A compleat treatise of preternatural tumours both general and particular as they appear in the human body from head to foot : to which also are added many excellent and modern historical observations concluding most chapters in the whole discourse / collected from the learned labours both of ancient and modern physicians and chirurgions, composed and digested into this new method by the care and industry of John Brown.

A compleat treatise of preternatural tumours both general and particular as they appear in the human body from head to foot : to which also are added many excellent and modern historical observations concluding most chapters in the whole discourse / collected from the learned labours both of ancient and modern physicians and chirurgions, composed and digested into this new method by the care and industry of John Brown.

Table of contents

Title page

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To his ever Honoured Uncle, Mr. WILLIAM CROP, Chief Chirurgion in Norfolk.

To the Ingenious and Judicious Reader.

To the Author Mr. JOHN BROWN.

To Mr. John Brown Chirurgion of Norwich, on his Treatise of Tumours.

To his Ingenious Friend Mr. John Brown, upon his Treatise of Preternatural Tumours.

To his Worthy Friend Mr. John Brown, Chirurgion in Ordinary to the Kings most Excellent Majesty, on this his Learned and Elaborate Treatise of Chirurgery.

The Names of the Authors concerned in this Tract of Tumours.

AN INTRODUCTION TO CHIRURGERY.

CHAP. II. Of Humours.

A Particular Scheme of Humours showing their several

A General Division of Tumours.

We begin with the Phlegmone.

Phlegmonous affects are

These oft follow a Phlegmone,

An Illegitimate Erysipelas is twofold.

To these also belong,

Its natural for all Scirrhous Tumours to arise from Melancholy.

Ʋnder Melancholy Tumours are,

These do border upon Scirrhous Tumours.

There are other Tumours also, which are very troublesome to mankind, bred out of Humours; as

Some also arise out of flesh, as

In the Head are,

OF Preternatural Tumours IN GENERAL.

CHAP. 1. Of the names of such Authors which have writ of Tumours in general.

CHAP. II. Of the name of a Tumour.

CHAP. III. Of the Causes of Tumours.

CHAP. IV. Of the Differencies of Tumours.

CHAP. V. Of the Ʋniversal way of curing Tumours.

CHAP. VI. Of Phlebotomy, its manner of Operation, and where it is most properly performed.

CHAP. VII. Of Evacuation of matter erring in Quality.

CHAP. VIII. Of a Tumour, the part affected drawing to it self Preternatural Bodies.

CHAP. IX. Of the four times of a Tumour, and first of its beginning.

CHAP. X. Of a Tumour in its augment.

CHAP. XI. Of a Tumour in its State.

CHAP. XII. Of a Tumour in its Declination.

CHAP. XIII. Of a Tumour tending to Suppuration.

CHAP. XIV. Of a Phlegmon or Inflammation in General.

CHAP. XV. Of curing a Phlegmon in its beginning.

CHAP. XVI. Of Curing a Phlegmon in its Augment.

CHAP X. XVII. Curing of a Phlegmon in its State.

CHAP. XVIII. Of curing a Phlegmon in its declination.

CHAP. XIX. Of an Erysipelas.

CHAP. XX. Of an Erysipelas in the Face.

CHAP. XXI. Of Oedema.

CHAP. XXII. Of a Scirrhus.

CHAP. XXIII. Of Aqueous Tumours.

CHAP. XXIV. Of Windy Tumours.

CHAP. XXV. Of a Cancer.

CHAP. XXVI. Of a Carbuncle.

CHAP. XXVII. Of Epinyctis.

CHAP. XXVIII. Of Herpes Miliaris, and Herpes exedens.

CHAP. XXIX. Of a Gangrene and Sphacelus.

OF Preternatural Tumours IN PARTICULAR▪ And first of those of the Head.

CHAP. XXX. Of Artheroma

CHAP. XXXI. Of Steatoma.

CHAP. XXXII. Of Meliceris.

CHAP. XXXIII. Of Psydracium.

CHAP. XXXIV. Of Hydrocephalos.

CHAP. XXXV. Of Talpa or Testudo.

CHAP. XXXVI. Of Tinea.

CHAP. XXXVII. Of a Ficus.

CHAP. XXXVIII. Of a Cataract.

CHAP. XXXIX. Of Hordeolum•

CHAP. XL. Of Ʋnguis.

CHAP. XLI. Of a Polypus.

CHAP. XLII. Of Parotis.

CHAP. XLIII. Of Epulis and Parulis.

CHAP. XLIV. Of Ranula.

CHAP. XLV. Of Strumae and Scrophulae.

CHAP. XLVI. Of Bronchocele.

CHAP. XLVII. Of Angina.

CHAP. XLVIII. Of a Tumour of the Tonsils.

CHAP. XLIX. Of Empyema.

CHAP. L. Of a Tumour of the Diaphragma.

CHAP. LI. Of Exuberancy of Milk.

CHAP. LII. Of a Caruncle in the Yard, and its manner of Extirpation.

CHAP. LIII. Of Ruptures in general.

CHAP. LIV. Of Bubonocele or Hernia Inguinalis.

CHAP. LV. Of Enterocele or Hernia Intestinalis.

CHAP. LVI. Of an Intestinal Rupture, the Peritonaeum being rent.

CHAP. LVII. Of Epiplocele or Hernia Omentalis.

CHAP. LVIII. Of Exomphalos or Hernia Ʋmbilicalis.

CHAP. LIX. Of Hydrocele or Hernia Aquosa.

CHAP. LX. Of Pneumatocele or Hernia ventosa.

CHAP. LXI. Of Sarcocele or Hernia carnosa.

CHAP. LXII. Of Circocele or Hernia Varicosa.

CHAP. LXIII. Of a Venereal Bubo.

CHAP. LXIV. Of a Pestilential Bubo.

CHAP. LXV. Of Phyma and Phygethlon.

CHAP. LXVI. Of the Hemorrhoides.

CHAP. LXVII. Of an Aneurism.

CHAP. LXVIII. Of a Paronychia and Pterygion.

CHAP. LXIX. Of Nodes of the Legs.

CHAP. LXX. Of Tumours and Apostems of the Knee.

CHAP. LXXI. Of an Abscess of the Foot.

An Index of the Chapters.

ERRATA.

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[...] COMPLEAT TREATISE OF Preternatural Tumours, Both General and Particular, As they appear in HƲMANE BODY From Head to Foot.

To which also are added many Excellent and Modern Historical Observations, concluding most Chapters in the whole Discourse.

Collected from the Learned Labours both of Ancient and Modern Physicians and Chirurgions, composed and digested into this new Method by the Care and Industry of

JOHN BROWN, Sworn Chirurgion in Ordinary to the Kings most Excellent Majesty.

Post varios casus Artem Experientia fecit,
Exemplo monstrante viam.—

London, Printed by S. R. for R. Clavel, at the Peacock at the west end of S. Pauls. 1678.

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LIbrum hunc Johannis Brown, Chirurgi Norvicensis, de Tumoribus Praeternaturalibus, Chirurgis studiosis utilem esse posse judicamus.

Johannes Mictlethwait, M. D. Col. Lo [...]d. Praeses.

Daniel Whistler, M. D. Col. Lond, Censor.

Geo. Rogers, M. D. Col. Lond. Censor.

Johannes Lawson, M. D. Col. Lond. Censor.

Elisha Coysh, M. D. ejusdem Col. Censor.

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Academiae Cantabrigiensis Liber

To his ever Honoured Uncle, Mr. WILLIAM CROP, Chief Chirurgion in Norfolk.

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Worthy Sir,

THE many great Favours and daily continued Courtesies which I have received from you, may well challenge and command a double Expression of Thanks and Acknowledgment: and as you have ever studied how to interweave your continual Bounty with the happy assistance of your great Art and Skill, each of these heightning both my Advance and Profit; should I not publickly repay you the Tribute of all imaginable thankful Acknowledgment, my hopes of ever doing well may soon sicken, and like Liquors poured from one Vessel to another, as readily lose their gust, and grow slat and dull. And although in these publick Addresses I may appear impertin [...]nt to offer my Mite to you, whose Skill in Art is large, and whose Knowledge in Universal Learning is great; yet have I presumed to shelter this Tumefying Brat under your Wing, and commit it to your Patronage, not as being worthy your Acceptance, but that it may receive a kind Value and a candid Repute by your Acceptation; whose Approbation hereof will be stamp enough to make it pass current amongst [Page] the Generous Sons of Art. That there may be Faults in its Conduct, I am not altogether ignorant; but these Lapses look'd on with an amicable view, will but appear as Moles in a fair Face. Sir, be you pleased to give it your Blessing, and it shall venture the Censure or Carping of others. All I shall further adde is, that when Greatness and Judgment shall be shrivelled to nothing, or at best into a cold remembrance, your Generous Charity as well as your great Learning will remain after you as living Monuments to after Ages. Sir, if you will please to pardon this Interruption with its Imperfections, and accept the Devotion wherewith they are offered, it will be the greatest Honour done

Your Obedient Nephew, JO. BROWN.

Norwich, Nov. ult. 1677.

To the Ingenious and Judicious Reader.

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SInce I have ventured the hazard of offering the few Grains of my Knowledge and Care to be put into the Scale of your Censure, and to be tried by the Standard of your Judgment; and although I am sufficiently conscious I may want somewhat of weight or measure: yet had I rather be censured for committing such an error, than be condemned for omitting so necessary a duty; Man not being framed to serve himself alone, he that formed him made him also a Brother to many, and this duty be oweth to them all; he being made much like the Princes Coin, the which after having once received his stamp proves current through his Dominions. This Tract well deserves the study and practice of a young Chirurgion, who ought to read it soberly, and practise it constantly. Whoever therefore is bred in this Chirurgick School, or brought up in the Nursery of Healing, let him endeavour to preserve knowledge in his lips, as well as judgment to guide his hand. I have here acted the part of a faithful Chirurgion, who sometimes must be admitted and allowed to make the smart the forerunner of his cure, and may be accounted excusable, though he seemeth to be hard hearted in not regarding the lamentable mo [...]s, and moving groans of his afflicted Patient, not sparing his Probe untill he have sounded the bottom of the Abscess. This is a subject indeed, which is not to be touched by every common Pen, every s [...]ip [Page] whereof in some cases may dislocate the Discourse, and cause a Solution of Continuity in the Matter. The Tract is not like a gay Tulip, clothed and tinged with variety of Colours, fair and goodly for view, but void of smell and all apparent vertue: neither doth it look like a piece of Tapestry, which appears best at farthest; its Leaves are not lined, covered, or filled with the thin Blossoms of Aiery Froth, or fetch'd from the Humours of an Emperical Romance, but rather gathered, furnished, and delineated, with the digested wholesom Fruits of Learning, Example, and History, most lively resembling the delicate and sweet Rose, the which besides its vertues of Perfuming the Air, proveth no less Medicinal than Fragrant. And now to you great Masters of Art, Brave Souls, whose Merits are above your Names, whose Vertues are no Shadows, and whose Noble Spirits can soar far above the common reach of Mankind, who can as well pity the Wantonness of one part of the world, who with a varnish and guilded Frame can plume their Impudence with the various coloured Feathers of Ignorance and Boldness; as reward the other part with the just dues and perquisites belonging to them; whose Hands are too white and clean to receive or give any black Dirt. It's you I may and intend to make my Judges, who can sooner pardon a thousand Errors than others find one. I question not but the Brightness of my Subject may have dazled my eyes, and my Expressions may fall low and flat, yet since the Lading is well bestowed in our Vessel, having received your gentle [Page] Winds to breathe on it, I question not its well sailing, and may be kept off from the Shelves and Rocks of others, who make it their business to pass an unhappy Censure, although not capable to pass Examination themselves. By some it may be objected, that this my Care and Pains may look like Flowers pluck'd from others Gardens. The Bees admirable Work is not to be discommended or thought the worse of, nor the Honey the meaner, for its sucking or extracting the same from the sweet Flowers of any mans Ground. I here have been more plentiful in Authorities, because very few of our younger Brethren have a will to read many or great Volumes, whilest greater Masters have less time or leisure. To you also who are of the lower Form in Practice, this Tract doth chiefly belong, it being as a guide to direct you in your whole course of treating Tumours both general and particular, from head to foot; my request to you is, if you find any thing worthy Collection or your Inspection, accept it with an amicable Hand; and if you give it the time of a Survey, play not the part of a Waterman, who Dum aliud proponit, aliud supponit. Let every man study his Art quietly and peaceably, that he may profess it openly and confidently, then may be expect it to have it guarded with the Lion and Crown, and encouraged by Royal Charters and Princely Privileges. I hope this Tract will meet with a Gentlemans Charity, whose Soul is drawn out to his Fingers ends, who can pardon an imperfect Draught, and where he meets with too deep Shadows, can with [Page] a light Hand and finer Pencil lessen its darkness. It may be well reckoned amongst Vulgar Errors in our days, wherein the Mists of Ignorance are very plentiful, the Evening of Knowledge appearing but through a small hole, and the dark Clouds of Folly obstructing our Light of Reason; and hence is it that the Light which we enjoy is so variously refracted by the glittering Vices of our times, and looks much disfigured by the Glasses of Humour and Fancy. If this may answer expectation, I am happy; if it be disliked by such who rather do measure another mans actions by number, than by either order or weight, I am not troubled, knowing it to be a common failing of some to be tempestuous in Temper, and troublesom either in Judgment or Desire, as to hate any thing they cannot themselves perform, or yield or lend a good look to another mans Labours, because they were not christned by their Name, be they never so lawful, good, advantageous, or honourable: To these and such others I offer this as a Conclusion; let us all study to be quiet and peaceable, and to do our own business for publick and private good, to work with our own hands such things as may gain afair repute and good name here, and a happy reward from Heaven hereafter; then shall our present actions smell like the Rose, and Eternal Bliss shall crown our end. And as I have in this Tract studied to be profitable to thee, so let thy endeavours be to help others.

From my House in Norwich, Nov. ult. 1677.

Vale.

To the Author Mr. JOHN BROWN.

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SIR,

SInce you were pleased to honour me with a sight of your Chirurgical Endeavours in this Work, I must in justice return you my Thanks and Commendations due unto it: for though the same Subject hath been handled by others, yet have you made so good a Collection out of Approved Authors, and so well disposed and set down the Nature and Cure of Tumours, together with apposite Historical Observations, that the same may become of very good use, especially unto younger Chirurgious, unto whom you chiefly designed it: and therefore I wish you happy success herein, and also in all future Endeavours, unto which Art and Industry shall enable you.

Your Loving Friend and Servant, THO. BROWN.

To Mr. John Brown Chirurgion of Norwich, on his Treatise of Tumours.

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SIR,

YOƲ have taken great pains in these your Collections, which having exemplified with so many very pertinent Observations, I do encourage you in the Printing of them: they will be of great use and instruction to all such as have not had the opportunity of consulting the many learned Authors quoted by you, which most imployed in Armes and Sea-service cannot be accommodated with. Sir, I am

Your Affectionate Servant, KNIGHT, Reg. Chir. Principal

To his Ingenious Friend Mr. John Brown, upon his Treatise of Preternatural Tumours.

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SIR,

HAving with great delight perused your Indusrious Discourse and careful Studies in this your Treatise of Preternatural Tumours, I must in gratitude and civility return you my just Acknowledgment due unto it. How lively you have examined their Causes, Signs, Presages, and Cures, no Son of Art but will acknowledge with thankfulness: and with what admirable Historical Observations you have adorned your Book, I need not to acquaint the Reader. All that I shall and in justice ought to adde, your Care and Ingenuity shewn herein may challenge a kind Opinion from the worst of those, who may pretend any disgust against your Sedulous Endeavours; which is the perfect Vote of him who is,

SIR,

Your assured Friend and Servant, ROB. DANIEL.

To his Worthy Friend Mr. John Brown, Chirurgion in Ordinary to the Kings most Excellent Majesty, on this his Learned and Elaborate Treatise of Chirurgery.

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WElcome (my Friend) upon this mundane stage;

Learn'd Artists very scarce are, and the Age

Abounds with Dolts, which doth its ills enrage.

We wanted one that would our Griefs declare,

And proper Medicines for them prepare;

And (thank our happy Stars) we have them here.

If Agues or Cut Fingers formerly

(Being cur'd) could raise men to a Deity;

What's then thy due, that cur'st each Malady?

Cheap in those cloudy times were Deities,

And little skill would purchase such a Prize;

But Physick now doth look with Argus Eyes.

Yet thy great Soul is such, thou canst appear

Before the Presidents and Censors Chair:

Thy Work being perfect, what hast thou to fear?

Were fam'd Hippocrates alive to write

Those Books, which first gave Greece her Physick sight,

He from this Work would humbly borrow light.

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For having this learn'd Book men need no more;

Of useful things it is a bounteous store,

And doth provide a Salve for every Sore.

Thanks then (dear Friend) for this thy worthy pains;

Cure but all Worms too in Fanatick brains,

And Immortality shall be thy Gains.

JOHN GADBURY, Student in Physick and Astrology.

The Names of the Authors concerned in this Tract of Tumours.

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Paulus Aegineta,

Albucasts,

Avicen,

Aquapendens,

Aetius.

Banister,

Berbert,

Bayrus,

Bauhinus,

Benivenius.

Cornelius Celsus,

Crooke,

Cordaeus,

Calmetaeius,

Columbus.

Dodonaeus,

Jacobus Dovonetus.

Gabriel Falloppius,

Fabritius Hildanus,

Fabritius de Aqu. pend. Forestus.

Galen,

Guido,

Gesner,

Osualdus Gavelchoverus.

Hippocrates,

Haliabbas,

Hercules Saxoniae,

Hollerius.

Jubertus.

Laurentius,

Lusitanus,

Leonellus.

Montanus.

Ocavus Oratianus,

Jacobus Oetheus.

Guilielmus Placentinus,

Ambrosius Paraeus.

Rhasis,

Read,

Rondeletius,

Ronsius,

Rogerius.

Johannes Schenkius.

Johannes Tagaultius.

Johannes Vigerius,

Johannes Vigo,

Vesalius.

Whartonius.

AN INTRODUCTION TO CHIRURGERY.

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AMONGST all the liberall Arts which the wise Creator hath made and bestowed on mankind, there is none extant that carry more excellency and dignity than this of healing: Considering either its Origin or Antiquity, its splendor of Invention, its honour and excellency, nobility and vertue, its subject and learning, benefit and necessity, constancy and firmness, with its liberality and charity. As touching its Origin and Antiquity:Its Origin and Antiquity. It came into the world almost in the same day with man, for soon after his Birth was this sought out as both reason and history makes good, it being generally our lots either sooner or later to make use hereof: for as soon as we leave our mothers womb we grow subject to receive the vapors of a putrid air [Page] and winds, and do thereby exprome diseases and sicknesses, as well as upon a further growth we share in others arising from meats and drinks. Can we either live well or act any thing to purpose without health? Are there not many enter this mundane seene with sickness, and make as speedy exit without this help of medicine? Are not our actions taken from the Soul, produced from its effective cause, and perfected by the body as its Instrument? And since it is reasonable to think that we can neither live nor move or yet arrive at a well being without this Jem of Healing, ought we not also to conjecture, that it was necessary from the first? Man was not made like an I per se I, to stand by himself, and hear the warbling notes and pleasant musick of the pretty Bird, or see how the ground out of a grain of corn yields its increase. No, this reasonable soul bred out of a higher spark was here planted also to labour: Non otiandum in via, sed laborandum in vinea. And here also may we opinionize healing and medicine were invented before other Arts, they being both of greater necessity and use: and this reason teacheth. And if this may not please, Holy writ and sacred History will shew us a great deal of its Antiquity [Page] and Origination.Its Origination shown in a great part by Holy writ. Amongst the people of God were alwaies Physitians, as we may see out of Moses, Solomon and so forth. Do we not read of Joseph ordering his father to be embalmed, and how that he was embalmed by Physitians? Gen. 50. May we not find scabs, sores, and blisters in Exodus 9? May we not read of s [...]aying and wounding in Exod. 21? Have we not the Leprosy and its marks, the plague and its spots in Levilicus 13? and its method of cure by applying the blood of Sparrows, Cedar and Hy [...]op, cap. 14? In Numb. 35. we read of murders and slayings, contusions and wounds. In Deuteronomy 23. no man hurt with a Rupture must bear any publick office. In Jud. 9. we may read of a woman, which with a peice of milstone wounded Ab [...]melech in the head, and brake his brain-pan; and [...] Kings 1. Jeroho [...]m's hand was so withered, that he could not get it pulled in again; and Asa in the 39the year of his Reign was so diseased in his feet, that he sought to Physitians. Chron. 2. These Holy authorities may be enough to show its Antiquity: the thing showeth it self evidently that people before this time were not onely troubled with inward diseases, but also perplexed with outward troubles. Moses drew the Israelites out of Aegypt above [Page] 3000 years ago; & if any will enquire, he may find there were Chirurgions; and not these only, but Physitians also, before which time they were in great esteem and admiration; and this was for certain that there was little or no distinction between Physick and Chirurgery. About 500 years (as Avenzoar observes) before his time amongst the Arabians were they joined together. I speak of the time where this art of healing flourished amongst the Greeks;As to its honour and Excellency. for the Aegyptians had it much earlier, as Herodotus writes. The wise man in Ecclesiasticus saies, God made both Physitians and medicine; and wise Solomon makes mention of Physitians healing inward diseases, and of the earth being furnished with plants and herbs for curing outward sores and hurts. Did not our wise Creator frame both the Physitians and plants for the good and benefit of mankind? Did not our Blessed Saviour make the blind see, the lame walk, and the deaf hear? It is noted that an Angel of the Lord taught Tobias to cure his father's eies with the gall of a fish. Have not Kings, Princes and Potentates studied, exercised and imbraced this Art, some for pleasure, others for ornament or contemplation, whilst some others make a more deep inquiry into it [Page] for necessity of life? Amongst the Senevans Cham had a wife whose name was Rhea, out of whom was bred Osiris, who for his knowledg in this Art was esteemed as a God, and adored and worshipped as a Deity. Jachenus amongst the Aegyptians for inventing a way to purify the Air was renowned as a mighty one, and by them had a Temple erected, in which he was interred. Mercurius Trismegistus a little after Moses in the time of Joshua appeared in Physick with great glory. Homer writes that Podalyrius and Machaon sons of Aesculapius went into the Trojane war and exercised this faculty; hence may we learn of what great esteem value and reverence this Art was in former times: But to look nearer home, have we not very oft times seen it kept, preserved, protected, and propagated in the Royal palaces and and Princely families of Kings and Potentates? Plutarch tells us, that Alexander the great was not only a Scholar to Aristotle, but was also a very great admirer of this Art. King Mithridates hath given to the world to his perpetual same a Signal token of his diligence and study in this Art by his Antidote Christned by his own name. May we not read of many Reverend persons who busied themselves [Page] in studying the knowledg of herbs thus Chirou the Centaur accounted most excellent in his time for curing of wounds gave Century its name; and hence came our Art to take its derivation, held by some. Gentian came from Gentianus King of the Illyricks. Avicen not unknown to any master of Art, came out of the Lineage of the Persian Kings. Arthemesia had its name from the Queen Arthemesia. May we not well with admiration see the Almightie provedence working strange effects by the hands of our Sacred King of blessed memory, and the French King in curing Scrophulaes? Have we not seen Rebellious tumours, which scorned and trampled on medicine, forced to yeild to his touch? Running sores all in their leakages, the weak made strong, and those members brought into good order which had formerly bin risled and distorted, by the Sons of the most high, imprinted as badges and true tokens of their being the only true heirs of the Imperial Crown? And as these are the great masters of our health, ought we not to endeavour and to defend them, and pray that they may last with us in England so long as the Sun and Moon shall continue? Fernelins telleth us there is nothing can be better shown or drawn to [Page] the life in Physick than by example;Its learning and vertue. for hereby may we, nay can we not be so readily deceived, the foundations hereof for the most part consisting of Judgment and Experience: for as reading makes a full man, conference a ready man, and writing an exact man; so also doth Experience give us the liveliest character of a knowing man. In all these some ages have been more happy than others. Amongst the Aegyptians this Art of healing was very carefully treasured up, these like generous souls born for publick good by great care and study have left to the world examples of their love and studies: and as the first amongst these was Aesculapius, who have writ to posterity: yea before ever writing or printing was, this Art was so much in esteem, that by the industry of man were their remedies marked out with Hyereglyphick signs; out from these came those rare volumns of Hippocrates; and he that hareth this way to find advance in his skill and judgement, may be well said to walk in the darkness of ignorance, and fed with the Chymaerical fallacies of fooleries and flatteries. Galen's books have been of great profit to mankind; may we not count our selves much obliged to him for his two books De Articulis & Fracturis? [Page] Since these have Heraclides, Diocles, Caristius, Praxagoras, Chrysippus, Erasistratus and Hierophilus, been esteemed great Masters of Art; after these are Asclepiades, Albucasis, Paulus, Aeginetta, Erastus, Johannes Fernelius, Gabriel Fallopius, as so many rising Suns in their Art, by whose resplendency have many obscured things been brought to light. Are not in our times these following in great estimate and service to us, and with us for ripening our knowledg, helping our insufficiencies, and assisting our practices, as Hierouymus, Fabritius de Aqua pendente, Cornelius Celsus, Fabritius Hildanus, Johannes Vigo, Ambroseus Parraeus, Tagaultius Berbettus, Crook, Read, Woodhull, Low, Banister, Vigerius and the like? what therefore ought more to be had in esteem or worth, reverence or honour, than that Art which teacheth to keep and preserve the life of man in safety health and vigour by its learning and vertue? for may we not with ease see, as through a Christal, that what ever is contained in this Orb is subject to a medicinal contemplation? Man, the heavenly coal blown up by the divine sparks of Almighty wisdome,Its Subject. is the subject of healing: it's this rational soul and compleat body whereon it exerciseth it self.

[Page] He that is the most admirable of all other Animals visible, and commands all others, and subjects them to him, is controuled by sickness, and therefore stands in need hereof: and this may well raise a Chirurgion into admiration, not of himself (with pride and arrogancy) but of the Almighty wisdome with fear and reverence, how that for his contemplation are all Terrene things made and framed; how that to him is given the Judgement of knowing the vertues and vices of herbs and plants, to keep and preserve pure the admirable harmony of man, comparable with the Sun in its glory, with the Moon in its moisture, with the Earth in its vegetables. And come we to view his three venters, we may see his upper room, his animal parts, furnished with intellective faculties, his soul arraied with an animal sense.Mans upper parts. From this fountain cometh our knowledg of our Maker, our Honour and obedience to our King, our subjection to his Laws, our prudence for exercising the same, and our harmony for politick societies. Here dwells our Councel; and it is by this prerogative that Justice is executed on the criminal, and Equity extended to the just. Here dwelleth our science, art, strength, perfection, knowledg, and reason. Here is placed natures cheif [Page] magazine. It is here that [...], as it were the souls eye, the commanding mistriss of morality: man hath this admirable work spun of sine threads of veins and arteries. Its outward wall resembles the element of earth, its next covering made of spermatick fibres imitates water, that sine web spun by the Almighty hand which covers the brain, paints out air; the body of the brain it self represents sire. This fountain sends forth many rivulets into the back part of the brain by its trunks, circuits, and plexures. Strange and admirable are its fabricks, as wonderful its net, hence comes the silver Chord the wise man speaks of. Its outward cap very prettily resembles a fair Wood clustered with young trees. The salt tears, which trickle from his eies, carry a lively resemblance of Dew; vapours obscuring his sight resemble clouds and mists; the noise of the ears winds and storms, frothy spittles carry the lively protraict of Snow, as well as coagulated or conglobated slegm the representative of hail. A Coriza in the nose carries the similitude of rain: sneezing resembles thunder, and the redness of the eies lightning. Is not the sun seen in the native heat of the brain, as well as the moon in its watery element? Jupiter [Page] in its temper, as well as Saturn in its melancholly? Mars in its choller, as Venus in its flegm? hath not this upper house the eies for its windows, the ears for its side doors, the nostrils for its scavingers, the mouth and tongue to bespeak and provide for its wants, and to tell its necessities, and the grinders here also placed for mastication? Is it not by its nerves that we lift up our eye to our maker? Jussit & erectos ad sydera tollere vultus; by its side doors doth not come in our hearing, which is our best instrument for discovering of freinds from enemies? are not its mammillary processes ordained for conveighing its spirits and tempering its heat? is not our tongue lift up and down by its nerves? Os sublime dedit homini, caelumque tueri. When we have considered all these, how admirably they are framed, what various functions they perform, how necessarily they were constructed, and with what art annexed, may we not with old Zoroaster cry out [...]; Draw but the Curtain and you may soon see a Metamorphosis, the Seene changed, and these rare parts impaired by sicknesses and diseases; for since Adam took the Apple from his wife, his children and sucsessours have been very capable of being [Page] deprived of these happinesses:The scene changed. for come we more nearly to consider him as relative to our present discourse, we shall find a suddain change; in his infancy we may find insects daily to grow in his outward cap; in his youth scabs and ulcers; when having arrived at riper years it is oft times with Artheromaes Stealomaes, and Melicerides, its Pericrane filled with Hydrocephalical Tumours, its outward wall is oft times battered and fractured, cleft and divided by fissures, bruised by Contusions, wounded by penetrating and not penetrating wounds, its Dura mater is made to flee from the skull, although so strongly tyed and rarely wrought into it, by fractures and incised wounds. Is not its princely palace pulled down inwardly by Apoplexies, shaken with Palsies, threatned by Epilepsies, burnt up by fevers and inslamations, stormed by winds, overflown by inundations, consumed by gangrenes and sphacelus's? are not its windows shut up by Cataracts, and darkned by suffusions? its side doors assailed by stormes, and windy ruffling noises? its musicall Organick pipes shut up by colds and deafness? Comes not hence, as from the main Ocean, those many trunks and channels which bring in our gouts, Dropsies and Cramps? Is not its [Page] excretory passages stopt up by Polypus and Ozaenaes? are not the grinders forced to leave going, and the Jaw put out of order by fractures and dislocations? when this light extinguisheth, are not all things made into darkness? doth not our reason become obscured, our wit sequestred, our Judgment affrighted, our memory lost, our understanding clouded, our senses banished, our tongue tied up, our tast gone, our silver chord shirvelled, our grinders cease, our hands contracted, our Columns and Pedestals brought low, and in a moment come to nothing?The middle Region. In the middle Region you have natures most curious cabinet wrought with various Roomes, wherein are lockt up the vital Treasury, the wheels and Instruments, whereby the watch of our life is alwaies kept in motion from our first hour to our last minuit. Here dwels the kingly heart the great master of courage, and warrior, exercising its nectarean faculties by giving life and vigor by its vivifying and quickning heat: and as the Sun in its Caelestial Sphere yeilds lusture and beauty by its motion and light; so also is our heat, light, life and motion upheld propagated and preserved by the heat and motion of the heart. This part is called [...] from a word which signifies to leap; its called [Page] Cor à Currendo, it being ever in motion; it hath Lungs allowed it for tempering its heat, and fanning its fervency: here's also a Diaphragma distinguishing or separating the instruments of nourishment from those of life, being as a muscle most different from all others: Its Sides and Ribs are guarded with a Pleura inward, bred of spermatick fibres; this serves for keeping the lungs from being intangled with the ribs: besides these is a Mediastinum, framed as a partition wall or thick hedg dividing this trunk in the middle, this keeps the heart up from falling. Thus may you see how serviceable every part is for performing its office and service to the heart as its Prince; and at the first view we might well conjecture, that this might be framed with safety, being the only and main Engin of life.The courage abated, and this Sun Ecclipsed. But this also suffers its gloominess, and takes shares with all its parts of sicknesses and diseases. How oft have we seen this Prince of life, which bestowed its vigorous influences to the body, as the Sun doth to Plants, to be ecclipsed by a cloudy slegmatick excrescensy? this watch furred and run into dissolution by Dropsy, Worms, and insects? Is there not seen Tartarous stones as well as coagulated slegm, the one endeavouring to dissolve this princely pallace, whilst [Page] the other stop its channels to suffocation? do not wounds and Apostems suddenly happening here as speedily put out this candle of life? Is not this princely palace oft parcht by Fevers, surrounded with Agues, stormed with Cardiacal Syncopes, washt away with the inundations of strange Dropsies, poysoned with malign fevers, obstructed by flegm? are not its flabellums burnt up by inflammation, consumed by Asthmaes and Empyemaes, rotted by ulcers, turned into wash-pools by Dropsies? is not here a lung oft times converted into purulent matter, and an Asthma into a Squinsey? are not our sides pricked with a pleurisy, troubled with a Peripneumony? These and many others take up their Quarters here: and although Physick and Chirurgery have the two substantial leggs of experience and Reason to defend them, yet the great knowledge hereof must come from that great Doctor, who hath Heaven for his chair, and the Earth for his foot-stoole. Thus have I carried you through the fortunes and misfortunes of his middle Region.The third Region. We arrive now to his lower and 3d room, his natural part: and here have we most exactly represented the Liver, with its interwoven distributions of the vena porta, and vena cava, with the vesica fellea, [Page] and its several capillary vessels, with its meatus cisticus, its porus biliarius, and ductus communis, framed from the separation of the gall or bilious humor from the blood, and conveying it into the intestines; and here also may we see the Almighty disposing variety of Organs for diversity of uses; and for its outward guard you may see it furnished with a fleshy Armour made of muscles; under it the two Spermatick coats of the Peritonaeum, the enwrapping and keeping warm the parts within; these being laid bare, may we meet with a crisped kell with its curled veins covering the bottom of the stomack and keeping it warm; under this lies the strange Series of Intestines, strangely wheeled about, contrived with much Art, and framed with variety of circles, here lodged for sending forth with more expedition the excrements from the body: to see such a length of intestines contracted about such a small mesentery, as it appears in its natural sight, may well challenge the greatest of admiration, how finely checquered with white & purple veins, ordered for conveighing its chyle and keeping it warm by its blood already made and elaborated; here is also a Pancreas tied to the guts, as a pillow to prop and keep up the veines arteries and [Page] nerves, as well as a juice to help forward expulsion; here also is placed the spleen, ordered to help forward concoction, furnished with arteries for drawing away its most feculent blood, to ventilate the natural heat of the spleen, and to invite a vital faculty to it; here also are planted the kidneys, ordered for expulsion and avoiding of exerementitious wheyish matter, the which being altogether unprofitable for nourishment is sent from thence by the ureters into the bladder, and by the good laws of nature is here also placed the bladder, ordered as a Receptacle of this urine, the which for a time it retaineth, and being therewith overloaded doth exonerate it self thereof. Thus have I shown you through all the Rooms of Nature's lower Region, where you have seen how every part is imploied whilst it enjoies its true function; but these also are robbed of their excellencies, taken off from their offices, deprived of their faculties and laid open to the enemy, by diseases, troubles,Nature made unnatural to it self by diseases. wounds and Tumours, Stones and Dropsies: thus may we see the Peritoneal spermatick sibres extended by Dropsies; the Kell burnt up and parched in long and tedious distempers, distorted and disaffected by instammations and Ruptures; the Intestines blown [Page] up and swelled with Collicks, pursed up and convolved by Iliacks, torn and lacerated with Herniaes, wounded and pierced with fistulaes; the Liver the magazine of blood inflamed, its trunks and channels obstructed by varices and melanchollick feces, hindred in its actions and motions by Tumours; the spleen suffer scirrhous tumours, and obstructed with excrementitious blood; the kidneys fretted with gravel, inflamed by pain, tormented with stones and ulcers, closed up by obstructions and Trychiacis, its pipes stopped by flegm, stones or gravel; the bladder suffer resolution, and that which was made the receptacle of urine oft times proving the receptacle of stones and gravel, perplexed with Ischuries and Dysuries, pissings of blood, preternatural tumours, abscesses, Ulcers, Caruncles and the like. Thus have I given you a short survey of the inward parts, their beauty splendor and formes, to which also are added their various sicknesses pains and diseases; and may we expect in reason that the outward Coffin or Chest may fare better and be more free from diseases than these? No sure; where the Jewels are lodged, there generally are held the security: for as poor man is subject to outward storms and winds, so may we [Page] as readily find him as capable to receive the impress and stamp of diseases: In his face we may oft times see a suffused eie, a hare lip, a polypused nose; in his neck and throat strumous and scrophulated tumours; in his mouth and throat Cancers and Anginaes; his shoulders distorted; his muscles cut, prickt, or wounded, his nerves contracted or lacerated; his veins and arteries ancurismated and variced; his bones luxated and fractured, and the whole sometimes gangrenated and sphacelated; his hands, the proper Instruments of his livelihood, corrupted with Chiragra and other Tumours; his wrist dislocated; his very singers ends terrified with Parony chiaes and Hypersarcocal excrescencies. May we not oft times see the brests, that first give us suck or nutriment, suffer the torments and unhappy assailing unruly disquiet of Cancers, Strumaes, Worms, Stones, Clefts, and the like? Is not the Penis, the proper instrument of generation, accompanied with Phymosis, beset with Ulcers, Caruncles, venereous and malign ulcers, whilst sometimes it is seen to have an imperforated Glans. The Scrotum is very oft times seen loaded with pains and troubles, tumesied by Ruptures, and made capable of inflammation and gangtene; the Hips [Page] greived with Scyaticks and running pains, pestered with venereal aches and dislocations; the muscles of the thigh oft wounded, tumesied inflamed, lacerated, ulcerated, and abscessed, as well as its bone fractured; the knee swel'd with oedematous Tumours; the leg shortned by amputation, occasioned inwardly by a desluxion of humours, or outwardly by some external causes, causing gangrene, Sphacelus, or the like. Do not they and the foot also by joint consent take share of hydropical tumours, scorbutick ulcers, gouts, and other pains? and when we have well considered these, may we not own with Job, man hath not a part free from distemperiety? In its constancy and firmness it is to be preferred before any other Art under the Sun:Its Constancy and firmness. for as it came soon after him into the world, so it never leaves him to his dying minuit; nay it continues longer for he being dead, it serves to help his succeeding generation. The truth of this daily experience makes good: for although our life be but vita brevis, yet our art is Ars Longa; and although it may be subject to change, yet this is to be better born with, being like man with whom it is concerned: but this is more constant, life is no life without health; and is not this our daily friend [Page] afforded us by our wise Creator for promoting and perfecting the same? It is by this Art of healing we have our daies lengthned, by cutting off distempers, eradicating their causes, and extripating their effects; and indeed what is health else, than the keeping of the whole body perfect and intire? And this may then most properly be said so to be, when all its actions are freed from the chains of impediments and pains; for this great happiness of health is onely that affection of the body, which from the first do make every of its actions answer its nature. This made Democritus write, that he would have every man study the Art of healing; because as it is honest, so also it is profitable and useful for life:Its fruit necessity and profit. Which brings me to the next branch of it, which showeth its fruit necessity and profit. This is a feild very large, considering either its order, condition, age or sex, wanting no fruit; it is this alone that produceth health, by divine permission, a more excellent thing than which this great world cannot boast of; to live is to be buried alive without it. No man therefore ought to be held in a greater estimate in a Common weal, than he that keeps the people thereof in health. This made [...]omer the Prince of the great Poets prefer one [Page] Physician well furnished with vertues and knowledg in his Art before many of other men. It is here alone guided by nature, that can see distempers, and snatch them out before they take root, discharge such as are adherent, destroy them in the bud, hinder them in their growth, repress their vehemency, mitigate their pains, extinguish their fervour; that can restore the semiputrid to health, recreate the afflicted, refresh the troubled, strengthen the languishing, and bring the half dead to a whole life. But should these fail, yet we have this to defend us before the great Doctor of our Souls; if to the utmost of our endeavous and judgments, and these strengthened by care and study, we use and apply the best of medicines our best knowledg can guide us to, we have discharged our parts, and let us leave the success to that God, who can work beyond the waies of man, whose secrets are past finding out. And this part I will conclude with this maxim, That this Art is by so much the more excellent and to be had in esteem, by how much it is necessary, useful and profitable. Of its liberality and Charity our great Master hath left a lively example,Its liberality and Charity. who had no respect to persons when he went and exercised this Art of healing. And although [Page] in Kings and Potentates it may receive Princely rewards, and amongst Lords and Knights fair gratuities; yet also must it be furnished with the graces of Charity and Humility, thinking no scorn to help the meanest; this being its rule, Quod tibi fieri non vis, alteri ne feceris; it being a maxim in natural Morality as well as Philosophy: And as Riches may spuron to honour, and both to the obtaining of fame and credit; so let charity and conscience command your diligence and care in the managing the same for the poor, for they are Gods creatures framed in the same mold; and although they be not furnished with the same plenty of outward gifts, yet may they ore top the rich Miser or covetous Churle in vertues and other excellencies. And let this be your comfort, that the great Pay-master, who keeps in his Register-book all thy good actions, will not be wanting to add store to your stock, knowledg to your Art, success to your practice, and crown your cures with credit; and when death his Bayliff shall with his Habeas Corpus summon thee to the great Audit of the world, the Angels will Joy in thy happiness, and eternal bliss will Crown thee hereafter. Thus have I given you an account of the Antiquity and Origination of Chirurgery, [Page] its honour and excellency, its learning and nobility, its subject, its constancy and firmness, its fruit, necessity and profit, its liberality and charity. We come next to know what Chirurgery is, and of what parts it depends.

That we may arrive at the essential knowledg of Chirurgery,What Chirurgery is. we ought first to consider what it is, what is its subject matter, for what end it was made and ordered, and what order ought to be kept in it. As to the first, Cornelius Celsus calls that Chirurgery, which cures by the hand, being the most evident part of Physick, to which is adjoined both Diet and Pharmacy: Or, if you please, it is a branch of the Curative part of Medicine, which teacheth how to restore health by manual operation and medicine. Ambrose Parry telleth us, it is an Art which informeth with reason how we may cure, prevent and mitigate diseases by the help of the hand: but its most proper and essential definition is taken from eradicating diseases by Art and manual Operation; for as [...] hath it, such medicines as are applied to Tumours, Wounds, Ulcers, or Fistusaes, cannot so properly be said to be cured by Chirurgery, because this health is purchased and procured by help of medicine which was applied. But [Page] where an Abscesse or Impostume is opened by Incision, bones dissocated or fractured reduced by the hand, Fistulaes dilated, Cataracts couched, Cancers taken of by Instrument, and the like, these may well come under the name of Chirurgery, it being from the use of the hand that it taketh its name: for it is derived [...] à mann & opera, and thus Chirurgery quasi [...].Its end for which it was framed. As for its subject matter I have already shown man, being alone the proper Instrument hereof. As to its end, it was ordered and framed to repair natures wants, to help her necessities, to make her curvations right. And to its order and method, it is divided into Theory and Practice.Its Order and method. The first teacheth and is called science acquired by demonstration and knowledg of the principles of Art; this carrieth with it the precepts of Art: The second practice found out by Knowledg and Reason, arriving at a greater degree of perfection by manual Operation; and this daily experience adds to its lustre and truth. It may also be divided into general and special parts. These held general,Into general and special parts. as the Articulations or soft parts: Those special, which teachthe right way of Operation about Tumours, wounds, ulcers, fractures, dis [...]ocations, and the like. The scope of [Page] Chirurgery directs the Chirurgion to the well knowing and understanding these four parts, as to remove solution of continuity, to restore union where wanting, to separate parts unnaturally united, and to supply defects. The first is called [...], the joining part, the second [...] the separating part, the third [...] the removing part the fourth [...] the supplying part. The first performed by Consolidatives, Agglutinatives, adducing Luxated bones and curing fractures: The second acted by Incision, Phlebotomy, or Scarrification, or Amputation; as in wry necks, hare lips, imperforated Anus and Penis: The third is finished by extirpating tumours, as Ganglions, Cancers, Nodes, Strumaes, Scrophulaes, Stones, Cataracts, drawing out of water from the Abdomen or Thorax, by a Paracenthesis, Amputation, and the like: The fourth he supplies in restoring Ruptures into their proper places, as in restoring a new nose, and bringing the blind eie to its sight: And these are to be done Citò, Tutò & Jucunde, suddenly without pain, safely without cheat or imposture, and pleasantly without fear or fallacy. And that the Chirurgion may perform these with honour and repute, let him take a turn with me in the several [Page] borders of this Chirurgick garden;In the Chirurgick garden grows things natural, unnatural, and preternatural. where he may first see what is natural, what unnatural, what preternatural, thereby the better to furnish himself with Indications or Intentions against these or any thereof. And the first that offer themselves here are the things of nature, for whose end this first intention is appointed,Wh [...] natural. and that is health, its cause, effect, its strength and temper, all which are to be kept in their order and beatuy:What preternatural or unnatural. These are generally allowed unnatural or preternatural, as a disease or distemperiety; for this is said to be a praeternatural effect of it self, and hurting action by its cause; and this may hurt by action, hindring it, or by accident; and then by symptoms, which follow a disease as a shadow doth the body.Three general I [...]tentions. There are three general Intentions here requisite. The first arising from a preternatural thing taking from its contrary;The first. as union from Solution of continuity, coldness from heat, heat from coldness, driness from moisture, and moisture from driness, ablation from matter exceeding, and encreasing from matter diminishing, apertion from obstruction, and dilatation from angustness, astriction from amplification, reposition into its proper place from whence it made its recession. And as we are to observe [Page] this order of contrariety; so also are we well to understand it, which affect ought first to be cured, the curing of which is the principal cause of curing the other,The second. and without which no perfecture. The second Intention sheweth, how we are to keep those parts intire, which are placed according to nature; and to discharge and expel those that are preternatural: and we may understand an incurable disease these three-waies.Three waies to know how to cure a disease. First when the disease of its own nature is incurable, as the Elephantiasis, or confirmed: Secondly when the patient useth not such means as should be proper for his recovery: Thirdly when the curing of one distemper threatens another greater and more terrible. The third Intention is performed by opportune helps and conveniency,The third. use of right and proper medicines: and these are either Medicinal or Instrumental; Instrumental for living well, and keeping a good order, as Pharmacy, Phlebotomy, Emplaisters, Uuguents Powders and the like. The unguents a Chirurgion should alwaies have in readiness satisfying his common Intentions, are these, unguent. Basilicon, to maturate and convert into Pus; Apostolorum, to deterge and mundify; Aureum, to incarn and fill up; A [...]um, to agglutinate and consolidate; Dialthaea, [Page] to mitigate and ease pain. Instruments for all occasions large and small, some for searching, others for cutting, for some drawing out extraneous bodies, and others for putting or reducing parts into their respective places: And these bring me to the Chirurgion himself, which is to be the man onely engaged both in their applications and administrations; and let us see what person he ought to be, how qualified, armed, furnished, and exercised. To consider in what chair of honour and esteem a Chirurgion is seated, may well require his care and study, learning and excellency: and since there is such a conjunction of the mind with the body, such a connexion and society, that they generally take shares of one anothers good and bad fortune, as some deliriated with fevers, whilst others are blown up with madness by the fury of choller; To see the wonderful effects of blood, while melancholy acts her innumerable changes in our bodies, may well call into admiration the best of mens knowledg, our thoughts varying according to the diversity of tempers in our bodies. Thus are we troubled with diseases, inflamed by anger, sweetned by love, exhilarated by joy, dejected by sorrow, tempered by sweetness, shaken by fear; and to search out [Page] the depth of these, their originations and causes, their diversity of shapes and postures, may well require a quick sight to penetrate, a powerful wit to search out, a well guided reason to consider of. He therefore that will enter this stage of Chirurgery, must well understand its various scenes and acts; for its he alone guided by the provident hand and divine assistance that can maintain and keep up our sorts and castles from the assailing batterings of wounds and contusions, &c. and by him also may herbs and roots, seeds and berries, gums and fruits, be made capable instruments to banish the enemy having once made its entrance. It's by his Art the swelling bubbles of scalding water are disperst, the burnings of gun-powder allaid, its pain removed, and its black marks fetched out. Its by his Art dislocated Articulations and fractured bones are brought into their right form and order, old ulcers and fistuales dilated, mundified, incarned and cicatrized, Herniaes and Stones bound up and drawn forth: and since these and many more are committed to his care and charge, what skill, knowledg, fathoming of diseases, and judgment, ought he to have and be furnished with to undertake this task? Take with me this as a short character of [Page] a good Chirurgeon,What person a Chirurgion ought to be. he being a man both honest and careful in his art, prudent and provident for his patient, expert and skilful for defending himself, well learned and educated for discourse with others, well exercised and practised for the help of both. He ought to be well furnished with books, these being as so many safe Pilates to conduct him in his unknown way, and to keep him off from the shelves and rocks of mistakes and errorsin his Art: Adorned with learning; for this makes him appear as a Sun, whilst others less literate shine but as smaller Stars; this conducts him to the tree of knowledg, whilst others can onely boast of their impudence and ignorance; it is this gives life to his practice, chearfulness to his study, and security to his conduct: And as we seldome see a wise man gain knowledg from a fool; so is it as rare, to gain awise medicine from an ignorant block. He ought to be well exercised in Anatomy,Exercised in Anatomy. for hinc discimus artem rectissime operandi & securitate incidendi: It being as the cheif pillar or basis on which Chirurgery planteth its foundation; this is the great magazine, from whence she fetcheth her richest treasure of knowledg. It is the knowledg of this, which bringeth Honour to his name, Praise to his practice, Worth to his skill, [Page] Plenty to his wisdom, Gain to his industry, Reason to his judgment, and a great measure of success to his undertakings; hence he learns how and where to make right, oblique, and transverse incisions; by this he finds out the Origination of the nerves, the trunks and channels of the veins and arteries; here may he find the difference between a nerve and a vein, a Tendon and a Muscle, a vein and an Artery, a Bone and a Cartilage. These may well convince their utility, necessity, and profit in Chirurgery.Well read in Physick. He ought to be well read in Physick, by which he may as well gain the knowledg of removing the cause, as the discharge of effects; and this gives a great light to the well timing of diseases; for outward medicines are very oft applied with little success, when they are not conducted with a cunning hand and a solid judgment. Besides these a Physician is not alwaies at hand to defend the Chirurgion, or to assist him; which should upon necessity put him upon this excellent study, which gives life to his knowledg by teaching him to eradicate the growth of a distemper. It is his best friend at Sea, and as great assistance in the Wars, in helping him to pull down fevers, in frightning agues, in curing scurvies, in discharging [Page] Itches, in allaying Calentures, and in bringing life, vigour, courage, and health, to his dying, weak, faint, and sick Patients. He is to be armed with Instruments both great and small; the greater for greater uses, whilst the smaller he carrieth as daily companions: but of these you shall read more at large with their figures elsewhere.The knowledg of medicine proper for him. The knowledg of Medicine is also very proper for him, and a main wing of his Art: it is by this that he can draw and heal, dry and close up, repel and resolve, digest and suppurate, attract and emolliate, escharioticize and ease pain; some of these being proper in Tumours, whilst others are more useful in Wounds and Ulcers, but of these also in their order. And when a Chirurgion hath purchased all these, thus furnished, adorned, armed, educated and experienced, there remains yet somewhat to add to his excellency, as a quick sight, having an eie pointed upward to fetch down a blessing upon his practice; a nimble wit to apprehend every advantage that he may get from his Seniors; a pleasant countenance to call chearfulness into the Patient's cheeks; a couragious spirit in things which he well understands, and are safe, but as wary in matters of danger; prudent in his presages, [Page] courteous in his behaviour, chast, temperate, not given to too much wine or venery; Charitable to the Poor for conscience and charity, as well as to the Rich for fame and profit; furnished with undauntedness in amputations and Lithotomy, having a steddy hand to act with evenness and without trepidancy, a hawks eie, sharp and clear to look into the distemper; dexterous at his work. He that is thus furnished, may well assure himself, he is in a happy estate of knowing how to remove solution of continuity, restore union, separate parts unnaturally joined, remove superfluous bodies, and then supply nature in her defects, taking this as his guide, [...] .

CHAP. II.
Of Humours.

SInce daily experience showeth, that out of Humors Tumours do take their Originals, our present task shall be to treat of the matter of Humours, of what they are, how made, and how many they are, what good and mischief they do; and then show you their Introduction [Page] in one Scheme, their general Division, and then arrive at Tumours themselves. To understand the nature and essence of a Humour, is and ought to be the work, study, and care of a Chirurgion, as well as a Physician; there being no disease with matter, which is not framed of a confused mass of Humours. It his hence that all Tumours, Wounds, Ulcers, and Fistulaes, and their differencies have their acknowledgments and distinctions; the which is the only cause which makes both Physicians and Chirurgions run presently to the tempering of the Blood, that is, to the correction of those Humours which are the occasion of these Tumours. By Physicians a Humour is taken for a thin and liquid body,What a humour is. flowing and cruising in our body. Tagaultius doth call them more properly Humours, which are juices made by the Liver in the sanguinary mass, for its nutrition and thinning of the blood all over our body. All these are Choller Flegm and Melancholy, adjoined to the Blood, scattered and sent into our veins and arteries, the which the variety of their colours and consistence will make good, as Galen hath it l [...]b. Natur. Human. Of these some are natural, some not natural. Those called natural, because so ordered according to nature, for [Page] keeping, defending, sustaining, and nourishing the life of man: Those counted otherwise, which act contrary to the rules of nature, and have unnatural effects. The one again being either alimentary, proper for life and growth of the body; the other excrementitious more proper for cleansing its sinks and channels. As the Humour is, so also is generally seen its Colour: for as Blood is of a pure florid rosy colour, so doth it give colour to the Muscles: It is this that graceth the cheeks, by affording them a a share of its redness: and as it is made of Chyle and Blood, so also doth it send forth its white and red; and by how much the red exceedeth the white, by so much are the Muscles more red than the Skin. Choller is citrine and yellow, thin and griping; and as the four Humours do work man into a good humour, so this burneth him into a passion: it gives a lively paint of its colour in the Jaundies. Flegm is white and washy, and so are they that have too much of it, being very cold and subject to Oedematous Tumours, Dropsies and Agues. Melancholy is black and masketh the whole body with an Ashy colour; this is long and tedious in executing its office, it being the most heavy an dsad part of the blood; but at [Page] length bringeth forth the terrifying Scrophula, Corroding Cancer, Scirrhous Tumours, Quartane Agues and the like: and we daily find, when it hath hatched them up to any growth, it is very long, if ever, before it be made to part with them. Besides these there are two others: one a serous Humour which serveth as a vehicle to the blood, ordered by nature for thinning it, that it may pass to its smallest capillary vessels. Part of this is sucked up by the kidneys, where having made a short stay it maketh its further progress into the bladder, and there remains whilst it be loaded; the which being therewith filled, is let out as useless and unprofitable. Besides these comes Wind taking its circuits and turns, and in our bodies is occasioned and bred by ill digestions, crudities, and wind: the former making watery Tumours, whilst this maketh slatuous Tumours. But that we may well understand the foundation of these Humours, let us examine from whence they are bred, and whence they come.What blood is. [...] or Blood as it is the cheifest and of the greatest service for life, so ought this to take the preheminency in our discourse.How [...] It is made from the temperate part of chyle in the stomack sent through the small guts into the milky [Page] vessels in the mesentery, whereby nature hath ordained it a Receptaculum commune, being here planted by Divine Providence as a bag for reserve, for the most part full, from whence passeth this chyle along the great Artery just by it, untill it reacheth the Subclavian vein; from thence it marcheth into the right ventricle of the heart by the vena cava; and from hence is carried into the left ventricle of the heart by the Arteria venosa from the lungs, and is there elaborated and made pure blood, sweet of taste, and florid in colour, mild and benign. This sanguification is a similar action and performed by assimulation; and therefore taketh this chyle aforesaid as its subject matter for this assimulation, and as they dewell together, so do they assimulate together; and this is done by process of time, never passing to the liver, as the Ancients dreamed, for the chyle seldom or never reacheth it. This blood, as the vital liquor, is sent through the whole body by its veins and arteries, as its proper trunks and channels. And although at its first appearance it sheweth it self pure and free, yet hath it alwaies these three Humours adjoined to it, as three several substances; as Choller, Flegm and Melancholy; distinguishable one from [Page] another not only in taste sapour or colour, but also in their effects: for as Galen observeth lib. de natur. homin. the melancholy humour is acid, choller bitter, blood sweet, and flegm having little or no tast; and out of those being benign and pure is bred Scirrhus, Erisipelas, Phlegmon, Blood hot and moist. Oedema. It is hot and moist, which are the two species of its natural and unnatural temper; and as Gal. lib. de Atra bile cap. 2. it is of a very red colour in its humour, and is made of the best of juices, and so bred from the best of tempers, made by a temperate heat; and those are its natural tempers. As of its unnatural, its proper substance is changed, as its thinner part converted into Choller, as Gal. 2. de Differ. where he saith, the thinner part is converted into yellow choller, whilst the thicker turneth into melancholy.Choller hot and dry. Next to this is choller, called by the greeks [...], it being a humour hot, bred out of the thinner and hotter part of the chyle and blood. It hath but few spirits, somewhat of Sulphure in it, most of Salt and Earth. Its parvity of spirits are evident, in that it is of its own nature bitter; neither hath it in it any great quantity of Sulphure, for if we view its masse carefully, it being neither Oleaginous or pingued, neither doth [Page] it soon take fire; yet it taketh Sulphure in it, being principally exalted by adustion, whence it bred this bitterness; and although its salt excelleth in quantity, yet doth it not gain preheminence. Its flegmatick watery substance doth enlarge its liquid faculty; its earthly parts thickeneth it, and gives it the body it bears; its heats and driness are sufficient signs of its being an enemy to the radical moisture, and so unfit for nutriment, that it is declared by all to be excrementitious. This heat is the manifest cause of its bitterness made by a perpetual digestion of the blood;A similitude between milk and choller. thus milk, unless oft times stirred in its boiling, soon burneth and turneth bitter, and as from heat and motion do colours change from white into red; as Quinces being pale by boiling gain a red colour, and chyle turned into blood by circulation and heat; so also choller is as readily discharged of its first taste by adustion and perpetual digestion. As to its uses,Its uses. Aristotle will grant it no waies useful. Coryngius and some others do as much cry up its value, offering that it serveth to warm the liver, and to help digestion. Helmontius calls it the balsom of the blood deduced from the liver to the mesentery; but this is contrary to Anatomy: for Anatomy teacheth, that this [Page] humour is carried out from the liver, not brought into it, but onely sucked up by the Parenchyma thereof, as through a strayner. Others there are also, as Zerbus amongst the rest, that offer, that if the bladder or gall be removed from the liver, the substance of the liver would soon be dissolved and melted. And to conclude this, its most proper use is to render the excrements fluxile.What flegm is. The third is Flegm, by the Greeks called [...]: and this also is of two sorts, natural, and not natural: The natural humour is cold, moist, crude in substance, white in colour, and sometimes sweet in taste: that also properly said to be unnatural, which is void of these, and hence doth it take its several names; as that generally caled a thin serious Flegm, which is endewed with a waterish or windy substance; that called thick and glassy, which is thick, viscous, and mucilaginous, and growing harder gets the name of glassy flegm; if it putrify and corrode, it is called salt, eruginous and corrosive flegm. Again [...]legm is said to be natural, being made in the blood not well digested; and hence Aristotle the 6. Top. saith flegm is the first of indigestions coming from meats; and Gal. 2. de different. feb. cap. 6. whatever humour in our body is cold and [Page] moist, this we call flegm; Avicen Prima Primi numbreth up 8 kinds of unnatural flegm. We may well consider it in respect of its sapour, and of its substance: of its sapour, and here are three differencies, salt, sweet, and sowr; and its insipidness may come in as well; but in respect of its substance, there may be four coupled to the former; and these will make up Avicens 8. Every nutrition is as an assimulation, which nourisheth that by which it is nourished: and as melancholy nourisheth the melancholly parts; so do flegm the articulations: and as this is a cold and flegmatick humour, yet in process of time it is digested and made blood held by some; yet this generation is not to be allowed reciprocally, for cold cannot be made by heat, the humours by nature being rightly disposed; therefore neither can flegm be made of blood; and so will its generation prove it self no waies reciprocal.What melancholy. We come now to melancholy: [...] is said to be either natural, or not natural. That natural which is the faeces or sediment of the blood, or the thicker part thereof, whose colour is black, its taste sowr and sharp, generated for nourishing the melancholy parts. The not natural which wholly doth degenerate from its own nature; it [Page] is a cold and dry humour arising out of the thicker part of the chyle, whose species are four.4 Species of melancholy. First, that is properly called a melancholy humour, in whose proper substance the blood is burnt and made putrid; and hereby is made Bilis nigra, which is acid, and being poured on the ground like vinegar riseth and bubbles up. The second is black choller, made out of the adustion of the other humours. The third species is unnatural, arising with a lapidous concretion. The fourth is when other humours are mixt with this; for then it puts it into its own bitter frame, and makes it a part of erosion. Gal. 2. de Temperament. cap. 3. saith the blood is the best of all juices, and that this is as its sediment. And 3 de Prognost. here he telleth us it hath a double generation, one arising from thick blood being as the lees of wines setling in the bottom; the other from yellow choller being much burnt, which passeth through and burns its parts. The natural is the faeces of good blood, and a superfluity, being compared with the blood. This unnatural is not as an Hypostasis and faeces, but more like a coal or cinder. Helmontius calleth the place, which is generally reputed to lodg this humour, the immediate Organ of the sensative soul, of [Page] understanding, venery, sleep, of various diseases; but these are merae nugae; but according to our later Anatomists it is held to serve for other uses, that it may prepare an acid juice for the fermentation of the whole masse of blood and chyle; and this acid part of the blood it draweth from the heart, and sends it prepared to the mesentery, that thereby the remaining part elaborated from the liver may be more pure and perfect, as Wallaeus observeth; and therefore as the bladder of gall is appointed by nature to be as a proper receptacle of choller strained in thither by the Parenchyma of the liver; so is this settled and perfected in the spleen, by which the spleen it self is made of a blackish blewish colour, and is acid. This acid humour mixeth it self with the blood, both with the vessels and chyle in the stomack, and so rendreth them more thin; for may we not oft find, the spleen being obstructed, that thick humours do course about our bodies? not because these thick humours are drawn from the spleen, but because it cannot communicate its attenuating acid humour to th [...] blood and chyle; and whatsoever of this acid humour is unfit for nutrition, it is sent out and discharged with the serum by urine. And having given you this general [Page] draught of the four humours, and shown you whence they are made, and for what use, how natural and not natur [...]l, I will now show their several natures, consistencies, colours, tasts, and uses in this one following Scheme.

A Particular Scheme of Humours showing their several

Nature.
Consistence.
Colour.
Taste.
Use.

Blood is,
As the Air,
Hot and
moist.
It is of a
mean consistence,
being neither to
thick or
too thin
Red
and
Rosey
Sweet
and
Benign.
It nourisheth the
fleshly parts, and
sendeth forth
its heat and
warmth through
the whole body.

Flegm
is,
Like Water
Cold and
mois [...].
Of a Liquid
Consistence.
White
and
Shining
Sweet
or
Insipid
This serves the
Brain, the cold
and moist parts
it being most
properly Ordered
here.

Choller
is,
Resembling
Fire,
Hot & dry
Of a Thin
Consistence.
Pale
and
Yellow
Bitter
and
Felleous.
This moveth the
expulsive faculty,
attenuates flegm, and
doth nourish
parts of its own
temper.

Melancholly is,
Paynting
Earth,
Cold and
Dry.
Thick
and
F [...]eculent.
Black
and
Ashy
Sowr
and
Pricking
This excites Appetite, nourisheth
the Spleen, and
prepares an acidness for the preventing
of the blood.

[Page] Thus have you a particular Scheme, wherein you may see the rules of nature in well ordering these humours. I now am to conduct you to the general division of praeternatural Tumours which arise from these and the like, it being a most excellent Pilot for conveighing you into the knowing the main of the differencies, effects, causes, signs, and presages of preternatural Tumours, or an exact Master teaching the grounds and choice rules of curing every sort of tumour.

A General Division of Tumours.

The first and general differencies of preternatural Tumours are six.

Plegmone,

Erysippus,

Scirrhus,

Oedema.

These from

Blood,

Choller,

Melancholy,

Flegm.

The One of the Other two Inflation, generated out of a windy matter:

The other Water, and to this belongeth watery Tumours.

We begin with the Phlegmone.

[...] it is made two waies.

One made out of pure blood, and this is called Phlegmone vera:

[Page] The other out of blood mixed with other humours, and this is called Plegmone non vera.

Out of blood mixed with other humours cometh,

Erysipelatodes,

Oedematodes,

Scirrhodes.

Phlegmonous affects are

Panaritium, or a sharp extuberance with pain and inflammation.

Bubo, a simple in [...]lammation of the loose parts.

Phygethlo [...], by the Greeks called Phlegmone Erysipelatodes, and Erysipelas Phelgmonodes.

Phyma, an inflammation of the glandules.

Carbunculus or Anthrax, a Tumour without pustles.

These are the names, and differencies of its names and parts.

These oft follow a Phlegmone,

Abscessus, sometimes coming without an inflammation premised.

Sinus, a profound and cavernous ulcer, which for a while hath lain Obscure.

Fistula, the aforesaid Sinus stretched [Page] out at length, the which not being speedily cured in process of time, grows hard, and runneth into the substance of a Callous.

Gangraena, an imperfect, not absolute, mortification of a part.

Sphacelus, by the Latines called Sideratio, it being a perfect corruption and mortification of the solid parts.

[...], This is the ofspring of Choller: and this is twofold,

1. True and legitimate; and here the cutis is onely affected without ulceration.

2. Not exquisite or illegitimate; where not onely the cutis, but the subject flesh is terrified.

An Illegitimate Erysipelas is twofold.

One bred of thick and sharp choller, exact and sincere; and this is called an Erysipelas with ulceration, the second of Choller mixt with other humours; and then this Erysipelas may be termed Either

Phlegmonosum.

Oedematosum.

Scyrrhosum.

To these also belong,

Herpes Miliaris, bred of the thinner part of choller▪

[Page] Herpes exedens, made of the sharper part of it; and this it showeth by its actions, for it both corrodes and exulcerateth the whole cutis and subject flesh.

[...] This also cometh under a double consideration.

First, as to its symptomes; for it is a Tumour rare and lax, and without pain, bred of a flatulent and windy spirit.

Secondly, as a disease; and thus is its Origination twofold.

First, bred out of flegm alone; for it's [...] Tumour loose, fungous, and without pain, arising from the thinner part of flegm: and this is called Oedema Legitimum.

The second having other humours mixt with it, and thence Oedema illegitimum:

This most commonly beareth these 3 differencies,

Oedema Phelgmonodes.

Oedema Erysipelatodes.

Oedema Scirrhodes.

To these also are related Hydrocele, when a waterish humour is collected in the Scrotum.

Ascites, a waterish dropsie filling the inward membranes of the Abdomen.

Leucophlegmatia, Hyposarca, & Anasarca:

[Page] [...]. This is a hard Tumour without pain.

1. Exquisite wanting sense, and admitting no cure.

2. Not exquisite, not alwaies without sense, but the patient feeleth somewhat of it. The exquisite, as well as the not exquisite, either first, from the begining, do encrease and grow bigger; or else secondly, are so made by transmutation.

Such as grow from the begining are said to be those, which do breed from thick [...]legm, and so are resolved into a thinner substance; or from melancholy.

Its natural for all Scirrhous Tumours to arise from Melancholy.

Some of these are pure, without any mixture; and these are called Legitimi.

Others have other Humours joined to them; and these are named Illegitimi. And these also have their three differencies.

Phlegmonodes,

Er [...]sipelatodes,

Oedematodes.

Such Scirrhous Tumours as are bred by Transmutation, are made by Phlegmon, Erysipelas, and Oedema.

[Page]

Ʋnder Melancholy Tumours are,

Cancer, made without Ebullition;

Phagoedena, with a Tumour;

Malign Ulcers;

Psora;

Lepra;

Elephantiasis, &c.

These do border upon Scirrhous Tumours.

Painful and dangerous affects of the Arteries happening by contusion in the Abdomen;

Enchymomata,

Metasmata,

Aneurismes, painful and miserable Symptomes;

Varices, swellings of veins by thick and grumous blood;

Chaerades, or glandular Strumaes;

Sarcocele or Hernia Carnosa, made when the flesh grows between the coats of the Testicles.

Of Inflations, are Tympanites, or the dry Dropsie.

Strange Tumours in the Penis occasioned by Winds.

Pryapismus,

Sataryasis,

Of the serose Tumours, may be reckoned,

[Page] Hydrocele, or a watery Rupture.

Hydrocephalos, a watery Tumour of the head.

Ascitis, watery Dropsie,

There are other Tumours also, which are very troublesome to mankind, bred out of Humours; as

Epiplocele, when the Omentum falleth into the Scrotum;

Enterocele, when there is an Intestinal Rupture;

Enterepiplocele, when there happens a Hernia of both;

Cirsocele or Hernia varicosa, made by a twisting of the vessels;

Bubonocele, or Hernia Inguinalis;

Omphalocele or Hernia Ʋmbilicalis.

Some also arise out of flesh, as

Sarcocele, being a fleshy Rupture;

Epulis, an excrescence growing in the gums;

Parulis, small abscesses of the gums;

Polypus, an excrescency growing in the nostrils.

In the Head are,

Artheroma, carrying in it the substance of pultice;

[Page] Steatoma, that of fat or suet;

Meliceris, that of Honey.

And thus have I conducted you through the whole Garden of my first scope: wherein you have seen not onely the Origination and Antiquity, Honour, Excellency and Nobility, Learning and Vertue, the subject Matter and Subject, the Constancy & Firmness, the Necessity and Fruit, the Liberality and Charity, of this noble Art of Chirurgery: but also I have shown you what this Art is, of what Parts it consisteth, and to what noble End it was framed; With these also have I presented to you the Chirurgion, and shown you how he ought to be furnished, armed, qualified, and endued: After this conducted you to the true knowledg of Humours, whence they were made, for what use, some of which being and serving for building up our life and growth; whilst others, being planted as vessels of a lower Orb, are imploied for washing, cleansing, and keeping in decency our Channels and other Rooms: With these have I adjoined the natures, consistencies, colour, tastes, and uses of these Humours; and have concluded this Introduction with a general division of Tumours, whence you may gain their several Affects, Causes and Differencies.

[Page] [...] [Page] [...]

[Page] I come now to enter the Stage of Tumours, where I shall act every part in its Order, concluding this Introductory discourse with this saying of th [...] Poet.

Principiis Obsta: sero Medicina paratur,

Quum mala per longas invaluere moras.

OF Preternatural Tumours IN GENERAL.

[Page]

CHAP. 1.
Of the names of such Authors which have writ of Tumours in general.

A Tumour by Falloppius is held to be a Preternatural disease, very difficult because it hindreth construction: and hence it may raise in us a diligent enquiry hereof, how this first happened, what may be the best and safest way to sail herein, what the best order to observe. But before we lanch too deep in this main Ocean, let us take and purchase such Pilots as may safely bring us of from the Shelves and Rocks of fears and distrusts; and amongst the Graecians may Hippocrates and Galen well be call'd for assistance, who writ a Book de Tumorib. praeter naturam; and Paulus Aegi [...]etta. Amongst the Latines are very few [Page] of the Ancients. The first is Octavus Oratianus, Cornelius Celsus, the best amongst them. Of the Arabians are Rhasis, Haliabbas, Albucasis, and Avicen. Amongst our late writers are Gabriel Falloppius, Hieronymus Fabritius de Aqua [...] Pendente, Gulielmus Placentinus, Ambrosaeus Parraeus, Johannes Vigerius, Johannes de Vigo, Johannes Tagaultius and many others. Of our own tongue we have Crooke de Tumoribus & Ʋlceribus, Banister, Read, Paul Berbet, and the like. Let these serve as a small Scheme of such Authors who have already writ of Tumours, from whence we shall derive this method in our beginning of Tumours, first acquainting you with the name of a Tumour; then its essence, and causes; then its difference and symptomes, its signs and presages; and after these its universal cures both as touching general and particular Tumours. Of each of these in their Order▪

[Page]

CHAP. II.
Of the name of a Tumour.

IT hath its name from the Greek [...], which signifies inflammation or extutuberance; and hence by Celsus and Avicen, The name of a Tumour. a Tumour is said to signifie a preternatural extuberance, and by Galen is called [...], Tumor praeter naturam; by the Asiaticks [...], as it were a condensed or conglobated matter; by the Arabians Apostema, which by the Greeks signifieth an Abscess, which is a substance converted into Pus, or as Aqua pendens calls it, an eminency of the body; this I call a preternatural disease, in which some parts of the body are indecently extended, being hereby unfit for performance of their proper action. Hippocrates doth christen all Tumours with the name of Oedema. Its difinition. Galen appearing somewhat doubtful and incertain, doth sometimes reckon this amongst diseases of the similar, sometimes amongst the Organick parts. Haliabbas is of his Opinion. Guido defines an Aposteme a disaffection composed of three sorts of diseases, aggregated into a bulk. And Avicen thus expounds them, ill complexion, [Page] ill composition, and a common solution of Continuity which is found in every Tumour. Tagaultius, after Guido, defineth an Aposteme to be, an Inflammation made in a member beyond its proper nature and form. Falloppius holdeth a preternatural Tumour to be a Disease in magnitude, and therefore simple and onely consistent in a great extention. Fabritius de Aqua pendente, offereth a preternatural Tumour for the most part to be a compound disease, and taketh its denomination from that which hindereth action. Read calls it sometimes a Disease; sometimes holds it to be a light Affection, for the most part incident to the Organick parts encreasing their quantity by superfluous humours. Or, if you please, after all these you may take a preternatural Tumour to be, a material Intemperiety dissolving the Union of the parts▪ and sometimes hurting them in magnitude, figure and sight.

[Page]

CHAP. III.
Of the Causes of Tumours.

A Tumour is said generally to have four causes attend it,4 Causes of Tumours. as a Material, Efficient, Formal and Final cause. By Guido the first is called the conjunct cause: The second, when Nature frameth any part so weak, as that it is not able and strong enough to keep the excrements of other parts out of its territory: A third cause, when any part of its substance is too rare or loose: & the fourth is a natural Humidity with exemplification of the part. Another cause may be said to be the Site of the part; for the upper parts are said to be less capable of receiving humours, than the lower part.6 Heads of T [...]mours by [...]. Falloppins offereth six heads, as so many Observations of Tumours. The first, when it begins to putrifie, it spreds and extends it self speedily, and suddenly groweth into a lump or masse. Secondly, there are Humours which [...]ake Tumours, and these are either [...] or preternatural. Thirdly, when some parts change and remove themselves [...] of their proper places into other [...] strange places, as you [...] in Rupt [...] and Dissocations. A fourth is such [...] mours as are bred of waterish [...] [Page] as Hernia Aquosa, Ascitis, and the like. A fifth when vapours wind and the like either naturally or preternaturally do frame a Tumour. And the sixth is that which maketh the body unnatural to it self, as Sanies, Excrements, and the like. But to bring this discourse of Falloppius to one head, you may find six Humours generally in our bodies, of which are generated these six Tumours, as out of Blood, Choller, Flegm, Melancholy, Wind, and Water, Phlegmon, Erysipelas, Oedema, Observation of Falloppius. Scirrhus, Pneumatocele, Hydrocele. Besides these we have Insects and other Animals, that very oft times are the occasions of Tumours: as Falloppius once observed in a Maid, who having a large Tumour about the Inguen, the Chirurgion in his presence opening the same saw it filled with Worms. Amongst the primary causes may well be reckoned Air, for out of its Contagion ariseth many Tumours. Secondly, Contaction, as a cold Stone may occasion a Tumour:A History. and for this Falloppius brings in another story of a Woman, who sitting upon a cold stone was afflicted with a cold Tumour. And a third may be solution of continuity, and this proveth either occult or manifest; thus after fractures we oft times find large Apos [...]emes to appear, [Page] and what was the occasion of Luxation is very oft also the occasion of Tumours; as too much contracting or binding of a part may occasion a Tumour, as Gangrene, biting of Beasts, taking of offensive things inwardly, these being sufficient matter for Humours to breed from.The causes of Tumours are either congestion or Fluxion. If a Humour do suddenly excite a Tumour, this is its evident cause, and the cause hereof is either Congestion or Fluxion.

The one when bred & carried in the part onely, whilst the other maketh its further progress by Fluxion, as Aqua pendens observeth. And therefere as he adviseth, we ought well to consider the part mit tant, and the part recipient; for the matter doth not move it self, but is moved by some other, as by the part mittant per [...], and by the part recipient per [...]. The mittant part ought first to be strong and able to expel the supersluities, as the attractive is made by the part recipient. And this bringeth me to the inward causes;Inward causes. and here sometimes the matter is hedged into one place, so that it cannot make its exit: Another may be its passage out of one place into another, and this is properly called Fluxion a Fluendo from thus [...]lowing; and as intemperiety is the cause of pain or solution [Page] of Continuity, so also is this intemperiety made either by outward or inward causes.

CHAP. IV.
Of the Differencies of Tumours.

THE true Differencies of Tumours by Aqua pendens are generally taken from these two Fountains, as from Humours, and the depending parts; and from these two do arise the cheif intentions in Tumours.Falloppius offers seven things as touching the differencies of Tumours. Falloppius doth offer seven things, which belong to the Differencies of Tumours. First a disease, when it receiveth more or less: Secondly the material cause hereof diversified, and then are its Species and Differencies diverse: Thirdly when the efficient cause, when manifold, doth draw many species to it: The fourth is the Fountain of accidents, which followeth the disease: The fifth the time, which is the cause of all the differencies of Tumours: The sixth the subject of the Tumour: And seventhly the motion of the disease; for it is as its owner, and moveth as he moveth. Besides these are we to consider of the times of diseases; for some are short, some [Page] long, some quick, others slow; and therefore are we well to understand their diversity of times. Hence also are we to consider the largness or smalness of a Tumour; and its species, without the knowledg of which we cannot be said to understand the curative method; its causes, which are conjunct with the disease; the circumjacent parts, and the symptoms which do follow, either from the nature or cause thereof; and lastly the signs. And when we have thus far arrived, we are to consider the four great Tumours in general; as Phlegmon, it being as our first to treat of, it proceeding of blood, the Son of nature generated for the treasure of life: Secondly, of Erysipelas, arising from choller, the fury of the gall: Thirdly of Oedema, coming from Flegm, the proper instruments of the joynts: Fourthly of a Scirrnus, bred of Melancholy, the lumpy and terrene masse of the rest. Of every of these are bred various Tumours, according to their various shapes and changes: but of these in their proper places.

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CHAP. V.
Of the Ʋniversal way of curing Tumours.

HE that will undertake the curing of Tumours, ought well to understand his curative scopes and intentions; and the well timing of Tumours is a very great matter here. And here may we expect a Tumour either already made, or in its making: And hence ariseth a double intention; the one prohibiting Fluxion, whilst the other cure is wrought by discharging the matter already flown; because removing of causes do hinder Fluxion. If this happen from Plethory, breathing of a vein is very proper; whilst in a cachochymick body purging is as useful. When a Tumour doth proceed from Fluxion,From whence cometh our first intention. we are to begin our cure from the matter flowing, and hence cometh our first intention; and this is performed by Repellers, Revellers, and Interceptives, save onely in these seven cases set down as our seven cautions by Galen. Galens 7 Cautions. First when the matter doth flow to the Emunctories or glandulous parts: secondly, when a venenate matter floweth; for this sends it more inwards and [Page] so poysoneth the heart: Thirdly, when this matter floweth Critically, not crossing Nature in her own way: Fourthly, when Fluxion is excited in a Cacochymick body: Fifthly, when the part, to which this matter maketh its Flux, is weak, and its heat but mean: Sixthly, when there is vehement pain, for here is more need of anodynes; and then seventhly, when this Fluxion is near some principal part. And as touching these curative scopes, we are first to probihit its Origination, and by this means to hinder its augment; secondly, to understand the quality of such things as are to be applied; for as Galen saith 13 Method. 16. we do destroy the breed of a Tumour, if we well understand its cause; and this being ablated, the Tumour is soon seen to vanish. Fluxion and congestion are the two cheif causes of Tumours; the first offending either in Quantity or Quality, and so with violence doth seize suddainly upon any member, either by reason of its loosness or weakness; Congestion being, when a Humour is gathered into a part gradatim by reason of this weakness of the digestive and expulsive faculties.

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CHAP. VI.
Of Phlebotomy, its manner of Operation, and where it is most properly performed.

IN this Discourse we have many things do offer themselves to our consideration: As when there is a fulness, Evacuation is in use; and here is to be let out as much as is necessary: If there be a Plethory Quoad vires, here it is to be repeated. And as touching the part which is to have the lancet exercised on it, whether from above or below, this also is to be minded and regarded; because Derivation, which Evacuation from the adjacent part doth not, agrees in the beginning of the cure; because this would make the Fluxion larger, and the Attraction to the part affected greater. And if we will make Revulsion aright,Note. we ought well to understand the place of Fluxion, that we may happily revell in the opposite part: Thus if the right kidney be hurt, we open a vein in the left arm; in Tumours of the groin vena Poplitis. And if any may question our meaning between the upper and lower parts, Galen himself giveth them this answer: [Page] All the parts above the navel, including the Liver and Stomack, are called the upper parts; and thus have we one part of the vena Cava called the ascendent Trunk: the other below these are properly called the lower parts. This knotty difference between Repulsion, Revulsion, and Derivation is not very easily untied; I shall thus endeavour to loosen it. Fluxion arising from Expulsion showeth expulsion: if it followeth from the quantity of matter, this is either to be revoked or evacuated; and hence ariseth this twofold intention, Revultion and Evacuation. This being out, another thing is to be observed, the matter that slows hath three places, one from whence it floweth; the second whither, and this is to the part affected; and thirdly through what parts, before it arrives hither. These being found out, we are to consider how to discharge this matter, and thereby prevent its further spreading; secondly we are to prevent the Fluent matter, which hath got passage into the channels, that it flow not to the part affected, and so run this also into a Tumour. And the well consideration of these may well make us use study, where, and when to make this Revulsion; and where to make evacuation. And in both of these [Page] we are to observe Hippocrates Rule,Hippocrates his Rule. that all be done secundum rectitudinem: and this is to be performed two waies, as by comparing the left with the left, and the right with the right; for with these there is held a proper consent. Thus the Liver vein hath a rectitude with those veins which ascend up to the head. Thus upon an immoderate Flux at the right nostril by applying a cupping glass to the Region of the Liver, the Flux doth suddenly stop; if the left, by applying one to the spleen doth work and perform the same effects. Galen hath also two species of Revulsion, the one from the upper parts to the lower, from the right to the left; the second not so exact, which we use when the matter is much, and threatens danger. Galen also in diseases of the upper parts doth revel by opening the upper veins, as in Tumours of the head he doth order the Cephalick vein to be opened: and Falloppius saith in a Squinancy he hath breathed the left arm, and the Humour presently vanished; and in some cases this is very proper. In Tumours of the Axillaries being venenate, if we should open the lower veins we must consequently draw its venome inwards to the heart; and vice versa, if we should open the upper veins [Page] in a pestilential Bubo, we may well make a free passage for the pestiferous matter to make its address to the heart, which is not onely a great fault in the Chirurgion, but also as unhappy to the Patient. And thus have I shown some of its benefits. I now come to teach the young Chirurgion how he is to use his Lancet,How the young Chirurgion should open a vein. and prepare himself for this Operation. First let him make a pretty strict bandage, a little above the elbow of that arm which he intends to bleed; not too strict, because he will very seldome hereupon but meet with obstruction in bleeding, the Artery being too close girt that it cannot discharge it self into the vein. And as to his Lancet, let him make his apertion a little sloping; or upon placing it a little obliquely, let him get his Lancet into the vein, and so lift it up, not penetrating too deep, lest he commit those errours which daily are acted by ignorant Pretenders and Quackes, who oft go so deep, as that they prick an Artery, and so cause Aneurisms and pains. Let the Orifice that you make, be neither too great or too small; the first endangering the Division of the vein, whilst the second runs it into a Tumour. Here also is he to judg of the goodness or badness of the Blood, and so according to his judgment [Page] may take away more or less; and also considering the necessity of the disease, the strength of the Patient, and the quantity and quality of the Blood. The veins which are generally opened are these the Frontal vein, one under the Tongue, the Cephalick, Mediana and Basilick; but of every of those in their order, and as necessity requireth. The Frontel vein is most properly opened in infirmities of the Face, and in pains of the Head. Two veins of the Temples opened in continual Head-ach, in distillations of the Head and Eies. The veins under the Tongue in Anginaes, Apoplexies, pains of the Teeth, the Jugulars, good in preventing suffocation, Squinsies, Asthmaes, Dyspnaea and the like. The three in the Arm, the first being the outward or Cephalick, this may safely be opened in distempers of the head, as Mania and other hot passions; The second Mediana, so called in respect of its Scituation, being made both of the Cephalick and Basilick vein, in opening of this vein is made a general evacuation of Humours; this oft times opened in pains of the breast, and Pleurisies. The third is Basilica, or Hepatica, by some called Axillaris, this dischargeth those parts which are beneath the Neck, as the Brests, Sides, [Page] Liver, Spleen, and Pleurisies. And this note of the three in all sicknesses, and times, except in time of Pestilence, That vein is to be taken, which is most full and large. In the Feet also are three veins Ischiatiea, Saphaena, and vena Poplitis: these or some of them are generally opened in Obstruction of the Monstrues, in bringing them down, pains, stoppings, swellings and the like. I shall conclude this with these directions. In an Apoplexy open the Cephalick vein; if this appears not, open the Mediana: In a Lethargy open the Frontal or Cephalick vein: In a Squinsey those under the Tongue: In a Pleurify the Basilica, and here bleed while the Blood doth change its colour: In diseases of the Lungs vena Axillaris or Mediana: In inflammations of the Liver Basilica or Hepatica: In obstruction of the Spleen the Basilick or Hemorrhoidal veins: In diseases of the Womb the Sciatick vein: In restraint of Menstrues Saphaena: In pains of the Hips first open the Basilica, then the outward malcolus below.

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CHAP. VII.
Of Evacuation of matter erring in Quality.

IF a Tumour or Fluxion happeneth in respect of matter not onely erring in Quantity, but also in respect of Quality, that this may be discharged we are to consider two things: First, whether this matter may be altered, as if hot cooled, &c. Secondly to remove the subject matter hereof, and in the first, if Plethory, Phlebotomy is proper; if less, Pharmacy is most convenient: And herein are we to observe these two Rules, that the matter may first be educed or sent forth being contrary to the true genus of the part, and then, if it doth still remain, to alter it. The most proper way to deal with this is by our later writers found out, which is by discharging the body hereof by purging Medicines, which do work both quickly and safely, ordering the strength of the Medicine according to the vigour and strength of the Patient:If the thin matter cannot be digested, it is to be revelled; and bow this as to be done. and herein also are we to mind the motion of the Blood; for if it doth move to the eies, this is to be revelled, first by Cuppingglasses without Scarrification, Secondly [Page] that the parts ought to be rubbed for the better thinning the Humour, thirdly frictions which are proper for revelling from the Center to the Circumference; And Galen nameth the last when parts are obstructed, we ought to obstruct with Medicines; but these are tedious, painful, and troublesome. Our later Writers have found out better means and methods, as by washing with warm water, which doth revell by opening the pores; another sort is by vesicatories, and these are in great use in Apoplexies,Observat. Rheumatisms, or Distillations; the third and last is an actual Cautery and Fontinels, and Setons very much in use in our times. And in all these we are to observe, that Revulsion doth take its indication from that part from whence the Humour sloweth, not from the Humour flowing, and this being known we are to understand the parts which we are to revell.

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CHAP. VIII.
Of a Tumour, the part affected drawing to it self Preternatural Bodies.

THE greatest occasion or cause of attraction in a Tumour of a preternatural body is cheifly to be attributed to Laxity and Intemperiety of the part, and pain. This Intemperiety is therefore first to be removed, by running it into a better temper. And this may be executed with oyl of Roses, Violets and the like, having fine linnen rags dipt therein and so applied; and these are oft to be repeated to prevent inflammation: For this use also Ʋnguent. Rosatum Refrigerans Galeni, Populcon, Album Camphoratum. If pain occasioneth this, we are here to give ease by Anodynes according to Galen 13. Meth. 1. and if any preternatural bodies offend, discharge them, either by Medicine or Instrument: if pain cometh from venome, cure this as you do venomed bodies; and herein also are you to consider the times of the poyson, for the longer it hath got room and entrance, the deeper doth it imprint its venomous Qualities and Effects. In this case Venice Treacle, Methridate and the [Page] like, are very good, Spirit of Wine, here also is very proper. And thus are we to vary our methods according to the variety of our Objects. In venenate distempers, in cold poysons, we use hot Medicines; and in hot poysons on the contrary, cold Medicines, as Rue, Frogs, Scordium and the like, commended by Dioscorides. Galen doth furnish us with many pleasant stories of poyson, and amongst the rest, he doth offer, that if any be bitten with a Scorpion, if the same Scorpion be taken, opened, and applied to the part affected, it draweth out its own poyson.Observat. This generally being here observed, that before you apply any Medicine to the poysoned part, you first well foment the part with a hot and sharp Lixivium; and when the place beginneth to grow red, to apply your other Medicines, as for example.

℞. A Lixivium. Fob. Absynth. Scord. Rut. Angelic. Hyperic. Salv. Agrimon. Veronic. au. M. j. Rosar. Rubr. m. ss. Scabios. Menth. Meliss. an. p. ij. coquantur omnia in Lixivio q. s. colaturae adde Spirit. vini lbj. with this foment the part, and then may you use such proper and mundifying Medicines as are most requisite, as ℞. Ʋrguent.Urguent. Basilicon. Bu [...]r. recent. au. ℥ss, Ol. Amygdal Dulc. ℥j. Theriac. Andromach. [Page] ℥j. cum Vitel. Ovor. nov. ij. misce, fiat Ʋnguent. Or this. ℞. Pulv. Mirrh. Alo. Aristoloch. Rot. Irid. Florentin. Angelic. an. 3j. Theriac. solut. in aqu. vitae 3j. cum mel. q. s. fiat unguent. Or this. ℞. Pulp. Caricar. ℥iiij. Ferment. act. ℥j. Sinap. 3iij. Sal. gem. torrefact. ℥ss. Sal. commun. torrefact. 3j. Sapon. moll. Theriac.Catapl. an 3j. Vitellor. ovor. no. iij. Ol. Lilior. alb. q. s. fiat Cataplasma. Or this Emplaster of Falloppius.Empl. ℞. Pic. naval. ℥j. Sal. nitr. ℥ss. Sem. Sinap. 3ij. Caepar. Allior. sub prunis coct. an. ℥iij. Assafaetid. Sagapen. an. 3iij. Stercor. Columbin. ℥iss. Aristoloch. rotund. Dictam. Cretens. an. 3j. Ol. Lilior. q. s. fiat Empl. If all these fail, apply live Pigeons opened to the part affected; and if these do not answer expectation, make a speedy address to the actual Cautery. If made by loosness of a part. Another cause hereof is loosness of the passages, the which, unless they be stopped, do make a Tumour: as if an Humour do flow out of several parts of the body into one particular part, unless this be altered, it is very easily raised up into a Tumour; if this happeneth with an Intemperiety, we are to mix restringents with coolers, as thus in Fluxes of the Head, take this for a defensative.

[Page] ℞. Unguent. Pulv. Rosar. rubr. Myrtillor. Balaust. Gallar. Mastich. Sang. Dracon. Bol. Armen. Oliband. Santal. omnium an. 3j. Ol. Rosar. q. s. Cer. alb. parum Acet. rosat. ℥ss. misce & coquantur omnia ad aceti consumptionem, his addere possis albumin. Ovor. no. j. vel ij. Or this. ℞. Pulv. Santal. omn. Sangu. Dracon. Bol. Armen. Pic. Colophon. an 3j. his adde Empl.Empl. Diapalm. ℥j. Acet. 3j. misce, fiat Empl. And these are proper Medicines here, and by Galen called strengthening as well as restringent Medicines, because they strengthen by compression, as Gal. 2. ad Glauc. 14. And having thus passed over the general Indications arising from the matter of a Tumour, and its curative scopes as Phlebotomy and Pharmacy, we come now to treat of the four times of Tumours.

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CHAP. IX.
Of the four times of a Tumour, and first of its beginning.

THE knowledg of these times are very proper for our Diagnosis, Prognosis, and Cure. They are four in number, Beginning, Augment, State, and Declination. That time most properly called the Beginning, when a part begins to tumefy: thus if a Tumour be made in a recipient part, Expulsion and Repercussion is the Intention; and this Repercussion is nothing else but Illision and Impulsion of the Humour, which floweth either from the whole body or some part thereof into the affected part. This Repulsion is a double motion from the part hurt, and from another part sending to this hurt part. And here we are to advise, that when members are loose and soft, then are we to strengthen with Medicines of a contrary affect,Observat. that is with such Medicines as are compact and dry. Gal. 14. Meth. cap. 17. saith that pure cold things do repel, as cold water; and he there adds that others which are not cold yet are restringent, as Mint, Roses, Wormwood and the like, and these he [Page] saies do repel: these for the most part are to be used in the beginnings of Tumours, but not alwaies in every kind of Tumour; For experience teacheth us that in Pestilential or Venereal Buboes,Observat: if in the beginning we should apply repelling Medicines, we should send the peccant matter to the heart.In 6 cases no Repelling Medidicines to be applied in the beginning: In these six cases apply no Repellers in the beginning: as if it be bred by a venenate matter, and repelling here you soon do shut up the doors of life. If the matter be critical, yet this doth not alwaies deny Repulsion; for in a violent Fever, in which it happeneth that the matter doth send it self to the membranes of the brain, in this critical case the Fluent matter is to be repelled, lest otherwise the brain becometh inflamed. And then when this Tumour happeneth either in a Cacochymick or Plethorick body. When the matter sloweth to the emunctories, we are not to repel, as Galen adviseth 6. de Comp. per loc. cap. 2. Then when the part into which this Tumour hath got footing groweth weak, as Galen also hath it, Meth. 13. cap. 7. And lastly when pain and exasperation of the part is present, for then Anodynes are more proper, as Galen citeth 6. de Comp. Medic. these I have formerly shown you in the differencies [Page] of Tumours; but this being their more proper place to bring them into, I have also here given you their brief repetition, and in all other causes we may and ought to come to use Repellers in the beginning of Tumours. Avicen speaking of repelling Medicines ordereth us not alwaies to use one sort or kind thereof, but in cold cases to use hot Repellers, and in hot cases to use cooling Repellers. Now if pain ariseth in the beginning, and draweth somewhat of Humour to it, here are you to use mild Repellers, these being of a sufficient capacity to lenify the parts being stirred up by pain. Such are Lettuce, Purslain, Trifole, Nightshade, Endive, Violets, and Plantane; these being endued with a waterish moisture do much better in this case, than such which are two astringent. And out of these may you frame many sorts of Medicines by adding thereto Oyl, Water, Vinegar, and the like. And of these may you make stronger or weaker Medicines as occasion may require: as, ℞. Malvar. Parietar. Plantag. an. Cataplasma▪ M. j. coquantur in aqu. fontin. & contusis adde farinae Fabarum, Hor dei an. ℥iss. Pul. Rosar. rubr. ℥ss. Ol. Chamomeli. ℥iiij. cum decocti. praedicti q. s. addendo fl. Chamomel. Melilot. in pulv. a[Page]ʒj. fiat Cataplasma tepide admovendum.

CHAP. X.
Of a Tumour in its augment.

THE Augment of an Inflammation or Tumour, as Gal. hath it cap. 4. lib. de Morb. Tempor. is, when the Influx hath ceased, and the part affected Tumefies more than it did formerly. And the reason hereof by Aquapendens is, because the blood prolapsed out of the vessels doth necessarily grow hot and putrify, whence the blood is poured out and converted into a Spirit. A [...]cen saith that the Augment is then most properly to be so called, when the Tumour encreaseth so that it is extended. We may know when Tumours have arrived at their Augment by their causes and Symptoms, by comparing its times; and therefore here our intention is two-fold, for that some part hath already made its Flux, and other part is still to make; and this requires two scopes, to remove the compacted matter, and that we take away the cause hereof. We have already discoursed of Repulsion, we [Page] more properly in this place and time speak of Digestion or Discussion.Here Digestives are most proper. This Digestion is an Evacuation of a thin matter gathered in a part by insensible Evaporation, procured by the natural heat, encreased by proportionate Medicines. And this is said to be performed four waies:Four waies of digestion. for first, the Humour is to be made thin, then resolved into a Vapour, afterwards drawn from the Center to the Circumference, and lastly expelled or thrown forth by the pores of the Skin; and these therefore do show that the proper Medicine to be here used is to be a Digestive, a Medicine hot and dry in the third degree, and of thin parts. Of these Digestives some are mild, some strong; some simple, others compound. Of the simples are Dill, Rue, Chamomile, Ammoniacum, Galbanum, white Lillies, Lupines, Fenugreek and the like. Such as are stronger are Time, Origanum, Mint, Pennyroial, Hyssop, and the like. Of the strongest sort are Sulphur vivum and Chalk, &c. Of the compounds. ℞. Malv. Dialth. Absynth. Lilior. Albor. an. M. i. coquantur in aqu. fontin. q. s. colaturae adde Pulv. Rosar. Rubr. ʒij. Pulv. Absynth. Puleg. Fl. Chamomel. Melilot. Catapl. an. ʒij. farin. fabar. Lupinar. Hord. an. ℥iss. cum ol. Chamomel. ℥iij.[Page]misce, fiat Cataplasma. Ever observing this,Observ: that according to the strength, Age, Temper, and Constitution, of your Patient, you endeavour to regulate and order your Medicines. If the former will not serve, you may make use of this Empl. ℞. Farin. Fabar. ℥i. Farin. sem. lin. ʒij. Empl. de mucilaginib. ℥i. Melilot. ℥ss. Pulv. Sem. Cumin. Absynth. a. ʒi. cum Ol. Chamomel. q. s. fiat Empl. Or this. ℞. Fol. Mal. Alth. Violar. an. M. Catapl: i. Rad. Alth. Irid. Lilior. Alb. an. ℥ss. fl. melilot. Chamomel. Aneth. an. p. i. Cumin. ℥i. Bacc. Laur. ʒij. Croc. ℈i. cum Adipe Anatis Anserini Butyri recentis ol. Lilior. an. ℥i. M. fiat Catapl. Or this of Aquapendens. ℞. Myrtillor. Lactuc. Catapl: Solan. a. M. i. Puleg. Calamenth. Hissop. an. M. ss. coctis & in aqua contusis adde Farin. Faenugraec. ℥iij. Pul. Betonic. Chamomel. an. ℥i. ol. Anethi Chamomeli a. ℥iij. cum decocto praedicto fiat Cataplasma.

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CHAP. XI.
Of a Tumour in its State.

THEN is it properly said to be in its State, when it can reach to no higher degree, the beginning of this State doth carry with it some rellish of the Augment; and here therefore are Anodynes and Digestives proper being equally mixed. In its middle you are to mix more of the Digestives; and at last to use Digestives altogether. It is in this state, that the matter is very near digested and converted into Pus. And these have sharp Symptoms attend them: for while this pus is making, there are Fever and pain as two inseparable companions that go along with it, these in its declination taking their leave with the Tumour.Observat: And this we are to observe, that when nature digesteth, we ought to help her forward in her designs. But a Tumour is very oft times seen to terminate into many other diseases; and herein we are to consider the Pulsation, if it hath been long, if pain be not diminished, when the heat endures, then is its transition to be expected; and where any one of these are, it is an evident sign there is [Page] matter at hand, against which we must be prepared, and so mind the symptoms, as Pain, Tension, Hardness, Heat; for these are toublesome companions, and then are we to assist nature in the discharge hereof, taking away their causes: which is to be performed by Medicines, as this or the like. [...]. ℞. Ol. Chamomel. Rosar. a. ℥iij. farin. fabar. pul. fl. Chamomel. an. ℥ij. Hyssop. ℥iss. Sapae dulcissim. ℥10. misce, fiat unguent. Or this Catapl. ℞. Lapath. Parictar. Chamomel. Melilot. Catapl. an. M [...]ss. Rosar. Rubr. pug. i. fl. Melilot. Chamomel. an. p. i. farin. H [...]rd. pug. iij. cum. s. q. aquae fontinae, fiat Catapl. Catapl. Or this. ℞. Fl. Chamomel. Melilot. an. pug. ij. Herb. Chamomel. M. i. Coquantur omnia cum Radic. Lilior. Albor. ℥iiij. & simul contusis adde farin. faenugraec. ℥ij. ol. Aneth. Chamomel. an. ℥ij. Vini albi. q. s. fiat Catapl.

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CHAP. XII.
Of a Tumour in its Declination.

WHEN all the former Symptoms do abate and cease, then we generally hold we have arrived at the Termination: and here according to Gal. cap. 1. lib. 2. [...]. we are to use purely Digestives or Discussives; and these are to be so much the stronger, the declination of the inflammation being in its progress. And in this part these two Cataplasms are very proper. ℞. Hyssop. Origan. an. M. i. coquantur in vino albo, & simul contusis adde Ol.Catapl: Lilior. Albor. ℥iiij. Pulv. Puleg. Absinth. an. ℥ss. Farin. Faenugraec. ℥iss. misce, fiat Cataplasma. Or this. ℞ Alth. Malv. an. M. i. fl. Chamomel. Melilot. Rosar. Rubr. an.Catapl: pug. i. Rad. Lilior. & Alth. an. ℥i. Sem. Lin. faenugraec. an. ℥ss. Ficuum pingu. no. 10. furfur. farin. hord. tritic. an. pug. ij. contusa coquantur in aqua ad mellis crassitudinem, fine addendo ol. Chamomel. Axung. Porcin. an. ℥iss. misce, fiat Catapl.

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CHAP. XIII.
Of a Tumour tending to Suppuration.

THE true waies and methods of curing Tumours we have already shown; but it oft times doth happen that a Tumour doth tend to suppuration, that is the influxed Blood is converted into pus or matter; whence doth arise another method of curing. And here Galen doth propose two waies, which are performed either by Digestion or Concoction: but the first is the best; for these two things follow concoction, two much generation of this matter, and an Abscess made hereof into another place. In respect of its generation its long in curing: in respect of the Abscess the Inflammation oft times doth run it self into another disease; as oft times into a Gangrene as Jubertus, observed in the wife of Rondeletius. As touching the efficient cause of Purity or Matter,The efficient cause of matter. Gal. offereth lib. de inaequ. intemper. cap. 3. that in an inflamed part there is found both a native and an extraneous heat; the first preserving the part, and doth administer such things to it as belong to its health and welfare; [Page] the other Extraneous, ariseth from the influxed Blood, prolapsed out of the vessels, and there putrifying, this being contrary to the former, and so doth destroy and pull down or extinguish the natural heat. The first matter is thick, laudable, white, equal, well tasted; but if the other prevail, it appears livid, red or black, thin, inequal, grumous. The Tumour offers it as a sign of its tending to suppuration by its intenseness;Signs of Suppuration. and when the inflammation is great, and the pain vehement and doth daily encrease, and when pulsation joins with this Tension and this be large, when these signs are at hand, use neither repelling Medicines nor Digestives; but use your greatest care to assist nature in her progress of suppuration by maturating Medicines, that is, to prepare the matter and make it fit for expulsion, and then to discharge it when we have thus prepared it. And that therefore we may procure the Tumour for this suppuration, and produce a good and laudable matter, we are to encrease this Quantity of native heat, by such Medicines as are of a digesting faculty, the which ought to be of the native heat with the part. These are to be applied from the beginning of the Augment to the end [Page] of the vigour. Some of these are simple, as Marshmallows, [...]iggs, Chamomile, Galbanum, Bdellium, Ammoniacum, Hogs lard, Goose grease, and the like. Of the compound may be reckoned Empl. Diachylon cum gummi, de Mucilag. Flos. Ʋnguentorum, or some of these Emplasters or Cataplasms: Of which for this use these may be applied very properly. [...]. ℞. Empl. Diachyl. cum gum. ℥i. De Mucilag. Parac [...]ls. an. ℥ss. Basilicon. ʒi. Croc. ℈i. cum Vit [...]l. Ovor. no. [...]. i. misce, & fiat Empl. Or. ℞. Bdell. Ammoniac. an. ℥ss. Solventur in Lixivio claro, adde Calc. viv. cum Axung. contrit. Catap [...]. ʒi. Sulphur. viv. ʒss. Alumin. ℥ss. mel. Opt. ℥iss. ferment veter. ʒij. misce. ℞. Rad. Lilior. ℥i. Alth. cum Rad. Malv. an. M. ss. fl. Chamomel. Melilot. an. pug. i. Ficuum pag. iij. sem. lin. faenugraec. an. ʒiij. fiat decoctum in vino albo q. s. & colaturae adde Vit [...]ll▪ Ovor. no. ij. Croc. ℈ss. Ol. Cham. Melilot. an. Catap [...]. ℥ij. misce, fiat Cataplasma. Or. ℞. Rad. & fol. Alth. Malv. an. M. i. Coquantur, & pist [...]tur ut artis est, quibus adde [...]arin. Tritic. ℥ij. farin. sem. Lin. [...]e [...] graec. an. ℥i. Butyr. recent. [...]l. Lili [...]r [...]. alb. Ʋnguent. Dialth. an. ℥iss. Croc. ʒss. vitell. ovor. no. ij. misce, fiat Catapl. The matter by these, orany of these, or [Page] the like being brought to Suppuration, this is to be discharged, and this generally is to be performed by Incision or Caustick. And before we attempt either of these, we are well to understand whether it be ripe enough,A method to find whether a Tumour be ripe enough to open. and this you may thus find out. The Tumour at this time seeming by contracting it self to appear less than it was in its state, then it draweth it self to a point, its hardness is much abated, and therefore discussed, and by touching it with the finger we find it Fluctuatous, the heat and pain ceaseth, the part is changed in its colour, the Cuticula is shriveled, all these being good signs of its Suppuration. This not being all drawn out, you are to arm your Tents or Pledgets with this or the like. ℞. Terebinth. Venet. ℥i. Mell. ʒij. succ. Ap. ℥ss. Farin. Fabar. ʒv. misce, fiat Linimentum. After the Application of which apply Diachylon cum gummi or Empl. de Mucilaginibus. All these being discharged, and the Orifice being well mundified and deterged, your next business is by the helps of Sarcoticks to fill up with flesh, as Ʋnguent. Basilicon. Aureum, and the like, and then with Epouloticks to induce a Cicatrice as with Ʋnguent. Diapompholigos, Desiccativum, Rubrum, Sanativum, or Diapalma. [Page] And thus have I run through the four times of a Tumour; and because a Phlegmon doth bear the greatest share in these four times and orderings, I shall be much briefer in its discourse and so proceed.

CHAP. XIV.
Of a Phlegmon or Inflammation in General.

IT is by all Authors granted that a Phlegmon hath its four times, and that out of Blood besides this doth arise several other Tumours, as a Carbuncle, Gangrene, Sphacelus, Pernio, Phyma, Phygethlon and several others. And here let us first inquire what a Phlegmon is,What a Phlegmon is. and whence derived. It taketh its name [...], which signifieth to inflame. This is an Intemperiety not only of the simple but also of the Organick parts, as Galen observeth in 13. Meth. Our latter Writers do make two distinctions about the material cause hereof, the Blood being either natural or not natural; the natural furnished with these conditions, being of the same Blood with that which cometh from the Sanguinary mass, having [Page] in it the four Humours and these Qualities, as being hot in action, and moist in consistence, in colour red, in taste sweet; the unnatural being denied of these good Qualities, and also devested and deprived hereof.Whence it ariseth. Thus out of pure and benign Blood ariseth an exquisite Phelgmon: if this Tumour hath any other humours annexed or joined to it, it occasioneth a various species of Inflammation; as having Choller admixed, it maketh Phlegmon Erysipelatodes; if Flegm, Phlegmon Oedematodes; if melancholy, Phlegmon Scirrhodes. Besides these also, other accidents belong to Inflammation; for if an inflammation doth get into the membranes of the brain, it maketh Phrenitis; when it creepeth into the Tunica conjunctiva, there it frameth Opthalmia; when into the Fauces, Angina; into the Pleura, Pleuritis, and so into the Emunctuories, Bubo. Its causes may arise either inwards or outwards:Its causes: Inward causes are Plethory or plenty of Blood; and this not having its free passage must necessarily inflame and putrify, inflamed heat in the Sanguinary masse, and this oft times doth exalt it self into Fevers, the part hot and painful doth draw the Blood, and this maketh up the Inflammation. Outward causes [Page] may be said to be Aires, which do inculcate and shut in this putrid matter; Attrition, Attraction, solution of Continuity or Luxation,Signs: these or any of these causing pain and so Inflammation. As to the signs, when you perceive a Tumour is soon made, and doth soon encrease, you may properly judge this an Inflammation; when the patient doth perceive a great heat, and burning arising from this heat, the colour of the part Florid and Red occasioned by heat and thinness of parts, pain great, and a pulsation joined to this pain, by reason of its hot intemperiety, when any part extendeth it self upon compression, aggravation, and vellication of the nervous parts, and the veins evidently appear, which before lay hid, when Tension is made by reason of the constipated matter, all these are sufficient signs which may pretend to paint out Inflammation. I shall follow Guido's method in the cure of Inflammations;Of the cure of a Phlegmon▪ as first by removing the cause, then come to the Inflammation it self, and so to the discharging of the peccant matter: And for this he propounds four methods,Four methods according to four times by Guido. according to the four times; and whereas a Phlegmon hath a Beginning while the Blood is nowing, an Augment when in its Flux it is [Page] made hotter, a State when it is converted into Pus or Matter, and a Declination when the Inflammation is digested, resolved, and the Tumour diminished: So also the four Intentions shall be these, first in having a respect to the order of diet, secondly to hinder the Flux of Humours, thirdly to discharge the Matter, and then lastly to correct and amend the Symptoms. The first doth consist in moderating the Air, and this more properly in a long inflammation: the second is ease and quiet, because too much motion heateth the body: the third is watching and sleep; for as the one doth put our bodies into action, so the other doth refresh and cool them: the fourth and last is order of diet: a fifth may be added, which is retention or inanition of excrements; for hard and dry excrements do obstruct, and hence are bred sharp and malign vapours, which do course through the whole body, and do render the inflammation more dangerous; and then actions of the mind may take a part here also. The whole cure may be performed by Diet, Pharmacy, and Chirurgery. Diet for prohibiting Inflammation of superfluous Humours and their generation, and making them more unfit for Fluxion; and here [Page] the Patient's diet should be thin,His diet. moist and moderately cooling: as broths wherein are boiled Lettuce, Borage, Bugloss, Spinage, Purslain, or Marigolds; if in Summer time, our green sauce (as we call it) is very good being made of Sorrel; if he will drink wine, let him mix it with three parts of water to one wine. Fluxion is discharged, if we dismiss its causes, as Plethory, and Cacochymy; and these may be lessened either by Phlebotomy or Pharmacy. If the Inflammation be large, and the Patient young, strong, and full of Blood, we may safely breath a vein:Observat. and here we are to observe, that we breath not a vein too far distant from the part affected, both for Revulsion and Derivation; the first being to be made in the opposite part, whilst the second is made in the same side near the part affected. And since the body is seen seldome so clean, but that there is some ill humours or other mixtures with the Blood, purging also is here said to be convenient; and for this case Cassia newly extracted, Tamarinds, Sebestins, and Syrup of Roses are very excellent: or if you please to take any of these, as for Electuaries, Bolus, or purging potions. As ℞. Electuar. Diacatholic. ʒvi. Lenitiv. ℥ss. Cass. recent.[Page]extr.Electuary.℥i. pul. Diasenn. ʒi. Cremor. Tartar. ℈ij. misce, and of this let the patient take the quantity of a Chesnut every morning: or this Bolus. ℞. Cassiae recenter. extr. ℥i. pulp. Tamarind. ℥ss. misce, Bolus. & cum Saccharo fiat Bolus. Or this Potion.Potio. ℞. Aqu. Endiv. Fumar. Cichor. an. ℥i. Aq. Rosar. Damasc. ʒvi. Electuar. Diacathol. ℥vi. Electuar. è Suc. Rosar. 3ʒij. Crem. Tartar. ʒss. misce, fiat potio mane sumenda. The body being thus discharged, cooling Syrups, Electuaries or Trochisces are very properly to be used, as Syrup of Violets, Roses, Mirtills, Poppies, Wood-sorrel, or the like; or these following,Troch. ℞, Spec. Diarrhod. abbat. ʒij. Aromatic▪ Rosat. Troch. de Rhabarb. an. ʒi. Sacchar. candit. solut. in Decoct. Agrimon. Veronic. ℥iiij. misce, fiant Trochisci. Of which let the patient take a dram or two a little before Dinner. An Electuary for this use may be this,Electuary: ℞. Cons. Rosar. Rubr. Violar. an. ℥ij. Conserv. Lujul. Paralis. an. ℥i. cum Syrup. Oxyacanth. Granator. Violar. an. ℥ss. misce, fiat Electuarium, of which let the patient take the quantity of a Nutmeg at his pleasure. Clysters also may be very necessary; and of these may this very successively be administred. ℞.Clysters: Rad. & Fol. Malv. Alth. [Page]Parietar. Ʋiolar. Agrimon. Veronic. an. M. i. fl. Melilot. Chamomel. an. M. ss. sem. Anis. Faenicul. dulc. an. ℥ss. sem. Faenugraec. Lin. an. ʒij. coquantur in s. q. aqu. fontinae ad lbi. colaturae adde Sacchar. rubr. ℥ij. Diacatholic. ℥i. Sal. Commun. pug. i. Ol. Violar. Rosar. an. ℥i. Purging potion. misce fiat Enema. Or this purging potion. ℞. Herb. Agrimon. Veronic. Cuscuth. Scabios. an. M. ss. sem. Anis. Faenicul. an. ʒij. Liquirit. ras. ℥ss. coquantur in s. q. aqu. fontinae ad ℥iiij. colaturae adde Electuar. Diacatholic. ʒvi. Syr. Rosar. solutivar. cum Rhabarb. ℥iss. misce, fiat potio: these being all managed with a prudent conduct according to the variety of occasions. We arrive next to the part affected,Revulsion: and this is to be dealt with by Revulsives, Interceptives and Repellers.Revulsion. And as I have already declared that Revulsion is made in the opposite part, so such things as are here most requisite are to be hot and attractive; of this sort are fomentations, made of Sage, Chamomile, Calamint, Hyssop, Lavender, Pennyroial, Dill, Tyme, and the like; these being boiled in water, and applied very hot, until the part looketh red. Lixiviums also are here very convenient,Vesicat [...] ries. and Vesicatories, especially if the Humour be [Page] fierce and plentiful, as in Inflammations of the eies, these being to be applied to the neck. Aqua pendens gives us this as the best Epispastick. ℞. Cantharid. praeparat. ʒi. sem. Sinap. ℈i. Ferment. ℥ss. Defensatives. Aceti Scillitic. q. s. fiat vesicatorium. After these Defensatives are to be chiefly used, these being most properly said to be for hindring of Fluxion, being in Quality cold and dry, fit for contracting the vessels: as ℞. Bol. armen. Sangu. dracon. Mastich. an. ʒij. Empl. Diapalm. ℥ij. misce, expande super corio, and apply it. A stronger than this, is ℞. Bol. armen. Sangu. dracon. Mirtill. Balaust. cort. Granator. Coral. rubr. Sus Cin. an. ℥ss. Farin. Tritic. ℥ij. album. Ovor. no. i. cum Aceti & Olei q. s. fiat Restrictivum. Observ. To prevent all mistakes and errors we are to be well advised, that after Application of these Medicines we commit not that error which is too common amongst some Chirurgions, who roll strictly upon the affected part, not considering thereby that they both do detain the Humours, and oft times by this their ignorance or carelesness they make a fair way for the invasion of a Gangrene into the part. The third and last way is by Repellers performed,Repellers. and their cheif use is to hinder [Page] the Fluxion of any Humour to the part affected. These should be cold in Quality; and so should also be either moist and waterish, or dry and restringent: and of these some may be Plantane, Balaustines, Roses, Dragons blood, Whites of Eggs, Vinegar, Bolarmeny, Myrtles, and the like, as thus. ℞. Aceti Rosati. Catapl. ℥iiij. Album. Ovor. no. ij. Bol. armen. sangu. Dracon. an. ʒij. Pulv. Myrtillor. Rosar. rubr. an. ʒi. misce, fiat Cataplasma. Or this, ℞. succ. Semperviv. Portulac. Plantag. an. ℥i. Acet. Rosat. Vin. Rubr. an. ℥iss. Ol. Myrtin. Unguent. Rosar. an. ℥i. pulv. Myrtillor. Rosar. Balaust. Bistort. an. ʒi. misce, fiat unguentum. Observ. And this thing we are to observe, that these repelling Medicines, by how much they do intercept, they are not to be applied to the affected part, but onely about it encompassing it. And this may serve for curing of Phlegmons in General. We come next to treat of the curing of Phlegmones according to the several times.

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CHAP. XV.
Of curing a Phlegmon in its beginning.

IN the beginning of a Phlegmon, repelling Medicines are most proper, as Galen doth offer, for hindring or stopping, the matters descent or arriving to the part affected.Question. But lest any may object, as Aquapendens doth propose, why in the beginning, the Blood being in the smaller and capillary vessels, may we not insensibly evacuate this matter by the affected part, as by digesting it, and drawing it out from other parts, and by attenuating and turning it into a vapour, Repellers being wholly dismist? I give, being led by the same Author, this as an answer,Answer. we are rather to use Repellers in the beginning of an Inflammation for these causes.By several reasons. For first, that which floweth is but small and thin, and therefore by the help of Repelling Medicine we send this Fluxed matter to another part. Secondly, because Evacuation by Repulsion is sooner performed, for it is by this Medicine alone that the Blood is sent and dimissed out of the smaller into the greater vessels. And thirdly, by these we do perform another [Page] intention,Their use and benefit. which is the allaying the extraneous heat. And these are to be regulated according to the Crisis of the body; for if there be a hot crisis both of the whole and the affected part, here are we to use mild and gentle Repellers, as the white of an Egg, Rosewater, and Vinegar, and oyl of Roses, leaving out the Vinegar if you please, dipping fine rags herein and applying them to the affected part:Catapl: Or this Cataplasm, ℞. Pulv. Rosar. ʒi. Farin. Hord. ℥ij. coquantur in Poscâ & fine addendo parum ol. Rosar. As also on the contrary, if the crisis be cold, the Inflammation large, we are to use stronger; and let this serve for a reason hereof, because here is signified a great plenty of Blood, and here conveniently may be used these following,Unguent. Another ℞. Ʋnguent. Rosat. lot. in aqu. Plantag. pulv. Rosar. Plantag. an. ʒij. Aceti parum, fiat unguent. Or this. ℞. Ol Rosar. ℥i. Aqu. Rosar. ℥iss. Albumin. ovor. no. ij. misce, or this Cataplasm, ℞. farin. Hord. ℥ij. pulv. Rosar. Plantag. Catapl. Unguent: Malicor. an. ʒiss. cum succis Semperviv. Lactuc. & Solan. Oxycrat. an. q. s. fiat Cataplasma. Or this Unguent. ℞. Mucilag. sem. Psyll. extr. cum aqu. Plantag. & Acet. Rosar. ℥iiij. succ. Plantag. Solan. an. ℥ss. ol. Rosar. [Page]℥i. coquantur ad succorum consumptionem, fine addendo Ʋuguent. Rosat. ℥i. misce, Catapl: fiat unguent. Or this, ℞. Lactuc. Malv. Plantag. an. M. ss. Semperviv. M. i. Coquantur in Oxycrat. q. s. fiat Catapl. fine addendo pulv. Rosar. Rubr. Plantag. cort. Granator. an. ʒij. Farin. Hord. ℥iiij. misce, fiat Cataplasma; but if the beginning doth turn towards the Augment, then may you use this, ℞. Malvar. parietar. Plantag. an. M. iss. coquantur in aqua & contusis adde farin. Hord. ℥ij. pulv. Rosar. R. fl. Chamomel. Melilot. an. ℥ss. ol. Chamomel. ℥iiij. misce cum decocti praedicti q. s. fiat. Catapl. This here also is to be observed, that these Medicines be oft times changed, lest they do inflame the affected part.

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CHAP. XVI.
Of Curing a Phlegmon in its Augment.

GAlen. cap. 4. lib. de Morbis, doth mention that for the Augment, when the Flux ceaseth, and the part seemeth more affected than it was formerly, and therewith increaseth; and the reason hereof may be this, because the Blood, which formerly was shut up in the vessels, now falls out, and doth grow hot and putrefy, an at length is converted into a vapour. And hence doth arise this Intention, the discussing of this vapour, or evaporation of this matter. And this being discharged out of the vessels, is not to be treated with Repellers,Cured by Digestives. or cured thereby, as it was when it was hedged in; but rather evacuated by Digestives. These [...] do cure by educing the Fluxed matter, and converting it into a vapour, and so do discharge it by insensible passages or pores of the Cutis. And of those some are simple, some compound; some mild, others strong. Of the simples are Chamomile, Marshmallows, white Lilly Roots, Faenugreek, Melilot, Cumins, Rue, Bayes, and the like. Stronger are, Tyme, Origanum,[Page]Mint, Pennyroial, Calamint, Hyssop, &c. The strongest are Nitre, Sulphur Vivum, Lyme once extinguished. Out of these mixed with some of the former Repellers you may make a compound Medicine, they being a like tempered are very proper here. As, ℞. fol. Malv. Catapl. Absinth. Plantag. an. M. ij. Coquantur in aquâ fontinae, contundentur. Trajectis adde farin. Fabar. Hord. an. ℥i. pulv. fl. Chamomel. Melilot. Rosar. rubr. Absynth. an. ʒiss. Ol. Rosar. Chamomel. an. ℥i. Oximelit. simpl. ℥ij. misce, Catapl. Authoris: fiat Catap. Or, ℞. Chamomel. rad. Alth. Aneth. an. M. ss. rad. Lilior. alb. no. ij. coquantur omnia in aqu. Hyssop. q. s. fiat colatura, Colaturae adde farin. Fabar. Hord. Lupinor. an. ℥ij. pulv. sem. Faenugraec. Rosar. an. ʒij. Ol. Rosar. Aneth. an. ℥iss. misce, fiat Catapl.

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CHAP X. XVII.
Curing of a Phlegmon in its State.

THAT is generally related and supposed the State, when the matter can make no further progress, that is, when very much pain is perceived, and a great heat doth accompany the part. There may a question arise, what Medicines may be here most proper? Gal. chapt. 16. lib. 13. Method. saith, that Digestives do chiefly take place here; and in another place, chapt. 4. lib. 1. [...] doth offer, that the indication of curing a Phlegmon in its State, ought to be both Repelling and Digesting. In the first part therefore of the State Repellers and Digestives equally mixed are very proper; Catapl. of this sort may be ordered such as these. ℞. rad. Alth. ℥iij. Lilior. alb. ℥i. fol. Malv. Partetar. Plantag. Chamomel. an. M. j. sem. Lin. & Faeungraec. an. 3iij. coquantur omnia in Aquae fontinae q. s. fine addendo farin. Hord. Fahar. Lupinor. an. ℥iss. pulv. Rosar. rubr. fl. Melilot. Chamomel. an. 3ij. Ol. Anethi Rosarum an. ℥ij. misce, fiat Cataplasma. Or this. ℞. Lapath. Parietar. Malv. [Page] Plantag. an. M. i. contundentur & coquantur, colaturae adde pulv. fl. Melilot. Chamomel. an. ℥ss. pulv. Rosar. rubr.Catapl: 3i. misce, fiat Catapl. Or this. ℞. rad. Lilior. alb. ℥ij. fl. Chamomel. ℥i. Aneth. Calaminth. an. M. ss. coquantur in a quâ fontinâ q. s. colaturae adde pulv. fl. Chamomel. Melilot. an. 3ij. pulv. sem. Aneth. ℥ss. farin. Hord. Fabar. an.Catapl: ℥ij. farin. sem. Faenugraec. ℥ss. misce & cum Ol. Chamomel. Ʋnguent. Dialth. an. ℥iss. fiat. Cataplasma.

CHAP. XVIII.
Of curing a Phlegmon in its declination.

IN its declination according to Galen. cap. 1. lib. 6. pure Digestives are to be used, such as you already have ordered you in the general cure of Tumours; and you may very well follow the same method, and use the same Medicines, as you have already set you down there for your direction. I shall conclude this chapter with this history.A History. Hildanus relateth of a Phlegmon in the Perinaeum equalling the bigness or largeness of a Goose Egg, accompanied with [Page] a pricking pain, with a hardness both of the Scrotum & penis, for which was applied this suppurating Cataplasm.Catapl. ℞. rad. & fol. Alth. Malv. an. M. i. coquantur & pistentur, his adde farin. Tritic. ℥ij. farin. sem. Lin. Faenugraec. an. ℥i. Butyr. recent. ol. Lilior. alb. Ʋnguent. Dialth. an. ℥iss. Croc. ʒss. Vitell. Ovor. no. ij. misce, fiat Cataplasma, of which is to be applied warm two or three times in a day. The abscess being broken, a great quantity of fetid and putrid matter came out for many daies together, and continued so long, that it left a large Ulcer; for the cleansing of which was used spirit of Wine and Ʋnguent. Aegyptiacum, over which was applied this Cataplasm. ℞. farin. Lupinor. Fabar. an. Catapl. ℥iss. pulv. summitat. Absynth. Scord. Rut. an. ℥ij. Coquantur, & cum Oxieml. simpl. q. s. fiat Catapl. fine addendo, dum calens est, Mirrh. Alo. an. ʒiss. The Ulcer by these being well deterged, and filled with flesh by a good cicatrice and well ordering of the body, the Patient recovered to his perfect health.

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CHAP. XIX.
Of an Erysipelas.

FROM Choller ariseth this Erysipelas, accompanied with many other Tumours, bred also from this Humour as Herpes miliaris, Herpes exedens, Pustulae and the like. There is generally allowed three sorts of Choller,Natural: natural, unnatural, preternatural. The natural is that fourth part of the Blood, which hath a hot and dry temper in it, being of a reddish yellow colour, and bitter-sweet in taste, much like tosted honey. This is one of the natural Humours, so called for a double cause, because they perfect natures work, and are as vehicles for nutriment and conservation of the body; for if man were without blood he could not be nourished, if without Spirits he could not be said to live; and were it not for this natural bilious Humour man would soon swell into a Dropsy.Second not natural. A second sort hereof is said to be not natural, because this yeilds no perfection to the body, its substance being altogether unfit for this office of nutriment, this hath in it no bitterness or sharpness: of this sort is [Page] that of the bladder of the Gall; and should this contain any sharpness in it it would soon fret the guts into pieces; and besides this, daily experience showeth it is free of all Acidity, for it daily passeth through the Kidneyes into the Bladder, and then maketh its exit. But this Question in the Physick Schools hath been very oft times controverted.Quest. Was not this Humour framed and ordered for deterging the capillary vessels, that Chyle might pass to the Liver, and so the Blood hereby consequently there made?Answ. But this consequence may be very readily denied, for the Chyle does never reach the Liver; and this may appear different from the other, in that it is not so natural.Third preternatural. There is a third sort hereof different from both the former, being neither good to help the body in its nourishment, nor yet so mild as unnatural; which although it do not nourish the body, yet doth it not offer any mischeif to it; this is both unprofitable, and unnatural, and preternatural, alwaies hurting the body; and so is called preternatural Choller, which properly perse and in se is apparently so. There is another sort of preternatural Choller, which mixeth it self with other Humours, and doth make them worse; [Page] the one having in it Serum and Flegm, and this is very fit and proper for obstruction. There is a second sort doth mix it self with tough viscous Flegm,Its differencies. and this is called Bilis vitellina; and this doth promote and help forwards obstructions. A third is burnt choller by admixture, and this doth make & frame our great pains and excoriations, whilst it doth lodge in the vessels; and when it getteth out from hence, is the most apt Author of cancerous Tumours and Melancholick vlcers. And thus much of the differencies of Choller. We now arrive to an Erysipelas, the proper subject of this Chapter, and Guido doth give that distemper which adhereth to the Cutis the name of Erysipelas. The names of Erysipelas. Some of the Ancients called it Ignis sacer; ignis, because it burneth like fire; sacer, being sent as a punishment from the Sacred hand: but it is more properly called Erysipelas, quasi [...]. For as [...] doth signifie redness (by some called [...]) so [...] doth as well signifie near. And thus may we define it, calling it Erysipelas, because it maketh all its neighbouring parts red: It is a hot Tumour, arising from the aforesaid choller, possessing some exterior part of the body.What it is. A true and simple Erysipelas is bred [Page] of thin, subtile, hot, and chollerique blood; and this appearing in any one part of the body doth form and fashion this disease; and because it cannot by reason of its thinness have any consistence in the inward flesh, it therefore doth content it self with getting into the outward parts of the cutis, and there it doth exercise its terrifying Qualities. You may know it by its hot signs,Signs. having belonging to it a large heat, pain, a red colour, or rather somewhat turning yellowish. But because these signs are so near related to those of a Phlegmon, Its differencies from a Phlegmon. I shall here make a larger distinction between them. And thus it first doth differ from a Phlegmon, in that a Phlegmon doth apprehend both cutis and subject flesh; in this onely the cutis is concerned. Secondly, this is much hotter, for you see it appear as it were burnt up by its blisters, by how much the choller is hotter than blood. Thirdly, here is less pain. Fourthly, its redness doth oft times change into a blackness or blewness. Fifthly, it yeildeth to the touch. Sixthly, upon the touch the redness doth vanish. Seventhly, here is no tension. Eightly, it doth differ from a Phlegmon, in that it never doth move from its place; whereas this spreads it self and encreases about [Page] its neighbouring parts. That which doth proceed from yellow choller is mildest;Praesage. it is a bad sign if an Erysipelas turns inwards. In Tumours, Wounds, Fractures, and Dislocations, it is generally held mortal; or if it doth tend to suppuration it is no waies to be accounted a good sign, neither may it be judged but very very bad, if it do possess the neighbouring parts of a bone being bare.Cure. As touching its Cure, according to Galen in his Arte medendi, whereas it is a disease encreasing in a great quantity of choller, this is to be evacuated, and the whole Cure performed by diet, Chirurgery and Pharmacy. As to the first, we are to observe that the Air be cold and moist, so naturally, or made so by Art; let the Patients diet be cold and moist, and as this choller is thin, let him take such diet as is cooling and thickning; and for his broths may very properly be boiled these herbs. Lettuce, Beets, Mallows, Chichory Sorrel, and the like. Chicken-broth here also is very good, Barly water, Ptysane, to which may be added Borage, Buglosse, and the former, or some of them. For his common drink he may take Almond-milks made of blancht Almonds, the cold seeds, wood-Sorrel and the like, sweetned with Syrup [Page] of Violets, Lettuce, Lemmons, Woodsorrel, &c. or such Juleps or Emulsions as these are very proper.The Authors Julep herein: ℞. Hord. perlat. ℥ij. fol. Lujul. Lactuc. Acetos. an. M. ss. fl. 3 Cord. an. pug. i. coquantur in aqu. fontinae. q. s. colaturae adde syr. Papaver. erratic. Violar. an. ℥ij. Lap. prunell. ʒss. aqu. mirabil. ℥ss. spirit. Sulphur. gutt. 10. misce pro Julapio. ℞. Amygdal. dulc. excorticat. ℥i. sem. 4. frigid. major. an. ʒij. sem. Lactuc. Papaver. alb. Emulsion [...] an. ʒi. contundentur in mortario marmoreo sensim affundendo aqu. Hord. & Liquirit. lbiss. in colaturâ solve syr. Violar. ℥ij. Lujul. Acetos. an. ℥i. spirit. Vitriol. ℈ss. misce, hujus sumat ad libitum. Let the Patient's body be kept open by convenient clysters, Apozemes or Purges,Bleeding. let him shun all watchings and anger. As touching Bleeding, in this case it is very disputable, whether it be at all proper or not; but if it be convenient at any time, and at any place, it is when it gets into the head and face, and then are we to open the cephalick vein, for prevention of a Pleurify or Squinancy. In an Erysipelas Phlegmonodes we have nothing which may contradict Phlebotomy; but in other cases I think it neither necessary or safe; in that you draw hereby [Page] the good as well as the bad blood out, and leave the thinner part of the blood behind. And since I have given these directions to arm your self with every instrument, which may quell or allay the heat and fury of this Tumour, you are to keep its doors alwaies open, and thereby discharge these peccant Humours; and this you are to do before you apply any outward means or Medicines. As for Simples very useful, here you may take Cassia newly drawn, of Manna, Tamerinds, Rhubarb, Prunes, Senna; out of these and the like may also be made many famous and excellent compound Medicines, having in them a sufficient power to pull down the heat and fury of this disease: and here may properly be taken such a potion as this.Potion. ℞. fol. Senn. ℥i. Crem. Tartar. ʒiss. Cinamon. elect. ʒss. Spic. gr. iiij. infundantur per noctem in aqu. Cichor. Endiv. Lactuc. an. ℥iiij. in colaturae ℥iiij. solue Electuar. Diacatholic. ℥i. aqu. Cinamon. tenuior. vel hordeat. ʒij. misce, fiat potio mane sumend. Or this of the Author,Potio purgans. ℞. Senn. Alexandr. ℥ss. Rhabarb. ʒiss. Macer. Z. Z. Caryophyl. an. ʒi. sem. Anis. Faenicul. dulc. Carn. omnium contus. an. ʒij. stent omnia per noctem in infusione aqu. Rosar. & vini alb. an. [Page] lbss. ad ℥iiij. colaturae adde Mann. opt. solut. ℥ss. syr. Rosar. solutivar. ℥i. misce, fiat potio mane sumenda. For an Electuary take this,Electuar. ℞. Cass. recenter extr. ʒvi. pulp. Tamerind. ʒiij. Elect. Linitiv. Diacatholic. an. ℥ss. Electuar. è succ. Rosar. ʒvi. Crem. Tartar. ʒi. pulv. Rhabarb. Cinamom. an. ʒi. Resin. Zallap. ℈i. misce, fiat Electuarium. Cujus sumat patiens q. nuc. moschat. omni mane vel omni secundo mane. Pill. ℞. Pil. aggregativ. ℈ij. De Rhabarb. ℈i. Diagrid. gr. iij. cum syr. Violar. fiant. pil. no. 20. harum sumat patiens 3 vel 4 omni mane, according to the strength and Constitution of the Patient. Clysters here also are very useful and beneficial, the Patient being more ready and willing to admit of these than any of the former. ℞. fl. Chamomel. Melilot. summitat. Parietar. Malv. Lactuc. Violar. an. M. ss. sem. Clysters: Anis. Caru. an. ʒij. fiat decoctum ad lbi. in colaturâ solve Electuar. Diacatholic. ʒvj. Sacchar. rubr. ℥iij. Ol. Chamomel. ℥ij. Sal parum misce, fiat Enema. Or this, ℞. fol. Alth. Malv. Parietar. Another. fl. Chamomel. Melilot. an. p. i. fl. 3 cordial. an. pug. ss. sem. Lin. Faenugraec. an. ʒij. coquantur omnia in Lacte ad lbi. colaturâ solve Electuar. linitiv. ℥ss. Electuar. è succ. Rosar. ʒij.[Page]syr. Rosar. solutivar. ℥ij. ol. Rosar. Violar. Another. a. ℥i. vitellor. ovor. no. i. misce, fiat Enema. Or this if you please. ℞. Decoct. Malv. Violar. Lactuc. Hord. an. q. s. ad lbi. colaturae adde mell. Rosar. ℥iiij. Sal. ʒi. ol. Violar. ℥iij. misce: this is very convenient for a young and tender person. After these we arrive to Topicks, and these in the beginning should be cold and moist without any adstriction; for this would make the Matter more sharp, and so make it to corrode and ulcerate further in: and for performing this office I have here furnished you with these various Medicines.Unguent. ℞. ol. Rosar. ℥ij. aqu. Rosar. ℥iiij. Albumin. Ovor. no. ij. misce, fiat unguentum. Unguent. Or. ℞. Troch. alb. Rhasis sine Opio ʒi. Plumb. ust. & lot. Camphorae, an. ʒss. Ʋnguent. Rosat. ℥ij. Pomat. ℥j. Ʋnguent. alb. camphorat. Diapompholig. Unguent. an. ʒij. misce, fiat unguent. Or, ℞. Mucilag. sem. Lin. extr. in aqu. Rosar. & Plantag. ℥i. pulv. Lithargyr. aur. Ceruss. an. ℥ss. Ʋnguent. Rosat. Populeon. an. ℥ss. misce, fiat unguent. Or this. ℞. ol. Violar. Rosar. an. ℥ij. Ʋnguent. Rosat. ℥iss. Litharg. aur. Unguent. & argent. an. ℥ss. unguent. Tuth. ʒij. Ceruss. ʒvi. Camphor. ʒi. succ. Sem. perviv. Plantag. an. ℥ss. misce, fiat unguent. [Page] In the application of these or any of these this you must observe, that they are very oft to be renewed, lest by their being left too long on the part affected they rather inflame than allay the fury and heat of the part affected; neither are they to be used too long, lest they do extinguish the native heat of the part; and then are you to abstain from their use, when the Patient doth acquaint you his pricking pain or heat in the part affected is not so much as it formerly was, and when the part appears more tepid to the touch, and then thirdly, when the red colour doth begin to turn into a blewish or black colour. After these you are to use Digestives, that thereby the part may get warmth and strength, which for some time hath been disabled of its native heat: and for this such a Medicine as this is good. ℞. farin. Hord. Orob. an. ℥ij. farin. sem. Lin. ℥iss. coquantur in oxycrato, Catapl: fine addendo pulv. Rosar. rubr. fl. Chamomel. Melilot. an. ʒij. ol. Aneth. Chamomel. an. ℥i. misce, fiat Cataplasma. Catapl. Or this. ℞. pulv. Absynth. Rosar. rubr. Betonic. fl. Chamomel. an. ʒij. farin. Hord. Fabar. vel Lupinor. an. ℥ij. cum Melle q. s. fiat Cataplasma. I shall conclude this Chapter [Page] with a History of a Maid here in Norwich, A History. who was much troubled with an Erysipelas in her brest, accompanied with a fever, pain, watchings, blisters, and the like; she being ordered a cold and moist diet, and her body being kept open with Chologogick clysters as oft repeated as occasion required, keeping her Room cool by oft times sprinkling vinegar thereon, and prescribing her convenient Juleps and Emulsions, I applied to the part affected this Unguent. ℞. ol. Rosar. ℥ij. Cer. flav. ℥ss. Vitellor. ovor. no, ij. misce, fiat unguent. She being drest three or four times in a day, until the pricking pain abated, with this unguent, afterwards was applied this Digestive for warming and comforting the part. ℞ farin. Hord. Catapl: ℥i. farin. Fabar. ℥iij. coquantur in vino q. s. tunc adde pulv. fl. Chamomel. Melilot. an. ℥ss. Scord. ʒ i. ol. Rosar. Chamomel. an. ℥i. vitell. ovor. no. i. misce, fiat Catapl. and if any blisters do arise, this following unguent is very good and proper.Unguent. ℞. Ol. violar. Rosar. an. ℥ij. L [...]harg. aur. ℥ss. Thur. ʒij. Ceruss. Plumb. ust. an. ℥ss. succ. Plantag. S [...]mpe [...]. an. ℥ss. misce in mortario [...] urgnentum. Or this. [...], [...] aur. ℥ii. pulv. Alumin[Page]ʒiiss. albumin. ovor. no. i. bene agitatum cum oleo Rosar. ℥iij. Acet. ℥i. misce, fiat unguent.

CHAP. XX.
Of an Erysipelas in the Face.

THIS for the most part ariseth from the nose, it first growing red, then doth swell, and then spreads it self, and sometimes it doth get into the head, and neck. The causes which may occasion this may be said to be two, being either inward or outward; outward as contusions, wounds, or the like, which may be accounted capable enough to excite heat and pain; or inwardly taken too much hot wine, spice, or the like, a hot intemperiety of the Liver, which doth breed this so plentiful a quantity of Blood, a redundancy hereof, and a Fluxion of Humours to the part affected. [...]. The cure hereof is much different from the former; and in this we are to make a diligent search as touching its causes, happening either by an outward or inward occasion. If by an outward, this being removed, the Erysipelas doth cease; if from a redundancy [Page] of chollerick Blood which floweth into the face, the outward veins are to be opened; and hence do arise three intentions in this cure, first a cooling of the hot intemperiety of the Blood; of evacuating and discharging of this chollerique Blood; and thirdly to hinder this Fluxion. And these are to be performed by Diet,Chirurgery. Chirurgery and Pharmacy; by Chirurgery in Revulsion by Phlebotomy, which ought to be performed in the arm in the same side; and here you may bleed plentifully, if the patient can endure it; if not, you may repeat it: besides this other Revulsives are good, as Cupping-glasses, Vesicatories, these being applied to the neck and shoulders. Pharmacy doth relate to the better tempering the intemperiety; and for this you may take these as proper Medinces, being very good and useful in this case to be used and administred, as,Electuar: ℞. Pulp. Prunor. damascinor. ℥i. Crem. Tartar. ʒi. Rhabarb. ʒij. Cinamon. pulv. ʒss. Santal. citrin. pulv. ℈ij. misce, fiat Electuarium; cujus sumat patiens q. nuc. castaneae omni mane. Or this potion,Potio: ℞. Tamerindor. ℥ij. Prunor. Jujub. an. par. no. 5. Passular. enucleat. ℥ss. Hord. mundat. pug. i. sem. Melon, Lactuc. an. ʒiij. fl. 3 cordial.[Page]an. pug. ss. fiat decoctum, in colaturae ℥vj. solve Cass. recent. extr. ℥ss. pulv. Jalap. ʒss. syr. Rosar. solutivar. ℥ij. misce, fiat potio. Or this of the Author. ℞. rad. Petroselin. Faenicul. Cichor. Lactuc. incis. an. ℥i. coquantur in aquae fontinae ut colatura redeat ad lb. huic adde vini albi lb. in his simul mixtis stent per noctem in infusione Senn. mundat. ℥ss. Rhabarb. ʒi. Polypod. querc. ℥ss. sem. Faenicul. Anis. contus. an. ʒij. Epithem. Ceterach. Capil. vener. an. p. j. ZZ. ʒi. hujus infusionis sumato ℥iiij. his adde pulv. Jalap. ʒss. Crem. Tartar. ℈ij. syr. Rosar. solutivar. ℥ij. misce, sumat cum costodia. As to his diet which is the third part, let the Patient abstain from Wine, and instead thereof let him drink Barly water, or Julep of Roses, or cooling Emulsions, such as you have already directed you. And thus much of the inward causes. As to the outward Applications, they ought to carry with them a moderate temper, between heat and cold; for when heat and pain do urge, these do call for ease and mitigation; and if pain doth proceed from heat, here most properly are we to use coolers, without astriction, as is the Decoction of Mallows, mixed with a little oyl of Violets [Page] or Roses; in the end we are to use Digestives, as we have formerly directed and prescribed. And thus much of an Erysipelas getting into any part of the head. A country man being vexed with an Erysipelas Phlegmonodes, A History. the which being anointed by the advice of a Barber with oyl of Roses for some daies, (this happening in the arm) hence did arise pain, inflammation, and other symptoms, so that at length the whole hand was correpted with a Gangrene, the which at last being well scarrified, and such convenient Medicines applied, as I have shown in my discourse of a Gangrene, he afterwards recovered. Let this serve as a caution to young Chirurgions, that Oyl doth add to the flame rather than extinguish it, as Galen doth offer in lib. 5. de Simpl. A Gentlewoman, a person of very good Quality,A History. had an Erysipelas all over her face, the which at length had a Herpes miliaris joined to it, in which time the Erysipelas imprinted its marks, so as the whole face was marked therewith; she being of a plethorick constitution, when neither by the advice of Physicians by bleeding, purging, or application of several external Medicines good could be done, after the applying of several [Page] Unguents this at last being applied brought her unto her health, as, ℞. Ʋnguent. de Lithargyr. ℥i. Hydrargyr. extinct. cum succ. Limon. ʒss. Tuth. praeparat. ʒiij. Ceruss. lapid. Calaminar. praeparat. an. ʒij. aqu. Rosar. acet. Rosar. an. ℥iss. agitentur omnia in mortario & pistillo plumbeis. Of this you may read in Observat. 34. Riverii.

CHAP. XXI.
Of Oedema.

AS the former two have their variety of diseases belonging to them, so also hath this its various companions bred of and from the same Humour; for from Flegm are bred, Oedema, Artheroma, Steatoma, Meliceris, Nodi in Juncturis, Ganglion, Leucophlegmatia and the like. This Flegm is the fourth part of the mass of Blood, that is, the colder and moister part thereof: and if it so happen that this doth increase in quantity,What flegm is. the expulsive faculty being stirred up by the great plenty of this Flegm, this doth offer very fair to the generating of an Oedema. This Flegm is cold and moist, and by some called [Page] pituitous Blood. And of this there is two sorts, one Alimentary, the other Excrementitious. The first is the origination hereof,Its name. by the Arabians called undimia, by the Greeks [...]; which word [...] signifies no otherwise then an eminency. There are of natural or excrementitious Flegm these three sorts: the first being acid, so called from its taste; the second salt Flegm; the third glassy Flegm, from its coldness, thickness, and toughness. And if Flegm doth erecede from its nature by admixing it self with Blood, it is called Oedema Phlegmonodes; if with Choller, Oedema Erysipelatodes; if with melancholy, Oedema Scirrhodes. A great matter hereof is a great quantity of Flegm residing in the body, cheifly about the extreme parts, as the hands, knees, or feet, these being the most remote from the Fountain of heat. This Flegm is thrown forth from the greater vessels to the smaller,Its generation. the which being there deteined by the thickness of the Cutis, is collected in the musculous parts, and there doth form this Oedematous Tumour. It is a Tumour soft, indolent, loose, yeilding to the touch, generated from a pituitous matter.Definition. It is soft and loose,Signs. and these two come from the Humour of thin Flegm; indolent, [Page] for it neither doth make or cause any pain, or dissolve unity; It gives way to the touch, and is a white Aposteme, and without heat; white, being most like its object Flegm; without heat, being like the matter out of which it is generated, which is cold and moist. A pituitous Humour redundant in the body is the cheif cause,Cause. to the which a cold and moist air, a flegmatick diet, too much sleep and idleness, and a cold dyscrasy both of Head, Stomack, or Liver may help forward to the encrease of its cause.Praesage. And as Galen saith, Comm. 46. that out of Fluxion of Humours some are cruel, as Chollerick fluxes, and burnt Melancholy; and others are more kind, as this Oedema: so this is a tedious and long disease, because it is cold, the native heat being herein very weak. It is oft times soft, and without pain, and so carrieth the less danger; but if it be hard, and with pain, it is dangerous. As touching its cure, here ought we first to use proper means by Retraction and Revulsion of the Matter, and lessening of it. Secondly, because it is cold, remove its cause by implanting heat and warmth herein. Let the Air be warm and dry, the Diet attenuating and drying; here Wine is good because [Page] it doth digest and warm. Let his diet be of good and light digestion, as Chickens, Rabbets, Partridges, and the like, to which may be added all sorts of spices. Let his sleep be moderate; and let him avoid all passions of mind, and venery, and observe that he keep a good habit of his body. After this let him use such evacuations, as may both attenuate, open, and discharge this Flegm. Bleeding here is in no wise to be used, unless a Phlegmon do accompany it, Fever, or the like. And for his use these Phlegmagogicks are very proper and convenient: as, ℞. Alo. lot. cum. Pill. aqu. Majoran. Agaric. trochisc. an. ʒi. Mastich. Cubebar. an. gr. vi. Troch. Alhandul. ℈ss. Cum syr. de Betonic. q. Pil. s. fiant pillulae, dosis ʒi. Or ℞. Pil. Coch. ʒij. Aurear. ℈i. Troch. Alhandul. gr. Pil: iiij cum Oxymelit. scillitic. q. s. fiant pil. no. 18 quarum sumat 2 omni mane. Or if you will ℞. Pil. Coch. ℈ss. extr. Rud. ℈i. Mercur dulc. gr. 15 ol. C [...]ryophyllor. gut. i. misce, sumat mane. A potion preparing Flegm,A potion. ℞. Hyssop. M. i. Menth. M. ss. Absynth. M. ss. sem. Anis. Faenicul. Calamenth. an. ℥ss. Rosar. rubr. ℥ss. fiat decoctum ad lb. colaturae adde Sacchar. lb. & aromatizetur cum pulv. Cinamom. ʒi. or this [Page] potion.Potion. ℞. aqu. Meliss. Bugloss. an. ℥ij. in his in funde per noctem Rhabarb. ʒi. Agaric. trochisc. ℈ij. pulv. Cinamom. ℈ss. ZZ. ʒss. colaturae adde Mann. ℥ss. Cambog. gr. iiij. aqu. Cinamom. hordeat. ℥ss. misce, fiat potio. Or if you please this.Potion. ℞. Electuar. Diacatholic. ℥ss. Diaphaenic. ʒij. pul Agaric. troch. ℈ss. solvantur omnia in aqu. Hyssop. Rosar. damascinar. Faenicul. an. ℥i. misce, fiat potio, cui adde syr. de Betonic. ℥iss. And because Oedema is a disease offending partly in quality,Topicks. partly in quantity; in respect of its cold and moist quality, we are to use such Medicines to the part affected as are warm and dry; and in relation to its quantity, we are to endeavour its discharge and evacuation. And since here is required a double intention, here ought we carefully to inquire and examine, whether Repellers mixed with Digestives are in the beginning first to be used. Galen doth satisfie us cap. 3. lib. 2. ad Glanc. that they are to be used: as you may find him there using a peice of sponge, or linnen rags dipt in Oxycrate, to which a little salt is added, and so applying it over the part, and then ordering it to be rolled up: for Repulsion is this roller, being dipt in vinegar; and the [Page] sponge and the water do digest the pituitous Humour.Question. But it may be asked, how Digestives, being hot and dry, may or can agree with water, which is cold and moist in digestion? Galen doth answer this, Chapt. 8. lib. 1. that water doth digest:Answer. and this we may see in the hands and feet of Fishermen, who having been much imploied in the water, you will find them both corrugated and wrinkled; which corrugation is nothing else but the evacuation of that matter which formerly filled up the spaces. But should an Oedema happen upon the Tendinous or Nervous parts,Observat. we are to use little vinegar; and for discussion of the matter this may be very proper.Digestive. ℞. fl. Chamomel. Rosar. Mirtin. Absynth. Staechad. a. M. ss. Alumin. Roch. Sal. commun. an. ℥ss. Balaust. nuc. Cupress. an. M. i. Salv. Rorismar. Squinanth. an. pug. i. coquantur, poscâ factâ ex Lixivio, & coquantur omnia usque ad ʒae partis consumptionem, in quo madefaciatis Spongiam; and this you are to use to the state: Or this Cataplasm. ℞. pulv. Rosar. Catapl. rubr. Mirtin. Absynth. Rorismar. Staechad. an. ʒij. pul. fl. Chamomel. Melilot. an. ʒi. misce, & coquantur cum q. s. Hydromelitis, fine addendo pulv.[Page]nuc. Cupress. Squinanth. Balaust. an. ʒiij. Or this Cataplasm.Catapl: ℞. farin. Fabar. mic. pan. an. ℥iiij. pulv. Terrae cimol. ℥ij. sem. Lin. Faenugraec. an. ℥j. Bol. armen. ʒi. coquantur in s. q. Lact. vaccin. ad Cataplasmatis formam; fine addendo Camphor. Croc. an. ℈i. vitell. ovor. Catapl: no. ij. misce, fiat Cataplasma, Or this. ℞. farin. Hord. Fabar. an. ℥iiij. pulv. Rosar. ru. Bacc. Laur. Mirtillor. an. ℥i. pul. fl. Chamomel. Sambucin. Melilot. Ivae arthritic. an. ℥ss. fim. caprin. ℥ij. cum vino rubro, fiat Catapl. fine addendo Sapon. nigr. ℥iij. applicetur bis in die. And because Quicksilver hath a very strange penetrating quality allowed it, that it can command Flegm from the most extreme parts of the body, it may very well and properly be here applied and made use of; and for which this composition is most excellent. ℞.Unguent. ex Mer [...]: Axung. porcin. ℥iiij. Pinguedin. human. ℥ij. Ol. Chamomel. Aueth. an. ʒij. Styrac. Calamit. Benzoin. Mastich. an. ʒss. Theriac. Methridat. an. ʒi. Argent. viv. ℥iss. agitentur omnia bene in mortario, quibus adde Ol. Spic. Salv. granor. Juniper. an. ℈ss. misce, fiat linimentum. With this you may anoint the part affected; or you may apply this often in this case applied with good [Page] success by my self.Empl. ℞. Empl. Diachyl. cum gum. Paracels. an. ℥i. Oxycroc. ʒij. Ʋnguent. Praescript. ℥ss. misce, extende super alutam, & parti admovetor. Or this. ℞. Empl. de Ran. cum ☿ ℥ss. Pic. Burgund. ʒij. Taccamahacc. ʒiij. Empl. Paracels. ℥ss. misce pro usu. It seldome or never is brought to suppuration, by reason both of its coldness, and that it for the most part is very far distant from the Fountain of Heat: but should it tend that way, Empl. Diachylon cum gummi, or a Cataplasm made of white Lilly roots, Marshmallow roots, and the like, as you have already prescribed and shown you, may do both very well here and be very serviceable. A young Maid, about eight years of age, being much troubled with a Phlegmonous and Oedematous Tumour in the outward part of Her lower Mandible,A History. which came to suppuration, fearing its fecies would hinder its cicatrice, before I could open the Abscess, I first tried by Guido's Counsel to resolve it, who saith that Apostemes being sometimes suppurated do end in resolution; the which was confirmed by Parraeus his experiment, who averreth that he cured a suppurated Aposteme by mixing Quicksiver with Diapalma, and so applying it: and thus [Page] I took to an Ounce of Diapalma a dram of Hydrargyrum, and applied to the suppurated Aposteme, and within four daies it was wholly resolved: and for discussing the suppurated matter to the following Conditions are these necessary, that the matter be small in Quantity, thin and serous, occupying the superfificies of the Cutis, and not penetrating; that it be in a strong and young body, happening in the soft parts, and a convenient time of the year. By the vertue of which Medicine, and observing of which method, a young Gentlewoman was perfectly cured of an Oedematous Tumour, which was but little suppurated, upon the Region of Her Loins the largness of the palme of a hand.

[Page]

CHAP. XXII.
Of a Scirrhus.

OF Melancholy cometh Scirrhus, Cancer Ʋlceratus & non Ʋlceratus, Elephantiasis, Psoras and others. Our late writers do call this Scirrhus Durities, because it is a hard Tumour destroying sense, lodging in a Member in that Capacity, as that it produceth little or no pain: or it may be called a preternatural Tumour, having no infesting symptome. It is by some called Apostema Lapidosum, by Avicen Sephiros. It is the onely brat of Melancholy: and this Melancholy hath a double construction. For there is [...], or succus Melancholicus, & [...] atra bilis. Between which two there is a vast difference, the succus or juice being as the fecies or dregs of the Blood, and is drawn from the purest part of it by the spleen: the other Black Choler, being caused of immoderate heat and burneth the parts, and like vinegar being poured on the ground, it boyleth and raiseth it self from thence. There are four species of Melancholy;4 Species of Melancholy first, when its species are burnt, it frameth [Page] an illegitimate Scirrhus; Secondly, when Melancholy is made preternaturally by other Humours, it doth take share of their qualities; Thirdly, when it is made thick by too much cooling or drying of Humours; Fourthly, when it is mixed with Flegm, Blood, or Choler, then it maketh Scirrhus Oedematodes, Burnt Melancholy made four waies. Scirrhus Phlegmonodes, Scirrhus Erysipelatodes. There are four waies also shown to the making of burnt Melancholy. The first is made of yellow Choler burnt, and so representing a yellow sinder, and doth burn like it; The second is made of thick and viscid Flegm; The third is made of burnt Blood, which is very bitter; The fourth is made of Melancholy Juice, being both acid and corroding.How a Scirrhus is made. There are two kinds of Humours which do make this Scirrhus; the one being a Crudity, as Flegm, thick and yet not viscid; the second is vitreous matter, or a glassy substance of Flegm. And hence may we take a Scirrhus either to be exquisite, or not exquisite: and therefore if Flegm be in a great quantity, it shapeth out Scirrhus Oedematodes; if Choler be predominant, Scirrhus Cancerosus. Or if you please a Scirrhus is bred out of a natural melancholy Humour, which is cold, dry and thick, [Page] and from glutinous Flegm;Its definition. and hence it may be defined a Tumour hard and indolent, a Tumour proceeding from a thick and glutinous Flegm, or a natural melancholick Humour. It may be known by these Signs, it is a Tumour without pain,Signs. hard to touch; if not exquisite, it is scarcely perceived. Every Scirrhus hath not pain; and this necessarily happeneth, because it is deprived of sense. Melancholick Scirrhous Tumours are generally of a leaden colour, but a Scirrhus arising from a Flegmatick Humour carrieth in it the natural colour of the Cutis. They take their principal Causes from the beginning of thick and tough Humours, and collecting themselves in the parts; and that occasioned by evil Diet generating a thick and viscid Humour,Causes: as by reason of intemperieties of the Liver or Spleen, all such causes may be said outwardly to generate thick juices, as a cold or dry Air, Watchings, suppression of Menstrues, and the like. Expect to do no good on an exquisite Scirrhus; for this alwaies is to be suspected: If it happeneth about the Joints,Presage. Knees, or these remote parts, be not too forward to undertake them. If it be exquisite and not turning Cancerous, yet it is hard to cure: for [Page] first, the Matter is dried up; and then cold and compact, and so tedious; and that which is lapidous gives no way to Medicine.Cure. As to the cure, the external causes are first to be removed, by choosing a thin Air, hot and moist, free from Fogs and Mists; let the Patient shun thick, leguminous and cold Diet; let his Drink be Wine to help forward Digestion, and warm the parts; and let him get himself clear of all passions of the mind. After this are we to take care to remove the inward causes, by preparing the Humour with Syrup of Apples, Bugloss, Fumitory, Hyssop, Oxymel, Balm, and the like. This being done, we are to purge this melancholick Humour with Senna, Polypody, black Hellebore, Confectio Hamech, &c. of these or the like may be framed excellent compound Medicines, as this Apozeme. ℞. rad. Faenicul. Scorzonar. Bugloss. an. ℥ss. cort. Tamarisc. Cappar. Polypod. Q. an. ℥i. sem. Anis. Faenicul. an. ℥iss. Citr. ʒij. fol. Capill. vener. Scolopendr. Meliss. Lupul. Thym. an. M. i. fl. 3 Cordial. an. pug. ij. Passular. enucleat. ℥i. Liquirit. ℥ss. coquantur in s. q. aqu. fontinae, his adde syr. de Cichor. cum Rhabarbaro, de Spin. Cervin. an. ℥ij. misce, hujus sumat. ℥vj. omni mane cum [Page]custodia. Potio purgans. Or. ℞. Veronic. Agrimon. Scabios. Fumar. Cuscuth. an. M. ss. sem. Anis. fol. Senn. mundat. an. ʒij. coquantur omnia in aquae fontinae q. s. ad ℥vi. colaturae adde Conf. Hamech. ʒiij. Diacatholic. ℥ss. misce, fiat potio. Or this, ℞. Rad. Polypod. ʒss. Epithym. ʒiij. Senn. ℥ss. Tamerind. ʒvi. sem. Coriandr. ʒiij. Santal. Citrin. ʒij. coquantur in aqua fontina ad ℥. 14. colaturae adde Agaric. Troch. ʒij. Rhabarb. ʒiss. stent in infusione per horas 4. colaturae clarae adde syr. de Pomis ℥ij. misce, capiat ℥vi. omni secunda vel tertia die. Or this.Another potion. ℞. Senn. opt. ʒiij. Epithym. Rhabarb. an. ʒiss. santal. citrin. ʒi. sem. Coriandr. ℈ij. Sal. Absynth. ʒss. spic. Celtic. ℈i. infunde in vase clauso per noctem in Vini albi & aquae ex Pomis an. ℥iiij. colaturae clarae adde syr de Epithym. ℥ij. Pills. Aqu. mirabil. ʒij. misce, fiat potio mane sumenda. Pills for the same. ℞. pil. Indic. ℈ij. Coch. ℈i. extr. Ellebor. nigr. gr. ij. extr. Castor. gr. ij. misce, fiant pil. Or this.Pills. ℞. pil. de Fumar. de lap. Lazul. an. ʒss. extr. Ellebor. nigr. gr. iiij. ol. Majoran. gutt. ij. cum. syr. Rosar. solutivar. Pills. a. s. fiant pill. Or ℞. Alo. ʒij. Myrrh. ʒss. Epithym. ℥ss. rad. Gentian. Asar. an. ʒss. Gum. Ammoniac. solut. in spirit. Vin. ʒss. Rhabarb. ʒiss. Spic. ℈i.[Page]cum succ. Absynth. misce, fiant pil. quarum sumat ℈ij. alternis matutinis. These being compleated, we arrive now at the part affected; and here are we to endeavour to discharge the Matter which makes a Scirrhus. Repellers here will do no good, for it is too thick for them; Digestives therefore, which can work by insensible Transpiration,Digestives: are most proper: and these at first should be milde, and in reference of its hardness Emollients are most fit; so that the proper Indications which are to satisfy these scopes, should be Emollients and Digestives. Of this sort may be reckoned Ʋnguent. Dialth. Empl. Melilot. Diachylon. Simplex, Ireatum, or cum gummi, or Empl. de Ranis cum vel sine Mercurio, the which do both mollify, resolve, and make thin this thick Matter. And to proceed methodically, we are to begin with the time of the Scirrhus, then consider the strength of the Patient, after this take care of the part affected, and these with judgment to order your Medicines aright, as thus. ℞. rad. Alth. ℥iiij. rad. Lilior. ℥ij. coquantur in aqua fontina, Empl [...] pistentur, & trajiciantur per Setaceum, addendo Ol. Chamomel. Lilior. an. ℥ij. Empl. Diachyl. cum Gummi solut. in ol. Lilior.[Page]℥iss. Cer. parum. fiat Emplastrum. ℞. Galban. Bdell. an. ℥i. Ammoniae. ℥ij. Alveor. Apiu. Oesyp. an. ʒij. Tereb. venet. Pic. liquid. an. ℥iss. Bacc. Laur. Staphisacr. Cumin. Pyrethr. an. ℥ss. stercor. Caprin. Ovil. Anserin. an. ʒij. Axung. Porcin. sev. Caprin. Cervin. Ʋrsin. an. ℥i. Ol. Chamomel. Lilior. an. ℥iij. Cer. q. s. fiat Empl. Or this Empl. ℞.Empl. rad. Breon. Cyclamin. Helen. Cucumer. agrest. an. ℥i. coquantur in Vino albo & Acet. an. q. s. deinde per setaceum pistentur & percolentur, colaturae adde pulv. Iridis, Myrrhae, Olibani, Mastichis, Croci, Aristolochiae rotundae an. Empl. ʒiss. fl. Chamomel. Melilot. Sambuc. an. ℥ss. Gum. Haeder. Styrac. Calamit. an. ʒiij. Euphorb. ʒv. sem. Staphisacr. ʒij. Hydrargyr. extinct. cum Saliv. homin. ℥ij. ol. Lilior. de vitell. Ovor. Oesyp. an. ʒv. adip. Auserin. Suill. Medull. crur. vitellin. an. ℥i. Mucilag. sem. Faenugraec. Lin. Alth. an. ℥i. misce, & cum Cer. q. s. fiat. Empl. Or this.Emple ℞. Empl. de Melilot. Bdell. Aceti scilliciti solut. ʒij. Castor. opt. ʒiss. pulv. Rad. Irid. ʒi. Empl. de Ran. cum ☿. ℥ss. Ol. Chamomel. Lilior. an. q. s. fiat Emp. And thus have I passed through the four general Tumours arising from the four Humours. I shall conclude this [Page] with the History of a Woman of fifty years of Age,A History. which had frequently in Her left Mandible a fixt Scirrhous Tumour, and this did grow to so large a bulk, that it almost hindred her swallowing; it swelled and filled her cheeks so much with its Tumour; it began just about the extreme process of the lower Mandible: and for the removing this Tumour, and preventing suffocation, and endeavouring to give ease and cure to the Patient, this method was proposed and followed, the Excrescency was to be surrounded with a thred, and apprehended therewith, and so by degrees bringing it closer until it had eaten it away, by which means it was wholly eradicated; by drawing out the tooth, and with astringent and deterging Gargarisms well ordered the whole cure was performed; this you may read in Bald. A History: Ronsius in his Epistle 7. Another Gentlewoman having had a Contusion in her Hand, a great pain did arise from thence, about the Carpus or Wrist with inflation of her whole Hand; at length it degenerated into a Scirrhus of the largness of a Hens egg, in so much that she could not bend her Fingers; her Body being universally purged and ordered, I applied a potential [Page] Cautery to the part; afterwards I removed the Eschar, which was but lightly penetrated; afterwards applying new Escharioticks, which might penetrate deeper, I soon saw appear a thick viscous and yellowish Matter, the which took sometime for the getting its discharge; Sponges being clapt into it for dilating the Ulcer, the Matter being exposed to the Air, hardened like a stone, much of which I drew forth, and the Ulcer being well mundified, I filled it up with Flesh, skinned it, and the Patient perfectly recovered.

CHAP. XXIII.
Of Aqueous Tumours.

I Proceed now to the other two Tumours arising from Water and Wind, out of which watery Fountain do arise and spring up Ascitis, Hydrocele, Hydrocephalos, Phlyctenes and the like. Now this Serum from whence these Tumours do arise, is a collection of Water in some member of the Body, void of pain, and there is but a small quantity hereof in healthful persons, it doth stamp its various species on its places where [Page] it inhabits or hath any thing to do. Galen calleth all waterish Tumours Pustles, that have any moisture in them. And when it thus getteth into the Scrotum, it maketh Hydrocele; if into the Navel, Hydromphalos. They arise from a thin Humour, which sometimes is profitable; profitable so far as it doth perform its office, which doth serve as a proper Vehicle to the Blood; wherefore if it at any time happeneth that a waterish Humidity be refunded into the Body forcing its excretion, this expelleth it to the Cutis through the other parts, and doth form and make these waterish Tumours. A second may be a redundancy of this waterish Humour in our Bodies, which oft times doth happen and arise from a weakness of the Kidneyes, which are not strong enough to attract this plenty of Serum: or may be occasioned by drinking too much Wine; for as Galen saith, this waterish Humour is the excrement of potion.Signs. You may know it by its Splendor and Fluctuation, if you press it with your Finger; and a particular Sign of a waterish Tumour is, that it is made with itching, occasioned by the saltness which is contained in the Humour. Such as cometh from an evil affect either of Liver [Page] or Spleen,Presage. is very bad and dangerous, not because of the Tumours but in respect of the principal parts; yet they are not so dangerous as windy Tumours.Cure. The Cure is to be performed by ablating the Causes: and if this do arise from two much drinking, order your Patient to lessen his quantity, and abstain from this course and habit of living, and use Driers: and if it happeneth from a vice either of the Liver or Kidneyes, this is to be corrected; Hydragogicks are most proper here; as, ℞.Pil. extr. Elater. gr. iij. Cambog. Resin. Jallap. an. gr. v. faecul. Rad. Irid. gr. ii. Ol. Macer. gutt. ij. misce, fiant pillulae, quarum sumat 2 omne mane. Or ℞.Pil. extr. Rud. ʒ ss. Resin. Scammon. ℈ss. ol. Nuc. mosch. gutt. ij. misce, sumat cum Custodia. Pill. ℞. Resin. Jalap. Scammon. an. gr. vj. Mercur. dulc. ℈ss. pulv. Jalap. gr. vj. cum syrup. Rosar. solutivar. q. s. fiant pillulae addendo ol. Caru. Ch. gut. ij. Pill. misce. Or these. ℞. Troch. Alkakeng. ʒss. spec. aromatic. Rosat. Diagalang. an. ℈i. Philon. Roman. ℈ss. pil. de succin. ℈ss. Terebinth. venet. in aquae vitae solut. q. s. fiant pil. quarum sumat 2 or ʒ omni mane. Or this Condite, ℞. Cons. Absynth. Menth. an. ℥i. Cort. Citr. condit. ℥iss. spec. Diacalaminth. [Page]ʒij. sal. Sambuc. ʒi. spirit. Nitr. ℈ss. ol. Cinomon. gutt. v. Macer. gutt. 10. misce, fiat Conditum. As touching Topicks, the Humour is to be discharged by Digestives: and here we ought to rarify the skin, that it may with ease come forth; and for this purpose this Cataplasm is very good and proper.Catapl. ℞. fol. Malv. M.i. farin. Lupinor. ℥i. ol. Aneth. Chamomel. an. ℥ij. coquantur & contundantur in Vino albo, fiat Cataplasma. Or if you be for a stronger, you may use this Unguent.Unguent. ℞. sem. Sinap. sem. Ʋrtic. Sulphur. Spum. mar. Aristoloch. rotund. Bdell. an. ℥i. Ammoniac. ol. Aneth. Cerae an. ℥ij. misce, fiat Ʋnguent. Or this, ℞. Sal. Nitr. ʒ10. Piper. bacc. Laur. an. ℥i. ol. Laurin. ℥vi. Cer. q. s. fiat Ʋnguent. If with these they are not cured, they are to be opened, and the Ulcers to be mundified with Resine, Turpentine, and Honey, or Ʋnguentum ex Apio, &c. then is it to be impleted with Flesh with Ʋnguentum Tuthiae, and dry it up with Pulvis Tuthiae Desiccativum, Rubrum, Diapompholigos, or Diapalma. Fabritius Hildanus relateth of a man of thirty years of age,A History. very strong and of a sanguine complexion, who fell into a Leucophlegmatia: that he swelled from the neck to his [Page] foot, his Optick nerves being obstructed, hereby he grew blind: Upon ordering the Patient opening Apozemes, and giving him preparative Decoctions, a great Flux of Blood fell accidently from his Nostrils, so that he bled above four pounds, and hereby fell into a Syncope; but being a little revived after his Flux was stopped, and his Faculties beginning to gain a better habit and condition, beyond the use of any Medicine, this flux perfectly cured him of his waterish Tumour. This is occasioned as the Greeks do call it, [...], from an aluminous salt of the Liver, or some other principal part, the which by its subtile penetrating quality doth force it self into diverse parts of the body.

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CHAP. XXIV.
Of Windy Tumours.

UNTO this windy Commander do belong these several Souldiers, as Pneumatocele, Tympanites, Priapismus, Satyriasis and the like. This Wind doth carry in it a very strange and wonderful power and force in our bodies, and is as it were a certain Lightning scattered through the insensible Trunks, insinuating it self into abstruse parts; for it reacheth the Bones,What i [...] Wind. and doth create very great trouble in our Joints; it bringeth greifs between skin and bones, and doth ruffle and disorder the whole Man, for where it is compact with any other Humours, it doth there make both a long stay, and doth stir up but many sad Symptoms: This sheweth what Wind is, whereof are bred these Tumours. Let us now see what these Tumours are.What a windy Tumour is. A slatulent Tumour by the Greeks is called [...], or [...], and he that is afflicted with these is oft times girded in his Sides, and stretches in his Belly. It is oft times caused of Crudities;Cause [...]. and because it maketh the part thick by reason of the [Page] grosness of these Flations, it doth oft times make troublesome and tedious work for the Chirurgion. Its causes are flatulent Spirits, viscid, or vitreous Flegm, and want of native Heat; thus the heat is but small which doth work it self into these Humours, and so doth somewhat dissolve them, and so doth arise this flatuous Spirit; and this being bred, doth elevate the part where it once getteth footing, because it cannot work its free passage by reason of the density of its parts. It is seen to arise in several parts of the Body, as well inwards as outwards. Here is held by Avicen a double kind of this windy Tumour:Differencies. the one being made by a light Vapour assimulated to Althege [...]um, the which is nothing else than a Tumefaction like to a Cachexy, this arising from the disaffection of the Liver: and there is another Tumour arising from a windy Vapour, and this by Avicen is called Inslatio. This is bred from Flegm coming from the larger Vessels to the smaller, until it hath arrived at the smallest, and at the coldest parts.Signs. It showeth it self apparent in compressing the Tumour with the Finger, and you may then see it easily yeild to the touch, as doth an Oedema: Then upon this compression [Page] it maketh a noise; for Wind being kept in, and being by your Finger prest out from its quarters, this never parts from its place without a noise or sound: Thirdly, it is deteined in a cavity: Fourthly, as Guido doth offer, it appeareth lucid and splendid in its upper part. Fifthly, it is not alwaies free from pain: And lastly, being contained in the larger Vessels, we daily find the great and many troubles and vexations it brings to mankind. As touching the Cure, pray observe with me this method,Cure [...] wherein we are to observe an Order, Mode, Time, and Substance, Order, this cheifly consisting in Diet. As touching the Patient's times or eating and drinking, that he neither eat too soon or too late, between meals, or after supper, going to Bed and the like, or in his bed. Mode, that he neither eateth more than may reasonably satisfy his Stomack without difficulty. And to its substance, this requires that he take notice, that he abstain from all Flegmatick Meats, or such Diet as hath therein a slatulent or windy s [...]stance, such as may obstruct the pas [...]es, as Fruits, Pease, Beans; and let [...] shun all windy A [...]s, or other such like Liquors. A moderate exercise is very good [Page] here, for it doth recreate and refresh all the passions of the Mind, and doth diffuse, concoct and digest the native Heat through all the Body, and maketh every Member and part to perform its office and function. In the Patient's Bread may well be ordered sweet Fennel seeds. Let his Meat be well Aromatized and his Drink be Wine of the best sort, that may both strengthen his Stomack and hinder the afflux of any windy Vapours ascending up to the brain, excite the native Heat, help forward Digestion, and drive the Excrements downwards; after these keep his body free from these flatuous Humours, by convenient Evacuations; as by Pills, Potions or Clysters, for which these are very convenient. ℞.Potion. Aqu. Meliss. Bugloss. an. ℥iss. infunde per noct. Rh [...]tharb. ʒi. Agaric. troch. ℈ij. Cinam. Elect. ℈ss. Colaturae adde Mann. ℥ss. Cambog. gr. iiij. Aqu. Cinamom. Tenuior. ℥ss. misce, fiat potio. Or this. [...]. ℞. Pulp. Tamerindor. ℥ij. Cons. Rosar. pallidar. ʒ10. Electuar. è succ. Ros [...]r. ℥i. Tartar. vitriolat. ʒi. misce, fiat Electuarium cujus sumat q. nuc. mosc. ℞. Galban. praeparat. cum Acet. Scill [...]tic. ℈ij. Tartar. vitriolat. Mastich. an. ℈i. Castor. Myrrh. an. gr. 15. Croc. ℈ss. Troch. Alhandul. ʒi. Resin. Jalap.[Page]Scammon. an. ℈i. ol. Aneth. Caru. an. gutt. iij. quarum sumat Patiens 2 vel ʒ hora somni. Pil. Or these, ℞. Extr. Rad. Alo. opt. Resin. Jalap. an. gr. vi. Sal. succin. volatil. gr. iiij. ol. Lavendul. gr. ij. misce pro dosi una. Clysters also in this place have been very experimentally of great service and use. As, ℞. Malv. Mercur. caul. Clyster. rubr. Calaminth. an. M. ss. fl. Chamomel. Fursur. an. pug. i. fiat Decoctum in s. q. aqu. fontin. ad lb. Colaturae adde Diaphaenic. ℥i. spec. Hier. picr. ʒij. ol. Aneth. ℥ij. Sal. parum. misce, fiat Enema. Or this, ℞. fol. Alth. Malv. Violar. Chamomel. Melilot. sem. Lin. Faenugraec. an. q. ut fiat Decoctum ad lb. Clyster. in quo solue Electuar. Caryocostin. ʒvi. syr. Rosar. ℥ij. ol. Aneth. Butyr. recent. an. ℥ij. M. fiat Enema. Or this, ℞. Mercurial. Betonic. an. M. ij. fl. Chamomel. Melilot. an. M. ss. sem. Faenicul. dulc. Cumin. Caru. an. ʒij. coque ad lb. colaturae adde Benedict. laxativ. ʒss. Electuar. Diaphaenic. Hier. picr. an. ʒij. ol. Chamomel. Aneth. an. ℥i. misce, fiat Clyster. Pouders for the same may be these. ℞. sem. Anis. condit. ℥iss. sem. Faenicul. dulc. ʒvi. Coriandr. praeparat. ℥ss. Cumin. Caru. Sesel. in Vino albo macerato an. ʒss. Cort. Citr. siccat. Cinamom. an. ℈ij. misce cum sacchar.[Page]alb. dupl. hujus quantitatis, hujus sumat Cochlear. Troch. no. i. post cibum. Or these Trochisces, ℞. spec. Aromatic. Rosat. Electuar. de Bacc. Laur. an. ʒss. Cardamom. sem. Citr. Coral. rubr. an. ℈ss. Spec. Diacumin. ℈i. pulverescantur & cum sacchar. A Hippocras Wine: q. s. & cum aqu. melissae fiant Trochisc. ℞. Sacchar. alb. ℥iiij. ZZ. ʒss. Electuar. de Bacc. Laur. gran. Paradis. an. ℈ij. Vin. generosissim. lb. colentur per manicam Hippocratis, & siat vinum Hippocraticum. Or this Powder, ℞. sem. Coriandr. praeparat. ʒij. Cinamom. Pulvis. elect. ʒi. Margarit. Perlar. ℈i. sacchar. Rosar. ℥ij. misce, fiat pulvis hujus capiat cochlearium i. in fine pastus: and thus have I furnished you with a plentiful variety of inward Medicines. We arrive now at Topicks; and here such as can most properly evacuate this windy matter are most proper and convenient; and before we apply any external Medicine, the parts are first to be well fomented with Sponges or Clothes dipt into such Fomentations as these. ℞. fol. Chamomel. Puleg. Hyssop. Meliss. Fomentation. Absynth. Aneth. Centaur. Calamenth. an. M. ss. Bacc. Laur. sem. Cumin. Anis. Caru. an. ℥ss. fl. Chamomel. Melilot. Rosar. rub. an. pug. ij. Coquantur omnia in aquae fontinae q. s. addendo[Page]parum Aceti & Vini albi lb. & fiat Fomentum. Foment. Or this. ℞. sem. Cumin. bacc. Juniper. Rut. Absynth. Chamomel. bacc. Laur. an. ℥i. fl. Melilot. Rosar. rubr. Chamomel. an. pug. i. fiat Fomentum cum aequal. part. Vini & Aquae. Or this, ℞. Betonic. Salv. Origan. Calamenth. Sambucin. Tanacet. an. M. ss. fl. Rosar. rubr. ℥i. sem. Anis. Faenicul. Caru. Cumin. an. ʒi. incidantur, contundantur & coquantur in Lixivio ad Fomentum. Cataplasms for the same may be such as these.Catapl. ℞. farin. Fabar. ℥iiij. pulv. fl. Rosar. Melilot. Chamomel. Sambuc. an. ʒii. pulv. sem. Anis. Caru. Coriandr. Cumin. Faenicul. bacc. Laur. Juniper. an. ℥ss. cum decocto Calamenth. Malv. Chamomel. an. q. s. fiat Cataplasma fine addendo ol. Unguent. Aneth. Chamomel. an. ℥ij. An Unguent for the same. ℞. Ʋnguent. Laurin. ℥i. ol. Chamomel. Rut. Anethin. an. ℥ss. Catapl. Spic. ʒij. misce. Or this Cataplasm. ℞. farin. Fabar. Hord. Lupinor. an. ℥ij. pulv. Origan. Calamenth. Salv. Absynth. fl. Chamomel. Melilot. an. ʒij. coquantur omnia in Vino & aqu. Absynth. an. q. s. Oximel. Simpl. ℥ij. cum oleo Aneth. Chamomel. an. ℥iss. misce, fiat Cataplasma. For the same the discussing Empl.Empl▪ Silv [...] of Silvius is generally reputed to be very good. ℞. Gum. Galban. [Page]Bdell. Ammoniac. an. ℥ss. Thur. Myrrh. an. ʒij. Opii ʒi. Solvantur omnia in Aceto Scillitico & coquantur ad Consistentiam, tunc adde Cer. Colophon. an. ℥iij. Balsam. Peruvian. ol. Phylosophor. an. ʒi. ol. Lumbricor. ʒij. Terebynth. venet. q. s. fiat Empl. And thus much for discussing of windy Tumours. And that Wind is bred in the Ventricle, and Intestines Physicians have alwaies confirmed; and that it hath crept and forced it self into other parts of the body, this thing I have very oft times seen; an example of,History: which you may here read off. A Child about ten years old, lately distempered with the small Pox, in so much that it had near cost her her life, for she was so blown up with wind from the Navel even to her Feet, this getting a passage between the Cutis and the Musculous parts. There was no pain, the inward parts were sound and almost [...]reed from the aforesaid distemper. Various Medicines were prescribed inwardly for strengthening of the parts, and creating in them a native heat; outwardly Medicines for discussing this Wind, and by these she grew well. Riverius observat. 69. writeth of a Child being eighteen months old, who was much blown up with Wind, and troubled [Page] with a Fever: several Medicines being prescribed, as Purges, Clysters, Juleps, Ʋnctions, and the like, with the Syrup made of a decoction of Agrimony both Wormwood and the lesser Centaury taking a Spoonful thereof twice in a day, within three daies perfectly recovered.

CHAP. XXV.
Of a Cancer.

AND because this is a Tumour doth happen very frequently in our Art, and proves an enemy both very powerful and painful, that we may understand the right way of dealing herewith, it generally happening in the Brest,What the Brest is. let us first consider the Brest it self and its parts. The Brest, according to our Countryman Wharton, is said to be framed of a glandulous spongeous Parenchyma, not divided into distinct conglobated Glandules,The Anatomy of the Brest. but is rather to be accounted a conglomerated Glandule; but in a Scirrhus and in a Cancerous Tumour they appear knotty. It hath Veins, Nerves, Arteries, and Lymphaducts, and a porous Cavity: its Veins and Arteries [Page] come from the Subclavians: it hath its Nerves from the fifth pair, and from other Originations: Lymphaducts are here very frequently scattered: and as touching its Porosities or porous Cavities, these do serve for its Excretion, or its excretory uses, they being more large in the Brest then in the common Ductus, which is opened with many small Foramulaes, their general use is to prepare the Milk fit for the Infant: and for the making this there is held a great controversy, some holding the Blood to be the Prima Materia hereof, whilst others do contend as stoutly for the Chyle to be its Origination. The first is not to be defended; for if Chyle be to be made most properly into Blood, it may very properly be accounted retrograde for Blood to turn into Chyle. And such as do stand up for the Chyle to be the onely substance of the Milk,How milk is made. they do offer this as their assertion, that the Chyle doth immediatly pass through the Milky vessels into the Brest, or that it is there received into the Veins, and thence effused through the Thoracick Arteries into the Brests, and that they have a power or faculty to separate the Blood from the Chyle, and to dispose it through the Mammillary vessels [Page] into the Body, and this they call Milk; but the way or passage which should conduct this to the Lactiferous vessels is not yet arrived at. Our worthy Wharton's opinion is, that Milk is peculiarly a nervous Juice, not properly constituted for the substance of the Milk, but also for carrying a double Matter with it, as being both Chylisick, and Spermatick; and these two do breed the greatest part of the Milk, not immediatly sent from the Ventricle to the Brests by the Milky vessels, but carried by or through the Ductus chyliferus into the Subclavian, thence circuled with the Blood through the Ventricles of the Heart, and so passeth through the Thoracick Arteries, and in time of the Mother giving milk it is refunded into the ample capacity of the Brests, and there do separate the Sanguineous part from the Chyle, and do reduce it through the Mammary Veins into the Meditullium of the body. And this he offereth as the cheif matter or substance of Milk, and the most proper nutriment for the Infant. And since we daily see the young sucking Babe is nourished by alluring this Milk from its mothers Brest by her Nipple, it is very necessary that it should contain in it [Page] such a substance as may give it satisfaction. And as the more noble part thereof doth come from the Succus nervosus; so also ought it most properly to be derived from hence for the Infant's nutriment: but thus much as touching Milk. We arrive now to that which nearer concerns our enquiry, which is the tract of a Cancer: and this by the Greeks is called [...] or [...],Its name: by us a Cancer, from the resemblance it hath with a Sea-Crab. For as the one hath expanded claws and feet in several places, being of a livid or cinerish colour; so also is this Tumour of a round Figure▪ of a livid Colour, and sticketh or adhereth so close to the part affected as a Key to a Door, or a claw of a Crab in its griping, having in it by some reported to carry in it exalted Veins; but this is more fabulous then true, for not in four of a hundred, as Falloppius observes, can you see them thus apparent. It carrieth with it a train of horrid pain and heat, shewing it self to view both cruel and horrible, it ariseth from black Choler. As Tagaultius supposed, it ariseth from the Fecies of Blood; but this is onely his opinion, for this doth more properly frame and make a Scirrhous Humour; and that which to the [Page] whole body doth make an Elephantiasis, to a private or particular part doth also frame a Cancer: and where this black Choler is sharp and hot, it maketh an Ulcerate Cancer: and by reason of its thick Juice, it can neither be repelled, or discussed; for as it slighteth and contemneth the company or acquaintance of mild Medicines, so also doth it like Lard or Oyl turn into a flame, rage, and fury, by the applying of any strong or vehement Medicine. The Causes of this Atra bilis are many; for first in the Liver is bred this natural melancholick Humour, which is called the Fecies of the Blood,Causes▪ and hence ariseth a Scirrhus, so this Atra bilis is made up of the adustion of the other Humours, and without flattery is the worst of all the rest, and as it groweth more putrid, sharp, and malign, it doth more speedily, violently, and painfully create an ulcerated Cancer. Sometimes it ariseth from a hot intemperiety of the Liver, which burneth it, and by this burning is bred Atra bilis. Sometimes as Galen saith cap. 10. lib. 2. ad Gla [...]c. from weakness and intemperiety of the Spleen, it being made incapable to attract this melancholick Humour, in so much that it is kept up and burnt up in [Page] the body. Sometimes it happeneth from a suppression of the Menstrues. Outward causes may also affect this, as a thick, and viscous Diet, as Onyons, Leeks, Beans,Its subject. and the like. It may arise in any one part of the Body; sometimes it doth throw it self forth into several places, but the Brest being a soft loose part is most subject to its Tyranny, and receiving the impress of its malitious stamp. Sometimes it happeneth in the parts of the Face, Nose, Lips, Mandible, and Tongue. Sometimes in the Inguens, and Thigh; a lively example of which I had in a Gentlewoman, my Patient in Norwich when I writ this. Another reason that a Cancer doth soonest grow acquainted with the Brest before any other part, is in respect of the great consent that there is made between the Breast and the Womb, by the Veins, through which this thick and feculent Blood is sent and dispatched; and for the same reason is it, that there have been seen so oft times Cancers of the Womb.Signs. At its first touch it doth appear hard in respect of its thick Humour; it is of a livid Colour, and the more malign the Humour is, the more livid the Colour of the Tumour is; and then painful, for here is made a solution of Continuity, [Page] occasioned by much Matter distending the Nervous parts, Heat and Inequality; it is hot like the Humour that breedeth it. The greatest matter here to be minded is the Hardness and Thickness of the matter; if you see a black and livid Colour in the place, and a Hardness accompany it, this is a Pathagnomonical Sign: if you meet with a melancholy Humour and a melancholy Habit of Body, and the Brest suspected, and the Body capable of entertaining such a Tumour furnished with evil Juices, this giveth a fair prospective to the thoughts of a Cancer. The Cancer which is Ulcerate may well be known by these Signs: For its Ulcer carrieth with it a fetid Smell, having thick, swelling, and blewlooking Lips, horrid in aspect, and accompanied with great Pain.Presage: In its beginning it is hard, having a blewish Colour, and pricking Pain about it. The event showeth the success; for you may never expect a cure of this: if any hopes may prompt on to proceed, it will be with a great difficulty: if you extirpate it, there oft times remaineth a Cancerous Ulcer, or it maketh its reversion some other way, and to some other part; so that, as wise Hippocrates saith, if the Patient be thus cured, [Page] this Cure will onely be as a means to shorten his daies. We ought not to meddle with ulcerate Cancers, these by Galen held to be altogether incurable. Cap. 5. lib. de atra bile, they coming from black Choler; neither ought we to attempt the Cure of any other without Amputation, the which way and method of cure doth carry with it great danger and hazard, as Celsus offereth. Cap. Cure. 28. lib. 5. As to the Cure, these three things are to be minded, that we have a great respect to the Patien'ts Diet, prescribing convenient Medicines, and well ordering the part affected; and these are performed by Diet, Pharmacy, and Chirurgery. And because the best kind of these are bad enough to be treated with, that it may have its great force and fury stormed, and its spreading venemous Quality the better contracted and lessened, we are here to begin our work with universal order and method of the whole Body. The better to strengthen the other adjacent parts, and to allay the fury and anger of this so potent an enemy, we are first to look to the good order of Diet, which in Quantity should be thin, although moist in Quality; and endeavour to quell the antecedent Cause by prohibiting the generation [Page] of this Humour; and purge gently your Patient by degrees: and in purging observe this rule, that you often prepare the Humour; the antecedent Cause being conquered, lay Seige to the conjunct Cause with all such Engines as may storm the force of the matter contained in the part affected; and if any furious motion hereof may either disturb the Quiet, unsettle the Rest, or discompose the order of this princely Fabrick, use all means to prevent the incursion of this private Enemy. And for the first intention, it being the most proper and ready method for hindring the augment of a Cancer and keeping it within its bounds, Purgation is as an excellent weapon. And here may you furnish your self with many excellent Methods, being either made into Apozems, Pills, Pouders, Potions and the like.Apozeme. As for an Apozeme, take this. ℞. rad. Faenicul. Asparag. Lapath. acut. Scrophular. Polypod. querc. Sanicul. cort. interior. Frangul. an ℥i. Agrimon. Veronic. Cuscuth. Cetrach. Fumar-Capil. vener. an. M. ss. fl. Genest. Sambucin. an. M. ss. sem. Anis. Faenicul. dulc. an. ℥i. Liquirit. rasur. Ʋvar, passar. exacinatar. an. ℥iss. coquantur omnia in s. q. aquae fontinae ad tertiae[Page]partis consumptionem, ad libram colaturae adde syrup. de Scolopendr. Epithym. an. ℥iss. Aqu. Cinamom. ℥i. misce, fiat Apozema pro tribus dosibus. Or this Potion,Potion: ℞. Conf. Hamech. ʒiij. Extr. Hellebor. nigr. gr. vj. Aqu. Cinamom. ℥ss. cum q. s. Decocti prioris, fiat potio mane sumenda. Or this. ℞. rad. Bugloss. Acetos. Cichor. an. ℥ss. Agrimon. Cetrach. Epithym. a. M. ss. Senn. mundat. ℥iss. fiat Decoctum ad lbi. Apozeme. fine addendo fl. ʒ Cordial. an. pug. i. in colaturâ infunde per noctem Rhabarb. elect. ʒiij. pulv. Cinamom. ℈iiij. exprime Liquorem, & in hac solve syr. Violar. de Pomis an. ℥iss. misce, fiat Apozema. Some of the aforesaid Pills mentioned in the cure of a Scirrhus may well be used and taken here.Sudorifick decoction. Sudorifique Decoctions are also very prevalent here: as, ℞. Lign. Sarsafr. ℥ij. Lign. Guajac. Sarsaperill. an. ℥iss. Cinamom. ℥ss. coquantur omnia in s. q. aquae fontinae addendo sem. Anis. Faenicul. dulc. an. ʒij. rasur. Liquirit. ℥ss. Of these make a Decoction; of which the Patient may drink three or four times in a day. And as touching the part affected, Repulsion, and Digestion, Scarrification, and Section according to Galen lib. 14. Meth. are very proper for evacuating and discharging of the repletion [Page] of Humours. As for the first two Repulsion and Digestion, Galen doth order these to be used both before and in the time of Purgation, and then to use Digestives when the Body is sufficiently purged, these being made and composed of such things as may not contain any corroding Quality in them: and of the Simples may be reckoned these, Plantane, Nightshade, Knotgrass, Lettuce, Sowthistle, Pomgranates, Balaustians, and the like. Avicen doth much commend Tutthy being washed and mixed with oyl of Roses. Paulus doth commend Nettles bruised. Some do admire the powder of Frogs, and others as much do praise an Unguent made of them. Others have a great value for Empl. Diacalcitheos dissolved in the juice of Nightshade and oyl of Roses in Cancers not ulcerate: But for compound Medicines take these. ℞. succ. Solan. ol. Rosar. an. ℥iij. pulv. Ranar. ustar. & testar. Cancr. an ʒiij. pulv. Rosar. Unguent. rubr. ʒi. Tuth. praeparat. Lithargyr. aur. pulv. Plumb. ust. & lot. an. ʒi. Agitentur omnia in Mortario plumbeo, & fiat Ʋnguent. Unguent: ℞. Theriac. veter. ℥i. succ. Cancror. ℥ss. succ. Lactuc. ol. Rosar. an. ℥iss. Vitell. ovor. no. ij. sub cineribus coct. Camphor. ʒss. agitentur[Page]omnia in mortario plumbeo & fiat Ʋnguent. Or this.Empl: ℞. pulv. Plumb. Ceruss. Min. an. ℥ij. Litharg. aur. ℥i. ol. Lin. lbss. Cer. q. s. fiat Empl. Or this pretious Unguent so much admired by Franciscus Arcaeus in Cancerous Tumours. ℞.Unguent. ol. Rosar. Omphac. lbss. sev. Hyrcin. Vitulin. Ʋnguent. Rosatum. Populeon an. ℥iiiss. succ. Solan. Plantagin. & Acetos. an. ℥iss. Vini granator. ℥iiss. coquantur omnia lentissimo igne ad succorum & Vini consumptionem, postea colentur, & colaturae adde Ceruss. ℥iiss. Litharg. aur. ℥5. Plumb. ust. Antimon. an. ʒ10. Tuth. praeparat. ℥iss. Cer. Alb. q. s. fiat Ʋnguent. in Mortario plumbeo. All these or any of these may be used in the beginning of a Cancer, when it is but small; but if it hath arrived at a greater bulk and largness, this as Galen directeth cap. 10. lib. ad Glaucum is not to be dealt with, unless by Amputation: and this I think in no wise may be said to come under the name of an exact way of cure; because it neither yeildeth the part its native Heat, but taketh away with it the sound as well as the disaffected part. And that we may proceed more effectually in this operation when occasion and necessity may command or oblige it, observe with [Page] me these Rules, being as so many just Guides which will hardly fail you in your conduct: as first, that Cancer which doth adhere to the Brest or Brests is very deplorable. Secondly, that which doth happen in the Head, Neck or Shoulders, or also in the Inguens, all these are to be pronounced incurable. Aetius cap. 44. lib. 10. gives this for a reason, because they creep and get in so deeply into the fleshy parts, that they are not to be got out thence. Thirdly, although it be not thus adherent, yet it is not without great danger. Fourthly, a worse Symptome then any of the former, which is also seen very frequently, unless the Tumour be wholly extirpated, cured, and cicatrized, it may either grow again in the same place, or in some other place, and so bring a life full of greif, and a certain dissolution of the whole in the end. Ulcerate Cancers do require Amputation by reason of the great pain and heat they do carry with them. And that we may proceed methodically herein, I shall here offer what Instruments are most proper for this work, as Incision Knives, a Dismembring Knife, large Needles, Sponges, other Needles and the like, the which you shall have more fully afterwards, [Page] I having there presented the young Chirurgion with a draught expressing his Instruments, and all other postures which he may use. And before I set down the method of Amputation, be pleased to listen to that famous History of Ambrose Parrey, History. relating to a Maid of Honour belonging to the Queen Mother, who being perplexed with a Cancer in her Brest which did equal the largness of a Walnut, had applied to it Plates made of thin Lead rubbed over with Quicksilver, the which although they did not cure her Brest, yet afforded her the kindness of preventing its increase. The above nominated Lady growing weary of applying these Leads, thinks upon a new Physician, who coming to her, very confidently promiseth her a perfect cure, and rejecting these Plates as trifles, began his cure with Emollient and heating Medicines, and added such things as attracted pain; upon the Application of which, the Tumour did suddenly grow to a vast bulk and largeness, and so much extended the Brest that it did break in the middle, whence issued out an immoderate Flux; for the stopping of which he makes present use of corrofive and caustick Pouders, by the Application of which pains and Inflammation [Page]

Place this Figure Fol. [...]

[Page] [Page] so seized on her, that poor Lady, instead of her promised health she yeilded her self to the Grave in the sight of her Physician. This I bring in as a Caution to all younger Brethren, hoping it may direct them to use more Reason than Passion, Study than Ignorance in their Art; and not like Mountebanks fall on a sudden upon desperate matters, but rather with Judgment and Reason back their Art, and secure their Reputations. I shall here breifly present you with my methodical way of Amputation, which I used in Norwich not many years since in a Woman whose Brest I amputated, the which being ablated weighed near two pounds. Her Body being prepared by Apozemes and convenient Purgations, both for hindring the Augment, and in some measure to prevent a Fever,History. and she in every respect being made fit for the Operation, being a Woman of an undaunted courage, never did shrink at the Extirpating of the same. Having made ready my Restrictives of Bolarmeny, Draggons blood, Mastich, and the like, with convenient Buttons, Pledgets, Boulsters, and Rollers, the Operation was thus performed, by drawing through two large Needles through the body of [Page] the Brest, armed with Silks cross waies, by the help of which I had the advantage to elevate the Brest for the better extirpating it and its Radix. The Brest being amputated with my dismembring Knife, I with my Fingers expressed all the Blood from the remote parts: after this done I applied my Buttons made of Tow to the Veins and Arteries being covered with the Restrictive, whilst others were onely dipt in Acetum and so well sprinkled with Calcanthum Rubrum: After these was applied my large Pledget or Cap armed with a Defensative; then with convenient Bolstrings and Rollers I performed and compleated my first intention. Here let the young Chirurgion take notice as a just Caution,Caution. that he attempt nothing of this Operation in a large and thick Brest, it being both dangerous and no waies safe. Within two daies after I took of my first dressings, and then applied such Medicines as might remove the Eschar; the which being ablated, I deterged the Ulcer, filled it up with Flesh, and induced a perfect Cicatrice, and the Woman did receive a perfect Cure: But within 2 or 3 years after, whether by a blow or the like given her on her Brest I know not, but it flew out again. [Page] A Mountebank coming to this Town promised her upon her address to him a perfect Cure; but poor Woman she was treated after the same manner as the Lady of Honour was, which I have already told you of, for he applying very attracting Medicines, drew both her out of her troubles by sending her into another world, and what she had into his own pocket.How an ulcerate Cancer is to be treated. If an Ulcerate Cancer might happen to our lots to be dealt with, this by Galen's authority is not to be medled with. But because it is cruel, and doth seem uncharitable to give no ease, if possible, to the afflicted Patient, we may use this double Method, if any good may be epected: the first is to be performed by Amputation or Caustick, or we are to endeavour to see what an Issue may do being made a little beneath the Brest. By some this Pouder is much commended, which is reported to have cured many ulcerated Cancers in the Lips, Nose, and other parts. ℞. Atrament. Sutor. lbiss. Auripigment. Sulphur. viv. an. ℥iiij. Sal. gem. ℥iij. cum Aceto misce omnia, & in vas impone, quod omni è parte lutatum ita ut fumus exire nequeat. Put it into an Oven, and keep it there until they be all burnt and dried; this is a Caustick, and this [Page] he puts about the confines of the Cancer, and one part being burnt therewith, he applied it to another, so ordering it until he had burnt away all the Brest. After which he applies this Unguent. ℞. Mel. despumat. ℥iiij. Sev. Hyrcin. Limatur. Cupr. an. ℥iss. Lithargyr. aur. ℥i. misce, & ad ignem fiat Ʋnguent. Fallopius doth offer this as a great secret in an ulcerate Cancer, being onely made of two things as Arsenick crystallized sublimed, whose nature is, that being applied to a part with Lint it doth so adhere to the Cutis that it cannot be got of, unless you do take the flesh also with it. The second is Radix Dracunculus dried, poudred, and mixed with the former Arsenick, and of these he hath had very great experience as touching their vertue and use; and this is his Method, if a Cancer be entire and not ulcerate, scratch it with the outward part of a reed, and apply the Medicine so as it may adhere; and he doth further advise that if this Medicine be applied without moderation it worketh little or nothing, but being put together and applied, you will find them work wonderful and strange effects. A second Method is,A second may. that we apply no Medicine having any biting Quality in it, [Page] but rather such as may make the Patient's life a little more pleasant and comfortable: and this we are to do by Lenifying the pain and preventing the spreading of the Ulcer; and for this case juice of Nightshade, and such Remedies as I have already prescribed are most proper. I shall conclude this Tract with some remarkable Histories of Cancerous Tumours, as that of extirpating a Cancerous Tumour at the Eye-tooth spoken of by Fabritius Hildanus. It being a Tumour equalling the bigness of a Walnut,Of a Cancer growing at the Eye-tooth. hard, livid, and inequal, adhering partly to the Gum and partly to the Lip, it had a pricking pain and other signs of a Cancer, and for cutting and attenuating the peccant Humour this Apozeme was first prescribed. ℞. Rad. Cichor. cum Toto M. i. rad. Petroselin. Faenicul. an. ʒ ij. Polypod. Q. ℥ss. Apozeme. Cort. Frangul. ℥i. Cort. Tamarise. Cappar. an. ʒiss. Scolopendr. Veronic. Betonic. Fumar. Scabios. an. M. ss. fl. Borag. Bugloss. Rorismar. Betonic. summitat. Thym. Marjoran. an. pug. i. sem. Anis. Faenicul. an. ʒij. sem. Coriandr. praeparat. ʒi. Passular. Corinth. ℥ss. coquantur in s. q. aqu. fontin. & Vini albi ad med. Consumption: hujus Apozematis accipe ℥iiss. in quibus infunde[Page]& macerentur per noctem Rhabarb. elect. ʒi. Potion: Agaric. troch. Turbith. gummos. an. ℈ii. fol. Senn. ʒiij. sem. Anis. Crem. Tartar. an. ℈ij. maneant per noctem in infusione in loco tepido, in the morning strain them off, and to the colated Liquor add Syrup. Polypod. ℥i. Aqu. Cinamom. ℥ss. misce, fiat potio. The Body being thus purged, of the former Apozeme the Patient is to drink three times in a Day. After this breath a Vein in the left Arm, and apply Cupping-glasses both with and without Scarrification. After these let the Patient sweat for 14 daies with this decoction, as ℞. rad. Polypod. cort. rad. Frangul. Tamarisc. Cappar. an. ʒi. Cetrach. Fumar. Scolopendr. an. pug. i. fl. ʒ Cord. an. pug. i. sem. Anis. Faenicul. an. ʒss. fol. Senn. ʒiss. Coquantur in aqu. Fumar. & Scabios. ut colatura redeat ad ℥iij. Potion. in quibus macerentur per noctem Rhabarb. rad. Machoac. an. ʒi. Agaric. recent. troch. ʒss. ZZ. & sem. Anis. an. ℈i. maneant in infusione per 12 horas, & colaturâ solue Electuar. è succ. Rosar. ʒij. syr. Polypod. ʒvi. aqu. Cinamom. ʒiij. misce, mane sumat. A Gargarism for the mouth was this. ℞. Rosar. rubr. M. Gargarism. i. fol. Malv. hortens. M. ss. Cort. granator. ʒij, Balaust. Gallar. immaturat.[Page]an. ʒi. fl. Betonic. Scabios. an. pug. i. Rad. Scrophular. ʒiss. coquantur in vini rubri lbiiij. ad Tertiae partis consumptionem colaturae adde Mel. Rosat. ℥ij. Diamoron. Mel. Violar. an. ℥i. misce, fiat Gargarisma. The Body thus being prepared, and the Patient having his head somewhat placed downwards, and his mouth being opened, he comprehended the Tumour with a crooked Needle and a double Thred; and afterwards with a small crooked Knife he by degrees did cut to the Mandible; the Tumour being cut out, for stopping the flux of Blood was applied this Medicine being mixed with the whites of Eggs. ℞. Farin. Volatil. ℥ss. Bol. armen. Oriental. Terr. Sigillat. an. ℈iiij. pulv. albumin. ovor. sole exsiccat. ʒi. Pilor. Lepor. minutissime incis. ℈i. Coral. praeparat. ℈ij. misce, fiat pulvis tenuissimus. And after this were applied the oyl of yolks of Eggs, to which was added a little Safforn for a Digestive, the Ulcer being digested the mouth was oft times washed with this Gargarism. ℞. fl. Betonic. Rosar. rubr. Alchimill. Sanicul. Pyrol. Scabios. an. pug. ij. coquantur in aqu. ad lbiiij. in colaturâ solue Mel. Rosar. ℥iij. misce, fiat Gargarisma, about the end of the Cure he [Page] applies this pouder to the Wound, and over this a thin peice of Lead, ℞. Tuth. praeparat. pulv. granator. Alumin. ust. an. ℈i. By this order and Medicines was the Patient perfectly recovered. In Schenkius lib. 1. de fac. fol. 225. is related of a noble Matron,History: who having the right side of her Face eaten away by an ulcerated Cancer, and when many other Medicines had been prescribed and applied and took none effect, she was afterwards cured by applying thin and broad peices of a young Chicken to the part affected, the which were to be very oft times renewed, by which onely Remedy she recovered her perfect health, as Cordaeus annoteth Comment. 7. Hippocrat. lib. de Mulier.

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CHAP. XXVI.
Of a Carbuncle.

THIS by the Greeks is called [...], by Avicen Ignis Persicus: for it burneth like a Coal, and carrieth with it the lively resemblance of a burnt Sinder; for it is much burnt, and hath a black Crustiness with it. It is a Disease composed both of a Tumour and an Ulcer, and is bred of hot Blood, that is the thinner part thereof, which is turned into yellow Choler, whilst the more thick doth turn into black Choler, and hence doth arise this Carbuncle. Or if you please, the thinner part is like to a Flame which ascends from this Fire, whilst the thicker doth more aptly resemble a quenched Coal. The Pustles sometimes are many, and small as Millet-seed, the which being rent you will find a Crustiness. The Humour which doth excite these Pustles, by Avicen is said to be thin and Cholerick. Now there is a double species of this Carbuncle, the one not being Pestilential, the other being Pestilential. The signs of the first are an Ulcer with a Crust, which sometimes is ashey, sometimes blacker, some-sometimes [Page] very much burnt.Signs. The inflamed part in its Circumference is painful, for the Patients do think they are girt up in the part affected, and as it were do carry a heavy burthen in it by reason of want of natural Heat, and Spirits. This Crustuous flesh is circled with a livid Inflammation, and doth appear much like pitch. It occasioneth very much itching about the part by reason of the corroding Vapours of the burnt Blood, which doth excite an incredible desire of scratching. A Fever very oft doth accompany it by reason of its fervour, and vehement pain, and watchings. Signs of a Pestilential Carbuncle are these.Signs. A Pestilential constitution of the Air, as in the time of the Plague; A slender and as it were an unperceivable Fever, and the Patient doth ofttimes walk while he falleth down dead; Thirdly, loss of the natural colour of the Face; Fourthly, the Tongue doth grow black or yellow; Then the Urine thin and troublesome; Besides these Liquid and Cholerick dejections; Seventhly, a prostration of the Appetite and vomiting; Eightly, much hot or cold Sweats; Ninthly, a grevious perplexity of Mind; Tenthly, difficulty of breathing and a raw Urine. Eleventhly, pain of the [Page] Head and Vertigo; 11 sometimes deep sleeps sometimes great watchings; 12 Syncopes, especially when Death doth come to seize; 13. the Crust which formerly was cinerish doth now grow blacker; and lastly, that which was formerly blew is now quite coloured with black.Causes▪ The immediate cause hereof is the Fluxion of a most vehement Blood to the part affected, which is thus excited by a redundancy of the whole.Presage: Gal. Com. 12. lib. 3. Epidem. doth call the pestiferous the worst. The other are also dangerous, because they do arise from vitious Humours, and do produce a strong Fever. The part inflamed doth never suppurate but by the exust Heat; and by how much the more the larger and greater in number they are, by so much the more tedious; and by how much the nearer they get to the Heart or any other principal part, by so much the more dangerous. If it seizeth on the Membranes of the Brain, it causeth Delirium; if the Brain it self, it proves mortal. In the Cure hereof the Fervour of the whole mass of Blood is to be minded, and a good order of Diet to be observed, and this redundancy of Humours wholy evacuated;Cure; and this to be done by Phlebotomy. And here you may [Page] safely breath a Vein until your Patient be ready to faint, according to Galen's authority Aphorism. 23. Sect. 1. For in a Carbuncle is a very large Inflammation. Cap. 1. lib. 2. ad Glauc. Here ariseth a great dispute about the most proper place to bleed in: for Gulielmus Placentinus will have us bleed on the opposite side for Revulsion; and Guido doth join with him. Falloppius offereth, as there is a double Humour in a Carbuncle [...]lowing and already flown, so also should there be proposed a double evacuating Method; The fluent Humour to be discharged by Revulsion, whilst the Flux is to becarried of by Derivation. But because as it for the most part happeneth, that when the mass of Blood doth flow, apart of this melancholick Humour doth flow therewith, for this reason also are we to use Pharmacy, as by ordering Manna, Cassia, Diacatholicon, Confectio Hamech, Electuar. è succ. Rosar. and the like. Decoctions made of Scabious, Sorrel, Cichory will do well here, used or appropriated as I have already shown and directed in melancholy Tumours. As touching Topicks, we are to mind these three things in the part affected, as the Crust, the Inflammation tending to blackness, and [Page] the Symptoms about the Crust. Paulus will have us here to make deep Scarrification, that this melancholy matter may the better be got out, and either to apply Sponges or Pledgets dipped in spirit of Wine and Aegyptiacum, Niter or Salt to the part; these and the actual Cautery are to be used in the great and virulent Carbuncle. But if it be not of so great a moment, I take two Eggs and boyl them on sinders until the white be hard, then I take out the Luteum of the Egg and mix Salt with it, and so apply them hot; and thus are you to serve it for four daies: if it requireth stronger use, Aegyptiacum: if it yeilds not to these, use the actual Cautery; and for ablating the Eschar, take a little Butter, Axungia, or Dialthaea or the like, let it be deterged with Mel Rosarum, Unguent [...] Turpe [...]tine or the like. Or with this. ℞. succ. Ap. ℥i. Mel. Rosar. ℥i. farin. Fabar. ʒij. misce, fiat Ʋ [...]guentum. Or apply to the part this Cataplasm made of Bean meal, of Lupines, French barly, Scordium, Ru [...], Wormwood boiled in Oximel resisting putrefaction. Upon the Carbuncle apply this. ℞. Calc. viv. ℥i. Sapon. moll. q. s. fiat Ʋnguentum, Unguen [...] and let it ly upon the Ulcer for two or three hours. You need [Page] not fear pain, for dead flesh is ever void of that; and for the removing of the Caustick you may apply this. ℞. Butyr. non salit. ℥iss. vitell. ovor. no. ij. Ʋnguent.Unguent: Rosat. Basilic. Aurei an. ℥i. Theriac. Andromach. ʒij. fiat Ʋnguent. to be applied upon the Eschar, and then mundify it with Ʋnguentnm ex Apio, then fill up and cicatrice. As touching a pestilential Carbuncle,The Cure of a pestilential Carbuncle: Antidotes are to be given with Scordium, Rue, and the like in them. We are here also to support the Heart against the invasion of this malign Enemy with Cordials; as, ℞. Aqu. Theriacal. ℥ss. Tinctur. Croc. ʒij. Vin. Hispanic. ℥ij. Spirit. Lavendul. Aqu. Mirabil. an. ʒi. Aqu. Angelic. Rut. Borag. Meliss. Calendul. Cardu. benedict. an. ℥iss. Conf. Alkerm. ʒss. cum syr. Meliss. Caryophillor. q. s. fiat Cordiale, cujus sumat patiens cochlearia 2 vel 3 in languoribus. And for defending its adjacent parts apply this Defensative of Chalmaetius. Catapl. ℞. Bol. armen. ℥ij. Terr. sigillat. ℥i. Corn. Cerv. ust. Rosar. rubr. Ebor. an. ʒi. Camphor. ʒij. Cer. ℥iss. ol. Rosar. lbss. Acet. ℥ij. Aqu. Rosar. ℥i. Albumin. ovor. no. misce, fiat Cataplasma. Phlebotomy here is very proper and useful; Let the Medicines you apply to the part affected be very [Page] potent and attractive, having in them an Alexipharmick Quality, to which you may add Mithridatum, Venice Treacle and the like. Cupping-glasses applied here with deep Scarrifications are very beneficial; and if you be necessitated, unslaked Lime put upon the part will effect the same.Histo [...] Riverius observat. 9. writeth of one of four years of age who was afflicted with a Carbuncle in the middle of his Forehead, with a red Tumour accompanied, being black in the middle, and the whole Face tumefied; to which was applied a Caustick to the black part; and for removing the Eschar an Unguent made of Basilicon, to which was added some Treacle, oyl of Scorpions and the Yolk of an Egg; and to the whole Tumour was applied a Cataplasm of Arnoglossus, purging and bleeding being afterwards prescribed, a Vesicatory to his Neck, and a Cordial ordered for supporting of his Spirits with Confectio de Hyacinth. &c. the Fever abated, the Inflammation grew more remiss, and every thing did seem mitigated. In this case the Vesicatory did perform the greatest part of the Cure by deriving a great part of this virulent Humour. And to every Carbuncle I think it very proper to apply it to all [Page] the neighbouring parts, and not to use Ʋnguentum ex bolo so generally used in these Tumours; because Repellers applied to the Face in its Inflammations are more generally subject to the doing more harm than good. And thus shall I conclude this Chapter of pestilential and not pestilential Carbuncles.

CHAP. XXVII.
Of Epinyctis.

PAƲLƲS and Celsus do write this to be a very bad Pustle, having in it an ashy or black Colour, about which doth grow a vehement Inflammation with nocturnal pains joined to it.Cause. The parts affected herewith are the outward parts of the body, which may easily be perceived by the Humour imprinting its Colour wherever it taketh. It is made of burnt Blood: The Pustles arise of their own accord with a reddish Colour somewhat tending to a lividness, sometimes to a blackness; They are most commonly seen in young Children and aged Persons; they bring no great danger without they be ill treated. There is three Intentions required [Page] in this Cure, a good order of Diet being cold and moist; a discharge of the peccant Matter, and here both Bleeding and Pharmacy are conveniently to be prescribed according to the age and strength of the Patient; and then in applying convenient Medicines to the affected part.Unguent. As, ℞. Ʋnguent. Basilic. ℥ij. Vitell. [...]. 2 Axurg. Huma. Caprin. an ℥ss. ol. Rosar. ʒiij. Croc. ℈ss. misce, fiat Ʋnguent. Or this Unguent.Another ℞. Ʋnguent. Rosat. ℥ij. Vitell ovor. no. i. Cer. all. parum, Acel. paul. fiat Ʋnguentum. This use if Inflammation; if you be to mundify, use Ʋnguentum Aegyptiacum, or ex Apio; fill up with Aureum, or Basilicon, and skin it with Diapalma or Desiccativum Rubrum. A History. A Wine-Merchant being troubled with black and sublivid Pustles, about which was a vehement In [...]lammation and nocturnal pains, when as he could receive no ease or benefit by other things prescribed him, by the advice of a Woman he was ordered to anoint them with oyl of Juniper, by the help of which he rested very well, and had more ease by this than he could ever obtain by all his former Medicines both inwardly taken and outwardly prescribed, and at length was hereby perfectly cured.

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CHAP. XXVIII.
Of Herpes Miliaris, and Herpes exedens.

THIS by Avicen is called Formica. It ariseth from a cholerick Humour; and when as this cholerick Humour is made preternaturally thin and hot, it frameth Herpes exedens, or that Disease by Celsus called Ignis sac [...]r, by Avicen Formica corrosiva, because by its corrosion it doth spread it self. This preternatural Choler mixing it self with Flegm it formeth that Herpes which hath many small Pustles in the skin, like to Millet or Hyrse-seed, and thence is called Herpes miliaris. And since as we may apparently find that there are two sorts, the one from Choler mixed with Flegm, the other arising from a dust Choler; our present discourse shall onely reach to the first, the latter more properly ought to be reckoned amongst Ulcers.Signs: The Signs of the first are many small Pustles like Millet-seed, in the upper part of the Cutis, and arising from the mixture of Flegm; then they encrease in their number, the former growing old; and when they are [Page] opened or rent, the Matter which cometh forth from them is between Sanies and Pus, partly reddish, being somewhat of a mixt Colour between red and white.Causes: All the Causes may be related to those of an Erysipelas, save onely that this Tumour is made from a redundancy of preternatural Choler; an Erysipelas coming from natural.Presage. Celsus doth propose, that as Ignis sacer hath little danger, so amongst such creeping Diseases its very hard to cure; for sometimes there is an Intemperiety of the Liver, which may be another Cause of this difficulty. This cure may be performed by having a respect to the whole habit of body: and since it doth not much irresemble an Erysipelas, I do commend you thither to [...]etch convenient Medicines both inward and outward, which may do you great service in this Cure,Herpes exedens. The second sort Herpes exedens is so called from Erodendo; for it doth not onely erode the Cutis, but doth also depopulate the subject Flesh. Celsus Cap. 28. de sacro igne lib. 5. doth describe its nature, when he saies it is made with an Exulceration of the Cutis, not very deep, large, sublivid, inequally planting its self in the extream parts.Signs. As often therefore as we see an Ulcer [Page] to grow and increase, and to make small Ulcers, and many small Cavities penetrating no further then the Cutis, this we may properly call Formica Corrosiva. It is to be cured with Cholagogicks, Cure. as the former: and whereas it is a Disease arising from a preternatural hot and sharp Choler proceeding with Putredness, Phlebotomy is no waies proper here, for it very oft times doth arise from Cacochymy, purging with Senna, Damask Roses and the like in Whay, or good, Cassia, Manna, or [...]e [...]itive Electuary, or a Decoction of Sarsaperilla, China, and Guaiacum. And as touching the part affected, these are very proper here to be used. ℞. succ. Tabasc. ℥iij. Cerate: Cer. Citrin. ℥ij. Resin. Pin. ℥iss. Terebinth. venet. ℥i. ol. Mirtin. q. s. fiat Ceratum molle ℞. Camphor. ℥ss Album. ovor. no. iiij. succ. Plantag. Solan. an. ℥i. Plumb. ust. Ceruss. alb. Lithargyr. aur. an. ʒij. pulv. Troch. alb. Rhas. Unguent: sine Op. ʒi. ol. Rosar. ℥iiij. Pomat. ℥ij. fiat Ʋnguentum. With this let the Patient be anointed three or four times in a day. Or this, ℞. succ. Plantagin. Lapath. Unguent. acut. Solan. an. ℥i. succ. Polygan. ℥ij. Lithargyr. aur. ℥i. Tuth. praeparat. Antimon. an. ℥ss. Alo. citrin. ʒiij. Cer. alb. ol. Myrtill. ol. Rosar. an.[Page]parum, misce, fiat Ʋnguentum, both for deterging and drying up of the Ulcer. I shall conclude this Chapter with this History of a young Gentleman who was burnt from his foot to his knee, but very slenderly that it did scarce hurt the Cutis, coming to an Emprick who from the first used Empl. History. ex Argilla Bol. armeny, with the whites of Eggs, mixed with the Juices of Nightshade and Housleek, dipping clothes therein and applying them to the part affected, the pain which was but small grew into a great degree by the use of these; he became vexed with a Fever, disquiet, and afflux of Humours to the affected part, and In [...]lammation of the whole Thigh, even to the Hip; and at length a Herpes exedens correpted the whole Thigh so vehemently, that some Chirurgions thought to have made Amputation; but at length was thus cured: having first prescribed him this Potion. ℞. rad. Scrophular. Cort. interior. rad, Frangul. Fomentation. rad. Polypod. an. ℥ss. Herb. Fumar. Cuseuth. Scabios. an. M. ss. fol. senn. ʒiij. misce, fiat Decoctum in aquâ ad ℥iiij. in quibus solue Conf. Hamech. ʒii. syr. Rosar. solutivar. ℥i. misce, fiat potio; the day following he was bled in the Basilica of the same side the Herpes [Page] was, and the Humour prepared with a purging Apozeme against Melancholy already prescribed in a Scirrhous Tumour. The body being thus prepared, we arrived at Topicks: and here, because the Cutis was already made hard by the use of cold Medicines formerly applied by this Quack, there was first used this Emollient Fomentation two or three times in a day, with which the part affected was fomented. ℞. rad. Bismalv. cum Tot. Lapath. acut. Screphular. an. ℥ij. fol. Malv. Violar. fl. Melilot. Sambucin. Melilot. an. M. i. sem. Faenugraec. ℥ss. coquantur in aquâ ad 3 partis consumptionem. The part affected being herewith near half an hour fomented,Catapl: cover the parts with this Catapl. ℞. farin. Fabar. Lupinor. an. lbss. sem. Fenugraec. Lin. an. ℥ij. rad. Alth. recenter coct. & cribrat. ℥iiij. pulv. fl. Chamomel. Rosar. Melilot. & Absynth. an. ℥i. misce, fiat Cataplasma. With this being applied for fourteen daies, and the Fomentation continued, the hardned Skin grew soft, the Pain allaied, the ichorous Matter which flowed out of the Ulcer was prepared and brought to a fair Digestion, after this was sprinkled upon the Ulcer Precipitate in pouder, being washed in Plantane [Page] and Rose-water, and over these applied this Empl.Empl: ℞. Empl. de Mucilaginib. Diapalm. an. ℥iiij. De Ran. cum Mercur. ℥i. Alumin. ust. Calcanth. an. ℥ss. ol. Rosar. q. s. fiat Empl. molle. And about the end this Unguent. ℞. rad. Scrophular. Lapath. acut. cort. Frangul. an. ℥iiij. succ. Fumar. Scabios. Acet. an. lbi. Pinguedin. Porcin. lbij. conquassentur Radices, & cum succis ad eorum consumpt. coquantur, colentur, & colaturam serva ad usum. ℞. hujus pinguedinis colatae lbi. pulv. Alumin. Vitriol. opt. farin. Lupinor. bacc. Laur. Ciner. fuligin. an. ℥iss. Argent. viv. extinct. ℥ij. Theriac. ℥i. fiat Ʋnguent in mortario. With this anoint the whole Leg keeping his Body open with Conf. Hamech. &c.

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CHAP. XXIX.
Of a Gangrene and Sphacelus.

A Gangrene is that which doth feed on the flesh, and poysoneth it, and imprints a strange unnatural Quality in it. By the Greeks it is called [...] from the verb [...], that is, Exedere: What a Gangrene is. But there are more essential Definitions hereof; by some it is said to be a change from a natural to a preternatural Colour, and by these it is called Mortificatio; Galen doth call a Gangrene the beginning of a Mortification in the part affected, the which doth so trouble and infest the neighbouring parts, that without the best of Medicine be applied by a very skilful hand, it does speedily run it self into a Mortification. Inflammation by him also is accounted as a very great Instrument hereof, and here beginneth a change of Colour, decay of Sense, a turning to Mortification. We more properly allow and decree it the beginning of a Mortification, and that it very oft times happens, the which I have very frequently found in my practice experimentally to follow or succed large Inflammations, [Page] and thereby do corrupt the soft parts as the Muscles,What a Sphac [...]lus is. Cutis, Veins, &c. A Sphacelus is worse than the former, for under this name we may comprehend Syderatio, Putrefactio, Corruptio, and Mortificatio. [...] by the Greeks is held to be a most intense Disease, so is a Gangrene by the Arabians. A Gangrene is a Disease consequent to the effect not to the cause: Sphacelus is a Disease exeding and compressing the parts: It is a perfect Syderation and Mortification, for a Member being corrupted with a Sphacelus is found plainly cold and dead. While the member is in a dying posture and not quite dead,The di [...]ference between a Gangrene and a Sphacelus. it is called a Gangrene; this for the most part remaineth in the upper superficies, and doth onely possess and affect the Muscles and soft parts: in a Sphacelus not these onely, but the Bones themselves become affected. In a Gangrene the Skin groweth red, by reason of its companion Inflammation; in a Sphacelus it first groweth pale, then livid, and afterwards black. In a Gangrene you have no very ill smell; in a Sphacelus never expect a good smell. In a Gangrene your greatest design must be to prevent the spreading of the Humour, and if it hath got place, [Page] to prevent its growth: in a Sphacelus its lost labour then to act or treat any other waies than by Amputation; for there is no hope of bringing a dead part to life. It gains its Name of Syderatio from that of Plants, being a proper passion of them; when they lose their natural moisture, the which doth afford them their full growth and beauty, this affect is called Syderatio, as if they were struck by the Stars.3 Causes of a Gangrene. The immediate Causes of a Gangrene are three. Intemperiety of the part, when the transpiration of the Spirits are obstructed, and when both the Heat and Spirits of the part are suffocated. Sometimes it cometh by cold, and then is to be discharged by heat; in Gun-shot Wounds it doth frequently happen by reason of large Contusions; it is sometimes also bred by the carelesness of Physicians, who in the curing of an Erysipelas in the beginning do order and prescribe cold things, so being in Act and Power, that they are made capable to destroy the natural Heat; oft times by defluxion of Humours, or venenate Pustles, which are left uncured; sometimes out of immoderate Driness; other times arising out of the Interception of the vital Spirits, and very often out of Obstruction [Page] in the beginning of the Nerves. And since there is a Mortification and Extinction of life, and Destruction of the native Heat,The universal Causes both of Gangrene and Sphacelus. let us consider which way, and out of what universal Causes this may happen. Mans innate Heat cannot be supported without a radical Moisture, and its Spirits justly and in their order implanted in all the parts of his body; so that consequently upon hurting or offering any injury to this radical Moisture its Spirits also will be resolved, dissipated and consumed; and therefore first there is an Intemperiety occasioned out of the vehement alteration of the manifest Quality: Secondly out of the occult Quality a malign and virulent Substance is contracted in the Body: and thirdly the Parts are thus mutually affected with an Interception and Suffocation of the vital Spirits. As to the first,To the first: Galen doth observe and offer, that every thing is kept, preserved, and propagated by its natural Heat and Temper, so that nothing can alter or destroy this sooner than a contrary preternatural Temper and Heat; thus a Gangrene doth happen after a long and tedious continuance of an Inflammation, made either by Affluxion or Congestion of some sanguinary or cholerick Humour, the natural [Page] Humour being dried up by the preternatural.To the second. It may arise secondly, either from a concomitant Malignity either brought outwards to the Body, by the biting of some venemous creature, or by adhibiting of Septicks. Signs of a Gangrene from a hot intemperiety. In a hot Intemperiety the Pain and Pulsation which formerly were concerned with the Pulsation is much more remiss, and the red Colour of the Inflammation doth begin to change into a Lividness; here also do arise Pustules filled with an ichorous Matter, these being all Forerunners of its tending to Mortification; and both Heat and Blood do perfectly run to the Center, whilst the other parts thereof do suffer Putrefaction. It arising from cold doth cause and make a great and pricking Pain.Signs of its coming from cold. Soon after this it changeth its red Colour into Lividness, and maketh it most cold; afterwards sending the Blood away by its Coldness, and dispatching the native Heat, and dissipating its Spirits, doth make the affected part perfectly void both of sense and motion, a horrour and trembling attending it much like the fit of a Quartane Ague. There is generally held five Signs of a Sphacelus. 5 Signs of a Sphacelu [...]: First, the affected part is much more heavy and dull than formerly it was. Secondly, the Floridness [Page] and Redness of the part do turn into a Lividness and Blackness. Thirdly, the part which was soft in a Gangrene groweth hard in a Sphacelus. Fourthly, the Cutis being taken up is seen with ease to separate it self from the Flesh. And lastly, there is no exquisite sense or perfection, but a perfect Mortification remains. We are, if we intend to cure a Gangrene aright, to study and find out the Antecedent Cause thereof,Cure. and from thence to take our first Intention,1 From the Antecedent Cause. as thus; If it happen from a fiux of hot and moist Humours, let the Patient's Diet be cooling and drying for purging; nothing is more proper here than Chologogicks, as Electuarium Diaprunum, Diacatholicon, Lenitivum, Syrup of Roses and the like. Phlebotomy is very necessary also, to prevent the further growth of Inflammation, for opening the passages, and making a more free Transpiration: but in all sorts or kinds of Gangrenes this is not to be used; For in a Cholerick and bilious Humour we are not to attempt it, Blood being as the bridle to check and command this Choler.6 Intentions in applying of proper Medicines. In the case of applying of Topical Medicines observe these rules. The first is taken from the Cause; for if the afflux be cold and flegmatick, evacuate [Page] more powerfully, and warm the Humours with Defensatives. The second is taken from the Age of your Patient; for in a young body the Flesh and all its parts are soft and tender, and therefore are you to order and prescribe milder Medicines than to those of a fuller growth. A third ariseth from the Sex; a Child being to be treated with more mildness and Gentleness than one of an elder age, and a Woman more tenderly dealt with than a Man. The fourth is from the Strength of the Patient; for you may powerfully exercise your operations on such as are of a good and strong constitution, whereas you are more sparingly and tenderly to use such persons as are weak and sickly. The fifth ariseth from the part affected; for the Eye, Mouth, Pudenda, Anus, Vertebre, and other such sensible parts are not to be dealt with, as you may deal with an Arm or Legg. Sixthly the greatness of the Disease is to be much minded and regarded: If it be new done, and the Putredness not much,A particular Cure of a Gangrene coming from Inflammation. nor made any deep impression, to scarrify the part lightly, and to apply Aegyptiacum alone is enough; If it be more powerful and do threaten a Sphacelus, here is to be made a deep Scarrification, and you are [Page] to mix Spirit of Wine with Aegyptiacum very hot and often: These are your general rules. I come now to the prosecution of a particular Gangrene arising from Inflammation;1 Intention. and here the first Intention is to be performed by Astringents or Desiccatives as, ℞. Bol. armen. ℥iiij. Unguent: Terr. sigillat. ℥ij. Corn. Cerv. ust. & praeparat. rasur. Ebor. an. ʒij. Camphor. ʒiij. Cer. ℥iij. Ol. Rosar. lbi. Acet. ℥iiij. Aqu. Rosar. ℥iij. Albumin. ovor. no. ij. misce, fiat Ʋnguentum. A Cataplasm for the same is this. ℞. farin. Hord. Catapl. ℥iiij. Bol. armen. ℥ij. pulv. Gallar. virid. nuc. Cupress. Cort. Granator. an. Second Intention. ʒiss. Camphor. ʒi. cum Oxymelite q. s. fiat Cataplasma. The second Intention is to revel the Humours and to send and discharge them into other parts. And here this Bolus is proper ℞▪ Cass. recentèr extract. ʒij. Elect [...]r Diacatholic. ℥ss. cum Saccharo q. s. fiat Bolus. [...] The third Intention is to restore the part to its former health, and this is to be performed by evacuating the Blood, and other compacted Humours from the part affected and therein concluded. And since I have given you the general and particular Method of curing a Gangrene in general, I shall still illustrate it with some examples: It being [Page] a thing of great import as touching the Life and Limb of many a Man. And for brevities sake, because I do not desire to swell up my book with Tautologies, or commit to your reading here any thing you shall elswhere find parallel, I will present you with a History of a vertuous maiden Gentlewoman in Norfflolk near Norwich, History. who after a long and tedious Sickness had a very large and great Inflammation seized her Foot, the which very speedily spread her Legg, and got upwards into her Thigh, with a great Discoloration, Pain, Heat, and Fever accompanying. My never to be too much esteemed Uncle being sent for to this Lady, could not go to her; I being by Sir Thomas Brown's order sent for, and finding all these already written symptoms upon her, consulted with my self and reason, what might be the most safe way to quit her from the ensuing danger she without speedy help might fall into: with this Method and Almighty assistance I got her loosed from her fears and perplexities which threatned a Gangrene. I first anointed her parts affected with this mixture.Oyl. ℞. Ol. Rosar. Aueth. Chamomel. a [...]. ℥ij. Acet. Acer [...]i [...]n. ℥i. misce, and having finished this [Page] Embrocation, I applied to all the inflamed parts this Cataplasm.Catapl▪ ℞. farin. Fabar. lbss. farin. Hord. Lupinor. an. ℥iij. pulv. Rosar. rubr. ℥i. pulv. fl. Chamomel. Melilot. Sambuc. an. ʒi. farin. sem. Fenugraec. ℥iij. Croc. ʒi. Bol. armen. ℥ij. Corn. Cerv. ust. ℥ss. Camphor. ʒiss. pulv. herb. Rut. Scord. Absynth. Scabios. Virg. aur. Agrimon. Veronican. ℥iss. pulverisentur omnia & misceantur cum Vin. & Aqu. fontan. an. q. s. his addendo Acet. Rosat. ℥ij. & coquantur ad Cataplasmatis formam, fine addendo ol. Rosar. Aneth. Chamomel. an. ℥ij. By the application of this Cataplasm within three or four daies the enemy began to take his leave of her. I continued every day anointing and applying this Cataplasm to her. After this upon the back part of her Foot a new flux of Humours began to make their incursion, and there they made two Ulcers, in which were contained a great quantity of thick cold indigested Matter lying very deep, and there spreading it self, much resembling a Coar or Eschar, for the removing and taking away of which I ordered this Fomentation, with which the whole Foot was fomented eight or ten times one after another, for three Weeks or a Month [Page] together. ℞. fol. Rut. Scord. Absynth. Veronic. Meliss. Betonic. Salv. Hyperic. an. M. i. Tormentill. Chamaedr. Virg. aur. Laur. Rorismar. an. M. ss. fl. Rosar. rubr. Chamomel. Melilot. an. M. ss. coquantur omnia in Aqu. fontanae lbvi. Vini albi lbvi.. ad med. Consumptionem, fine addendo Alumin. Roch. ℥ss. With this was bathed the Legg and Foot very oft times every day. The Ulcers I dressed with this.Decoction. ℞. Spirit. Vin. ℥ij. Aqu. Absynth. composit. ℥i. Aegyptiac. ℥ss. pulv. Myrrh. Aloes an. ʒss. Camphor. ℈i. misce. With this Decoction were they washed very often: after this was applied Ʋnguentum ex Apio for deterging it. By these means I discharged these preternatural Matters; and then I digested the parts with this Digestive. ℞.Digestive: Tereb. venet. lot. in aqu. Rosar. ℥iiij. mel. Rosat. ℥iij. farin. Lupinor. Lolii an. ℥ij. Ol. Rhod. ʒiss. pulv. Myrrh. alo. an. ʒi. vitell. ovor. no. ij. coquantur lentissimo igne, fine addendo Theriac. Andromach. ʒij. Croc. ℈ss. misce, fiat Ʋnguentum. Sometimes I applyed this Cataplasm. ℞. farin. Fabar. ℥iiij. Ca [...]apl. Sal. marin. ℥iss. pulv. Scord. Rut. Absynth. an. ℥i. pulv. Rosar. sem. Faenugraec. an. ʒiij. farin. Hord. ℥iss. Camphor. ʒss. pulv. fl. Melilot. Chamomel.[Page]an. ʒiss. coquantur lentissimo igne in Oxymelite q. s. fine addendo pulv. Myrrh. Aloe. an. ʒiij. misce, fiat Catapl. This being as excellent a discussive Cataplasm as may or can be used. After I had deterged it, I filled it up with new Flesh by applying Ʋnguent. Basilicon ℥ss. Aurei ʒij. his addendo pulv. Myrrh. Alo. an. ʒss. And so I continued until I perfected the Cure by producing a Cicatrice with Ʋnguent Diapompholigos with a little Ʋnguentum Rubrum mixed. Dodonaeus in his 53 Observation doth report of a Child of six years old having both his Hands and Feet correpted with a Sphacelus coming up to his Knees, and reaching each Elbow, upon whom death speedily did seize. Albucasis lib. 2. cap. 87. doth relate a very strange story of one who having a little blackness appearing in his Toe,History. did very speedily over spread his whole Foot; and seeing it extend it self so much with pain and adustion, for the prevention of its further growth, stopped it by taking off the Foot at the Ancle. Sometime after the same Patient complained of a Tumour which happened in his Finger, who coming to ask his advice about the same, and having followed all directions as was thought most proper to be [Page] [...] [Page] [...] [Page] used, as cleansing the Body, and purging the superfluities by a good order of Diet and habit of Body, and the like, yet none of these took place, but this Curruption still spread until it got him hold by the Hand: he being by the Patient desired to make Amputation of it for fear it might serve him as did his Foot, he refused it, hoping by other Remedies, and advantage of good Medicines, to put a stop to its increase, and to quell its fury; but these were spent to no purpose: the Patient being both of a Cacochymick Body, and weak, and perceiving no help by these, was willing to have his Arm taken of, the which being performed, the Patient perfectly recovered and grew very well. Another pious person, a Gentleman of good descent, having been let blood in his right Arm by an unskilful Chirurgion, was perplexed with a Gangrene and Sphacelus: and here advice was given that he might abstain from strong Remedies, the Nerve being pricked, for this would onely subject it to the increase of pain; and therefore such mild Medicines were ordered, which might have a drying Quality in them to parch up this serous Humour, such as this. ℞. Terebinth. venet. lot. in [Page]aqua Plant aginis ℥ij. Bol. armen. pulv. ʒij. simul incorporentur. In this case also our Balsom is accounted a most excellent Remedy, thus composed. ℞. Ol. Rosar. ℥iss. ol. Terebynth. ʒiij. suce. Plantag. ℥ss. sem. Hypericon. contrit. M. ss. Tuth. praeparat. ʒiij. Calc. decies lot. in aqua Plantaginis ʒij. Antimon. ʒi. sevi Hircin. Vitulin. Verm. terrestr. in vino lot. ℥iss. coquantur simul; dempta Tuthia, in Cyatho decoctionis Hordei ad consump. & Vini & aquae, colentur, rursumque igni admoveantur, addendo fine Tuthiam, & fiat Linimentum cum Cer. alb. & Croc. an. ʒss. & serva ad usum. These I produce as Introductions to my future Discourse as touching the order of Amputation, which is very material in the true and methodical proceedings in Chirurgery, and the onely Remedy left to secure the whole, by ablating of the disaffected part. And that I may use all the sweet Methods to procure the young Student into a fair compliance and affection of his Art, and that he may quit the repute of a Quack, and defend himself against the calumnies that daily do shroud themselves under the pretences of ignorances and mistakes, let him with me observe this my oft experienced Method, [Page] both used in the Wars in his Majesties service at Sea, and not onely in England, but also in France and other places, with good success and credit. I have also in this Chapter set down what Instruments the Chirurgion ought to have in readiness to perform this office of Amputation, what Method he ought to proceed in, how he ought to be furnished, how prepared with Rollers, Bolsters, Pledgets, Buttons, Restrictives, Sawes, dismembring Knives, dividing Knives, actual and potential Cauteries, Needles, Sponges: and after these have been all made ready and fitted for your intended purpose, you are to make ready your Restrictive, with which you are to arm your large Pledget, which is to cover the amputated part with, being made of Bolarmeny, Amber, Dragons blood, Mastich, red Roses, Powder of Hares hair, with Flour, Vinegar, oyl of Roses, and Rose-water; with this you are both to cover your large Pledget, and also to spread your Chin-band (as it is generally called) which is to be laid above as a Defensative to hinder the Defluxion of Humours; and then to arm your Buttons with Calcanthum or calcined Vitriol; then to have Cordials in a [Page] [Page]

Place this Figure Fol: 20 [...]

[Page] readiness. A lively Portraict of this operation you have here expressed in this Figure. And supposing the Legg was to be amputated, having all your Instruments and other things made ready, you are first to make a strict Bandage by Roller four Fingers beneath the Knee, and a little below that with your dismembring Knife divide or cut the Muscles and other parts from the Bones, by guiding it round with all expedition; then having your dividing Knife in readiness, separate the Membrane which lodges and keeps between the two Fossils; and then with your Saw divide the Bones. And while you are going to perform this Operation be sure you be furnished with two Assistants at least, one to hold the Legg which is to be amputated steddily, whilst the other doth contract or gripe the upper part to prevent a large flux. And that your Patient may not droop, you are to have in readiness such like Cordial as this, ℞. Aqu. Cinomom. Spirit. Menth. aqu. Mirabilis an. Cordial: ʒij. Aqu. Theriacal. ℥ss. aqu. Meliss. Acetos. Calendul. an. ℥i. Confect. Alkerm. ʒss. cum syr. Caryophyllor. & Lujul. an. q. &. fiat Cordiale. The Legg being taken of, you are next to apply your Buttons being armed with [Page] [...] [Page] [...] [Page] Calcanthum; over these lay your large Pledget covered with the Restrictive; after these your Bladder to inclose the former; and then with convenient bolstring and Rollers perform your first Intention, observing that your Patient be presently committed to his Bed; and after this endeavour to correct all insuing accidents. On the third day you may loosen your Patient, and open it; then apply such things as may remove the Eschar, as Ʋnguent. Basilicon, Aureum, Dialthea, Axungia or Butter; Then cleanse the part with Spirit of Wine and Aegyptiacum, if occasion require; Then digest with Aureum, or Basilicon, adding to them a little powder of Mirh, Aloes, the Yolk of an Egg, and a little Turpentine, fill it up, and Cicatrice it with Basilicon mixed with Rubrum Desiccativum, or Diapompholigos, or the like. By the use of these Medicines within a very few years I cured a Child of about five or six years of age at Wootton in Norfolk, History. who by an unhappy mischance had a Gangrene, and afterwards a Sphacelus correpted his Arm above the Elbow. The Child by a fall fractured both the Radius and Ʋlna, a Country man being sent for to reduce it, after he had finished his [Page] Operation, whether by two strict Bandage, or another fall occasioned this, I cannot certainly justify, but the poor man being much amazed at the sight came to Norwich for me; where seeing how far it had spread, we had no other way to save the Patient's life but by Amputation, the which being performed, and the same Method being observed, the Child was perfectly cured, and still remains in health. And thus much of preternatural Tumours in general.

OF Preternatural Tumours IN PARTICULAR▪ And first of those of the Head.

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CHAP. XXX.
Of Artheroma

I HAVE omitted several other Tumours, which by most Authors have been ranked amongst Generals, and have them contracted amongst others in their particular places, where they generally or for the most part are reputed to take their abode: and of these I begin with such which frequently do possess and inflict the Head, and so then gradually usher in all such as do affect the rest of the parts of the Body even to the Foot and Toes. Of these which do afflict the Head are reckoned Artheroma, Steatoma, Meliceris, Ta [...] pa, or Testudo, Hydrocephalos, Tinc [...], Psydracium: all these being most commonly allowed to border and inhab [...] [Page] upon the outward,What Artheroma is. and inward, and upper part of the hairy Scalp and Cranium. Of the first of these is Artheroma, which is an Abscess containing in its Cistus or bagg Matter much resembling that of Pultice, arising from mixt Humours, in which is Flegm as its cheif Agent, from whence it gaineth its white Colour. It is also accompanied with other Waterish qualities, eroding the parts, being much like Whey. It is a longish round sublated Tumour, being pressed with the Finger not readily yeilding, nor yet making retrogradation the fingers being taken off. The Curative Intentions here are the same with those of all other Abscesses:Observa. Yet here is to be observed, that the Curation of all Abscesses is contained in the Discharge and Evacuation of the Matter, the which is either Sensible or Insensible; the Insensible to be cured by Digestives, the Sensible to be ablated by Section.Care. These being proposed, we are to cure Artheromaes by Septicks, as Verdegrease, Chrysocolla, Arsenick, Orpiment, Lime, Chalk and the like: or this. ℞. Calc. viv. ʒij. faec. Vin. combust. Nitr. liquid. tost. ʒij. Min. ʒi. Lixivio terantur, & ad mellis substantiam reducantur. If it yeildeth not to these, or you find it [Page] ripe for the Instrument, use this Method, place your Patient in a good form for your Operation, let his Head be shaven about the place where the Artheroma is; 'then mark with ink how far or long you intend to make your Incision, which should be quite through the whole Tumour, the which sometimes doth require a cross Incision, as that you pass it as far the other way, if it be large. Here use your Incision-knife, it being for this purpose the most proper and convenient Instrument;Observ. and here are you carefully to observe that you only divide the upper Cutis, and that you perform this so dexterously, that you do no ways touch the Cistus of the Artheroma; and that you may do this more promptly, you are to have Spunges in readiness to dry up the Blood, that the part may better shew it self. The Section being made, separate the Cistus either with a Probe or some other convenient Instrument, the which for the most part you may do with ease: separate it from the Cutis with your Incision-knife; but in the lower part, that you may divide the Vein or Artery that gave it its being, origination, and growth. After you have discharged the Matter, and the [Page] Cistus, apply this following Digestive ℞. Terebinth. venet. ℥i. pulv. Thur. ʒi. Myrrh. ʒi. Ol. Hyperic. ℥i. Ol. de Vitel. Ovor. History q. s. fiat Ʋuguentum. In this City of Norwich I thus cured A French Mans Wife of several Artheromaes which possessed her Head, one of which was very large and soft, the which I opened with making a cross Incision, having well prepared and purged her Head with Cephalicks, as Extractum Rudii, Pillulae Aureae, and the like: After this I opened the Abscess, and discharged the Matter, ablated the Cistus; and this being removed, I perceived a small Capillary Vessel upon the taking away of the Bag to spin and spend its Blood which streamed out, the which I speedily stopped by the application of some of his Majesties Stiptick water, which I applied to the part by dipping a small Pledget of Lint (the which answered my expectation) and so bound it up: The Day following I drest her again with Spirit of Wine, & Elixar Proprietatis, by the application of which within few days the Woman was perfectly cured; her large Abscess discharged; her other small ones, which were six (the which I believe were fed and nourished by the same small Arterial [Page] Branch) were by degrees dispersed, and at length vanished. Coming to the same Patient not many Weeks after to enquire how she was, I found the rest perfectly were gone, which gave me satisfaction of my conjecture: for upon the escharotizing of this Branch not only their growth were hindred, but also a perfect banishment procured of the whole, and (to the praise of the Highest) she remaineth very well without any fear of a new growth of the same.

CHAP. XXXI.
Of Steatoma.

THIS is an Abscess having in it the substance of Fatt or Sewet, small at first, but in process of time growing larger: It is a Tumour round, not elevated, but depressed; and Aetius doth add, it adhereth firmly to the Skin: Its substance is not fluid, but compact and coacted: It is not therefore contained in one Bag, as the former, but is lodged between two Coats. And when [Page] it is in the Head, it doth contain in it a Matter resembling Sewet, a large Basis, and doth not yield to the touch; when it is in other parts, it is seen to contain in it Matter much like Fatt, more like this than Sewet; neither is its colour there so white: It is generated, as is Sewet, by reason of the Intemperiety of the place, or by reason of ill Blood. They are scarce ever cured, but by manual operation. If the Vesicle be broken, and you do not draw all out, it will leave either a Fistula, or a foul Ulcer. As touching its Cure, in respect of its hardness, broad Basis, multitude of Sewets, it is only to be handled as other Abscesses; this Sevum is to be wholly separated from the Pericranium, lest the Abscess do make a fresh return. Here may you make a cross Incision, if it be large, and take care of touching the Vesicle, lest you make a faetid smell and ulceration: This being performed, press out your Cistus, cut off the branch that fed it, and have a care that the least particle remaineth not: this being done, cleanse it, and use your greatest care to produce a Cicatrize. There was a Gentleman, who was troubled with a Steatoma in his Inguen,History. weighing near forty pounds, his [Page] whole Body redounding with pituitous Blood; a good and thin Dyet being prescribed, ordering him to abstain from all viscid and thick food, as Milk, Cheese, and the like, and prescribing him a Honey-drink, in which Ginger and Time were boyled, and outwardly applying such Medicines as may discuss this Flegmatick matter, as Fomentations and the like being every Night and Morning repeated, and preparing the Humour with Oxymel of Squills, and then by intervals ordering him to take some of these Pills of Aloes Rosatae ℈5. Troch. de Agaric. ℈ij. Turbith. gummos. ʒss. Squinanth. rad. Asar. an. gr. 5. ZZ. ℈ss. Cinamom. ℈i. Rhabarb. ʒss. Troch. Alhandul. gr. 15. cum Oxymelit. Scillitic. q. s. fiat massa pillul [...]rum. dosis a ℈ij. ad ʒi. And this Oyl being outwardly applied as ℞. Ol. Philosophor. Latern. lss. Thur. Mastich. gum. Arabic. Terebinth. venet. an. ʒiij. pistentur, & per alembicum distilla, & fine distillationis addatur Sal. ex ciner. Cerr. & iterum distilla, quod pro usu reserves. By these this great Tumour was dissipated and digested; this you may read of in Langius Epistol. 4. lib. 3.

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CHAP. XXXII.
Of Meliceris.

THIS Abscess hath a Matter contained in its Cistus much resembling Honey, and is thus by Aetius described; It is an Abscess enclosed in a Nerveous Coat, containing a Matter like Honey, wanting pain, having a round Figure, easily yielding to the touch, and the finger being taken off it doth as speedily turn into its former condition.Its Cause. The cause hereof is a mixt preternatural Humour. And although every Abscess contained in a Bag hath Matter going along with it, yet are these divided into four Modes or Forms: hence in a Meliceris, because it is soft and thin, its Flegm is mixed with a greater quantity of Choler than in an Artheroma, or Flegm, out of which is made this Meliceris.Cure: This is to be cured three ways, by Digestives, Causticks, or Amputation. As touching the Septicks or Causticks, we have already treated in Steatoma: we shall here more properly treat of Digestives, the which because they do discharge this Matter perporos[Page]cutis, they ought to be powerful and strong, and to exceed in their vigour more than in those Abscesses which are enclosed in Bags. Whence in small and moist Melicerides a Decoction Pulegii, Calamenthae, Hyssopi & Melissae made and applied hot with a Sponge is here accounted very proper: but if stronger be required, you are to make a stronger Lixivium, in which boil the aforesaid Herbs, and apply it to the part affected: or for the same you may use this of Aetius, which he hath in his 15th Book, ℞. Sal. armoniac. Spum. argent. li. Cer. Terebinth. Galban. Opoponac. an. ℥i. Rubric. Synopic. ℥.vi. Acet. heminam. misce; Or this, ℞. Diachyl. ʒ 12. pul. Irid. ʒij. misce. or Diachyl. cum gummi, to which may be added a little powder of Ireos. Empl. Emplastrum Alexandrinum here also is much commended, thus made ℞. Sal. Armoniac. Litharg. Cerus. an. ʒi. Galban. Opoponac. an. ℈iiij. Sem. Sinap. ℥ss. Ol. veter. ℥iiij. Cer. Terebinth. an. ʒi. misce, fiat Emplastrum. If this Method succeedeth not, we are to come to the use of Suppuratives: And of these some may serve for the prohibiting the egress of Vapours, and not only obstructing, but also keeping in the inward native Heat: [Page] others do not only obstruct, but do also heat, and by the calefying quality do rarefie and thin the parts; of the same qualities should our most proper Medicines be framed, as this of Rhasis. ℞. Farin. Sem. Lin. ʒij. Faenugraec. ℥ss. pulv. Sem. Caul. ʒi. Mucilag. rad. Alth. q. s. fiat Empl. In the last place I take crude Figs, and beat them in a Mortar, and to these I add a Snail, and beat with them, and order this Medicine to be laid on, and so kept on, until it falleth off of its own accord. After you have made it fit to open, discharge the Matter, as I have directed you in the other two Chapters; then apply Digestives, convenient Detersives, Sarcoticks and Epouloticks. Amongst all these three Tumours I must acquaint you, that it is not very frequent for the putrid Matter to exalt it self in these Tumours of the hairy Scalp; and therefore Causticks are the most proper Instruments to occasion this, but here not to be used. Langius lib. primo Epistol. 38. Writeth of a Woman, who having an Ulcer in her Matrix had also a Meliceris accompanying it; and when it gave the greatest hope to the Chirurgion of its consolidation,History. a new Ichor began afresh, and forced it self out; she being thought [Page] to be bewitched, by good Prayers and divine Ejaculations the Woman had her Ulcer spontaneously consolidated and cured.

CHAP. XXXIII.
Of Psydracium.

THIS is a yellowish sharp Pustle, out of which, if it be pressed, cometh a Moistness according to Celsus. Galen seemeth to place it sometimes amongst the Tumours of the Eye-lids, sometimes he will have it a Tumour of the Head.Whence its Name: It is called Psydracium, either because it is seen to appear sharp in the Head, or else because it doth contain in it a great quantity of a waterish humidity. These do arise from mixt Humours; and by how much the whiter they are, this shows they have more Flegm in them, the harder come from Choler, and the sharp and small from Water.Cure. The Cure is to be performed by moderate Coolers, and Discussives; Coolers as for allaying and tempering the heat of Choler, and [Page] Discussing in respect of Flegm: here also are to be observed a good order of Dyet, a good respect to the habit of Body to keep it open, and by purging it from its Flegm and waterish Humours as this. ℞.Pil. Extr. Rud. ℈i. Pil. Coch. ʒss. Resin. Jallap. Pil: gr. vi. misce: or this, ℞. Pil. sine quib. aur. Indic. an. ʒss. Resin. Scammon. ℈ss. misce for two doses. The part affected is to be treated with Coolers and Discussives, as are Mallowes, with Barley Meal and Cicers being made into a Decoction, or some of my discussing Cataplasm already prescribed, or this ℞.Catapl. Farin. Fabar. ℥i. Hord. ℥ij. coquantur poscâ ad formam Cataplasmatis, in fine ebullitionis adde pulv. Rosar. rubr. ℥ss. post unam ebullitionem ab igne remove, tunc misce album. & vitel. Ovor. no. Ol. Rosar. parum, misce, fiat Cataplasma. If the Psydracium be ulcerated, and a moist Humour cometh from thence, apply this ℞. Litharg. aur. ʒi. Ceruss.℥ss. Alumin. ʒij. fol. Rut. cum Aceto & Oleo simul mixt. fiat Ʋnguentum, with which anoint the Skin; and having well embrocated it with this, you may conclude your Cure with this Liniment. ℞. Lithargyr. aur. Ceruss. pulv. an. ʒij. Sulphur. ʒi. Ol. Rosar. q. s. fiat Linimentum: And lastly, aqua [Page]Scahiosa is by many held to be most excellent here Alome being added to it.

CHAP. XXXIV.
Of Hydrocephalos.

THIS is a proper Tumour of the Head, arising for the most part from Water, and hence doth it take its name. This is a Distemper which doth very oft come into the World with young Infants, being either bred with them in the Womb, or else so as they are bringing into it. It may also be occasioned by a careless, or ignorant, or unhappy Midwife. It may well be called a Cephalick Dropsie, for it doth contain in it a proper Waterish substance, known by its indolency, softness, its easie yielding to touch, but chiefly from its inundation of Water running out of one place into another in its compression. These Tumours do often times vary;its differencies. for in some they are small, whilst in others they do appear very large; It is a peculiar Disease in [Page] the Head of young Children, the which ariseth from too much Humidity of the Head; for which very Cause they which are much troubled herewith, do seldom live long, as both Galen, Aetius, and Paulus do observe. This Tumour by Galen in Libr. Its Definition. definitionis is thus designed, as being a collection of waterish Humours, or feculent Blood in some parts of the Body, which doth force it self up to the Head. And here is a double meaning to be explained; the one, whereas he calleth it not only a collection of a Serous Humour, but also of a feculent Blood, as when the Head & Cranium suffers an outward Contusion or Collision, and the Veins by this Collision do sprinkle their Blood between the Cutis and Pericrane. This Blood here thus putrifying doth make a most soft Tumour; and if a serous aquosity were collected, the which by dayly experience may well be offered to happen, from a Contusion thus happening it may frame a Hydrocephalos. Aetius lib. 6. cap. 1. will have that a Hydrocephalos may be generated from a Feculent or bloody Matter, the which being changed into a thin substance. A second of Galens is, that a Hydrocephalos is a collection of an aquous Humour in some part of those Bodies, which have a forcing quality towards the Head; out of [Page] which it may be conjectured, that Galen doth offer, that Hydrocephalos to be a Disease of some part of the Head, not a Dropsie of the whole Head; and this is confirmed by Aetius and Paulus, who treating of Hydrocephalos do allow four species hereof: First, when this Humour getteth between the Brain and Membranes: Secondly, when it lyes between the Membranes and the Skull: A third between the Bone and the Pericrane: And Lastly, when between the Pericrane and the hairy Scalp.Signs: I have already shown you part of its Signs; that it is a Tumour soft in touch, whitish in colour, indolent, turgid, much like a Pillow to other parts, easily yielding to touch, and as speedily filling up its former made vacancy, the Finger being removed. If it ariseth from a Contusion, it doth appear first red, and doth carry pain with it, as Aetius doth write; but being afterwards changed into a thin substance, it doth spread it self without pain. In those where it happeneth between the Pericrane and Bone, they answer plainly the rest; for here it is hard in Tumour, and very painful, by reason of the distention of the Pericrane; If it happeneth (as sometimes it doth) between the Membrane [Page] of the Brain and the Skull, it will be a Tumour, but not yield to compression, nor soft to touch. Here it maketh the Infant soon to give way to it, and to yield up its Ghost.Causes. Its Causes may be said to be sometimes outward, sometimes inward. One of the outward may be said to be that which is mentioned by Paulus in Children newly born, who had their Heads but ill bound up by their Midwives; Another is contusion, or collision, or ruption of one or many Vessels; Another cause is a cold Air, or too much Water, or thinness of its passages or Vessels, out of which this Serum or matter do recide, as Aetius hath it; or also too cold or waterish Milk, which it may suck from the Nurse: these may be said to be the inward Causes hereof, as when the Brain is too much cooled, or the matter being here first collected, and hence sent to the Brain. Every Hydrocephalos is very slow in its motion, as Aetius doth prove. Lib. 6. Cap. 1. For it hath a cold Brain inwardly from its beginning, arising from its inward Cause, and also an outward by and from its outward Cause, by reason of its delay and contaction.Two Species of a Hydrocephalos. To draw all these to one head, there is to be allowed two Species of a Hydrocephalos: [Page] One in which this waterish Humour is contained and made by an inward Cause, that is out of an abundant collection of this serous matter in the Body: The second doth not contain the sincere Serum, but as it were a mixt feculent Blood, the which doth eat it self out of the lacerated Veins, arising from Contusion or some other outward Causes. As to its Presage,Presage. Paulus Aetius and Galen do offer, that if this Humour be collected between the Brain and its Membranes, it is mortal; in other parts it may admit Cure, by curing its Causes, and removing its Effects. But here, as well as in other parts of the Body, the Rules of Celsus and Galen are to be observed; every Disease is so much the more dangerous, by how much it gets into a greater bulk and bigness. As touching its Cure,Cure. we shall begin with that which is extant between the Hairy Scalp and Pericrane: And herewe are to observe, that every Hydrocephalos is to be cured by discharging of this waterish substance, which is to be performed by purging the whole, and cleansing the affected part. And with this we are to begin with general Cephalick Purgings; in which Case may be used these and the like for Pils: as ℞. Pil. Coch. ʒss. Resin. Jallap.[Page]℈ss. Cambog. gr. iiij. misce. These are to be given to such as have arrived at Manhood; Children may be prescribed Syrup of Roses solutive, Syrup of Cichory with Rhubarb, Syrup of Buckthorn Berry and the like, either by themselves, or given with a Decoction made of Betony, Fennel-Seeds, Anisc-Seeds, Asparagus, Liquorise, and the like. Sweating here also is very proper, for which you may make a Decoction of Sarsafras, Sarsaperilla, Guaiacum with Seeds, &c. Hence are we to warm and strengthen the cold and moist Brain: and this is to be performed by Insensible Evacuation, the which I much better approve of than of a sensible; because it is neither so safe nor so secure, for oft times times here, as well as in making a Paracenthesis, the Patient dyeth in few days after the Operation, if not at the Operation. For discharge of this contained Matter, by reason of the thickness of the Cutis, this is to be rare [...]ied and softned; and for this purpose this Fomentation is very proper, in which we may dip Sponges and apply to the part, as ℞. Malv. Melilot. Aneth. an. M. i. Rad. Alth. ℥i. fl. Chamomel. Decoction: Melilot. Rosar. rubr. an. M. ss. coquantur omnia in Vino albo q. s. & fiat Colatura, in hac colaturâ im [...]uatur[Page]Spongia & parti admoveatur. In such which are large, to these you may add Roch Alume or Sal Armoniack, and boil with them, and so apply them. Gulielmus Placentinus doth offer Discussives as to be here most proper,Oyl. and doth order this. ℞. Ol. Aneth. Chamomel. an. ℥ss. pulv. Sulphur. ʒss. misce. Fallopius on the contrary doth as much esteem of Repellers, wherewith he doth declare he hath done very strange things, and saith, that only by the help of Oyl of Roses and of Oyl of Myrtils he hath cured several Hydrocephalick Tumours in four days space. Sometimes he doth add to those two Oyls green Cypress leaves and Wormwood bruised, and with this he frameth a Liniment.History. Amatus Lusitanus writeth, that he cured a Child of a Hydrocephalos in three days with this following Unguent. ℞. pulv. Absynth. fl. Melilot. Chamomel. an. ℥ij. Butyr. recent. Unguent. Ol. Chamomel. an. ℥iiij. Cer. flav. q. s. fiat Ʋnguentum. Or here also may you safely use this Unguent. ℞. Ol. Laurin. Costin. an. ℥ij. Ol. Spic. de Laterib. an. ℥i. Sulphur. Sal. commun. Alum. Unguent: ust. an. ℥ss, Terebinth. ℥ij. misce, fiat Ʋnguentum: Or this Cataplasm, ℞. pulv. Absynth. Origan. an. ℥i. Mell. lss. Empl. Sal. ℥ss. misce, fiat Cataplasma: Or [Page] this Emplaster of Empl. de Bacc. Laur. Sulphur. & Ammoniac. of each equal parts. If it yieldeth not to these, but you be forced to Section, be sure your part be ripe enough and fit for your Knife: and when you make it, let it not be made too deep, but make it through the middle, as Paulus doth order, if it be small; if large, then are you to make a transverse Incision like the Letter X, and afterwards get out all the Matter, cleanse it, and follow its Cure, as I have directed you formerly in Artheroma, S [...]eatoma and Meliceris. But before you proceed to this operation, consider with your self these Inconveniences, which may follow and ensue, that whilst you let forth this Serous Matter, you do let in Cold and Air, which do extinguish the native heat of the Brain. I rather assent in such desperate Cases to the opinion of [...]abritius, by letting out this matter by degrees, by making a small Orifice, and therein placing a silver hollow Pipe, which is shut up with a Silken Stopple, by the drawing forth of which you may let out as much or as little as you please, in the same method and manner as you use it in a Paracenthesis; through this Pipe also may you inject any convenient Liquors, or Decoctions; And this partly sensibly, [Page] partly insensibly this Humour may both with ease and safety be drawn forth. And if it should arise from any Rupture of the Vessels, in which not only the Serous Humour, but also feculent Blood is contained, these are to be both discharged, discussed, incised and attenuated; and for this you may dip a Sponge in Posca, or Wine and Vinegar, and apply it. Barly Meal and Oxymel well mixed together may be very properly applied here. I shall here give you some strange Examples, by which you may easily perceive, how soon our natural Fabricks may be pulled down and washed away, even at our first appearance on this mundatory Stage.History. Vesalius writeth, that he saw a Girle of two years old, whose Head was larger and greater than any Mans Head, occasioned thus by this sort of Tumour, and the Cranium not bony but membranous, and that there was nine pound of water did run out from this Tumour.History. Leonellus de Morb. Pueror. Cap. 14. saw a young Child, which had its Head so much swelled with Water, that one might see through its outward Scalp the sutures of the Skull; the cause of this great quantity of Water thus expending it self out from the Skull was occasioned by the Midwife and Nurse, the one in the extracting of the Child [Page] from the Womb, whilst the other did second it by compressing its Head too strictly, whence the Commissures were cut and opened, and the Humidity it self, which was in the Brain, came to the outward covering of the Head, and thither pressed out its Humidities; and this was the occasion of this tumesied Head. Rhasis doth write, that he saw a Child, whose Head did so encrease in length and bulk, that its Body could not carry it: and it ceased not its augmentation, until the Child ceased not to live. This you have Cap. 3. Lib. de morb. Pueror. Forestus relateth of a Child being brought to him, having a very great Head occasioned by this Distemper, and this was his Curative Method: He commanded the Nurse that he might have a drying Dyet, it was oft times purged with Pills of Hiera Picra, and was anointed with this Unguent. ℞. pulv. Absynth. Chamomel. Origan. an. ʒiij. pulv. Unguent: Myrtillor. Rosar. rubr. fl. Melilot. an. ʒi. Ol. Chamomel. q. s. fiat cum Bntyro & Cera q. s. ad formam unguenti: After the anointing with this, these Powders were sprinkled on its Head, made of Myrtils, Cloves, Roses, Cinamon, and Chamomile, by the benefit of which it was perfectly cured. [Page] And to conclude this, Montanus de Infant. pag. History. 8. relateth of a Smith, who had his Head tumesied to that greatness, that it did exceed the bulk of an Oxes head, and that it obscured the whole Face with the Nose; he ordered a stick to be put into his Mouth, that he might obtain a free breathing, and by keeping every kind of a thin Dyet, and just Methods to carry off and remove the Humour, this Tumour at length abolished and vanished.

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CHAP. XXXV.
Of Talpa or Testudo.

THIS Disease is thus so called from the resemblance it hath with a Mole, which dwells and inhabits in the Earth; for this is a creeping Humour, and gets between the Cutis and Pericrane. It differeth a little from Ficus, because as that is a Tumour arising from mixt Humours; So is this elevating the Skin into a Tumour. It oft times doth so closely adhere to the Cranium, that it fouleth it. It differeth from a Ficus, in that it is larger and bigger, and therefore is longer in its coming to suppuration; for it is made of thick Humours. Its Causes are various,Its Causes as salt and nitrous Flegm mixt with Choler, or a putrefactive Water. In Children it doth breed most from sweet Flegm. Sometimes it doth breed of Flegm and Blood together, but seldom of Melancholy. We ought to be very careful and circumspective in Administring our Medicines here, because here we meet with both Humour and Fluxion; the Body therefore is to be prepared and purged, the Humours corrected, [Page] and the Peccant Matter discharged: and for these Pil. Aur. Coch. Aggregativ. Extract. Rud. Pil. sine Quibus, these or any of these are very useful and profitable. Masticatories, and Sternutatories, are here very convenient: and to the affected part we are both to use Emollients, and Digestives. If in the beginning of the use of Emollients the Humours may any wise rebel, quell their fury by Digestives, as by mixing Diapalma and Minium with a little Betony together. Stronger are Lilly-roots with Honey, Narcissus, Ireos with Honey, or the like applied. If it yieldeth not to these, it doth show it self tending to Suppuration; the which when you perceive, you are not to disturb it, but rather help it forwards in its operation, by applying Empl. Diachyl. cum gummi Mucilagin. Flos Ʋnguentor. In other Cases we are to use Digestives; as ℞. Caepar. Digestive. coct. sub cinerib. no. iij. Vitel. ovor. indurat. no. iij. Mucilag. Alth. Faenugraec. Lin. an. ℥i. Ficuum contus. no. 10. Farin. Fenugraec. Lin. an. ℥iij. fiat Cataplasma, sub finem addendo Axung. Porcin. q. s. then let it be opened, and discharge all the Matter; then cleanse it with Meal of Lupines and Honey, or Ʋnguent. ex Apis, and generate [Page] Flesh with Ʋnguentum Basilicon or Aureum, and dry up with this or the like:Unguent. ℞. Tuth. praeparat. Rosar. rubr. an. ʒi. Balaust. Bol. Armen. an. ʒss. misce cum unguento Diapompholigos, & fiat unguentum. Guido in his Chirurgick Tract.History. 2. Doctr. cap. 1. relateth of a Man who had an ulcerated Talpa upon the Musculous part of the Head, the which corrupred, and fretted the Cranium so far, as might with ease be perceived the motion of the Pannicles: more of which you may read in the aforesaid Tract.

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CHAP. XXXVI.
Of Tinea.

THIS is a Disease of the Head,Three sorts hereof. possessing the hairy Scalp. Of this there are three sorts, The first hereof by Galen said to be furfurous or squamous, for upon scratching it there do fall off many squamous Dandriff fleaks: A second called Ficus, it somewhat resembling the inward part of Figs: A third by Galen called Achor, and this commonly is called corrosive and ulcerous. All these species do arise from a corrupt Humour, erring more or less in quantity or quality. The first cometh of the mildest sort, the second is more corrupt, and the third is more putrid than the two former. If this Disease do forbear to show it self, until the party which is therewith perplexed is arrived at the Age of Man, he may both purge and bleed;Cure. and for this effect such Pills and Potions, as I have already prescribed in an Erysipelas, may with advantage be used here. As touching Topicks, let them be emollient and discussive; as Marshmallows, Lilly-roots and the like; a discussive Fomentation [Page] and the like: Scarrification and applying of Leeches, are here also very profitable: and afterwards anoint the part with this Ʋnguent of Guido. Unguent. ℞. Ellebor. alb. & nigr. Atrament. Sutor. Latharg. aur. Calc. viv. Vitryol. Roman. Alumin. gallar. virid. fuligin. Ciner. faec. Vin. ust. Argent. viv. extinct. an. ℥iij. Aerugin. Aer. ʒij. fiat pulvis, incorporetur in succo Borag. Scabios. Fumar. Oxylapath. Acet. an. quart. i. Ol. antiq. li. coquantur usque ad succorum consumptionem, in fine decoctionis adde Pic. liquid. ℥ss. Cer. flav. q. s. fiat Ʋnguentum. This is by all Authors held as a most excellent Unguent in scall'd Heads. The Crusteous or Ficous is to be fomented so long, as until the crusts do fall away, and for this Nasturtium tritum cum Axungia Porcina do make all fall off in 24 hours. Or this of Ambrose Parrey. ℞. Pic. nigr. ℥ij. pulv. virid. Aeris, Vitryol. Roman. an. ℥i. Sulphur. viv. ʒss. coquantur omnia in aceto acerrimo q. s. fiat Ʋnguentum. This is to be laid on for three days, and afterwards to be removed, this being our general way used in St. Thomas Hospital in London, the place from which I took my First-fruits of Chirurgery, under that Worthy Master Hollyer, by [Page] all allowed a most excellent Lithotomist and Operator in London. As to the third, deterge it with Ʋnguentum Aenulatum cum Mercurio, Aegyptiacum, of each ℥ss. Vitriol. alb. ust. pulv. ℈i. misce, fiat unguentum. And when the business hath been thus successively treated, for easing of pain, and smoothing the Skin, anoint the parts with this following Unguent. ℞. Camphor. ℥ss. Alumin. Roch. Vitriol. Roman. Sulphur. viv. Fuligin. an. ʒvi. Ol. Amygdal. dulc. Axung. porcin. an. ℥ij. misce, fiat Ʋnguentum. History: Hercules Saxoniae relateth in his Observations of a Woman troubled with a Disease possessing the Hairy Scalp, called Tinea, who by frequent washings of her Head recovered her health, but in the interim she endured a continual pain thereof, and Fever, the which were not to be conquered by any Revulsives, Derivatives, or Purgatives, and in thirty days after she dyed; and upon opening the Cranium, the half of the Brain with its Membranes were found putrid, and filled with a yellowish Ichor much resembling Urine.

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CHAP. XXXVII.
Of a Ficus.

THIS hath its Name from the resemblance it hath with a Fig, for it carryeth in it as it were the Seeds of a Fig. This sometimes doth arise from the Head, and doth descend into other parts; sometimes it is wholly in the Head. Our present Discourse shall be only of that which doth possess the Head, the which being rent will yield a fair prospective of the Seeds of a Fig. It is by Paulus called an ulcerous eruption, hard, and red; with pain. Hyppocrates doth number it amongst Tumours. It is therefore a Tumour, because it doth soon degenerate into an Ulcer, as Galen hath it. 5. De Med. per Locum c. 4. It is a Tumour generally in the Head, especially of Children. It is made of mixt humours,Cause. as thick Blood, Flegm, and Serum, because it is a red Tumour, round in the Head, and by its Flegm mixing with it cometh this serosity; and hence it is that these sort of Tumours do so suddenly run into Uucers, if not suddenly and well cured.Cure▪ In its Cure are we to prohibit its Ulceration, for it [Page] soon exulcerates, if not well cured. And here we are to begin with purging and cleansing the Body from these Humours by Pil. Coch. Aggregativ. Sine Quibus, and the like, and by Diaphoreticks to dry up this moisture; the part affected is to be discharged of this Serum, and prohibiting suppuration. And therefore to Children troubled with such a Disease you may use such a Medicine as this, ℞. Aqu. Marin. vel aqu. fontan. in quâ imponatur Sal M. j. in his coquantur herbae Saliv. Rosar. rubr. Absynth. an. M. ss. cola. In this you may dip Sponges, and apply them warm to the affected part, and afterwards lay this Plaister-wise, Take Figs being boiled in Water to the form of a Pultice and apply them. If you require stronger Medicines, ℞. Alumin. Roch. Calcanth. ust. an. part. aequal. sqam. Aer. dupl. Glut. in Aceto diluatur, & cum reliquis imponatur. If it be exulcerated, apply Ceratum Citrinum, Sem. Lin. trit. cum aqua. Let it be deterged with the pulp of Figs, to which may be added a little burnt Alume: and skin it with Desiccativum Rubrum or Diapompholigos. [...]story. There was a Minister of forty years of Age, who was much perplexed with a Scirrhous Tumour at the great corner of his Eye, [Page] the largeness of a Chesnut, being of a livid colour, intertexed with many capillary Veins. The Body being well purged, and a good Dyet ordered, and being let Blood on his left Arm, the same side where this Tumour possessed, the Tumour was extirpated with a pair of cutting Forcipes. After which was applied the white of an Egg mixed with Rose water: then following were applied Anodine, Abstersive, and very drying Collyriums, oft time [...] repeating the Purgations, and Administring cupping Glasses to the Neck and Scapulaes; and to the Forehead was applied this first being Anodine, and afterwards this second being very drying. The first was this, ℞. Mucilag. sem. Cydonior. & Plantag. cum aqu. Rosar. extract. Lact. muliebr. an. ℥ij. Camphor. Croc. an. ℈ss misce, apply i [...] warm. The second this, ℞. A [...]u. Plantag. Rosar. an. ℥iij. Tuth. praeparat. [...]. ust. & praeparat. Ceruss. lot. an. [...] fiat Collyrium. By the benefit of these, and observing his prescribed Direction he was perfectly cured.

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CHAP. XXXVIII.
Of a Cataract.

I NOW proceed to Tumours of the Eyes, and under this Head I shall comprehend Suffusio, Hordeolum, unguis Oculorum and Encanthis. Suffusio or Cataract by the Greeks is called [...], and this is an affect of the Eye, whose cause is as it were a concreted glassy Humour gotten between the Cornea and the Chrystalline Humour, clouding it and obscuring its Species of Objects, sometimes covering the whole Pupil, whilst at other times it is seen only to cloud but half thereof. And according to its more or less spreading, it doth either in process of time wholly abolish, or partly diminish the sight. And as Platerus doth observe, it groweth in length of time to the thickness and hardness of an excocted Egg. It is oft times made by a concretion of a Flegmatick Humour,Cause. bred either between the Coats of the Eye, or its Pannicles or Spots: It ariseth also from an influx of Humours; or is occasioned by some outward Action, as a Blow, or Fall; or thick and fumid Vapours arising from the Stomach, and so [Page] getting into the substance of the Brain, are from thence sent and diffused into the Eye, and at length do there contract its concretion. It may arise also out of weakness and cold. Celsus lib. 7. cap. 7. saith, that there is a space or distance between the Cornea and the Ʋvea, and in this empty space, as he does imagine, lodgeth this Cataract or Suffusion, and there takes its Origination. Paulus lib. 6. cap. 21. saith, that a Suffusion is a Concretion of an idle or sedentary Humour in the Cornea near the Pupilla; but this carrieth not so full a measure of truth as the former. Galen 10. de usu partium cap. 1. & 4. offereth that this Humour doth grow between the Cornea and the Crystalline. Yet Fabritius ab aqua pendente doth affirm, that in the three persons which he hath couched, and that in all People which he hath seen use the same Operation, the Needle hath been applied backward under the Ʋvea before the Suffusion would appear: and therefore it is probable, as he mentioneth, that behind the Foramen of the Ʋvea this Humour should consist, because if it did grow in its Circumference, it could not be dilated. Where this Cataract is confirmed, and comes to maturity,Signe. we may with ease perceive the [Page] thin Membranes visited with a strange Species of a thin clouded Pupil, variously coloured according to the diversity of Humours, as sometimes with white, or black, or blewish, yellow, red, or green; and by these or any of these the Eye is oft times clouded and deprived of its sight. If it do possess half the Pupil, it takes away but half; but when it creeps and overcasts the whole, it doth cause perfect blindness.Cure. Its Cure is to be begun with a good order of Dyet, and convenient Medicines, and Instruments artificially prescribed and applied: Abstaining from Wine and such hot things, as may disturb the Brain; Shunning flegmatick Dyet, and such as is of a flatulent and pituitous Juice. If the Patients Bread have some Fennel-seed put into it, it will be so much the better; for this is generally reputed not only to help the sight, but also is very advantagious for dissipating of cloudy Vapours. Bleeding, Purging, Frictions, are here very useful; Masticatories chewed in the Mouth are proper; Cupping Glasses and Vesicatories applied to the Neck and Shoulders are here also very requisite for Derivation; Pills and Potions for purging the Head of these flegmatick Tumours are wonderfully helpful. For Purging [Page] Means or Methods take some of ℞.Pil. Pil. Sine Quib. ℈i. Pil. de Cynogloss. ℈iss. Ol. Faenicul. gutt. iij. cum syr. Betonic. q. Pil: s. fiant pillulae. Or these ℞. Alo. optim. ℥ss. Turbith. gummos. Hermodact. Agaric. recent. trochiscat. an. ʒij. Diagrid. ʒi. ZZ. Caryophyllor. an. ℈ss. Croc. Sal. gemm. an. gr. vij. pulverisentur & cum Syrup. de Staechade q. s. fiat Massa pillalar. hujus sumat à ʒss. ad ℈ij, Potion. &c. A potion for the same. ℞. Sen. ℥ss. sem. Anis. Caryophyllor. an. ʒss. fol. Menth. Betonic. an. M. ss. Summitat. Thym. Paralys. Anth. an. pug. ss. coquantur ad ℥iiij. colaturâ infunde Agaric. recenter troch. ℈ij. Cinamom. ʒss. misce fiat potio. For outward Medicines there are innumerable by most Authors already mentioned: amongst the best of them all may be reckoned this, very oft times used by my self with good success. ℞.A Medicine of the Authors. Succ. Haeder. terrestr. Chelidon. Bellid. an. ℥ss. Aqu. Rosar. albar. ℥i. pulv. Sacchar. condit. albissim. ʒss. Mix these, and being made lukewarm let the Patient wash his Eye oft times in a Day. it both attenuateth, dissolveth, and penetrateth. And these are the most powerful intentions in this proposed scope. But if all these should fail, and this Cloud do still encrease and grow [Page] thicker, leave off the use of external Medicines, and let it grow until it be full ripe for manual Operation, and this you may gain by observing this Method; the sound Eye being shut, if the other be well rubbed with the Finger, the Pupil will presently dilate, and diffuse it self, and will very speedily return into its place, figure, colour, and State, and this by some is reputed to be ripe enough for manual Operation. Those Cataracts are by most Authors held to be incurable, which do arise out of a sharp and tedious Disease, and having with them great pains of the Head, or that which cometh by a vehement blow or stroke; such as are black, green, livid, yellow, or of a Quicksilver colour are hardly curable. On the contrary, such as have a Chesnut colour, or resemble that of the Sea with some White, are cured without much difficulty. And since it is not such an easie Operation, but may and hath puzled the best Oculist and most exact professor of this Art, consider that this Cure by couching is not always successful: But as it oft times happens well, so also hath it its intervals of bad success; for by these the Grapy Coat is too much diduced, sometimes rent, whence follow its amplification; or distorted, often after [Page] [Page]

Place this Figure Fol. [...]

[Page] this do follow inflammations and loss of sight. Therefore how careful, faithful, and diligent ought the manual Operator be, who undertakes this so curious an Art, the only piece to be admired of all Chirurgery? And here ought we to consider and understand the Coats, Muscles, and Humours of the Eye, so that not one part of the Eye may be injured by your operation: We ought also to consider and observe, how these parts are connexed together, while we move the Needle upwards and downwards. And having given you this as a Caution or monitory Introduction, I come now to teach you the way of performing this Chirurgick Operation, a lively Protraict of which here you may see expressed, with all its necessary Chirurgick Instruments belonging and appertaining thereunto. Your Patient having both his Body and Head well cleansed, and all other accidents which may yield any appearance of obstructing your Operation, you are to remove, and then bind up the contrary Eye, and place the Patient to the best advantage, both for his ease, and your better sight, and executing your Operation; and having your Needles both sharp and round pointed ready fixed, and fitted for your use, and [Page] your other Dressings fit to be applied, then with an intrepidant Hand and undaunted Courage thrust through your Needle, so as that it may enter the Ad [...]ata in the middle, charging your Patient to turn the Eye towards his Nose, thrusting it near half a strawes breadth from the Iris into the Cornea; and having got it safely in, you are to work it unto the hollow of the Eye; and when the Needle hath touched the Cataract endeavour to press it gently with the Cataract downwards, and this you are to do so often until you see the Pupil quite discharged of its Cloud, and with that strength as to keep it down, that it may not rise up again; and order your Patient not to stir his Eye; for if it sticketh below, and returns not again, you may be confident of a perfect Cure. Then is the Needle to be brought up again, not to be taken out presently. Upon which done, and your Needle taken away, close up the Eye with all speed, by applying to the Eye some linnen Clothes dipt in Rose water, the White of an Egg, and a little Alume mixed together, taking as an Observation, that you beware of hurting the Crystalline Humour, and the sound Coats in the Operation,Observ: and with convenient [Page] Bolsters and Rollers compleat the rest of your Operation; after this get your Patient to Bed, and order him to ly high with his Head, from all Noise; and let your work be done with sobriety and carefulness, acquitting your selves of all Mountebank gestures and impostures. Let his Diet be Barley water, Ptysans, Gellies, poached Eggs, and the like: At the eight day you may remove your Dressings, and then wash the Eye with Rose water, being made lukewarm before you apply it to the Eye; and for some season, order your Patient to wear a piece of green Silk over his Eye, that it may not have the full Air come to it, but by degrees; and let this serve for your couching Method. I shall conclude this Chapter, wishing all success to the manual Operator, leaving this also with him to have in his remembrance, that it is the Eye alone which is Mans greatest Guide in this World, and therefore let Conscience and Charity perswade all Men that tender any thing of good, not to meddle with this Cure or way of curing, unless he be well Skilled and exercised in the Art, and understandeth the Parts and Coats very well, lest he comes off with no more Credit than that Mountebank, of whom Montanus Consil. 81. writes [Page] the Story, I will here give you as a just example of impudence in these Locusts. A Person being troubled with an Opthalmy in part of the Cornea of the Eye against the Pupil,History. the which being but very small and scarce discernable, an Emperick coming under pretence of giving ease, applies an Apple which had been roasted on hot Embers thereunto, and ordered to let it remain on until the next Day; that Night the pain ceased, and the Patient slept well; Upon which the Mountebank began much to praise his Skill, and himself with hopes of a speedy Cure; but taking off his rare Medicine, the Waterish Humour followed it, which preceded the Crystalline, so that contrary to his boasting expectation, the Patient was made blind in this Eye. A Day will hardly suffice to reckon up those mischiefs and injuries, which are dayly done by these Quacks and Mountebanks. A Woman of thirty years of Age (as Riverius in his 100.History. Observations writeth) having a confirmed Cataract, and being for a whole year blind, recovered her sight, her Body being well purged and cleansed, by the benefit of Quarcitanes Opthalmick water; for the same I have oft times used the Juice of Celandine, Daisies, Rose water & Sugarcandy with very good success.

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CHAP. XXXIX.
Of Hordeolum [...]

THIS is a small extuberance, by the Greeks called [...] from the resemblance it hath with Barley, and (as Celsus saith) this is included in a Husk or Coat, and doth contain in it somewhat which is hard to suppurate. This Tumour by us in England hath generally given it the Name of a Stiony. It generally groweth in the upper part, and in respect of its smalness it may sometimes be discussed, sometimes digested: Discussed by laying hot Bread or Wax to it; when you have digested it, open it with an Incision knife or Lancet, and let out every part of the Humour which is contained.

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CHAP. XL.
Of Ʋnguis.

ALTHOUGH this by the Greeks is called [...], yet this is not so easie by us understood or described: for if we may conceive the whole Fibrous Membrane arising in the greatest Angle of the Eye, and produced above its White to the Cornea, and sometimes extended as far as to the Pupil, we may view and perceive this lively expressed adherent in this part. Celsus doth oft times say, that it ariseth from part of the Nostrils, and sometimes from part of the Temples, and where it toucheth the Pupil it adhereth to it. Paulus affirmeth this is without much difficulty to be discussed, as by applying thereunto white Wine and White Wine Vinegar mixed together, or Eye-bright and Sugar, or Fennel-water, Niter or Salt. If it hath had a long time to grow, and cometh to any perfection, as Celsus directeth, it is to be cut out,Celsus Method. for which he useth this Method: Let the Patient be placed in a convenient State with his Head somewhat downwards on one one side, [Page] that you may come the better at the Tumour, and let him be so held and placed, as that he do not disturb your Operation; and then with a sharp Hook, being a little bent or made crooked, apprehend the Unguis, and with a small Needle and Thred draw through it, and so by compression eat it off.Paulus's Way. Paulus's way is thus: He uses a strong and long Horses hair, and with this he doth comprehend the Unguis, and so in a short time doth eat it off. And here ought we to take care how we apply our Silk, or Hair, or any other thing, with which we do or may intend to eat of those, lest when we come to the Angle, the Caruncle it self benot cut off also, and so there happeneth another Mischief by the Greeks called [...], out of which a Humour doth always flow. After it is clean taken away, Paulus would have a little fine Pouder of Salt sprinkled on it, mixed with the White of an Egg, and so applied upon Cotton or Lint; We rather approve of Pompholix being poudred both for deterging and drying, and over all to put a little Sheeps Wool. Celsus doth put over his Liniment, being made of Honey; but the true and more proper way is, to use more drying Medicines, such as have [Page] no corroding quality,History. or do stir up any Inflammation. A Girle of ten years old being much perplexed with a tedious and troublesom weeping at the right Eye, to which convenient Medicines not being applied, the Humour that made its course thither grew sharper, after which followed an Inflammation, and an Erosion of the Pupil; hence the Pupil grew into a great, thick, hard, and white Cloudiness, which depraved the Sight, by its long continuance, there being but little hopes left of doing good to this Patient; yet by the request of her Friends, and perswasions, by these following Medicines, she following directions recovered her sight: to the Front was applied this Defensative. ℞.Defensative. Farin. Hord. ℥ij. pulv. Rosar. rubr. nuc. Cypress. Gallar. Cort. granator. an. ʒiij. pulv. fl. Betonic. Euphrag. an. ʒi. misce in mortario cum aqua Betonic. Euphrag. & Acet. & Abumine ovi, fiat defensativum. Into the Eyes was instilled this Collyrium. ℞.Collyrium. Mucilag. Sem. Cydonior. cum aqu. Rosar. extract. ℥j. Aqu. Foenicul. Euphrag. an. ℥ij. Mel. Rosar. ℥ss. Tuth. praeparat. & Corn. Cerv. ust. & praeparat. an. ʒss. Camphor. gr. iiij. With this Collyrium and a good Diet, with [Page] a good Order in purging being observed, and by the benefit of a Seton she recovered her perfect sight. If the Collyrium be not strong enough, you may add Extract of Celandine to deterge the thick and viscid Matter which sticks to the Pupil.

CHAP. XLI.
Of a Polypus.

WE come next to the Nose, where we may meet with a Polypus, the which by Paulus lib. 6. cap. 25. Is said to be a Preternatural Tumour arising in the Nostrils; so called from the resemblance it hath with the Fish Polypus, as Galen hath it, and also from its substance, it being made of a Flegmatick and viscous substance. Its proper place, wherein it inhabits, is the Nostrils, where it both obstructs the Nostrils Respiration, and in some measure doth hinder the Speech. Celsus doth add, that where a Polypus is thus produced as that it reacheth the Fauces, [Page] they which are correpted herewith are soon suffocated.What a Polypus is. This Tumour is like White flesh soft, filling the Nostrils, not uniform, but doth appear as many Caruncles knotted or joyned together, or hanging one on another, some coming to the Cartilages, some to the Bones either of the Nose, or Spongy Bones. Albucasis lib. 2. saith, that it ariseth from a flegmatick matter, and hath no Veins for its nourishment. Whence it is most likely it is made of pituitous Blood, which floweth to the Brain,Cause. and is thence sent through the Nostrils. There are many Differencies hereof,Differencies as Paulus Albucasis and others do own, for sometimes it is hard, adherent, livid, painful, and cancerous, not to be cured with Instrument. Another sort is soft, loose, white, indolent, bordering only on the Cartilages of the Nose, or to the Bones, or to its Spongeous Roots, being pendulous. It is so pendulous, as it oft times is seen to hang out beyond the Nose. Sometimes it is drawn upwards, sometimes it passeth the other way to the Fauces. Hyppocrates doth describe all its Differencies, de Polypo, and the manner of curing.Celsus's way. Celsus doth order us to put up a sharp Iron through the Nostril, made in form of a Spatula, [Page] and with this to resolve the Polypus from the Bone, taking all care that the Cartilage be not hurt, and being cut with this draw it out.Paulus's way. Paulus openeth the Nostrils and delateth it, and with a Spatula made in form of a Myrtle leaf, doth cut it out orbicularly: But I shall not hang on either of these. These do shew the Nostrils to be free from a Polypus, if breathing through the Nostrils be free, and without any Obstacle. I rather with a great satisfaction admire and approve of Fabritius de Aqua Pendente, whose Method and Instrument is both safe and harmless, which Operation is made with safety and with repute; for this Instrument doth apprehend, cut and draw forth the Polypus, the which are the three chief intentions in this Cure. And besides these advantages it keeps and defends all the other parts of the Nose in safety and harmless. It apprehends and draws it out without effusion of Blood, for it neither cuts nor divides no other Veins or Vessels, than such as are spread or interwoven into these Caruncles, of which this Polypus is made. I shall, after I have presented you with its commodities, shew you the exact Figure of this Instrument; it cureth suddenly, safely, without pain, and [Page] danger. This Instrument doth perform these Four Intentions, it apprehends, cuts or separates it, separateth its reliques, and doth induce a Cicatrice. It hath an edge to cut, and apprehends like Forcipes, and therefore is to be made like a pair of cutting Forcipes: It apprehends and draws forth like Forcipes: it presently separateth the Polypus from the Bone; and for the last we only blow up restrictive Pouder: And thus have I shown you its Four Intentions. It cuts inward to prevent all trouble and danger, and it bringeth this commodity with it, it showeth to every one apparantly what it hath done. In the Cure of a Polypus certainly could there be never a better framed.

Falloppius hath an Instrument made of Silver like a Pipe for this purpose, into which he puts a Wire, with which he doth apprehend the Polypus, and with this he draweth it to the root thereof, and by a close contraction of this Wire he divides and draws forth the Polypus; but if the Polypus be too hard, he draws it forth with this, and cuts it with an Incision Knife. I have here also set down its Figure, so that if any desire to use it, here may they see its shape and form.

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[figure]

[Page] [Page] Johannes Paulinus in his his Observations doth relate of a Countryman,History. who had such a large Polypus descending to his Palate, or in the Glandule hardned in the Larynx, that he was almost suffocated, & could scarce speak or swallow. Baynius in lib. History. 5. cap. 3. saith, that he

[figure]

cured the Secretary of a Reverend Cardinal of a Polypus, which not only stopped the Nostril, but also at sometimes hanged out beyond it, by this Method of applying a Caustick at the end of a leaden Instrument, the which being made hollow at its end for receiving the Caustick, and not bigger than to put up into the Nostril, with which the Patient himself was to hold it with the Caustick next to the Polypus for the space of one whole hour; and then this being removed, he applied Butter, until the Eschar was ablated or removed also; and thus he as oft renewed the Caustick, and afterwards applied a convenient Medicine for ablating the Eschar, as until he had quite extirpated the Polypus. A true Figure of Falloppius Instrument you have here expressed.

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CHAP. XLII.
Of Parotis.

WE arrive now at a Tumour of the Glandules of the Ears called Parotes: And before we explain any further hereof, it will be here necessary that we understand what a Glandule is. It is a Spermatick Parenchyma included in one common Membrane,What a Glandule is. and with many private. And these may more properly be said to be Spermatick than Sanguinary, they being furnished with four kinds of Vessels, as Veins, Arteries, Nerves, Lymphaducts. And since we have shown what a Glandule is, let us further inquire into the nature and substance of this Parotis.What the Parotides are. These are Glandules seated behind the Ears, and do fill up the whole substance thereof in the back part; they are more hard and viscid than the Mamillary Glandules. It is from these do come the Salival Ductuses: and by Falloppius are said to be ordered for receiving some superfluities of the hard branch of the fifth pair, and to send them into the Veins refocillating the inward and outward Ear by its Heat, and to explete [Page] the same in its Circumference. This Tumour, which preternaturally gets into the Glandules and these Emunctuory parts, they being loose and spongeous, and so the more capable for the reception of Excrements) hath inflammation generally as its companion, both sharp and painful. As it is also oft times seen to arise from a viscid Humour; so also doth it very frequently succeed a long and tedious Disease, the which sometimes doth terminate hereby, throwing some of its Venome hereinto. It is tedious in cure, it arising from a thick and viscid Humour.Its Cure. It is to be cured by good order of Diet; and if plethory appear, use Plebotomy, and then to discharge such peccant Humours as do occasion it. Galen adviseth us not to use Topicks here, as we do in other parts; for it is not to be repelled in its beginning, lest hereby you give the Enemy a deep impression into your Patient, and so encrease more Pain and Danger; but rather to attract and draw forth the Humour: But if Fluxion be large, Pain sharp, and thence Fever and Watching follow, here may we use Repellers; and by Galens Authority we are to use Digestives mixed with Repellers:Catapl. as ℞. farin. sem. Lin. [Page]Hord. Fabar. an. ℥ij. coquantur cum decocto Melilot. Chamomel. fine addendo Ol. Rosar. Chamomel. q. s. fiat Catapl. Or ℞. Butyr. sine Sal. ℥ij. Ol. Chamomel. Aneth. an. ℥i. Dialth. ℥ss. Cerae parum, Unguent. misce, fiat Ʋnguentum. The pain being ablated, come to the use of strong Resolvers, such as this; ℞. rad. Alth. Breon. an. ℥iss. fol. Rut. Scord. Origan. Veronic. an. M. fl. Melilot. Chamomel. an. pug. 1. Coquantur in Hydromelite, Catapl. trajiciantur fine addendo farin. Hord. Fenugraec. Lupinor. an. ℥i. pulv. Irid. iij℥. Ol. Rut. Chamomel. an. ℥i. misce, fiat Cataplasma. A Woman of thirty years of age being perplexed with a Parotidal Tumour behind her Ears,History. in which beginning was no Fever, neither did she keep in; but about the fourteenth day of her Disease her Tumour grew to a great bulk, and the matter was plainly prepared, but by reason of the toughness of the Cutis, it was kept in longer than it ought to have been: At length being broke, the Woman fell into a few swounding vomitting Watchings, with pain of her Back and Kidneys; yet little or nothing came out of the Abscess, neither did she spit up any: Within a few days she dyeth. Hence may a Chirurgeon learn that Abscesses [Page] be either in the Emunctuories, or their neighbouring parts, that they do not break them, until they of their own accord break.

CHAP. XLIII.
Of Epulis and Parulis.

THIS is a Hypersarcosis, or fleshly Excrescence of the Gums, gathered at the roots of the Teeth, and doth Tumefie with Pain, Heat, and Redness; it poureth fourth a saline and fetid Sanies, and oft times runneth into a Cancer, which ought to be understood out of the property of its extraneous Heat; and that which is not painful may be revelled, the manner of which may be this way acted and performed, by tying a double Thread about it, and bringing the same every day straiter, until you have wholly eaten it away: when it is off, you are to burn the place by applying a Caustick thereunto, being sent thither through a Pipe, but so safely that it hurts none of the adjacent [Page] parts. Parulis is a Tumour of the Gums with Inflammation, which is very often resolved, and sometimes suppurated; It is made of hot Blood. This may be cured by prescribing in the beginning convenient purging, bleeding, and cooling and repelling Gargarisms, as Plantain, Roses, Adderstongue, Nettles, Sage, and the like, being boiled in Water with Alume, to which add some Syrup of Mulberries and dried Roses; If it tends to Suppuration, further its progress by putting in here Marshmallow roots, Figs, Mallows, and the like. And being made ripe, open it with your Incision Knife or Lancet, and cleanse the Ulcer with Mel. Rosarum, Wormwood or the like: If it be scirrhous, and proves very stubborn, draw out a Tooth where it fixeth: and by this means you will both discharge it from its root, and have no reason to fear a new growth. Placentinus Chirurg. History. lib. 5. cap. 20. cured a Gentlewoman of a very large swelling which was in her Gums in the upper Mandible, the quantity of which Flesh was very much above the Teeth swelled to the bigness of a Goose Egg. He removed this in four times applying an actual Cautery, and removing some of [Page] the Teeth about it with some part of the Mandible: He let it bleed in a great quantity, at length he stopt the Flux with Vitriol applied on Cotton or Lint, pressing out all the clotted Blood with his Fingers, and so perfectly cured her within eight days.

CHAP. XLIV.
Of Ranula.

THIS Tumour by the Greeks is called [...], by the Latines Ranula, it lodging under the Tongue: It is occasioned by a moist, pituitous, gross, and thick Substance, falling from the Brain into the Tongue, much resembling in it the Substance of the White of an Egg, being somewhat of a more yellowish Colour. And here observe, if the party be plethorick, breath a Vein under the Tongue, and use proper and peculiar Gargarisms for this purpose, and anoint it with some restringent Unguents, or rather open it with some red-hot Iron Instrument [Page] being sharp, the manner of which is thus: Get a bended hollow Ironplate which hath a hole in the midst; making the Patient to hold open his mouth, you must so fit it, that the hole is to be just upon the part which you intend to open; with the Instrument open the part, so as you may hurt none of the circumjacent parts; when you are ready to burn it, thrust your Thumb under the Patients Chin, that you thereby may somewhat elevate the Tumour, and hereby you may open with more certainty. Being thus opened, throw forth the contained Matter; after which wash the Patients Mouth with Barleywater and Sugar of Roses; and thus may the Ulc [...]r be safely cured. Gulielmus Placentinus doth order only Aqua Aluminosa to be held under the Tongue, in which hath been boiled a little Myrrh. Gesner in Histor. animal. lib. 2. pag. 51. writes,History. That a Physitian related to him, that he saw a Tumour under the Tongue the breadth of two Fingers, which hindered the speech, and that this Tumour was cured by drawing a Needle through it, and afterwards opening it with a sharp Instrument; the which being done, came out matter from thence much like that of an Artheroma, resembling [Page] coagulated Milk to the quantity of as much as would fill two hands; the which being discharged, he ordered the Patient to gargarize his Mouth with Aqua mulsa, and sent into the Ulcer of the same by a Syringe, and the Body being well purged, and by the use of Restringents the Patient perfectly recovered.

CHAP. XLV.
Of Strumae and Scrophulae.

THIS Tumour doth arise with much [...]ase from too much fibrosity, thickness and viscidity of the nutritive Succus, and for this cause only is it that this Juice is so difficultly despersed into all the parts of the Body, and therefore must confidently redound in some place, and with ease lay its first grounds and Foundations of a Tumour. There is held a great difference between Strumae and Scrophulae; and by Dr. Wharton in his Book De glandulis, the one of these is called by him Wenns, the other the Kings evil: Scrophula [Page] signifying the first, and Struma the latter: Scrophulae are soft, Wenns hard: the first pale, carrying in them the colour of the Skin, the second having a redness turning to lividness; Scrophulae soft and not much penetrating, Strumae immovable and deeply fixed: the Kings-evil swellings generally encrease into a great bulk and magnitude; and besides their glandulous Fleshes they do carry in them several sorts of Juices in their little Bags, the which do help much forward their growth and bulk. It is credible that these concreted Juices are as some rejected Excrements thrown from the glandulous Flesh in its nutrition; for these Glandules have no excretory Vessels, and therefore necessarily they should carry their Excrements in their Bags: And this is one reason of their growth. Secondly, the Blood effused from hence through the Arteries is more plentiful, than that which is reduced through the Veins; and hence therefore may there arise another reason of its growth. Thirdly, The Nerve which keepeth here is but small, and that makes them so dull; and hence is it that, were the parts pricked with Needles, the Patient would not much complain of pain. Now as touching Strumaes, these [Page] are not always seen to run into a bulk or magnitude,Descript [...]on of Strumaes. but sometimes they encrease, sometimes they lessen, and at length do vanish. These Tumours do receive their proportion from the reductory Vessel, and are discriminated from its first genus, here is nothing found besides Nerves V [...]ins and and Arteries. And by how much the Veins are better capacitated and enabled to convey and carry off that which is sent them from the Arteries, by so much also are these Strumatous Tumours less capable of running into bulk, than such as are Scrophulated. And how these Tumours are translated from one place into another, I attribute chiefly to the Nerves in their Operations, these being most proper Messengers to carry to and fro. Now if there be any matter carried to the Emunctuory Vessels or Glandules, and be there excerned, the Struma doth soon lessen, and sometimes doth wholly vanish, and is very often seen by applying of Hydrargyrical Mêdicines or Salivation to consume and waste away, these having in them a very powerful influence of making the Nerves spit forth their Humidities into the Emunctuory Glandules. And hence by Paulus and Celsus these are said chiefly to arise in three [Page] places more especially, as in the Inguens, Axillaries, or about the Neck or Throat, but most chiefly about the Neck and Throat, because here they be nearer the Head, their Fountain, from whence they draw their flegmatick Matter to their conglomorated Glandules.Signs. Some of these Strumaes do succeed other Distempers, whilst others do breed of themselves: Sometimes an outward Cause may occasion them, as by applying too hot resolving or too drying Medicines.Presage. As to their Presage, we ought here to consider their different places where they make their abode; for these are also either small or great, loose or fixt, few or many, painful or without pain, arising from Flegm or Melancholly: Some being in the inward part of the Neck, whilst others do border on the outward: Some terrifying young Children, whilst others do lay their impresses on people more aged: And by how much they are more movable, by so much are they with less difficulty cured; yet take them at the best, the Chirurgeon will find work enough to get well off, & clear them with repute. Such as adhere to the Bones are incurable; there are three ways of eradicating them:Three ways to eradicate them. Either when the Radical Moisture, which is carried and reserved [Page] in their several Cystuses or Bags, is sucked up by the Nerves, or the affluxed Blood reduced by the Veins, or a free transpiration brought to the part affected. The first and main cause of this translation is the Nerve, which doth bring and breed the first rudiment of a Struma out of its matter, and to help forwards this work, both Veins and Arteries are as its Assistants. The curing also of these Diseases are very difficult, in that most generally such as are troubled with these swellings outwardly, they also have them inwardly.Cure: As to the Cure, the thick Lympha is to be incised, tempered, and evacuated; the Glandules softned; the Humour, if possibly, either to be discussed or suppurated, and at length, if no otherwise to be overcome, is to be treated with Escharioticks. And first let the Body be well purged with Phlegmagogicks.Pil. As ℞. Alo. lot. cum aqu. Majoran. Agaric. troch. an. ʒi. Mastich. Cubebar. an. gr. vi. Troch. Alhandul. ℈ss. cum Syrup. de Betonic. q. Pil. s. fiant pillulae. Or these, ℞. Pil. Coch. ʒij. Aurear. ℈i. Troch. Alhandul. gr. iij. cum Oximelit. q. s. fiant. Pil. Or ℞. Turpeth. optim. Zinz. Hermodactyl. Diagrid. Sacchar. an. partes aequal. misce, fiat pulvis, of which the [Page] Patient may take from a Dram to a Dram and a half with Oximel once in a Week,Pouder. in the Morning. Or this, ℞. Turpeth. Zinzib. Sacchar. alb. an. ʒi. detur cum vino. If the Patient be of a pretty good Age and strong, he may take this. ℞. Pulv. Turpeth. ʒss. Hermodact. ℈i. Zinzib. condit. ʒss. mix them for use. Pil. Cochiae, Sine Quibus, Trochisc. Alhandul. and the like, are here very good and proper. Sweating also here is very advantagious, and taking inwardly of acid things is good: Or you may prescribe this Pouder.Pouder. ℞. Ciner. Spong. marin. Oss. Saep. Piper. long. Cinamom. Sal. gem. Pyreth. nuc. Moschat. Cupress. Gallar. cort. Querc. fl. Rosar. rubrar. an. ℥ss. misce, fiat pulvis, dosis a ℈ij. ad ʒi. Or this, ℞. Lap. Spong. ʒiij. Sal. gem. ʒij. Tartar. vitriolat. ʒj. misce, fiat pulvis, dosis ℈iss. vel ℈ij. And to the part affected such things as are proper for a Scirrhus, are here also as prevalent; but such things here are more peculiarly to be added, which may more powerfully resolve, as these which have been applied with most excellent success.Aqva. ℞. Ol. Philosophor. [...]. Thur. Mastich. Gum. arabic. Terebinth. venet. an. ʒiij. pistata simul per Alembicum distillentur,[Page]tandem distillationi addatur Salex cinere Sevi, & iterum distilla, & serva in vitro ad usum. Or, ℞. Galban. Bdel. an. ℥i. Ammoniac. ℥ij. Scord. Alveor. Apum Oesyp. an. ʒij. Terebinth. venet. Pic. liquid. an. ℥iss. bacc. Laur. Staphis acr. Cumin. Pyreth. an. ℥ss. Stercor. Caprin. Anser. Alth. an. ʒiij. Axung. Porcin. Sev. Caprin. Ʋrsin. an. 3℥ss. ol. Chamomel. Lilior. an. ℥ij. Terebinth. venet. ℥ss. Hydrargyr. ℥iss. misce, fiat Emplastrum, ℞. Ol. Laurin. ℥i. pulv. Ceruss. cum aqu. laevigat. ℥i. Alumin. Roch. ℥ss. Sal. commun. ʒij. misce, fiat unguentum. Unguent. Or ℞. farin. Fabar. Orob. an. ℥ij. pulv. flor. Chamomel. Melilot. Rosar. rubr. an. ʒiij. Ol. Irin. Ʋnguent. Dialth. an. ℥i. succ. Rut. ℥ss. Catapl. misce fiat Cataplasma. Or ℞. farin. sem. Lin. Fenugraec. ℥iij. farin. Orob. ℥i. fl. Melilot. Chamomel. Sambuc. an. ʒiij. fl. Anthos. ℈iiij. pulv. Irid. ℥ss. coquantur in vino mulso, tunc adde sub finem ol. Lilior. q. s. fiat Cataplasma. Or this,Catapl. ℞. rad. Alth. ℥iiij. rad. Lilior. ℥ij. flor. Melilot. Chamomel. an. pug. ss. coquantur, pistentur & percolentur, postea adde pinguedin. Gallin. Dialth. an. ℥i. medul. 'Pomor. sub. cineribus coct. ℥iij. Ol. Chamomel. Lilior. an. Catapl. q. s. fiat Cataplasma. And for [Page] this also the resolving Emplaster in Scirrhous Tumours is here very excellent, it being by me very oft times applied with good success. Barbett writes of a Maiden of fourteen years of age,A History. who was very much afflicted with many and grievous Diseases, as swelled Lips, and several ulcered Glandules in her Neck and Parotidals, and much tumefied with Scirrhous swellings, so that she could scarce move her Neck, and by this following Method he recovered her: First ordering her a Decoction of Guaiacum, prepared with attenuating and opening Ingredients, of which she took three Ounces for Four days, into which was dropped of Spirit of Sal. Armoniac. eight drops, and once in a Week she took this Pouder. ℞. pulv. Jalap. ʒss. Tartar. vitriolat. gr. 5. Ol. Faenicul. gutt. ij. This wrought with her three or four times: outwardly was applied Empl. de Ranis cum Merc. Ol. Rutae & Fuligin. malaxat. And to the ulcered Glandules Ʋnguent Basilicon: then Balsamum Sulphuris: and she within three or four Months was restored to her perfect health. Or this Emplaster may be well used. ℞. Empl. de Ran. cum Merc. ℥ss. Gum. Galban. ʒij. Sacchar. Saturn. Sal. volatil. Armoniac. an. ʒ℥ss. malaxentur[Page]Oleo Rutae q. s. fiat Empl. Sometimes these Strumaes will not yield to Resolution, but do much rather incline to Suppuration; that is, when any other Humour is mixed, which gives it a greater Heat, as Blood and Choler: and when it takes its course this way, we are to help forward with such Suppurating Medicines, as may speed it in its operation; such as be Marsh-mallows boiled in water, Diachylon cum Gummi, De Mucilaginibus, and the like: or instead of those take some of these following compounded Suppurating Medicines.Catapl. ℞. Bdell. Ammoniac. an. ℥ss. dissolvantur in Lixivio, adde Calc. viv. cum Axung. contrit. ʒi. Sulphur. viv. ℥ss. Alumin. ʒss. Mel. optimi ℥iss. Ferment. veter. ʒij. misce, fiat Cataplasma. Catapl. Or this; ℞. Caepar. & rad. Lilior. albor. sub cinerib. coct. an. ℥iiij. farin. Tritic. ℥ij. Axung. Gallin. Anser. an. q. s. vitell. Ovor. n.. 1. Croc. ʒss. misce, fiat Cataplasma. Catapl. Or this; ℞. farin. Fabar. Tritic. an. ℥i. farin. sem. Lin. Foenugraec. an. ʒij. Ficuum contus. ℥iss. Axung. veter. ℥ij. Croc. ℈i. misce, fiat Cataplasma. Being suppurated it is to be opened by a Caustick or Incision: and for a Caustick there's none better than sublimated Arsnick; and upon applying it defend its neighbouring parts with a Defensative, [Page] discharge the Matter, & remove the Eschar, fill up with Flesh, and then skin it. I shall conclude this Chapter with one Patient of my own (though on this subject I could offer many, having had the honour of obtaining the Touch from His Majesties hand) for many, most of which I have had afterwards to conclude their cure: amongst the rest in this City of Norwich was one Mr. Rootees son, much perplexed with Scrophulous Tumours, which tended after His Majesties Touch to Suppuration, who after having his body well purged, and the Humour well prepared, his Neck from his Ears was environed with these small filled bags of Flegmatick Matter: over these I applied Emplastrum Diachylon cum Gummi ℥ij: De muci [...]aginibus ℥i. Emplastrum de Ran. cum Merc. ℥ss. Ʋnguent. Dialth. ʒvj. misce. With this or the like Emplastrum was his whole tumefied part covered, and having brought it to Suppuration, I drew forth all its matter which was contained; then I mundified, digested, and incarned all the parts, and the Patient (I bless God) remains in perfect health to this day.

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CHAP. XLVI.
Of Bronchocele.

THere is a Tumour (as Celsus calleth it) between the Cutis and the Wind-pipe, which the Greeks call [...]. This is not a Tumour in the Glandule, but arising upon the Aspera Arteria. It's thus called [...], which signifies Aspera Arteria, and [...] Tumour; and therefore by Celsus is said to be a Tumour arising between the Cutis and Wind-pipe, and by him is numbred amongst Abscesses, whose Matter is lodged in a Bag or a Coat, which is dull Flesh somewhat like Honey or Water. Celsus doth here also propose two sorts of Medicines, as Caustick and Instrument, by burning Medicines, so as that the Cutis and Bladder may be burnt, and thus the Matter discharged: but this is a great deal of trouble to a little purpose; and therefore he more readily comes to Incision. And here he orders a direct Incision to be made into the Coat, so as the vicious matter may be separated by the Finger; after which let it be well mundified with Vinegar, to which adde some Salt or Nitre: and in every Abscess we [Page] are to take notice, that there is a small Vein or Artery that doth feed it, and its Membrane whereto it doth adhere to the sound part; in the other part it is free. If any Patient should come to your hand with such an Abscess, be always careful of these four Intentions, as in the ordering your Patients Diet, in preparing and purging the antecedent Matter, in removing the Matter contained in the Tumour, and in applying convenient Topicks. Let his Diet be thin, his Air hot or temperate: for purging these may serve.Pil. ℞. Pil. de Agaric. Pulv. Hier. Colocynth. an. ʒij. cum syrup. de Stechad. q. s. [...]i [...]nt pil. dos. a ʒi. ad ʒiss. In this case Sweating is also good. And as to Chirurgery, you may use this Ungu [...]nt and Emplaster:Unguent. ℞. Sulphur. Sandarach. an. ℥ss. Euphorb. ℥i. cum Cerae & olei q. s. fiat Ʋnguentum. After anointing herewith apply this Emplaster: ℞.Empl. Rad. Ireos, Sal. Gem. an. ℥i. Terebinth. q. s. Diachyl. cum Gummi Apostolor. an. ʒi. misce, fiat Emplastrum. If these will not do, Rogerius does advise us to make a double Seton, so as that the Humour may slow out by degrees. In old people very commonly the Larynx is so attenuated, and the Muscles as it were so dried up, and as it were discharged of their [Page] Fleshy Substances, that it happens frequently in chewing, that some part of the Aspera Arteria is seen to fall: and this was verified by Osualdus Gabelchoverus de observationibus suis, Histo [...]y. who writes of an old Gentleman that could not take down any liquor, as Beer, Wine, or any liquid substance, but a great part of his Aspera Arteria would slip; yet he could take and eat his meat very well without any hindrance. The same I knew of one Mr. Goodman a Minister here in Norfolk, a man of about 40 years of age, who could eat his meat very heartily without any lett or disturbance; but when he hath had occasion to drink, was forced to bend himself forward, and by degrees let his liquor pass down very moderately, lest a part of his Wind-pipe should slip out, and so prove very troublesom to him. I have been oft in his company, when I have both seen him use this Method, and also taken all care to prevent the falling down or relapse of his Aspera Arteria.

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CHAP. XLVII.
Of Angina.

IT is called Angina from [...], which is all one to S [...]rangulo, the which doth signifie every Affect both of the Jaws and Throat, whereby Breathing is hindred; or if you please, it is that Affect of of the Throat, the Larynx being overstraitned by some inward occasion, so causing Suffocation. It is a very acute Disease, and is an Inflammation of the Fauces. Of this there are two sorts, one Legitimate, the other Illegitimate. To the one a Feaver is a continual companion; but it hath nothing to do with the other.Three species of a true Squinsey. There are three species of a true Squinancy: one with Inflammation, and not in the Fauces, neither apparent in the Neck, but in the Throat; and this bringeth speedy danger of Suffocation. A second accompanied with a manifest Phlegmon, with no Tumour or Redness in the the Neck. A third, when the Neck seemeth to be inflamed with the Fauces, having along with it Tumour, R [...]ness, Heat,Ca [...]ses. and Pain. The inward Cause is Blood abounding, and oft times peccant; the which doth not alone raise this, unless [Page] more vitiated by a sharp and four Lympha. The outward Causes are evident, Cold, Fish-bones being received the wrong way, cold Drinks, and too much Repletion. A Bastard Squinancy is made by a pituitous Distillation falling upon the Fauces and Muscles of the Neck, exciting a Tumour, without Redness, Heat, and Feaver.Signs. Of these are [...]de three Differencies by some Author [...] ▪ and these they christen with three [...] names, as Cynanche, Parasynanche, [...]che: but these are but of small moment towards our encrease of Knowledge. The Diagnostick Signs are, when the Patient cannot move his Neck, and breatheth with difficulty, neither can he well swallow, and finds a pain and heat in his Jaws. That is accounted most dangerous,Presag [...]. which with the most speed doth threaten Suffocation, and yet is neither perceived in the Cheeks, neither doth it any ways appear in the Neck, yet there is felt a vehement pain, and the Spirits scarce seem to be drawn; for oft times this Suffocation doth happen the first day. There is no Squinancy with safety, and the lesser the Tumour, the greater the danger: and Hippocrates lib. 4. Aphor. 34, 35. saith, if the Humour of the Angina be carried to the Lungs, it maketh its exition before [Page] the seventh day; otherwise the Patient grows in danger of Suffocation. And if it hath made its efflux without leaving any evil symptom in this time, the Flux being converted into Matter, this is to be suppurated and not kept here; for where it is not cleansed from hence the Patient doth very readily run or fall into a Consumption. This Lympha and Bilis is to be tempered in the Bloud,Cure: and to be very speedily revelled and derived; and therefore are we first to breathe a Vein in the right Arm; and this is as oft to be repeated as necessity may offer. And if this will not do, breathe a Vein under the Tongue; but this is to be performed at the beginning: then cool the body with Clysters or Purges, and let your Patient have convenient Gargarisms prepared for him: [...]argarism: as, ℞. fol. Rosar. rub. Balaust. an. pug. 1. cort. Granator. ℥ss. fol. Querc. m. 1. Alumin. ust. ℈i. coque ex aqua ferreata [...]. adde syrup. Diamor. ℥iiij. misce. In the end you may order this discussive Gargarism:Gargarism. ℞. rad. Liquirit. cort. Granator. an. ʒij. fl. Balaust. fol. Rosar. rub. an. pug. 1. Jujub. no. 12 Ficuum no. iij. Passular. Corinth. ʒiij. coque in aqua Hord. [...]. in his solve syrup. cap. Vener. Mel. Rosat. an. ℥iss. misce. This following also in the beginning is very proper. [Page] ℞. fol. Ros. rub. Sambucin. an. M. j. coquantur in Cervisia tenniore q. s. fine addendo Alb. graec. ʒj. colaturae [...]. adde Sacchar. Saturn. ℈ss. Sal. Prunell. ℈i. Or this Cataplasm: Catapl. ℞. rad. Alth. Lilior. albor. an. ℥j. Nid. Hirundin. no. j. Ficuum Dactylor. an. no. iiij. Caepar. ʒvj. coquantur ex aqua Hord. & colaturae adde farin. Tritic. sem. Lin. an. ℥i. Faenugraec. Alth. an. ℥iss. vitellor. Ovor. n.. ij. Croc. ʒij. ol. Chamomel. ℥ij. misce, fiat Cataplasma. Galen doth report of one troubled with a Squinancy,History. after having used many proper Remedies, and these failing, this at last recovered the Patient; he ordered the Excrement of a Boy well dried and powdered, and mixed Honey therewith, and with this he anointed the Jaws of the Patient, and in the space of half an hour the Abscess did break, and the man was restored to his perfect health. Aetius cap. 5. lib. 6. saith, that Agarick doth suck up hidden Abscesses, and doth draw them outwards. And Jacobus Dovonetus apolog. lib. 3. cap. 2. writeth, that having a young Gentlewoman much troubled with a Squinancy, he cut a little Agarick in pieces, and put them into a Decoction made of Marshmallows, Figs, with a little Ginger, and a fourth part of Wine and Water, to which he added a [Page] little syrup of Marshmallows: this Potion he gave to the Patient, and ordered her that she might not swallow it, but hold it for some time in her mouth; she following his directions, whilest he was but discoursing with another, a great quantity of white Matter came out at her mouth, and after this some putrid; this being discharged she came to her perfect breathing, and got off from her Fever and all other bad Symptoms, and perfectly recovered.

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CHAP. XLVIII.
Of a Tumour of the Tonsils.

THese Tonsils are by the Greeks called [...], amongst the which is reckoned the Columella. And Nature hath placed two Glandules at the root of the Tongue, much resembling in figure and shape an Almond, and therefore by some these are called Amygdals. And before we proceed any further in this Discourse,What the Amygdals are, [...] how made. let us take a more curious view of them, and see for what uses they were framed; and then if being either hurt, tumefied, inflamed or ulcerated, how they ought to be cured. They are as it were framed out of a cold, concreted, oleaginous, and malleous Substance, save onely that it is thicker and more firm, they being of a yellow colour, soft in touch, but in being boiled hard, spongeous, and porous. They have belonging to them Veins, Nerves, Arteries, and proper Cavities: Veins and Arteries from the Jugulars; Nerves from the third and fourth pair. Each hath its proper Ductus allowed it, opening into the Mouth, and very many small Glandules dispersed from thence about the whole Root of the [Page] Tongue. Through all those Foramulaes is our mucous Substances expressed, and thence disposed through the Root of the Tongue.Uses? Their Uses are various, as being first the chief Organs of Tasting;They being the chief Organs of Tasting. for the same Membrane which covereth all the parts of the Mouth, doth also take this Glandule into it. Secondly, it is the Excretory Iustrument, for its office is to separate the Mucous or Pituitous Matter which falleth from the lower part of the Brain, especially through the Nerves of the third Pair, and so to refund this into the Fauces and Mouth. Thirdly, this moisteneth and keepeth soft the Jaws, Larynx, Tongue, Oesophagos, and maketh the Tongue so voluble, and the Oesophagos the better capable to perform its office of Deglutition. Fourthly, in plentiful Catarrhs of the Brain, the Nostrils being obstructed, they do imbibe into their spongeous substances the Matter, which might otherwise have been disposed the other way. And lastly, they help towards the Concoction of the Ventricle by their Fermentative Faculty; for these with much ease do contract Acidities, which is the great Agent in Fermentation, and its chief cause. All these are worthily allowed by the curious hand of Dr. Wharton, in his Book De Glandulis. [Page] Now if this Saliva be spent or consumed by violent Fevers, the Patient does soon begin to grow impotent and weak, unless the Tongue and Mouth be kept moistned by some cooling Decoction or other; for these Glandules are planted in a hot and moist place, and therefore the sooner subject to Inflammation. Into these also with Blood do flow a pituitous Matter, crude and viscid; and this being condensed by Cold, does elevate them into a Tumour. Aetius telleth us, it may happen in a young body by drinking too much sharp Wine, and by eating very often of too sharp Meats. With these Glandules do frequently their neighbouring Glandules of the Larynx joyn in Tumour, and then the Patient is ready to suffocate. It is very apparent both to sight and to feeling.Cure. This eminent danger may be both prevented and resisted by Purging and Phlebotomy, Cupping glasses, Vesicatories, applied to the Neck and Shoulders, then wash the Mouth and Throat with this Gargarism:Gargarism. ℞. Rosar. rubr. Plantag. Balaust. an. ʒi. summitat. Papaver. Myrtin. an. ℥i. Bol. armen. ℈i. fiat Gargarisma. Another. Or this: ℞. fol. Plantag. acetos. Hyssop. an. M. i. gran. Sumach. ℥ss. Cort. Granator. Rosar. rubr. an. pug. i. fiat decoctum ad lbi. in quo solve syrup. [Page]Moror. ℥iss. Lap. Prunell. ʒiss. misce. Or,Another. ℞. fol. Salv. Plantag. Rosar. rubr. an. M. ss. Cort. Granator. Balaust. an. pug. 1. Santal. rubr. Bol. armen. an. ℈i. Betonic. M. i. coquantur in aqua fontana ad lbi. colaturae adde syr. Myrtin. Sambuc. an. ℥iss. Sal. Prunel. ʒi. misce. These Trochischs are also very proper to moisten the mouth and parts with,Trochisc. and also to allay Heat and Inflammation. ℞. Spec. Diatragaganth. frigid. Diapapaver. an. ʒi. Bol. armen. praepar. ℈ij. Amyl. succ. Liquirit. an. ℈. Sacchar. candit. ʒij. cum syrup. Papaver. erratic. q. s. fiant Trochisci, to be dissolved in the mouth. Or this: ℞. Aqu. Prunel. Plantag. Rosar. rubr. an. ℥iiij. fol. Rosar. Cort. Grantor. Balaust. fol. Plantag. Ophi [...]gloss. an. Mss. sem. Cydonior. ʒi. coquantur omnia simul, & colaturae adde syrup. Diainor. ℥i. Granator. q. s. ad aciditatem. To the outward Region of the Neck apply this Cataplasm:Cataplasm. ℞. rad. Alth ℥i. Scabios. Sambuc. Rosar. rubr. fl. Chamomel. Melilot. an. M. ss. sem. Alth. ʒiss. coquantur ad mellis consistent. pistentur & his adde farin. sem. Lin. Foenugraec. an. ℥ss. ol. Rosar. Aneth. Chamomel. an. ℥i. misce, fiat Caplasma. Pills proper for purging the Patient may be these:Pil. ℞. Pil. aur. ℈i. Extract. Panchymagog, [Page]Croll. ℈ss. ol. Cinamom. gutt. ij. Diagrid. gr. i. cum syrup. Rosar. q. s. fiant Pil. A very convenient Electuary may be this: ℞.Electuary. Stercor. canin. alb. aq. Rosat. lot. & pulv. ʒiss. Sacchar. Rosat. ℥ss. syrup. Violar. Moror. an. ℥i. ol. Amygdal. dulc. recenter extract. ℥ss. pulv. Irid. ℈i. spec. Diatragagant. ʒss. ol. Foenicul. Ch. gut. ij. misce, History. fiat Electuarium. Dodonaeus Observ. cap. 16. telleth of a young Child two years of age, who was troubled with an Inflammation of her Glandules; and whereas she could have nothing applied to her by reason of her youth, Nature found out a way to discharge this Matter. There are bred in the Neck under the Ear simple Tumours, the which being opened with an Incision Knife, this Matter flowed out, and thus was she freed and discharged from this Abscess of her Tonsils. Forestus hath also another History of a Woman, (lib. 15. Observ. 27.) who having swallowed the Back-bone of a Fish, and sticking in her Throat, so that it had near suffocated her, the which could neither be removed, neither could she eat or drink without great difficulty; upon prescribing and taking of this following Eclegma she recovered. It was made of Figs, Marshmallow-roots, Mallow-seeds, Currants, Sebestens, and Jujubes, [Page] mixed with Syrup of Violets, the which he ordered her to have continually in her Mouth; and by applying such a Cataplasm as you have already prescribed outwardly, she speedily got discharged of this Bone, and recovered.

CHAP. XLIX.
Of Empyema.

THis is most properly called Empyema, when there is a collection of purulent Matter got into the cavity of the Thorax: and if this within 40 days be not expurged by Spitting, Urine, or the like, it does either produce Suffocation or Phthisis. The Matter which filleth the cavity of the Thorax, and does so frame it fit for Suffocation, is threefold, it being either Flegm, Water, or purulent Matter. If this Matter be collected either in the Thorax, or in any other part, and be transmitted from the Head, and so flegmatick; from the Liver, and so serous; and srom the Thorax, and so purulent; as also from the Squinzy suppurated from the Fauces: but if it proceed from the Thorax, it does always come from an Abscess, and maketh Repletion. [Page] This may also arise from the Pleurisie, if the Aspera Arteria hath not perfectly discharged its Matter.Signs. Its Signs are an obtuse pain, with Commotion of Humour contained in the Thorax with Fluctuation. And as a most certain Sign it hath some Humour appearing outwardly, lodging between the Ribs and the Exteriour parts. Or if you will, this Humour is discerned by its Tumour, accompanied with Pain, Heat, Weight, Noise, and Fluctuancy: for it swelleth, and appears with a certain bluishness in the place outwardly where this Matter is collected; this is an infallible Sign, as clear as the Day, the which I have seen very often never to fail. The Native Heat being corrupted is the occasion of this change of Colour. It does rend and fret its Muscles by its Matter, and it breaks into them; the which Matter being discharged, the patient findeth some ease, but there remaineth a small and sinous Ulcer, which is very hard to cure. Such persons as are herewith perplexed, when they lie on their contrary side, the other part does seem to be very heavy and depressed, and are very apt to cough, and be soon weary of this posture. There is a manifest Noise and Fluctuation apparent in the Side affected when [Page] [...] [Page] [...] [Page] the Patient does turn himself, unless the Matter be thick, or so plentiful that it filleth up the whole capacity of the Thorax, and does thereby hinder it. And here are we to observe, that this Disease at the best is not easily to be cured, neither can the whole Matter be discharged by Salivation; therefore does require more than an ordinary help. Out of Hyppocrates Counsel the Patient is to be nourished with Milk and Euchymick Meats, and the Matter must be digested, and to deferr for fifteen days from Ruption; the which fifteen days being expired, it is to be speedily opened either by Incision or Caustick, lest it do injury to the Viscera, and do weaken the Faculties. When you make your Section, let it be between the fourth and fifth Rib, tending from the lower parts upwards; and by this Method may you prevent all fears of injuring Nerve, Vein, or Artery. Make neither Incisions, nor apply any Causticks right downward, but according to the Fibres of the Intercostal Muscles. This being performed, you are sparingly or by degrees to let forth the Matter, both for keeping in the Spirits, and preserving vigour and strength in your Patient. The Matter being thus educed, the Wound is to be healed with all convenient [Page] speed, for keeping safe of the inward parts. For which purpose such a Decoction as this is very excellent. ℞. Herb. Decoction. Sanicul. Veronic. Pyrol. an. M. j. Consolid. major. Sarracenic. Botrys. an. pug. ij. fl. Borag. Bugloss. an. pug. j. sem. Anis. Foenicul. dulc. an. ʒij. Cinamom. ʒiij. Jujub. no. 6. Sebesten. no. 4. Dactylor. no. 4. coqu. omnia in aqua Hord: Hujas sumat ℥iiij. cum pulv. ocul. Cancr. ℈ij. misce. Another for the same. ℞. rad. Chin. ℥iiij. Symphyt. Tormentil. Irid. an. ℥j. Capil. Vener. Tussilagin. Scabios. Marrub. Hyssop. an. M. j. flor. 3. cord. an. pug. j. fl. Paralys. Betonic. an. pug. ij. fl. Auth. pug. iss. Caricar. pinguid. ℥iij. Liquirit. ℥ij. scm. Anis. Coryander. an. ʒvj. infundantur omnia per noctem in aquae fontanae lbjj. & coleniur: colaturae adde Mellis lbj. misce, hujus sumat omni mane. Trochischs made of Saccharum Rosatum and Diacodium Tabulatum do very well here. When your Eschar is out, and you have procured a small Orisice, you may inject into the part such a Decoction warm as is this: ℞. fol. Salv. Hyperic. Scabios. Veronic. Virg. aur. Centaur. Absynth. an. M. ss. Rosar. rub. pug. j. Alumin. Roch. ʒij. coquautur omnia in s. q. aquae fontanae, colaturae adde Mel. ℥ij. misce. You may meet with an Observation [Page] of a pleurisie turned into an Empyema in River. History. obsevat. 79. centur. 1. of a young man about 20 years of age, who fell into a pleurisie, so painful that he could not lie on either side of his Bed, but onely walk upwards. Many Remedies were prescribed in the Consultation of three physicians, and the patient was let blood above ten times; yet the Affect persevered. Although the pain of the Side sometimes seemed to cease, yet both his pain returned and a Fever with it. This Fever continued to the five and thirtieth day, then the Side began to swell, and proved painful to the Touch, suffused with redness; it was judged a pleurisie turned into an Empyema; and for this reason suppurating Cataplasms were ordered, by which the Tumour might encrease its bulk, and the peccant Matter endeavour to discharge it self. But the opening of this Side being procrastinated too much, the Abscess broke inwards, and the Patient did spit out some of this Matter with ease by coughing, which appeared very laudable, and not at all fetid; and this he did for many days in a great quantity. After the Abscess brake outwardly, it was with ease converted into either Side, because he found and felt a great pain in the pained Side: [Page] which thing is noted by Hippocrates in Prognostic. Having past the eighth day of its running, this purulent Excretion ceased, and he onely vomited up Flegm: then he perceived the pain again in the same Side, so as it turned not to the sound: then was conjectured that there was a new Collection of Matter in the Side, and he being prepared for the discharge of the same, the Empyema was opened by a Caustick being laid on the Side, and Matter for a long while came from the Side, and at length the Patient perfectly recovered.

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CHAP. L.
Of a Tumour of the Diaphragma.

THE Diaphragma hath two sorts of Tumours belonging to it, and either of them do bring the Patient in danger of death; the one long, the other short: for by the Excrements forcing here they may make a Tumour both with or without a Fever. If without a Fever, from the beginning pain and difficulty of breathing, a small and a hard Pulse, and these Excrements we are to allow to be thin and crude, and thence do follow a Tension of the Bowels, because the Muscles are extended to the Diaphragma. And if a Fever be joyned to these Tumours, Experience does satisfie, it is not sharp; and it ariseth from the too long contention of Excrements in the part affected. An Inflammation of the Diaphragma beginning, there necessarily does follow a Fever; and in respect of the Affect, because the Tumour is made of hot matters, and in relation to the part affected by reason of its near bordering upon the Heart, there do generally follow from this Inflammation, Pain, and Difficulty of Breathing: and therefore, [Page] as Galen saith, Breathing here in this case is small and frequent, (lib. 5. de loc. affect.) sometimes Convulsions do succeed these Inflammations. When such a Tumour of the Diaphragma is offered to you for cure, let your first Intention be to discharge the Matter or Substance that is lodged. And because the Origination of this does generally arise from Fluxion, this also is to be prohibited, and this is done by discharging the fluent Matter. If you take them in the beginning, they may give some hopes of Cure: but if they be of any long continuance, they admit of no Cure; because they generally hurry the Patient into a Consumption, and will not be taken hold of by the best of Medicines.Cure. As to the Cure, the first Intention is to discharge this Matter by well purging and clearing the Body of its Excrements: and here such things are most proper as can discharge both Flegm and Water; such as is Elaterium, Radix Sambucinus, or the like. Phlebotomy is no ways proper here; for the peccant Matter is cold, and therefore Discussives are here most convenient. And these may be said to be of two sorts; some to be administred inwardly, whilest others are outwardly to be applied: and these ought to be both emollient and relaxing, as [Page] Butter, Fats, Marrows, and the like; and these are to be ordered according to the Humour and the Strength of the patient; first beginning with milde Medicines, and then proceeding with such as are stronger, as Oyl of Chamomile, Dill, and the like. Here also you may use Emplasters and Unguents, as of Mallows, Marshmallows, Lilies, with Linseed, Fenugreek seed, &c. preserving and desending the inward parts with such things as can discuss, as Treacle, Methridate,History. Sarsaperilla, &c. I once saw in a Gentleman a Tumour bred in the Diaphragma out of crude and thin blood, in which pain and difficulty of Breathing, a hard and small pulse were present, the Matter and Humour was cold, and tough, and crude, and this shewed it Mortal, for it brought him into a Consumption, and the Abscess breaking he did spit up Blood and much indigested Matter. These Tumours, although they are bred of a thin and cold Matter, yet in the place affected they thicken; and for the performance of this there is required pain, difficulty of Breathing, a hard and a small pulse, little or nothing changing it self, no apparent Tumour shewing it self: and if to these Tumours a Fever do joyn it self, as Experience does oft times shew it doth, [Page] it is not sharp, yet they bring Death with them; and when they persevere, and are not resolved, they bring the patient into a Consumption, and so lay him even with the dust, as it did the aforesaid Gentleman.

CHAP. LI.
Of Exuberancy of Milk.

MAny Women in their first days, after being delivered of their Burthen, have a great redundancy of Milk, because much Blood is sent thither, and not taken away or sucked out: for the helping of which it is thought by some, that Repellers are very proper to be applied before such Women be delivered, and so to hinder the address of Blood thither; for after this much Milk being received, it cannot afterwards be so well repelled, but ought to be discharged by the Breasts, or drawn out by Sucking, or otherwise. It may be prohibited, if the Blood do not flow violently, by these Medicines following;Liniment. as, ℞. Bol. armen. ℥j. Sangu. Dracon. Oliban. an. ʒij. Ol. Rosar. ℥ij. Cer. acet. an. parum misce, fiat Linimentum. Or my Emplaster oft times used in this case with good [Page] success.Empl. ℞. Emplastr. Diapalm. ℥ij. Ol. Rosar. ℥ss. pulv. Sangu. Dracon. ʒj. misce. Or this;Another. ℞. Ol. Myrtin. ℥ij. Amygdal. dulc. ℥ss. Terebynth. Venet. ʒij. pulv. Mastich. Bol. armen. Corall. Sangu. Dracon. an. ʒj. pulv. Myrtil. Balaust. Rosar. rubr. an. ℈ij. pulv. Salv. Betonic. an. ℈j. misce, & cum cerae citrinae q. s. fiat [...]mplastrum. A Schirrus does oft times proceed from coagulated Milk in Women;History. as it fell out in a young Woman, whose left Brest, while she was giving her Child suck, was wholly correpted with an Inflammation; the which being allayed, a large Tumour and Hardness remained, which gave me suspition of a Scirrhus. Her Body being well purged with a lenitive purgation, the Brest and its circumjacent parts anointed with Oyl of Roses, to which was added a little Vinegar, and this for some days was used, afterwards the whole Brest was anointed with this Liniment:Unguent. ℞. Empl. de Mucilaginibus ʒij. ol. Lilior. Amygdal. dulc. pingued. Gallinae an. ℥j. Gum. Amoniac. solut. in Acet. scillitic. & colat. ℥ss. misce, fiat Ʋnguentum. Over which was applied this Cataplasm:Cataplasm. ℞. fol. & rad. Alth. q. s. incidantur minutissime, postea coqu. in aqua, & mortario pistentur, fiatque cum farin. Fabar. Axung. Porcin. Gallinae & proprio[Page]decocto Malvar. Cataplasma. By these Medicines, and the Body being well purged, and a good order of Diet observed, the hard Tumour grew soft and resolved; and to the Ulcer I applied powder of Precipitate, and over this Empl. de Ranis cum Merc. And with this method beyond expectation she recovered her perfect health.

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CHAP. LII.
Of a Caruncle in the Yard, and its manner of Extirpation.

AMongst the most dangerous and frightful Affects which do seize on Humane Bodie,The Causes of a Gonorrhaea. this of a Gonorrhaea may be well reckoned: and this is excited by many causes; for Acrimony and Thinness of the Sperm may be one cause so that it does continually flow. An Imbecillity of the Testicles does give another great suspicion hereof. Another Cause amongst some is attributed to Coition with a Menstruous Woman. Oft times it happens by overstraining the inward parts; a thing very frequent in snch who being in their Drunken fits do act beyond their power of Reason. If the Seed therefore which is thus thrown forth be pure, and is not in any respect tinged with any strange quality, and is void of all fetid smell, this either does shew and express a plenty thereof, or a weakness of the Retentive Faculty, or Convulsion of the Spermatick Vessels. But if it be accompanied with any other vitious Humours, and furnished with thin ill Juices, and appears with another colour [Page] strange to its own proper nature, and yieldeth a smell which sheweth no good Concoction, this first of all does calefie, and by its acrimony does corrode, pricketh, and invadingly ulcerateth. And this Ulcer does much differ from that which exerciseth it self in the Bladder, and thus may with ease be distinguished: where the Neck of the Bladder is ulcerated, the pus or Matter does as it were compactly precede the Urine it self; and the pain between making water is most mightily sharp about the ulcerated part. On the contrary, the Bladder it self being ulcerated, there is no pain felt, nor Matter pissed forth, secreted by the Urine, but cometh along with it. The Urine does yield a strange strong smell where the Bladder is affected with an Ulcer. When the Urinary passage is ulcerated, the Yard is very painful and heavy, and bendeth downwards. An U [...]er contracted in the Neck of the Bladder, or in the cavity of the penis, unless it be both speedily and knowingly cured, does convert it self into preternatural Caruncles, by which the Urinary passage is obstructed: For as out of most pure Blood the best Flesh is generated; so also vicious Juices enwrapping or keeping company with the Ulcers, there is oft times seen a spongious [Page] Flesh to grow and breed. And therefore when we have arrived at the sure knowledge, that this unnatural Guest hath made his entrance into these quarters, which we may speedily find out by the search of a Candle, and to gain advantage of this Disturber of the Humane peace, we ought, if Plenitude be a main wing of its vigour, to discharge this by Evacuation. And here let the Patient use a thin Diet; if the Juices be sharp and thin, thicken them, so as that they may give strength to the Spermatick Vessels; if we do here find or meet with any weakness, strengthen them. And for clearing this Method, observe with me these Curative scopes. First, loosen the Body with emollient Clysters made of Mallows, Violets, Pellitory, Lettuce, French Barley, and the like, adding thereunto Cassia in the end: After this breathe the Basilick Vein [...] the right Arm. These two being premised, let the Thighs be washed with a Decoction of Red Roses, French Barley, Violets, red Poppies, and the like. Let the Kidneys, Spine, and Testicles be cooled with this. ℞. Ʋnguent. Rosat. Refriger. Galen. an. ℥j. ol. Violar. ℥ss. pulv. Rosar. rubr. Santal. Citrin. Spod. an. ʒj. Camphor. gr [...]iij. Acet. Rosat. gutt. aliquot. As to the part affected, [Page] deterge it first with a Decoction of French Barley, in which have been put some Mel Rosarum: this being made lukewarm is by a Syringe to be injected into the Yard. Then produce a Cicatrice with this following.Injection. ℞. Aqu. Rosar. Plantag. an. ℥iiij. Sacchar. candit. ℥j. Ceruss. Lithargyr. aur. Alumin. Roch. an. ʒiss. Camphor. ℈ss. misce, fiat injectio. Trochisci albi Rhasis do here also very well; but if you have a mind to dry more powerfully, adde to the former a little Aegyptiacum. Shun all strong Diureticks, which may force or drive the Humours to the ulcerated parts; and such things are especially to be used, which have a quality in them to lessen the pain. For this purpose Lac Amygdalatum is very good. A Hyposarcosis in the Neck of the Bladder, or in any part of the Urinary passage, may be collected out of the great difficulty of Urine, the which comes not onely out by drops, but by forcing, and endeavour to perfect this: So that sometimes upon a great straining, while the Patient makes water, he hath a Laxity joyned with it. Neither can that Urine come right, which hath its passage obstructed by a Carunculous Flesh: Neither doth it easily come forth, unless it be compressed with the Hand. Oft times [Page] there is seen such Obstruction, that unless the Catheter be called in use, there's no coming forth of Urine to be expected. There is a twofold Method in curing of a Caruncle of the Yard;A double Method in its Cure. the one is performed by Instrument, the other by Medicine. A Fomentation for this purpose may be this:Fomentation. ℞. fol. Malv. M. j. rad. Alth. Ap. Faenicul. an. ℥iij. sem. Lin. Cydonior. Foenugraec. an. ℥j. fl. Chamomel. Staechad. Melilot. Puleg. Origan. an. pug. ij. Caricar pingu. ℥iss. coquant [...]r omnia usque ad radicum dissolutionem, & cum hoc foveatur radix penis. Or else dip Sponges herein, and apply them to the part affected. After it is thus fomented, it is to be absterged with such an Unguent as this:Unguent. ℞. Ʋnguent. Dialth. Agrip. Oesyp. Butyr. an ℥j. ol. Amygdal. dulc. Lilior. albor. Chamomel. an. ℥ij. Ammoniac. ℥iss. Succ. Ap. ℥iij. Mucilag. semin. Foenugraec. rad. Alth. Lin. an. ℥ij. boil them all untill the consumption of the Juices, then adde the Fats, and strain it off, and to the strained Matter adde a little white Wax. Here also are you to make use of searching Candles made of white Wax. And for this Affect a Leaden Probe is excellent good, for that whereas besides that it is an Anodyne, so also hath it a very drying faculty. When [Page] these fail, we come to the use of a Catheter, but this without a very respective care and steddy hand does very often occasion strange Hemorrhagies, and so thereby doth frequently bring fear both to the Physician and the Patient. But should such a Flux as this appear, this may with ease be stopped by injecting into the Passage with a Syringe some Plantane water and Rose water, to which the White of an Egge should be added. Here also are you to mind, how upon applying your Candle, what part thereof is either bent, or bruised, or compressed; for upon this part is to be applied your Medicines you intend to use: and for this purpose Philips Emplaster is reputed to be a most excellent and sovereign Medicine in this Affect, because it healeth the adjacent parts, and keepeth them whole and safe; but that which grows with the Ulcer it taketh away without pain. This is its description:Empl [...] ℞. Aerugin. Auripigment. Chalcat. Alumin. Roch. an. ℥ij. his adde Acet. acerrim. perfus. inter duos marmoreos & fiat pulvis subtibissimus, exponantur Soli. Then put it into fresh Vinegar again, after dry it as formerly: let this be done for 8 or nine times, untill it hath lost all its Acrimony and Mordacity. This Powder being thus made, take of [Page] Litharge of Gold ℥ij. Oyl of Roses ℥iiij. with which boil it, being mixed with the former, to the consistence of an Emplaster. This is to be put at the end of a Searching Candle or Leaden Probe, so as that it falleth not off. This is in much esteem for this Affect. But because all Bodies have not one and the same constitution and temper, therefore are Medicines to be changed accordingly: and after the Application hereof you are to inject into the part affected Goats Milk, or other Milk, or Rose water; to which may be added a little Camphire; and these to be applied untill the pain cease. You may know when the Caruncle is extirpated, when out of its inordination it is perceived about the ulcerated part, and also out of the copiousness of the effluent Matter; the which also, whilest it is extracted, the Candle does appear as if it were wholly imbued with it: and after this, if the Urine flow liberally, freely, quickly, and copiously, and in its right method, there will be left but little occasion of doubt, but your Patient will do well, it being discussed and extirpated. The Ulcer is to be discharged by a Liquor sent into the part affected through the Syringe: as, ℞. Centuaur. maj. Apii Caud. equin. an. M. ss. Hord. contus. ℥j. [Page] coquantur in aquae fontanae lbij. ad consumpt. med. colaturae adde mel ℥ij. & utere. The Ulcer being cleansed, you are to induce a Cicatrice, as with this or the like. ℞. Aqu. Plantag. Rosar. rubr. an. ℥iiij. Ser. Lact. caprin. ℥ij. Ceruss. ʒvj. Alumin. Roch. Marmor. candidissim. Spod. Crystal. an. ʒiss. Camphor. ℈j. fiat pulvis subtilissimus. And this is the whole Method which is and ought to be used for a Caruncle. Unto these also might I adde Phymosis and Paraphymosis; but Fabritius Hildanus has writ most exactly hereof, and thereto do I commend the curious Chirurgeon.History. I shall conclude this Chapter with this History of a Gentleman, who fell into a suppression of Urine by a tumefied Caruncle in his Yard, generated by an impure and immoderate Coition. A Chirurgeon being sent for to search him with a Catheter occasioned a great Flux of Blood: the Patient being in much pain, and thus suppressed in his Urine grew into a Fever; for prevention of which I breathed a Vein, afterwards ordered an emollient and cooling Clyster, and anointed the Perinaeum and all its adjacent parts with a cooling Unguent: after this I prescribed him a Vomit of Sal Vitrioli, by vertue of which he vomited up much [Page] pituitous Matter, and in the second Vomit went out an Ounce or two of Urine, whereby he found himself somewhat cheared; and thus by degrees his Bladder was altogether unloaded within 4 or 5 hours, and the part affected being cured with S [...]l Prunella, Injections and Clysters, such as you have already prescribed, the Patient recovered.History. Riverius in his 14 Observat. writeth that Charles the Ninth, King of France, being much afflicted with this Distemper, was by these following Medicines cured; for which Cure was given 200 Pieces of Gold. ℞. Cass. recenter extr. ℥ss. Suc. Liquirit. ʒj. Electuar. è succ. Rosar. ʒij. Aq. Lupul. ℥iiij. fiat potio mane sumenda. And for ten days after he drank of this Decoction half a pound. ℞. rad. Liquirit. Alth. Sebest. Passul. an. M. iss. Alth. malv. Apii. Petroselin. an. ʒss. aqu. fontan. lbij. coquantur ad mediae consumpt. After which were applied these two Unguents. ℞. ol. Rosar. lbij. Ceruss. Venet. ℥iiij. Camphor. ℥ss. Tuth. aqu. Rosar. lot. & praeparat. ℥ss. Lithargyr. praeparat. ℥iij. pulv. Antimon. opt. ℥iss. Op. Thur. mascul. vel Oliban. Mastich. Alo. Epatic. an. ℈ij. misce, servetur in pixide plumbeo. The second for Consolidation was this; ℞. Ʋnguent. Rosat. & aqu. Rosar. lot. Ʋnguent.[Page]alb. Camphorat. an. ℥j. Pomat. ℥ss. misce. Keep thefe for use. The way of applying these is at the end of a Searching Wax Candle, it being rubbed over with Oyl of sweet Almonds; and if there be a double Carnosity, then apply the first Unguent to both of them for fifteen or twenty days; and as it seemeth to dissolve, and to turn into pus, then abate the applicacation of the first; the Urine coming free and with ease, and for eight or ten days afterwards, apply the second, untill no further Matter come forth. Hitherto hath our Discourse treated of the Parts as they arise from the Head even to the Penis; the next which we shall produce are the variety of Herniaes or Ruptures, and these as they arise shall offer themselves, with their several Forms, Shapes, and Places, their Causes, Signs, and Cures, and Differences; and shall begin with an Intestinal Rupture, and so proceed to the rest in their order and form.

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CHAP. LIII.
Of Ruptures in general.

WE arrive now to Herniaes or Ruptures, the which for the most part do dwell on the Hypogastrick Region. And whereas other Humours have allowed them three Causes, as being bred either out of an Influx of Humours, or Decumbency of Parts, or Congestion: All these have their lively Forms and Shapes in the Tumours of the Testicles; for Tumours are made here either by Humours flowing, as Inflammations, Erysipelaes, Oedema, and Scirrhus; or from the Decumbent Parts; or from Congestion, as from Water, or any other Humour. These kind of Tumours are better and oftner cured by Chirurgery than Pharmacy. And as they are various in their Places, divers in Shapes, and manifold in Forms; so do these, and every of them, make various Intentions and Indications for the Chirurgeon. And that every thing may fall successive to the wish both of Practiser and Patient, in this place it will be very proper to know well and understand the Parts framing the Testicles, they being [Page] as the chief Causes and Effects of most of these Ruptures. Celsus lib. 7. cap. 28. does account the Testicles to be Glandulous Bodies, wrapt about and twisted with various Vessels, Coats, and Ligaments. By the Greeks they are called [...], as being two in number, and these are the Authors and Workmen of the Seed; for they have allowed them a vernaculate faculty of attracting and educing the Spermatick Matter from all the parts of the Body. The Coats of the Testicles are four, the first called Epididymis, immediately enwrapping the Testicles, from whence it taketh its Name: the second Elythrois, so called [...], or quasi rubro similis, or vaginalis: the third Dartos, [...], because it is easily excoriated, and lieth next the Scrotum: the last is the Scrotum it self. To these Testicles also belong Vasa deferentia & Vasa praeparantia, the Cremaster Muscles, and the like. This may serve as a brief Anatomy of the Testicles and its neighbouring parts. We proceed now to the various Differences of Ruptures, before we treat singly of each by it self. And here be two kinds which do offer themselves, Bubonocele & Oscheocele, to each of which is bestowed its proper name, for [...] signifieth inguen, and [...] [Page] Scrotum, as also [...] Tumor. Thus have we Bubonocele represent Hernia Inguinalis, and Oscheocele Tumor Scroti. There are many Differences of either, according to the Discriminancy of the Conjunct Causes and Tumefying Substances. Of Bubonocele are onely properly said to be two, Epiplocele and Enterocele. Oscheocele hath six, Enterocele, Epiplocele, Pncumatocele, Hydrocele, Sarcoccsle, and Cirsocele. Enterocele is called Hernia Intestinalis, Epiplocele Hernia Omentalis, Omphalocele Hernia Ʋmbilicalis, Pneumatocele Hernia Ventosa, Hydrocele Hernia Aquosa, Cirsocele Hernia Varicosa, Sarcocele Hernia Carnosa and Hernia Humoralis, this being bred from a Repletion of the Testicles with unnatural Humours. Or (if you please) there are generally allowed eight Ruptures, one complete called Bubonocele, when an Intestine or the Omentum descend no lower than the Inguens; the second a complete Hernia, when they penetrate into the Scrotum, the Tunica Vaginalis being opened, or the Peritonaeum; If the Intestine descends, it maketh Enterocele, if the Kell Epiplocele, if a Tumour be made by a waterish Rupture Hydrocele, if by Wind Pneumatocele. If a Fleshy Substance grows within [Page] the Scrotum Sarcocele, if the Veins be repleated beyond measure, and be dilated in the Scrotum, Cirsocele. To these Avicen does adde Exomphalos, or a Prominency of the Navel; and of these he offers these four species to follow, as Enteroepiplocele, Hydroenterocele, Hydrophysocele, & Hydrosarcocele. Every Rupture does demonstrate its Signs and its Causes; Presages and Cure we shall offer in their proper places, beginning first with Enterocele or Hernia Intestinalis, an Intestinal Rupture; before which as an Introduction it will be most proper to discourse of Bubonocele, it being as a leading Card to the rest.

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CHAP. LIV.
Of Bubonocele or Hernia Inguinalis.

CElsus and Paulus, lib [...]. 18. will have this reckoned amongst Ruptures, and there does call these Varices of the Groin, and a Tumour of Inguen. Paulus, lib. 6, cap. 66. affirms it an Intestinal Rupture of the Inguen onely or simply, that is, when the Intestine does not descend any further: by the Greeks called [...]. And here the large Veins which are in the Groin may so swell, and prove so varicous, that they may create a Rupture here, so as this proves a Chirurgical Affect. But before I proceed any further in this Chapter, be pleased to consider those many Errors, which are committed by unskilful Chirurgeons, who very frequently do take Venereal Buboes for Inguinal Ruptures, and so do cut for the Intestine without either Wit or Honesty, or else do prejudice to the great Vein there ordered by Nature, and thereby bring danger of death. But that you may the better understand the difference, consider with me, that if you perceive a soft Tumour in the Inguen, from the beginning [Page] you may well suspect a Dilation being made by the Intestine; a Bubo in the beginning being hard, especially being Venereal. It being a Rupture, if the Patient lie on his back, the Intestine falleth inwards with ease, and the Tumour does vanish; and upon the Patients rising it returns with as much ease: In a Bubo there is always a contained Tumour. But arriving to the matter of our present Discourse, a Bubonocele does most generally gain the name of being the beginning of an Intestinal Rupture more properly, than the name of a Rupture; the Intestine first making its fall through the Inguen, before it enters the Scrotum, and so does necessarily dilate it: And therefore Paulus saith, that the Intestinal Rupture of the Inguen does precede a Rupture elsewhere; for if the Peritonaeum be made intense in its lower part by Wind, or any other cause, and the Intestine makes its turgid way thither, being also filled with Wind; or by being filled with Excrements, and thereby forceth it self, it makes this Bubonocele; the which by Paulus requireth a double method of Cure, the one being to be performed by Incision, the other by Ustion. The first of these by Paulus is thus performed: He cuts upon the tume [...]ied place in a [Page] streight line the length of three transverse Fingers, and so passeth through the Membrana carnosa, and then makes so deep an Incision, untill he finds the Peritonaeum bare, and the Fat also being ablated and removed. Celsus will have this done with courage, and the Incision to be made to the middle Coat, which maketh the Vagina; afterwards he with a Probe does depress the Peritonaeum, and so as that the Intestine be compelled inwards; and having lodged his Probe, and compressed the Peritonaeum, he by Sutures does draw the lips of the Wound together; the which being done, he takes out the Probe, and cures the remain as you do simple Wounds. This is Paulus Method, which is performed by Suture, binding up only the Cutis, as by Astriction. The second of his, which is performed by Ustion, is both cruel, painful, and terrible, contracting the Cutis by the strength and force of the Fire, and making a contracted and hard Ciccatrice, and by this means do depress the Tumour, and will not suffer the Peritonaeum to lift it self upwards. But leaving these, a well made Truss is much better, performeth its business with more ease, gentleness, and satisfaction; this having in it the faculty of prohibiting the soft Tumour, by compressing [Page] the Distention of the Peritonaeum, and hindering the Impetuosity of the Intestine: to which Truss we usually six a Quilt or small pyramidal Pillow, it sometimes being made in form of a Myrtle Leaf: and after the Reduction this being sown to the Truss is to be applied to the part affected. In some cases here this may not be convenient; as should there happen a Varix in the Groin, and the Veins tumesie, the Veins by this being compressed by the tying of both its ends up; and if the preparing Vessels be varicosed, if they be bound up, the Generation of the Seed would be hindered. And therefore in this case Restringent Medicines are more proper, as Balaustians, Cypress Nuts, Lignum vitae, Galls, Pomgranate Rinds, Red Roses, Medlers. Women for the most part are troubled with a Bubonocele, because the Womb falleth from the exteriour Coat of the Ʋterus, and so doth produce Hernia Ʋterina, as Casparus Bauhinus observeth, Lib. 2. Anatom. Observ. 62. Fabritii you may read of a new married Woman, who in respect of an ill Dyet and bad Habit of Body was perplexed with the Itch, and not long after growing big bellied, and having a hard burthen, there followed a Prolapsion of the [Page] Ʋterus; she coming to him for advice and help, he orders her this following Bag to be applied for three or four days to the part affected, and to carry it always about her, by the benefit of which she was speedily cured. The things which were put in it were these, and thus ordered ℞. Fol. Plantag. Salic. Mespilor. Querc. Prunor. Sylvestr. summitat. Rosar. rubr. an. M. j. rad. Tormentil. Consolid. major. Bistort. an. ℥j. Nuc. Cupres. Balaust. an. ℥ss. sem. Anis. ℥iss. incidantnr & contundantur omnia grosso modo pro sacculo intertexto.

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CHAP. LV.
Of Enterocele or Hernia Intestinalis.

BEfore I proceed to the Cure of a perfect Intestinal Rupture, I shall begin with that which hath the Peritonaeum relaxed or dilated. The Intestine does descend, either because this Coat is either dilated or rent. The Signs of a Dilation are, because the Intestine does not suddenly descend, but does remain in the Orifice; then it does not descend to the bottom of the Testicle, the Tumour is equal and profound. The Signs of its Coat being rent are, a sudden Descent of the Intestine, an unequal Tumour, a speedy Relapse of it into the bottom of the Testicle. Celsus cap. 14. lib. does offer these as Signs of an Intestinal Rupture; the Tumour sometimes encreasing, sometimes lessening; encreasing, either because a greater part of the Intestine falls down, or because it is more repleted than it ought, sometimes by Wind, sometimes by Excrement. If the Tumour do encrease, because the Excrements are fallen into the Intestine, then Scarse it is to be expected to be drawn forth again; then is there pain in the [Page] Scrotum, Inguen, and Abdomen; because here is made a solution of Continuity, whereby the Stomach is affected, and thereby throws forth Choler, afterwards green or black, then Excrement, and after these follows an inflammation of the Testicles. A second Sign, the Tumour is not painful, sometimes it wholly vanisheth, and being compressed it with ease returneth into the Abdomen, and with as much ease falls out again with some noise, the Tumour being light, lubricous, and round. Most times the Ileon falls down, yet sometimes the other Guts come out with it, and do fall into the Scrotum. But this happeneth not by a simple Distention of the Peritoneal Process, but it must necessarily burst in all great Ruptures. This oft times happens in Children by falling, leaping, vomiting, coughing, any vehement motion, crying, concussion, or the like. The Duodenum and Rectum cannot fall into the Scrotum, this Anatomy sufficiently maketh good. The Jejunum is tied by the Liver by the Meseraick Veins, and the Colon knit to the upper parts; and here is no Rupture without division of these. The Caecum, because it is slippery in the right side, and separates from the rest, does easily fall into the right side of the Scrotum, the Peritonaeum [Page] being either rent or dilated; and this Galen alloweth Com. ad Aphorism. 3. sect. 4. lib. 6. Epidid. Into the left side the Ileon also is subject to fall into the Scrotum, and thus there may be a double Enterocele, one of the Caecum, another of the Ileon. This of the Ileon is the most dangerous and terrible, because by this is intercepted the distribution both of the Chyle and Nutriment, and the secretion of the Excrement, which is the necessary office of the Ileon as touching preservation of Life: besides this an intolerable pain is excited, and is oft times inflamed, whence follows a Gangrene, into whose sympathy of affection are all the rest of its neighbouring parts drawn. Here is also made the Iliaca Passio, after which follows vomiting both of Chyle and Excrements, this being as the Harbinger or Forerunner of Death. Now as touching Dilatation according to Avicen two things are required,How the Intestine is to be reposed. the one a reduction of the Intestine upwards into the Abdomen or Belly, the second preventing its coming forth again. The first is easily resolved, if the Intestine do not much fall out, or it be not swelled with Wind, or filled with Excrements, for then it may with ease be driven in by the Fingers, laying your Patient on his [Page] Back, with his Legs somewhat elevated, and a little asunder: but if it be filled with Excrements or Wind, then are we to use another Method, by using of hot Baths, Cataplasms discussing Wind, and by prescribing lenifying Medicines, for which use and purpose take these as proper Engines to work this; ℞. rad. Alth. ℥ij. Cataplasm. Lilior. albor. ℥j. fol. Malv. Violar. Parietar. an. M. ss. fl. Chamomel. Melilot. Rosar. rubr. an. pug. ij. coquantur omnia in aquae q. s. Colaturae adde farin. Fabar. Hord. an. ℥ijss. farin. sem. Lin. Fenugraec. an. ℥j. ol. Rosar. Chamomel. Aneth. Axung. Capon. an. ℥j. misce, fiat Cataplasma. This is to be applied when the Excrements are indurate. When the Wind swells them up use this Unguent: ℞.Unguent. ol. Chamomel Rut. an. ℥j. ol. Aneth. Lilior. an. ʒvj. Spirit. Vin. ʒij. Cer. flav. q. s. fiat Ʋnguentum. And for a Bath use this as very excellent: ℞. Bislingu. Plantag, Polygon. nuc. Cupres. cort. Castanar. German. Hypocyst. cort. Granator. Capular. Gland. rad. Symphit. major. an. M. ij. Gallar. M. j. aqua fabror. in quo ignita extinguuntur lb 20.Decoction. infundantur per horas 24. & deinde lento igne redigantur ad 3 partis consumpt. & ante ab igne removetur, adde Acet. Optim. lbiij. serva ad usum. This Fomentation is most [Page] proper when the Intestine does lodge in the Inguen; a Cerate for the same of a Venetian Physician:Cerate. ℞. Theriac. opt. Bol. Armen. Sangu. Dracon. in gutt. Alo. Succotrin. an. ℥ss. misce in mortario cum Terebynth. Venet. vel cum pice navali pro Cerato. For purging in this case Electuarium Diacatholicon and Powder of Rhubarb are very proper Medicines. Here also may you order Manna, Syrup of Roses, with convenient Decoctions, and the like. The Intestine being reposed, you are to use all restringent things after the applying of the former Bath, and such as have an agglutinating and drying quality, such as are Rupturewort, Betony, Compfrey, Solomons Seal, Plantane, Balaustians, Red Roses, Pomgranate Rinds, Cypress Nuts, Bol. Armen. Dragons Blood, Mastich. Amber, Coral, Olibanum, out of which may be framed Powders, Electuaries, Pills, and the like. A Decoction of Sarsaperilla, Guiacum, and Sarsafras, are here also proper. The outward Topicks should also have the same saculties and vertues, being made of Galls, Cypress Nuts, and the like. Here also Empl. Adherniam is very good. Avicen does praise this;Empl. ℞. Nuc. Cupress. acac. Balaust. Gallar. immaturat. an. ʒj. Myrrb. Thur. Sarcocoll. Tragaganth.[Page]Gum. Arabic. an. ʒiij. Sangu. Dracon. Mummiae an. ʒij. terantur cum Aceto. Or this accounted better:Empl. ℞. Malicor. Bol. Armen. Sangu. Dracon. an. ʒj. Tegul. pulverisat. ʒij. pulv. Bislingu. ʒijss. cum albumine ovi modico aceti & Colophon. fiat Emplastrum. Empl. Or this Empl. ℞. Empl. Adhern. Grat. Dei an. ℥j. pulv. Sang. Draco. Osmund. Regal. pulv. Oliban. Guaiac. an. ʒiss. cum parum Ol. Myrtillor. fiat Empl. A purging Apozeme to give the Patient may be this:Apozem. ℞. Osmund. Regal. Hernar. an. M. j. rad. consolid. major. Bistort. an. ℥iss. Hypericflor. M. j. sem. Anis. ʒij. conquantur omnia in vino rubro, & colaturae lbiss. adde syrup. consolid. major. ℥iij. vel 4 pro Apozemate. These two Emplasters of Hollerius are much commended applied outwardly:Empl. ℞. Mastich. cort. Thur. Nuc. Cupress. Myrrh. Sarcocoll. glutin. pisc. Icthiocoll. an. ℥ss. solvatur Icthiocolla in Aceto & fiat Empl. super corio extendatur. Or this:Empl. ℞. Balaustian. ℥iss. Gallar. ℥ss. rad. Asphodil. rad. Narciss. vel rad. Arnogloss. & Betar. an. ℥iss. coquantur in vino, fiat Emplastrum. All things being performed, the Patient conveniently purged, the part affected well fomented, and proper astringent Medicines being applied, after the reposition of the [Page] part, we are after this with convenient Bolsters, and Trusses to finish our business, and these are to be kept on so long, untill the lacerated Peritonaeum be so firmly united either together again, or to the Muscles of the Belly, that there can be no fear of any more Relapse. A general example of all Trusses I will shew you at the end of this Tract, their various Forms and Fashions for single or double Ruptures.Histo [...]y I shall conclude this Chapter with an History of a Proctor, whose Intestine falling into his Scrotum, he afterwards fell into an Iliaca passio, the Intestine being so filled and stuffed up with dried Excrements, that hindered its [...]position▪ and after many Remedies had been used for nine days in vain, he ordered the party to be opened to the production of the Periteuaenm, where the Intestine was choaked up, lest the Continuance of this Distemper might create a Gangrene; and following Celsus Opinion when he offereth, Satiùs est anceps remedium experiri, quàm certo exitio aegrum exponere. Upon which Consultation it was agreed, the Patient being conveniently placed, to make an Incision even to the production of the Peritonaeum, after which was sent in a small Silver Pipe, round at one end, and hollowed at the other, and into the [Page] Cavity whereof this Incision was made to that length which was requisite; after this was the Intestine reduced, and sent into the Belly, then was the Process sown up, and the Wound of the parts healed up by Gastroraphia, and with Conglutinating Medicines the remainder of the Cure was performed, and the Patient perfectly cured.

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CHAP. LVI.
Of an Intestinal Rupture, the Peritonaeum being rent.

HEre are required the same Scopes as were discoursed in the former Chapter; the Intestine is to be reposed, and care taken that it cometh not out again, the which is performed if the Rupture be united and agglutinated. Pure drying Medicines for this purpose alone take no place, but such as have a glutinous and viscid quality, mixed with a driness; these are most operative and useful, as such as was in the last Chapter prescribed by Hollerius; or for this Affect take some of these:Cerate. ℞. Oliban. Sang. Dracon. Bol. Armen. Mastich. an. ʒvj. Alo. Epatic. Thur. alb. Mumm. an. ʒiij. lento igne fiat Emplastrum. Or these of Aquapendens: Empl. ℞. Terely. [...]th. ℥iss. Cer. Thur. Myrrh. Icthiocol. carn. cochlear. an. ℥j. gluten triduo in aceto macerat. inde in mortario plumbeo levigetur ac conteratur, post igne liquescat, ac caeteris misceatur. An [...]ther. Or this: ℞. Resin. arid. Ammoniac. Thur. Bitumin. Sulphur. vin. an. part. aequal. terantur terenda, lique. fiant liquanda, deinde Sulphur adjiciatur, [Page]applicetur vel linteo vel corio; and let it remain on so long untill it spontaneously fall off.Oyl. An Oyl for the same: ℞. Sarcocoll. Thur. Mastich. Sangu. Dracon. an. ℥ij. Terebinth. Venet. vel Resin. lbss. Gyps. pulv. lbj. stent in fimo equino per dies 40, & tunc distillentur, & ex hoc locus inungatur. A Bath for the same is very excellent, such as is this: ℞. fol. Myrtil. Rosar. immaturatur. Bisling. Consolid. major. an. M. ss. Balaust. Plantag. cort. Granator. an. ʒiij. Caryophyl. ʒiss. coquantur omnia in aqua fontana à lbviij. ad lbiiij. & coletur After this apply some of the former Emplasters, and then truss your Patient up. And this is the Methodical way of ordering your Patients. And in your Proceedings you ought also to take respect to the Habit of your Patients Body, by purging all such Humours as may seem to disturb our Undertakings; and here may be ordered inwardly several sorts of Medicines, as either Bolus, Syrups, Pills, Electuaries, or the like, being ordered according to the strength, capacity, age, and constitution of your Patient; for which use you may take some of these: ℞. Electuar. Linitiv. ℥ij. Spec. Hier. picr. ʒij. mix them with Sugar, and order it for a Bolus for your Patient to take some every morning. This Syrup is also excellent: [Page] ℞.Syrup. Syrup. Betonic. Mel Rosar. an. ʒij. Decoct. Betonic. Bisling. Cichor. an. ℥iij. misce. An Electuary for the same: ℞.Electuary. Limatur. chalyb. praeparat. decies cum aceto lot. & totidem cum aqua Rosar. ℥iij. Mastich. alb. ʒij. pulv. Rad. consolid. major. Pilosell. an. ʒiij. Sacchar. Rosat. lbj. cum syrup. è succ. Plantag. q. s. fiat Electuar. hujus sumat ℥ss. per dies 30. Pills here also very proper:Pil. ℞. Alo. succotrin. Agaric. praepar. Rhabarb. Pilosell. an. ʒii. cum Terebinth. Ven. q. s. fiant Pil. Let these serve for a Taste of inward Medicines; for outward Medecines avail but little, if there be not well observed a good order of Diet, in which we are to take care both for the Patients quiet and rest. But if these fail,A second Method by Adustion. and will not answer expectation, Avicen adviseth us to use a second Method, which is performed by Adustion, making a strong impression by the hot Instrument, which may hereby contract the Cutis, and also hinder the descent of the Intestine. But in this Operation take special care of not touching the Intestine with the Iron; for should this happen, it would or might bring danger of Death to your Patient. This is to be performed by many small pungent red hot Instruments, keeping also all the Seminary Vessels safe and secure from injury, the which [Page] being any ways hurt, the Generation of Seed would consequently be impedited. Some of these should be semicircular, whilest others ought to be more pungent, having a very sharp point, ever beginning the Ustion from the upper part, so descending through the whole Region of the Rupture.A third Method is Incision. A third Method is Incision, and this is two fold, the one performed by the Chirurgeon, of which we will first treat; the other of an Emperick: the first Cure being performed without extraction of the Stones, the second with it. In the first let the Patient stand and hold his Wind, that the Tumour may more evidently appear; and when you intend the Operation, you are first to mark the place, with Ink where you intend to open or incise, then are you to make your Incision through the length of the whole dilated Vaginal Coat, the Vagina being elevated either with the Finger or small Hooks, then with an Incision Knife you are to make a Diametrical Incision, both to the Membranes and Vaginal Coat rent or dilated, then with a firm, thick, and crooked Needle, you are to make a Suture according to the length of the whole Dilatation in the dilated Vagina, drawing a thick and strong Thred (the inward Vessels of the Seed inwardly remaining [Page] safe and entire) through, the Coat is to be agglutinated, without extraction or hurting of the Testicles; then let the Patient be put to Bed, and after this apply such things as are agglutinative, then induce a Cicatrice, and keep your Patient well trussed.The fourth Method. The fourth and last Method is performed the Emperical manner, and this is with Extraction of the Testicle, a way very useless and dangerous. It is thus repeated by Paulus, cap. 65. lib. 6. The Patient being placed with his Head downwards, the Intestine being reduced, part of the Abdomen being compressed by an Assistant, and the Patient being bound make an oblique mark in his Groin, after this make a deep Incision, so that the Testicle may come forth with the Spermatick Vessels, the which the Chirurgeon having in his hands, let him separate all the Coats, and draw forth the Testicle through the same Orifice, all the other parts being taken aside with small Hooks, let them be sown together or tied, after this above the place tied take them off, and with an hot cauterizing Iron being there instantly ready, cauterize the mouths of the Vessels, hereby hindering all Flux; besides which you will find the parts sooner agglutinated: the which [Page] being done, they leave a long Thred remaining, applying Digestions inwardly. After this they make a Cavity in the Scrotum, and there applying a Digestive, they use Butter, to which they adde Frankincense, the Yolk of an Egge, and a little Turpentine; then they study the generation of Flesh with Basilicon, Aureum, Ʋnguentum de Betonica, or the like, and induce a Cicatrice with dried Lints and Unguents, Diapompholigos, Diapalma, Desiccativum rubrum, History. &c. I shall conclude this Chapter with a History of Hildanus, who writes of a Gentleman, which for many years was troubled with an Intestinal Rupture, distended by Wind, having a great pain of his whole Belly, continual Vomiting, Watchings, Restlesness adjoyned to it; for whom this Clyster was first administred:Clyster. ℞. Rad. Alth. Malv. cum toto, fol. Violar. Parietar. fl. Chamomel. Melilot. Sambuc. an. M. j. sem. Fenugraec. Lin. contus. an. ℥ss. sem. Anis. Foenicnl. Caru. Cumin. an. ℥j. incidantur & contundantur omnia, postea indantur in sacculo ejus magnitudinis quâ totum Scrotum cooperiri possit: the which being sown up, boil it in twelve pounds of Water. Take of this Decoction lbj. in which dissolve of Electuar. Diacatholic. ℥j. Vitel. Ovor. n. ij. Butyr.[Page]recent. ol. commun. an. ℥iij. misce. fiat Enema. After the Bag being pressed out, apply it to the Scrotum, and this repeat very often by dipping it into the Decoction, and so pressing it out, and applying it warm. Within half an hour after the Clyster was injected, there was administred the same Decoction, by which the Scrotum began to grow lax, and the Patient being put into his Bed, with his Head placcd supinely or downwards, and his Feet upwards, his Intestine was reduced; and for keeping it in its place he applied to the Scrotum this following Restringent Bag;A Restringent Bag. ℞. Rosar. rubr. Absynth. vulgar. prunor. sylvestr. Caud. equin. fol. salv. Mosc. Quercin. an. Mss. Cort. Querc. ℥ij. sem. Foenicul. Anis. an. ℥j. incidantur & contundantur, postea indantur in sacculo; which is to be sowed up, and boiled in red Wine, and afterwards applied. The day following he prescribed this Purge:Purge. ℞. Rad. Foenicul. Petroselin. Gramin. Polypod. Querc. an. ℥ss. herb. Agrimon. Veronic. Cuscuth. an. M. ss. sem. Anis. Foenicul. an. ʒij. fol. Senn. mundat. ℥ss. coquantur ut colatura redeat ad ℥iiij. in quibus solve Electuar. Diacatharm. Diaphaenic. an. ʒiij. aqu. Cinamom. Hordeat. ℥ss. misce. After this was applied Emplastrum[Page]ad Herniam, and a convenient Truss: and by these Helps and Remedies he was perfectly cured.

CHAP. LVII.
Of Epiplocele or Hernia Omentalis.

THis [...] so called by the Greeks from Epiploon or Omentum may happen in either side of the Scrotum, and may not very easily be reduced. This Rupture is occasioned by the Dilatation of the middle Coat onely, not because of the Peritonaeum being rent, by reason no great part of the Omentum descendeth, it being annexed to the bottom of the Ventricle, Colon, and Spine. This therefore is chiefly generated by the Coats Dilatation, especially the Omentum being armed with Fat, which gives a more easie cause to this Relaxation and Dilatation, although not to its Ruption.Signs. Signs of an Omental Rupture are these; the Tumour is always the same, unequal to touch, soft, and slippery in respect of its Fat, it lieth more in the Os pubis than in the Scrotum, and is small in Tumour. Its Curative Scopes are two, to reduce the Omentum inwards, [Page] which is performed by the Hand, and to hinder its exition; and this is done by Pharmacy. And because this Dilatation generally is occasioned by Moisture, or the Fat relaxing this Rupture; therefore Restrictives are the most proper Medicines in this place required; and here take Aquapendens his Emplaster: ℞. Alo. Malicor. in vino austero elixat. succ. Hypocystid. Thur. glutin. fabror. an. partes aequales, gluten passo incoquatur ad integram dissolutionem, post teratur in mortario, & cae [...]era addautur. As touching the rest, this Cure dissereth not much from an Intestinal Rupture, and therefore Trusses, Caustick, or Incision may upon occasion be used, observing Celsus Rule, lib. 7. cap. 25. If a small part of the Omentum descend, this may properly be reposed; but if a great part, this is to be burnt, or dealt with so that it falleth off: yet this is not to be attempted very readily, because this Rupture is seen very often beyond expectation cured. I shall shut up this Discourse with two or three pleasant Histories, very convenient for this purpose and matter.History. Hollerius relates of a pious youug man, who died Ileous, from a Prolapsion of the Ileon with the Omentum into the Scrotum; the which Body being diffected, the Ileon was wholly [Page] found gangrenated by reason of Inflammation, which was conceived to be by this Prolapsion.Another. Columbus lib. 15. Anatom. writes, he saw above a pound of Omentum in the Scrotum. Another. Jacobus Oetheus lib. Observat. propr. writes of a young Gentleman, who having been troubled with an Inguinal Rupture, and the Intestines oft times falling into the Scrotum, he at length found somewhat else fall into it also, it being no part of the Intestines, but the Omentum which swelled the Scrotum at this rate; and the Signs hereof were, he had neither Cholical Pains, nor Motions, nor Fever, nor Obstructions of the viscera. That part of the Omentum which was lapsed, by application of convenient Fomentations, Emplasters, and Ligature to the part affected, they were well reposed, the Patient soon felt ease, and in process of time received a perfect Cure.

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CHAP. LVIII.
Of Exomphalos or Hernia Ʋmbilicalis.

EXomphalos is made by the Peritonaeum being either relaxed or rent; and hence oft times happens that the Omentum and the Intestines do fall into its place. If it happeneth by the Omentum, it retains the colour of the Cutis; and there will appear a soft and almost indolent Tumour, and is reposed without any noise; but happening by the Intestines, it appears unequal, and upon its Reduction it maketh a Murmuration. If it happens from Flesh, it appears hard; if from Wind, soft: and this by the Learned called Exomphalos, by us a Navel Rupture, proceeds from the same Cause as the former, and may be treated with the same Curative Method; save onely in this place you are to mind, that you cover the whole Rupture with hard, and thick, and large Bolsters, that hereby it may sufficiently be kept in. If it happens that it proves a flatuous Tumour of the Navel, cure it as you do Physocele; if a waterish Tumour, this is to be thus treated, by making a small Incision, and keeping it open so long as untill you have [Page] discharged the whole Water. Hildanus in his Centur. 3. Observ. 64. relates of a pleasant story to this purpose; so does Benivenius tell us of a strange one: the last I will produce first, because that of Hildanus I intend to give according to the Author himself, with his Figures and Method how to make and apply the outward Dressings and Ligatures.History. Benivenius chap. 6. Abditis, relateth a strange story of John Binus, who had a Son whose Navel grew out like a Mans penis, four fingers in length, and as it were had a Coat of the Testicles joyned to it, out of which sometimes Spirits did fly, the which many Physicians saw; whereupon some of them judged, some of the Intestines had thrust themselves out; others, the Omentum; others attributed it to Wind and Humours; but at length it was concluded, that it was a Fleshy Excrescency, and for the taking this off there was a strict Bandage made, the which was every day contracted or bound closer, untill the whole was eradicated; the which being removed, the Patient recovered his perfect Cure and Health.History.

This of Fabritius Hildanus is of a noble and pious Martron in Germany, in whom not onely the Navel it self, but a little above the Peritonaeum, and some [Page] part of the Abomen, it hung down dilated into a great Bag; in this Bag also not onely the Omentum, but somewhat of the Intestine was contained. Sometimes a murmuring was there perceived; and then pain was present, sometimes proving very vehement, otherwhile more remiss, according to the quantity of Winds then present. She affirmed to him, she got this Affect in the time of her Childbearing. Of the rest, because Prolapses of this sort, of the Navel or Abdomen, can be seldom reduced into the Belly; or if they might be, they are not there retained without great difficulty; they produce wonderful troubles to the Patients that are therewith vexed, when they by reason of the weight do draw their upper parts downwards. For this purpose he hath invented a new Bag, by which this Extuberance may as well as possibly be drawn upwards, and so elevated, that the grieved Patient may bear the burthen with much less trouble and incommodiousness. This is to be made of a strong doubled Cloth fitted to the Thorax, so as that it descends no lower than the first Bastard Rib, and so backwards to the Thorax from the Region of the Omoplates, making a Ligature on either side placed two fingers breadth, [Page] and perforated in several places, to fit it the better to the Thorax. To this Ligature is to be annexed this large one with the Bag, so as it may be lifted up or taken down, according to the will and pleasure of the Patient; by the benefit of which holes this may be done. This Figure you may see very fairly described in this following Leaf, together with the Bandage, with Figures directing how to make and use it.

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CHAP. LIX.
Of Hydrocele or Hernia Aquosa.

HYdrocele or Hernia Aquosa do either possess the whole Scrotum, or part thereof. This Aqueous Humour is not collected in the Scrotum, but in the Membrana Erythrois, containing the Testicle, for into this a thin fluid Humour does make its influx, being much of the consistence of Urine, distending this Erythroidal Membrane; and the subsistance of the Testicle in process of time is also corrupted by its acrimony. By Aetius Leonidas this Aqueous Tumour is said to be loose, and without pain, the which is not to be eased by any Cataplasms, Fomentations, Emplasters, or Unguents. There's one onely Remedy which must discharge it, and that is Section or Incision: and this is very manifest and apparent, because the Seminal Vein of this part ariseth not from the Cava, as do the right, but from the left Emulgent. The Kidney being by this evilly affected, not performing its proper function, part of the Urine, the which the Emulgent protracts to it self, whenas it cannot descend to the Bladder from the [Page] ill-affected Kidney, it falleth into the Membrance Elythrois, and here breeds Hydrocele; and this being sublated with the Testicle, this Humour can no longer remain here, as Dodonaeus observes, cap. 39.Causes. Observ. The Causes hereof may be many, some being occult, others manifest; occult, as this waterish Humour being gathered from the repleted Vessels. Guido adds a Vice of the Liver herein or Spleen, by reason of which there is a Liquor collected in the Hypocondries, which with ease does make its descent manifest, as Percussion, Collision, Fraction of Vessels which are in the Testicles; for the Blood which flows into the Vessels is changed and turned, by reason of the weakness of parts, into an aqueous substance. Percussion and Collision,Signs. and the like, are its Signs; the Tumour vanisheth if Hunger hath preceded. If the Habit of the Body be ill, this Hernia proceeds from the ill accident of some Bowel; if not hence, it may from too much Liquor, for Repletion is made by too much Potation. Aetius taketh the Causes from the Humour it self, the which if it be yellowish and pale, the Hernia will appear from the Repletion of the Vessels; if feculent, from Percussion; if white, from a Vice of the Liver or Spleen; the Veins of the Scrotum [Page] are tumefied; if it be compressed, the Humour floweth into the Vessels which formerly were empty. It shineth and appears very bright, and is soft, light, and clear, by viewing it, and applying a Candle on the opposite part. It is a particular Dropsie; and as a general Dropsie is bred by a collection of Matter, as in a Critical Abscess, by drinking more freely of Water than can be discharged by Vomit, by Generation, by interception, or alleviation of a Sanguisick Faculty. So a Hernia aquosa & flatuosa do either come by a primogene affection, or by succession of some other Distemper: and for this reason Hollerius does prescribe here such things as are to be given in either kind of Dropsie, this sometimes happening between this and the Erythrois, sometimes between the Erythrois and Dartos. As touching the Cure,Cure. all Causes are to be removed, the ill Habit of the Body corrected, from too much Drink the Patient ought to be prescribed, the plenty of this watery Humour to be discharged and evacuated, and the whole Habit of the Body amended. And for the performance of these, Purgatives, Diaphoreticks and Diureticks are very proper instrumental Weapons to discharge this invasive companion, of which [Page] I have already presented you with many in my Tract of Aqueous Tumours.Topicks. As touching outward Applications, these ought to contain in them a power to discharge this Water contained in the Testicles, this to be performed either by Repellers driving it back, or by educing it by the part affected,Empl. or by Scarrification. Hollerius does offer this as an excellent Plaster, being made of fresh Cows Dung, adding thereto a third part of Bol. Armen. Fomentation. and Dragons Blood. A Fomentation for the same may be this: ℞. Lixiv. Barbito [...]sor. iiij. in his coquantur Cumin. ℥iiij. Rut. Absynth. Puleg. Petroselin. Apii an. ℥ss. Sal. j. with this let the part affected be fomented. Or this:Another. ℞. Cumin. Bac. Laur. sem. Sesel. Rut. an. ℥j. fiat Decoctum in vino rubro, & fiat Fomentum. Or for this use take this Cataplasm;Catapl. ℞. Stercor. Vaccin. ij. Sulphur. Cumin. an. ℥ij. Empl. de Bacc. Laur. pulv. Juniper. Anis. an. ʒij. misce, & cum pauco mellis fiat Cataplasma. Or these; ℞. Cumin. Baccar. Laur. fimi Columbin. Castor. an. part. aequal. coquantur cum oleo Rosarum & pauc. Cerae. First apply your Baths, then anoint the part affected, and afterwards apply your Caplasms. If these fail, we are to come to Apertion, which may be used two ways, [Page] either by Incision or Caustick; if by Caustick, the place is to be cauterized in the place where the Water is, and then after it is once discharged, a new Collection is to be prevented. And here Galen does order the part to be kept open for a long while, by placing in a Silver Pipe into the affected part. Guido maketh a Seton, and keeps it a long while. Celsus teacheth the place of Incision, saying, If it be a Child that is herewith troubled, it is to be laid open in the Inguen, and the water to be drawn upwards. If in one of a greater age, this is to be opened in the bottom of the Scrotum, and that way the water to be let out; taking this as Advice, that water is not to be left long in the Scrotum, lest by its delay there it does the Testicle injury; or hereby there grows a Hernia carnosa. The Body being well prepared for your Operation of Incision, and a good order of Diet prescribed, let the Patient be well placed, then in the upper part even to the Tunica Erythrois is the Scrotum to be incised; this is somewhat to be separated in its outward part from the Membrane it self. And because the Water wholly is contained in this Coat, so the Testicle swims therein; and lest this Water should descend, with a crooked Needle and double [Page] Thread the whole Coat is to be apprehended (besides the Seminal Vessels) and then to be moderately bound and tied; after this divide the Membrane in the lower part of the Ligature lengthways, and draw out the water or liquor contained within; then with a long Tent, it being of a moderate thickness, being dipt in the White of an Egge, to which some restrictive Powders have been added, apply it to the side of the Testicle, and about the lower part of the Scrotum, anointing the Inguens and Abdomen with Oyl of Roses: the day following let this Digestive be applied; ℞. Terchinth. lot. ʒij. Cer. nov. ℥ss. Gum. Elem. ʒj. ol. Rosar. & Amygdal. dulc. ℥ss. ol. de vitell. Ovor. ʒij. dissolve Gummi lento igne cum ol. Terebinth. & Cerâ cum pauxillo Oleorum liquefactis, fiat Ʋnguentum, fine addendo Croc. ℈j. With this let the Tents be armed, which are to be put into the Orifice; afterwards apply a mundefying Powder to cleanse the Ulcer, and keep it open for near two moneths; and then close up the Wound with a Cicatrice. I conclude with a History of Hildanus, History. who writes of a Commissary 40 years of age, a man strong and of a good Habit of Body, vexed for many years with a watery Rupture, unto whom both many inward [Page] and outward Medicines were prescribed and applied without any success; and it growing to a great bulk, that it occasioned a large Tumour in the Scrotum, and proved so painful that the Patient would rather yield to any Method which could give appearance of ease; his Body being prepared, and a good order of Diet ordered him, with administring Purgings, and their reiterations, with Bleeding, &c. he being conveniently placed, the Scrotum was opened in the upper part of the Coat Erythrois, and this on the fore part somewhat separated; and because the whole Testicle did swim in water, which was contained in that Coat, that the water might make no further descent, with a crooked Needle and double Thread, the whole Coat and Seminary Vessels were moderately taken up and bound; after this in the lower part of the Ligature the Membrane was divided lengthways, and by degrees was drawn forth some pounds of Water, after which was applied a Pledget long and thick enough, dipped in the White of an Egge, Bol. Armen. and the like, then was applied the same Digestive I formerly have described, and with this were armed the Tents and Pledgets, and over these Ʋnguentum Basilicon; and with all care the Ulcer being mundefied, [Page] digested, and filled with Flesh, it was skinned, and the Patient perfectly recovered. Riverius relates another story of a Child of 15 moneths old, who was troubled with a watery Rupture in his right side of his Testicle, with Matter contained in the Dartos, equalling the bigness of a small Egge; and this he had almost from his first coming into the world: how he received his Cure I will commit you to the Author himself.

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CHAP. LX.
Of Pneumatocele or Hernia ventosa.

THis windy Rupture does happen with and without a Dropsie; if with a Dropsie, cure the Dropsie, and the Rupture will be dismissed; if without a Dropsie, we are to use Topical Medicines, and these ought to be Digestives, and purge the Body from the flegmatick and windy Humours, and if possibly gain a digestive faculty in the Stomach, and these you have already prescribed in Tumours arising from wind. This Tumour is known from the former, because it is more lucid and red than it; the Veins are puffed up, and the splendour appears more bright than the former, and is suddenly framed, and as speedily discharged. And having already furnished you with Medicines for discharging the Antecedent Cause, we now arrive at the Conjunct Cause, which is this flatuous Spirit got into the Scrotum, or its Coats; the which we shall thus endeavour to discharge by outward Medicines, as Fomentations, Oyls, Unguents, Emplasters, Cataplasms, and the like, neither here using Caustick or Incision [Page] For Fomentations you may use these:Foment. ℞. Origan. Calamenth. Puleg. an. M. ss. sem. 4 Calid. major. sem. Vitic. Bacc. Laur. Juniper. sem. Cumin. an. ʒij. fl. Melilot. Chamomel. an. pug. ij. Sal. ʒij. coquantur in s. q. vini albi ad 3 partis consumptionem. Another. Or this: ℞. Lixiv. Barbitonsor. iij. Cumin. Bacc. Laur. an. ℥ij. fol. Laur. Rorismarin. Rosar. rubr. Meliss. Menth. Majoran. an. M. j. Sal commun. ℥iiij. with this bathe the part affected with a Sponge.Another. Or this: ℞. Acet. fortissim. ij. in quibus coquantur rad. Pyreth. Staphis. ac. Bacc. Juniper. Laur. Cumin. an. ℥ss. fol. Laur. Haeder. terrestr. Salv. Thym. Rorismarin. an. pug. j. bathe also with this the affected part; or with this:Another. ℞. sem. Cumin. Bacc. Laur. Rut. Chamomel. Bacc. Juniper. Absynth. an. ℥i. misce, fiat Fomentum, cum aqua & vino mixta. Oyls. Oyls for the same are these: ℞. ol. Rut. Laurin. an. ℥iss. ol. Petrol. ℥i. ol. Spic. Terebinth. an. ℥ss. misce. Or, ℞▪ ol. Chamomel. Rut. an. ℥i. ol. Aneth. Nard. an. ʒiij. spirit. vin. ʒij. Cer. q. s. fiat Ʋnguentum. Unguent. Or, ℞. ol. Castor. Rut. Euphorb. an. ʒvj. Ʋnguent. Martial. ℥ss. misce. Catapl. Or for Cataplasms take these: ℞. sem. Cumin. Bacc. Laur. sem. Sesel. Rut. an. ℥i. stercor. Bovin. j. Sulphur. viv. Cumin. an. ℥ij. mel. q. s. fiat Cataplasma. [Page] Or this;Another. ℞. Farin. Fabar. ℥iiij. sem. Danc. Cumin. an. ℥ss. Bacc. Laur. Juniper. an. ʒij. fl. Chamomel. Melilot. Rosar. rubr. & Lavendul. an. pug. j. Salpug. iss. cum vini albi q. s. fiat Cataplasma. Or,Another. ℞. Farin. Fabar. ss. sem. [...] nugraec. cumin. an. ʒij. sem. Apii Rui. an. ʒj. fl. Chamomel. pug. ij. pulv. Rui. Absynth. Scord. Rosar. rubr. ad. ʒss. c [...] quantur omnia in vino albo q. s. fine addendo Oximelit. Scillitic. q. s. fiat Cataplasma. Empl. Empl. de Bacc. Laur. is here also very good; or this mixt Emplaster: ℞. Empl. de Melilot. de Bacc. Laur. de Ran. cum Merc. an. ʒiij. nitr. Cumin. Sulphur. Calc. viv. Sal. an. ℈j. ol. Laur. & Cerae q. History. s. fiat Empl. Benivenius cap. 81. Abditor. writes of a Person of Quality, who having his viscera and Stomach so filled with Wind, that it proved very troublesome to him; and when the part was compressed, there was perceived no exition: and hence not onely the Bowels and the Brest, but the Scapulaes also were extended with incredible pain, and the Spirits very narrowly con [...]ined; all convenient and proper Medicines being prescribed and used without any effect, the third day the Gentleman dieth; the dead Body being dissected, the Intestines and the other viscera were seen to be much [Page] swelled and puffed up with wind, and in the left Ventricle of the Heart was found a hard Callosity equalling the largeness of a Nut, and these two were generally held to be the onely Causes of his Death.

CHAP. LXI.
Of Sarcocele or Hernia carnosa.

THis is a Tumour contra naturam, which is generated about the Testicles out of a Scirrhous Flesh; or it is a Tumour bred out of the defluxion of thick Humours, which are collected between the Coats of the Testicles, and they there not assimulating, there oft times grows as it were a Hyposarcosis, oft times Varices accompany the Tumour, and these are very troublesom; and these Humours being thick and viscid, bred from Flegm and Melancholy, as they breed Scirrhous Tumours in other parts, so also do they generate a hardness in these.Signs. It is known by its Hardness, Asperity, Inequality, and Indolency. It ariseth from Melancholy, it having a sublucid colour. If it ariseth from Flegm, it does not differ from the colour of the Cutis. [Page] If it ariseth from burnt Melancholy, it hath a pricking pain, and the Tumour is inequal, in some places soft, in others hard. If the Tumour be not confirmed, cure it as you do a Scirrhus, by using Emollients, then Discussives; but the last seldom does any good here. But if these fail, you are to come to Section; but if it be Cancerous attempt nothing. Matthiolus affirmeth, that he hath absumed a Sarcocele by the onely using of Pulvis Radicis Anonidis being taken for many moneths. But if it yields not to Medicine, Incision is the next remedy; and this way or method is not void of danger, the Testicle being either left in or taken out. And by the way we are to consider, that if any fleshy substance grows about the Coats or Testicles, this is wholly and absolutely to be taken away in this case for more safety; the Vessels are therefore to be drawn out and tied, and afterwards incised and cauterized: for to leave any part hereof, does more represent the ignorance of a Quack, than knowledge of an Artist; for no Son of Art will give the advantage of a new growth, whenas he may well prevent any appearance of the same by a careful managing of his Operation, and taking care of preventing all accidents; for a small [Page] quantity, but left remaining, will soon run up (like a rank Weed) to a great bulk, and this in a short time grows worse and worse. If the Tumour be not very hard, the Chirurgion comprehending the whole Tumour, that is the whole tumefied Substance in the Testicle, every way encompassing it, let him make his Incision even to the Tumour above the Scrotum; then abduce the Testicle from the Scrotum, drawing a strong Needle and Thread through the middle Process above the Region of the tumefied Testicle, and then drawing it back again through the same part of the Process; then tie both of them; these being performed cut off the whole Process, the Testicle being concluded with it. It being ablated, apply a Repercussive Medicine, and strengthen the neighbouring parts with convenient rollings and bolsterings, and heal up your Ulcer as you do others. Fabritius Hildanus tells a very pleasant story of a young man,History. who embracing his Mistress in Veneral Ceremony, he being near ready to eject his Spermatick succus, was prevented of his intended purpose by a Messenger which rushed in unawares, by opening the Chamber door, and disturbing him in his pursuit, on which his Sperm receded, and was retained. [Page] Upon which a pain seized on his Groin, his Testicles tumefied, and the pain began to be remiss in his left Testicle, and the Tumour vanished, and returned to its former state; but about the right the Tumour continued, the which in process of time turned into a great fleshy Rupture; and he being called to the Patient amongst other Physicians in consultation, saw not onely Flesh about the Testicle concreted, but found it also extended with serous Humours, so that it equalled near the largeness of a Childs Head.

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CHAP. LXII.
Of Circocele or Hernia Varicosa.

THis is nothing else than a Dilatation of the Veins in the Testicles, conglomerated in manner of Varices: and these (as Celsus and Paulus write) are either the Veins of the Scrotum, or those in the Membranes of the Dartos, or those which do nourish the Testicle: and therefore Celsus adviseth, if the Rupture be in the Scrotum, you are to apply thin and sharp Instruments to the Veins, and with these the Veins are to be cauterized, and there to be most cauterized where most variced or twisted. The general Curative Method here is the same to that prescribed in curing of a Scirrhus; Intentions. the Intentions here are three, to repell the flowing Humour, to discharge and dry up that which hath already slowed, and to astringe the dilated Vessels. Now Astringents do satisfie these two scopes; for as being cold and restringent, they repell the fluent Humour; as being drying, they dry it up; and by its Astriction do also bind up the dilated Vessels. And for this Affect, Balaustians, Red Roses, Pomgranate Rinds, Juice of Hypocystus, [Page] Bol. Armen. Dragons Blood, Mastich, Olibanum, Glue, Amber, and the like; these, or any, or some of these mixed with the White of an Egge and a little Vinegar, may very well be used here: but if these do no good, come to the use of Incision or Caustick, and here are we to be very careful in onely cauterizing the parts where they are thus twined or twisted together; after which done remove the Eschar, then deterge and digest it. But if the Veins of the Dartos be tumefied, you are to make your Incision in the Groin, and the Membrane is to be drawn through there with the Testicle, and after this separate the dilated Vessels from the Coat either with your Fingers or a convenient Instrument; then tie up the Vessels, and cut them off under your Ligature; then repose or reduce your Coat and Testicle. And if the Rupture be in the Erythrois or Tunica vaginalis, and either two be dilated, proceed in the same Method as in the Dartos; but if it be between the inward Coat and the Testicle it self, make your Incision in the Inguen, draw out the Vessels, amputate the Testicle, and cauterize the parts. And this is Paulus his Method and Distinction. As touching Hernia Humoralis, take this brief Description of it: [Page] It is framed out of a Confusion of many Humours in the Scrotum, Hernia Humoralis. or between the Coats which enwrap the Testicle. Oft times also it is seen to be bred in the proper Substance of the Testicles. You are to cure this as you do the former. And thus much of Ruptures.

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CHAP. LXIII.
Of a Venereal Bubo.

WE arrive now at the Inguens, where we may meet with these four following Tumours, Bubo Venereus, Pestiferus, Phyma, Phygethlon; of each of these in their order. These Glandules have their proper names as well as others, and hence is it that they are called Bubones, by us in England called the Popes eye, in veal and mutton. They are held to be eight in number and very large. There is held to be a great commerce between the Nerves and these Glandules: for it is very credible that the Nerves do conveigh somewhat hither, as their excrementitious succus, and also do send hither any nerveous quality that at any time doth perplex them; but they do not unload themselves into these as into their excretory ports, but into their adjoyning vessels; and hence it is that they are placed at the greater division of the vessels: neither is it less probable, that they take somewhat from hence as a nutritive juice, the which being allured by a similar attraction of the Glandulous substance, the [Page] Lymphaducts to pour out their Lympha here, and by the benefit hereof these Glandules do separate one and leave the other: And this is confirmed by their sweetnes and delicacy, they having a familiarity with the nutrive Succus. And the reason they are so large and numerous is, because the Crural Nerves had need to have such large Organes for discharging their superfluities. We come now to their Diseases with the Affects; these being either simple or not malign Tumours, or pestilential or venereal Tumours. The Causes of all which may be reduced to two. The first being the hindrance of the Circulation of the Blood, and hence ariseth a Tumour by reason of the continuity and impetuous afflux of the Blood from the heart through the Arteries, and by reason of its making no reflux from these through the Veins: An evident example we have hereof in Contusions of the Glandules and in their Obstructions. A second common Cause ariseth generally from the Nerves themselves, spitting forth their superfluous Humidities being either here vitious in Quantity or Quality: now these are 2 common causes. Every special Tumour hath its specifick causes & differences: and thus if these superfluities only err in quantity or quality, as in viscidity, thicknes, or the like, it frameth a [Page] simple Tumour: If from a malign quality, there ariseth a Tumour being of the same nature (as malign;) and thus being either venereal or pestilential it occasioneth a venereal or pestilential Tumour.Causes. We are now to enquire of the efficient causes of this venreal Bubo: and this poyson oftimes is communicated to the Liver, and hence is sent into the Inguens, as its proper Emunctuories, and hence ariseth these venereal Buboes. The cheif matter of which they are bred is of a part of thick, cold and viscid Humours, which may wel be perceived by the hardnes, whitenes, ilnes of pain, and colour of the Tumour. Sometimes they arise from a hot, sharp, & cholerick Humour with a great pain, and a conjunct heat, and these make them so oft to run into Ulcers, being both virulent & corroding.Cure. As to the cure, never-use digestives, lest the thinner part being resolved, the thicker excrement lyes and encreaseth inwards; much less Repellers, for these do drive the virulent matter inward; and therefore Attractives and Suppuratives here only do take best place. The Tumour being made ripe, open it with a potential Cautery. As touching the cure of the whole body, neither purge, bleed, or keep any order of dyet. Make your orifice not very large, but so as you may lodge in it a pretty handsome large Tent for discharge of this [Page] peccant Matter, you may keep it open for 20 or 30 dayes according to the greater or lesser quantity of Matter. This being discharged, we may both prescribe purging, bleeding, and a good order of dyet. It being discharged, cleanse it well, fill up with flesh, and skin it. And thus may you cure the kinder sort of a Venereal Bubo: but if it proves more rebellious, then instead of Suppurating Medicines we should come to the use of Cupping Glasses every other day, and after these to apply Diachylon cum gummi mixed with black Soap, and these will maturate the most rebellious Buboes; and having brought it thus, deterge the Ulcer by keeping it a long while open, and freed of its peccant Matter; then fill up with flesh,Hist. and skin it. Hildanus tels us of one, who in an impure coition with a Strumpet had all his genital parts so dilated, that a malign Vapour passed to the next immediate Veines, and afterwards coursed through the greater to the Liver, and so infected the whole mass of Blood, hence were generated many crudities instead of Blood. And as nature is alwaies careful to defend her noble parts, and to vindicate them from blemish and injury, she generally sends these Humours to the Ing [...]ens, as to its Emunct [...]ories: and [Page] here they breed these Tumours we call Buboes, which were made of a hot and sanguinolent matter, the which with ease came to suppuration; others there be which being generated of could and thick Humours do require a longer time to suppur ate, and a greater diligency to cure, the Matter was sharp and malign, and many Medicines being used both inwards and outwards with small success. The Tumour appeared but small, and was very hard, and after having applied many attractive Cataplasms and Emplasters, by the benefit of a Caustick it did break, out of which for six or seven dayes space it did run near ten pound of Matter. About the Rotator of the Thigh broke out several Abscesses, out of which did also run such a great Quantity of Matter for some months, that many thought him scarce curable, but by care and convenient Medicines he recovered.History. Schenkius relates of a noble man about 30. years of age, who having recreated himself in Venereal embraces with a young noble woman being filled well both with wine and venery had soon after his fulness of pleasure an implacable pain about his Hips, and in his left Groyn did grow a large and red Tumour, the which after wards turned it self into an Ulcer to which applying [Page] Diachylon cum gummi and such like Medicines it was speedily brought to suppuration; the which being opened a great quantity of Purulent Matter came out much like to that of Pultice; his Spirits almost being exhausted, he fell into a consumption, accompanied with a Hectick, and afterwards within a little while leaves the world with his pain. I write this as a Caution to young Chirurgions, that they do not supress such Venereal Buboes, or leave any Venenate or Virulent matter to lodge in such Tumours or Abscesses, they at last turning to Fistulaes, if not bring a Consumption with them, and so Death.

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CHAP. LXIV.
Of a Pestilential Bubo.

THis Tumor by the Arabians is cal-Althois. It is a Tumour long, and moveable, in its Vigour sharp with a mucronated Turbination, immoveable and deeply fixed in the Glandules, in which the Brain exonerates it self into these Glandules somewhat of its venenate and pestiferous Matter, as to those which are in the Throat and Ears, the Heart to those which are under the Axillaries, and the Liver to the Inguens. It consisteth of a thick and viscid substance, as a sharp Anthrax [...]ixing an Eschar in the part. Of these are two conjunct Causes, the Efficient is strength and vivacity of the expulsive Faculty of these principal parts, which expulsion is made by these to the Emunctuories. The material Cause is corrupt Blood deprived of its proper Nature, Effence and benign Quality, and altogether altered and changed from its pristine Substance, that it turneth an enemy to its nature. And here ought we to enquire into the cause of this Corruption. It is to be noted in an Inflammation and Erysipelas the fluent Blood [Page] is good, because it is not expelled, only aggravated in Quantity: This is expelled in respect of its ill Quality.Causes. Galen giveth this as a Cause, as Corruption, when that be received be of an evil juice, they being of the worst Nutriment. Another Cause is corruption of Air, the which being attracted doth force it self into the Spirits, and so corrupt the whole Mass of Blood. we do own a Pestiferous Bubo to be an Inflammation of the Glandulous parts: and here therefore we are to mind the whole colour of the Body; For in a Pestiferous Bubo this is sometimes changed.Signs. Another sign is a dry and black Tongue; another is a thin and waterish Urine, his Excrements very fetid, because this putrid Heat doth corrupt them. In a Pestiferous Flux there is oft times a Cholerick Flux adjoyned, and the Excrements are of various colours, frequent Vomiting and stinking Sweats, a general Itch over all the Body, pains of the Head, oftimes Delirium, great pain and griping in the Stomach, by reason of the putrid Humours sent thither from the Guts; then Syncope and at last Death.Presage. In this case Death is generally to be presaged, the disease being so potent and forcibly assailing the natural Fort, that it cannot long hold out. As [Page] to the Cure;Cure. First cure his Air, this being as a main Actor in this Tragedy, and therefore sprinkle his room with Vinegar, or burnt Tarr, &c. let his Dyet be thin, because his Humour is thick; all Passions are to be shunned; Venery [...]led from as the greatest enemy, because it is a great disease. Galen ordereth Venae Sectio; and in every putrid Fever you may see him ordering Phlebotomy as you may see it in 11. Meth. cap. 14. And in a Pestilential Bubo there is concomitant a putrid Fever; and therefore Bleeding is very requisite. Besides these, the common signs of the Bloods offending in Quality requires Bleeding: But this is to be done and performed both warily and judiciously; for in some cases it is by no means to be admitted, as in the Small Pox appearing, or Buboes; for by Venesection here we send the peccant Matter inwards to some noble part, and so instead of quenching we rather add Fuel to the Fire. And in purging be sure you observe to mix somewhat of an Alexipharmick to strengthen the Parts. As to the outward Applications, Epispasticks, Cupping Glasses and the like Medicines, are the only proper Instruments to abate the Fury and fetch forth the Malignity. Somtimes Causticks also do take goop place [Page] here, anointing the Skin first with Oyl of Lilies, that the more loose the Skin be made, the deeper the impress the Cupping Glass may make. And being thus brought to Suppuration apply Venice Treacle or Mithridate plaster-wise. Or for this use you may use this Unguent. ℞.Unguent. Ʋnguent. Dialth. ℥iss. Ol. Scorpion. ℥ss. Mithridat. Solut. in [...]q. vitae ʒss. this hah in it a discussing Quality. Or this,Another. ℞. Ʋnguent. Basilicon. ℥iij. Ferment. acr. ℥ij. Ol. Lilior. alb. Chamomel. an. ℥ss. Theriac. Andromach. cum vitellor. Ovor. n•. ij. misce fiat Ʋnguentum. A Vesicatory applied under the Bubo is very proper: As if it were in the Throat apply a Vesicatory to the Scapulaes; and after they have performed their work, cut them open, and discharge the Matter, and keep them open for some time, by applying Beets, or Ivy-leaves, or Melilot-plaster to them. These may be ufed if your Patient lives to use them: But this is very rare, for they seldome are cured, they dying the first day, and very few living beyond the fourth. I shall conclude this Chapter with this History related by Petrus Bayrus lib. 20. cap. 8. of a Woman which had a Pestilential Tumour bred behind her Ear, and he being sent for [Page] about eight hours after it was perceived, it grew into a large Bulke in that time with much pain, the pain afterwards began to cease, but the Venome descended to the Heart, and did horribly trouble and vex it; neither could she beleive herself to live an hour: being by his directions ordered to smell to Vinegar and Rose-water; after this she was bled on each Cephalick, first Breathing a Vein on the contrary Side, then on the distempered Side. Then was there applyed a large Ventose to the Part affected with a deep Scarrification, reiterating its application: And when there was drawn near half a pound of Blood by this Ventose, the Patient began to find her self somewhat better and to have some hopes, and found manifestly that the Venome receded from her Heart by these Frictions, Odours, Cordial Powders, and Potions and the like; that by Divine Blessing and help of these Remedies she perfectly recovered. Hollerius saith live Oysters being applied to Pestilential Buboes do attract all the Venome from them.

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CHAP. LXV.
Of Phyma and Phygethlon.

IN cap. 1. lib. 2. ad Glauc. Phyma is said to be a Tumour in a Glandule, which encreaseth with some Vehemency, and hasteth to Suppuration; for [...] agrees with all sorts of Tumours arising out of the Earth: and these happen not only in the Inguens, but very oft in the Axillaries; for these Glandulous Bodies being very loose are the most apt to give Entertainment to all strange Appearances, Fluxions and Tumours, particularly in the Groins, because of their depending Site, strong Motion, and humid Redundancy. After here having prescribed a convenient Dyet, and the general Method, which we have already shown you in a Bubo, we are to apply Digestives to the place affected, and then Suppuratives; and the Tumour being by these made ripe, we are to discharge the Matter either by Caustick or Instrument; and the rest of Cure perform, as you have already directions in curing of a Bubo. What Phygethlon is. Phygethlon is an In [...]lammation and part of Erysipelas, or an inflamed Erysipelas; and [Page] this you are to cure by Phlebotomy, Purging, and Diet. As touching the affected part, you had better apply Digestives than Suppuratives, because this Tumour hath a mixture of Choler: and hence it is that Galen. lib. 6. Simpl. doth praise Atriplex, and the Leaves of Garden Mallows, and a cold Cerate, and is at length to be cured with mild Discussives. Lusitanus Cent. History. 6. Curat. 82. telleth of a young Gentleman troubled with a Phygethlon under his Axillary, the which did spread to a very large bigness, in process of time it grew soft and livid, and so proceeded with Pulsation, that both Physician and Chirurgion conjectured Matter to be lodged in it; and therefore by a general consent it was opened; but the Success was miserable, for it was scarce opened but the Blood flew out impetuously, with a great noise of Spirit, upon which the Patient presently dieth with his inclining downwards, and he speedily departed this miserable Life.

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CHAP. LXVI.
Of the Hemorrhoides.

HEmorrhoid is a Compounded word [...], which signifies Sanguis, and [...], fluo; and this is a Flux of Blood. The Veins of the Anus onely gain the place of their dwelling and being: or they are Tumours encompassing the Veins of the Anus, excited by the great in [...]lux of Melancholy Blood, resembling somewhat of a species of a Varix. Some of these at certain times do open themselves, and so do discharge and exonerate the Blood: others there are that onely tumefie. Some are hidden, others more manifest. Such as flow, they pour out almost all Blood mixed with a yellowish Serum, which is as a Vehicle to make its more speedy exit, and by its acrimony does make a more speedy opening of the Vessels. Such as do not flow, do either lodge in some small Bladders, and by some called Vesicales; and these are made by the influx of Flegm and Serum, resembling Grapes, from whence they are called Ʋvales, from the efflux of Bloud, being laudable in quality, but bred by a copious Redundancy. They [Page] are different in their Magnitude, some being large, others small; in their multitude, some having many Orifices, others few; in their Figure some narrow, some broad; in their Colour, some being of a blackish colour, others more red; in their Place, some being in the Anus, others in the Sphyncter, others bordering upon the right Gut; in their Constitution, some being mild, others more cruel and painful.Their Origination. These Hemorrhoides arise (as both the ancient and modern Anatomists allow) from the Splenetick branch, deducing its issue from the Porta produced downwards towards the Rectum, and then carrid backwards to the Coccix, and there to be inserted and propagated. But from the Vena cava there are two Branches produced from the Os sacrum or Coxendix, and sent to the Anus; the one from the right, the other from the left part, the which are disseminated through the Muscles of the right Gut and Anus, and do there constitute these Hemorrhoidal Veins, here pouring forth their Blood: and this is confirmed with good reason, for the rectitude of the Vessels, the Blood flowing downwards by its weight must necessarily fill its Vessels, and being girt up or constringed, being thus filled by the Muscles, does make way for this [Page] Apertion. And to give a better light to the well ordering and curing of both sorts, let us make an exact Anatomical Inquiry about these parts. These Hemorrhoidal Veins again have an Artery belonging to them to feed them, this Blood first coming from the Porta to the Anus; for from the great Branch of the Porta is this carried to the Spleen, and thence through the Mesentery is it sent to the right Gut. These Veins are onely two, arising from the Cava and the Porta for this cause, because these serve, as do the other Veins of the Body, for nourishing the parts with Blood: and thus are the parts of the Anus nourished therewith (This was a thing unknown to the Ancients;) and therefore it is necessary that the Melancholy Blood should this way be discussed; for by this Passage onely is Melancholy best discussed, and the Schirrus of the Spleen cured. Besides these, these also are by nature as Scavingers to cleanse the feculent Blood, and make a sound Body; and when therefore she cannot perform these, we make our speedy address to Phlebotomy: and the Evacuations thus made we daily find to yield great comfort and ease to the troubled Patient. Besides, these not being kept open, a man having a great quantity [Page] of Melancholy Humour lodged in him, the whole Body will hereby be less capable to undergo any other Method which may be prescribed. And lastly, in Malign Fevers, being lodged in the larger Vessels, and there putrefying the Blood, these most properly ought to be opened, being nearer related to the affected part, where more good may be expected than from the Arm. Should these be stopped, they breed a Consumption in the Lungs, a Dropsie in the Liver, by suffocating the Liver as it were in its native heat; and if they flow immoderately, the Blood being evacuated the Liver is cooled, thereby is excited a Dropsie, and a decay of the whole Body. For this immoderate Flux take these: ℞.Unguent. pulv. Alo. Thur. Balaust. Sangu. Dracon. an ℥ss. misce cum albumine Ovi, fiat Ʋnguentum. Or this: ℞. ol. Rosar. Cer. alb. nov. an. ℥j. Axung. Porcin. ℥ij. pulv. Plumb. alb. ℥iss. liquefiant praedicta, & supra marmoream injiciantur, tunc adde plumbum. Another. Or this: ℞. Axung. Porcin. ol. Lin. an. ℥ij. succ. Taps. Barbat. Cynogloss. an. ℥ij. coquantur ad succorum consumptionem, postea adde Sacchar. Saturn. ℥ss. & cum pulv. sem. Lin. q. s. fiat Ʋnguentum. Another. Or this: ℞. Tuth. praeparat. Coral. rubr. Plumb. an. ʒiij. Lap.[Page]Calaminar. Lithargyr. aur. an. ℥ss. ol. Rosar. ℥iss. succ. Taps. Barbat. ℥iss. misce, fiat Ʋnguentum. Or if Pain, Heat, or Acrimony be urgent, you may use some ot these:Another. ℞. ol. Rosar. ℥ij. Ceruss. ℥ss. Lithargyr. aur. ʒij. Cer. nov. ʒiij. Opii ℈ss. vel ℈j. misce, fiat Ʋnguentum. Or this: ℞.Another. Thur. Myrrh. Croc. an. ʒj. Opii ℈j. fiat Ʋnguentum cum ol. Rosar. & Mucilag. sem. Psyl. addendo vitellor. Ovor. no. j. Or this:Another. ℞. ol. Rosar. Olivar. Myrtin. an. ℥ij. succ. Plantag. Milii an. ℥ij. Acet. ℥j. coquantur ad succorum consumptionem, tunc adde Bol. Armen. Sangu. Dracon. Thur. Chalyb. praeparat. & pulv. an. ʒj. Cer. flav. q. s. fiat Ʋnguentum. Or this: ℞. Vitellor. Ovor. no. j. ol. Rosar. Violar. an. q. s. fiat Ʋnguentum, addendo Ʋnguent. Rosat. Popul. an ʒiij. misce. Amatius Lusitanus Cura. History. 3. Cent. 5. writeth of a man about 45 years of age, who was formerly vexed with a Venereous Disease, from whence came from him every moneth Blood through his Hemorrhoids, as the Menstrues in Women elsewhere. He had such a plentiful Evacuation of Blood, the which when he failed of his accompanied time performing its duty by these Veins, he vomited much Blood out of his mouth, being of a yellowish red, without Cough or Fever: and for the preventing [Page] of which evil he comes to advise with Lusitanus, who advised him to be chearful, and to the parts he orders 4 Leeches to be applied, the which extracted six Ounces of Bloud; after this prescribed him a good Diet, and cooling Syrups, as Syrups of Endive, Fumitory, Woodsorrel, and the like, for some days together; and taking a purging Potion of Manna, Rhubarb, with Diaphoenicon, &c. with this order the Blood followed its former course, and the Patient grew well. Oethius writes also of one, who, when his Flux was obstructed below, he did every moneth spit Blood at the mouth, as you may have it lib. Observat.

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CHAP. LXVII.
Of an Aneurism.

THis is a soft Tumour▪ yielding to the Touch, made by Dilatation or Relaxation of an Artery: Every Artery, except those which are dispersed through the Brain, have allowed them a double Coat, the inward of which being either corroded or rent, the outward may extend so much as to cause an Aneurism. Aneurisms may be made by Anastomasis, Diapedesis, Ruption, Erosion, or Wound of the Arteries. It happeneth in most parts of the Body, but chiesly in the Throat. It is a Swelling encreasing by degrees, and hath the same colour with that of the Skin, a continual Pulsation. If it be small,Its Causes. it easily yieldeth to the Touch. It is difficult in Cure. If it be large, and in the Axillaries or Inguens, in which the Vessels are large, here expect no cure. Incision very oft times causeth such a Flux of Blood and Spirits, that it both dischargeth Art and Life very speedily. This too often happens by the imprudence of an ignorant Chirurgion, by pricking of an Artery instead of a Vein, and so occasioning this Pulsation, [Page] Pain, and Tumour. Some allow inward Causes, as Intension of the Spirits, Contusions, Concussions, Obstructions, these being accounted as the chief of the inward Causes. Some also do adde Melancholy Blood to be a Cause hereof lodged in the Veins and Arteries; but the most usual sign of its Causes is drawn from the ignorant Chirurgion, who by pricking too deep does wound the inward Artery, the which is not easily to be cured by reason of its Spermatick Substance and Motion; and thus the Blood by degrees is percolated out of the Arteries, and making a Cavity for it self formeth this Aneurism, the Matter hereof being a Spirituous Blood made by Dilatation, the outward Matter is made by Grumous Blood thus raised together. It generally receives these two Methodical Scopes in its Cure, viz. Pharmacy and Chirurgery; and where the one takes not, the other must be attempted. The first are Repellers and Restringents, and convenient Ligatures, or Lead strictly bound over the part; or such an Astringent as this may serve the turn,A restri [...] gent [...]. as, ℞. Pulv. Bol. Armen. Terr. sigillat. an. ℥ij. Pulv. Rosar. rub. Sang. Dracon. an. ʒij. Gallar. immatur. nuc. Cupress. an. ʒi. misce, & cum Albumine Ovi, parum Aceti & Oleo Rosarum fiat[Page]Restrictivum. Let this remain on for two or three days. These are to be used in smal Aneurisms, but in large Aneurisms not happening in the Head or in the Groins, they are accounted Mortal, according to Aetius, lib. 15. cap. 10. Some Artists do tie up the Artery both above and below, and then divide between these two Ligatures; but this Operation is dangerous, painful, and troublesom, and seldom bringeth any benefit. But to preserve Life I would rather, if it happen in a place where it may lawfully be performed and exercised, have Amputation made; and before you begin this, be sure to purge the body with Cassia, Manna, and the like; and order cooling Juleps, Emulsions, and Hordeate Decoctions, and keep the Body open by Purging and Clysters. Hildanus in his 44 Observat.History. relateth of a young Gentleman, who being troubled with the Itch, upon which sending for a Barber to breathe a Vein for him, he pricked the Artery instead of the Basilick Vein; whence did arise an Aneurism. For the ablating of which above a moneth was used variety of Medicines to little or no purpose; the Tumour equalled the bigness of a Goose Egge; it was pale and hard, in which was so perfect a Pulsation, that it elevated the Dressings [Page] and Rollers, as they might with ease be perceived. He could not extend his Arm; his pain was not great, but onely when he would extend it. Seeing how desperate it was, he was very unwilling to undertake its Cure; but being perswaded by the Prayers, Desires, and Requests of the Patients Friends to take it in hand, he used this Method, a good Order of Diet being prescribed, to the part affected was applied Emplastrum de Cicuta, and this Clyster was administred; ℞. Rad. Alth. cum Tot. fol. Violar. Malv. Parietar. Mercurial. an. M. j. fl. Chamomel. Melilot. an. M. iss. coquantur in aqua s. q. ad tertiae partis consumptionem, in j. colaturae solve Benedict. Laxativ. ℥j. Mel. Mercurial. ℥ij. ol. commun. ʒiij. Sal. pug. j. misce, fiat Enema. The next day was ordered this Apozeme for digesting of this Melancholy Humour;Apozem [...]. ℞. Herb. Lapath. acut. Rad. Polypod. Q. Petroselin. an. ℥j. Herb. Agrimon. Veronic. Cuscuth. Fumoterr. summitat. Lupul. a. M. j. fl. 3 Cordial. an. pug. j. Liquirit. Ʋvar. passar. Rhaharb. Rapontic. an. ℥j. sem. Faenicul. Anis. an. ℥ss. coquantur in aqua fontana s. q. ad tertiae partis consumptionem: hujus colaturae accipe j. syrup. de Fumoterr. Epithym. an. ℥ij. Aqu. Cinamom. ℥iss. misce, fiat Apozema, pro tribus[Page]dosibus, to be taken for three mornings. Afterwards was prescribed this Purging Potion; ℞. Decoct. praescript. ℥viij. in quibus infundantur & macerentur Rhabarb. optim. ʒij. Senn. mundat. ℥j. in dimidia parte hujus Decocti solve Diaturbith. cum Rhabarb. ʒj. syrup. Rosar. Solutivar. ℥j. misce, fiat Potio. Empl. de Cicuta was every day renewed, and afterwards he took this Purge; ℞. Confect. Hamech. ʒiss. Extr. Cort. Esul. ℈ss. aqu. Cinamom. ℥ss. misce fiat Potio. After this the Tumour began to lessen, and then was applied this Emplaster; ℞. Empl. Diapalm. ℥ij. Empl. pulv. Mastich. Rosar. rubr. Myrtilor. Radic. Symphyt. major. an. ʒj. cum q. s. ol. Rosar. fiat Emplastrum. After this he applied a small Knot oft times doubled, and this was joyned to the Ligature, and this was for repressing the Tumour, and for dilating or throwing out of the coagulated Blood: and by these Remedies, and by Gods blessing, he perfectly recovered the use of his Arm.

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CHAP. LXVIII.
Of a Paronychia and Pterygion.

ITs place and seat is generally at the Fingers ends; here it fixeth it self, and from hence does it send forth its pains.Its Figure. Its Figure is longish, somewhat Oval.what it is. It is a Preternatural Tumour apostemated, small and scarce perceivable, beginning at the Fingers ends, arising from a hot, venenate, and nitrous Blood, and oft times places it self between the Bone and the Periostium. At its first appearance it is mild and gentle; but afterwards grows fierce and troublesom, causing pains, Fevers, sometimes a Caries and Putrefaction of the Bones. It's called Paronychia, because it is a Distemper [...], marching to the roots of the Nails.Its differences from Pterygion. Fabritius de Aqua Pendente maketh no difference between Paronychia and Pterygion. Pterygion is a Hyposarcosis or Excrescence of the Skin, and this does not immediately reach the Nail. Aeginetta cap. 81. lib. 3. shews the difference, where he calls Panaritium an Abscess fixing it self about the roots of the Nail; Pterygion to be an Increment of Flesh spreading out of another part of [Page] the Nail.Its Signs. The Blood of its nature is hot here, being kept in and denied a Difflation, Redness arising from this great Heat, Pain from this Intemperancy, and Solution of Continuity by this violent Matter, distending and aggravating the nerveous, tendonous,Its Causes and manner of breeding. and membranous parts. These are sometimes said to be bred by an inward cause, occasioned by a nitrous, sharp, cholerick, venenate, fervid, and most thin Blood or Humour; the which is infixed in the affected part. External Causes may be Contusions, after which followeth an Ecchymisis of Blood under the Cutis, or between it and the tendonous parts, or between the Bone and Periostium; this Blood being putrefied, large Inflammations increase, and Pain and other Symptoms appear. The Generation of this nitrous Blood is to be hindered, and that it may not flow is to be intercepted and revelled; and that which hath already flown is to be weakened by Repercussives or Suppuratives; but of these in their order.Revulsives. Revulsive Medicines are such as are to be applied to the opposite part, and these are hot and attracting; amongst which may be reckoned Scarrification, Friction, Vesication, and the like.Interceptives Interceptives, commonly called Defensatives, have a Stiptick Faculty, [Page] shutting the Mouths of the Vessels and by the Coldness and Stipticity they thicken, coagulate and hinder the Flux of Blood:Repellers. Of either of these you may find various in my former Tracts Of Repellers these are Cold, Moist and Restringent, and do repell the in [...]uent Blood, and hinder its coming to the part affected. So long as you have any hopes of repelling an Humour, follow this freely; where this is not to be done, come to the use of Suppuratives. Take this one for all,Catapl. in this place most proper. ℞. Pulv. rad. Bismalv. Consolid. Major an. ℥ss. sem. Lin. Foenugraec. an. ʒiij. Malv. Alth. an. mj. Plantag. Hyosciam. an. mss. Ʋngul. Rosar. rubr. mj. Farin. Hord. Lol. an. ℥iss. fl. Melilot. Chamomel. au. pug. ij. pulv. Gallar. Melicor. an. ʒij. Bulliant simul in lacte vaccino vel aqua fontana Caepar. Sub. cinerib. coct. ℥ss. fine addendo Ol. Rosar Myrtin. an. ℥ss. Lilior. albor. Chamomel. an. ℥i. Vitellor. Ovor. History. n [...]. Croc. ℈ss. misce, fiat Cataplasma. Fabritius Hildanus useth a decoction of Cows milk here, wherein were boiled Mellilot flowers, Chamomel flowers, Quinch-seed and Lin-seed, and so Fomented the part: after which he opened the Skin, the which being opened dropped one or two drops of a reddish [Page] thin Substance; this being discharged, he applies a little Venice Treacle which was dissolved in Aqua vitae, and with this the pain soon vanished. The Incision being made, we are to Mundify the part with Mel rosarum, unguentum ex Apio, or Aegyptiacum. For this use also Precipitate is very good. Glandorp is fearful of using these sharp Medicines, these being very subject to cause Pain; and so he prescribeth Anodyne Mundifiers, as Oyl of St. John's Wort, affirming that this doth both Digest and Mundify the compact Matter, lenify the Pains, deterge and incarn. Very oft a Caries of the Bone follows a Paronychia: and here most drying Medicines are most proper, as Falloppius his Powder. ℞. Pulv. Rad. Peucedan. Irid. an. ℥i. Euphorb. ℈i. misce. As curing a Pterygion; [...] Pterygian. Having already acquainted you that it is nothing else but a Hyposarcosis about the Nail, and this sheweth its own Indication, which is to ablate the superfluous Flesh: and for this cause Ʋnguent. Egyptiacum or Alumen ustum or Praecipitatum is excellent good. Or this.Unguent. ℞. Ʋnguent. Populeon. ʒiss. Alumin. ust. ʒij. misce. Or this ℞. Ʋnguent. Diapompholig. ʒij. Alum. ust. ʒi. or the like. And thus much of those.

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CHAP. LXIX.
Of Nodes of the Legs.

THese very often happen after a long continued venereal Disease, the which do not shew themselves very speedily, but in what plases so ever the lurk in, they creat very great and Nocturnal Pains, being and having in them a contrary quality to most of other Tumors to bereave the Patient of his rest by perplexing him more in the Night than in the Day. These Tumours are hard, bred from a hard, Flegmatick, thick and viscid Flegm, which are not to be discussed but by hot Medicines, and such as have a Faculty of making the Nerves spit forth this Matter contained in them, these carrying with them an Emollient and lenifying quality; and hence may you confidently make use of such Medicines here as I have set you down in my Tract of a Scirrhus, adding thereto Argentum vivum: Empl. de Ranis cum Merc. is very proper here also. In the whole time your Patient lyes under your hands take care that he be ordered a sober Lie, shunning Venery as the greatest enemy imaginable. [Page] It proves much better, if it have not touched the Bone, than if it had: but suppose it should get thither, and foul it; this is to be Scaled either by actual or potential Cautery, the which being removed, apply such convenient Sarcotick drying Medicines, as may produce a new Skin over this: And for this affect, Powder of Myrrh. Aloes, Ireos, Euphorbium, Gentian, Aristolochia rotunda and the like are proper. I have seen these very frequent in St. Thomas Hospital in Southwarke, and sometimes here in Norwich, where I have met with the Signs very exact, painting out Pains and Aches, and nocturnal vexations as continually, as the Day leaves it self to be shut up by the Clouds of the Night.

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CHAP. LXX.
Of Tumours and Apostems of the Knee.

AFter long and difficult Diseases Tumours are oft seen to breed in the Knees; and by how much the longer they are in breeding, by so much the longer expect will be the getting of them extirpated. They bring sharp and bitter pains with them, because these Humours are crept into very sensible parts, as Membranes, the which do both distend and rack them. The Cure hereof is difficult, because this Humour is seldom seen bred but in Cacochymick Bodies, and such as are of an evil habit of body; and then because the part affected is cold and weak, being far from the Fountain of Heat. Sometimes it is made by Flatuencies, crude and serous Humours; the which do flow and mix themselves betwixt the nervous parts and Membranes. As to the Cure, if it proceed from Blood, order a thin and cold Diet; and for Revulsion Venesection is good; and here observe your 4 times in its Cure. But if it cometh from a waterish Matter, the Body is to be purged by Phlegmagogicks; and for your Topicks apply such Medicines as [Page] have in them an incisive, attenuating, rarifying, and a powerfully drying quality, as these:Catapl. ℞. Farin. Orob. & Hord. Lent. & Lol. an. ℥j. furfur. ℥ss. fl. Chamomel. Melilot. Sambucin. summitat. Absynth. Scabios. Veronic. an. pug. Stercor. Caprin. lbss. Sapae ℥ij. ol. Rut. Chamomel. Aneth. an. ℥iss. coquantur in Lixivio vel in aqua Absynth. composit. cui addere possis Oximelit. Scillitic. q. s. fiat Cataplasma For this Affect this Emplaster is also held. to be good: ʒ. Diachylon cum Gummi Paracels. an. ℥ss. Oxicroc. ʒij. Melilot. ℥ss. Empl. de Ran. cum vel sine Merc. ʒiij. misce, fiat Emplastrum. A Maid of 18 years of age falling on the Ground hurt her Knee,History. out of which did arise a large In [...]lammation, accompanied with many pains; by applying Empl. ex Argilla, Bol. Armen. Bran, the White of an Egge, and a little Vinegar, the pain somewhat abated, and the Inflammation grew remiss. About the Rotula a very large Tumour did arise, which was also very hard, in so much that without great pain to the Patient it was not to be contracted. Hence was collected, that there was Matter gathered about the Rotula, and a very large Tumour did arise, which was also very hard, in so much that without great pain to the Patient it was not to be contracted: [Page] And for the Cure hereof this Method was used, that the Blood and Humours might be lessened, and their Afflux to the part affected prohibited; a drying and thin Diet was prescribed, and the Patient afterwards thus purged;Potio purgans. ℞. Herb. & flor. Betonic. Scabios. Cuscuth. Agrimon. Veronic. an. M. ss. sem. Anis. ʒj. fiat Decoctum in s. q. aquae fontanae, in ℥iiij. solve Diacatholic. ʒvj. Electuar. e succ. Rosar. ʒij. misce, fiat Potio. After this a Vein was breathed in the Arm, out of which was drawn 10 Ounces of Blood; then was prescribed a purging Apozem made of opening Roots; Agrimony, Veronica, Majoram, Rosemary, and the like, being made into a Cataplasm, was afterwards applied to her Knee; then was applied this Cataplasm;Catapl. ℞. Farinae Hord. farinae Fabar. an. ℥iiij. pulv. Rosar. rub. Bacc. Laur. Myrtillor. an. ℥j. pulv. fl. Chamomel. Melilot. Sambuc. Inae. Arthritic. an. ℥ss. fim. Caprin. ℥ij. cum vino rubro q. s. fiat Cataplasma, fine addendo Sapae ℥iiij. apply it warm twice in a day. This was used for 3 weeks, and the Apozem prescribed and taken; and by these and a good order of Diet the pain ceased, and the whole Tumefication vanished. But in the lower part of the Rotula there was perceived a manifest Hardness, for the [Page] emolliating of which all care was taken, but in vain; at length was applied a potential Cautery to this lower part, the breadth of the Tendon, then was the Eschar removed by this Liniment:Unguent. ℞. Ʋnguent. Basilicon. Butyr. recent. sine Sal. an. ℥j. ol. Amygdal. dulc. & de vitell. Ovor. an. ℥ss. ol. Rosar. ℥j. misce, fiat Ʋnguentum, fine addendo vitell. Ovor. no. j. Croc. ℈ss. This being removed, there was found a thick viscid Matter lodging in the lower part of the Rotula, and by applying of Pulvis Aluminis usti cum pauxillo Praecipitati, taking great care that the Tendon might come by no injury or detriment, the Ulcer was mundified, and afterwards was induced a perfect Cicatrice: and by these means the Patient perfectly recovered.

[Page]

CHAP. LXXI.
Of an Abscess of the Foot.

THe Foot as well as the Hand is troubled and perplexed with viscous and strumatous Tumours, oft times planting themselves in the Joynts, sometimes making the Bones bare and foul. The onely way to cure this Evil is to discharge the Matter by Resolution, and if possible not to open it. At the end of the Toe there oft times falleth a sharp pain, arising without any manifest cause, not without some inward occult Malignity, without Tumour or Redness, depriving it of sense or motion; and hence oft times the end of the Foot being destitute of its native heat and colour, is affected with a Lividness and Blackness, and in process of time does terminate into a Gangrene and Sphacelus; this more frequently happening more in aged people than in youth; because as the parts themselves are a great way from the Fountain of Heat, so also are aged people less capable to help towards the producing of this Heat into those parts; and therefore in such cases let it be your first Intention to apply warm and comfortable. [Page] Medicines here. If they run into a Gangrene, treat it as I have already directed you in the cure of a Gangrene.Hist. Hildanus writeth of a young Gentleman, who upon too much walking had a Tumour occasioned in his Foot, and for want of convenient Medicines thereto applied, there speedily happened an Inflammation, and within a very few days a very large Phlegmon accompanied with great pain and Fever; yet by this following Method his Patient was eased and recovered. To him first was prescribed a thin Diet, then was ordered this Purging Potion: ℞.Potion. Electuar. è succ. Rosar. ʒij. pulv. Rhabarb. ʒss. cum syrup. Rosar. solutivar. ℥j. & Decoct. Agrimon. Veronic. Rad. Lapath. acut. Cort. interior, rad. Frangul. & sem. Anis. fiat Potio. The day following he breathed a Vein in the Arm: the Hip, Knee, and all the inflamed parts, were freed from Inflammation by this following Unguent;Unguen. ℞. ol. Rosar. ℥ij. ol. Lumbricor. Axung. Human. an. ʒij. misce; and afterwards was applied this Cataplasm:Catapl. ℞. sem. Cydonior. Foenugraec. Alth. an. ʒij. pulverizentur & macerentur in aqua calida, tunc adde farin. Hord. ℥iij. pulv. Rosar. rubr. ℥ss. coquantur s. q. aquae fontanae ad Cataplasmatis formam, fine addendo vitella ovorum no. ij. cum albumine. [Page] Apply this, and renew it as often as occasion requireth. By these the Pain abated, the Matter began to shew it self, and by Basilicon being applied to the part it was discharged, and by the use of the Cataplasm the Patient was perfectly recovered. Thus have I carried you through the whole Discourse of Preternatural Tumours, both in General and Particular; in which I have with all care and industry endeavoured to shew you their Definitions, Differences, Causes, Signs, Presages, and Cures.

Si quid novisti rectius istis, Candidus imperti; si non, his utere mecum.

FINIS.

An Index of the Chapters.

[Page]

AN Introduction to Chirurgery 1

Of Humours 34

A particular Scheme of Humours 45

A general Division of Tumours 46

Cap. 1. Of the Names of such Authors which have writ of Tumonrs in general 55

2. Of the name of a Tumour 57

3. Of the Causes of Tumours 59

4. Of the Differences of Tumours 62

5. Of the Ʋniversal way of curing Tumours 64

6. Of Phlebotomy, its method of Operation, and where it is to be most properly performed 66

7. Of Evacuation of Matter erring in Quality 72

8. Of a Tumour, the part affected drawing preternatural Bodies to it self 74

9. Of the 4 Times of a Tumour, and first of its Beginning 78

10. Of a Tumour in its Augment 81

11. Of a Tumour in its State 84

12. Of a Tumour in its Declination 86

13. Of a Tumour tending to Suppuration 87

14. Of a Phlegmon or Inflammation in general 91

[Page] 15. Of curing a Phlegmon in its Beginning 100

16. Of curing a Phlegmon in its augment 103

17. Of curing a Phlegmon in its state 105

18. Of curing a Phlegmon in its declination 106

19. Of an Erysipelas 108

20. Of an Erysipelas in the Face 119

21. Of Oedema 123

22. Of Scirrhus 132

23. Of aqueous Tumours 140

24. Of windy Tumours 145

25. Of a Cancer 153

26. Of a Carbuncle 175

27. Of Epinyctis 182

28. Of Herpes miliaris and Herpes exedens 184

29. Of a Gangrene and Sphacelus 190

30. Of Artheroma 208

31. Of Steatoma 212

32. Of Melicoris 215

33. Of Psydracium 218

34. Of Hydrocephalos 220

35. Of Talpa or Testudo 231

36. Of Tinea 234

37. Of Ficus 237

38. Of Cataract 240

39. Of Hordeolum 249

40. Of Ʋnguis 250

41. A Polypus 253

[Page] 42. Of Parotis 258

43. Of Epulis and Parulis 261

44. Of Ranula 263

45. Of Strumae and Scrophulae 265

46. Of Bronchocele 275

47. Of Angina 278

48. Of a Tumour of the Tonsils 283

49. Of Empyema 288

50. Of a Tumour of the Diaphragma 294

51. Of Extuberancy of Milk 297

52. Of a Caruncle in the Yard, and its manner of Extirpation 300

53. Of Ruptures in general 310

54. Of Bubonocele or Hernia Inguinalis 314

55. Of Enterocele or Hernia Intestinalis 319

56. Of an Intestinal Rupture, the Peritonaeum being lacerated 327

57. Of Epiplocele or Hernia Omentalis 334

58. Of Exomphalos or Hernia Ʋmbilicalis 337

59. Of Hydrocele or Hernia Aquosa 341

60. Of Pneumatocele or Hernia Ventosa 349

61. Of Sarcocele or Hernia Carnosa 352

62. Of Cirsocele or Hernia Varicosa 356

63. Of a Venereal Bubo 359

64. Of a Pestilential Bubo 365

65. Of Phyma and Phygethlon 370

[Page] 66. Of the Hemorrhoides 372

67. Of an Aneurism 378

68. Of Paronychia and Pterygion 383

69. Of Nodes of the Legs 387

70. Of Tumours and Apostems of the Knee 389

71. Of an Abscess of the Foot 393

FINIS.

ERRATA.

Page 6. line 18. read call. l. 27. put out and. p. 12. l. 8. r. environed. p. 16. l. 24. r. scite. p. 22. l. 3. r. l. e. p. 28. l. 5. r. perfect cures. p. 46. l. 16. r. Erysipelas. p. 84. l. 11. r. this hath attended it. p. 96. l. 9. r. Electuar. Diacatholicon. ʒvj. p. 98. l. 17. r. Succin. p. 188. l. 14. r. Chamomel. in many places r. aqu. fontanae. p. 225. l. 18. r. oft ti [...]es onely. p. 229. l. 13. r. ceased to live. p. 232. l. ult. r. Unguent. ex Apio, p. 237. l. ult. r. Ulcers.

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Title statement

A compleat treatise of preternatural tumours both general and particular as they appear in the human body from head to foot : to which also are added many excellent and modern historical observations concluding most chapters in the whole discourse / collected from the learned labours both of ancient and modern physicians and chirurgions, composed and digested into this new method by the care and industry of John Brown.

Browne, John, 1642-ca. 1700.

Edition statement

1678

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Text Creation Partnership,

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2008-09 (EEBO-TCP Phase 1).

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A29837

ID [STC]

Wing B5125

ID [STC]

ESTC R231817

ID [EEBO-CITATION]

09501698

ID [OCLC]

ocm 09501698

ID [VID]

43322

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(EEBO-TCP ; phase 1, no. A29837)

Transcribed from: (Early English Books Online ; image set 43322)

Images scanned from microfilm: (Early English books, 1641-1700 ; 1326:3 or 2509:3)

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— A compleat treatise of preternatural tumours both general and particular as they appear in the human body from head to foot : to which also are added many excellent and modern historical observations concluding most chapters in the whole discourse / collected from the learned labours both of ancient and modern physicians and chirurgions, composed and digested into this new method by the care and industry of John Brown., Browne, John, 1642-ca. 1700..

Extent

[14], 395, [4] p., [5] leaves of plates : ill.

Printed by S.R. for R. Clavel,. London :: 1678.. (Includes index.) (Reproduction of originals in the Cambridge University Library and the Glasgow University Library.)

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