons minds the skin must be cut that the fracture may lie open and other things may conveniently be done as they ought Idem For Nature is not able to rectifie such faults and granting that the Sanies could be drawn through the skin yet the small bones and skales that stick within are not easily drawn out VII A certain person fell backwards from on high and remained as if he had been quite dead Wherefore by the Advice of D. Pimpernelle and D. le Juif after his head was shaved a cataplasm of Bean-flower was applied all over it And because the case required haste for the Patient had lost his speech that the Cataplasm might sooner drie they got hot cloths applied to the cataplasm for the space of six hours when it was dried and taken off the figure of the latent fissures of the skull was found plainly delineated on it P. Borellus cent 2. obs 20. for the cataplasm will not grow dry in the places of fissures or fractures And a great fissure appeared in the middle of the Crotaphitus Muscle VIII A little Girl fell down a pair of Stairs and knockt the hind part of her head against a stone step so that it made a great depression of the bone with contusion onely And when her Parents would not yield to cutting nor the necessary operations but would onely have Medicines applied proper for the inflammation and contusion she was beyond expectation cured by Nature yet there remained a notable depression of the bone We need not therefore be much afraid for Children bruised after this manner by reason of the softness of their skull Marchetti obs 5. IX Aquapendent Chirurg l. 2. c. 8. shews when Trepanning the skull may be used Trepanning sath he may be used in these two Cases 1. If a descent of the matter be feared 2. If there be not a sufficient outlet for the matter On the contrary if the Fissure be open or the fracture reach not through the whole bone and if there be no contusion so that there is no fear of Sanies contained within the skull must not be opened nor the dura meninx exposed to the air to no purpose We must observe that if the Fissure or seat of the Instrument descend to the middle part of the skull scraping will not be sufficient but we must proceed to trepanning although no other â—ymptome appear upon this account because the purulent matter running from the lips of the wound to the middle part of the skull doth also by its vessels penetrate to the membrane also betwixt which and the skull it being gathered causeth death I have observed this in several Marchetti obs 15. who for this reason were trepanned that they all recovered X. We put the Trepan to the broken or contused skull that partly we may raise the depressed bone partly that matter or bloud stagâ—â—ating in the dura meninx may when the hole is made be evacuated Yet Peter Marchetti saw matter evacuated without the Trepan ¶ A young man falling from a window contused his skull which caused Convulsions and other symptomes The skin after incision made sweated out Pus by the Pores of the Skull as sweat useth to come through the skin ¶ A Boy having contused his Skull voided bloud at his Nose Mouth and Ears his Mother refused the Trepan The Boy being neglected thirty days an abscess and inflammation arising in his head Pus ran out at his Nose in great plenty Marchetti being called at last performed the opening of his Skull with a Trepan excellently well indeed but because thirty days had past the Boy at length died for according to Hippocrates in wounds of the Skull of this nature we must not tarry four days The nature of our Soil and Clime is otherwise and doth not exactly agree with the seasons of Hippocrates his Air nor will admit of such generous operations Our colder air retards the quickness of the inflammation and stronger bodies if a little time be allowed them do with Natures assistence raise the bones of the Skull of themselves T. Bartholinus cent 2. hist 41. For I have seen profound contusions of the Skull cured in our City without a Trepan onely by applying Emplastrum magneticum de Betonica ¶ A Walker in his sleep at his full growth and of no small bulk of body in the Summer 1673. fell from the second story upon a flint pavement he fell not with his whole weight upon his head but the trunk of his body first bore the chiefest force of the fall otherwise he had hardly escaped
preternatural motion Riverius Prict cap. propr the ordinary passages being obstructed by which they use to be purged And then the Catarrh is opportunely cured by opening the passages together with gentle and continual Purging by Broths or some Decoctions celebrated for several days ¶ From Cauteries actual or potential upon the coronal Suture a Physician can expect nothing but great harm for though they be commended by Aetius Avicenna Aegineta Rolfinccius Cons 1. l. 1. yet I cannot approve of them This Commendation is founded upon the old Hypothesis That the Brain is the fountain of Catarrhs which however is now expired ¶ A Catarrh is not bred in the Brain because either private or publick excrements are gathered there Private excrements the Brain hath but few The publick invented by Argenterius that are confluent thither from the whole Body are none neither moist nor vaporous It is a Figment that the Brain is like a Cupping-glass or an Alembick or like the Roof of a House that receives the Vapours from below or like the Middle region of the Air in which the Vapours ascending from the Earth are condensed and fall like Rain or Snow upon the Microcosm The whole Body gives occasion to these Catarrhs This doth by the Arteries put away the impure Atomes of the Bloud before it comes to the Head either upon the Membranes of the Nose or Jaws These Membranes do imbibe and sweat out these Atomes after this manner The Arteries and partly the Veins also are divaricated like Spiders-webs into the spongy flesh of the Nose and Jaws and sweat through like dew after the same manner that Aliment does or Liquour in a new earthen vessel Idem ibid. The Catarrh penetrating after this manner while it is not altered by the Membrane runs down thin c. Crato II. Crudities are the cause of all Catarrhs ¶ And there are Impurities not onely through the fault of the first and second Concoction but of the third also which is onely made for the due nutrition of every part of which depravation also the Archaeus provoked by external causes and therefore neglecting the office of appropriate digestion is the cause For it is a certain Axiome where there is aliment there is excrement and Where there is nutrition there is also segregation of excrements or if the expulsive faculty languish collection of them Frid. Hofmannus m. m. l. 1. c. 11. Therefore there is no necessity that we should so industriously fly to Catarrhs and Distillations of humours when every part if it labour of any Infirmity may manifestly gather its own proper preternatural excrements the same way as Helmont hath explained it III. There is need of much caution and distinction in the Cures of Catarrhs For an old Man destitute of native heat and labouring of perpetual Crudity must be cured one way A hot young Man who abounds with a bilious and easily fermenting Serum another way They whose distempered Bowels and very moist Head create this Floud one way They that create themselves this trouble by Surfeiting and Crudities Franc. Ignatius Shiarmair lib. 2. cons 1. another A Catarrh in the beginning while the humours grow hot ferment and are in motion must be treated one way When the Ebullition is ceased another And we must proceed differently with respect to the quality quantity and motion of the matter IV. The concoction and maturation of Defluxions is the moderation or adequation of their substance and qualities which especially cures and ripens Fluxions Therefore Hippocrates de vet Medic. Fluxions saith he which I think are all caused by the acrimony and intemperature of humours are recovered and cured when they are temperate and concocted that is made thicker as in an Ophthalmia the heat and inflammations of the Eyes cease when the Fluxions are concocted and made thicker and the weeping matter of the Eyes stop And concoction is made by thorough mixture and mutual tempering And he subjoins Moreover Fluxions falling upon the Throat from which Hoarseness Quinseys Erisypelas Peripneumonies all these first of all come down moist and sharp wherein the Diseases are confirmed But when being made thicker they are grown more ripe and free from all acrimony then both the Fevers and whatever things offended by reason of the Defluxion of the Catarrh are at an end ¶ Nor yet are they to be irritated by Medicines as Plutarch saith in his Book to Apollonius Neither saith he do the best Physicians presently draw out their Auxiliaries of Medicines against copious Defluxion of humours but they let the gravity of the Phlegm by outward anointings ripen of it self because time uses to ripen all things And that this does not onely hold good in Diseases of the Body but in Passions also of the Mind Oceanus also hath left us it in Aeschylus who persuades Prometheus that Jove was not to be prayed to nor addressed in the first heat of his Fury J. Langius Epist 160. lib. 2. but after he had concocted his anger V. Sometime the Brain is temperate yet fruitfull in Catarrhs because of the narrowness of the passages either natural or ascititious by which it purges the excrements into the nostrils therefore when its excrements do not run by their due chanels being increased in the Brain they cause distillations by other ways Zecchius which appears in those that snore and keep the nostrils open in their sleep VI. Sometimes the humours offend neither in quantity nor quality but are suddenly squeezed out onely upon occasion of the Cold that shrinks the part in good strength whereas they would otherwise have been expelled in a longer tract of time He that would treat the mittent part in this manner disposed with Medicines might cast his Patient into a Fit of sickness I have sometime seen persons well in health that have been tormented some days with a Distillation of the Brain by reason of the cold Air who within a short time after the matter being consumed which could not be contained because the parts were contracted by the external Cold remained well in health because the mittent part was every way sound Empiricks while they prescribe Washings Embrocations Cupping and things of the like nature Sanctorius meth vit err l. 10. c. 2. to these men for the cure of the part mittent do fall into a manifest errour VII Sometimes in a cold Distillation we must begin with Bloud-letting Saxonia pract prael when a plenitude is annexed common or determinate and that mixt And this must be done when the matter that falls upon the Lungs and Breast gives some fear of a Peripneumony bastard Pleurisie or Quinsey Joubertus ¶ Bloud-letting is not convenient because it renders the humours more fluid therefore unless the Lungs or Sides or Breasts be disaffected we must onely use Purgation ¶ One of these five conditions do best shew it 1. The Nature and Quality of the fluent matter if the Fluxion be hot sharp and
Distillations by the use of Whey fall into the Gout ¶ I prefer the Spaws before Whey of Goats-milk for Whey as it is a moistner Sylvaticus cons 93. cent 1. cannot chuse but increase Defluxions XXIII There can nothing more hurtfull be used in Diâ—â—illations than such things as simply attenuate the humours Which I would have the Moderns take notice of who in cold Distillations so willingly fly to Decoctions of Guaiacum and other attenuaters Martianus Câ—m in v. 14 sâ—ct 6. l. 2. Epid. not considering that by the use of these things Distillations increase daily which should be cured by Concocters and moderate Thickners as Hippocrates teacheth XXIV In a phlegmatick Catarrh it is a piece of rashness to hope for a Remedy by raising a Fever another way of cure not being first tried by evacuating inciding concocting and aperient Medicines especially if you know the man to be one who is not lightly in a Fever Vallerius meâ—h med l. 2. c. 13. yet sometimes we must come to a Fever XXV It is an errour of the Moderns to use Decoctions in water for Fluxions seeing it is evident that whatever is taken in form of Drink Martianus cont l. 1. sect 3. de mâ—râ—mul though it have a drying faculty yet it always increases moisture in the body especially if it be taken with food XXVI Avicenna approves of bathing in sweet water both for a hot and cold Catarrh If it be cold he disapproves it before maturation In a hot one he approves of it because the matter gives way but not in a cold one because the matter is thick and viscid If a Catarrh be imminent he forbids it because it moves the matter And while the Patient uses it he ought to sweat for so the faulty matter is evacuated Capivaâ—cius and drawn to the out side of the body ¶ When the Body is full and the Distillation yet crude I think Bathing not convenient because it melts the humours Fortis otherwise it draws from the Head and moderately digests XXVII I have observed in those Cities where Distillations from the Head are familiar such as Rome is that Women Martianus in vers 14. sect 6. l. 2. Epidem onely by Washing their heads are presently eased of their Head-ach which has its original from a Catarrh For by it the Pores of the Head are opened through which the Vapours that are retained by the Closeness of the Skin and that increase the Distillation may exhale and the acrimony of the humours is mitigated which is the cause that Fluxion remains and causes Pain ¶ I do not approve of Washing with a Decoction of cold and drying Herbs because for the most part people offend in wiping it But if either custome or necessity require it a Ly with some Leaves of Red-roses and Myrtle may be used Crato apud Scoltzium cons 21. so the Head be washed afterwards in cold water and a hot Cloth fumigated with Powder of Roses and Storax be applied XXVIII Some disapprove of Fumes building upon that of Hippocrates aphor 28.5 But if when the Body is purged and the Veins of the whole habit abound not with bad hot Juices they be made use of it is certain they sometimes help a cold Brain such as are made of Nigella seed Frankincense Sugar hot Vinegar Powder of Storax with Sugar and a little white Amber You may refer hither Smoak of Tobacco which draws much phlegmatick humours into the mouth Heurnius l. 1. meth ad prax mentions it Tobacco saith he taken in smoak is endued with a wonderfull virtue for it brings away great plenty of Phlegm out at the mouth and nostrils The dry leaves are cast upon hot coals and the smoak is taken in at the mouth wide open by a narrow funnel for it goes through the whole brain and it may be got into the ears or womb the same way I can affirm that this herb is peculiarly adapted to the brain that it easily affects the way thither and doth cleanse it from all filth But the frequent smoaking it does violence to nature especially in young and cholerick Bodies as it does good to cold and over moist Brains that overflow with Water and Phlegm Let this be the principal Caution that it be used for necessity but not for wantonness there must be sparingness and measure first let the whole Body be purged and then the Head with Sternutatories Crato in Scholtzius condemns much Fuming which he saith must be avoided by People subject to Catarrhs and such as have a Weak head And he condemns the custome of the Italians who heat some Tow in the fume of Frankincense or Amber or some such thing and apply it to the coronal Suture affirming that they doe hurt by stopping the matter of the Catarrh where it is in great quantity and especially if the Head be hot But lest the Head should be oppressed let the Cloths be fumed without the Chamber XXIX Plasters applied to the head stop the Defluxion for a time afterwards the whole matter falls down on a sudden whence comes sudden suffocation It stops for two or three days because it suspends the Catarrh Montanus but in the mean time this increases and by its sudden descent in two hours time kills a man XXX In a stubborn destillation of the head I allow of Fomentations by the frequent applying of bags filled with Millet Bran Salt and Marjoram but with rubbing with warm cloths that the heat may reach deep and concoct the humours for no man can be ignorant that frictions must not be used in destillations of the head Zecchius Cons 20. XXXI Anointings proposed by Trallianus are to be omitted as useless in a cold Catarrh and suspicious in a hot one Galen 3. Meth. 13. applied Rubificants of Pigeons dung and Stavesacre with good success in a hot Catarrh to draw back and divert the violence of the defluxion but not to take away the cause therefore Trallianus found fault with him without a reason Yet I think we had better not meddle with these two Medicines since it is not granted us to imitate him in all things onely indeed they are safer in a cold one yet suspected when there is a sympathy with the parts below Aetius also is of the same opinion and subscribes to Galen himself who 6 de san cu. determines the contrary Fortis cons 14. cent 2. Wherefore it is safer in the beginning to apply our selves to revulsive diverting and intercipient Medicines XXXII A drying Diet seems convenient by the law of contraries because abounding moisture makes the Catarrh But what is the material cause of Catarrhs A multitude of phlegmatick thick tenacious and cold humours now consider well whether Plenty do not require evacuation thickness attenuation toughness detersion or inciding cold heating what vacuation a drying diet makes will not take away a great quantity because onely thin and serous humours are evaporated by it
which causes a deadly Fever or by reason of abundance of ill humour unfit for nourishment whether it be in the veins or in the flesh Also that which breaks through the Skin is either fastened in the flesh and skin and so causes Pustules and Tumours or it onely defaces the skin with its colour and thinness and raises a very diseased affection in the skin while it prevents a greater in the bowels Which things premised it is resolved that a purge must not be given in any defoedation of the skin as it begins and in the very breaking of it out whether the matter be malignant or not And this should be observed especially in spots of malignant Fevers Small-pox and Measles nor yet after the complete time of apparition of the Small-pox and Measles But sometimes upon the score of some most urgent danger in Malignant-fevers because while they are yet appearing there is abundance of pernicious humour and the Fever encreases after the violence of the eruption and while the motion is continued outward by nature sometimes it may be lawfull to purge by friction and cupping although this must be done but seldom and with premeditation But in other spots of the skin which degenerate into the Small-pox and Measles we must neither purge in the beginning nor after the time of eruption is complete nor at any time because the humours that caused the Fever are they which degenerate into the Small-pox or Measles and for that Reason the Fever presently ceases which is discoloured though there follow another from suppuration In an Erysipelas very slowly because in these Diseases the matter is very moveable But if that which has appeared in the skin whether Erysipelas Measles Small-pox or Malignant-spots do suddenly fall back disappear and turn inwards we must purge forthwith before it fall on any principal part as the manner is in turgent humours But in some scabious eruptions such as Hippocrates observed in Simon and in others of the same stamp because they are settled in the flesh and skin and come of a thick matter and are moved slowly you may give a Purge when you think fit yet not in the beginning and very height of the eruption For we must permit Nature to finish the motion she has begun and afterwards we may purge at any time because what remains within as it breeds dayly more and more so also it desires to be evacuated for the matter is neither all together nor expelled but remains to be expelled without any Inflammation or Fever which can require coction or it must be expelled because of urgency yet by no means in the violence of its motion For it is determined among the Prudent to permit as yet the violence of the irritation and commotion in erring Nature before we stop it in evacuations which we must of necessity stop Nor must we doe it in those evacuations which Nature moves from the principal parts to the ignoble for the better because of the deadly humour In which matter the wiser guided by reason and experience fear to divert Nature from the work of expulsion she has begun by giving a Purge which motion it were a thousand times safer to help by cupping scarifying c. Because Nature would sink very much and be wearied in the contest by the violence which is done her by the Medicine drawing to the Bowels contrary to her own motion outwards Besides upon its turning back we must fear it will settle on some principal part for the turgescency is not more mortal than the foresaid retrocess inwards and from the skin contrary to the motion of Nature from within outwards Nor also is it in the power of Medicine necessarily to force the humour Mercatus when it is moved to the Guts II. A Nun without any precedent Fever or decay of strength or any other usual signs appearing was suddenly seized with Pustules all her body over and she was then sensible of no other ail besides She recovered onely by Diet without the help of Physick I judged because the Disease came in the wane of the Moon that Nature helped by the monthly motion rather drove the excrements which were few to the circumference as if she had endeavoured insensible transpiration Since the Pustules appeared not all red as in others Rumletes but were somewhat black and greenish A GUIDE TO The Practical Physician BOOK VI. Of Diseases beginning with the Letter F. Febris in genere or A Fever in general The Contents The ordinary division comprehends not all sorts of Fevers I. There are Fevers of a doubtfull nature II. In a Disease whereof it is a concomitant Bloud must not always be let III. The cure by Alexipyreticks IV. A Fever raised by Art for the cure of some Diseases V. Epidemick Fevers sometimes seize a man when there are no ill humours in his body VI. They that are sick of a Fever must not always be kept in bed VII It is not requisite that every Fever should end in sweat VIII IX I. I Am of the opinion that old Writers knew not the kinds and differences of all Fevers I will propound a fourth found out by me and hitherto observed by no man And it is an uniform continual Fever without any exacerbation following immoderate heat of the Breast and Lungs without putrefaction And this heat seizes the Lungs for want of breathing in Air through the fault of narrow Lungs Which indeed being immoderately heated cause a Fever for two reasons in the Heart and then in the whole Body Both because they communicate the conceived heat immediately to the Heart and because they so heat the inspired Air how cold soever it be that it is in no wise sufficient to cool the heart according to Nature's appointment Hence arises a continual Fever which can neither be called properly an Ephemera nor a Putrid nor a Hectick Fever If any one will refer it to a Hectick Fever improperly so called as arising from a principal part disaffected he will not be far out so he understand the manner of its generation not as yet observed at all by others I have more than once observed that they who were taken with this fever laboured of an Asthma not at intervalls but continually ¶ Sennertus besides Ephemera's continual primary or symptomatick and intermittent admits also of a certain kind which proceeds from Worms Milk corrupted upon Childrens Stomachs concrete extravasated bloud putrefying such as sometimes attends a Dropsie And I add such a Fever as arises from Phlegm swallowed down and putrefying on the Stomach Such Fevers proceed slowly because while the matter is far distant from the Heart Hoëferus they send slower and fewer fumes to it and counterfeit Hectick Fevers II. Some Fevers as well continual as intermittent are observed in practice to be in a manner doubtfull which we can neither certainly refer to Ephemera's nor to any one kind of putrid Fevers For some run out sometimes beyond the third
use either fresh juices of herbs or such as are dried for use Idem obs 5. we having for precedents Messarias Bucephalus and other most learned Italians XXII Emulsions are usually more gratefull than Juleps and are then especially of use when the Fever is accompanied with a dry intemperature of Bowels or a thin Catarrh or an Inflammation of the Lungs and parts belonging to breathing Riverius ¶ Martianus comm in lib. 2. de Diaeta 164. puts us in mind that we must consider what Hippocrates in that place says of Cucumber-seeds that they moisten and inflame because they are fat and oily Thence he concludes that the Moderns doe amiss who use such seeds to cool for if Cucumber-seed inflame because fat Melon-seed may much more doe it whole flesh by consent of all is less cold than that of Cucumbers Therefore he being Judge the use of them in Ptisane and in Emulsions is not so safe in Fevers and especially where violence of heat prevails XXIII Sorrel Juice is given in acute Fevers promiscuously and at hours and days wherein Nature uses often to move a Crisis Which custome I can no ways approve for then onely a small quantity of things can be used and that boiled lest Nature be diverted from her office So if onely an ounce or half an ounce of the said juice well boiled and clarified by it self were used it would quickly be brought into act and Nature would not be so much hurt by such things Poterius nor have such an aversation to them XXIV Some use Saccharum Saturni in burning Fevers and a Dysentery from 3 grains to 4. But the use of it is not so safe Sennertus for it takes away Virility XXV Epithems and Inunctions are frequently applied to the Brain Heart and Liver when the Fever is come to the state or declension Before indeed it is not so safe to cool by applying things for that we might rather fear the fire in the Bowels would be more kindled by Antiperistasis and constipation of the skin Nor are they altogether so convenient in my opinion at any other time except it may be in the process of the declension because here they would certainly hinder the free dissipation of abundance of fumes and therefore would foment the Fever the longer Applications indeed please the Patient as long as they afford a sense of Cold but a little after they doe harm the heat being made hotter by keeping in I should think it were better to apply Pigeons Whelps Lungs of Animals c. to the shaven head breast and Hypchondria to the end the sumes may be drawn out whereby cooling is caused much more conveniently But however so violent a heat does sometimes so weaken the sick that unless we allow a mitigation of the heat by outward application very bad Symptoms seize a Man which it is better to prevent by a cure Joubertur not regular as they call it for we may in a little time after make amends for all the harm done ¶ In burning Fevers I have found by experience nothing better to abate the heat of the Lungs and Breast seeing the less hot the Lungs are the less they heat the attracted Air. Therefore it is abated by moist and cold things when the Fever dries the body and the driness increases the acrimony of the heat And they are made of moist things which were first invented by me that is of Oils and Water of Pearl Barley a little boiled lest it should obstruct and hinder eventilation by its clamminess and so a fault be committed worse than the first Rondeletius They are made also of a decoction of the four greater Cold Seeds or of a Decoction of Cucurbites c. ¶ It is very good to apply cooling Epithems to the Liver and the whole region of the Hypochondria for they do not onely promote concoction but they also amend the intemperature of the Bowels and hinder the principal parts from falling into a Consumption Cooling things are also beneficially applied to the Stones because of the consent they have with the principal parts By reason of the same consent with the whole cooling of the hands and feet does good Nor do they hinder the evacuation of Excrements for little flows from these parts Riveriu◠therefore more good than harm comes from cooling of them ¶ Observe that Frontals must be taken off on the critical day that is on the fourth and seventh Enchir. Med. lest they hinder bleeding at the Nose which usually puts an end to a burning Fever XXVI We must have a care of very cooling Meats unless the violence of the heat not regarding other evils do require it For they both thicken the humours and stop the passages But the whole method of cure either consists in extinguishing the heat of the humours or it shews how the boiling humours may transpire through the body For a remission of the Fever is caused by transpiration of the hot humours which we may attempt either by opening the pores or an equal diminution of the humours Whence it comes to pass that over cold and astringent things by way of Food the case is otherwise as to drink are contrary both to reason and experience Wherefore before a crisis we may not use them Mercatu◠for it often happens that crises have a worse issue Nature being made dull by the Cold and the Pores almost shut XXVII Sleep which is disallowed by several all the time of the Fever when the heat tends to the outward parts lest in it the heat should turn inwards must be allowed because it greatly recruits strength But since it sufficiently shews that the heat is drawn outwards rather than inward in sleep for that people use to be hottest and sweat most in time of sleep and for that very reason and in that it quenches thirst it likewise does good there is no need to fear that which rather does good and therefore to keep people from sleep and so weaken them more Seeing in sleep nature is not called from her duty because she is more intent upon the concoction of food for in time of sleep she minds concoction less but Nature's power is not idle in elaborating the cause of the disease when a Man is asleep Yet in the mean time it is better to abstain from sleep in the very fit of a Fever Platerus XXVIII If a Fever be protracted Purging must in like manner be repeated Preparers and Concocters being given between whiles till the whole Mine be taken away for avoiding a relapse Yet this rule wants a restriction for if after several repeated Purges a slow Fever continue which insensibly consumes the Patient and seems to cast him into a Consumption it will be the best way to omit Purging and to resist the Fever onely by a course of Diet and altering remedies For it sometimes happens where there is some ill disposition of the Bowels by reason of the
shews its head again and creates Nature a new trouble running over the same course which we have shewed before II. And of Agues some belong to the Spring others to Autumn For although some arise in the intermediate seasons yet because they are not so frequent and may be reduced to the former to those namely which they are nearest to I shall therefore comprehend them under these two kinds And indeed this distinction of Agues is so necessary that unless in our practice we take notice carefully of it we can neither make our prognostick aright how long they will last nor keep our Patients bodies under a right regiment with respect to the different nature both of the Seasons and the Agues It is true indeed the Agues of each Season have their nature not altogether unlike whether you consider the manner of their first coming which first begins with Shivering by and by bursts out into Heat and at last ends in a Sweat or the difference of their Types in respect whereof there are some Tertians both Spring and Fall yet in the mean time I do not doubt but these Fevers are fully distinguished in their nature or essentially Idem p. 72. III. And that I may first speak of Vernal Agues they are all either Quotidians or Tertians and they come either sooner or later according to the various disposition of the season For in Winter time the â—pirits are concentrated and in their recess gather strength to themselves which being now brisk the heat of the approaching Sun draws out and being mixt with the viscid humours yet they are not so viscid as those the heat of the foregoing Autumn has boiled and rosted which Nature during Winter had gathered in the mass of bloud while they endeavour to fly away are kept implicated and as it were intangled and so they cause the Vernal Ebullition After the very same manner as Vessels full of Beer and set long in a cold Cellar if they be set near the fire they presently begin to work and the Liquour is apt to fly The Bloud being in this manner affected endeavours the Purging of it self and by the help of volatile Spirits does the business soon enough unless perhaps it be too full of viscid juices which may hinder the fermentation begun And though this happen yet the Vernal Effervescence is seldom continual and constant but is usually parted into several fits For the Bloud being now turgid with these rich Spirits Nature falls to her work as it were in haste and makes a secretion of some parts by particular Paroxysms after the manner of perfect solution before she finish universal separation And this seems no improper reason why in Spring-time especially that part of it which is nearest Summer we meet with few continual Fevers unless perhaps the constitution be Epidemick for the fermentations that then arise are either quickly laid or hasten to an intermission or finally the parts of the humours being more prone to separation are too hastily and with some violence translated to another place from whence by and by Quinseys Peripneumonies Pleurisies c. do grow shewing their heads especially in the latter end of Spring Idem p. 73. IV. Therefore we may undertake these Agues various ways and indeed with desired success as it is abundantly manifest to me from frequent observation Sometimes a Vomit given in season namely that it might doe its work before the fit succeeded well especially if you give a large dose of Diascordium when the Vomit has done working immediately before the fit comes Sometimes you may observe Health recovered by Diaphoreticks which may provoke Sweat arising in the end of a fit covering the Patient well with clothes And it must be done as much and as long as the Patient's strength will bear it and this has often done the work in Spring-agues especially in Quotidians For the humours in this season not being very thick the solution that would otherwise be imperfect grows to a perfect one which indeed never happens in the Autumn What shall I say for that I have cured Tertians sometimes by the benefit of a Clyster given on the intermission days for three or four days together Nevertheless if those Spirits be depauperated and weakned which should suddenly make themselves ready for despumation either by reason of Phlebotomy celebrated with too liberal a hand to which the season it self easily inclines the unwary or through some antecedaneous weakness of the Patient it may so happen that these Vernal-agues may vye in length with the Autumnal but indeed they last not quite so long because they either end of themselves or are more easily cured with light Medicines Idem p. 74. V. But Autumnal-agues are not so easily removed If the Autumnal constitution be Epidemick they use to come about the latter end of June If not they tarry till August and the beginning of September in the following months they more rarely occur Assoon as a great troup of them comes together you may observe the fits to come all at one and the same hour of the same day the fits sometimes preventing and sometimes postponing in the like manner and the same tenor unless it so happen that this order be altered or perverted in some bodies by Medicines which have a faculty of stopping or hastning the fit In respect of their Types they are either Tertians or Quartans and it may safely be said of Quartans that they are the genuine off-spring of Autumn Truly they are so near of kin one to another that they are oftentimes found to take their turns at least for a time and it may be presently they will return to their wonted Genius But Vernal Tertians never put on the Types of Quartans for they are as far different as Heaven and Earth Nor farther have I ever observed a Quotidian come at that season unless one will have a double Tertian or a treble Quartan in accurate speaking so called Now I suppose these Agues derive their original in this manner namely as the year comes on the bloud also is exalted according to the rated proportion just as all Vegetables shew the course of the year by their increase and declension till they come to their height and utmost vigour Then proceeding in parallel motions with the seasons of the year and as the year declines it also begins to be relaxed and then especially when it is promoted by any accidental cause suppose by immoderate loss of bloud taking cold by crude and excrementitious meats unseasonable use of bathing c. Now if the bloud constituted in this state of decidence decay so far as that it is not able to maintain its oeconomy and protect its fortunes with its present stock Nature taking new advice does at length incline to this that it may prepare a certain new texture for the effoete mass and so endeavours an alteration of affairs so contriving it that the parts of the mass of bloud which are most
in it Febris Algida or The Cold Ague It s Nature and Cure COld Agues are observed some times to be troublesome not onely in cold especially but in Cold alone so that sometimes and more frequently a little Heat does follow sometimes but more seldom none at all We have such in our University Hospital so manifest that not onely in the beginning and encrease but at the very height and declination of the fit yea and when it is over the Patients are always sensible of Cold never so much as warm much less hot at any time They owe their Original to a more acid Pancreatick juice joined with great store of viscid Phlegm Bile in the mean time being very dull This Mixture will be proper for the Cold and other Symptoms that use to accompany it Take of water of Parsley 2 ounces Fenil 1 ounce Theriacal simpl or vitae Matthiol 1 ounce and an half volatile salt of Amber 1 scruple Syrup of Carduus benedictus 1 ounce Which will be more effectual if you add to the same of Laudanum Opiatum 4 grains Oil of Cloves 2 drops I have not hitherto observed any thing temper the cold equally to this Sylvius de le Boë Prax. l. 1. c. 30. And as long as the Ague lasts the Patient may take one spoonfull of this or some such liquour 3 or 4 times in an hour Febris Anginosa or A' Fever and a Quinsie It s Description and Cure IT invades men at any time of the year but most between Spring and Summer time and young men and them that are of a Sanguine complexion above others but red haired men as I have observed more than once above all the rest At the very first invasion of the Disease they are cold and shake a Fever follows and a little after comes a pain and inflammation of the Jaws which if it be not speedily helped immediately the Patient cannot swallow any more nor draw his breath through his Nostrils but his Throat is stopt with a certain sense of strangling by the inflammation of the Vvula and swelling of the Tonsills and Larynx In the first place I take a great quantity of Bloud from the Arm then from each Ranula then I touch the inflamed parts with Honey of Roses and Spirit of Sulphur By and by I prescribe the following Gargarism to be held in the mouth till it be warm without stirring it Take of Water of Plantain red Roses and Frog-spawn each 4 ounces Whites of Eggs reduced to a water by beating No. ij white Sugar-Candy 3 drachms I order an Emulsion as in a Pleurisie The next morning if the Fever and Pain do not abate I open a Vein again in the Arm and let Purging alone till the next day If both be abated I presently give a gentle Purge which after bleeding is necessary above all things as experience testifies If perchance even after purging the Fever and Symptoms should proclaim War this must be subdued by repeated Blood-letting Let the Patient every day keep up some hours from his bed because the warmth of it adds strength both to the Fever and the Symptoms But we must take notice that these Quinsies which are onely a Symptome of this Stationary Fever Sydenham Obs in Acut. Sect. 4. c. 6. as I call it love to be cured by the self same method which the Fever challenges for it self and therefore must be thrown off by Sweat and the Pores of the Skin or by any other method that is due to the primary Fever whereto they are inherent Febris Anhelosa or The Short-breathed Fever It s Nature and Cure ANhelous or Short breathed Fevers have their name from difficult and anhelous respiration and they put the Patients to strange and miserable Anguish either with or without palpitation of the heart I have observed them more than once begin with a distension of the Abdomen and anxiety of the Praecordia the Pulse being immediately weak small and frequent chilness and pain troubling them in the Region of the Loins at the same time But if then they broke wind either upwards or downwards the fit was less if not it was more grievous for after this distension and anxiety had lasted one or more hours both of them sensibly abated and then an exceeding difficulty and shortness of Breath was raised so great indeed that the Body could not indure to be stirred or moved in the least the Pulse by degrees growing rather weaker than stronger and continually more frequent together with the Veins every where very turgid which out of the fit were small and scarce conspicuous This shortness of Breath was sometimes more grievous sometimes more slight and grieved them sometimes a longer sometimes a shorter time Wherefore Medicines that are good for Hypochondriack prefocation were often here likewise used with good success And at length the fit ended rather in a Damp than a Sweat till a new one returned seldom every day often every other day I think these Fevers as also suffocating Fevers of which hereafter should be ascribed to Vapours but not very austere ones and in like manner from a less austere Pancreatick juice but arising from this mixt with viscid Phlegm meeting it in the small Guts and therefore the more flatulent from which the symptoms enumerated may easily be derived and well enough explicated Sylvius de le Boë Prax. l. 1. c. 30. The anhelous anxiety since it owns the same but a slighter cause will be cured and abated with the like Medicines as well in the fit as at the beginning of it being often used in a less quantity Febris Arthritica or The Gout-fever It s Nature and Cure SOme Practitioners reduce Arthritick fevers to Catarrhal fevers because they think the Gout owes its rise to Catarrhs But because I am of opinion that another humour is carried together with the Bloud by the Arteries to the joints which breeds the Gout I cannot but think that Gout-fevers should be distinguished from Catarrhal ones But because I could accurately enough observe the rise and progress of the Gout from the faithfull relation of the sick I as often took notice that it came with a Continual fever or an Ague Wherefore when a new Ague fit came the Gout was not a little increased till it either turned to a Continual fever or ceased of it self or the Ague was removed by art the Gout-pains nevertheless continuing I reckon to find Gout-fevers in the Pancreatick juice so corrupt that it is troublesome onely to the joints whether it being also endued with a considerable Acrimony which is most frequent carries the Bile thither along with it wherewith it had vitiously fermented and causes a most bitter pain Or being not so sharp and hurting the viscid Phlegm not the sharp Bile which is much dulled with mixing with it it rather hinders the motion of the part affected with an oedematous tumour than a sharp pain Where we must observe that the Ague fits which come every or
immoderate Heat last Summer was attended by as intense Cold the Winter following The Earth was covered with Snow a North Wind blowing till the Calends of June All the Winter it was a pretty healthy time About the end of April in the year 1658. there arose a Disease on a sudden which siezed very many at once so that in some Towns above a Thousand People were sick together in one week's time The Pathognomick Symptome of this Disease and that which first invaded the Patients was a troublesome Cough with much spitting and a Catarrh falling upon the Throat Palate and Nose There was also a febrile Intemperature with Heat and Thirst want of Appetite spontaneous Lassitude and a dull pain in the Back and Limbs The Fever was in some more remiss that they could walk abroad in others more intense with heat great thirst watching hoarsness and other Symptoms The original and formal reason of this Disease were chiefly founded in two things namely in that there happened at the same time a more than usual effervescence of the bloud caused by the Spring season and also a great constriction of the Pores caused by a precedaneous tract of time that was exceedingly over cold that there was not free room for the bloud as it wrought in the Veins The case stood thus as if Wine when it begins to work were put in Vessels close stopt for by this means both the Vessels and liquor are in danger of being lost But that a North Wind is most apt to produce Catarrhs besides Hippocrates his Testimony common Experience confirms it As to the Symptoms joined with this Disease they were caused by Bloud fermenting too much and not eventilated enough therefore a simple Continent fever or one of many days was caused a little of the thinner bloud being heated and the rest onely put into confusion In some that had an ill disposition of the bloud or a bad habit of body it turned into a putrid and mortal Fever The Cough with a Catarrh that accompanied this Fever had its original from a serous humour that had been long gathering in the bloud because transpiration was stopt and then upon the rising of an effervescence sweating out so much the more by the small Arteries that open inwards For when the Pores are stopt the superfluous serosities that were used to evaporate outwards are by nearer purification of the bloud poured inwards upon the Lungs Which is the reason that a Cough is for the most part raised upon taking a Cold that is upon transpiration outwards being hindred As to the Cure when this Disease is but slight its Cure is for the most part left to Nature for this Fever since it is onely a simple Continent uses to end within a few days in sweat Wherefore after a plentifull sweat the heat and thirst weariness and dull pains are done usually about the third or fourth day Then the Cough continuing a little longer does ever after by little and little decrease If the Disease be more thoroughly fixt it must be cured according to the rules that are observed in Putrid fevers but with this difference that because transpiration hindred and the pouring of the serous humour into the Lungs are in fault therefore Diaphoreticks and Thoracicks are of more frequent use for they hinder the flowing of the Serum out of the Vessels inwards and either by opening the Pores convey it outwards or by precipitating it from the bloud discharge it by the urinary passages The Remedies therefore which are by frequent experience vulgarly held to doe most good in this Disease are Sweating and Letting bloud For when the Vessels are emptied either way Willis de Febr. c. 16. both the immoderate effervescence of the Bloud and the exuberance of the Serum are restrained Sylvius de le Boë Pr. Med. l. 1. c. 30. calls them Catarrh agues which come from a Catarrh falling not onely on the Lungs but on any other part that moves and ceases together with the Ague fit for a new humour falls not on the parts out of the Ague fit and what is faln already does not recede or leave the part affected although the Ague fit be over And they are owing to the humours gathered by little and little in the Head which are dissolved by the cause of the Ague being carried thither and moved every way to their distillation and defluxion The Catarrhs that are moved to their defluxion at the time of the Ague fit require different Medicines according as they consist of a different matter and affect different parts In general their vitious quality must be corrected their plenty abated and the parts that are usually affected by them must be strengthened Therefore thick and viscous Catarrhs must be attenuated and cut by Aromaticks But serous and salt ones must be tempered with oily things and Opiates Thick ones must be evacuated with Phlegmagogues serous ones with Hydragogues The parts affected or like to be affected must be strengthened against viscous and thick Phlegm by Aromaticks that are gratefull to them against a salt Serum by glutinous things both external and internal II. Galen 6 de Sanit tuend 9. said right that they who are obnoxious to distillations are prone to many and divers Diseases according to the imbecillity of different parts For when the Brain it self has poured abundance out of it self lib. de Carnib 17. if the Patients have weak Lungs by Nature and the Brain be weakned by a foregoing Fever and made fit to produce matter for a Catarrh wherefore Galen 3. de Sympt Caus 4. said that a Catarrh is caused when the Brain being either too much cooled or over hot is weakned and so concocts badly and breeds much Excrements to which the retentive faculty is forced to give way whence on necessity a fluxion to the lower parts is raised which falling on the Lungs causes a Cough sometimes a far greater quantity of the Catarrh falls upon the Stomach and Mesentery by the Gullet than does upon the Lungs by the Wind-pipe And this being kept a long time in the Mesentery and not ventilated often conceives a putrefactive heat and raises a Fever obstructions giving no small help to the putrefaction together with the defluxion which maintains them And it is not to be doubted but Vapours are carried from the lower natural parts by the Veins and spaces into the Head and crudities also from the whole venous kind which circulation is accounted the worst by Hippocrates Nor let it seem marvelous to any Man that this Fever must be called a Putrid but not a Humour Fever since Galen called the watry spittle of the Aliment and the serosities that distill from the Brain excrementitious humidities but he would never call them Phlegm because it is a juice declining a little from the perfection of bloud But this juice of the Brain or improper Phlegm is an excrement of the third concoction and therefore should not be reckoned among pituitous humours And
Phlegm and it into Choler II. The common Symptoms are Inflammations inward or outward which we must help neglecting all other things And if this be internal revellents repellents and alteratives are proper and therefore Bleeding application of Substypticks and inward Coolers will be necessary But if they be external through the translation of the humours or a Crisis naturally procured by their settling Or if the matter by reason of long sickness be attracted to some part it must be diligently observed by the Physician that he abstain from all Diversion procured by Bleeding and Medicines especially Purges but they must insist on slight Preparatives Alteratives and Clysters In the mean time the care of the part recipient lies upon the Chirurgeon hat the Inflammation turn not to a Gangrene the innate Heat in the whole and part being weakned by a tedious Fever Idem III. Wormwood must not be given before Coction because it causes loathing Rudiuâ— l 3. c. 33. the Humours being moved in the Stomach IV. A true Hemitritaeus to wit a Continual Quotidian and a Tertian between whiles requires a more subtile Diet than is proper for interpolated Fevers but a grosser one than what is convenient for continual Fevers from one simple Humour because it is longer than any one of them And since Nature has a dispute with two Humours contrary both in quality and substance she stands in need of strength and time to conquer them both therefore upon both accounts namely that she may continue a long time and that she may have strength against both her enemies she has need of more ample Alimony We must mix therefore either such things as may repress the Qualities of the peccant Humour together with the Meat and of contrary Qualities or we must use temperate Meats One may not administer such things as respect onely one of these things for the Physician must be carefull of both Fevers I call that meat temperate which suffers onely from the natural heat You may apprehend that this is not fit for them that are sick of a Hemitritaeus because the Bloud must of necessity have a bad quality which is bred of it in Fevers for in the Tertian the part effective of the bloud is out of its natural temper that is hot and dry because of the heat and sharpness of the putrefying Bile Wherefore temperate meat by reason it suffers onely from the natural heat and cannot by contrary qualities correct the intemperature of the part will be affected with them wherefore the Bloud which will be bred of it will grow hot and dry according to the intemperature of the part which will in a moment immediately be turn'd into Bile The like judgment may be given in a Fever which has its rise from Phlegm that makes the Body preternaturally moist wherefore things must be mixt with the meat which are of contrary qualities or that must be taken in which both qualities are found which I rather approve but if moreover it be incisive it should be chosen before the rest Vinegar is one of those simple Medicines which is remarkable for the foresaid qualities For it is good for both the Humours moreover it is endued with subtile parts whereby it cuts but if you mix this with any thing that is abstersive you have that which we require Sugar is one of those things which is moderately abstersive and is convenient for People in Fevers Wherefore you may reckon that a mixture of Sugar and strong Vinegar which Physicians have named Syrupus Acetosus is very convenient for a Hemitritaeus which you may use in this manner Take of Time Parsley French-barley each 1 handfull stoned Raisins 1 handfull the Bark of one sharp Radish a little Salt Boil them well with a fleshy Hen Take 1 pound of this Decoction as much sharp Syrupus Acetosus as will make it palatable let them boil till they are mixt give him to drink when be ought Make Broth of the rest Use this before a violent fit and in its declination but on the more moderate day use the same Brudus de Victu Febr. â— 3. c. 24. and give the Patient the extremities of the Hen. IV. One of the Arabians in a Hemitritaeus feeds the Patient with Gourds Spinage Orache and the like But he is mistaken as I think upon a double account Of the very Nature of the body and Of the Meat it self Cold Meats must not be given at the hour when Nature is intent upon separation lest they oppose Nature and repell the periodick expulsion the contrary way which is made from within outwards and stop the Pores by reason whereof the fit will be made longer as is manifest to them that diligently consider the nature of Meats and search what they are able to doe at all hours Hereto you may add the Meats which are made of Herbs are obnoxious to corruption because they breed a watry Bloud which soonest conceives an extraneous heat It is therefore the wisest way not to give Meats of this nature when the corrupting cause is strong Idem ibid. Febris lenta or A Slow Fever It arises from an evil disposition of the Bloud THAT is reckoned among Symptomatick fevers which is vulgarly called Slow They that are sick of it are hotter than they should be especially after eating any motion or exercise The Urine for the most part is red the Spirits are low and Strength decays they are indifferent well as to their Stomach and Sleeping they neither cough nor spit much but they waste every day like consumptive People and without any manifest cause The Blame is generally ascribed to obstruction of some of the Inwards through whose fault the Aliment is neither concocted nor dispensed aright But it seems to me that such an affection is founded immediately in an evil disposition of the Bloud whereby it inclines to an over salt and sharp temper and therefore is rendred less fit for nutrition and equal circulation for the Bloud in the Heart just like Oil in a Lamp if it abound over much with saline particles burns not pleasantly and quietly but with crackling and great evaporation of parts whereby it is sooner spent and yields but a languid and weak light Formerly I opened one who died of this Disease in whom the Bowels designed for coction were well enough but the Lungs were sapless and dry and were beset all over with a kind of fabulous matter like Chalk And ofttimes in this Disease the Mesenterick Glands are full of such chalky matter But whether the salt bloud first caused such Diseases of the Bowels or the Discrasie of the Bowels first infected the Bloud is uncertain Willis de Febr. c. 11. It is probable that one of them depends on the other and the causes of either Disease are reciprocal Febris Leipyria or A Fever wherein the inward Parts are violently Hot and the outer Cold. The Contents Hippocrates his Cure by applying cold things is methodical
is low and there is no fulness of bloud or but a very little and when it consists of the thinner part of the bloud Then because the whole Body cannot be evacuated by opening a Vein for these contraindicating Causes I should admit the use of moist Cupping-glasses by which we might advantageously evacuate that virulent Cacochymie Augeniâ—â— which is mixt with the thinner bloud X. In the Year 1648. an Epidemick Malignant Spotted fever raged with great destruction in which I often observed that the frequent application of dry Cupping-glasses and of Vesicatories to the middle of the Limbs and behind the Ears did much good even in desperate persons and such as had a Lethargy or a Phrenzy But if the heat or motion of the bloud were over high Petrus Borelius Cent. 1. Obs 60. then you were to abstain from cupping and scarifying for they were mortal but the use of Cordials was very advantageous XI It is the way of the Italians to apply Cupping-glasses to the lower parts for revocation of the poisonous matter from the Heart to the most disstant places To the Shoulders and Back by no means lest it be drawn towards the Heart from other places But they are properly applied to all these places beginning at the lower parts for the foresaid reason Which application since it does not sufficiently draw the poisonous humours and vapours from the heart and neighbouring parts therefore it is of necessity made to the shoulders and back Hear Mercatus his Opinion of them It is most advisable to scarifie where you set the Cupping-glasses to the Back over against the Heart Which Invention Practice has often shewn to be of such moment that I have seen anxiety inequality of the Pulse and other most cruel Accidents presently cease thereupon Wherefore till you find the accidents of the Poison in some sort to abate you must not leave off Cupping XII I had a Porter under Cure of a Burning Malignant fever When he was in great anxiety I ordered Leeches to be applied to his Anus but either through the negligence of the Attendant or the ignorance of the Patient they were set to his Paps which falling off full of bloud gave occasion to copious bloud-letting When I came P. Salius Diversus I found the man recovered of his Disease and I ascribed his succeeding health to this Remedy XIII When one has been sufficiently bled in the Arm opening a Vein in the Forehead is proper he may bleed 6 ounces Leeches may also be set behind the Ears which indeed are an usefull Remedy but not so effectual as the former because the thinnest part of the bloud onely is drawn by the Leeches when by a Vein of the Forehead sometimes in a Phrenzy more impure and corrupt bloud is drawn Riverius than from the Arm. XIV Vesicatories are condemned by some 1. Because they encrease heat and burning 2. Because by intervention of Pain they cause Watching 3. Because they often hinder the critical motion of Nature to the Nose I answer to the First That they cause heat onely in the external parts whereby the internal heat is abated To the Second That Watching and Pain come of themselves To the Third That they do not divert Nature from any wholsome purpose because she endeavours no critical motion But indeed they are necessary 1. That the heat which is almost stifled may be refreshed 2. That the poisonous matter that is about the heart may be attracted 3. That the raging matter rapt to the heart and brain Rolfinc Cons 9. l. 4. when it has a great urgency and causes a Delirium and makes the Pulse low may be retracted to parts far distant Vesicatories doe all these things as a present Remedy ¶ Being taught by experience I judged it a proper Remedy in this case because I observed the internal heat was very great when the out parts were cold and most grievous symptoms of the principal parts were imminent by reason of the malignant Evaporations of the boiling bloud By this means Revulsion is made to the out parts in which respect the Physician imitates Nature Horstius l. 1. obs 30. which uses to transfer Spots Buboes and Carbuncles to the out parts in Pestilential fevers ¶ Vesicatories applied to several Parts do powerfully draw and make revulsion of the bad and poisonous Ichores They are commonly applied to the hind part of the neck for there they draw out the poisonous matter and derive it from the head and serve to cure comatous affections which frequently happen in these Fevers Yet where a great Malignity has siezed the whole Body and very cruel Symptoms are urgent one is not sufficient but several must be applied In an exceeding severity of a Disease I use to apply them to five places namely to the Neck each Arm on the inside between the Elbow and Shoulder and to each Thigh on the inside Riverius between the Groin and Knee with good success XV. What Issues Sores and Vesicatories are able to doe in preventing and curing Malignant Diseases yea the Plague it self has been already in some measure known since Galen's time and is worthy of a more exact enquiry In our clime where the humours are for the most part gross phlegmatick and dull sometimes we observe present relief from Vesicatories especially if they be applied before the seventh day of the Disease to the inside of the Arms and Thighs where the large Veins run Yet there is a time when they are applied whole months to no purpose yea sometimes in a whole year no sensible relief is found from them The reason may be drawn from the difference of the Infection When these Malignant particles stick not very fast and do not embrace the tenacious moisture of the Body they are more easily discharged by a Vesicatory and the fugacious poison departs as the Serum breaks out But when they reside in viscid matter or are closely joined to any smooth matter they commonly elude the force of a Blister But how shall we know in what particles the malignity resides To consider the constitution is not sufficient for I have sometimes observed that Vesicatories were very beneficial to phlegmatick persons and that they have done no good at all to extreme cholerick Men. They must be applied in season especially when it appears by examples that they have done good to others who have been sick in the same manner Olaus Borrichius Act. Danic 1676. p. 77. near the same time But if they fail your expectation you must persist in Alexipharmacks which must nevertheless be made use of ¶ Since it is the ill custome of several Physicians when Malignant fevers do rage much if there be Head-ach and Delirium to rely much upon the application of a Veficatory that I might be certain of the success I enquired of several Chirurgeons from whose report I understood that most Patients died to whom they were laid And indeed I knew several who were
marvellous efficacy given from half a drachm to a whole one in Malignant fevers Small Pox Measles yea and the Plague it self But whence comes its diaphoretick virtue considering its astrictive faculty Simon Pauli Quadrip Botan p. m. 225. affirms it is used to stop the ebullition of the bloud not to raise a sweat for as it is far better to spit on a spark that it may not burn and consume a whole House with the flame which it would rise to so it is most advisable by cold and dry things such as Antimonium diaphoreticum is and also Root of Tormentil Bistort which are astrictive and Diaphoretick Bole Armenick Terra Sigillata burnt Hartshorn Calx Antimonii c. to stop the burning of the bloud or the fermentation following it which if it exceed measure so as the circulation of the bloud being altogether disturbed the bloud be unspeakably corrupt it can neither return again to its natural habit and the contagion which follows that corruption that takes so many off is called the Plague whose fomes seminary or contagion you will never cast out of the Body except by Alexitericks or Sudorificks But this reason does not yet satisfie for if it held good the cure would not be safe while the cause of this burning or ebullition would not by this means be taken away and Opiates were better able to doe this work Nay Whence proceeds the usual eruption of Sweat after the use of the enumerated Medicines which are cold and dry Diaphoreticks Wherefore I judge that Antimonium Diaphoreticum as also the other Medicines are not indeed among the number of those Sudorificks that have the faculty of attenuating and dissolving gross humours but that they are such as imitating Nature do by their fixing and precipitating virtue which depends on a peculiar texture of the parts fix and precipitate the morbifick ferments or the volatile Sulphureous Salts Frid. Hofmannus Clavis Schroderiana p. 303. and also strengthen the Tone which being done the tumultuating faculty of the Archaeus is quieted and throws off what is troublesome by Sweat or Urine from the Lympha or mass of bloud XXIX We must take notice that Oxyrrhodina are not so convenient in Malignant as in Simple Putrid fevers because the dispersing of poisonous vapours must be procured by all means and not hindred therefore gentle repellents must be made use of or if the violence of the Symptoms be urgent we may proceed to strong ones Riverius so they be not kept long on XXX In Malignant fevers we must have a care of Epithemes for they may by no means be used in poisonous Diseases Mercatus and therefore we must avoid them as a pernicious Poison ¶ In Malignant fevers we must utterly avoid cold Epithemes which are proper for the Heart but they must rather be applied warm for otherwise there is fear lest when the Malignity is translated and struck back from the Circumference to the Center more harm than good result from it Therefore cordial Baggs are besprinkled with no liquours Wedellus but what are spirituous for fear of repulsion XXXI If the extreme parts happen to be cold there is great suspicion of Malignity and Languidness of faculty for that Coldness testifies there are both these Causes to wit a Malignant Putrescence of the Humours in the Bowels or Ulcers or great Inflammations or violent pains in the Intestines all these things force the heat to run inwards and to desert the out parts In this case there should be the greatest care imaginable to recall the heat and by all means to keep these parts in an equal temper with the other parts For although this coldness of the Feet be no cause of the Disease but a Symptome yet it is removed by revocation of the Heat that is of the Bloud and Spirits And nothing is more beneficial than to call them back because of the harm of their running to the internals which increases the inflammation and other affections of the Inwards and the heat it self by its being pent in is the cause of its own extinction Therefore we may not apply cold things to the Feet lest the burning heat be repelled inwards for in colliquating Fevers applications are best made to the Body between the Armholes and the Groin it is well if you can keep them from being cold Vallesius XXXII When in Continual yea in Malignant severs where a Delirium is imminent or the Patient cannot sleep we apply Plasters to the Soles of the Feet which are held to be applied for revulsion sake truly here is a notorious fallacy of the Cause committed For they are all hot things which abound with their volatile Salts and are of very thin parts Pigeons cut open alive pickled Herrings split Horseradish Leven with Salt Mustard c. Hence while in the said extreme parts of the Body both the venous and arterious Bloud being burnt up with the febrile heat is made heavy and dull cannot freely circulate these very things applied to the Soles of the Feet do attenuate melt and put in fusion that fixt Bloud and Serum by means of those subtile and volatile Salts wherewith they abound and so by accident while the free circulation of the bloud is procured in the Feet and it cannot restagnate into the Head Simon Pauli natural sleep creeps on XXXIII The use of Wine in this Fever sometimes is very beneficial for it is a great cordial and very opposite to Malignity Yet it often does harm by increasing the feverish heat Wherefore the constitution of the Patient and Nature of the Disease must be well considered If the Fever be small the poisonous quality intense and the Patient Phlegmatick mixt with water it may be given safely and successfully In a violent Fever and a cholerick Body Wine is destructive I have by infinite experiences observed these things especially in the purple Fever which was at Mompelier anno 1623. distinguishable from the true Plague onely by the Bubo For to those Patients whose Pulse was not very frequent but like the Pulse of a healthy man their Tongue moist and no thirst I gave Wine with good success and the relief thence emerging indicated the continuation of it both because the Fever was not heightned by the use of it and there was no thirst nor driness of Tongue raised In what Patients the contraries were I forbad them Wine altogether Yet we must observe never to give Wine in the first days lest the crude matter be too much moved but onely about the State when the signs of Malignity begin more fully to exert themselves Riverius XXXIV In the year 1623. after the Siege of Mompelier a very Malignant fever raged for several months of which half that were sick died and they peculiarly who had the Parotides or swellings of the Kernels behind the Ears which came usually about the ninth or tenth day of the sickness did all die And when I had seen several such but could
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
is on Fire But Opiates and Anodynes that fix and thicken the bloud and spirits must rather be used Also Juleps and Decoctions which cool the raging Bowels temper the Bloud and refresh the Spirits must be made use of frequently Acetous Liquours of Vegetables or Minerals and purified Nitre because they restrain the raging of the Bloud and quench thirst are very proper Let hot and spirituous Waters cordial and bezoartick Powders as long as the Disease has no malignity be avoided If the bloud circulate unevenly and be carried more impetuously towards the head than the feet Epithems of the warm flesh or bowels of Animals applied to the Soles of the feet are good Idem III. When the Fever is in the State Nature's motion must be carefully attended whether she will make a Crisis or no. Wherefore nothing must be attempted rashly by the Physician Bleeding and Purging must be avoided but when the febrile heat is somewhat abated after the deflagration of the bloud and signs of coction appear in the urine if then Nature's motion be too slow a Sweat or a gentle Purge may be given But if all be crude and disturbed if the urine be still turbid without a sediment or secretion of parts if the Spirits be languid the Pulse low if no Crisis or onely what was provoked precede no evacuation whatever either by Sweat or Purge can be attempted without manifest danger to life But we must tarry longer that the spirits of the bloud may recover themselves may in some measure concoct the excrementitious and crude humours and then separate them a little Then let the Spirits be refreshed with moderate Cordials let the immoderate effervescence of the bloud if there be any be hindred and its due fermentation sustained which truly is best performed by Coral Pearl and such Powders for indeed they are dissolved by the ferments of the Bowels and then ferment with the Bloud and very much restore its weak and wavering motion In the mean while Nature labouring let all obstacles and impediments be removed and especially the increase of excrements gathered in the first ways must be abated with the frequent use of Clysters Idâ—m IV. In what manner or method the most urgent Symptoms ought to be treated it will not be easie to prescribe by certain rules because the self same must sometime be immediately stopt and quieted sometime more hastily promoted and which is more than all it may be at another time they must wholly be left to nature We must oppose some of them with asswaging and lenient Remedies and others with rougher and irritative Physick Yet in the mean time this Rule must be observed in all of them that we religiously insist in Nature's footsteps who if she doe amiss her disorders must be reduced If she go right but too violently she must be restrained but if she go right and operate slower or weaker than she ought it would doe well to promote and aid her endeavours by the help of Physick Idem V. In the declension of the Fever when after the Crisis is over Nature is above the Disease all is safe and there is not much for the Physician to doe it onely remains for him to propound an exact course of Diet that the Patient may quickly recover his strength without any fear of a Relapse It is also good to carry off the reliques of the febrile matter by a gentle Purge In Diet Men oftnest split upon the Rock of a Relapse that is the Sick after preposterous eating of Flesh or strong Meat relapse into a Fever for when the Bowels are weak and they do not easily concoct aliment unless it be very thin and when the Crasis of the bloud is so weak that it cannot assimilate a strong nutritious Juice if any thing disproportionate be offered to either of them the oeconomy of Nature is perverted and all goes to wrack Wherefore Convalescents must long abstain from Flesh and must not eat it till after their Urine be like healthy persons and does no more grow turbid in the Cold and then indeed it is best to begin with a dilute Meat-broth and after gradually to ascend to stronger things Idem VI. When after an imperfect Crisis the case is doubtfull and the controversie under decision then a difficult task is incumbent on the Physician Let Nature's motion and strength be diligently attended whether she begins to prevail upon the Disease or to yield to it If there be signs of Concoction and strength be good a gentle evacuation may be made In the mean time we must help the most urgent Symptoms with proper Remedies all impediments must be removed and strength must be restored as much as may be by Cordials and a right course of Diet. VII When after a bad Crisis or none at all all things grow worse and when the Physician almost despairs of the Cure of the Disease let him give the prognostick that the event is doubtfull and much to be feared Yet he must not so far rely on the prognostick as to let his fears too much possess him but still let him provide as much as lies in Physick's skill for the health of his Patient though despaired of let Remedies be used for the most troublesome Symptoms and let the Spirits of the bloud almost extinct be recruited by Cordials When we despair of Recovery let life be prolonged as long as we can and an Euthanasia at least procured Idem VIII In Continent Fevers because they are always accompanied with great strength we may give a thin Diet But after Putrefaction is begun we must feed the Patient higher because the Corruption of the humours requires it according to Galen's opinion lib. 8. Meth. and 1. Aphor. 17. Mercatus Febris Tertiana or A Tertian Ague The Contents Whether Bloud may be let I. The time to let bloud II. Whether a Purge may be given onely after the third Fit III IV. At what hour a Purge must be given in a double Tertian V. Syrup of Damask roses not fit to purge withall VI. An exquisite Tertian curable by alteration alone without purging VII Sometimes it onely gives way to a Vomit VIII Whether it may not be cured without one IX A Vomit is seldom proper for a legitimate one X. The efficacy of Spirit of Sulphur XI A bastard Tertian cured by the use of Spaw-waters XII Made longer by the abuse of cooling Juleps XIII The excessive use of Aperients hurtfull XIV Drinking of Water good for an exquisite one XV. The remaining ferment must be extinguished by Specificks XVI We must have regard to the indisposition of the Bowels XVII What way a Decoction of Wormwood does good XVIII Cured by a Diaphoretick XIX By applying Bottles XX. A caution in the application of Epithemes XXI Applications to the Wrists not to be rejected XXII The Diet must be thin and spare XXIII The Patient sometimes killed with a multitude of clothes XXIV The Cure of a
in other places requires But he forbids the giving of it before signs of Coction because it hinders attenuation and digestion of tough humours and causes difficulty of breathing convulsion and trembling in some But Averroës tarries not till that time because the Patient in the mean time is in danger of having his innate heat extinguished by the febrile and because the damage done by the cold Water is less than what would be done by the burning Heat for by drinking cold Water there is onely danger of lengthning the Disease by the violent Heat of Death Besides Coction is a sign the Disease is overcome and when the Heat is quenched drinking of Water is useless Therefore when Bile is raging cold Water may safely be given When it is cooled and the state of the Disease is over it will be useless because the humours will grow crude again with the Water and new occasion will be given to Obstructions and lengthning out of the Fever espeally in Natures that are obnoxious to Obstructions as the melancholick XVI Because in the place of Putrefaction in long Fevers a certain Infection like to a Ferment is usually bred and left behind whereby the humours though not so very bad are fermented and corrupted Therefore to extinguish this ferment and stop the humours convenient Evacuations premised we may proceed to the use of the Peruvian Bark which must be given in the beginning of the fit with Malmsey Wine in manner and quantity as is well known to all Physicians Fortis XVII A Tertian ague is sometimes prolonged by a hot and dry intemperature of the Liver which continually produces fewel for new fits As I have often observed in several who were of a dry and squalid habit of Body and altogether cholerick and without any store of humours they have had a Tertian for three or four months especially in a hot season of the Year Violent Purgatives and violent Aperients and Heaters are hurtfull to such But they must be treated with a cooling and moistning Diet and with Juleps and Broths of the same quality And the superfluous humours must be purged away by degrees with emollient and cooling Clysters Cassia Tamarinds Catholicon and Syrup of Roses but in this case Baths of sweet water especially doe wonders by extinguishing the hot and dry intemperature impressed on the Bowels which the Patient may use without Sweating Sometimes also the length of a Tertian depends upon an indisposition of some part especially of the Liver or Mesentery which cannot be cured by Purging never so often repeated because the ill quality remains in the part and daily gathers new humour which maintains the fits And this ill quality is removed by Diureticks Sudorificks and other dissolvents Things endued with such qualities are Wormwood lesser Centaury Carduus benedictus root of Dittany Burnet Tormentil c. whereof decoctions may be made Enchir. Med. pract Riverius to be given several days before the fits XVIII Many are ignorant what Galen's skill was in giving of Wormwood in Tertian agues In curing of them this among many other is one Indication to purge store of bilious humour by stool and Urine Another is to strengthen the mouth of the Stomach much molested with bile Wormwood performs these things of which Galen 6. simpl Wormwood has an astringent and bitter and also a sharp quality both heating and cleansing and drying and strengthning Therefore it drives down the bilious humours of the Belly by stool and purges by Urine But it purges what is bilious in the Veins most by Urine therefore it does no good when it is given for Phlegm contained in the belly And Dioscorides lib. 3. cap. 23. It has an astringent and heating virtue it purges bile which sticks to the Stomach and Belly it provokes Urine Therefore Wormwood is given for these two Reasons to purge Bile and to strengthen the Stomach It does no hurt because hot for its substance is not given but its decoction or infusion in Melicrate as Galen said besides onely the leaves are infused that is a small quantity to cause heat To say nothing Augenius l. 7. tom 1. Epist 8. that if it doe a little harm it need not be valued in respect of the good it does They doe amiss who give the juice XIX A Woman 45 Years old after a disorderly Diet was taken in the latter end of May with a Tertian ague I neglecting the Ague betook my self to restrain the fierceness of the sharp Salt redounding in the Patient and not without success for when I had given her of the volatile Salt of Harts-horn half a scruple with 6 grains of Salt of Carduus benedictus and 5 grains of Salt of Wormwood but the first time and that one hour before the fit it not onely came later by two hours but held her much more mildly Georgius Sogerus Misc Cur. an 72. Obs 244. Wherefore insisting on this Medicine and when because of its nauseous taste she began to loath it I made it into Pills with a little crum of Bread and I cured her XX. A Gentlewoman was taken with an exquisite Tertian ague she obstinately refused all that I prescribed in the mean time the Disease grew worse and for eight fits it grew stronger and stronger every fit I visited her a little before her ninth fit and when she refused to take any thing inwardly I order bottles filled with hot water to be placed here and there about her to make her sweat against her Will. She on the contrary commands the bottles to be taken away I being not at all moved with the clamour of my Patient order the Maids to observe my commands and to force her to sweat against her Will remembring that of Hippocrates 2 Epid. We must endeavour that anger may be provoked in such as are pale Now said I to my self if anger must be provoked that the bloud may be diffused through the habit of the body and dispell paleness perhaps it may also drive out the Ague and open the inward obstructions the cause of the present mischief Borrichâ—ins Misc Cur. ann 72. Obs 234. Nor did my Augury deceive me the Ague ceased forthwith and though she was outragious angry it stopt and never returned any more XXI In the height of the fit to allay the heat cooling Epithemes of water of Cichory Roses Plantain Vinegar of Roses c. may be applied to the Liver Yet we must have a care that the waters lie not upon the Liver Enchir. Meâ— Pract. when Sweat is at hand for they might hinder its coming out XXII Thoâ—e Remedies that use commonly to be applied to the Wrists are not to be rejected altogether for the opinion of the Vulgar is not onely satisfied with them because they think many are cured with these remedies but also they may doe some good by communicating their virtue to the heart by the large Arteries Riverius which run to the Wrists XXIII The Diet in
exagitates and thins the mass of Bloud and stirs it to excretion of any thing superfluous and also it irritates the mouths of the Arteries opening towards the Guts so that the humour being rejected by the Bloud may find a passage by these outlets Hereby first of all the Water fluctuating among the Bloud is plentifully washed away then the emptied vessels soak up the intercutal Water and they discharge it partly by stool immediately and partly by urine or sweat In the mean time there is no fear lest as in a Tympany because the fibres in the Stomach and Guts are too much irritated by the Purge these Bowels should be incited to tetaneous extumescencies For while the Bowels are firm and well constituted the particles of the Medicine doe them no prejudice but being thence delivered into the mass of Bloud they do not onely draw Water out of it but by exaigitating its mass they raise the active particles before overwhelmed and dispose them towards a fermentative faculty Willis II. But sometimes it requires Letting of bloud when it arises from abundance of cold Bloud Indeed upon the account of its Coldness it does not stand in need of Heating but because the abatement of its quantity eases Nature so as she may the more easily conquer the Disease It is not contrary but very consentaneous to reason to use Bleeding here And we must evacuate after Bleeding which Bleeding must be tried before any thing else if strength will permit for if it be low though there be abundance of Bloud yet we must not let bloud till strength be repaired Trallianus l. 9. c. 1. ¶ It may very well be administred if stopping either of the Menses or Haemorrhoids have caused it or if there be a bilious Cachexy Yet Bloud must be taken much more sparingly than in other Diseases because of the want of Heat Enchirid. Med. Pract. III. We must carefully observe this that in an Anasarca as also in a Dropsie what days evacuaters whether purgative or diuretick are not given always on those days opening Alteratives and Strengthners of the innate heat of the Bowels especially that the altering and concocting faculty may be strengthned must be given Knoblochius for if these things be neglected evacuaters will doe little good IV. For curing an Anasarca Lixivial Diureticks as has ever been evident from my observation do far excell all other Diureticks For now it is a trite and vulgar Remedy after Purging to take 6 or 8 ounces of a Lixivium made of Ashes of Wormwood or Broom with White-wine and to continue the use of it for several days This Medicine as I have observed in several provokes Urine plentifully so that the Patients to a Miracle recover in a short time But why Medicines endued with a fixt and lixivial Salt do force Urine more than those endued with an acid Alkali or a volatile the reason I think is this viz. in persons affected with this Disease upon the failing of the fermentation and sanguifick virtue of the Bloud watry and crude humours gathered both in its mass and within the habit of the Body after they have tarried a while there immoveable then they as it is the nature of all watry Juices when they stagnate a little grow sowre wherefore the Lixivial particles of the Medicine being poured into the Bloud do immediately ferment with the acid particles of the Water and moreover while they exagitate and ferment them they raise a notable excretive fermentation in the whole mass of Bloud so that farther when all the particles are put in motion not onely the watry and recrementitious separated from the rest are discharged by the Kidneys but also the innate and active particles of the Bloud it self do extricate themselves from the grosser with which they are entangled and at length recovering do begin to resume their fermentative virtue Willis and to sanguifie V. Diaphoreticks often doe much good and are usually more agreeable with this Disease confirmed than in other kinds of Dropsies And although at the first they be not able to cause Sweat because the habit of the Body swims with a floud of thick humours however while they exagitate the Bloud they rouze up its inbred active particles that were asleep and half drowned before dispose them to a fermentation and moreover put all the recrementitious and especially the watry particles into motion so that these running immediately out of their receptacles go off with ease and speed But Hydroticks must be given in a little larger doze for their quantity is very small and their active particles are drowned in the Water before they can be diffused in the Bloud and can begin to exert their virtues upon the Bloud Wherefore Spirits whether Armoniack or of Wine Tinctures also and Elixirs yea and Powders are seldom used for this Disease because in a little dose they doe little good and if they be given in a large dose they by their efferation often hurt the Bowels But some such things must rather be made use of which taken in a larger dose and hot may pass into the Bloud not weakned such especially are Decoctions of Wood and Seeds whose particles being pretty congruous to the Bloud and invincible by it do pass through its whole mass and exert their elastick virtue by putting all the humours in motion Idem VI. Among external Administrations whereby the Water gathered within the habit of the Body is stirred Oil of Scorpions so it be genuine applied by it self or added to Liniments made of Sulphur and divers kinds of Salts and of Quick-lime and other Minerals which being powdered and mixt with the mucilaginous extracts of sharp Herbs may be reduced to the form of an Unguent does oftentimes much good I knew a Boy who was much swelled with an universal Anasarca and was cured by this onely Medicine for his Mother I know not by whose Advice did anoint all his Body morning and evening with Oil of Scorpions rubbing all the parts with her hot Hand very hard Upon doing of which within three days he began to make a great deal of Water and when he had continued for some days so to make Water the Swelling fell by degrees Idem and he recovered VII Baths are scarce proper for any Dropsie but an Anasarca and not for this neither unless in the inclination to it or decrease of it Because when the Bloud is heated and incited by the ambient heat of the Bath and moves the Waters stagnating every where and drinking them up into it self transports them by divers ways there is danger lest as it often happens it receiving them out of the habit of the Body into its mass should presently discharge them into the Brain or Praecordia for nothing is more usual than for Diseases of those parts to wit an Asthma or Apoplexy to seize Hydropicks after bathing Notwithstanding when the conjunct cause of the Disease that is the intumescence is either
ordinary remedies conveniently used they think the Patients are not perfectly cured upon which they cast them into new torments and at length into an Atrophy and Consumption When notwithstanding these Symptoms do usually after a little time disappear or are discussed with easie remedies A certain Nobleman besides Nightly-pains and other Symptoms of the Pox had a Swelling in his Neck bred of Phlegm and Melancholy After anointing all the Symptoms perfectly disappeared except the Swelling of which two third parts were discussed The Patient believed he was not cured yet the Tumour was discussed in a months time onely by applying Emplastrum de Vigo quadruplicato Mercurio Another after Fluxing thought himself not cured because there remained an Ulcer in his Neck about his Windpipe yet this Ulcer was cured with common remedies within a Month without any remedies respecting the Pox One among other Symptoms had a great Pain upon his Shin-bone he was cholerick and had been four times rubbed which made him very lean he used a moistning diet for a Month afterwards he was rubbed with Mercury all over whereby the pain ceased a Ptyalism was raised of yellow thin and stinking humours for a Month and then he voided thick Phlegm for fifteen days At length Incision being made upon the place that was pained before a Caries was found which being taken away by an actual Cautery and a Catagmatick Powder the Patient was perfectly cured A Nobleman being cured after the ordinary method there were great pains remaining in all his limbs so that he could not stir them without crying out Monsieur de Lort thought the pains proceeded not from the Pox but rather from a dry intemperature in the Ligaments D. Pomeret apud Riverium that knit the joints and nervous parts He cured him perfectly with a moist diet and Bathes continued a long time LXIII People talk much of a thin diet in this Disease But because it abates strength much and keeps it low it is good in acute Diseases which because they last not long the strength though brought low can continue to the end But seeing the Pox is a Chronical Disease and the cure is extended to many weeks if the strength be brought low by a spare diet it cannot hold out to the end of the Disease And the reason why Physicians keep their Patients with Bread and Raisins I take to be this Because it is a simple food and affords good juice for since variety may easily breed bad humours and since flesh and fish and such meats are more easily corrupted than Bread and Raisins it is good to forbid variety of Meats and Flesh and to be content onely with Bread and Raisins Sennertus LXIV Many commend Biscoct Bread yea they allow onely it which as we do not disapprove for strong bodies that are moist and abound with Phlegm and excrements inclining to putrefaction rather than with adust ones so we do allow Bread once well baked and not too moist as the best food and most familiar to all natures Yea Biscoct seems to have its inconveniences for it is not easily concocted and most people in the Pox have a weak stomach Besides these people abound with adust humours which are increased by Biscoct Bread on the contrary they are tempered by the common Bread as being moister Idem LXV One had had the Pox sixteen years with Exostoses in both Legs which pained him so that he could not sleep all night I perfectly cured him within a month by bleeding in both the Arms by purging with an Apozeme and by a Sudorifick Diet-drink of a Decoction of Guaicum and Antimony Sweat was procured by burning Spirit of Wine I gave an antivenereal dose once in five days The Exostoses were taken off by applying Blisters twice or thrice when they give over running and grow dry Riverius LXVI Since it is safer to prevent a Disease than to cure it some Physicians among whom are Fallopius Minadous and others do teach what way one may save himself from the Pox though he have to doe with a Pocky Woman But I think such things cannot be taught with a safe conscience as incourage so many Men to Lust when perhaps the very fear of this Disease would have deterred from it Yet Minadous thinks they are deceived that teach thus and he overthrows Fallopius his foundation who thinks the Pox is communicated by small serous corpuscles which if they be wiped off the Pox may be prevented And he shews that the Contagion does not onely enter by the external parts of the Pudenda but by the internal and penetrates the Body and that the infected vapours and spirits pass by the internal porosities and are admitted by the veins and therefore no Man can promise himself safety from washing which onely comes to the external parts of the Pudenda or from outward applications because they cannot take away the inward infection But the safest way is to keep from Whores and to remember Sennertuâ— that Whoremongers God will judge N. B. The Medicines for the Pox have been so amply treated of all along the Title foregoing that I shall forbear to recite any more Lumborum Affectus or Diseases of the Loins The Contents The pain must be cured differently according to the variety of the causes I. The serous distension of them must be cured with Hydragogues II. The pain ceasing by voiding of black Vrine III. The Description and Cure of a Rheumatick Lumbago IV. I. IF we would discourse aright concerning pains in the Loins it is necessary for us to distinguish between the parts constituent of the Loins and the adjoining parts that give the occasion The parts constituent of the Loins and subjects of Pain are the Skin with the fleshy Pannicle the Muscles lying upon the five vertebrated Bones on the outside and inside with the Os Sacrum within the cavities of the Vertebrae the Spinal Marrow with its Membranes and a numerous off-spring of Nerves and the membranous ligaments knitting the Vertebrae one to another The parts adjoyning which may hurt by their vicinity or gravity or by the disposition of the matter are the Mesentery joined to the Loins the lower part of the Gut Colon the two Kidneys contiguous and sticking to the Loins by their fatty membrane the Trunks of the Vena cava and the Aorta lying upon the Loins and the Vessels arising thence which are dispersed into the Muscles of the Loins and the Spine such as the veins and arteries of the Loins and the Haemorrhoid Veins which descend along the Loins to the Podex the Spermatick Vessels also turgid with seminal Humour which in their passage impart branches to the Loins In Women the Womb with its Ligaments and the Testicles may hurt the Loins but most in a Woman with Child because of the weight of the Womb and the Child which may make the veins and Arteries that are dispersed through the Os Sacrum to trouble the Loins The remote parts which
all the Soldiers having the Scurvy who were besieged in a certain Castle were cured ¶ An Infusion of Brooklime and Scurvy-grass in Whey of Goat's Milk is a vulgar Medicine but does truly a great deal of good in the Scurvy ¶ Goose dung is also commended in this case Hofmannus from the juice of which Soldiers troubled with the Scurvy in a Siege found great relief 6. This is a Secret Take of the middle yellow rind of the root of Sloe-Tree 4 handfuls Pepper powdered 2 spoonfuls boyl them with Beer and Water with this Decoction hot wash the Mouth repeating it several times then Take of the juice of Water-Cresses pour to it some Wine mix them and keep them Jobus Kornthaverus wash and rub the Mouth and Gums often with this ¶ Take the juice of Squills rub the Teeth and Gums so the Scurvy is cured 7. Among Diureticks which are used for the Scurvy Penotus his opening Spirit bears the Bell from all others I make it thus Take the Spirit of Goslarian Vitriol 3 pounds and an half Salt of Tartar 2 pounds and an half calcined Flints 6 pounds put them in an Earthen Retort and destil them increasing the Fire by degrees let the caput mortuum be boyled and the Spirit be impregnated with the Salt when it is boyled out of which and Potters clay make balls which being put again into a Retort let them be destilled and the destilled Spirit be rectified and kept for use ¶ Cnoffelius thus prepared his Narcotick Arcanum Take of Vitriol finely pulverized and dried in a certain heat to whiteness half a pound pour to it 30 ounces of rectified Spirit of Wine set it in Horse-dung for a Month when it is poured from the Dregs distil it in Balneo Mariae till the residence of a yellow Liquor like the distilled Oyl keep this when it is cast forth This is far better and safer as the Author affirms then Laudanum Opiatum The Dose is 12 grains in some convenient Liquor 8. The common People in Holland commend a well known and easie Medicine made of the Leaves of Marsh Trefoil for most Scorbutick Persons especially such as are inclined to the Dropsie with very good success I gave to a certain Scorbutick Person who had a Palsie Consumption and Spots Simon Pauli an infusion of marsh Trefoil by the use of which alone he was perfectly well in 14 days I have done the same in others See before § XII XIII XIV Willis his Cure of the Scurvy Scroti Gangraena or a Gangraene of the Cod. A Man about 40 years old being drunk with Wine fell suddenly into a swelling of his Cod with an acute Fever and a sudden failure of Strength he got a Surgeon to cure it who when he observed the blackness of that Part and the exulceration of the whole Penis yea and danger because there was a manifest Gangraene being doubtful of the Cure desired the advice of a Physician When I was called having first given him a Clyster because he had not been at Stool for 2 dayes I prescribed him a Cataplasm of Scordium Rue Meal of Lupines and of Bitter Vetch with Oxymel Wine c. I gave him Diasenna Fracastorii and now and then Treacle-Water because I observed some Malignity communicated to the Heart for without it he could scarce breathe The next day when we took off the Cataplasm we found the outer Cuticle separated and the third day the Scrotum open of it self and about night ten pounds of Water run out The fourth day his Stones were all bare for the Scrotum was fallen away from the pecten to the perinaeum Here we advised what should be done and by drying and incarnating Remedies we prevailed so far in 14 dayes time that we had not only guarded the Stones Petrus Holtzemius with a Scrotum but Nature also had clothed the Scrotum with new hair the whole glans came again to the penis all the Ulcers of the penis were healed and he was able afterwards to act the part of a Man One forty years old a strong Man and of very good habit of Body when in Summer-time he had heated himself excessively and had drunk a great draught of cold Water was within a few dayes taken with a continual Feaver of which he was rather cured by the benefit of Nature than by Art in the mean time the intemperature and fault of his Liver remained wherefore a little after he fell into a Cachexy for he was first taken with a Jaundice then with a Dropsy Dr. Cronenburgius used all things necessary at last a serous Humor falling into the Scrotum they called Dr. Slotanus to consult Both of them use their utmost Industry in the mean time the swelling of the Cod ceases not but by degrees the Native heat being extinct it turns to a Gangraene in the Part. They scarify the Scrotum all over with a Lancet and wash it with Salt and Treacle dissolved in Vinegar not neglecting Vnguentum Aegyptiacum and a Cataplasm of meal of Lupines of Darnel Aloes Myrrhe Scordium and other things that resist putrefaction They prescribe a very good course of Diet Strengthners and Openers of obstructions inwardly and outwardly In the mean time when the Water ran plentifully out of the Scrotum the Patient grew better At length the gangrened Scrotum part of it fell away by the benefit of Nature and Medicines part also which was gangrened was cut off with a Razor so that the Stones might be seen bare the Ulcer remained open for some Months Fabritius Hildanus Cent. 5. Obs 77. In the mean time Nature by this way evacuated whatever excrementitious Humors were in the Bowels so that the Noble Parts were perfectly restored and the Patient fully cured of his Disease Singultus or the Hickup The Contents The Cure must be varied according to the variety of Causes I. A Periodical one which would only give way to Bleeding II. A Tedious one stopt III. The Efficacy of Opiates IV. To what Place outward Applications must be made V. Antimonial Vomits are best in this Case VI. Vomits repeated do good VII Medicines I. B. Sylvaticus gave to one that had had the Hickup grievously for seven dayes Hiera with Oxymel Rhodius when he had voided above 12 ounces of Phlegm he was perfectly well ¶ Several who have been almost killed with the Hickup after purging for 5 dayes with hiera piera Daretus have put an end to the Hickup ¶ One who had had the Hickup 20 dayes and was in great danger of Death was at length saved by an infusion of Mechoacan Epiph. Ferdinandus ¶ A Boy ten years old Hickuped day and night for 8 dayes I gave him water of Green-Nuts destilled with Radish first steeped in Vinegar Although he did not Vomit yet his Hickup ceased after the second Draught about night he was wholly freed of it Platerus ¶ A Surgeon falling Sick was in a little time so troubled with
a Miracle XI Blisters applied to the Hips are of use to prevent Fits But I have often observed that Sinapisms applied to the Hips 2 or 3 hours before the Fit have diverted it Fortis which is a Remedy of less trouble XII Like as where the said Suffocation is urgent Castor is deservedly preferred before many other things and its Tincture with rectified Spirit of Wine and Spirit of Sal Ammoniack so where Cold is very urgent as well outwardly as inwardly as in a Syncope and Diseases of that nature above all things that I have hitherto yet known I commend the destilled oyl of Cloves which is not ingrateful nor do I disapprove of the oyl of Turpentine which is less grateful seeing mixt with Spirit of Vitriol it raises an effervescency accompanied with great heat Let this mixture serve for an example Take of Water of Penny-royal 2 ounces Theriacalis simplex 6 drachms Tincture of Castor 2 drachms destilled oyl of Mace of Amber each 3 drops Syrup of Fennil half an ounce Give it by spoonfuls it is good also in Hypochondriack Diseases One scruple of Spirit of Sal Ammoniac may be added to this mixture which will make it much stronger or a narrow mouthed Glass containing the said Spirit Sylvius de le Boe. prax l. 1. c. 19. may be held to the Nose for by its sharp smell People are got both out of Fits and the falling sickness XIII I observed in a Matron a most grievous Aphony often returning with Convulsions She had been Barren many years and upon the approach of her Menses was taken with a most grievous Fit of the Mother then with a small Epilepsie at length with partial Convulsions of Hands Feet Back and horrible ones all the Body over She upon using of proper foetid uterine Medicines fell into more grievous Symptomes for which cause we fell to Perfumes Musk to wit and Amber and we gave them in a small quantity with other Cephalick strengthening things with good success Which should also be observed in other Hysterick Women that is in such whose Head and Nervous kind has been weakned in their youth by Epileptick Fits Horstius ◠1. Obs 26. or some other cause XIV A Woman was afflicted with most cruel Symptomes Head-ach Belching contraction of the Body pain in her Groin gnashing of her Teeth sometimes falling to the ground speechless her Mouth shut so that she could not open it and all these things from the fault of her Womb. She having tried many Medicines to no purpose an old Woman coming in gave her 13 grains of Musk and as many of common Dragon's blood in 4 drachms of Orange flower water she was cured and never after had any Fits Solenander Sect. 5. cons 5. §. 10. I have given the same Medicine in the like case and it alwayes did good I have given it several times XV. In the cure of a pregnant Hysterick Woman we must take great care that Remedies be prudently administred and that violent and very foetid things be not given lest abortion be caused And the business must be done more by external than internal things Riverius XVI Aetius well advises that a Woman when she has recovered her health should not wholly be neglected but for preservation sake she should use Medicines at certain intervals especially at suspected times so that the use of them should not wholly be left off but the quantity abated XVII I and Dr. Dobritius had a Woman under Cure of Fits of the Mother who had a very foul Body She was taken about Night especially with a straitness about her Stomach her Heart was oppressed and almost all her Limbs had a tingling in them her Head also aking Various things were tried by us the Humours were prepared evacuated strengthning things were given yet we did no good At length through my perswasion we gave her Antimonium diaphoreticum upon taking of which she began by degrees to amend We continued it for a Fortnight in which time she was so much relieved that because she was better and grew weary of Medicines she had rather commit the rest to Nature than longer insist on Medicines I ascribe her recovery chiefly to the Antimony She indeed is well now but not without complaints of a weariness in her Limbs Doringius XVIII We often meet with Women who think they are ill of the Spleen when they are Hysterick By Hysterick Affections I mean these Symptomes that happen not in the Womb it self but in other Parts which have a Sympathy with the Womb for the Womb has some Sympathy with all the Parts especially with such as are contained in the Abdomen to which it is joyned by its Veins Arteries Nerves Membranes and by its Ligaments from whence because of some vitious Blood Seed or other Humours foul vapours expire into other Parts And there is a very great Sympathy between the Spleen and Womb by the Arteries whence come Hypochondriack Ails rumblings and pains of the Belly And this Sympathy is so frequent and familiar that many say they are only Sick of the Spleen Trimirosius when the Disease is in their Womb. ¶ A Maid of a Melancholick nature had for several years been troubled with violent Fits that returned often Most Physicians thought this mischief came from Malignant Vapors bred in the Spleen and rising to the Diaphragm It so happened that the Patient was held almost a whole Night with so violent a Fit that they thought she would dye every moment I suspecting it to be a Fit of the Mother gave her compound Balm water which is much in use among us I poured 2 or 3 spoonfuls of it into her Mouth she came to her self to a Miracle Thonorus Obs 2. l. 3. p. 185. and all her difficulty of Breathing ceased Whence we knew it was an Hysterick Fit XIX I was called to a Matron who was dangerously ill of Fits I found her lying with her Eyes shut and speechless I immediately prescribed her Aqua matricalis de Melissa Composita instead whereof through the Apothecaries mistake Aqua matricalis camphorata was sent a spoonful of which when I had poured into her Mouth she began to complain as well as she could What do ye do Then all her Head burnt as hot as Fire But when the other de Melissa Composita was brought and given the Sick Woman she immediately recollected her self began to open her Eyes and to speak and was recovered to her former health Now though Camphire in some Hysterick cases be no ignoble Medicine yet you may find many Women to whom it is an Enemy especially such as have a hot Head for by reason of its volatil Spirits it presently flies to the Head Idem Obs 3. This Patient was of a Sanguine Complexion and ruddy Countenance XX. Laudanum is admirable in Vapors that Sympathically annoy the Brain especially in Fits of the Mother mixt with Hystericks Madamoiselle de la Font after
so that a great part of the crassa meninx and the motion of the Brain might very well be seen yet the Patient recovered but after the Ulcer was cured and cicatrized the motion of the Brain might then be observed Nevertheless I would advise no Surgeon to undertake the Cure of so great Corruption at his own peril But if the corruption be little the Bone must be taken out with a Trepan or scraped the Ulcer cleansed and the Body fluxed as in the Pox yet there must be a less quantity of Quick-silver Chalmetaeus Enchir. p. 85. For a Talpa with the corruption of the Bone must be cured as the corruption of the Bone in the Pox. XXV A Nobleman had a Ganglium grew in his right Groin by little and little as big as a Child's head He advised with Physicians and Surgeons who tell him of the danger of Bleeding of a Gangrene and Lameness He chose rather to dye than endure it any longer unfit for Arms or Wedlock The Lump was cut about in an Oval line from the Groin to the Scrotum then at the Membrane a little of the Tumor was cut off and by degrees the Skin which was under the Swelling was separated towards the root the Veins and Arteries as they were laid bare were tied for fear of an Haemorrhage The Lump was pulled out with its Coat glandulous white without any Blood or Flesh within easily separable from its root As the Wound was healing he had a Fever bitterness in his Mouth filthy Matter pain in the other Groin Hollerius but he was cured by a Purge XXVI Fungi very often grow from the Membranes of the Brain yet they grow also in divers other parts of the Body because of the vast conflux of Humors from the whole Body and that through Natures great Providence as Hildanus cent 2. Obs 19. sayes For since nothing is a greater Enemy to the Nerves than the injury of the Air especially if it be cold Nature which is ever intent upon the conservation of the individual covers the nervous and membranous Parts when wounded and laid bare with this sort of Excrescence lest the Nerves should be hurt by the Air while the Wound is in curing And their Cure must be begun by drying and finished by Erosion or Excision Drying Medicines in the beginning are safer than Eroding or Septick ones For these in Wounds of the head hasten death and in Wounds of the Limbs cause Pain Inflammations and other most grievous Symptomes And seeing out of Nature's great beneficence this Excrescencie is produced for the Patient 's good it must not be consumed at the very beginning till the Nerves and membranous Parts be sufficiently covered with Flesh that they can no more be hurt by external injuries When the Pain Inflammation and other Symptomes are abated if the fungous Excrescence fall not it must be depressed by Dryers of which rank are root of round Birthwort Florentine Orrice Angelica leaves of Savine Rosemary c. When these things have been applied for some dayes if the Fungus abate not but grow up in the Flesh it must be cured by eating things as burnt Allum burnt Vitriol Mercury precipitate strewing on the Powder and then applying a Cataplasm Or a Ligature may be made and it may be cut off either with a corrosive Thread or with a Knife Which when done Hofmannus the Powders of the said drying things may be strewed on XXVII One had for some Months a Swelling rising upon the right side of his Forehead with a broad basis as big as a Hazle-Nut of the same colour with the Skin soft and as it were puft up it grew of it self when it was pressed with the Finger it gave way and suddenly rose into the same shape again without Pain yet it was not observed to be moveable this way or the other nor did it increase And because I thought it was one of those Tumors which are more easily extirpated with the Knife than dissolved by Medicines I order the Skin to be cut obliquely with a sharp Penknife As soon as it was done no Blood but a very little limpid Humor like the vittreous one of the Eye ran out It fell upon the Patients right hand and he affirmed it was very hot Praecipitate was immediately put into the Wound and other things put after to hinder Inflammation and when it was opened the next day the Bladder was taken out and the Wound was within a few dayes so dextrously healed that there was not the least sign of a Scar left behind Thus we may easily prevent things in the beginning which if neglected till they grow old will scarce give way at all to any Remedies And no question but this Tumor J. Rhodius Cent. 1. Obs 29. if it had been let alone would have turn'd at length into a Meliceris or Steatoma when the Mucus had grown thick by delay XXVIII If there be a swelling in the Cheek let the Physician have a care that it break not for so that Seat of Beauty might be deformed by a Scar However because oftentimes dissipaters ripen and ripeners dissipate by reason of their likeness in qualities it may so happen that Suppuration may come contrary to the intention of the Physician When therefore it is made let him draw the peccant Matter by proper Medicines to the inside of the Mouth or to the commissure of the Jaws which is by the Chin. Hofmannus For Women will sooner endure their Lips to be cut than to have a Scar in their Cheeks XXIX Dioscorides writes that the swelling of the Paps is abated by applying Hemlock which experience testifies to be true Although Dodoneus disapproves of such a Remedy because of the malignant and poysonous nature of this Herb Riolanus which being applied to the Paps may hurt the Heart XXX Steatomata and several Abscesses are often bred in the Omentum because great store of Fat and Glands is found here So the Mesentery both of it self and because of plenty of Glands is very subject to Inflammation Tumors and Corruption Because these Diseases are difficultly distinguished one from another they require an experienced Physician We may say the same of the Pancreas and Spleen In the mean time I shall communicate this Plaster the efficacy whereof in curing the Tumors of the said Part I have often experienced Take of Gum Carranna Barbette Ammoniac each 1 drachm Mercury killed with Turpentine half an ounce Mix them Make a Plaster XXXI We must proceed gently and gradually in cutting or pulling out axillary Tumors for while we draw and separate the Tumor with Pincers or any other way the Muscles that serve for respiration are contracted also hence an interception of Breathing As soon as ever this is observed we must desist a little from the Operation till they have gathered strength also Cold and very repercutient things must by no means be applied to these Parts Fabr. Hildanus lest
the Matter be repelled to the Pleura or other Parts and there cause Inflammations XXXII An Infant about eight Months old was ill of a Swelling in his Groin which when I was intreated by the Parents to bring to a Suppuration after divers sorts of Medicines had been tried before I observed that one Stone lay in the Groin by the same token that the other was alone in the Cod on the other side and therefore I advised them afterward to abstain from all Medidicines for it was not a Tumor but a stone which afterwards in 7 or 8 Months time slipt down into the Cod and so there was no need of cutting it Marchetti Obs 58. which a Barber was going to do XXXIII Swellings in the Knee are very dangerous and difficult to cure for want of Muscles and great store of Ligaments Tendons and Bones being Parts that are of a cold and dry Nature and unable sufficiently to disperse Humidity Therefore it is necessary to give help as soon as can be by hot means Yea if there be any signs of Suppuration the Abscess must be opened at the very first time lest otherwise the Patient might fall into a Lameness Consumption and at length death it self A continual owzing of some Humour which renders the cure very difficult usually follows opening the Ulcers Barbette highly commends his restorative Powder for this XXXIV In swelling of the Knees this must be observed that Scarifications when there is need of them must be prudently administred for all joynts are weak yet endued with exact sense Wherefore pain and other accidents follow Scarification Chalmetaeus XXXV A Boy after he had had the Small Pox had a swelling of pituitous and flatulent matter about his left Ankle which seemed to threaten an abscess But because such Imposthumes about the joynts are difficult and tedious in curing and sometimes erode the Sinews and very Bones we agreed among our selves to try all means whether the enclosed matter could be evacuated by insensible evacuation We therefore applied a Cataplasm of flower of Beans Lupins Darnel Powder of flowers of Chamomil Elder Melilot Bay berries Anniseed Cuminseed boyled in a simple Lixivium adding a little Salt We applied this Cataplasm 15 or 18 dayes without success the matter at length being heated in the part affected an itching and an herpes pustulosus or miliaris came on a sudden Wherefore for a day or two we omitted the use of the Cataplasm and we anoynted the place affected with Vnguentum album Rhasis and we suffered the Boy to rub his Foot as much as he list And after that a great deal of Humour had run at the Pustles the swelling about the joynt abated when the pustles were healed we applied the Cataplasm again till new pustles arose which we dried up as before and applied the Cataplasm again These being changed by turns this rebellious evil was at length successfully cured I therefore write this that the Surgeon may not change his Medicine as often as success does not immediately follow For frequently in Children and weak People time is required before Nature can bring the Medicine out of power into act Hildanus Therefore we must not give over but expect Nature's motion XXXVI A Girl 10 years old was after the Small Pox troubled with hard Swellings about her joynts in her Arms Hands and Feet that would scarce come to suppuration Some were open others not out of them that were open a thin Ichor ran rarely any pus I gave her a Decoction of China root and Sarsa parilla mixt with Splenetick and Hepatick Herbs yea and purgatives wherewith I use to cleanse the Blood I ordered that her Sores should be washed with Lime water and the Tents should be dipt in the following unguent Take of Vnguentum Diapompholygos half an ounce Saccharum Saturni 1 drachm Mix them And that they should be then covered with Emplastrum Gryseum Wincle Misc curios an 76. Obs 100. For the hard Tumours that remained I prescribed Emplastrum Diaphoreticum Mynsichti So she was perfectly cured XXXVII A Nobleman fell with his Knee upon the pavement he felt a pain under the whirl-bone and a little after a certain callous excrescence When the Swelling was not lessened with the Medicines that the Surgeons gave him I quickly cured him with the following Plaster Take of Emplastrum diaphoreticum Mynsichti de Ammoniaco Foresti each 1 ounce black destilled Oyl of Tartar 1 drachm Mix them Idem an 76. Obs 101. I have often discussed hard Tumours that were not fit for maturation with the same Plaster XXXVIII Johannes à Ketham in his summula venarum has observed out of Avicenna that Inflammations and pains in the Kidneys Loyns Hips and Bladder are wonderfully cured by opening the Veins by the Knee Gâ—â—â—â—â—â—us And I by opening the inner Vein of one Mans Knee who had a Phlegmonous Tumour over all his Leg and Calf gave him present Remedy ¶ One had been greatly pained with an oedematous Inflammation in his Leg and had been long troubled with a black Vein that ran obliquely up his Leg which being opened cured him And so another was cured who had been long troubled with relapses of Ulcers in his Legs This was done by me at Galen's perswasion Idem l. 2. ad Glauconem and by Ben. Victorius his advice XXXIX In all Medical Observation nothing is more excellent than to know all the disaffected parts about a Tumour And swelling is so near of kin and consentaneous to every Disease that a latent mischief is sooner declared by nothing than by this Either because the part being weak cannot turn the aliment brought thither into it self and so the matter remains or partly because Pain calls the Humours from all parts Now when with the Swelling the Veins do sometimes strut with their full tubes as if they would burst all about the places that feed the Disease they do but perswade us to empty them with the prick of a Lancet as I have often done with very good success when the Body has been well emptied with universals before Therefore Hippocrates l. de Vlc scarifies round old Ulcers and opens the strutting Veins thereabout Most Authors boldly scarify Contusions Inflammations and Tumours of all parts But I say if we slash the Flesh how much better may this subtraction be made out of the Veins that swell out in the afflicted part which is more plentiful commodious ready easie safe Idem and with less pain XL. If the matter be bred in the Liver Spleen or Womb and tend upwards you may make an Issue in the Thigh or Leg observing alwayes the rectitude which makes revulsion that the matter may not infect the upper parts Wherefore take notice that if the matter be sent from them parts downwards and get into either Leg they do very ill and are quite out who make Issues in the upper Parts for revulsion sake from the lower although they observe the rectitude
tough by the preceeding heat that the Patient be almost strangled which is not usual on the eleventh day a Gargarism must of necessity be used and order must be given to Syringe the Throat often with it Night and Day Let it be made either of Small Beer or Barley water with Honey of Roses But if the Patient have been treated as he ought Salivation even when it begins to abate will do its office so well that there will be no need of this Remedy And truly when it is come to this that the Patient is in danger of being choaked every moment quite dulled and his Breath almost gone we cannot safely trust this Remedy When the Patient is thus at his last cast I have sometimes very seasonably and successfully given a Vomit of Infusion of Crocus Metallorum but in something a larger dose to wit 1 ounce and an half because by reason of the extraordinary stupidity which the Patient labours under a less dose will not work at all and in the mean time by disturbing the Humours which it cannot carry off Idâ—m p. 210. will put the Patient in great danger of his Life XXX By this same tempering of the Blood I have seen purple spots removed but neither by this nor any other Method could I ever see either pissing of Blood or a violent eruption of it from the Lungs stopt as yet but both these Haemorrhagies as far as I could hitherto observe Idem p. 211. do undoubtedly presage death XXXI In suppression of Urine which sometimes takes the younger and brisker sort from the great confusion to wit and disorder of the Spirits which serve for the voiding of it by reason the Blood and Humours are disturbed with too great heat I have taken all the tribes of Diureticks to my assistance but nothing succeeded so well with me as to take the Patient out of his Bed who being supported by some that were by Idem ibid. when he had walked twice or thrice cross the Room presently made store of Urine to his great relief XXXII But the Symptomes which proceed from repercussion of the Variolous matter by external cold or evacuation unduly made they must be removed by the use of Cordials and a regiment conformable which yet must not be continued beyond the time that the Symptomes continue The chief of them are depression or falling in of the Pustules and a Loosness in the distinct Small Pox For in the Confluent neither does the depression of the Pustules forebode any ill because it is the nature of the Disease Nor a Loosness in Children that are sick of them because it causes health and no danger In both these cases a Cordial Potion of some proper destilled waters with Diascordium Laudanum liquidum c. may very well be given and that not only to remove the foresaid Symptomes but at any time of the Disease if the Patient complain of a pain at his Heart and sickness And indeed I think the redness which is so much upon the often striking in of the Pustules arises hence because they who have observed the depression of them in the Confluent sort have taken it for a recess of the Variolous matter upon taking cold when it is nothing but the nature of the Disease And they suspect the same in the distinct kind because to wit they expect the coming out and increase of the Pustules before their time Idem p. 212. whereas they have not taken notice of the time when Nature uses to bring this fruit to maturity XXXIII When the Patient is upon recovery and the Pustules are falling when the Patient has eaten Flesh a few dayes namely about the 21th day I reckon he may be bled in the Arm if the Disease have been violent since the Inflammation which the Small Pox has impressed on the Blood whether the Patient be old or young does no less indicate Blood-letting than the filth which has then been gathered does purging which is evident enough both from the colour of the Blood which when taken after a violent Small Pox is like that of Pleuriticks and also from those great Inflammations which after this Disease fall upon the Eyes and also from other dire effects of Blood over heated and depraved by this Disease Which is the reason that they who lived very well in health all their time before do all the rest of their Life after conflict with hot and sharp Humours falling upon the Lungs or on some other part But if the Pustules be few Idem p. 213. there will be no need of Bleeding After Bleeding I give two or three Purges XXXIV The Epidemick Measles which came in the year 1670 and they that were abroad in the year 1674. introduced black Small Pox whose Pustules were as black as soot that is when they fluxed and the Patient died not till they came to maturity for before they were ripe they were only of a brown colour Moreover the Pustules were very small if they were numerous for when they were but few they were not less than in other kinds of Small Pox and very seldom Black A great Putrefaction was latent in both of a thick and incoctil nature When they were ripe they smelled very ill so that when People were very bad of them a man could not come near them for stench They finished their course slowly and stuck longer on than any that I ever yet saw This is worth observation that how much more gentle the Disease is so much the sooner the Pustules ripen and the Disease comes to an end So in the regular sort of Confluent Small Pox which came in the year 1667. the 11th day was the most dangerous which once over there was no further fear usually of the Patient In the irregular sort of the Confluent next following which came in the beginning of the year 1670 the Patient was in greatest danger on the 14th or at furthest the 17th day which if the Patient got over he was safe But in this sort of Confluent Small Pox the Patient died even after the 20th day And sometimes if he did recover not only his Legs swelled which indeed is usual with some in the Confluent Small Pox but his Arms moreover Shoulders Thighs and other parts which Swellings begun the Tragedy with intolerable pain just like that of Rheumatick Persons afterwards they often suppurated and ended in great Sinuses and Imposthumes of the Muscular parts And these Small Pox seem to me a new kind arising out of the former then grown old Although the Black Small Pox which in the beginning of the year 1670 first showed themselves according to the disposition of the Air which made it Epidemical did go on towards the height yet like the relapse of some Disease the old matter fermenting again the Air which inclined to the production of the Small Pox drew them out of their old store which Disease indeed gathering strength anew seemed as it were
when diseased Persons are sent hither without any regard had to the Patient or his Disease their end is hastened I have seen it several times especially in a Matron of seventy who had been several years ill of a painful and contumacious Ulcer with a perishing of the Bone about the juncture of her left Foot wherefore she went to Neuhausen Bathes near Berne and found benefit for her pain asswaged and the Ulcer healed up Yet not long after she grew ill again and her Ulcer broke a new The next year she used them again but then she was taken with a dangerous Fever wherefore I advised her for the future to abstain from the Bathes but to no purpose for she went again to the Bathes at Blumenstein which she had no sooner entred but she was so weak that she scarce could recover it Do you ask the Reason The putrid matter that is in the musculous parts about the Ulcer or in the Bone growes hot with the heat of the Bathe becomes sharp acquires a Malignity and makes the Ulcer more painful Wherefore Humours flow continually from the whole to the part affected and with the rest of the foresaid Humours inclosed in the part do corrupt Besides the matter grows hot in the Vessels which the heat of the Bathe turns into Vapors which go to the Liver Heart and Brain whence proceeds an Infection of all the Spirits Hildanus Cent. 5. Obs 90. and other grievous Symptomes II. Beware that you do not take all that Crollius has told of his Lapis Medicamentosus for oracle For sometimes a Theorist writes many things with a feather of Icarus and extols them to the Sky which when they touch the Sun of experience melt and turn to nothing If you examine the ingredients of this Stone you will find it hot and dry with great acrimony Nor can I see how it should possess those innumerable virtues Crollius ascribes to it and how it can be applied in so many Diseases without damage He writes that it cures all Ulcers in the exterior parts quickly But have a care you do not try it in Ulcers of the Nervous parts that are full of pain and Inflammation especially in delicate bilious and cacochymick Bodies for it immediately causes pain inflammation watching disquiet and other Symptomes I saw this formerly in a young Man who I remember upon the application of it after a violent pain fell into a Swoon Have a care also that you do not apply it in cancers or cancrous Ulcers of any part Idem Obs 91. for you will immediately find the aâ—l grow worse III. Aluminous water also is suspected in cancrous Ulcers M. N. was ill of an Ulcer at the root of his Tongue of a cancrous nature It was exasperated by the application of the said water prescribed by a Physician Wherefore I perswaded him to wash his Mouth with water of Frogs Craw-fish and Plantain with Honey of Roses and to strow powder of Frogs and Craw-fish burnt upon the Ulcer Idem after this the Malignity of the Ulcer abated quickly to the admiration of them all IV. Ulcers seeing they have cacochymie and faults in the Humours for their causes do also require purging therefore Hippocrates seeing and well considering the necessity of it in this case mentions it lib. de Vlcer which he uses not to do in other such cases We have two sorts of purges in Ulcers and other external Ails the one Catholick drawing from the whole Body which we seldome use the other contrary to this which draws neither from the whole Body nor all Humours Each of them must be used with great care always The former indeed is more simple because of more frequent use the latter more compound because it is given for compound diseases This is commonly threefold Purging of Phlegm Choler or Melancholy But we propound another both absolutely necessary and especially for our purpose which is properly the purging of the Blood by its repeated use This is not only omitted but seems not so much as to be known by its name The Blood has 4 Hypostases of different natures that is bile phlegm and melancholy and Blood in all mens judgment is the legitimate Humour the fourth substance of the mass the purest part of the nutrient Humours Now every one of these distinctly taken has its peculiar Ichores that is moist superfluities depending on them When Ichores and Humours may corrupt and putrefy contrary to Nature's law both joyntly and severally of which there is a numerous conjugation Therefore either all the Blood and Ichors and Humours are in fault as in the small Pox and Leprosy and with some of these as in lesser Cacochymies Or all the Blood is polluted absolutely as much as it can be as in the small-Pox and Measles Although we ought to restore and correct all these Modes of putrid Blood with Physick yet this Mode of Corruption especially comes under our consideration which is not in a total and perfect corruption Blood therefore receeds from its nature two ways either the most part of it or but a little But the farther the recess is the greater industry and stronger Medicines are required And the measure of the Putrefaction can be no way better known than by observation of the Blood as it is drawn out of the Veins Or if we cannot do that from the discolouring especially of the Eyes Lips Gums Teeth Hair Nails also from their strength especially compared with their feeding or fasting from the quality of the excrements and other affections appearing in the body When you have searched out these things then you must proceed to make up proper Medicines which may purge the Blood several wayes by abstersing opening obstructions ventilating provoking Sweat and Urine by giving a stool by attenuating and qualifiing their second or third qualities But among all things they are chief which act by peculiar property Among purgers the chief is Hellebore either black or white which Hippocrates therefore used so much because he knew it had a singular faculty to purge the Blood Nor need we be so abhorrent from this Medicine nor be so fearfull because the Diseases wherein they are used are more frightfull and proceed from black Choler wherefore Galen lib. de atra bile writes That in Diseases proceeding from a melancholick Humour you must at the very first stop the growth of it by Melanagogues As for the safe preparation of it see Salius l. de Aff. part cap. 19. and others Also Senna Coloquintida and Turpeth are strong weaker than these are dodder of Time root of Fern Fumitory Hops Agrimony Cichory Ground pine Speedwell Strawberry leaves Maiden-hair Asparagus Parsley which according to Montuus Purges the Blood by Urine Among Compounds Treacle is the chief which by reason of the Viper it has in it has the divine faculty of Purging the blood and humors Trochises and Salts of Vipers and infinite things out of Hermes his Elaboratory To which you may reckon
When it was grown inveterate and could as it seemed be cured by no Remedies he came to me His Toe was swelled and inflamed On the outside of it there was an excrescence of Flesh as big as a Bean which covered almost half the Nail The Barber-Surgeons had several times wasted it away with causticks but to no purpose for whatever they wasted in the day it grew up again like a Mushrome in the Night I enquiring out the hindrances of cure found the Nail under this Flesh extuberant and separated from the Flesh underneath which therefore did prick the sound Flesh continually towards the root of the Nail caused pain and attracted the Humours plentifully When the cause was known I put the Patient in hope of a speedy cure Therefore having purged and bled him on the same side I strowed some burnt Alom powdered upon the excrescence of Flesh And I applied to his Toe and to his whole Foot a cooling and anodyne Cataplasm Take of Bean-flower 2 ounces powder of red Roses Pomegranate flowers and Cypress-nuts each 2 drachms Saffron half a scruple Boyl them in Plantain and Rose water and a little Vinegar Add towards the latter end the yolk of an Egg and a little Rose water Apply it warm With this the pain and swelling abated much the excrescence of the Flesh was a little wasted so that the Nail separated from the Flesh underneath which the excrescence of Flesh had covered came into sight I cut it away as carefully as I could with a Pen-knife and Scissers and when I had strewed on it a drying powder aad applied Diapalma plaster he quickly recovered Hence let Chirurgeons learn how much it concerns them Hildâ—â—â— to know the cause of a disease XLVI Frequently after the cure of an Ichor and a Meliceria we find the joynt so stiff and hard that it can be bended neither one way nor other Here oftentimes Chirurgeons labor a long time to mollify the joynt Ligaments and Nerves but in Vain for that Ichor which flows from the whole Body to the wounded joynt and has such acrimony corrodes and wasts first of all the ligaments and tendons which encompass the joynt and then the Cartilages which cover the joynt Hence it comes to pass that the Bones being divested of their Cartilages and Ligaments do as firmly grow together by a Callus which I was the first that observed as if there had never been a joynt there Idem XLVII Why is a full and a moist course of Diet bad for all Ulcers and a thin and dry one good Whether because a moist Diet makes the matter of the excrements more fluid for moisture is terminated by any thing but it self and driness by it self Or is it because moisture opens a passage for Moisture makes lax the passages which driness stops up And they flow especially when they are sharp and when the moisture of meat and drink abounds And a passage easily succeeds by these parts which of their own Nature are apt to receive the excrements of the whole Body Or is it because the Skin among all its other uses has this remarkable one to retain the Humours and Juices which run from within to the habit of the Body and to stop them as it were when otherwise they would easily run out and be discharged So therefore as the want of Skin is the cause why the serous Humour ouzes out it will be much more in sick Persons like as in Plants and Fruits when the bark of them is cut the useful Humour runs out so an Ulcer ceases not to run till it be crusted over nor does it cease running in Plants till the Cut close up Wherefore Hippocrates lib. de Vlceribus sayes The dry is next to the sound the dry is sound Or is it because of weakness for which the part does ill receive much adventitious moisture whether excrementitious or useful and wasts the moderate heat and is distempered so that it can neither concoct nor assimilate the same Wherefore it is said by Arnaldus doct 5. cap. 18. Aliment attracted and not incorporated turns to sanies and therefore superfluity of Aliment hurts wounded persons Or is it because by how much more aliment comes to the parts by so much more Excrements are bred And this being poured in plentifully infects and spoils the place Moreover Hippocrates writes l. de nat human that when an Ulcer cannot be healed of a long time Moisture is the cause of it It is necessary therefore that the whole Body be dry and that the part be dry for the agglutination of an Ulcer Or is it because an Ulcer that is moist by Nature is encreased by the accession of a moist diet as withered Plants when they are watred afresh grow green again But not only the Ulcer but the parts about it grow moist and stiff with an inflamed or some other Tumour without the soundness of which the Ulcer can neither dry nor heal These are Reasons sufficient to reject a moist Diet. Now a slender Diet is approved of in Ulcers as Eustachius Rhudius has observed to the end Nature may be more desirous to distribute that which is scarce sufficient for it self For an Empty Stomach attracts from all the parts round so as that by long consequence the circumference of the Body is emptied And that ill Humours may be corrected by Nature's constant evacuation of them which would be hindred and diverted by plenty of victuals Therefore Hippocrates lib. de locis p. 47. sayes Whatever Diseases turn to Vlcers and are eminent above the rest of the Body they must be cured by Medicines and Abstinence And a little after Proud and rising flesh must be brought down by Diet. But otherwise when the Bodies of ulcerous Persons abound Cacochymy they will find huge inconvenience from a full and moist Diet. For 2 aph 9. Impure bodies the more you nourish them the more you hurt them Wherefore I use to say Severinus that by a spare Diet much mischief which would ensue is retrived XLVIII If you would clearly know how hurtful an ill course of Diet is for Ulcers I will propound to your consideration the evidence and experience of Apparencies which have informed me when the Patient has been any way irregular For the Sores continue a long time and sometimes putrid and fungous caruncles breed in the Ulcer sometimes callosities and other filth and tumors grow in them sometimes there is a troublesome pain and sometimes an Inflammation about the part and an internal one too To say nothing how ill sometimes the Ulcer looks and what a strange colour and stench sometimes uses to follow The Patient must needs suffer these and such like things who indulges his Appetite and crams his Gut and has no command of himself On the contrary he that can rule himself and his Appetite will both quickly be cured and will feel none of those things I have spoken of For as Celsus l. 2. c. 16. sayes Nothing
effectual ¶ In whatever cause Bread tosted dipt in Vinegar of Roses and bestrewed with powder of Mint Cloves and Roses is good ¶ This is a certain experiment and reckoned as a secret by some After the takeing of Antimonial Medicines which vomit too much to give a spoonful or two of Spirit of Wine Sennertus and it gives present help 9. Dried Coriander infused in Vinegar does admirably in a hot cause Stokkerus 10. Sower Leven soaked in strong Vinegar and juice of Mint applied and renewed twice or thrice most certainly stops Vomiting by Purging and due Revulsion Varendaeu◠11. A few Coriander Seeds in Vomiting after the taking of a violent Medicine Welkardus have an admirable property to stop it if they be chewed Vomitus Sanguinis Puris or Vomiting of Blood or Corruption The Contents Purging is good I. It must not be stopt in all II. Things that are hot and of subtil parts must be put into the Applications III. Oyly things are hurtful IV. Vinegar must not be given alone V. Caused by swallowing a Leech VI. From the Spleen VII The Cure and Prevention of Vomiting of Pus VIII Medicines I. GEntle and frequent Purging must be celebrated whereby the Blood is purged from those serous and bilious Humours which produce this Disease Which kind of Purges celebrated by a prudent Physician do wonders as I have learned by experience And they must be made of Rheubarb Myrobolans Tamarinds and triphera Persica which Medicines purge and bind and no way disturb the Humours so that you need not fear any vomiting of Blood will be caused thereby Riverius II. There were two Women at Padua who the day before their Menses came Vomited Blood they perceived the Vomit before it came which if the Physician tried to stop Rhodius divers Symptomes would arise and go away with vomiting III. In Oyntments Epithemes and other applications we must take care that they have some heat with their astriction for though the flux be stopt with cold and astringent things yet this is done upon taking the indication from the function of the part that is the Stomach and from the time Cyperus Spike Cassia and Cinnamon are the best among other Astringents For besides that they preserve the nature of the part they help also the penetration of the astringent and cold things which are of gross parts IV. In vomiting of Blood the use of Oyls is suspected because they open the orifices of the Veins rather than close them Therefore Aloysius Mundella denies Oyl of Sweet Almonds to all that vomit Blood Bartholinus V. The use also of Vinegar alone is suspected because it exasperates the parts and raises a Cough whereby it promotes a new fluxion Therefore it must be sweetned with Honey or Sugar VI. A Country-Man was ill of Vomiting of Blood that would give way to no Remedies for several dayes The Physician being desirous to carry off the Blood that was gathered in the Stomach by vomit prescribed him 2 ounces of Oyl of sweet Almonds which made him vomit and he brought up clotted Blood and a Leech also that moved upon the ground Riverius Obs 26. Cent. 4. This was an unknown and rare cause of vomiting of Blood The Patient said afterward that he drank of a rivulet where he had swallowed a Leech with the water VII In the year 1662. I saw in the Town Boudri within the Territory of Newenburgh a Notary fifty years old who vomited at one time a pound of clotted black Blood and as he said he had vomited as much the day before His Stomach was then squeamish with a sense of a load wherefore I gave him a little warm Oxycrate for there was nothing else at hand which brought up no less quantity Because the strength was good I prescribed him a bolus of Conserve of Roses with I drachm of the powder of Rheubarb which brought away a great deal of clotted Blood mixt with the Stools Then I proceeded to strengthners For Preservation I ordered him to Bleed at the Haemorrhoids twice a year for the flux came from his Spleen as the swelling of it returning at times did testifie giving him Chalybeates and openers of Obstructions He followed this wholesome advice for 2 years which being neglected the third year his vomiting returned with greater violence which deprived him of Life I have known many sayes Dodonaeus cap. de Absynthio l. hist stirpium who have brought up Blood by vomiting I remember I saved one or two by my advice after once vomiting and indeed by the frequent use of Worm-wood all manner of wayes VIII The excretion of Pus by Vomit and Stool must not be stopt but gently promoted seeing it is an Humour toto genere preternatural and every way hurtful to Man But the new growth of it must be hindred as much as can be since it is bred of Blood the fewel of our vital flame and the food of all the parts of the Body as well containing as contained Among all things which move or promote excretion of Pus I prefer and commend Antimonial Medicines for I have often observed that they have not only a virtue of correcting the mischief which comes from Pus but also of hindring the breeding of new Pus for rightly prepared and administred it serves no less for the purifying of Man's Body than for purifying of Gold Also Balsamus Sulphuris Anisatus and any other stops the continual generation of Pus out of corrupt Blood if 2 or 3 drops be taken several times a day from which also the cleansing and certain healing of the Ulcer may be expected and perhaps more certainly than from any other Medicine To this end also Antimonium Diaphoreticum will conduce Sylvius de le Boe. and any other altering Medicine made of Antimony and a Balsame artificially made of its flowers Medicines especially made use of by eminent Physicians 1. To stop vomiting of Blood I gave these with success Take of Mummy 1 drachm juice of Horse-tail 1 ounce water of Plantain Horse-tail each 1 ounce and an half After the Patient had drank this cold his Bleeding and Vomiting stopt ¶ To a Woman who brought up her Menses by vomit I gave this Clyster for diversion Take of Chicken broth wherein a few Prunes Raisins and Aniseeds were boyled Cassia for Clysters 1 ounce oyl Olive of sweet Almonds Chamomil each 1 ounce common salt 1 drachm Sal Gem. half a drachm the yolk of an Egg. Mix them Make a Clyster She recovered beyond expectation with this one Remedy But every Month before her vomiting came Forestus she was bled in the Foot 2. Practitioners use to apply Remedies to the Spleen as I have observed from experience when the Patients have vomited great quantities of black Blood the vomiting has been presently stopt by this Plaster Take of Barley flower A corns root of Comfrey each 1 ounce and an half blood-Dock 2 drachms Plantain water and red
spoonfuls at one time The Wound may be washed with this Decoction and a red Cabbage leaf may be wet in it and applied to the Wound Ranzovius with the rough side towards the Wound which must be bound fast on 14. This is one of the best Medicines that I know which we may most safely use for Haemorrhages of the Membranes of the Brain Take of Frankincense 1 part Aloes 1 part and an half Mix them when you would use them mix them with the white of an Egg till they be as thick as Honey then mix some of the softest Hare's down with it and so store of it is applied to the Vessel or to all the Sore and then it is bound up ¶ Some reckon the Down upon the inner shell of Chesnuts in Powder Eust Rhudius as a secret 15. The Crum of wheaten Bread steeped in hot water is effectual to stop pain ¶ For a Palsy from Wounds this Balsamick Liquor of Mesue's is excellent wherewith the Neck all the Spina dorsi and also the Part affected must be anointed it is good for all Diseases of the Nerves the Palpitation of the Heart and it is admirable good for all manifest weariness beyond all imagination and no better Medicine can be found where the Heart wants refection according to Mesue And this is it Take of Myrrhe Aloe Hepatica Spikenard Dragon's Blood Frankincense Mummy Opobalsamum Bdellium Carpobalsamum Ammoniac Sarcocolla Saffron Mastich Gum Arabick liquid Styrax each 2 drachms Laudanum Castor each 2 drachms and an half Musk half a drachm the best Turpentine what is sufficient Mix the Powders with the Turpentine Destill them by Alembick Tagaultius keep the Water Some Cowslips may be added to make it the stronger 16. This has been tried in many Wash the Wound morning and evening in Wine then apply a little Cotton dipt in Oyl of St. John's-wort to the Wound it will heal with this only remedy without any further trouble Rulandus Vulnera Sclopetorum or Gun-shot Wounds The Contents Whether they be poysoned I. No Empyreuma remains II. Common Digestives are not proper III. In a Wound that goes quite through a Seton must not be used IV. The cutting off a Limb must not be urged because of a great Fracture V. Cold and very Astringent things must not be applied presently VI. The Expulsion of the Bullet must sometimes be committed to Nature VII It must always be taken out when it is near a joynt VIII Which is the best Instrumemt for taking out a Bullet IX Tearing the flesh must be avoided in taking of it out X. Nothing extraneous must be left in XI Too much dilatation of the Wound must be avoided XII When extraneous things must of necessity be taken out XIII Haemorrhage must be avoided in the Extraction XIV When splinters of Bones must presently be taken out XV. When a Wound must be dilated to get out what is extraneous XVI What Medicines are proper XVII Their Bleeding must not presently be stopt XVIII When Repellents are proper XIX Whether Oxycrate be good XX. Whether hot things may be applied XXI Whether hot Oyls be of use XXII At the first visit what must be taken notice of in the Wound XXIII Whether Blood may be let XXIV Blood must be let sparingly XXV Whether Purging be proper XXVI Whether Butter may be added to Digestives XXVII How long we must insist upon Digestives XXVIII They must be liquid XXIX What such the Tents should be XXX In a Wound with Fracture what such the swathing ought to be XXXI How a supervening Haemorrhagy may be stopt XXXII In a wounded Head when Section must be made XXXIII When the Skull is to be laid bare XXXIV If Trepanning be necessary we must not defer it XXXV There must be a right use of Cephalick Powders XXXVI In a Fracture of the Skull with what caution Bones must be taken out XXXVII A Fracture in the Skull sometimes curable without Section XXXVIII When a Fever may hinder Trepanning XXXIX In a great Fracture of the Skull where the Skin is whole we must be very careful in cutting XL. The Trepan must be dexterously used XLI In Wounds of the lowest Belly with what caution we must Purge XLII If the Bullet have not hurt some of the Viscera in the lowest Belly it must not be too much searched XLIII If it cannot be easily found it must be left in XLIV I. There be three opinions about Gun-shot wounds Some hold they are poysoned Others deny that they are poysoned yet hold they have an Empyreuma Others will grant neither but all that these wounds differ in which are made with a bullet from other wounds that are made with a sharp weapon is in the contusion and dilaceration But if there were any poyson it must come from the Gun-powder or from the Bullet It comes not from the Powder because the Ingredients whereof Gun-powder is made are not poysonous Sulphur Nitre and Char-coal are none of them poysonous Yea Experience testifies that abundance who have been so wounded with Bullets have had no Symptome which was any sign of Poyson It could not come from a leaden Bullet For it is evident that Lead especially whole carries no poyson in it because many carry Bullets along time in their Body without any harm Which Sennertus though sometimes they may be be poysoned yet it is not so in all wounds II. Nor is there any Burning for first of all the Bullets would be fiery hot and melted which are taken whole out of the Wounds Secondly The Burning would be perceived especially in the things that are most combustible as in the wounded Parties Clothes Thirdly The Wadding of Paper or Tow when it is put in instead of a Bullet is discharged without any marks of burning coloured only a little black Fourthly Wounded Persons feel no heat or burning only pain from Contusion and Dilaceration in which the Nature of these Wounds consists But the thing that has deceived them all is this that other Symptoms happen in these Wounds and require another Cure than Wounds made by Arrows But they ought to have taken notice that there is a great difference between these Wounds For Arrows are sharp and wound by cutting but Bullets are round and hurt by contusion Idem wherefore a corruption of the contused Part and bad Symptomes may easily follow III. Although what is contused must be changed into Pus and separated from the sound Parts yet since the contused Parts do easily putrefie and that there is danger of a Gangrene the common Digestives and Suppuraters which are used in other Swellings and Wounds are not proper here alone especially if Nervous Parts be contused which cannot endure such moist and simply oâ—eous and fat things and require drying things but such things must be used as indeed help to change the contused flesh into Pus yet cause not Putrefaction and are also Anodyne Quercetan to avoid the inconveniences which attend
macerated with purgers unless these be chiefly taken away in the first place For it is always better sayes Sennertus that vitious Humours should not be generated than that they should be evacuated when generated Thus for example in the cure of all Fevers before all things the febrile ferments the next cause of the ebullition in the mass of Blood as most urging are to be fixt and precipitated by Specifick antipyreuticks Diureticks and Diaphoreticks that imitate Nature which having extinguished the febrile ferments may afterwards withal resolve the vitious matter produced by them and having resolved it may separate it from the mass of Blood by convenient wayes and when at length the febrile ebullition of the Blood is allayed and the paroxysm banished then the occasional febrile cause is by a methodical cure to be removed by purgers and a relapse to be prevented The Method is the same in Chronical diseases which although they have taken firm and strong rooting in the Body with obstructions of the viscera from serous crudities every where collected and the balsamick Saltness of the Blood turn'd into acetous and sowr yet are to be cured by precipitating Alteratives which may tame the Humours tainted with morbifick ferments may resolve them and the dyscrasie of the Blood being amended and the obstructions of the Viscera unlocked may consume and cast them out Now Alterative Medicines do perform this precipitation either in a privative or a positive manner Of the former sort are those which not only make a fixt of a volatile and a volatile of a fixt but also of an acid a sweet of a bitter a Salt of a Salt a bitter yea and also by imbibing the preternatural and acrimonious Salts cleanse the Blood and correct the depraved ferments of the Viscera and so stop the preternatural fermentation of the Humours Such kind of Medicines are resoluble hungry and thirsty easily imbibing acid corrosive Salts and when they are filled and have done their business depart and they act partly by way of Alteration acquired in a possibility of their own partly by changing the internal qualities of those and such as descend from the specifical quality How this is done Joh. Lang. in Miscellan the more intimate Skill of Spagiricks demonstrates for he that understands the dulcification of Salts throughly knows very well the reason of this also For the Alterations that happen in the vital oeconomy from vital principles depend not on the fire or cold of the Body heat and cold are accidents not belonging to the nature of Diseases Thus a Thorn being prickt into any part in an instant there follows pain to the pain succeeds the pulse from the pulse an afflux of Blood whence ensues heat a tumour an aposteme c. the thorn therefore moves the other things after it Now the metaphorical thorn of Diseases is the strange ferment conceived in the Archeus or other foreign acids ponticks corrosives c. which if the Archeus drive or deposit into the mass of Blood what disturbance is thereby raised So in the Liver there are often felt preteâ—natural heats but all these are caused by means of the wild acid Salts which accend the Archeus c. sayes Helment lib. potestat medicam § 20. Seeing every thing acts not upon every thing but upon something determinate nor every thing suffers not from every thing but from something determinate so also every Morbifick matter being furnished with its own peculiar Ferment cannot indifferently be dissolved and precipitated by any one but only by its own appropriate precipitating Medicine For it is not enough that attenuating Remedies be opposed to thick and viscid humours and incrassating to thin but their Nature also according to the diversity of the figure of their Parts with their specifick Ferments is to be heeded and specifick and proper precipitating Remedies are to be used Alkali's for Acids Acids for Alkali's Sulphureous for Sulphureous c. Whence Walaeus says that Alteration is made by Conjunction and Perfection Hence if altering Medicines ought to alter they must needs be mixed with the humours that are to be alter'd if they would be mixed throughly they must be like the humours not in respect of their qualities for so they should be contrary but in respect of their Constitution Therefore what things are oily in our Body let those be alter'd with oily Medicines what are watery with watery what are acid with Alkali's what are Alkalizate with Acids c. When thick viscid and acid humours produced from the vicious Ferment of the Stomach or from the depravation or corruption of the Chyle stick close in the coats of the Stomach then those Remedies are to be opposed to them either that abound with a volatile aromatick Salt such as is in Wormwood Aron root Centaury Carduus Benedictus c. or that are endued with an Alkaline fixt Salt or a volatile lixivious such as are the Salts of Wormwood Ash Succory the volatile Salt of Hartshorn the volatile Salt of Tartar c. As also if this acid Crudity be after a sort volatile and exalted by a fermental humour so that it penetrate even into the mass of Blood it is fixed and changed not only by all fixt Alkaline lixivial Salts prepared from Plants but also if there be need of greater penetration by other alkaline volatile Salts such as the salt spirit of Sal Armoniack of man's Blood of Hartshorn c. with which effervescing it is in some measure temper'd coagulated and made neutre Moreover for this purpose serve also Crabs Eyes red and white Coral prepared Spodium Mother of Perle Perch-Stones c. all whose alteration is of a middle sort betwixt the stronger effervescence that arises from the aforesaid Salts and the concentration or fixation made with the aforesaid Alkali's If the Ferment of the Stomach be filled altogether with sulphureous and bitter Excrements so that it estuate too much thereby and a nidorous crudity spring thence acids are to be given of which sort are spiritus vitrioli Martis salis striatus c. the juyce of Citron Pomegranat Corinths Berberies c. To correct a lixivial Alkali abounding in the first ways whereby driness of the mouth and thirst is too much encreased acids also being taken are profitable also Emulsions made of the four cold Seeds See the Title of Sitis Thirst Where the Ferment of the Stomach is very weak or departs too much from its acid Salt volatil Balsam those things are to be given that supply its place such as are volatil acido saline Salts volatil acid Spirits of which number are the fixed Salt of Hartshorn prepared with the Spirit of Salt or the terra foliata of Tartar D. Moebius's aperitive tincture Arcanum duplicatum c. For these are the genuine wakeners or exciters of the Ferment of the Stomach and of the other Viscera they do withal cleanse away the filth of all the Digestions resist Putrefaction unlock long-continued Obstructions of the Viscera
Spirits are exhausted and spent the remainder be tyed Death ensues presently XXII For easing the greatest Pains where digesting Anodynes being first applied have done no good let the pained Part be hastily touched with a Bladder full of cold Water and let the Bladder be removed again without delay and repeat this twice or thrice this is the advice of Hippocrates and Sanctorius for a moderate torpor has a vertue to cure Pain and then the application is made more conveniently in a Bladder because the pained Member is not offended by the moisture which perhaps might do it harm XXIII Oil of yelks of Eggs and of sweet Almonds is not to be drawn out of the yelks or Almonds burnt which some Perfume-makers do that they may draw the Oil more easily and plentifully but they are only to be gently warmed and then the Oil to be drawn out of them with that diligence that is necessary For indeed by burning of them the Oil is easily drawn Fabr. Hild. l. de Gangraena c. 24. but then it is sordid stinking and very unfit to allay Pain Aperients or Openers See Obstructions Book 13. and Preparers below The Contents Volatil Aperients should be moderately thick I. Absorbing and Resolving Aperients II. XI The Vniversal Indicant of Apertion is 1. An Obstruction III. Viz. 1. An Obstruction of the Viscera IV. 2. An Obstruction of the Vessels V. 3. An Obstruction of the Passages VI. 2. A Concrete or tartareous Body indicates Aperients VII Humours and Wind are subject to concretion VIII 3. A thick viscid clammy Body indicates Aperients IX Thick Humours often lie hid although the Symptoms of thin be most urgent X. 4. An acid acrimonious sowr Body indicates Openers and on what the vertue of Steel-Medicines depends XI Purgers are Openers and we must use these by turns XII What degree of heat Aperients are endued withal XIII Their active Principles XIV All Diureticks are Aperients XV. Let Vniversal Remedies precede the use of them XVI We must not insist too much on them especially on the volatil XVII Medicines that respect the Part are to be mixed with them XVIII They are not to be mixed with our Meat XIX We must take heed they dry not too much XX. Stirring about is necessary upon taking Chalybeates XXI I. APerient resolving attenuating inciding and absorbing Medicines all serve the same end for some of them only express the manner of acting more Their vertue namely and manner of acting consists principally in the thinness of their Parts Aperients are endued with Particles that incide are acute penetrate and loosen the Passages whereby they procure Motion to fixed Humours and make way for themselves to pass by But secondarily they ought to have a moderate thickness that their vertue may not so soon expire or dissipate which that of Rarefiers does which are more proper for what sticks in the Surface and Pores for they loosen the Pores and fuse the Humours Hence bitter things are of great esteem among Aperients because through their earthy Parts they strengthen withal For it stands for a rule That those Aperients are the best which strengthen the Parts and Fibres withal and do not induce a loose tone II. And these are the Aperients properly so called or rather of the first class namely of the volatil But besides these there are others that absorb and resolve not as if they were endued with thin Particles and so penetrated by their own vertue but because they absorb or drink up the coagulum that fixes the Humours as it were and for the most part is an acid pontick and sowr quality whence the Humours are sweetned as it were and consequently do not restagnate in their Receptacles or Chanels but pass readily to and again and are either circulated or cast out III. The Universal and as it were common Indicant therefore of Apertion I mean common to the Vessels and Pores obstructed and to the matter obstructing is 1. Somewhat obstructed and so hence Aperients in a great latitude are convenient for all obstructions in general For example for an obstruction IV. 1. Of the Viscera as of the Liver Womb Kidneys Spleen Mesentery where it is to be noted that those viscera are more liable to obstructions that have many vessels as the Liver and Spleen especially V. 2. Of the Vessels as of the Veins and Arteries which are like pipes or channels Whence as otherwise waters in pipes do by little and little deposit that slimy matter wherewith they abound in the pipes they pass through and fix it to their sides so it is in the Vessels whence we see that those whose Vessels are obstructed have their pulse increased and that the Blood is moved the quicker because the space it moves in is narrower Also for obstruction of the Nerves as in the Palsie where those Nervine Aperients are fitting that open the obstructed pores of the Nerves Also of the salival and lymphatick Vessels c. VI. 3. Of the meatus or passages as that of the Gall of the Intestines of the Ureters c. whence they are proper in the Jaundice Colick Stone c. where we must note by the way That all Persons troubled with the Stone are also Hypochondriacal or abound with a tartareous or obstructing matter in their Blood VII 2. Somewhat concreted or tartareous does indicate Aperients when saline tartareous and earthy Humours cause obstructions in which case they are properly called Resolvents Whence in the Stone Scurvy or the Hypochondriacal affection they are the only Remedies whether the concretion and coagulation be in fieri or but a growing whence in clodding of the Blood palpitation of the heart Swooning Fainting a polypus of the Heart c. they are good or in facto when it is completed as in inward Abscesses Pleurisie Apostem of the Liver c. also in a fall from some high place and in Wounds inwardly whence most Antipleuriticks and Antitraumaticks are withal Resolvents and in a Pleurisie the same things are convenient as in a fall from on high so also these Resolvents on this account are good in spitting of Blood if they be join'd with Adstringents VIII Now subject to this sort of concretion are either Humours viz. Blood Choler Serum Urine Milk whensoever they restagnate and are moved without their proper sphere as I may say or are out of their Element or flatus or wind whence Resolvents are also very good in flatulent Distempers IX Aperients are indicated 3. by somewhat thick viscid and clammy whether that be meant of the bile when it becomes sluggish puts off its proper nature and loses its salino-Sulphureous kindly and balsamick acrimony or of phlegmatick cold and moist juices whence in an Anasarca thick Catarrhs ill habit glutinous stone the Stomach fill'd with Phlegm c. they are good in which case they are particularly called Attenuaters and Inciders X. Now although thin Humours also may often seem to offend in obstructions as in the Scurvy and
omitted in many grievous Diseases without cause seeing it was so successfully used by Hippocrates Galen Celsus Paulus c. On the contrary I am wont chearfully to fly to this miraculous Remedy although abhorred by our Modern Physicians and I call God to witness I have always found it profitable but I use it chiefly where there is a cold and moist temperature Epiphan Ferdinand Hist 7. But they made Inustions not that Ulcers should be made thereby for a perpetual and continued evacuation such as are now made by our usual Cauteries but either for drying or to call out the matter to the outer Parts or to intercept it Salius in v. 21. lib. 2. de morb and they treated them like Burns and heal'd them up and skinn'd them over as soon as they could on this manner they healed the greatest Diseases At this day the Chinese Japanois c. undertake to cure almost all Diseases by Inustion But for this purpose they use not Iron but Moxa which is made of the downy tops of Mugwort this they lay upon the part where they would make an Inustion and setting it on fire it performs their intention But they chiefly use it in the Gout The Reader may find the vertues of those Burns that are made by it c. at large in Wilhel ten Rhyne's dissertation of the Gout part 3. pag. 69. c. or more briefly in the first Book of this Treatise under the title of Arthritis or the Gout where the said Author's discourse is Epitomiz'd XXXIV Vstion either penetrates to the very pus so that it is both burning and cutting or it is that which is called Inustion that is a burning that wounds the Skin only and makes a crust but does not penetrate By the former burning the pus or matter is drawn out as freely as by cutting but not so by the latter or Inustion but there are Blisters raised by it that by them Nature may let out what used too be gathered inwardly or may also thrust out by little and little what is already collected and so clear the inward part Inustions are also good for drying and strengthning the parts when they are moist and loose and sometimes for stopping the way of fluxions to wit by a cicatrix the parts are hardened and constringed Hence when we would draw out Pus that lies deep we use section If the Pus be not malignant nor the part ready for putrefaction then only cutting but if it be then a red hot knife which may both cut and burn because fire restrains and extirpates putrefaction And then only we should use inustion when the fluxion lies underneath not as yet changed into matter or there are mucors and laxities of the parts as of the ligaments in the Sciatica and other pains of the Joints or unless it may be when we dare not make Section though otherwise the Disease requires it Lib. de in t Affect as Hippocrates commands that in such as are suppurated within their Breast we should make penetrating section that the Pus may flow out namely advising that which the Disease calls for But others are content with inustions between the Ribs as fearing the greatness of the Remedy Valles comment in 5. Epid. p. 462. and its difficulty in a weak Patient XXXV The ustion of the Joynts that was grown out of use has been restored by M. A. Severinus l. de Effic Medicin and I have seen him perform the operation just after the same manner as Alpinus describes it l 3. p. 101. namely by a pyramid made of Flax and Cotton He called it the Arabick ustion because it is familiar not only to the Egyptians but also to the Arabians that live in Tents This Inustion is good chiefly in pains of the Joynts that are caused by a cold and glutinous Humour fixed in them also in Phlegmatick tumours arising up and down the surface of the Body for the stubborn matter will yield to no other Remedy J. Van Horne micro techw p. 2. § 33. ¶ As to burning with crude Flax and fungi or Toad-stools because Hippocrates hath not taught the manner it is worth the while to open it Take crude Flax and twist it close make it up in the form of a pyramid so as that one end of it or its basis may be broad and the other narrow and pointed the largeness that the basis is to be of may be learned by the largeness of the place that is to be burnt by it only note that the burning will extend it self somewhat further than the basis of the Pyramid is broad set the basis upon the part to be burnt and set fire to the other end and keep it on till all the matter be consumed by the fire for the fire creeping along and coming to the Skin makes the ustion and which seems wonderful almost insensibly and without pain When the fire is out Hippocrates laid a boil'd Onion upon it till that which was burnt fell off Our people apply Butter with a Colewort leaf and so keep the Ulcer open as long as is thought convenient Hippocrates sometimes used fungi of which they make touch-wood to strike fire withal with a flint The Egyptians make these pyramids of old Imnen rags filled with Cotton The Armenians burn with rags alone tyed close with a thread All which ways indeed are very good as I have learned by experience And they differ only in this that the more dense the matter is that receives the fire and the closer it is made up the deeper burning it makes P. Martian comm in v. 25. sect 3. lib. de affect Wherefore the matter may be varied with respect to the place affected the age sex and temperament XXXVI The Ancients made ustions in the Abdomen for the sake of the Liver Spleen and Stomach which have grown out of use seeing they are painful and obtain not their scope For they were made 1. to amend the cold and moist intemperies of the subjacent viscera but it is not adviseable to correct inveterate intemperies so hastily seeing a contrary intemperies may be easily induced thereby And then an intemperies diffused through the whole substance of the Liver will not be amended by a small burn with an Iron for hereto are to be preferred such fit Medicins as may be had 2. They were made for the evacuation of vitious Humours but although there be vitious matter in the Viscera yet because the Viscera are not contiguous to the peritonaeum the matter cannot flow out by the Ulcer that is made by the Iron As to imposthumes of the Liver and Spleen in particular Aquapendent writes well To burn the Skin and the Muscles that lie under it and the Peritonaeum with a red hot sharp Iron and to penetrate with it as far as to the Imposthume of the Liver and burn it also seems to me just like killing a Man outright that is almost dead already Sennere pract lib. 3. in
of concoction and most agreeable to Nature XX. Ptisan is not generally good for any unless those that are in Fevers or that have an estuating Stomach or Hypochondres it produceth a thick juice especially joyned with Pine-apples and being endued with a deterging vertue it also hurries the meat off the Stomach sooner than is fitting Fortis cons 82. cent 3. XXI Many things are deliver'd concerning the choice of water and how to know which is better and which worse Some approving most of all of Rain-water as being thinnest and boiled as it were by heat others greatly dispraising it as partaking of all Malignant qualities inasmuch as it is drawn out of all things even the most hurtful and sordid Some preferring before all other Well or Conduit-water as being the best cleansed by their percolation through the Earth others thinking these to be the most thick crude and flatuous of all and some lastly esteeming Fountain or River-water the best I think it is consonant to the opinion of Hippocrates and Galen and so to the truth that Summer Rain-water that descends with Thunder and Storms is the best of all inasmuch as this is not truly made of Vapours that are thick and that ascend with abundance of moisture but of such as are thin and are hardly extracted by the force of the heat but that other Rain-water which descends from thick and very opaque Clouds and is foggy is the worst of all sordid partaking of evil qualities and easily putrefying Moreover Well or Conduit-water that is sweet and is known to be derived from the next River or Spring is better than River or Spring waters themselves unless the Ground that lies betwixt the Wells and the Rivers or Springs partake of some foreign quality But if the Well-water as it commonly does proceed from that abyss of waters that is every where under the Earth it is certainly the thickest and most crude Seeing therefore the best Rain-water cannot be procured without too great curiosity and Rain-water is seldom to be had from a River and has that danger with it which we spoke of the ground or soil it is better to use Spring or River water the best that is in or near the Town we live in especially seeing that vertue which is in the Summer Rain-water you may impart to Spring-water by boiling it and that vertue that is in Well or Conduit water you may impart to River-water by barrelling of it up For both by barrelling up the water is purged and by boiling it is moreover attenuated but Spring-water cannot be kept so well as River-water Yea and besides the boiling that Water which flows out of Springs that are high and exposed to the Sun that run down a steep place towards the Rising or Noon-Sun is wont to be more concocted and better than that which runs out of dark and foggy places towards contrary places But because one Water differs so much from another Spring from Spring River from River and Well from Well that many Spring and River Waters are worse than most Well-waters 't will indeed be better to try by proper Notes the very Water by it self omitting its manner of breaking out of the Ground and in every place to use that which Nature has provided the best there whether it run along the Ground or spring up in a Fountain or be drawn out of a Well That is best which is most simple and thin you may know its simplicity from the greatness of its want of taste colour and smell and its thinness from the quickness of its growing hot or cold as it is said in the Aphorism Valles comm in l. de vict Acut. p. 127. for you will find this a better and more exact sign than that which is taken from its weight XXII Hippocrates adds In acute Dâ—seases I have no other operation to attribute to the drinking of Water that is Water performs nothing else for the Body than to serve for drink and to serve for drink is nothing else than to be a vehicle for the Aliment You will object that it is said 6 Epid. s 4. Water is devouring that is it stirs up an appetite to meat and that Galen m. m. reports very many things of plentiful drinking of cold Water namely that it extinguisheth burning Fevers if it be taken seasonably and by a fit Person namely by such an one in whom there is neither crudity nor any inward inflammation nor weakness of any principal Part nor too much leanness of Body for these things are not to be remedied by drink only but by the best Medicines But inasmuch as it is said to be devouring that belongs not to acute Diseases but to the Diet of healthful Persons As to what we said of its extinguishing of burning Fevers Hippocrates does not deny the first vertues of Waters that is those which are in them in respect of their first qualities for he will not gainsay that they cool and moisten but only the second and third for Water neither incides nor cleanseth nor doth any other thing in a Man which belongs to the second faculties nor does it either astringe or loosen or draw or repel but as it refrigerates and therefore it neither asswageth a Cough nor brings up Phlegm nor loosens the Belly nor provokes Urine nor does any other thing that belongs to the third faculties nor does it draw forth sweat or breed Milk nor lastly is any other faculty attributed to it than to convey the aliment and to cool and moisten Idem and by cooling and moistening it extinguisheth a Fever XXIII But a little water adds Hippocrates if it be supt betwixt Oxymel or Vinegar and Honey and Melicratum or Mead brings up Phlegm because of the change of the quality of the Drinks That is if he that useth Oxymel or Mead made with Wine do betwixt these sup a little water sometimes even the water will further the Coughing up not indeed as if that were proper to the Water but because seeing it is void of all faculties it easily receives the vertues of all the things wherewith it is mingled or which are boiled or steeped in it When therefore it is drunk betwixt Mead and Oxymel it makes an inundation and moves the other drink and is mixed with it and encreaseth the fusility and therefore the Coughing up Idem XXIV Hippocrates in the foresaid place sayes that water is Cholerick to a Cholerick Nature and therefore such as have a Cholerick Nature it cannot quench their thirst but rather irritates it But how is Water Cholerick to any that is so greatly contrary to Choler seeing it is cold and moist Not surely as if it self were turned into Choler for so it cannot be but because making an inundation of Choler it does after a sort encrease it and causes it to redound this way and that way like indeed as he that pours Water into Wine makes there be more Wine namely such as is dilute Indeed
that Milk but the raw is better than the boiled for it cools more because of the admixture of much watriness which is consumed by boiling and therefore it alters less and is made thicker and less apt to temper the febrile heat On the contrary some Fruits are the better for being cold as Raisins Prunes and all such as abound with too much moisture when they are new and may be reduced to a more wholsom nature by being laid up Primiros de Febr. p. 144 XXXIV Pot-herbs and others are profitable in Fevers to alter 1. Cold as Lettuce Eâ—dive Spinach in bilious Fevers 2. Hot as Tyme Hyssop Majoran in Phlegmatick but we must not use them alone for they have no nourishing vertue in them or but little they are rather Medicinal therefore they are prescribed to be boil'd in Broths that there may be Medicin with Aliment The Sick therefore may not have leave to feed upon Herbs and Roots for most of them use to be turned into a porraceous or leeky choler in the Stomach and Galen having dispraised almost all Herbs in relation to food seems to grant Lettuces only as being less hurtful Let them therefore be taken boiled with other Aliments for alteration XXXV Moreover Salads are not disallowed of some Galen 1. ad Glaucon cap. 9. and 10. grants not only Lettuces but also Garden orach Mallows Sorrel and if Vinegar be added it will stir up the Appetite resist Putrefaction cut tough Humours open Obstructions yet but a little Oil is to be added because it is easily inflam'd in Fevers But Vinegar being used with Salads or other Meat in a little quantity cannot dry much but rather according to Galen resists Putrefaction stirs up Appetite makes Victuals pass down well colliquates and attenuates the thick and so Olera as Cabbage Spinach c. with Vinegar are not so hurtful they nourish but little are cold and moist excite appetite and being boiled in Broth and prepared or dress'd with Salt and Vinegar Primiros de Febr. p. 143. may be good XXXVI Galen in Arte parva commends Wine as a Restorative for old Men and such as are recovering from Sickness but so it is that Wine dries and does not moisten I answer that Galen allows of Wine of an indifferent age such as is pure and clear in substance namely that which is a little yellowish or whitish smells well and as to the taste seems neither altogether watry nor exceeds much in any quality whether sweetness or acrimony or bitterness but such Wine as this does not dry but moisten This we note from this place against almost all the Moderns who think that all Wine dries for if the Wine described by Galen dried doubtless it would be bad for Persons recovering from Sickness and old Men who are already too dry therefore we say that the Wine proposed by Galen for taking away the dry disposition of Persons recovering from Sickness and old Men has a faculty to moisten substantially and is temperate as to heat and dries not Sanctor art parv c. 99. for no temperate quality can dry or moisten heat or cool XXXVII It is observable that Hippocrates used Water for drink in a drying Diet and neither Wine nor Wine and Honey though both of these moisten less than Water which he did not that he suspected Wine for any reason for besides that he grants black racy Wine in an exulceration of the Womb if he had suspected Wine he should have prescribed some other Drink and not simple Water Hippocrates therefore approves of Water inasmuch as it affords very little or no nourishment to the Body the principal action of which nourishment is to recruit and moisten the radical moisture of the Body which is continually spent and so it happens by accident that water dries Add also that Drinks that nourish the Body are sooner distributed through it and by consequent moisten it than Water which because as Hippocrates said P. Martian comm in v. 183 Sect. 3. l. 1. de Morb. mul. it stays longer in the Hypochondres it does not proceed so to moisten the Body as other Drinks that are more pleasant to Nature XXXVIII Santorellus Lib. 26. Antepr c. 8. admires that Avicen has written that Snow-water is good where he says 2. 1. Doctr. c. 16. But Snow and Water turn'd to ice seeing it is clean and not mixt with any other thing that has a bad quality whether it be melted and Water be made of it or other water be cooled by it by lâ—ying it on the outside of the vessel or it self be put into water it will be good But the admiration will fall if you understand Avicen of a Morbous state wherein if you give Water diluted with Snow as a Medicine you will not err XXXIX Those do ill that let many enter into the Patient's Chamber because the breaths of many People corrupt the Air. Galen 10. Meth. cap. 8. sayes that a crowd of Friends heat the Chamber On that account the Windows are to be kept open for by shutting them the Chamber is not only heated but seeing the Putrid steams are not ventilated with the inspiration of pure Air the Patient falls into a worse condition And let none object that the Skin is made dense and obstructed by the colder Air for by the inspiration of cold Air there arises greater benefit to the Patient than there does hurt by densating the Skin But though the condensation of the Skin be the cause of heat this inconvenience may also be avoided by covering the Patient and the cold Air being breathed in will cool the internal Viscera for nothing sooner changes the temperatures of the Humours than the Air as Galen says 3. de humor comment 2. Indeed in malignant and continual Fevers there is perhaps no errour greater Sanctor Mâ—th Med. V. H. l 13. c 4. See Gal. in m. m. than to keep the Patients in close hot places and such as are full of a crowd of People XL. To change the Patient's Linnen often seems a hainous thing to the vulgar for they think that Sick Persons are made weaker thereby But Hippocrates commands all things to be kept clean about the Sick and Galen endeavours by all means to keep transpiration free that cold Air may be breathed in and steams excluded especially in continual Fevers which happen for the most part through constriction of the Pores And therefore when they are obstructed both by the sordes and Sweat there follows a retention of the vapours and steams whence the pre-existent Fever is increased or a new one is kindled on the contrary that man shall hardly fall into great Diseases whose Body has a good perspiration Comm. in l. 1. de vict Acut. In which thing says Vallesius vulgar Physicians offend who will not permit their Patients either to put on a clean Shirt or change their Sheets or wash their Face or Hands or to do any thing else that belongs to cleanliness
not though the Disease be long or as if this did not encrease all Putrefaction XLI In some Diseases great respect is to be had to the Patient's manner of living otherwise they will be very hardly cured A cleanser of Jakes having smelt too good odours fell Sick and was at length cured by the smells he had been used to Zacutus placed a Patient that liv'd by the Sea-side in the Sand and cover'd him with it that he might cure him A Physician cured a Countrey-man that others had given over by allowing him Pulse and Rye bread And that the Region wherein we live makes many impressions upon us which we must have regard to I have observed that as we that live upon the Land grow nauseous and vomit in a Ship which Symptoms cease when we are returned to our accustomed Land so I have seen a Sea-man namely a Venetian that endured the same Nausea by riding on Horse-back that we do on the Sea â— Poreâ—us Obs 59. â—ent 3. XLII Sleep procured by Art gets the Physician great esteem A certain Physician said that the way whereby he curried favour with his Patients was that they might have quiet rest the Night after he was called which he procured with the Syrup of â—â—d Pâ—ppies which he prescribed for that Night I my self also being delighted with this Stratagem often please my Patients by giving them a magisterial Anodyne But how comes it to pass that Sleep coming either of its own accord or procured by the use of Soporiferous Medicines is often very offensive to the Sick who when they awake complain of a great weariness and uneasiness and find fault with those that wait upon them for letting them sleep so long desiring them to waken them if perhaps they should drop asleep I answer that even the healthful when they sleep immoderately are said to be soakt because their flesh is made more moist and the habit of their Body pufft up or bloated through the suppression of the fuliginous Excrement which ought to be digested and exhale by waking and the same thing happens sometimes in Persons ill of Fevers yet we must not therefore abstain either from spontaneous Sleep into which a man falls when his Spirits are enervated with heat or from that which is procured by Art Rolfinc de febribus c. 133. for all the uneasiness goes off in a little while and the Spirits are refreshed The Diet of Febricitant Persons in general The Contents Whether Food is always to be denied in an Ague-Fit I. Whether simple Food be alwayes best II. Whether the Food should be alwayes moist III. Whether the Meat be to be seasoned with Salt IV. Whether Milk may be granted V. Whether Fruits are to be denied altogether VI. Whether Fish be proper VII Whether Eggs be hurtful VIII Raw Lettuce may be granted IX Whether the juice of unripe Grapes or Verjuice c. be rightly put to their Meat X. The use of sweet things is hurtful XI Ptisan is extreme good XII Whether Wine be good in Putrid Fevers XIII Whether simple water be to be granted XIV Beer is not to be denied XV. How Drink is to be given to People in acute Fevers XVI It may be granted in the Paroxysms XVII It is to be given sometimes cold sometimes hot XVIII The same cooling Drink is not to be given to all without difference XIX Whether Barley water be to be rejected XX. Water is not to be boiled long XXI Cold water is not to be given through the whole course of the Disease XXII Whether the Sick are to be fed more liberally in the Winter than in the Summer XXIII When Sleep does good when hurt XXIV I. IN an Ague-fit food is not to be given according to Hippocrates aph 11. 1. For Nature as Galen in comm teacheth by the concoction of the new aliment is called off from the concoction of the morbifick Humours And besides in the â—it all the Body is defiled with an impure vapour which taints and in a great measure corrupts the meat that is newly taken But if the Fit be so long or the Body of the Patient so hot and dry lean and of so thin a texture that it is easily dissolved and cannot hold out to the end of the sit he must eat somewhat even in the fit it self which will be better done in the state than at other times although even in the beginning and augment meat may be given if necessity urge So Galen 10. meth c. 5. in Agues was forced to allow victuals even in the beginning of the Fits to such as were of an hot and dry temper who can least indure fasting lest they should faint away In imitation of him Amatus Lusitanus cur 68. cent 4. gave to one in the beginning of the Fit that vomited clean Choler upon which he swooned bread soaked in water and sprinkled with Vinegar and so he hindred the foresaid Symptoms River That hurt which may happen from giving of meat in such like cases is obviated by giving some Veal or Chicken broth cold in France they call it Veal or Chicken water because it has a middle consistence betwixt mere water and broth thoroughly boiled for by this means the acrimony of the heat is attemperated and the imminent driness is hindered and yet Nature is not called off from her office of concocting the Morbifick matter which she more easily conquers when the acrimony of the Humours is mitigated and the fear of driness avoided Hippocrates sayes aphor 1. 11. It is hurtful to give meat in Fits we must therefore abstain the whole Fit if it may be but if not then till its declension but if we may not do that neither however we should avoid the beginning and three hours before unless in picrocholis or those who vomit up Choler who faint away through the acrimonious Choler that at that time flows plentifully towards the Mouth of the Stomach unless there be some fresh food there by the mixture wherewith it may be dulled for if meat be put off in these as it is wont to be in other febricitant Persons of an intermittent there is often made a continual Fever and for a simple one and one that would end with sweat if meat should be given in the beginning there ensues a syncopal or swooning one and for one that would end in health a mortal But if meat be given even in the very time of the Fit it sometimes not only hinders these dangers but also prevents the Fever it self which chiefly happens in those that vomit Choler Yea and moreover in others in whom there begins to be moved a Choler that is not so much thick and putrid as little in quantity thin and very adust and fumous through the twitching whereof the sensible parts begin in many to be pricked and quake and yet this Choler by taking something to eat presently or perhaps by drinking some Wine diluted with water is so attemper'd that they give over
obstructions and consequently in the Dropsical and such as have Scirrhous Livers in the Jaundise Hypochondriack Melancholy to whom he sayes it is given to the certain destruction of Thousands Fallopius affirms the same and * 2 Hermet Medic. p. 238. Conringiūs grants it only to Scirrhous Livers that are swelled with water as they generally are But I will moderate these things thus wheresoever there are obstructions of the Viscera the Liver and Spleen with moisture exceeding and the Liver not too dry there Steel Remedies are more convenient in a dry form as Crocus Martis pulvis Cachecticus flores Martiales but wheresoever there is both driness and Scirrhescence there the more moist preparations or at least not without diluters So likewise Septalius and others write the same of Rhubarb that in a dry intemperies it is rather the death of the Liver but the same things hold in it as we have now said of Steel Remedies VII Note that the Liver is hurt by the over-long use of openers whence those erre who endeavour to expell the obstructions of the Vessels by Inciders volatil Acids or aperient decoctions alone so that where there is an obstruction of the pores we must open but so as that it be not done with violence Such examples are often seen in the Hypochondriacal VIII Note also that neither have astringents place always in Diseases of the Liver we said indeed that strengtheners should be also tonicks but there are cases where we must abstain from astringents for instance if the Liver grow Scirrhous in the Jaundise or stubborn obstructions they are not alike profitable Now we call those astringents that hinder the tone of the Viscera from being loosened Hence those things that have an astringent faculty operate with a thinness of parts those that open with earthy parts IX This also is to be noted that we must not trust to Syrups amongst Aperients and Hepaticks for sweet things are apt to hurt the Liver because they turn into Choler G. W. Wedel de s m. fac 105. whence obstructions are apt to be bred Hypnoticks Narcoticks See Anodynes The Contents In the using of them there are to be consider'd the constitution of the Patient I. The nature of the Disease II. The tenour or condition of the Animal Spirits III. The state of the Blood and Humours IV. Cautions in their use V. They are enemies to the Stomach VI. Let them not be given in the beginning of a Paroxysm or near a Crisis VII They are not to be given after Blood-letting VIII They should be taken at a good distance from eating IX How their too great Operation is to be restrain'd X. Things indicating their use XI We must not mistake in the Dose XII Laudanum strengthens all the Faculties and is safely given to Children XIII They are not convenient in a simple hot intemperies XIV And where thick juices abound XV. The amendment of the harm they sometimes cause XVI Being applied outwardly they are not to stay long on XVII When to be removed XVIII When applied outwardly they are ineffectual or not safe XIX They are to be varied according to the diversity of Temperaments XX. What Hypnoticks are good for old men XXI Cold Soporificks are to be shunn'd in Diseases of the Breast XXII Opiats are to be given in a small quantity and by little and little XXIII A Narcotick or Anodyne of Vitriol XXIV We must not come to Opium and Laudanum save when Diacodiats are insufficient XXV Whether Opium be Poison XXVI How to be corrected XXVII Laudanum being rightly given is a safe Medicine XXVIII Opium is a very safe Narcotick if it be used rightly XXIX Yet it is an enemy to the Brain XXX And to the Breast XXXI Nor are they always useful in Diseases of the lowest Belly XXXII The most simple Laudanum is to be preferred before the compound XXXIII Opium bridleth the vicious effervescence of Humours and the flatus that are raised therefrom XXXIV Laudanum works more effectually being given immediately before Meat XXXV Narcoticks are not to be given the day before Purging or Bleeding XXXVI They are available in a fluxion from the Head upon the Lungs XXXVII The day following sweat bursts forth XXXVIII When weakness succeeds how it is to be helped XXXIX They often stop a flux of Humours without sleep XL. They may be given the day before the Crisis XLI A Phlegmatick vomiting sometimes follows them XLII Sometimes a suppression of Vrine XLIII They may be given with Purgers XLIV When a Purge is to be abstained from the next day after the taking of them XLV If they be given with Purgers the Dose of the Purgers must be increased XLVI They are of avail in the Plague XLVII In continual Fevers XLVIII In Tertians XLIX With what caution to be given in Intermittents L. Let Laudanum be prepared without Henbane LI. I. Concerning the right use of Opiatick Pharmacy these four things following are to be observed viz. before we give a Narcotick Medicine we must consider 1. what such the constitution of the Patient is 2. What such the Disease is that he 's ill of 3. In what state the Animal Spirits are with respect to both Animal and Vital function 4. Lastly in what condition the Blood and other Humours are As to the first when an Hypnotick is indicated see that the temperament of the Patient the habit or indisposition of his Body his custom or manner of life do not contraindicate As for example Those who are endued with an indifferent stature a firm and well set Body hot Blood a lively or sharp aspect bear this Medicine better and take it often with benefit but they shall take it more securely if they have moreover been formerly us'd to it But on the contrary it is not so convenient yea sometimes it does a great deal of hurt to them who are over fat or lean as likewise to those who being either of a rare texture have their Spirits easily dissipable or of a colder temperament and have soft and flaggy flesh and are of a sluggish and indocible disposition and dull and drousie of themselves to which hindrances or scruples this may be added and encreases the weight of the rest if they have never taken this Medicine before The Nature of the Disease is sometimes of great moment for or against Opiats In slighter Distempers it is the part of a flattering Physician according to Septalius to use them moreover in some great ones their use is either forbidden or is held very suspected In the Palsie Vertigo Night-mare Apoplexy also in the Orthopnoea or great difficulty of breathing in a Dropsie of the Breast or Abdomen in numbness or trembling of the Joints in very malignant Fevers and in the fits of Agues or the crises of other Fevers Narcoticks are very often forbid Moreover in a cough with much and thick Phlegm in an Asthma and in whatsoever other Distempers of the Breast with oppression of the Lungs and in
that which otherwhiles she does of her own accord And if she can profitably evacuate without help she may evacuate more profitably when assisted by the help of Art for nothing can hinder Purging before Concoction that does not also and far more oppose symptomatical evacuation But when besides want of Concoction or turgescence there are present all other conditions that may disswade from Purging then abstaining wholly from it if I may not let Blood I will however provide for the faculty and use only Clysters and Suppositories But if though there be neither Concoction nor turgescence yet other conditions do not wholly deterr me I will venture to Purge for urgency and that by so much the more confidently by how much the conditions that invite shall be the more numerous for this is indicated if the evacuation may profit and not hurt which it is the part of an Artist to find out Now by what conditions one may know whether this or that Person are to be Purged at this time I shall endeavour from Reason and Experience to shew A special condition that permits Purgation is if the Hypochondres be quite free of a Phlegmon for if any one shall endeavour to remedy an inflamed Part by Purging he shall take nothing of that away which is inflamed but shall increase the Phlegmon cause a colliquation and so procure Death Moreover a moderate Fever permits it but if a Purge be given in a very high burning Fever the hot flesh attracts it and so nothing is evacuated but the Fever and Cacochymie is increased But a principal thing that hinders is the heat of the Head and spiritual Parts because these Parts when they are hot are apt to draw all things to themselves and to absorb what the Medicine stirs Driness of the Belly or costiveness also hinder because this indicates that the Humours incline some other way and 't is to be feared that when they are moved and not evacuated but snatcht some other way they prove a cause of greater mischief 'T is also of very great moment to consider the nature of a man for some are easie to Purge and that without any Symptoms or Mischief Purge them when you will Some are so hard that though they be Purged in the fittest Season they are seised upon by horrible Symptoms and are manifestly worse afterwards When these conditions that hinder are two or more of them present we must rather put it to the hazard than Purge But if the Patient be one of those that are easie to Purge and be sick of a Putrid Fever with some suspicion of Malignity if he have been let Blood sufficiently and the Humours be not turgent indeed and wandring up and down nor yet altogether quiet but fused as it were and tending towards the Belly which is shewn by a rumbling in the Hypochondres or loose Stools two or three in a day for this is no small invitation to Purge if the Hypochondres themselves be loose and not hot to any considerable degree nor the flesh burn through the whole habit of the Body if there be felt no great heat in the Head or Breast when one lays his hand thereon but the Fever that is is dispersed equally all over the Body or incline to the lower Parts in these cases though there be no concoction as yet I will give a Purging Medicine because that which is present does not very much hinder and that which is feared is urgent and the indication of urgency is the first of all But if there seem to be any Inflammation or Phlegmon lying hid in the Belly though I fear a Cacochymie I will not give a Purge I will rather venture even though the faculty be doubtful to let more Blood than I had thought for I will do the like if the Breast or Head or all the flesh burn vehemently unless there be great despair of the faculty for if there be I will moisten the Head with Vinegar of Roses the Breast or even all the Body over with Water and Oyl and will give cold things to drink So if he I am a speaking of be very costive I will refrain Purging though I fear the nature of the Humours till I have first a little softened the Belly with mollifying Clysters for acrimonious ones are not good for this purpose because they have the hurt of Purgers in them and rather dry the Belly and the use of light Meats as stew'd Prunes c. But it is manifest that if two or more of the aforesaid things hinder we must take a course with them before we Purge and that together if we can as if both the Head burn and the Belly be dry the Belly must be softened and the Head cooled by irrigation at the same time But if the Disease do not at all yield to these Remedies but the concourse of Symptoms continue and there be no urgent cause we must not Purge for if we do the Patient will on the same day be taken with light-headedness and convulsion and it may be die to the great infamy of the Physician We must therefore do any thing rather There are many things in this Art Valles m. m. l. 4. c. 2. wherein for urgencies sake it is an art to depart from Art c. II. Many keep a great pother about expounding Aphor. 22. 1. and 29. 2. Things concocted are to be purged forth and not crude c. But in my opinion the matter is not so abstruse for I think that Hippocrates understood nothing else by things concocted but such things as may be separated from the mass of Blood And in the other aphorism by the words If any thing be to be moved move it in the beginning of the Diseases I think he means that we should purge presently after the beginning of the Disease before the vitious Humours by means of the perpetual motion of the Heart be confused and mixt with the whole mass of Blood For if we please to consider this matter further we see that Humours may then be separated 1. when they are overcome by Nature 2. when some vitious matter sticking somewhere in the Body is not as yet consounded with the Blood Walaeus Meth. Med. p. 35. as I have said 3. when by due helps we assist Nature that is endeavouring to attenuate and conquer the Humours III. A concoction of the Humours is not always to be tarried for nor is their preparation always to be premised before we will purge the Body for when the matter is moveable prepared for excretion ebullient or turgent what need is there of digestives and one Purge does generally less offend the Stomach than so often repeated digestive potions that dissolve and taint the Stomach so that crudities being thereupon increased there is a greater afflux to the joints he is speaking of the Gout Add hereto that while we are busied with digestives the pains increases Sennert l. de Arthrit See Zacut. Pr. hist l. 4. c.
irritation LXV Hippocrates forbids Purging to them that are very much troubled with Pains till the Pain be either allayed or at least abated because there is danger lest the Humours being moved by the Medicine should through the vehemence of the Pain be rather drawn to the pained Part than expelled by Stool by the vertue of the Medicine A Precept that is neglected by most Physicians to the destruction of men yet every where observed inviolably by Hippocrates as we may see l. 1. de m. mul. s 3. v. 148. l. 2. s 3. v. 303. de in t aff s 2. v. 29. and in many other places Martian comm in v. 396. l 4. de vict ac for he first appeases the Pain and then Purges LXVI If a Physician prescribe to a Woman with Child any Medicine that Purges hastily the force of Nature will cause an Abortion Pills are the longest of working next to these Powders then Electuaries but the quickest of all are Potions We must therefore give to Women with Child Pills Walaeus m. m. p. 51. or the more gentle Powders not long before meal LXVII If one intend to Purge a melancholick Person unless he add Looseners he shall not obtain his end A certain Practitioner gave a Purge to a melancholick Person three or four times and yet purg'd him not at all An old Woman coming advised to take a Decoction of Senna with Prunes He that would Purge a Phlegmatick Person will find it necessary to add stimulating Medicines Idem p. 50. ¶ A noble Lady fifty years old wanting a Purge consulted me and tells me that she was not moved even by the strongest Catharticks that another Physician had often try'd to Purge her in vain who had prescrib'd her as she said what would have Purg'd an Horse She was strong and her hair black and curled I advised her to take before Supper six Drachms of Elect. Catholic with half a Drachm of Cream of Tartar in the form of a bolus hereby she went six times to Stool nor did she afterwards make use of any other Cathartick having always the like success with it LXVIII When both Phlegm and Choler have transgrest their natural bounds Choler is never to be Purged strongly neglecting the Phlegm for the Phlegm is warmed by the heat of the Choler I have known some die of an Apoplexy by having the whole Oeconomy of their Body inclining to Phlegm through the long-continued and much use of Rhubarb and Manna for Choler and Phlegm temper and bridle one the other All things in the great World would grow stiff with frost if they were not cherished with the heat of the Sun now what the Sun is in the World Heurn Meth. l. 2. c. 25. the same is Choler in the Body LXIX N. N. minding to Purge his Body when the Spring was drawing on taking a violent Purge there was presently a translation of the Humours made into his right Foot which before was weak by having indured a vehement cold which Humours by their malignity and plenty suffocating the weak heat of the Part brought upon it a sudden Gangrene Hence you may learn that it is dangerous to attempt with churlish Medicines Bodies that are filled with impure Humours and are either weak by Nature Horst l. 9. Obs 25. or have been made so by some external accident ¶ A Minister though in health would needs take a Purge whereby his Humours were presently so disturbed that he died in a few days after for when naughty Humours are wanting Borel obs 45. Cent. 2. these Remedies disturb the good See Aph. 2. 62. and 16. 4. LXX In compounding of Medicines we must see according to Hipâ—ocrates 2. Acut. t. 11. that they be all 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 of a like condition such as may exert their Vertues in an equal space of time with a like distinction of the Faculties and a like force so that one may not make haste and go before and another linger behind for by that means there will be perturbations and tumults in the Belly Humours will be stirred up and produce grievous Sympâ—oms As if for thick Humours you give the Pods of Senna with the Seeds of Anise and wild Carrot and add to the liquor after you have strain'd it Heurn comm 〈◊〉 11. l. 2. c. â—c Syrup of Roses for such Syrup brings forth the Serum and leaves the thicker matter and makes it more stubborn ¶ Hellebore and Myrobalans endure not one anothers company Such things as bring violence upon the Body ought not to be detained long in it Rondelet m. cur l. 1. c. 41. See Valles contr l. 9. c. 4. wherefore they are not to be mixed with astringents but rather with other things that Purge briskly LXXI The Stomach is very much hurt by Hellebore and other violent Purgers especially its attractive Faculty Whence it comes to pass that whereas naturally it ought to attract Aliments being imbued with the evil quality of the Medicine it draws to it self vicious Humours and such as are agreeable to the vertue of the Medicine and is readily filled with them wherefore unless thenceforward he be Purged again by intervals Crato apud Scholtz com 3. this vicious attraction of the Stomach is the cause of many Diseases LXXII Walaeus m. m. p. 40. commands the Body to be moved up and down when we take a Purge for says he all rest or sleep even in the beginning hinders Purging Yet I know that Purgation is hindred in some if they forsake their Bed and that the effect thereof is forthwith intercepted by that means Namely the warmth of the Feather-bed conduces to the fusion and colliquation of the Phlegm and to its exclusion out of the Body LXXIII I do not disallow of warming Purging potions before we drink them for so they seem sooner to begin their Operation and to be reduced into act But yet they may no less conveniently be drunk cold in the Summer time by such as have an hot Stomach For very many Purgers that enter the composition of these Potions do not so well endure boiling and their vertue exhales by a gentle heat at least is dulled in part as appears in Rhubarb which is made more sluggish if it be set on the fire as its Extract teacheth which is made first by infusion that draweth forth its tincture and vertue and afterwards by gentle drying is reduced to the consistence of an Extract for some Drachms that are sufficient for several infusions are hardly enough for one Dose of the Extract because by drying the infusion the Cathartick vertue vanishes also Add that a cold Potion is both more grateful Primiros de vulg err 4. c. 14. and is better retained by the Stomach LXXIV It has been the opinion of some that cold water should presently be drunk after having taken a Purger Bourdelotius a Parisian Physician endeavoured to introduce this Custom in the North because he believed that the vertue of
with a full and uninterrupted stream Idem LXXVII Why does bleeding by a large Orifice cool more than bleeding by a strait when the quantity of the Blood that is let is equal Because there is made a more sudden change in the Body when the Blood is poured forth by a large hole namely because there is a greater withdrawing of the Blood that is a returning to the Heart whence there ensues a less influx of Blood from the Heart into the whole Body and hence all the Parts are cooled Add hereunto that the quick withdrawing of Blood is follow'd by a sad sensation in the heart and from thence with a straitness thereof likewise with a less effervescence of the Blood its expansion being hindred all which things lessen the heat in the Heart and the whole Body Moreover by a quick and hasty evacuation of Blood transpiration is more promoted than by a slow Whence conclude that Venesection by a large orifice cools more not because thicker Blood is then poured forth but because it flows forth quickly For the Blood that is poured forth by a narrow orifice is as thick as that which issues out by a large seeing none will deny that all the Blood is percolated through the capillary Veins wherefore the orifice can never be so small but its width will exceed that of the capillary Veins only it comes out more slowly which is common also to that which is more thin I wonder that those who think otherwise have not observed in their Hypothesis that the thinner Blood is the more hot which therefore if it were let out by a strait orifice and the thick retained the Body should be more cooled than when the thick and less hot is poured forth Fr. Bayle Probl. 3. LXXVIII Those who let Blood should observe the situation of the Valves for the Vein ought to be opened a good way from them for if it be opened just by a Valve the Blood either does not flow out rightly Challov de Orig. Met. Sang. or not at all yea sometimes there rises a bump from clotted Blood LXXIX Have a care you open not a Vein near its Anastomosis with an Artery for if this be done the Blood being all of a scarlet-colour will spurt forth impetuously and its efflux is not easily stayed nor is the orifice of the vessel soon shut Willis LXXX If when we have occasion to bleed the Vein do not appear a large Cupping-glass with much flame is to be fixt upon the Part and that will make the Vein shew it self LXXXI Some esteem so much of the first time one is let Blood that they will not use it but in great cases because they think that like an unusual and first Remedy it may cure a man of great Diseases whereas yet very skilful Physicians write on the contrary that men suffer more by such things as they are unaccustomed to Thus Galen 14. Meth. cap. 8. did not let an Old man Blood that had a hot Tumour upon his Tongue because he had not been used to it Therefore say they he that has been used to be let Blood if so be his faculties be not as yet impaired by frequent evacuation the same will bear it more chearfully and lightly than he that has not been so used But the vulgar opinion seems to be justified by what Hippocrates writes 3. Aph. 28. of the first eruption of the Terms and the first Copulation And says Celsus lib. 2. c. 1. If any kinds of Diseases have happened in Infancy and end neither when a Man comes to maturity nor upon the first Coitions nor in a Woman upon the first flowing of her Terms thâ— same are generally of long continuance And speaking of the Epilepsie If says he Remedies have not removed it Coition in Boyes and the flux of the Terms in Girles does cure it Pliny also says l. 8. c. 24. That many kinds of Diseases are cured upon the first coition and upon the first flowing of the Terms or if that do not happen they are then of long continuance and especially the Falling-Sickness Add hereto Hippocrates's authority who 3 Epid. sect 2. aegr 12. writing of a Maid of Larisa that labour'd under a sore Disease says that it was judged or ended on the sixth day and returned not again which certainly was a rare and wonderful thing But this he ascribes to her Terms which then broke of her for the first time when she had the Fever and it was now judged Therefore that is not altogether vain which is vulgarly spoke of the first letting of Blood Rub. in c. 10. lib. 2. Celsi LXXXII We must take some Broth half an hour before Venesection according to Hippocrates's advice Lib. de Vlcer A Vein is to be opened when a man has dined and drunk more liberally or more sparingly and is a little warmed Some Arabians will have the mouth of the Stomach to be fenced and strengthened with a little Meat especially in those who have a weak Stomach or its orifice of a more acute sense and are otherwise weak the innate heat is dissolved by the letting out of the Blood and the cholerick Humours rage more when their bridle is taken off whence there is darger of Swoonings There is given either Bread dipt in the juice of Pomegranats or simple water with Sugar and the juice of Lemons for a Stomach that is weak from an hot intemperature or has bitter Choler floating upon it Some give a cup of cold water to drink and so prevent fainting away in such as are subject to it through swift motions of the mind Galen Comment in lib. de Vlcer seems to dissent advising to defer Venesection so long as may seem sufficient for the Concoction of the Victuals and that the Excrements of the Belly may have while to descend Rhases l. de v. s cucurb c. says whilst the Victuals are not digested in the Stomach or expelled by the Guts either spontaneously or by a Clyster let there be no letting of Blood lest something be attracted of that which is in the Stomach and Guts to the Liver and its passages and is as yet crude Others alledge that the use of Meat before is inconvenient denying the validity of that Argument that is taken from the impairing of the Faculties The Bodies of all Sick Persons are not weakened or resolved by bleeding such as are oppressed with a burthen of Plenitude or Cacochymie are rendred more lightsom They also reject drinking of water before Venesection seeing Avicen teacheth that he that drinks cold water before or after bleeding may fear a Dropsie because of the water 's being snatched into the Veins The truth seems to persuade one to approve of the use of Broths these may refresh Nature both by way of prevention and cure Julaps c. may be used also as well as these A draught only of Water or Beer or a potcht Egg can produce no harm To the Reasons I
for cookery 'T is better to preserve this part diligently and to strengthen its tone than to dissolve it by Vomiting unless Nature affect that way and there be an easiness to vomit and the preparation of the Ancients have been used ¶ Celsus lib. 2. c. 13. says that Vomiting does not always good to the sick Riolan Euchir Anat. lib. 2. c. 2◠but always harm to the well which is true especially in our age wherein men are not much used to vomiting for often vomiting is a cause why Nature uses to send naughty Humours to the Stomach for though they advise to vomit after dinner yet seeing that motion is violent it always draws something Add hereto that the concoctive faculty is rendred weaker and the tone of the villi or fibres of the Stomach becomes more rare and thin Also Nature being accustomed to this evacuation in health when she is hurt by a Disease she is very apt to fall into it whence the retentive faculty is vitiated Rubeus in Celsi cit loc besides that it prejudices the Head Lungs and Liver XV. Those act unskilfully that I say not impiously who after many Medicines have been administred when the Patients are ready to die and their strength spent use Vomits as the last Remedies which suffocate the life that remains and hasten death But you will say Mountebanks do thus and have good success I answer If you took account of the Patients with whom they have had bad success you will find an hundred dead for two robust Persons that were preserved who escaped by the help of Fate and not of this Medicine The more wary Empiricks when they are called to such Patients use to pronounce great danger of life and therefore they warily administer aurum potabile or some other recruiter of strength till Nature resting from all perturbation recover her self a little Riolan Enchir Anat. l. 2. c. 23. and then they take the opportunity of giving a gentle Vomit which brings forth serous Humours or the like indifferently XVI Hippocrates 4. aph 4. bids us Physick the upper venters rather in the Summer and the lower in Winter And 6. aph 6. says that the lean and those that Vomit easily are to be purged upwards avoiding the Winter Reason consents because the Phlegmatick Humour abounding in the Winter being naturally heavy inclines downward therefore it is to be purged downward according to the aph Whither Nature inclines c. He hath writ the contrary 3. de diaeta n. 3. where prescribing a Winter diet We must also sayes he use Vomitings thrice a Month if the Patients be moist but if dry twice after meals of several sorts of meat This he confirms lib. de sal diaeta 'T is profitable to Vomit the Six Winter Months c. to which Celsus subscribes lib. 1. cap. 3. Solve these things by saying that Hippocrates did not utter that opinion in the Aphorism simply but by adding the particle 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 rather as though he did not deny but that in the Summer also we might purge downwards and in the Winter upwards Or say If universal purgation be meant as that which is made by Hellebore common with Hippocrates it ought in the Summer to be made upwards and in the Winter downwards If a particular it ought to be made by Vomit in the Winter and by Stool in the Summer According to Galen's comment on the foresaid aphorism Therefore because Phlegm is generated in the Belly in Winter he advises us to evacuate it by Vomit and to revel downwards the Choler that swims a top in Summer And yet if you desire to purge the whole Body you shall purge it upwards in the Summer and downwards in the Winter as it is written in the Aphorism for those things which are superfluous are cured by purgation which must be made by those wayes whereto the Humours tend for these are to be drawn through fit places that way they incline but when you would hinder Humours from increasing 't is good to draw them back by contrary places Sinibald Antiph l. 3. XVII We must Vomit the Fat in one manner and the Lean in another for the former because the Humours are sluggish and unapt for motion ought not to be Vomited but when they are fasting and after considerable walking or other exercise for so the Phlegm which is naturally clammy and tough waxing hot is fused and made more apt for exclusion On the contrary the lean as not at all abounding with Humours if they be to be Vomited it ought to be done after Meal when we have eat several sorts of meat according to Hippocrates's precept l. de sal diaeta Idem Antiph 9. l. 3. and 3. de diaeta n. 4. XVIII 'T is hurtful to use Alteratives and Purgatives before Vomiting for by these the Guts are spoiled of their clammy Mucilage so that the Vomit will corrode their substance and cause great griping ¶ Alteratives indeed may be premised Walaeus p. 57. but not of absolute necessity for the Vomitories themselves may fuse the Humours by their proper vertue Idem p. 56. XIX If the condition of the Patient and the Disease require both Bleeding and Vomiting 't is most safe that Bleeding should precede for otherwise while the Vessels are distended with Blood there is danger lest from the violent strainings to Vomit either the Vessels of the Lungs should be broken or the Brain should be hurt Sydenham tract de febr the Blood being poured thither with violence and extravasated and so the Patient die Apoplectick XX. 'T is profitable to mix the Humours contained in the Stomach with sundry sorts of meat both that it may the more closely embrace them on every side and also that Nature may the more easily expel them when they are mixed with the Victuals but the Victuals ought not to be of any kind indifferently but salt bitter acrimonious inciding attenuating and turgent which as Galen 3. de usu part advises have a bilious nature and execute the office of Choler namely absterge and cleanse the Belly for all these besides that they conduce to expulsion prepare the Humours themselves also to the same But the clean contrary ought to be done in those whose Stomachs abound with crudities Mercat de Ind. Med. c. 5. for then it is sufficient to use vomiting potions without eating which is suspected and often very hurtful in crude Stomachs XXI We must not Sleep upon Vomits especially when the Bodies are Cholerick lest the Choler be carried into the Brain in Sleeping Hartman in Crollium yet when the Patient has seem'd to Vomit enough Sleep may be allowed XXII When the Patient has taken a Vomit Walaeus m. m. p. 60. let him drink after it Beer or fat Broth for so he will Vomit the easilier XXIII He that rests and lies in his Bed hardly Vomits half so much as he that stirs up and down Idem XXIV