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 35] 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 36] 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 37] 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 38] 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 39] 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 40] 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 41] 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 42] 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 43] 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 44] 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 45] 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.

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 56] 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▪

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 58] 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.

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 60] 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 61] 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 62] 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 63] 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.

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 65] so poysoneth the heart: Thirdly, when this matter floweth Critically, not cros­sing Nature in her own way: Fourthly, when Fluxion is excited in a Cacochy­mick body: Fifthly, when the part, to which this matter maketh its Flux, is weak, and its heat but mean: Sixthly, when there is vehement pain, for here is more need of anodynes; and then se­venthly, when this Fluxion is near some principal part. And as touching these curative scopes, we are first to probihit its Origination, and by this means to hinder its augment; secondly, to under­stand the quality of such things as are to be applied; for as Galen saith 13 Me­thod. 16. we do destroy the breed of a Tumour, if we well understand its cause; and this being ablated, the Tumour is soon seen to vanish. Fluxion and con­gestion are the two cheif causes of Tu­mours; the first offending either in Quan­tity or Quality, and so with violence doth seize suddainly upon any member, either by reason of its loosness or weakness; Congestion being, when a Humour is gathered into a part gradatim by rea­son of this weakness of the digestive and expulsive faculties.

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

IN this Discourse we have many things do offer themselves to our conside­ration: As when there is a fulness, Evacua­tion is in use; and here is to be let out as much as is necessary: If there be a Plethory Quoad vires, here it is to be repeated. And as touching the part which is to have the lancet exercised on it, whether from above or below, this also is to be minded and regarded; because Derivation, which Evacuation from the adjacent part doth not, agrees in the be­ginning of the cure; because this would make the Fluxion larger, and the Attra­ction to the part affected greater. And if we will make Revulsion aright,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 67] 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 68] 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 69] 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 70] 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 71] Liver, Spleen, and Pleurisies. And this note of the three in all sicknesses, and times, except in time of Pestilence, That vein is to be taken, which is most full and large. In the Feet also are three veins Ischiatiea, Saphaena, and vena Poplitis: these or some of them are generally open­ed in Obstruction of the Monstrues, in bringing them down, pains, stoppings, swellings and the like. I shall conclude this with these directions. In an Apoplexy open the Cephalick vein; if this ap­pears not, open the Mediana: In a Lethar­gy open the Frontal or Cephalick vein: In a Squinsey those under the Tongue: In a Pleurify the Basilica, and here bleed while the Blood doth change its colour: In diseases of the Lungs vena Axillaris or Mediana: In inflammations of the Liver Basilica or Hepatica: In obstruction of the Spleen the Basilick or Hemorrhoidal veins: In diseases of the Womb the Scia­tick vein: In restraint of Menstrues Sa­phaena: In pains of the Hips first open the Basilica, then the outward malcolus below.

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

IF a Tumour or Fluxion happeneth in respect of matter not onely erring in Quantity, but also in respect of Quality, that this may be discharged we are to consider two things: First, whether this matter may be altered, as if hot cooled, &c. Secondly to remove the subject mat­ter hereof, and in the first, if Plethory, Phlebotomy is proper; if less, Pharmacy is most convenient: And herein are we to observe these two Rules, that the matter may first be educed or sent forth being contrary to the true genus of the part, and then, if it doth still remain, to alter it. The most proper way to deal with this is by our later writers found out, which is by discharging the body hereof by purging Medicines, which do work both quickly and safely, ordering the strength of the Medicine according to the vigour and strength of the Patient: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 73] 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.

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 75] 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 76] ℥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. n^o. 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 77] ℞. 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. n^o. 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.

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 79] 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 80] 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 81] 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 82] 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 83] 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.

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 85] 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.

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. n^o. 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.

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 88] 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 89] 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. n^o. [...]. 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. n^o. 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. n^o. ij. misce, fiat Catapl. The matter by these, orany of these, or [Page 90] 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 91] 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 92] 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 93] 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 94] 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 95] 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 96] 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 97] 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 98] 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. n^o. 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 99] 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. n^o. 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.

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 101] 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. n^o. 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 102] ℥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.

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 104] 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. n^o. 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.

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 106] 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 107] 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. n^o. 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.

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 109] 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 110] 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 111] 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 112] 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 113] 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 114] 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 115] 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. n^o. 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 116] syr. Rosar. solutivar. ℥ij. ol. Rosar. Violar. Another. a. ℥i. vitellor. ovor. n^o. 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. n^o. 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 117] 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 118] 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. n^o, 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. n^o. 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 119] ʒiiss. albumin. ovor. n^o. 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 120] 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. n^o. 5. Passular. enu­cleat. ℥ss. Hord. mundat. pug. i. sem. Melon, Lactuc. an. ʒiij. fl. 3 cordial. [Page 121] 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 122] 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 123] 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 124] 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 125] 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 126] 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. n^o. 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 127] 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 128] 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 129] 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: n^o. 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 130] 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 131] 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.

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 133] 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 134] 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 135] 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 136] 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 137] 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 138] ℥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 139] 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 140] 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 141] 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 142] 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 143] 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 144] 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.

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 146] 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 147] 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 148] 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 149] 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 150] alb. dupl. hujus quantitatis, hujus sumat Cochlear. Troch. n^o. 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 151] 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 152] 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 153] 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 154] 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 155] 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 156] 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 157] 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 158] 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 159] 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 160] 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 161] 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 162] 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 163] 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. n^o. ij. sub cineribus coct. Camphor. ʒss. agitentur [Page 164] 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 165] 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 166] 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]

[Page] [Page 167] 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 168] 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 169] 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 170] 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 171] 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 172] & 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 173] 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 174] 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.

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 176] 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 177] 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 178] 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 179] 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 180] 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. n^o. 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. n^o. misce, fiat Cataplasma. Phlebotomy here is ve­ry proper and useful; Let the Medicines you apply to the part affected be very [Page 181] 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 182] 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 183] 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. n^o. 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.

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 185] 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 186] 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. n^o. 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 187] 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 188] 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 189] 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.

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 191] 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 192] 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 193] 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 194] 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 195] 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 196] 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 197] 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. n^o. 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 198] 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 199] 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 200] 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. n^o. 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 201] 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 200] [...] [Page 201] [...] [Page 202] 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 203] 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 204] 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]

[Page 205] 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 205] [...] [Page 206] 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 207] 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.

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 209] 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 210] 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 211] 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 212] 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 213] 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 214] 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.

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 216] 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 217] 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 218] 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 219] 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. n^o. 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 220] 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 221] 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 222] 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 223] 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 224] 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 225] ℈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 226] 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 227] 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 28] 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 229] 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 230] 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.

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 232] 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. n^o. iij. Vitel. ovor. indurat. n^o. iij. Mucilag. Alth. Faenugraec. Lin. an. ℥i. Ficuum contus. n^o. 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 233] 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.

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 235] 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 236] 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.

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 238] 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 239] 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.

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 241] 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 242] 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 243] 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 244] 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]

[Page 245] 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 246] 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 247] 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 248] 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.

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.

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 251] 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 252] 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 253] 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 254] 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 255] 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 256] 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.

[Page]

[Page] [Page 257] 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

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.

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 259] 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 260] 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 261] 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 262] 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 263] 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 264] 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 265] 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 266] 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 267] 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 268] 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 269] 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 270] 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 271] 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 272] 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 273] 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 274] 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.

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 276] 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 277] 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.

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 279] 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 280] 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. n^o. 12 Ficuum n^o. 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 281] ℞. 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. n^o. j. Ficuum Dactylor. an. n^o. 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 282] 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.

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 284] 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 285] 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 286] 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 287] 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 288] 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 291] 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 288] [...] [Page 291] [...] [Page 290] 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 291] 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. n^o. 6. Sebesten. n^o. 4. Dactylor. n^o. 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 294] 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 295] 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.

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 295] 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 298] 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 299] 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 298] 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 299] 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.

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 303] 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 302] 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 303] 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 306] 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 305] 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 306] 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 307] 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 308] 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 309] 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.

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 311] 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 312] 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 313] 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.

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 315] 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 316] 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 317] 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 318] 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.

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 320] 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 321] 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 322] 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 323] 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 324] 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 325] 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 326] 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.

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 328] 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 329] ℞.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 330] 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 331] 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 332] 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 333] 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 334] 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 335] 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 336] 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.

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 338] 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 339] 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 340] 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.

[Page]

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 342] 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 343] 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 344] 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 345] 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 346] 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 347] 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 348] 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.

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 350] 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 351] 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 352] 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 353] 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 354] 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 355] Upon which a pain seized on his Groin, his Testicles tumefied, and the pain began to be remiss in his left Testicle, and the Tumour vanished, and returned to its former state; but about the right the Tu­mour continued, the which in process of time turned into a great fleshy Rupture; and he being called to the Patient amongst other Physicians in consultation, saw not onely Flesh about the Testicle concreted, but found it also extended with serous Humours, so that it equalled near the largeness of a Childs Head.

CHAP. LXII.
Of Circocele or Hernia Varicosa.

THis is nothing else than 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 357] 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 358] 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.

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 360] 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 361] 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 362] 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 363] 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 364] 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.

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 366] 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 367] 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 368] 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 369] about eight hours after it was perceived, it grew into a large Bulke in that time with much pain, the pain afterwards began to cease, but the Venome descen­ded to the Heart, and did horribly trou­ble and vex it; neither could she beleive herself to live an hour: being by his di­rections ordered to smell to Vinegar and Rose-water; after this she was bled on each Cephalick, first Breathing a Vein on the contrary Side, then on the di­stempered Side. Then was there applyed a large Ventose to the Part affected with a deep Scarrification, reiterating its ap­plication: And when there was drawn near half a pound of Blood by this Ven­tose, the Patient began to find her self somewhat better and to have some hopes, and found manifestly that the Ve­nome receded from her Heart by these Frictions, Odours, Cordial Powders, and Potions and the like; that by Divine Blessing and help of these Remedies she perfectly recovered. Hollerius saith live Oysters being applied to Pestilenti­al Buboes do attract all the Venome from them.

CHAP. LXV.
Of Phyma and Phygethlon.

IN cap. 1. lib. 2. ad Glauc. Phyma is said to be a Tumour in a Glan­dule, which encreaseth with some Vehemency, and hasteth to Suppurati­on; for [...] agrees with all sorts of Tumours arising out of the Earth: and these happen not only in the In­guens, but very oft in the Axillaries; for these Glandulous Bodies being very loose are the most apt to give Entertain­ment to all strange Appearances, Fluxi­ons and Tumours, particularly in the Groins, because of their depending Site, strong Motion, and humid Redundan­cy. After here having prescribed a conve­nient Dyet, and the general Method, which we have already shown you in a Bubo, we are to apply Digestives to the place affected, and then Suppuratives; and the Tumour being by these made ripe, we are to discharge the Matter ei­ther by Caustick or Instrument; and the rest of Cure perform, as you have alrea­dy directions in curing of a Bubo. What Phy­gethlon is. Phy­gethlon is an In [...]lammation and part of Erysipelas, or an inflamed Erysipelas; and [Page 371] 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.

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 373] 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 374] 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 375] 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 376] 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. n^o. 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. n^o. 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 377] 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.

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 379] 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 380] 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 381] 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 382] 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.

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 384] 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 385] 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 386] 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.

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 388] 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.

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 390] 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 391] 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 392] 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. n^o. 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.

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 394] 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 n^o. ij. cum albu­mine. [Page 395] 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.