WHich is a ſolution of unity from an inward cauſe eroding. The cauſes are either Antecedent or Conjunct. The firſt are foure.

Firſt, Cacochymia, when any of the humors ſavouring blood is peccant in quality.

Secondly, Contagion, this proceeds either from rotten vapours, as Phthyſis, or from lying with uncleane or itchy perſons, &c.

Thirdly, Diſtempers of the parts which are cauſed either by cold or heat.

Fourthly, all venemous ſtingings and bitings.

The Conjunct cauſe is when any humour is changed from its naturall temperature, whether by putrefaction, aduſtion, or commixtion of any thing unnaturall.

ITs like a Conyburrow cauſed by Apoſt: lying deep a long time, or if long before opened. They are of two ſorts, one without, the other with calloſity.

The Cure. Cure.

Firſt internall, purge cum pul. Arthr. vomit, uſe Diaphor. eſpecially drying, and purging drinkes, ℞ Sarſap. ℥vj. rad. Sarſaf ℥js. Guaic. ℥iij. Eupator. Scabioſ. Tuſſilag. Saniculae Hyper. ana Mj. rad. Symph. Torment. biſtort. ana ℥s. rad. borrag. bugloſ. ana ℥. paſſul. Mai. enucleatar. ℥iij. Liquor. ℥ij. infund. per Noct. in in aq. feruentis lib. xiiij. ſeq. die coq. Lent. igne cum reliquis ad conſ. ſs bibat ſingul. diehus lb iiij. vel lb s. mane tantundem hora. 4. pomeredia. in prand. bib. lb j. ac tantund. in caenam quando ſitit. ſupereſt lb j. hauriend. take it for 21. dayes.

Externalls, firſt, by injection, ℞ decoct. Hord. lib. j. Mel. roſ. ℥iij. Sarcocol. ℥ i s. Myr. Thur. ana ℥ij. rad. Torment. biſtort. Symphy. ana ℥ s. balauſt. ʒj. bacc. Mirt. ʒ ijs. Sumach. ʒjs. vini odorat. ℥vj. bul. ad conſumt. 3 part ac. col. cui ad ſpir. vini ℥j. if you perceive this is not ſufficiently mundified, which you may know if matter bee either ſtinking, reddiſh, pale, blackiſh, thin, or wateriſh, then apply this ℞ vini in quo infuſ. ſunt Marrhub. alb. Centau. minor abſinth. flor. hyperic. Card. Bened. lb s. unguent. Aegypt. ʒ ij Mel. roſ. ℥s. if matter flow not much, dreſſe every three dayes, when the matter is white, and doth not ſtinke, and the cavity be without paine, and remarkable Tumor, then agglutinate it S. A. in the manner of dreſſing, obſerve theſe three thus:

Firſt, lay upon the whole cavity, Empl roſ. vel Emp. Cont. rup.

Secondly, inſect the Medicament.

Thirdly, put in a leaden pipe ſhort, ſhut up the pipe with an Empl. Snipt. and above it a peece of ſponge, and upon that a pledget of tow, letting from the lower cavity to the orifice a boulſter be applyed, and above all a double linnen cloath, beginning your cowler at the bottome ſomewhat ſtrait and towards the orifice ſomewhat ſlacker.

Secondly, by opening when the matter cannot conveniently be diſcharged, and that is done two wayes:

Firſt, by Cauſticke, and that when the cavity is lower, then the orifice, either direct or oblique, but not very deepe, yet though deep, if in the breaſt, or the cavity be broad, you may either uſe cauſticks, or inciſion of it; to open either firſt the lower end, or the whole cavity, the firſt is beſt, if the ſinus be enorme, or in a great joynt, or there be great veſſels, tendons, or nerves in the way, upon which a great flux and lameneſſe, the whole cavity with a cauſticke.

Secondly, inciſion which is ſooner done, with leſſe pain, and eaſier cured, which done, arme, pledgets, and doſſets, with this ℞ alocs Hepat. ʒ ij. reſin. nigr. ſuccin. ana ʒjs. farinae volat ʒij. Calc. non extinct. ʒijs. alb. ovo q.s. f. ung. fill the place well, that the lips may bee kept aſunder, and dreſſe it not till the ſecond day at leaſt.

ITs ſituated in the greater corner of the eye, being preſſed, the matter flows the probe will paſſe to the very end of the ſinus.

Prognoſtick.Prognoſt.

Its of hard curation in regard of the motion and moiſture of the motion and moiſture of the place if the bone be foule, and lips livid.

Cure.

Let bleeding and purging bee repeated, Cups veſicatories, and Cauſticks be applyed,Cure. exhib. the decoct. of Chin. & ſarſap. for many dayes at the ſame time, dry the braine with fumes and powders as in the curation of Catarrh.

Externall.

Firſt, dilate it,Externall then remove the Callus with this, ℞ Turb. M ʒ ij Alum cal. ℥j. Miſce of the powder. ℞ ʒ ij. ung. popul. ℥ j. f. ung. and with it as in your Tents. To mundifie ℞ aq. rutae ℥ ij. Syr. a ſucc. rut. ℥ij. aut Mel. roſ. Miſce dreſſe once a day. To incarn ℞ ij. aq. plantag ℥ij. Syr. Mirtil. aut roſ. rub. ſicc. ℥ j. Miſce. Dreſſe with this but every other day, unleſſe quittor doe flow remarkably. If the bone be foule, either the actuall Cautery muſt be applyed, or this courſe to bee followed, firſt finde out the cavity, with a bended probe both upward and downeward, then draw a line with nicke between the glandule of the eye and the pupilla; then make inciſion to the bone, dividing the parts inciſed with you naile till you can put in a pretty pledget; after thruſt in a Troch made of Turbith. M. vitriol. vomit. & Ter. ſigillat. wrought with ung. popul. til it be a ſtiffe paſte, & afterward dried, upon which apply pledgets armed with popul. being kept on, cum diapal. cum ſuccis, malaxed with the oyle of Henbaine, afterward filling the orbit of the eye, with little bolſters moyſtened in ſperm. ranar. cum Camph. & ſo roul it up, dreſſe it thus twice a day till the Troch with the callus fall out of themſelves, then diligently vlew the bone, & ſo how much is carious, to which apply if the party be ſtrong, pul. Euphorb. or if weak, pul. Cephalic. the cavity fill up with prepared ſpunge upon it pledget of popul. &c. after the ſcale is fallen which is about the twenty day mundifie and cure, S. A.

If the whole ſubſtance of the bone be foule, peirce it with a gimlet, that the matter flowing inward, it may be healed up, and this is the laſt refuge: If you perceive it maligne, or tend to cancroſity which is knowne by the hard and livid brimmes, pain, ſtinking, and virulent matter, apply this ℞ Calamin. uſti & in vini acet. extincti ℈j. Myrrh. plumbi uſti & lot. ana ℈ s. Croci g. v. opij g. ij. aeris uſti ℈iiij. decoc. faenugr. vel axung. lot. in aq. roſ. Miſceantur exquiſite omnia ſuper lapidem pictorum; this is alſo excellent for all ulcers of the eyes whether maligne or no.

Prognoſtick.

HArd to cure:Prognoſt. If it hath corrupted the diaphrag. incureable.

Cure.

Firſt,Cure. convenient diet.

Secondly, pectorall decoct. (upon the uſe of which the cure chiefly dependeth) as that of Arceus, or the experimented ℞ ſarſap. ℥vj. Guaiac. ℥v. Chin. ℥iij. rad. enulae ℥i. Capill. Ven. ſcabioſ. fol. Tuſſil. Vener. ſcolopend. ſummit. Hyper. ana Mj. flor. borrag. bugloſ. viol. betonic. ana p. 1. polypod. ℥iij. liquer. ℥j. Paſſul. majore exacinat ficuum ping. inciſa. ana ℥ij. infundantur iſta per noctem in aq. fontan. feruentis lib. xxiiij. deinde lento igne coq. ad conſumpt. lib. viij. ac coletur decoctum bibat aeger ſing. diebus lib. iiij. i.e. ſs. at five a clocke in the morning, foure in the afternoone, at his meales two pints, and the reſt between. If the ending of the Fiſtula be lower then the externall orifice, a lower is to bee made by inciſion, beginning at the beginning of the next rib,Cure. and not at the lower end of that above the which, the orifice ſhewes it ſelfe, for under is a veyne, artery, and nerve couched.

Firſt, divide the skin, then make way through the intercoſtal muſcles, after dry all this with a ſpunge, and put into the inciſion a ſwelling ſpunge; if you paſſe no further then pleura, you need not feare, if you doe, beware of the diaphragma & pericardium. If with it there bee a Maraſmus or hecticke (uſe coole and moyſtning diet, and of eaſie concoction) and the orifice bee inconvenient, you may pronounce them incurable or very difficult. For a Maraſm: its an immoderate dryneſſe and conſumption of the body by reaſon of the defect of humidity ſubſtantiall, of which there is two degrees:

The firſt, is in fieri in conſuming.

The ſecond, is in facto eſſe, or conſummate.

In the firſt, the muſcles begin to fall, the skinne becommeth flaggy, ſtrength and ability decay, and a manifeſt defect and impotency in the body in all the faculties. Againſt this degree, contend with a moyſt dyet.

FOr the firſt, if the vertebr: be foule they are incurable, which onely dreſſe cum aq: plantag: regin. pratenſ: ſyr: roſ: ſicc: & ſpir: vini being tinctured with aloes, myrrh maſtic, & Crocus, you may judge the vertil foule if extraordinary ſtore of ſtinking ſores flow out, the party dayly grow weaker, and more extenuate, notwithſtanding all means.

FOr the ſecond, of the Belly, they are of two ſorts:

Firſt, thoſe in the groyne.

Secondly, thoſe in the Ano:

The firſt falls out moſt often after venerall bubos or in Plethoricke and Cacochym bodies, yet ſometimes they are above the groine: If in theſe the guts bee eroded, they are incurable, therefore uſe an inject ex rub: vino in quo par. alum. diſſol: cum ſyr: Mirtin: lot the party obſerve to eat calves and ſheeps feet ſtewed, ſheep and calves heads, Rice boyled in milke, wherein ſteel hath beene often quenched, every morning and evening take a draught of Aligant warmed with a white toſte, keep the orifice open with a ſpunge untill the gut bee conſolidated, then proceed as in Fiſtula's in generall, if they runne onely ſuperficially, the beſt cure is by inciſion.

FOr that in Ano, it either peirceth into inteſtinum rectum, or not, if it doe, the excrement and wind will breake forth with the matter, the injection and probe will paſſe into the gut that you may feele the latter; it is hard of cure, being the jakes of the body.

Cure, is either by inciſion, injection or deligation; the two former have beene ſufficiently handled, which are to bee uſed when it peirceth not inteſtinum rectum, to conſolidate uſe the Syr. Magiſtr: & pul. Cephalic. if you cannot conveniently uſe the firſt, uſe the Troch: or the ſpunge; for the laſt deligation, firſt dilate, then remove the callus, after bind it with ſealed thred, or ſilke twiſted, put one end of the thred in the eye of the probe, after thruſt it in at the ſinuoſity into inteſtin. rectum, where have your finger ready to receive the thred, and draw it out at ano if it be not thicke and long, you may binde it at twice, otherwiſe you muſt uſe ſundry, after its done, cure S.A.

IF they be not with corruption of Cartilages or bones, curable, if accompanied with hard tumors, its incurable.

Cure, Firſt,Cure. dilate cum ſpunge proper.

Secondly, remove the callus cum pul. Turb. Min. Ter. lem. ſigillat. bol • orient. vitriol. vom. an. part. aeq. Miſce cum ung. popul. for eaſing paine, ℞ ol. Lumbric. Cham. Aneth. ana ℥ij. furfur. flor. Cham. farin. Hord. aeſypi and ℥ijs. vini aligant. • x. f. Catap. renew it twice a day, after Callus is removed, cure. S.A. If they bee incurable, move the patient to ſuffer diſmembring, before they grow weake, whether foot or arme; but in aged and craſie perſons beware.

NOw of Maligne Vlcers, which are not eaſily cured, they have fierce cauſes, extraordinary ſymptomes, and yeeld not to ordinary medicaments, theſe happen when Cachexia hath poſſeſſed the ulcerated part, and doe corrupt the aliment ſent for nouriſhment thereof, this is done either by putrefaction, or a venemous quality communicated.

Sign, Signe. Of Maligne Vlcers, great paine, plenty of virulent and ſtinking matter. The firſt is, Herpes exedens.

ITs livid and uneaven, the middle heales, and lips remaine ſore, they appeare moſt often in old people in the leg at the beginning of the tayles of the Muſcles, being very painfull and rebellious, the lividity is cauſed by melancholy joyned, when its abſent, the part is yellowiſh.

Prog. Not eaſily cured, the liver, Gall & porus bilaris, being out of frame, and ſo they not able to evacuate the humor by the guts and urin, and therefore they paſſe to the habit of the body by the veynes and arteries. If Atra bilis be added its more hard to cure.

Cure. Firſt,Cure. ſtay the humor by purging, pul. Noſt. ſol. or ℞ rhab. ℥j. fol. ſen. ʒiij. zz ʒ s. ſpic. ℈s. infundantur iſta per hor. 2. in aq. Font. fervent. ℥vj. deinde. lento igne exhalent. ℥iij. ac coletur decoctum in quo diſſol. Mannae & ſyr. Cichor. cum rheo ana ℥j. Miſce ut f. potio, if the body bee Plethorae or cacochy. uſe a purging decoction for ſundry dayes, as ℞ rad. Cichor. nalu. borrag. ana ℥js. polyp. q ℥ij. flor. borrage. bugloſ. viol. ana p. 1. fol. ſen. & Hermod. ana ℥ij. ſem. aniſ. & faenic. d. ana ʒvj. rhei. ℥vj. liquir. ℥js. infundantur infundenda per noctem in aq. Font. fervent. lb viij. ſequent. die adjectis reliquis coq. ad medias, ac coletur decoctum quod aromatieztur cinam. ʒvj. ſumat. aeger mane lbs. ac tantundem hor. 4. pomeridiana, betwixt ten and eleven a clocke, let them take ſome broth, caudle, or alebury, exhibit the medicament in Summer cold, and in Winter hot.

Second Intention is to evacuate the humor imparted, this is done by ſuch medicaments as abate ſpungeous fleſh, as the Troch Muſ. Andronis, &c. but the beſt is Turbith M. as ℞ Turb. Mj. ʒij. alum. Calc. ʒj. Miſ. theſe are to be mixed with Paracel. Mundif. to every ℥ of it adding a ʒ of pul. uſe theſe till the ulcer be red, leave ſpreading, and bee very cleane: where note, it mercu. proper lot. in aq. roſ. & miſ. cum ung. ſarcot. doth admirably heale rheumetick ulcers in tender perſons.

Third Intention, wherein firſt fill up the cavity, then cicatrize it, for which uſe ung. Enul. cum merc. to an ℥ of which, adde flos ſulph. ℥. vel ſpir. vitriol. as for the reſt proceed S.A.

IS a Tumor unequally painfull, hard, livid, and hot, having full veynes in the adjacent parts. In the beginning, being hard to diſcerne, being no bigger then a Pea, proceeding from Bil. Atra, begotten of yellow choler cauſed from a hot diſtemper of the liver, weakneſſe of the ſpleen, ſtopping of the Hemorod or menſtr. or from ill dyet, as by hot things; ſhewing themſelves moſt commonly at the end of Sumer, and in the harveſt quarter.

Prog. None are of eaſie curation.Prognoſt. If they poſſeſſe any great cavity, as Matrix and Anus, deale not with them by exciſion, cauſticke or burning. If they bee great, and the party weak, incurable: If in the outward parts and ſuperficiall, and be not of remarkable bigneſſe, they may by inciſion be cured.

Cure. Cure. Dyet cold and moyſt, ſhunne all melancholy meats, as alſo watching, immoderate grief and labour, as alſo all other things which thicken the blood, and inflame the humors. Bleed in the full of the moon, for it miraculouſly ſtayeth the ebullition of blood, aſſwageth pain, and hindereth encreaſe of the Tumor. If it be in the lip, open Cephalic, if in the breaſt the Baſilic of the right arme; if in the right breaſt. If in the Matrix or Anus, open ven. Poplit. or Saphaena. Purge ℞ pul. Sanct. ʒ • s. ſyr. roſ. dam. ℥j. ſeri. Lact. q.s. f. pot. at the firſt exhibit them twice a weeke, and afterward a day before, or after every quart, and full of the Moon. The fitteſt applications outward, are thoſe that repell and digeſt, as ung. de Ranis viridibus, Catap. made of ſucc. ſolani, farin. ſiligi. & ung. popul. vel coclear. & Hederan vel far. lupi, aq. ſper. ranar. & fol. Herb. Ropert. Take a good number of green frogges, whoſe mouths fill with freſh butter, afterward put them into an earthen pot well glazed, having the bottome full of holes and a cover, place this in the mouth of another ſet in the earth, lute theſe well together, and the cover of the upper pot; then for the ſpace of three houres, let a gentle fire of charcole bee ſet about the upper pot; when the pots are cold, take out the frogs of the upper pot, and beat them into fine powder, then mingle the moyſter in the lower pot with the powder, and f. unguent. a plate of lead rubbed with merc. viv. excellent.

THe firſt is of foure ſorts, red, yellow, livid or blacke, red proceeds from heat, or by blood offending either in quantity or quality. The firſt is knowne if the body bee plethoricke. The ſecond, if it be too hot and fervid.

For the firſt, bleed, ſcarifie the part, and apply leeches, if it happen through defect of Hemorod or menſtr. procure their fluxion: The firſt by applying the leeches: The ſecond by uſing Elix. propriat. or pil peſtilent Arab. being taken ſundry mornings. For the ſecond, open Saphaen. in foot is moſt apparent, exhib. calyb. medicament: for quality uſe cold and moyſt dyet, apply acet. roſ. vel ſambuc. & acetum.

Secondly, livid comming by corrupt and blacke blood ſetled in the part; for this you are to ſcarifie, apply leeches, after foment. cum oxymet. diſſol. in aq. Card. bened. If it proceed from cold which is perceived by the temper of the part apply this, ℞ a Turnip and a radiſh root, ſcrape theſe two, and adde to them of the powder of muſtard-ſeed, ℥j. Caryoph. pul. ʒiij. ol. lini & jugland. q.s.f. Catap. which apply warme, this hath cured divers Gangreens.

Thirdly, blacke, which may either proceed from heat or cold, if from heat an inflammation went before. If from cold lividity did proceed, which is a ſigne of mortification, eſpecially if no heat or feeling doe remaine.

WHich is the tumefication of the veynes, by reaſon of ſuperfluous groſſe blood, it happens oftneſt to thoſe that have bad ſpleens to men rather then women, its cauſed by thick and impure aire, immoderate exerciſe, long ſtanding, thicke wine, and groſſe food.

Prognoſt. Prognoſt. If they appeare in thoſe that are mad by reaſon of melancholy, the griefe ceaſeth, they mitigate bunchings of the body, thoſe that proceed from the ſpleen, are not to be cured.

Cure Phyſicall,Cure. uſe convenient diet, purge often groſſe humors, as ℞ Elect. lenti. ℥vj. pul. ſanct. ʒ. ſyr. Cichor. cum rheo. ℥j. M. cum aq. ejuſdem q.s. ut f.p. Chirurg. The beſt is to take up the veyne above and below, and upon it betwixt the deligation, that the blood may be diſcharged out of it.

WHich is knowne by a ſtrange itching and paine in the part and ſtinke: uſe decoct. of dry Tobacco, excellent, or ℞ abſinth. Centaur. M. Marrub. ana Mj. Coq. in aq. Fontan. in lb. v. cola. diſſol. aloes ℥s. ung. Aegyp. ʒiij. Miſce.

WHich are of two ſorts, moiſt and dry: the firſt are two, Acher & Favus, the former is an ulcerous Tumor of the head in the skinne, red and duglike, having ſmall holes, out of which iſſueth a thin and ulcerous ſanies; the latter is the like, onely the holes are larger, and the humor in thickneſſe like hony. Note they are contagious, and are cauſed of ſharpe and fretting humors, in both there is an itching, and the Favus hath ſcales, they are of hard curation.

OF the firſt of theſe, the cauſes, are either outward, as blowes or falls; or internall, as ſharpe humors ſent from the braine, its ſometimes with excreſcence of fleſh.

Cure. Firſt, purge, as ℞ Pil. aggreg. Aur. ana ℈j. Troch. Alhand. diagrid. ana ℈s. ſpir. vit. q.s. & for. pil. foure doſ. two at five in the morning, foure houres after take broth.

Cure externall,Cure. Troch Andronij diſſol. in aceto ſambuc. vel Croc. Mart. Coq. in vino aceto ad conſiſtent. Lt. vel ſyr. ſanatiu. In winter uſe Nicot. ſucc. coq. in ale, this is excellent, if it be foule, and worming, if they afford great ſtore of quittor, dreſſe them once a day, if not, once in two dayes, if there be excreſcence of fleſh; firſt adminiſter the Pills, and then conſume the fleſh with the Fiſtule powder, after inject this, ℞ vini alb. ℥ij. Aegyp ʒj. Mel. roſ. ℥ s. Miſce ſyr. after dreſſing on the ſound part a good while.

WHich have the ſame cauſes as before. In curing uſe good diet, bleeding, purging, applying of the Seton or Fontin. the ulcers are either milde or maligne, and becauſe opthal. are the forerunners of the ulcers of the conjunctiva of it, we will firſt treat.

ITs a Tumor with paine, and horrible heat; of which there is three ſorts.

1. Conturbatio, ariſing from outward cauſes or inward, and is not much.

2. Is reall, and is alwayes from an inward cauſe.

3. Is called Chymoſis, when the inflammation is ſo great that it cauſeth the turning up of the eye-lids, which often falleth out to thoſe that are very plethorick, and have abundance of Pituitous humors. If it bee from the ſtomach, the deſire to vomit, if from the head, there is a paine, if from the veſſels without the Cranium they will bee full in the forehead, the Arteries beat, and the eye-lids be heavy; if within, the party often neezeth, and the noſe itcheth, if of blood, the face will be red, the veynes full, if from flatuoſities, there will bee ſinging in the eares, and tenſive paine, if from flegme, the eyelids will in the night time cleave together.

Cure. Cure. Uſe cold and moyſt diet, after a Glyſter, let blood plentifully, if it bee grievous: yea ſometimes open Jugular (according to the length) if it bee neceſſary, the opening of this is excellent in the megrim, inflammation, of the Pia & d. Mater & Polypus. Purge by repetition; if the diſeaſe be in princip. with pot. as ℞ Tamarind. ℥s. ſen. mund. ℥iij. ſem. aniſ. ℥s. fol. end. chichor. fumar. ana Ms. coq. in aq. ad ℥iiij. in Colat. infunde rhei elect & Myrobal. Citrin. ol Amyg. dul. cenfricatarum ana ℥j. Santal. Citrin. ℈s. in expreſſ. diſſol. Man. & ſyr. roſ. ℥j. Miſce f. Pot. if in the ſtate, uſe pils, theſe excellent, ℞ Pil. luc. major ℈ij. Aur. ℈j. Troch alth. g iiij. ol. faenic. gut. 6. cum ſyr. de ſtaech. ad f. pil. 5. if there be ſuppreſſe of cuſtomary evacuation, procure them, apply Cups veſicator. excellent defenſitives to the forehead, Catap. to eaſe paine, as panis Cocti ℥j. Mic. pan. alb. ℥s. ovum N. 1. cum lac. mulieb. in the eye uſe this Col. ℞ aq. roſ. vini alb. ana ℥ij. ſacc. Cand. alb. ʒj. extinc. three times in the liquor, after powder it, and put it in, or ℞ vitriol. vomit. ℥j. diſſol. in aq. roſ. vel plantag. ℥iij. ad ignem deind. Colat. this ſeton. or Font. are excellent, alſo veſicat in ſinccipite opening of the ſalvitella is good.

ANd firſt of the lips, as alſo chops for theſe, uſe Pomat. or the ſweat behinde ones eares, or ℞ Cerae Flau. ℥ij. ol. roſ. mel. & axung. porcin. in aq. roſ. lot. ana ʒiij. litharg. arg. Myrrh. zz. pul. ana ℥j. f. Lt. this is good in Fiſſur in any part of the body, for the ulcers whether they be milde or maligne, ung. rub. Camphor. is excellent, as alſo in other parts.

THe mild may be cured with this ℞ Hord. mund. ℥iij. rad. alth. ℥ ij. liquor. ℥js. bul. iſta in lib. vj. aq. font. ad medias & Colat. cui adde ſyr. viol. Tuſſilag. & ſcab. ana ℥ js. If maligne, uſe merc. d. ſpir. ſulph. in children, mixe it cum mel. roſ. if they be above foure yeare old, a. g. of laud. is excellent.

GArgar. cum decoct. morſus diabo. vel fol. ſcab. & Agrimon. ana Mj. nuc. cupreſſ. ʒj. rad. ireos flor. & Ariſtol. rotund ana ℥s. myrrh. ʒs. roſ. rub. p. ij. Coq. in Hydromel ad lib. j. colatura colluatur os frequ. after apply this, ℞ Centau. minor. rad. irid. ſter. Can. ana ʒj. cum mel. deſpu. f. Elect. if they be hard they are never cured.

℞ AQ. Plantag. lib. i. roſ. rub. flor. Aurant. ana ℥i. mere. ſub. ʒii. digerantur in arena per hor. quadrantem, ac coletur aq. qua in vaſe vitreo ſervetur, if by reaſon of theſe Ulcers, the party cannot ſwallow any ſolid meat; miniſter to the patient merc. d. for foure mornings together in new milke, and you ſhall finde a wonderfull effect.

THeſe commonly fall out after ſharpe diſeaſes, which continue till the fortieth day, or Chronicall diſeaſes, whoſe time is uncertaine, being from tranſlation of the matter.

Prognoſt. Prognoſt. If the Tumor be long before broke or opened, hard to cure. If the vertebra bee foule, or the body decayed, deſperate; thoſe in the upper parts are more eaſily cured then thoſe in the loynes.

Cure. Cure. Internall: Firſt, purge ℞ aq. Cichor ℥iij. ſyr. roſ. cum agar. ℥i. elect. e ſucc. roſar. lenit. ana ʒiij. Miſce f. p. If ready to open, apply lap. infernalis, or any other; after mundifie, cum vino alb. lb j. Mel. roſ. ℥iij ung. Aegyp. ℥j. Miſce, and in ject to Conſol. ℞ aq. plantag. ℥iiij. ſyr. My. tin. & e ſucc. roſ. ana ℥s. Troch. alb. roſ. ſine opio ʒij. Miſ. & injic. upon theſe, uſe diachy cum gum.

As for ulcers of the joynts, purge often, ℞ Elec. eſucc. roſ. Caryocoſt. ana ʒiij. ſyr. roſ. ſol. cum agar. ℥j. aq. Cichor. ℥iiij. apply to the ulcers Deſiccat. rub. anoynt the brims with this, ℞ ung. popul. alb. Camphor. ana ℥j. ol. Gydon. & pap. ana ℥s. f. Linem. before you apply the medicaments, uſe a foment of ſumach. Cortio. granat. roſ. rub. & bac. myrtil. infuſ. in vini rub. ſtet. intuſ. in aq. Tepid.

Of Thighes and Legs.

Uſe purging, diet drink, vomit, ſweat, apply aq. Camphor. vel ung. diapomph. cum alum. Cal. vel aq. Calc. viv. ſiccat.

WE are now arrived at the laſt branch of ſolution in the hard part,Defin. in which wee ſhall follow this method; Firſt, what it is, viz. Its the going out of the bone from its proper cavity, and ſo hindering voluntary motion.

Secondly,Cauſes. the Cauſes which are either 1. Internall, as excrementitious humors and flatulencies, which I have ſeen in divers. Secondly, externall falls, ſtroaks, ſlippings, &c. to theſe addes Pareus a third, which is hereditary, and not improbable.

Thirdly,Difer. the differences are Firſt compleat, when altogether forth. Secondly, when not altogether. Thirdly, when only diſtorted. The firſt of theſe are fourefold, forward, backward, outward, inward; theſe againe are either ſimple or compound.

Fourthly,Signes. the Signes are a Tumor in the part whither its fain, and hollowneſſe in the place from whence its come, alſo pain and privation of motion.

Fifthly Prognoſticks, in children,Prognoſt. and thoſe that are young, and ſimple, eaſie, but hard if compound, painfull, inflamed, if long forth, and the part be extenuated.

Sixtly the Cure, Cure. in generall; obſerve firſt, extenſion is to bee made till there be free ſpace betwixt the diſlocated bones, yet in ſome caſes this is not needful, as you ſhall ſee in the ſhoulder.

Secondly, force it into its proper ſeat, which is knowne by a popping noiſe, eaſe of paine, and likeneſſe of parts, theſe are all neceſſary in ſome joynts.

Thirdly, apply fit medicines (yet note ſimple luxations need no applications or ligations, but are happily cured without, as by experience I have found, beſides the conſtant practice of Mr. Hailes in Northamptonſhire, who in his time was moſt eminent and ſucceſſefull in his practice, with whom I had much familiarity, by reaſon of a Cancer he had in his tongue, and chin.) If any be neceſſary, ſuch as are in Fractures may be applyed.

Fourthly, uſe ligations.

And fifthly, keep it in a ſitting poſture; but theſe need not unleſſe the luxation be compounded.

Laſtly, remove ſymptomes, as paine and inflammation, onely obſerving that if theſe happen together before ſetting, let it alone till they be removed, as in the Treatiſe of Fractures. If it be old, then diſcuſſive fomentations muſt be frequently uſed, and after this Catap. (having made gentle motion up and downe, too and againe) ℞ rad. Althaeae ℥vj Cucum. aſin. ℥iij. fol. malu. Althaeae ana Mij. Cost. in aq. & Contuſ. add. farm. faenigraes. & ſem. lini ana ℥js. l. Cham. ℥vj. lilior. ℥ij. Miſce, f. Carapl. and ſo with fit boulſters and ligatures, let it be bound up conveniently. Yet after all this, when its performed, you will finde the motion of the part little or none, as I have obſerved.

Thus having done with generalls, which muſt bee both in Fractures and diſlocations, as far as is neceſſary carryed to the particulars, we come to them: and firſt of luxation in the Jaw-bone.

THis is either on one ſide or both, which if not ſpeedily ſet, may procure death. If onely on one ſide the chin is drawne aſide. If both, it hangs forward towards the breaſt. To ſet them, put your thumbs lapped in linnen into the mouth, and with them preſſe hard downe the great teeth, and lift up the jaw with your finger underneath. Thus I reſtored an old woman, which came by yawning. Others put wedges of haſſill or firre a finger thicke, caſting a band about the chin, ſtand behinde the patient, and draw the chin towards them, and at the ſame time preſſe downe the wedges. After this, apply medicaments, if neceſſary, as alſo ligatures; for dyet uſe liquid things.

ITs hard to be knowne, and as hard to be cured, as alſo eaſie to be miſtaken; they may be diſlocated, inward, outward, and ſide waies. The reſtoring of them, is either by moving and extending the arme, or as is ſet downe in the Fractures of the ſame.

WHich being, diſlocated, cauſeth ſuch an impotency in the leg, that he cannot bring his heele to his buttockes, nor bend his knee, unleſſe with great force. The cure is performed as in a Fracture in the ſame part.

IT cauſeth if inward, difficulty of breathing, paine in bowing downe, or lifting up the body. To deliver from which the diſlocation is ſpeedily to be reſtored, and if the rib fall on the upper part of the Vertebra, the patient muſt hang with his armes upon ſome high doore, and then the rib is to be depreſſed downe into its cavity; if it fall downe on the lower part of the Vertebra, the patient is to bend downward, ſetting his hand upon his knees, and then preſſe it in. If it be inward, its ſuppoſed incurable in theſe, as alſo in the Vertebra's is to be uſed beſides Empl. fomentations; as ℞ ſalu. Althaeae ſtor. Cham. Melilot. & Hyperic. ana Mj. Coq. pro fom. after this anoint the part cum l. Lumbric. irin. lilior. ana ℥ij. dialthaeae ℥. ung. Agrip. ℥s. Miſce.

FOr the reſtoring of which divers wayes are uſed, that which moſt commonly was practiſed by Mr. Hailes (whether diſlocated inward, outward, or ſide-waies) was this, he tooke the patients hand, & laid it in his neck, after with the right hand preſſed his arme cloſe to the ribs, and after ſuddenly thruſt the elbow upward. This I have uſed, and as he, ſo I never failed. Some others, if inward, doe it upon a doore, ladder or couleſtaffe, upon two mens ſhoulders, in theſe the patient is to be held by the arme, the head of the bone rightly placed on the inſtrument, and hee ſtanding upon a ſtoole is to bee caſt.

Of the Elbow.

This is hard to be reduced, unleſſe ſpeedily effected, whether it be backward, or forward, or ſidewayes, its to be ſet by ſetting the part into which the bone is falne upon your arme, and ſo endeavour to bend the arme; by which its reduced, as alſo the wriſt; this was the practice alſo of Mr. Hailes, but for the wriſt ſome take by the hand near the joynt, the arm being held and ſo move the hand upwards and downewards, or ſidewaies till it be reſtored, this I have practiſed.

IT may be diſlocated upward, downward, or ſide-wayes, its to be reſtored to its place by the hand,Cure. the patient firmly ſtanding, and ſo after medicines applyed, let it, with fitting boulſters, filling the ham, and ligatures, be bound up, and a caſe made to ſtrengthen it, and ſo command reſt as long as is convenient. Which being done, let the knee by little and little be bowed till it come to its proper motion, to it apply Emp. Paracel.

THey may be diſlocated inward, outward, and backward, ſeldome or never forward, you may know them by the debility of the joynt, and he cannot bring his heele to touch his buttocke; for the two firſt, after due extenſion inforce them into their places; for the third, take the patients leg between yours, he fitting upon a low ſtool, and ſo bring his leg forceably toward his buttocke; if the laſt happen, lay him upon a table with his face upward, and force in the bone.

For the diſlocation of the fociles, heele, and ankles; what hath been ſaid may ſerve, onely ſymptomes are to be ſpecially eyed, the bones of the hand, ſingers, feet, and toes are to bee reduced, as is ſet downe in Fractures.

Thus having done with luxations; wee come to ſome rare ſymptomes which happen after both Fractures and Diſlocations; as firſt, Atrophia or waſting of the part.

ITs occaſioned either by idleneſſe of the part, too hard ligature, or as Hildanus; by Tumor poſſeſſing a joynt. If by too hard ligature, looſe it. For the firſt, uſe Frications for halfe an houre, and then anoint it, cum ol. Amygd. d. ℥ij. Cham. ℥j. Miſce. This doe morning and night; this you may uſe for fifteen dayes; after for as long, ℞ ol. Catellor. lumb. ana ℥ij. ol. Amygd. ℥iij. Miſce. After for fifteen dayes more, ℞ ol. viol. olivar. ana ℥js. pic. Naval. ℥ij. ol. Amygd. d. ℥j. f. Lt. before the anointing uſe this, foment. ℞ rad. bryon. lilior. Althaeae. ana ℥iij. Coq. in juſcul. Capitis, pedum & inteſtinorum vituli aut vervecis. Let this bee applyed two houres, night and morning; if you ſuſpect the originall of the nerves to bee obſtructed, then uſe ſtrong reſolvers, as may be ſeen in palſie upon a wound; as for the laſt, Hild. uſed firſt purging by phlegmagogues, after uſing the like decoct. and oyntments, as before. Note if by theſe meanes the part grow red, there is hope. Some apply dropax. I cured one by frications, bleeding on the ſame arme, and unguent. dialth.

FIrſt, anoint the whole backe; and this, ℞ aq. granor. juniperi, ſine vino diſtil. aq. ſalv. betonic. lavendul. ana ℥ij. pul. rad. biſtort. Tormentil. roſar. ana ℥ij. miſce f. q; infuſio. in ampulla magna per dies 8. vel 9. deinde per inclinationem a pulveribus ſeperata aq. ad uſum reſervetur. After anointing apply the following plaiſter, which is alſo excellent in Fractures; ℞ Empl. ſlotani. ℥v. Cer. flau. ℥ij lap. oſteocoll. ℥ • . pul. rad. conſolid. major. Ter. ſig. ana ʒiij. pul. balauſtior. nuc. Cupreſſ. roſar. • dorifer. ana ʒj. Miſce lentiſſimo igne f. q; Emp. cum ol. roſ. aut maſtic. q. ſ. Emp. ſlotano. ℞ axung. porc. rec. ℥xij. ol. roſ. rec Minij. ana ℥xx. Calchitidis uſtae ana ℥ij. adip. cervi. ℥iiij. Maſtic. • liban. ana ℥ij. f. Emp. S. A. agitando bacillis ſalicis & ſucculentis. If there bee bunchings forth in other parts, by no meanes as the cuſtome of ſome is, breake the member againe, but rather aſſay to waſte what is ſuperfluous by frictions, and reſolving, foment. ung. and Emp. obſerving that the plaiſter upon Gibboſities in the loynes need not be removed in three or ſix dayes, though the backe and thigh may be anointed. Hildanus.

Thus having done with ſolution in hard parts, we ſhall put an end to the firſt part of Chyrurgery by handling Combuſtions, Ecchymoſis, and Gangreens, the ſecond frequently following Contuſions, and the laſt may happen upon all ſolutions.

ITs an effuſion of blood under the skin, and cauſeth blacknes, it being cauſed moſt frequently by contuſions, ſometimes by the mouths of the veſſells being opened; the blood ſometimes poures it ſelfe inward.

For Prognoſticks, if the blood be thin, and can be diſcuſſed,Prognoſt. its well, otherwayes it may gangreen.

If it be great and much paine,Cure. let blood (eſpecially if you feare it fall inward,) and purge as ℞ pul. lax. ℈ij. ſyr. roſ. com. cum rhab. ſen. & agar. ℥j. cum ſ.q. decocti agrimon. Cuſcut. veronicae, & ſem. aniſ. f. p. after give this; ℞ rhei, Terr. ſig. bol. opt. mum. ana ʒ • . f. pul. doſ. ʒj. in acet. vel oxycr at. Iriſh ſlate, or ſperm. ceti. is good. This is excellent, ℞ conſer. flor. geniſt. ʒs. Mum. ℈ij. rhapontic. g. 25. ſem. Naſturtii. hortenſ. ℈j. Miſ. cum oxyerat. f. bol. take it at the houre of ſleep, & drink this upon it; ℞ aq barbar. & nuc. viridis ana ℥ s. ſyr. acetoſ. Citrij. ʒx. ol. vitriol. q.ſ. ad gratam aciditatem, Miſce f. julep. after uſe a clyſter. Outwardly anoint the part cum ol. roſ. and after it for foure or five dayes. If in the beginning, twice a day apply this; ℞ far. Hord. & Fabar. ana ℥ij. pul, roſ. ℥j. Coq. vino rub. parumque aceti ad. Catapl. add. ol. roſ. parum & vitel. ovi cum alb. then if the blackneſſe bee not gone, uſe this; ℞ rad. Althaeae ℥j. abſinth. roſar. origani, agrimoni. flor. Cham. Melilot. Sambuc. ana Mj. ſem. aniſi. Cumin. faenugraec. ana ℥j. incidant. & contund. indanturque ſacculo, quem intertextum & vino rub. cum aq. incoctum apply it hot to the part three or foure times a day, after anoint with this, ℞ ol. Cham. aneth. lumbric. ana ℥ • . aniſi. ſubtiliſſ. pul. ʒij. f. Lt. thus Hildanus. Rad. ſigil. Solom. if new, bruiſed, and applyed, if old, boyled in wine, is accounted the moſt efficacious remedy. I with good ſucceſſe applyed Empl. Paracel. vel crocatum. If theſe doe not, uſe cups, and ſcarifie, which is excellent; if it tend to a gangreen, cure as followeth. Obſerve in all contuſions of the joynts, Catap. are better then oyntments.

ITs a beginning or partiall mortification of the ſoft part, the cauſes as you have heard may be all ſorts of ſolution, eſpecially after wounds made by gunſhot, and great contuſions, &c. But beſides there are internall cauſes, as from exceſſe, or malignity of humors, as alſo cold, &c.

Signes. Signes. If from inflammation, there is paine and pulſation, with a ſudden changing of fiery red, into livid and blacke, which being preſſed returnes not. If from cold, a ſharpe, pricking, burning paine, and ſhining redneſſe, ſeiſeth ſuddenly upon the part, after it turnes livid, there is alſo a coldneſſe and numneſſe, and as if ſhooke with a quartane Ague. If from hard binding; its knowne by the hardneſſe of the part, little pimples and bliſters riſe upon the skin. If from bits and punctures. Signes are as inflammation, and obſerve there may bee motion, though there be a gangreen, nay a mortification, if the heads of the muſcles be not affected.

Prognoſticks. Prognoſt. If the malignity bee not ſpeedily withſtood the part will periſh, and will alſo infect the ad • acent parts, and the rather, if the humor firſt take hold on the bones, and inflammation proceeds from them, they are incurable frequently: but if the muſcles and nerves bee not hurt the perſon young, and of good conſtitution being well handled in the beginning it may be cured. If from an afflux of venemous humors or of occult quality or abundance, as alſo in bodies affected with a dropſie, hardly cured.

Cure Internall. Firſt,Cure. preſcribe a convenient dyet, cold and dry.

Secondly, if plethoricke, let blood, and purge.

Thirdly, uſe cordialls to ſtrengthen internall parts againſt putrid vapours, as ℞ lap. Bezoar. oſſ is de Cord. Cervi ana ℈j. Margar. prep. ℈ij. C.C. uſti, Terr. ſig. ana ʒ • . ſacc. Cand ℥s. Miſce f. pul. doſ. ʒj. cum aq. Cordiali, or this; ℞ Confect. Alker. ℈ij. in aq. vel decoct. Cinam. ℥j. aq. Calend. bugloſ. ana ℥s. ſyr. Caryoph. ʒvj. you may of theſe make Epithemes for heart and wriſts, adding ſome vinegar; if paine torment the head, uſe clyſters and ſuppoſitories, and anoint with this, ℞ ol. roſ. Nenuph. ana ℥s. Camphor. opij diſſol. in aq. betonic. diſſol. ana g.vj. Miſce f. lin. with it anoint the temples and forehead. Cordiall juleps every two or three houres, are to be exhibited, and diaphoreticks ſometimes to be uſed.

Externall. Firſt, defend the ſound parts, and ſtay the flux, ℞ bol. Arm. terr. ſig. ana ℥s. miſc. cum ac • to ſcord. apply this. Or this, ℞ far. Hord. ℥iiij. bol. opt. alb. ℥ij pul. gallar. nuc. cupreſſ. Cortic. granat. ana ʒjs caphur. ʒ j. cum oxymel. f. Catap. apply them higher then the part affected, and remove them often, and apply freſh.

Secondly, revell or derive the humors from the part affected by cups, leeches, as well as purge and bleed.

Thirdly, bring the part to its naturall temper by evacuating the blood, and other humors in it incompacted. If little by ſcarification; if much by inciſion, taking care of the great veſſells: to the ſcarifications apply ſmall cups, but rather leeches; after apply with ſtuphs, if the affect be ſuperficiall, vinegar and ſalt; if great and deep, uſe this hot, ℞ lixiu. fortiſ. aceti. opt. ana lb iij. ſcord. abſinth. lupinor. contuſ. ana Ms. rad. Ariſtol. rotund. vincitox. ana ℥s. ſal. marin. ℥iiij. Coq. ad conſumpt. 3. part. in Colatur. diſſol. Aloes. myrrh. pul. ana ℥s. rurſum ſemel at que iterum ebulliant. tandem ad. Mel. roſ. ℥j. ſpir. vini ℥iij. Caphur. ʒj. miſc. f. fot. or Woodall; which is this; ℞ lixiu. de cineribus lig. frax. gal. 4. Herb. Centaur. ſcord. Card. bened. abſinth. roſmar. Hyperic. ana p. iij. flor. Cham. melilot. ana p. 1. f. decoct. ad 3. part. Conſumpt. col. ad ſal. Mij. vitriol. virid. lb s. ſpir. vini lb ij. Miſce S. A. If you pleaſe, you may adde Myrrh, Al • es, and Caph. and leave out the vitriol. After the uſe of theſe for halfe an houre, apply into the inciſions ung. Aegyptiac. with pledgets of tow, adding thereto ſpir. vini & oxymel. S. or Aegyptiacum alone, of which receive two deſcriptions, ℞ aerugi. ℥v. mel. opt. ℥xiiij. aceti vini ℥vij. Coq. omnia ſimul donec f. ung. ſpiſſum & color is purpurei. vel ℞ Aerugin. ℥iiij. mel. opt. & cum decoc • . abſin •• & ſcord. deſpumat. lb j. aceti ſcillit. ℥vj. Alum. ſal. Amonia • . ana ℥ • . ſucc. ru • ae, ſcord. utriuſque & alliariae ana ℥iij. Coq. ad ſpiſſi • udi Mel. deinde add. Theria • . op • . mit • rid. ana ℥s. cap • urae ℥ • . miſce. It reſiſts putrefaction; diminiſheth, & tempereth the maligne vapours ariſing from the gangreen, ſeparateth the dead fleſh from the living, and produceth a gentle and laudable eſcar; if the affect be in ſcr • tum, this is excellent, as alſo in other parts; ℞ vitrioli ℥ • . ſummit. querc. Mj. Thur. ℥ • . Cap • ur. ℥ij. vini lb ijs. C • q. ad 3. part. conſump. & Colet. upon theſe are to be applyed this following: ℞ farin. fab. Hord. & orob. ana ℥iiij. lixiu. lb iiij. Co • . hoc ad Catap. conſiſt. ad. oxymel. ℥ij. ung. Aegypt. ℥ • . Miſce. Ʋel farin. • upinor. le • tium fabarum, lolii. ſal. Marin. ana ℥iij. pul. ſummit. abſinth. ſcord. utriuſque, alliariae, rutae ana ℥ • . Coq. in oxymel. S. & f. Catapl. re • rigerato adde Aloes, myrrh. ana ℥j. aq. vitae ℥iij. Miſce. or this which hinders put • efaction, reſolves, cleanſeth, dryes up the virulent ſanies, ſtrengthens and eaſeth paine, ℞ far. Hord. fabar. orob. lentium lupinor. ana lb s. ſal. commun. Mel. roſar. ana ℥iiij. ſuc. abſinth. marrhub. ana ℥i • s. aloes maſtic. myrrh. & aq. vitae ana ℥ij. oxymel. ſ.q. ſ. f. Catap. Sometimes uſe actuall cauteries, which are excellent to hinder putrefaction of neighbouring parts, comforts the member being cold, reſolves corrupted matter, and ſtayes blood flowing. Lay upon the eſcar the juice of leeks and ſalt beaten together, adding what may haſten the fall of the eſcar. Which being effected, mundifie and cleanſe, cum ung. mixto i. e. ung. Baſilic. & Aegyptiac • ana part aeq. or ℞ fari. ervi. rad. Ariſtol. rotund. irid. florent. vincit • x. Angelic. ana ℥ • Theriac. ʒij. cum ſ q. Mel. re • . f. ung. But take heed cauteries bee not applyed to gangreen. 〈1 page duplicate〉 〈1 page duplicate〉 Here might bee handled gangreens produced from various cauſes; but its needleſſe, if we conſider the maine intention, which is to ſeparate the dead from the living, and hindering further progreſſe. Beſides, moſt Authors are ſilent therein. Hildanus herein hath done excellently, and ſome of his imitators. I ſhall therefore conclude with one obſervation of Riverius, which is this, being called to one, who through the ill opening of a veyne, had a gangreen poſſeſſed his arme, and ordinary meanes uſed, and yet not effectuall; he cauſed the ſcarification formerly made to bee humected with ſpir. ſulphur. which cauteriſed the mortified fleſh, after hee fomented the whole part with Spirit of wine, in which the powder of Aloes and myrrh had been infuſed; this was applyed very hot, then in great quantity hee ſtrewed the part affected with the powder of myrrh and aloes, and upon it cloaths dipt in the foreſaid ſpir. vini. In ſome houres by theſe, the arme in a miraculous manner came to its native colour, the tumor aſſwaged, the gangreen ſtayed, ſo that the next day the mortified fleſh ſeparated from the living; after which, he applyed a digeſtive of the yolkes of egges, turpentine, and hony, and after proceeded according to Art. If the meanes preſcribed will not prevaile, diſmembring muſt bee uſed. But this belonging to the third part of Chyrurgery, wee for preſent ſhall wave it. And having run through the firſt Part, wee come to the ſecond Part of Chyrurgery.

OTher Symptomes might here have been handled, but they more properly belong to the practice of phyſick, whither to we refer you; and come to the ſecond part of things ſuperfluous by event; in which may be handled all kinds of Ruptures. And here we ſhall ſet down ſuch as are ſo in regard of ſimilitude, as alſo properly ſo; And begin with

Bronchocele.Bronchocele

It is a round tumor of the throat ingendred of phegmatick humors betwixt the Trachea Arteria, and the Cutis. Some of them covering the whole throat.

Sometimes they are hereditary, otherwhiles caus'd by the coldneſs of the air, drinking water, and eating ſuch things as cauſe phlegm and wind; the differences may be according to the various matter therein contained.

Such as are hereditary are uncurable, as alſo thoſe that are great and inveterate: If ſmall, or not of long ſtanding, it's curable.

Cure.Cure.

For univerſalls, what is preſcribed in pituitous tumors, are here diligently to bee obſerved. The cure externall is either by Reſolutives, Cauteries, or Inciſion. It's true in the beginning aſtringents muſt be applyed, as Empl. contra Ruptur. for reſolvers, a fomentation of Dill. Chamomel, Melilot, &c. boyled in white wine; or rather a Lixiv made of wine-lees burnt: after apply Empl. de vigo cum Mercur. reduplic. vel Empl. diachil great, cum gum. Galb. et Bdell. diſſol. in aceto Scill. vel Empl. dia Sulphur. & Balſam. ejuſdem. Fluxing in this caſe is excellent.

If it cannot be reſolved, then you muſt open it either by Cauteries or Inciſion, but rather the latter; which being done, let the matter be ſpeedily evacuated; but if it cannot be done at once, then at divers times, and keep upon it ſome of the former Emplaſters: Some paſſe through a needle and thred, and keep it in as a Seton; if it be in Ariſtis, it's to be handled as Atheoraema.

IT is a Tumor of the navell,Exomphalon. cauſed either by the relaxation or breaking of the Peritoneum.

Signs.Signs.

If the caule be in the Tumor, it's ſoft, and continues it's naturall colour; If the inteſtines, it's ſoft, unequal, and returneth with noiſe; If from blood, it's like Aneuriſma; If of fleſh, hard.

Prognoſtick.Prognoſt.

If great, it's hard to cure; if of the guts, caule, wind, or water, it may be cured; if from fleſh or blood, it's not to be medled with.

Cure.Cure.

If from the caule or guts, force them into their proper place, after which apply this, ℞ bol. Arm. Sang. drac. Maſtic. Sarcocol an. ʒ j. biſlinga tegul. pul. an. ʒiij. reſin. pin. ℥ is. alb. ov. & cerae, q. ſ. f. cerat. If it be large; take up the skin after reduction, and bind it, and ſo let it fall, having firſt cut it off to the Ligature; but before you binde it, paſſe through the needle two or three times, or as often as it's needfull, and after cicatrize it. If it bee fleſhy, or from blood, it's uncurable; if water or windy they are to be cured as ſhall be taught hereafter: You are to obſerve beſides the medicament, there are fit ligatures and boulſters to be applyed, eſpecially a girdle with a bunch for the navill.

Bubonocele,Bubonocele or Hern. Inguinalis.

It's when the caule or inteſtines fall into the flank: if it be the O mentum, it returns in eaſily: If the inteſtines, there is a noiſe in the preſſing of them.

THERE is little difference in theſe,Enterocele. Epiplocele. the place affected being the ſame, onely the firſt is when the inteſtines fall into Scrotum, the latter when the Caule. The cauſes of both theſe and the former, are eating too much fruit, too much violence in exerciſes, and drinking water, riding great horſes, ſtrokes, vomiting, coughing, great travell, fals.

Signs.Signs.

The ſigns of the firſt is great Tumor unequall, ſometimes hard; if you aſſay to reduce them, there will be a murmuring noiſe.

The ſigns of the latter is alſo inequality, but more ſoft and ſlippery, neither doth it tumefie more by ſtrainings of the breath.

Prognoſticks.Prognoſt.

If the firſt be great, be inflam'd, have continued long forth, are very dangerous, if the part grow livid, and the excrements avoided at the mouth, & abound, is deadly; if little, they may be cured; for the latter, it's hardly reduced: And herein ſometimes the Peritoneum is broken, otherwhiles only relaxed: in the firſt, the tumor ſuddenly increaſeth with ſharp pain; in the latter, tumefaction is by little and little and alſo ſmall pains, yet pains return ſo often as the tumor is renewed by the falling down of either the guts or caule, which happen not the Peritoneum bring broken.

Cure.Cure.

Generall evacuations muſt here be uſed, good diet preſcribed, after the inteſtines or caule muſt be reduced, and then ſo conſerved that they again deſcend not, which requires long patience, otherwayes little ſucceſſefull.

If there be need, firſt let blood, after purge cum diacath. vel purgans Catholic. uſe glyſters: Then aſſay to reduce if it be the guts, the Patient lying on his back, his hips lying higher then his bead, put them up by little and little with your hand, preſſing moſt on the part where it deſcendeth. If by abundance of wind the reduction is hindered, either give five or ſix pricks into the bowels with a needle, or elſe for two hours make fomentation with Aquavitae hot, and then put them up; if the ſaeces hinder being indurated, then apply the Catap, of Pareus, which I experimented upon an ancient man, near 80 years old, who I found vomiting with ſuch a ſtench, as I could ſcarce indure it; yet though I prognoſticated his death by the application of it, and caſting in a glyſter made of the decoct. cum diacathol. & ſale, beyond all expectation either of his friends or my ſelf, word was brought me his bowels was of themſelves reduced, though there was much out. I conceive the ſaeces being mollified, the ſtraining in his vomiting forced them up: the Catap. is this, ℞ rad. Althea & lilior an. ℥ij. Som. lini & faenugr. an. ℥s. fol. malu. viol. pacietar. an. Ms. Let them be boyled in fair water, (I did it in milk) afterwards beaten and drawn through a ſearſe (which I wanted;) adde thereto Butyr. S. ſ. & ol. Lilior. & Catap. apply it hot; before you apply it, anoint the part cum ol. lilior. & Aneth. If, as it often happens, reduction cannot be, becauſe the proceſſe of the Peritoneum is not wide enough, then inciſion is to be made, as after you ſhall hear; but if they bee reduced without inciſion, then uſe this fomentation for 15 or 20 dayes, ℞ Cort. granat. balauſt. Sumach berber. nuc. cupreſs. gallar. media Cortic. quercus, an. ℥j. flor. Cham. melilot, an. p. 1. Sem. aniſi fenic. ul. an. ℥s. alum. ℥ij. conquaſſentur & includantur in duobus ſacculis inter punctis: boyl them in Smiths water and red wine, and apply them; after uſe a Catap. of the ſame decoct. made up. farin. hord. aq. fabrer, an. ℥j. pul. al • es Maſtic. Mirtil & Sarcacol, an. ℥s. bol. Arm. ℥ij. Miſce f. Catap. in this time: ſometimes the bagge is to be left on, and the Cataplaſ. to be left off; after proper Emplayſters are to be applyed, as this, ℞ Reſin ℥vj. Terebint. ℥iij. Sang. drac. ol. ovor. an. ℥ij. rad. Conſolid, Major. Santil. rub. an. ℥s. Croc. Martis ʒvj. alum. uſti. ʒj. f. Empl. This is to be noted, fit truſſes are upon all applications to bee uſed, and the Patient to be kept in bed as long as neceſſary. For children ſome uſe a paper ball after reduction, wet in an aſtringent decoct. Others exhibit Loadſtone finely powdered and given in apple or pap, and anointing the groines with hony, caſt thereupon fine filed iron on it, and ſo bind it up. Fonſeca exhibited, Chalyb prepar. ℈j. cum diarrhod abbat. and outwardly upon a plaſter caſt the Loadſtone in powder, and apply it: they are to be kept in bed 30 or 40 dayes. Internally may be exhibited, eſſent. Conſolid. Maj. Coch. cum balſa. ſal gem. gut. ij: to children leſſe. vel ℞ rad. Sigil Salom Maj. rad Conſolid. Maj. M j. lot. & contand. deind. coq in Zithi (i. e. Cereviſia ſine lupula) lb iv. ad conſum. demid. colat. & reſerv. ad uſum; drink of it morning and night, this was given me for a ſecret: vel ℞ Sem. perfoliat. Cymini an. ℥j. rad. Aron. rec. exſic. Acori aquat. Tormentil Conſolid. major. an. ℥s. Herb. uincia perunic. Saniculae pyrolae virg. Aureae piloſella Herniaris, Craſſull major an. ℥ij. roſ. rub. balauſt, galang. minor, caryoph. an. ʒj. inciſa & craſſiuſculc contus coq. invino alb. gener. S. q. ad 3 et f. decoct. clara S. A. Let them take morning and night a good draught.

As for Epiplocele being reduced,Epiplocele. it's cured as the former, removing plaſters every 7 day for a month or ſix weeks together: Obſerve this, as they are to lye long, ſo their lying muſt be ſo as their head and ſhoulders may be lower then their hips and fundament.

As was ſaid before, if they cannot be put up, becauſe the paſſage is too narrow, or the faeces cannot be mollified, then inciſion is to bee made after this manner; lay the Patient upon a form or table on his back, being bound thereto, make inciſion in the upper part of the Scrotum, touching not the guts; then with your directory put in at the inciſion, & under the production of the Periton. with your knife make inciſion ſo much as is ſufficient for your purpoſe up toward the belly, and after having made reduction, ſtitch up ſo much of the Peritoneum, as ſhall ſeem ſufficient, that by the paſſage being made more ſtrait, nothing may fall into Scrotum after cicatrization: This is not to bee done, unleſſe ſtrength be ſufficient.Rupture. If a Rupture will not bee cured by theſe meanes by reaſon of the greatneſſe of the brokenneſſe, or relaxation of the Peritoneum, (and the patient will undergoe the danger) then we are to uſe the laſt help, which have divers differences, as to be done either with the extraction of the ſtone, or without it; that without it, is either with the hurt of the ſeed veſſels, or without; that without hurt is double, either by inciſion or cautery: I ſhall onely ſet down that in Pareus. Pareus. The Chirurgion is to make inciſion about the ſhare bone, into which he ſhall thruſt his directory conveying it long wayes under the proceſſe of the Peritoneum: And by lifting up, ſeparate it from the adjoyning fibrous and nervous bodies to which it adheres; then preſently draw aſide the ſpermatick veſſel with the cremaſter or hanging muſcle of the teſticle; which being done, draw the proceſſe it ſelf alone, aſide, and take as much of it as is to lax with ſmall mullets perforated in the midſt, and with a needle having 5 or 6 threds, which thruſt through as near as you can to the ſeed veſſels and cremaſter muſcle, but the needle muſt alſo be drawn again into the midſt of the remnant of the proceſſe, taking up with it the lips of the wound; then the thred muſt bee tyed on a ſtrait knot, and ſo much muſt bee left after the needle is cut off as will hang forth of the wound; and it is not to be drawn forth till there be ſufficient concarnation (leſt labor prove vain) then cure it according to art. To conclude, obſerve, that you in children doe not miſtake the ſtone not yet fallen into Scrotum for a Rupture, which I know have been the fault of divers who have brought their children unto me to be cured.

VVHich is a wateriſh tumor in Scrotum, Hydrocele. which groweth by little and little, ſometimes diſtending the cod to a great bigneſs; ſometimes being gathered betwixt the two membranes that cover the ſtone, cauſed either from falls, blows, &c. or ill diet, cold, diſtemper of the liver, extinction of naturall heat.

Signs.Signs.

It's cleare betwixt you and the light, not painfull, heavie, hard; ſometimes it appeares as a third ſtone, and will not be driven into the body.

Cure.Cure.

Twofold, either by reſolving or inciſion. The firſt is thus performed, after opening a veine fitting, purging, (cum jalop. Mercur. dul. vel purg. Catholicon) uſing diureticks and diaphoreticks, as Sulph. Aurat. diap. Aureum vitae: apply reſolvers, as ℞ farin. fabar. ℥iij. Hord. ℥j. Coq. in vino gener. ad form. Catapl. in fine admiſce flor. Cham. melilot an. ℥ij. s. ol. Cham. roſar. an. ℥j. cum oxym. ſ. f. Catap. Fomentations, reſolving is alſo here to be uſed; if theſe prevail not, inciſion is to be made, and a tent put in armed with a digeſtive, and upon it apply Emp Baſiliconis: let the inciſion be ſome half fingers breadth, and be kept long open till all the water be evacuated, in the interim purging. Some uſeth to draw a ſtring through like a Seton in the lower part of Scrotum. If it bee in the membranes, make inciſion into the Lid of the Scrotum, taking heed to the Stone, and dreſſe it, S. A.

A Fleſhy Tumor in the Scrotum cauſed from groſſe and viſcid humors,Sarcocele. it often corrupteth the ſtone.

Signs.Signs.

It's hard, unequall, and rough, painfull, often accompanyed with varices or ſwollen veins; ſome not painfull.

Prognoſticks.Prognoſt.

If in young ones, and in the beginning, it ſometimes is cured; if it be big, and got to the groins, it's dangerous, but it's alway moſt hardly cured.

Cure.Cure.

Mathiol ſaith, rad. anonidis taken in powder many months, hath cured. If medicines prevail not, then inciſe, firſt placing the ſick in a fit poſture: if the ſtring of the teſticle bee ſmall, make inciſion into Scrotum to the Tumor, then ſeparate it from the cod, thruſting a needle with a ſtrong thred through it, and having tyed the Dedrin, cut it off, cauterizing that which is cut, and bringing forth the rupture, if any portion remain, cut it off, otherwayes it will come again; apply to it and neighboring parts repercuſſives; if inflammation and dolor happen, let blood, and reſt 5 or 6 dayes.

ITs a tumefaction of the veins in Scrotum, Cirſocele. cauſed from groſſe melancholy blood.

Signs are evident,Signs. hard to bee cured.

Cure.Cure.

Firſt, purge melancholy cum confect. Ham. pul. Sanct. in ſeri lact. extrac. Hellebor nigr. excellent; if need be bleed for externall; and inciſion is ſet down in ulcus varicoſum; which method is to be here uſed.

IT's a Tumor generated by the confuſed mixture of many humors in the cod,Hernia humoralis. or betwixt the tunicles that cover the ſtones; if it continues long, it corrupts the teſticles.

Cure.Cure.

It ſometimes ſuppurates, and otherwhiles reſolves: Purging and bleeding is here neceſſary; vomiting is good. Externally, apply this, a Catapl. made cum vino art. flor. fabar. & ol. roſ. vel Sambucin & parum cerae, ſo that the whole may come to 2 lb. to which adde oxymel ℥ 5, 6, 7, or 8. and boyl it into a body, if it tend to ſuppuration, make your inciſion in the ſide of the cod, and cure it according to Art; only obſerve this, they often become incurable Fiſtula's.

ITs the out-comming or turning over of the great gut,Ani procidentia. cauſed by the laxation of the Sphincter muſcle, being moſt common to children: Others, it's the comming forth of inteſtina recta.

Signs are needleſſe,Signs. it's cauſed of too much ſtraining, fluxes, ſtrokes, ſitting on cold ſtones.

Cure.Cure.

Abſtain from much moiſt things, purge gently, and open a veine, if neceſſary, externally uſe this fomentation, with which two was cured, ℞ Chamom. vel potius flor. Cham. Mj. vini malnatic lbjs. macerentur per hor. unam et alteram ſuper carbones lento igne. Foment with linnen ſtuffes as hot as can bee ſuffered, after with the finger put it into its proper place, then with a ſpunge wet in the ſame decoct. and wrung forth, applyed hot to the fundament, and ſit upon it, or ℞ fol. & flor. verbaſc. alb. flor. melilot, rad. & fol. althaeae an. M j. Sem. lini faenugr. an. ℥s. Coq. in lacte • ec. and foment as formerly is ſet down; after put it up, being anointed with ol. Murtin. & Laur. and beſtrowed with pul. alb. graec. which is excellent: vel ℞ roſ. rub. cortic. granator. nuc. Cypreſs Maſtic. croc. mar. & plumbiuſti an. ℥s. nuſceant & f. que pul. ſubtiliſſ. Suffumigations and aſtringent Cataplaſms may here be uſed; obſerve in the putting it up let the patient draw up his breath, when it's up, let it bee diligently wiped, and a ſwath about the middle to bring the ligature betwixt his legges, and under it a ſpunge as before; when the patient goes to ſtool, if he can, let him ſtand and take heed of too much ſtraining.

THIS is a dreadfull operation,Amputation. and a part may bee ſubjected to it, notwithſtanding the diligence of the Chirurgion, which being ſphacelated, muſt neceſſarily be amputated, leſt life for want of it be removed.

In this foure things are to bee handled. Firſt, the ſignes of a part ſubject to ſuch an operation. Secondly, the place where. Thirdly, the manner how. Fourthly, how to conquer the Symptomes which uſually follow the operation.

Signes.Signs.

If it look black, the part bee throughly dead, and cold as a ſtone; if it ſmell ſtrongly, ſo that it can hardly be indured, eſpecially if ulcerated; if a ſanies, moiſtneſſe, viſcid green, or blackiſh flow from thence; if void of ſenſe and motion, they are to bee taken with theſe cautions: Firſt, they may ſay they have ſenſe when they feel it not. Secondly, motion may remain, by reaſon the head of the muſcles are not affected; and yet the part bee fit for Amputation, which delay not.

Secondly, the place where; and this is either in the ſound part, which ever hath been in moſt frequent uſe, and moſt practiſed: Or, ſecondly, in the corrupt part.

Thirdly, how it is to bee done: and here is to be conſidered, what is to be done before the operation; 2 In; 3 After. Firſt, the body is to bee prepared by good diet; as, yolks of egs, and bread toſted and dipped in muſcadine. If it bee neceſſary, and time permit, which is ſeldome, uſe purging; but eſpecially thrice a day adminiſter cordials; as ℥j. of this at a time, ℞ Lap. Bazar oſs. de C.C. praep. an. gran. vj. C. C. uſt. pr. ℈j. Margar. praep. ℈. confect. Alcher. ℈ij. aq. Cinam. ℥j. bugloſs. calendul. an. ℥js. Syr. de Succ. citrorum ℥j. Miſce. Secondly, have in readineſſe a ſaw with two heads, a good diſmembring knife, an inciſion knife, three or four rowlers of flannell, five or ſix yards long, three great ſtitching needles, large clouts, and ſome leſſer, pledgets of tow, greater and leſſer, dorſels and buttons, a large bowle with aſhes, water and vineger bladders, and ſatchell for the member which prohibits blood, draws up the muſcles, and keeps the Saw from the fleſh. Secondly, in the operation draw up the muſcles, then make a ſtrong ligature, which ſtrengthen with a ſtrong mans hands to ingirt the part, eſpecially preſſing hard upon the place of the great veſſels: This being done, with your diſmembring knife ſpeedily cut the fieſh round to the bone; if it bee in the legge, or below the elbow, with your inciſion knife divide the fleſh betwixt the bones; after with the back of your knife, the Perioſtium being removed, with your diſmembring Saw take off the bone, as near the fieſh as you can: If the party bee plethorick and ſtrong, let it bleed a little, then ſtay it, which is done three ways. 1. By powders that cauſe an eſcar; as this, ℞ Umber and unſlaked Lime an. part equal, file them to powder, and reduce them to the form of a Liniment with the whites of egs, and the hair of an Hare; vel ℞ farin. volital. ℥vj. Sang. dracon. Thuris an. ℥j. bel. Arm. orient. Ter. Sigill. an. ℥s. gypſi ℥j s. ranar. aquatilium pp. ℥ij. miſce cran. Human. ℥j. pil. Lepor minutiſs. inciſor. ʒij. pul. alb. ovor. ſole canicular. exſiccat. Spum. mar. ſpongiae non torrefact. an. ℥j. Miſce f. que pul. ſubtiliſs. In wound of the throat to uſe theſe for the greater veſſels, four buttons made up cum vini acet. & aq. is to bee armed with them, and applyed, upon which ſpeedily apply a thick bed made of tow as before, and ſp • ead with the reſtrictive; this is to be fit for the member; another made after the ſame manner, but ſo much larger as will reach an inch or two over every ſide round, is to be applyed, being firſt armed: Upon theſe a bladder, upon which make a ligature near the top an inch broad, upon that a linnen cloth doubled, (obſerving to have buttons armed, to lay to the places where blood appeares) then with your rollers bind up the member, and ſo blood will be ſtayed. Second way, is by applying the actuall cauteries, which alwayes have in a readineſs, apply them to the mouths of the veines, (having cleanſed them from clotted blood) once or twice at the moſt. The third is ſtitching, which is troubleſome and dangerous, in which the veſſels are to be taken up, and after bound. Above the place amputated (as if in the legg, upon the knee; if in the thigh, neare the groine; if in the arm, upon the elbow, &c.) is this defenſative to bee applyed and removed every day, ℞ bol. Armen. Song. drac. Maſtic. gypſi an. ℥j. ol. • oſ. myrtin an. ℥j s. alb. ovor. N.ij. aceti q. ſ.f. ung. in Mortario. After this, which is the third thing, let it be dreſſed, if in Summer, on the 2 day; if in Winter, the 3 or 4. for which have in readineſſe ſtuphes of white wine, and a decent rouler; with the white wine moiſten thoſe applications which are on, that they may bee the eaſilier removed; which being done, beſprinkle the veſſels with the reſtrictives, and having 3 or 4 pledgets armed with white of egges, and reſtrictive caſt upon it, and alſo applyed upon the veſſel. Upon theſe, to the reſt of the wound this digeſtive, ℞ Terbinth in aq. plantag. lot. ℥iij. ol. roſ. Amygd. an. ℥j. an. ℥j. gum. elemi diſſolut. cum prodictis oleis & Colati ℥s. Croci ℈j. Miſce f. ungen. adde vitel. ovi. This is not to be changed till digeſtion bee perfect; but have a ſpeciall care to uſe the reſtrictive every dreſſing as before, till danger of Hemorage be paſt. Upon theſe a plaſter, and ſo roll it up, after it's digeſted, then apply this which both mundifies and incarnes, ℞ Succ. apii, Scord. Arnogloſſae Major. rutae an. ℥iiij. coq. ad conſiſten. ſyrupi tum admiſce farin. Lupinor. pul. rad. ariſtoloc. rotund. Angelic. vincetoxici, theriac. an. ℥s. aq. vitae ℥j. miſce f. unguent. In ſtead of this, it being not to bee had, ung. Baſil. maj. will ſerve: in the mean time, whilſt you are thus buſied, labor to bring the muſcles together with the dry Suture, applying the plaſter a fingers breadth from the lips of the wound, round about the member; which after a day you may ſtitch. The plaſter is this, ℞ farin. volatilis ℥j. Maſtic. thuris, Sang. drac. pul. rub. roſar. gum. Tragacant. an. ℥ij. miſce f. que pul. tenuiſs. cui add. alb. ovi & aq. roſ. q. ſ. ut craſſitiem mellis adipiſcatur glutinum. maneant inful. per noctem, ſequento die, ſi nimis ſpiſſum iterum affunde aq. roſ. quantum ſatis eſt: But ſometimes through the abundance of matter it's looſened: to remedy which, apply this; ℞ rad. aristol. rotund. peucedani Irid. florent. cortic. pini. Lig. guajaci an. ℥s. miſce f. que pul. tenuiſs. which caſt upon the ulcer once or twice a day; this dries without biting, and cauſeth the ſcales of the bones to fal, which will be within 30 or 40 dayes; if proud fleſh ariſe, either uſe this, ℞ alum. uſti ʒij. Lap. ca • aminar plumb. uſti, ceruſs. an. ʒj. vitriol. calcinat. ʒs. miſce, f. pul. tenuiſs. Or rather this of Woodals, Woodals. which I have tryed, ung. Egyptiac. applyed very hot, and laying another pledget upon it, bind it up, dreſſing no more in 48 houres; the next dreſſing uſe onely dry Lint, this alſo takes away the great ſenſibleneſſe of the Ulcer: after cicatrize cum Emp. palmei de ceruſ. coct. ung. de ſiccat. rub. vel diapomph.

THis is onely to bee performed when the Sphacelus or mortification hath taken up its limits, or elſe moves very ſlowly (and not when it moves ſpeedily) here purging may be admitted, and longer preparation made for the operation, which is thus performed.

Having your inſtruments ready as formerly, with cauterizing irons both broad and round, with two perſons to hold both parts of the member ſtrongly and ſteady, then make Amputation as before, as near the ſound part as you can, but not too near: after the member is taken off, then with your Inciſion knife take as much of the mortified fleſh away as you can, and then ſuperficially run over the dead fleſh with a cautery; as alſo therwith heal the end of the bone, and after make fomentations for half an hour with a good lixivium (as deſcribed in a gangrene) not too hot: which being done, apply woollen ſtuffes to the part, warm; and ſo bind it up: The ſecond dreſſing doe the like, cutting off the dead ſlough with ſciſſers; and forgetting not to heat the bone. Thus doe till the putrid fleſh fall, then dreſſe it according to Art. At laſt in the

Fourth place, wee are come to the Symptomes: As, 1 Syncope. 2 A Convulſion. 3 Pain. 4 Hemorage. 5 Fever. 6 Frenſie: all which wee have formerly handled in the Treatiſe of wounds, and other places, and therefore need not to be again recited. Sometimes abſceſſe is produced; for which, and eaſing pain, ℞ medul. pan. alh. ℥vj. rad. Altb. ℥ij. pul. Sem. lini fenigraec. an. ℥j. ficuum N. vjs. cum decoct. rad. Althaeae, f. Catap. adde in fine butyr. recent. axung. porcinae. rec. ℥js. vitel. ovor. N.ij. croc. ℈j s. apply it warme to quench thirſt. ℞ aq. roſar. bugloſ. borag. viol. an. ℥iiij. Syr. violar. ℥iiij. miſ. vel aq. luiul. lbij. ſyr. lim. viol. an. ℥q. ol. vitr. gut. xii. If it be needful, uſe nouriſhing glyſters made of broth and yolks of egges, with ſaffron, mace and cinnamon.

As for the cutting of a finger or two, it's beſt done by cutting mullets, which takes away the fleſh and bone at once; with theſe may alſo be taken away ſuperfluous fingers. Thus having paſſed over theſe dangerous operations, we come to that which is of no leſſe conſequence: Which is the

OF a Cancerous tumor or Ulcer poſſeſſing any part,Extirpation. (and therwith, if it be neceſſary, the part it ſelf, as the breaſt) the ſignes of both which, with their prognoſticks are ſet down pag. 82. This operation is not to bee attempted where the Cancer hath taken too deep rooting; as if it enter into the pit of the eye, ſo far that the root cannot be come at; or if it have entred into the mouth, and withall poſſeſſeth the moſt part of the face, when it hath made its paſſage into the capacity of the breaſt, or adheres ſo cloſe that it cannot be ſeparated; alſo if it bee great, and in the arm-pits, it's not to be touched; but if they be looſe, or have not taken too deep rooting, they may bee taken away; which is uſually performed two wayes, either by Cauſticks, or by Inciſion. I ſhall not ſpeak much to the firſt, having ſaid ſomething in the place forecited, onely commend unto you a French experiment, which is to be uſed if ulcerated, which is this, ℞ aq. fortis ℥j. ſublimat. crud. ℥iiij. Sal. Ammoniac. ℥ij. Arſenic. ʒj. ponatur in Alembicum et diſtil. ad ſiccitatem: add. acet. diſtil. iterum donee materia ad paſtae conſiſtentiam redeat. It's thus to be applyed, firſt waſh the Cancer with hot wine and linnen clothes, rubbing it hard; afterward having a Plaſter ſpread of the paſte upon a ſix doubled cloth, not altogether ſo big as the Tumor, apply it, and let it there remain for 24 houres; this cauſeth an eſchar bigger then the medicine, which brings away the Cancer; which is afterward to be cured S. A. Hee ſaith it cauſeth ſeverall ſymptomes but ſuch as are beneficiall, as fever, vomiting, and fluxes, if I forget not. This is worthy to bee noted, though not ſo properly here placed, that he cured really one, and palatively another with a medicament compoſed with roſe, plantain, and red poppy waters, and honey of roſes. But we come to Exterpation by way of Inciſion, which though it bee proper for ulcerated Cancers, yet more in ſuch tumors: And this may be done either by inciſion firſt, and then Cauterized, or elſe done both together: Or elſe by Inciſion with application of aſtringents onely; which is good, though the other may ſeem more rationally proper unto this account; that the Cautery bridles more the malignity of the matter; as alſo if any ſmall portion of the Cancer remain, it may come to fall with the Eſchar. Your Cautery muſt bee fitted to the part you exterpate. If the Cancers be ſmall, and not ulcerated, but are looſe, and may b •• freed on every ſide from the fleſh, then Inciſion, as ſhall be declared, and aſtringent powders may ſerve; but this is to bee obſerved before theſe operations are attempted, the body is to be prepared with Apozemes fittings, or magiſtrall Syrups diſſolved in ſutable water; and after purge, and then ſweat, and then purge again, withall opening a veine, and apply the Leeches. Your Apozeme may be this, or the like, ℞ rad. Cichor. cum toto Mj. rad. petroſelin. faenicul. an. ʒij. polypod. q. ℥s. Cortic. frangul. ℥j. Cortic. Cappar. & Tamariſ. an. ʒj s. Herb. Scolopend. veronic. betonic. fumar. Scabioſ. an. M s. flor. borag. bugleſ. roriſmar. betonic. ſummit. thym. & majoran. an. p. 1: Sem. aniſ. faenicul. an. ʒ ij. Coriand. praep. ʒj. paſſul. Corinth. ℥s. decoq. in ſ. q. aq & 3. part. vini ad conſumpt. medietatis; hujus Apoz. ℞ ℥ijs. in quibus inſund. per noct. rhei electi ʒj. Agaric. Troch. & turbith. an. ℈ij. ſol. Sen. ʒij. Sem. aniſi & Cremor. Tartar. an. ℈ij. maneant per noctem in infuſ. in loco tepido deindè f. expreſſ. add. Syr. de polyp. ℥j. aquae Cinnam. ʒj. f. po • . Having pu • ged the body thus 3 or 4 dayes, take of the Apoz. alone twice aday, three houres before dinner, and ſo long before ſupper for 5 or 6 dayes, in the mean while open a veine in the left arme, and apply the Leeches; then purge again divers times with the ſame Apoz. & extrac. Hel. nigr. after ſweat for 14 dayes eum aur. vitae vel Sulp. aurat. diaphor. or ℞ Lign. Saſſafr. ℥ij. Guaiac. Sarſepar. an. ℥j. Cinnam. ℥s. projiciantur in poculum ſtanneum aut. terreum & affunde aq. clarae lbiiij. claudatur quam diligentiſſime veſica madida primo; dende linteo ne quid. expiret. tandem f. dec • ct. per horas ſex aut 8. in duplici vaſe, nec autem illico aperiendum eſt poculum ſed expectandum donec per ſe ſit frigefactum. do. ℥iiij. twice a day; after which purge the body again; having thus prepared the body, make in readineſſe pledgets, b • ulſters, and roulers, and needles, aſtringent powders as in Sphacelu • deſcribed, and Cauteries according as you intend to operate. If you are to extirpate ſome off, or all the part, then take hold of it, either with your left hand, or elſe with Forceps for that purpoſe, (made round in compaſſe) and preſently exciſe it; which being done, ſpeedily apply your Cautery, having, as much as time and ſtrength gives leave, preſſed out the blood which lies in the ſwollen veines: but you had better doe it with a knife for the purpoſe made red hot, and ſo doe two works at once: after which dreſſe it up with medicines appeaſing dolor, and cauſe the Eſchar to fall, anointing all the part cum ol. roſ. & mirtill. Now you may know the Cancer is exterpated, if after the Eſchar is fallen quite, or become laudable, the paine and ſymptomes bee allayed, and when the fleſh growes like graines of pomgranat. The other way is this, firſt cut the skin, and ſeparate it from the Cancer, as alſo the parts to which it adheres, either with a knife, or rather if you can, with your nayls; after which, either paſſing a needle and thred through it, and ſo holding it up, cut it out, or elſe following the former courſe, with your fingers pull it out; for thus may you know more aſſuredly you have not left any remaining; after apply your aſtringent powder with white of egges, vel ℞ farin. volatil. ʒs. bol. orient. Ter. ſigill. an. ℈iiij. pul. alb. ovor. exſiceat. in ſol. ʒj. pilor. leporis minutiſſ. inciſor. ℈j. Corall. praep. ℈ij. Miſce f. pul. The next day apply a digeſt, then incarnate, and to ſeal it up, ℞ Tutiae papaver. pul. gum. maror. Alum. uſti an. ℈j. Miſce. And upon this a thin plate of lead, by theſe operations they may bee removed from the ſeverall parts of the body.

THey are round Tumors of the nervous parts and head, without pain,Lupiae, Wenns, Ganglion. yet they differ; for the firſt is hard, the other is ſoft; the Ganglion moving onely to the ſides, but Lupia every way; they are moſt commonly incompaſſed with a Cyſtis, which is the cauſe of their motion; ſome of theſe are great, others little.

The cauſes are blows,Cauſes. falls from high places, and ſtrains; as alſo by humors flowing to the part: The ſigns are in the diſtinction.

If they bee great, uſe good diet,Cure. and purge; if ſmall and new, break them with your hands, (which I have done ſucceſſeſully) I mean, the Cyſtis, and after rub it well; which being done, apply a plate of Lead beſmeard with Mercury for 10 dayes; it's to bee applyed with a plaſter, and ſo it will ſtick the better; this way hath cured divers, though they could not be broken. Some adviſe to annoint before with this, R. Ceruſ. reſin. pini. ol. veter. Amoniac. galb. an. ℥j. f. unguent. Riverius in his Obſer. Com. cured three with Sorrell leaves roſted under the embers,Riverius. and applyed for many dayes.

If they bee in ſuch places where ſtrong expreſſions cannot be made, yet the former meanes will ſerve, or this; ℞ Gum. Amoniac. bdel. galb. an. ℥iij. liquifiant in acet. vin. & trajiciantur per Setaceum add. ol. lilior. & laurin. an. ℥j. aq. vitae parum, pul. irios ſal. Amoniac. ſulphur. viv. vitriol. Roman. an. ʒs. f. Emplaſt. but if they cannot be reſolved, they muſt bee opened with a knife or cautery; and if the latter, after the membrane is waſted by Egyptiac. vel pul. praecip. & alum. uſti; then follow the cure ex L.A. When they are very great, and cannot becured, by the foreſaid meanes; they muſt be taken away with handy operation, if ſo be they bee not ſituated on, or near great veſſels, and cleave too cloſe to the adjacent parts; then take up the skin, and make inciſion, and with your directory drawn many times about betwixt the skin and it, divide them even to the root, (your directory is to be thick) then the former inciſion being made down to the root, make another inciſion overthwart, wch being done, draw the skin from the Cyſtis, (beginning at each corner) to the root, with your ſingers covered with a fine linnen cloth, or elſe a raſor, if need require. And obſerve, though the veſſels which feed it be ſmall, yet at the bottome they are great, and will cauſe a flux of blood, which let bee ſtayed as you have heard, firſt binding (if you can) the root of the Wen with a piece of whipcord, or many threds doubled, and let the end hang forth untill it fall away of its one accord; this is to bee remembred, ſo much of the ſuperfluous skin is to bee cut off, and onely ſo much left remaining, as will cover the part which is to bee ſtitched, and with a tent kept in it till it bee perfectly cleanſed; if any of the Cyſtis bee left, bee ſure it bee eaten away by fit medicines; after all which let it be cured S. A. Thoſe that are ſmall at the roots, may be ſtraitly tyed, and ſo cut off. Thoſe near the jugular veines in the armpits, groins, and under the hambs, are very dangerous.

A Tumor in which is matter like Rice pottage,Atheroma. or curds, it's long in figure, and with preſſing it goes in ſlowly, and returns not ſuddenly; it's ſoft, without pain, yet harder then Meliceris.

THe firſt is white pointed and wateriſh; the ſecond red,Hydrac. Ficus, & Talpa. round, hard, and painfull, and matery ſeed like figs; the third is larger then both the former, and hath in it little moiſture; theſe have the ſame production with the former, yet have no Cyſtis.

If neceſſary,Cure. uſe generall evacuations. pils are good, to them may be outwardly applyed this, ℞ Caepar. ſub cineribus coctar. vitel. ovor. ad. durit. coct. an. N.iij. axung. vel butyr. S.S. lb s. rad. althaeae ad mollitiem coctar. & minut. contuſ. lb j. Miſ. f. Catap. and apply it before they be perfectly ripe; open them, after which mundifie and incarne S. A. they ſometimes foul the Cranium, then you are to uſe the method as in Lue Venerea.

MOſt commonly poſſeſſe the throat,Strumas, or Scrophulas. being their Tumors in the glanduls, incloſed in a Cyſtis movable, and round alſo, may bee ſeparated from the skin.

The cauſe is phlegme,Canſe. ſometimes joyned with melancholy, as alſo craſſe and crude diet, drunking ill waters, they are ſometimes few, otherwhile many.

Thoſe which are few in number,Prognoſt. moveable and ſuperficiall, may reſolve or bee taken forth by inciſion, or if they break, by Canſticks; thoſe that are hard, fixed, and maligne; as alſo neare the Trachea, great and complicated with veines are dangerous, it frequently poſſeſſeth the hands, feet, elbows, and other parts which I have ſeen and cured.

Firſt, matter offending muſt bee evacuated, diet of light digeſtion preſcribed, bleeding if neceſſary appointed; for purging, uſe pul. Arthritic. cum ziuzib. every week, once or twice, bleeding after the firſt day: Others preſcribe this as excellent, ℞ Turbith. gum. Hermodact. an. ℥ij. rad. utriuſ que Scrophular. ℥j. rad. Angelic. major ʒj. ſol. ſen. orient. ℥j. Scam. crud. ℈iiij. f. pul. take it in ſyrupe of Roſes ʒij. or according to the age and ſtrength of the patient, adde Mercur. dul. give this every other day, for 15 dayes together: For children, a purging Nectar may bee provided for 15 or 20 dayes together; ſometimes, if you ſee cauſe, intermit. This courſe I have found ſucceſſefull: to conſume the matter, aq. flor. ruſci is good; vel. rad. ruſci. ʒj. iridis gr. x. cum vin. dulc. for 40 dayes. Sweating is profitable with this; ℞ Sarſaepar. ℥j. flor. betonic. p. 1. fol. Agrimon. & veronic. an. M s. macer. hor. 20. in aq. Font. lb iiij. deind. coq. ad conſum. 3. part. in vaſe bene clauſo dainde colatu. moderat. calid. & ſacc. dulcor. give ℥iij. hor. 6. mane. Sleep upon it if you can, or elſe lye ſtill two houres and ſweat: The ſecond may bee provided for ordinary drink. Theſe pils are good, ℞ Maſ. pil. coch: ʒij. Hier. cum Agaric. ʒi. Trochiſ. alhand. Mirrh. verae an. ℈s. ol. faenic. dulc. gut. j. eum ſyr. Staechad. q. ſ. f. pil. After which this, ℞ Butterbure, ſo many leaves as may bee ſteeped in the following liquor, the powder of Woodlice a ſpoonfull, of the ſtone of a horſe a ſpoonfull, boyle them in two quarts of old Ale, till a quart be conſumed, after ſtraine it, and put it into a bottle, and drink four ſpoonfulls firſt and laſt: vel ℞ Jalapae alb. flor. & fol. betonic. Sanicu. Tuſſilag. Artemiſ. quinque fol. fol. cichor. an. Mj. gly cyrrh. ſem. aniſ. & faenicul. an. ℥j. paſſul. major. lb s. Minor. ℥iiij. coq. omnia in aq. Font. lb x. lento igne ad conſumpt. ½ colat. diſ. ℥iiij. in the morning, and ſo much at foure a clock in the afternoon.

For externalls, Empl. devigo. cum mercur. quadrupl. vitriol. Roman gum. Ammoniac. an. ℥ij. cum Tereb. f. Empl. The place may be fomented firſt with a ſpunge dipt in aq. Calc. viv. vel ℞ rad. Althaeae, brion. ſcrophular. maj. et ebuli an ℥j. flor. Cham. Melilot. Sambuc. Ebuli an. Mj. ſem. aniſi, faenugr. an. ℥ s. coq. in aq. ad conſumpt. 3 part. Apply it hot for half an houre, after anoint it with this; ℞ Ʋng. dialthae. ℥ij. ol. lilior. alb. pingued. gallinae, anſeris, urſi, et humani an ℥s. aq. vitae ℥j. Miſce f. Lin. Then apply Empl. ciculi, or the former, a fume of Lap. pyrit. extinct. in acet. is good; the top of the funnell muſt be fitted to the part upon which you may apply this, ℞ Empl. de vig. cum Mercur. quadruplic. ℥j. vitriol. rom. ʒj. If it break, waſh it, with verjuice and butter, and dreſſe it with cauſtick medicament if there bee need; otherwiſe cure it as other Ulcers S. A. If they bee in places convenient, cut them out; if they come to ſuppuration, open them not till they bee throughly ſuppurated, unleſſe the part be ſubject to corruption.

IT's the obſtruction of the pupill of the eye by a hard and congealed humor,Cataract. this humor is the aqueous offending in quantity or quality; if in quantity, it either by the increaſe or decreaſe of it, which is known by the dilatation or conſtriction of the pupil; if from the quality, it is thickened and condenſated, and this vulgarly is called a Cataract.

If they be of the colour of ruſty iron,Cure. or white like pearles, or an aſhy green like Sea water, or cheſnut, they are curable; if of the colour of chalk, black, or yellow, not. If from acute Fevers, Peripneumony, Phrenſie, and pain in the head, it's hard: if it bee new, and not confirm'd, it may be diſcuſſed, otherwhiſe not. If ready To Couch, ſhut the whole eye, and • ub gently the lid of the ill eye; if ſpred and come round again, it may bee couched, otherwiſe not, Gal. 1. de Sympt. cauſis, Cap. 2.

Is twofold: Firſt, phyſicall,Cure. River, prax. Med. Tom. 2. pag. 33. ſaith, hee cured ſome in principio, yea, though fifty years aged, with univerſall evacuations, a ſweating diet, and veſicatories, without any externall applications; in this firſt purge the whole body, eſpecially the head, is exactly to be evacuated, and the humor in the pupill diſcuſſed, if you perceive it come from the ſtomach, vomit, if not purge Cum pil. Catholic. vel ℞ ſen. Mund. ℥s. ſem. faenic. ʒj. fol. beton. euphra. an. Ms. Liquir. ʒiij. Coq. in aq. ad ℥iij. in Colat. diſſol. diaphaenic. ʒvj. Syr. roſ. ℥j. f. pot. After which a proper Apozeme will doe well, and then purge with pils as in Opthal. for externalls, uſe this, ℞ aq. Euphra. Chelidon. roſ. cum medic. aqua vit. vel ℞ aq. Chelidon. Maj. ℥vj. Croc. Metal. ʒj. infund. ſimul. of this drop 3 or 4 drops, 3 or 4 times a day, this is excellent.

If it cannot bee diſſolved, then we are to uſe the needle, which is done thus, turn the eye toward the noſe, and thruſt in the needle boldly in the middle ſpace betwixt the leſſer corner and the horny coat, juſt againſt the midſt of the Cataract, bringing it from above downward beneath the Pupil, there keep it for ſome ſhort time; when it abides firmly, draw back the needle gently, after apply the white of egges, with roſewater, and a little alum; then binde up both the eyes, and apply a reſtrictive on the forehead; let his head lie high, uſe liquid meats; after the former manner dreſſing it once aday for 12 or 15 dayes, moving the head and teeth as ſeldome as is poſſible. Let it bee done in a morning. It wil be convenient after the Patient is well, to prevent reciduvation, to uſe purges, and open a fontinell.

There are divers other effects, which though it be not ſo proper, we ſhall inſert here, becauſe we are treating of the eyes.

THe ſigns are evident for cure,Oculus procidentia. after general evacuations, and particular, binde up the eye with a decoction of Sloes, which I have tryed, vel ℞ fol. cupreſſ. ℥s. flor. Cham. ʒij. Thur. Maſtic. an. ʒj. f. Sacc. in aq. madefact. and apply it, uſing defenſatives to the forchead; if this will not do, it muſt be taken out and cured S. A.