The methode of phisicke conteyning the causes, signes, and cures of invvard diseases in mans body from the head to the foote. VVhereunto is added, the forme and rule of making remedies and medicines, which our phisitians commonly vse at this day, with the proportion, quantitie, & names of ech [sic] medicine. By Philip Barrough.

THE FIFT BOOKE CONTAINING THE CVRING OF TVMOVRES WHICH HAPPEN A∣BOVE NATVRE. (Book 5)

CAP. I. VVhat that svvelling is, vvhich happeneth besides nature, vvhich commonly is called by his generall name Apostema, and the sifting out of the true definition, and of the diuision of the same, according to the opinion of the Neoterickes.

THESE Tumours which haue their being besids nature, the later sort both of Phisitions and Chirurgians, and not they onely, but almost the vniforme consent of olde writers haue comprehended vnder this name Apostema:* 1.1 whereas indeede 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, both by Ga∣lene, and all other Grecians, hath bene reputed, but as one kinde of those swelling tumours, which commonly are said to chaunce besides nature, which the Latines haue verie fitly tearmed absces∣sus,* 1.2 and the crewe of yonger Phisitions do call it exitura, deriuing the originall of the word from the interpreter of Auicene: of the which, and of all other kindes we will intreate particularly in his

seuerall chapter. Although in deede it hath pleased some of the later sorte to make Apo∣stema as the species or differentia of those tumours besides nature: appointing it to be di∣uerse from that which they call exitura, and also from that other kinde pustula. For vnder the name of Apostumes, they will conclude and place those tumours onely, which being lifted vp into a great bignes, doe fetch their procreation from the influence of naturall hu∣mours (as they tearme them) whereuppon they call them vera Apostemata. Therefore when Apostema is taken for the genus, comprehending vnder it all the tumours besides nature by Auicene and his followers it is thus commonly defined. An Aposteme is a dis∣ease compounded of three kindes of maladies, all aggregated into one bignes,* 1.3 which de∣finition they doe affirme to be essentiall, consisting (as they say) of genus and differentia, which doe verie sufficiently explane the nature of that, which is defined, appointing this worde disease to be the genus, and the other wordes which are annexed, doe stand to ma∣nifest the difference of other the like infirmities, which doe happen by the composition & construction of the instrumentes: All which distinctions and diuersities, Galene doth re∣cite in his booke intituled de morbo & symptomate. But these three kindes of sores,* 1.4 which in that swelling besides nature commonly called Apostema, do concurre establishing the essence of one onely disease, are these: intemperature, which they also call an euill com∣plexion: immoderation, whereby they intend a synister composition, and the solution of that agreeing vnitie which nature affordeth to euerie bodie. To which three kindes, the Greekes haue assigned three apposite and fitte termes, calling the first, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, the se∣cond 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, the thirde 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉: but they bring also many other discriptions rather then definitions of this Apostema: for definitions I dare not tearme them, when as they doe not conuert with that which is defined, neither doe they serue either to the sufficient explication of his nature, or the constitution of his essence, which they verie wel•• know∣ing, are content to let them goe vnder the name of accidentall definitions. One of them they haue desumed and taken out of Galen his booke which he wrote de tumoribus praeter naturam. An Aposteme or tumour besides nature,* 1.5 is one of those thinges which happe∣ning to the bodie, doth inflate that part which it occupieth, to the extremest dimension. This definition they haue extorted out of Galene his wordes, which he set not downe as an exquisite definition, but as an ordinarie assertion. You may fashion (if you please) ma∣ny such definitions, as this for one.* 1.6 An Aposteme is an increment exceeding naturall con∣stitution: or this: an Aposteme is a tumor, in the which the partes haue departed from their naturall state and habite in quantitie, and bignes. Whereas Galen in his lib. 13. the∣rap meth. hath these wordes: in this thirteth part of our whole worke we will beginne to discourse of those tumours happening besides nature, in which the partes haue forsaken their naturall constitution by becomming more bigge, so that you seeing the slēder weight of these definitions, you must annexe this Particle, actiones laedeus, hurting the duties of the bodie, or thus, inducing an euident detriment to the actions, or else they will not be ab∣solute or essentiall: for euerie tumour making distention or swelling in length, breadth or profunditie, beyonde the ordinarie constitution of nature, other in all the bodie, or in any part thereof: or euerie excrement or greatnes exceeding nature, must not according to the vulgar acception be named either Apostema, or a swelling besides nature. For (as Galene saith in his booke de tumoribus praeter naturam) such like augmentations may befall not on∣ly to the diseased, but also to the healthfull, as well in the whole bodie, as in any member of the same. For grosse men, although they be enlarged,* 1.7 and as it were distended both in breadth and profunditie: yet they haue not this distention besides nature, but (as he saith) onely not naturally: for they haue not yet passed the boundes of nature, neither are the a∣ctions and duities of their part maymed or anoyed, which is the border of those increments which are besides nature: and those tumours which abide in those partes, which are yet sound and without the tast of griefe, may well be saide to be aboue and beyond nature, but not besides nature, as for example: if both the teats, or one of them onely be marue∣louslie increased, or inflated, yet so that his substaunce be free from all annoiaunce, this cannot appositiuely be sayd to be besides nature, but onely beyond nature. Therefore if you desire on absolute definition of this tumour, which happeneth besides nature, collected

out of the writinges of Galene, you shall thus define it: A swelling besides nature is an in∣crement surpassing the ordinarie habite of nature, bringing with it a maime to the actions thereof. But such like tumours besides nature are wont to be diuided into three kindes by Guido,* 1.8 and those of his age, into impostumes, abscessions, and pusshes or vlcers. Im∣postumes they call great tumours, in which the matter, whereof it springeth, doth offende in plentie or quantitie:* 1.9 pusshes are those little tumours (which they call bothor) in which, the substaunce whereof they arise is troublesome rather in qualitie then in quantitie, yea & in them there lurketh a poysonous venyme (as they say) but the abscessions are those tu∣mours which the Latines call Abscessus, and of the Greekes may well be named 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, as we proued before:* 1.10 but let it be lawfull for euerie man to impose what titles or names they will, so that (as Galene saith) they doe not swarue or straie from the naturall mea∣ning of the thinges them selues: but leauing all the scrupulous and scholerlike contentiōs, which some doe vse in the intreatie of this subiect, as impertiment to our purpose. I will orderly set downe the braunches of all the tumours or imposthumes, (if so you will terme them) which happen besides nature: and first we will beginne with inflammation.

CAP. II. Of the differences of those tumours which happen besides nature. DE DIFFERENTIIS TVMORVM, QVI PRAETER NATVRAM INCIDVNT.

THERE be many and sundrie differences of tumours besides nature, which commonly are called by this generall name Apostumes: the difference wher∣of,* 1.11 of the later Chyrurgians are obserued to proceed, either from the substāce of the sore, or from the matter thereof, or from the Accidentes, or from the affected partes, or else from the efficient causes. The differences, which they desume from the substaunce, are supposed by Auicene and his sect to be two, either the greatnes of the swelling, or the littlenes thereof. Amongest the bigge tumours, they doe recken phlegmone (which appeare commonly in fleshie places, which are fit to be distended) and aedema, erysipelas, and schirrhus, which all doe growe vp to a great bignes & quantitie. Little tumours are called of them little eminences or appearings, or breakings out called pusshes, which are commonly seene in the skinne, and the vttermost partes of the bodie, as the Greekes leprosie, the scabbe, the ringworme, and such other like, of the which we will speake more at larg hereafter. The matter of the aforesaide tumours are the foure humours,* 1.12 as well naturall, as not naturall (that is to saie) fleame, melancholie, cho∣ler, and those humours which are altogeater besides nature, sometime the soundnes of cer∣taine bodies, and sometime a yealowe or pale humour, the handling of all which diffe∣rences we will referre vnto another place. The symptomates or accidentes, which are commonly incident to these tumours are,* 1.13 griefe, heat, softnes, hardnes and such like: from the which they will deriue some differences: but those which they take from the members and from the affected partes, as ophthalmia, the inflammation of the eye, the squince, the inflammation of the throte,* 1.14 phyma, phygethlum, and those inflammations which we terme glandulae and bubones. But the efficient causes from the which certaine differences be bo∣rowed,* 1.15 are congestion and fluxe, and crisis (that is to saie) iudgement thereof which hap∣peneth in diseases: there be also certaine other causes both internall and externall, wherof we wil dispute more copiouslie and earnestly in that which follow. But yet truely all the di∣uersities and differences of these kindes of swellinges chauncing aboue nature,* 1.16 haue their beginning from the nature and substaunce (which prouoketh the swelling) of that which floweth (as witnesseth Galen in his booke which he wrote of Tumours happening aboue nature.) Likewise in his seconde booke that he wrote vnto Gluco. cap. 13. meth. med. in which places he declareth that the varietie of all swellings which are aboue nature, doth a∣ryse

of the nature of that which floweth: for when (sayth he) a flatuous matter hath more free accesse, then also the tumours are made more flatuous: but they are more like vnto phlegmone when as bloude aboundeth: as likewise Erysipilas, when melancholie hath his course: and they be also more vexed with aedema, when fleame or reume discending from the heade doth raigne. Also they be grieued with the disease Scirrhosis, when either a thicke or too colde a humour is settled in some parte thereof. Therefore all tumours doe chaunce (as Galene affirmeth) besides nature which proceede either of humours, or of a flatuous and windie spirite, which is gathered sometime vnder the skinne, sometime vnder the thinne filmes that couer the bones, somtime in the bellie, somtime in the intrailes, often∣times in the middest of these, and of the peritonaeum. The Greekes call it Emphysema:* 1.17 A∣uicene termeth it a windie apostema. If such swellinges happen of humours, then they are either hote, or colde, or mingled togeather.* 1.18 Hote tumours come of the best bloud (that is to saie) which is parfectly ruddy, and of a meane soundnes and moderate qualitie, and then the Greekes call it phlegmone, the Latines, inflammatio: or they proceede of yealowe choler or of burning and thinne bloud, or else of those thinges which be hotter then bloud or choler. They terme this euill Erysipelas, but these name it Sacerignis. But cold swel∣linges are prouoked either through thinne fleame, and then the Greekes call it aedema,* 1.19 but our Phisitions terme it laxus tumor: the interpreter of Auicene vndimia, or else it is caused through the humour of choler, or through thicke, colde, and clammie fleame. They call this Scirrhon, the Latines, durities, the Arabians, sephirus.* 1.20 Also swellinges sometimes do chaunce by reason of a late taking awaie of superfluous bloud, as hereafter shall be decla∣red. Tumours are saide to be mingled, when such kinde of humours are tempred to∣geather, and if one maistereth the other, from that which exceedeth in the mixture,* 1.21 is the name giuen to the swelling, as in bloude ruling choler, we will call phlegmone the prin∣cipall, to be Erysipelatodem, and also because of melancholie gouerning, Erysipelas is saide to be phlegmonôdes. Nowe of other mixtures there is the like interpretation, both Scir∣rhus phlegmonosus with phlehmòne scirrhosa: and aedema phlegmonosum with phlegmone aedema∣tôsa. And after this example you shall name the other tumours, although there chaunceth commixion togeather of three or foure humours at once. Moreouer, if the humours be of like force, and equally incorporate, so that the one can not ouercome the other, then we will name the tumours by the coupling togeather of those humours, which they stirre or rayse vp. As if bloud be equally mingled with choler, that euill may be called, by reason of their ioyning togeather phlegmone and erysipelas, or (as Galen hath it) it may be termed a meane in the kinde and nature of phlegmône & erysipelas.* 1.22 These truely be the chiefe swel∣linges and tumours, which are recyted in Galene by the flowing of humours: (that is to say) phlegmone, erysipelas, aedema, scirrhus: vnto the which innumerable other tumours, ex∣ceeding the measure and boundes of nature are reduced, and comprehended vnder them, although they haue chosed to themselues diuerse names according to their sundrie causes. Therefore, there partayneth vnto a kinde of phlegmone, phygethon,* 1.23 which is called panus (Celsus being the authour) but of our men phyma and tuberculum, also it is named of the same Celsus terminthon of Oribatius, the kindes or species of phyma, but of Aetius, phigethlum: also they be called dothienes, which Celsus doth call furunculi, felons. Likewise gangrena of some member, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 (that is to say) mortification but not absolute, and also sphacelus, which is called of the Latines syderatio, & of Auicene ascachilos. Carbunculus also called of the Greekes Anthrax: whereof Auicene writeth in the chapter de pruna & igne persico. But vnto erysipelas are referred herpetes,* 1.24 which in kinde be two manner of wayes (that is to say) miliares and exedentes, byting and gnawing, which the Greekes do call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. He which expoundeth Auicene hath called both the kindes formicae,* 1.25 but he being deceiued with the likenes of the name, hath mixed thē in the same chapter by great ouersight, with those verrucae, which the Greekes call mirmeciae, the Latines formicae. Celsus seemeth to haue comprehended those herpete vnder the name of ignis sacer: but the Chirurgians of la∣ter time haue numbred them among the cholericke pustules (as they terme them.) There commeth also of choler almost those diseases called of the Greekes phlyctaenae, and therefore they belong vnto erysipelas,* 1.26 whereof Auicene doth intreate in his chapter de vesicis & in∣flammationibus.

Vnto the tumours caused of fleame, that is, vnto aedemata, are referred cer∣taine tumours, comprehended of the Greekes vnder the name of apostema which be called of Auicene nodi, of Haly abbas, selaa, and dubeleta phlegmatica, of the Latines abscessus: whereof there be diuerse kinds according to the diuerse matters conteyned in them. More∣ouer in Galene there be three such kindes of abscessus chauncing verie often whereof euery∣one hath borrowed his proper name of the Greekes: those be, atheromata, steatomata, me∣licerides, which in deede be called after the likenes of bodies conteyned in them, as we wil hereafter declare more at large. There is also a kinde of apostema, that is, of abscessus, wher∣in are other thinges conteyned, which do represent not onely the proprieties of humours: but also of certaine sound bodies: but these (sayth Galene) chaunce verie seeldome. And of these also we will speake hereafter, when we shall intreat of abscessions. But now vnto the saide kindes of abscessus, there appertaine certaine names of tumours being deuised of the latter sort,* 1.27 and neuer as yet founde out amongest auncient writers, as testudo, which is a soft swelling cleauing to the whole heade of a man, and talpa: the one seemeth to be∣long vnto atheroma the other vnto melicerides. But vnto stratomata doth belong a certaine swelling without paine, which they call nata, or napta, whereof we will speake in his place. Hitherto also doe pertaine the euils called of the Greekes ganglia, of Auicene glandulae, which doe differ from the aforesaide nods. There commeth also of fleame that which the common sort call scrofula, and therefore they are reduced vnto aedemata. These be called of the Greekes charades, of the Latines, strume. Notwithstanding Galene in a certaine place amongest the diseases named scirrhi,* 1.28 doth take it for durities. Also vnto aedema is re∣ferred in Galene that kinde of Hydrops, which is named of the Greekes, leucopblegmatia, and hyposarca.* 1.29 But the swellinges or tumours which partaine vnto choler, and which be com∣prehended vnder the saide schirrbus, are cancri, which of the Greekes be called carnici, & carcinomata: Notwithstanding Celsus maketh a difference betweene cancer, and carcino∣ma, that he might saie, that it did come and proceede by little and little of those thinges which do chance outwardly, & that it is engendred within (some member being corrup∣ted). The same Celsus deuideth cancer into many parts or kindes (that is to say) into erysi∣pelas,* 1.30 gangrena & vlcus nigrum of this kind also is elephantus or, elephantia, or elephantiasis, cal∣led of the common sort of Physitions lepra, & of some sancti lazari morbus. Therfore the name of lepra signifieth with Auicene and with the vnlearned company, a most grieuous and deadly disease, when yet with Gal. Paul. Aegineta, and with other grecians it is coun∣ted but a light griefe not much differing from that which we call scabies, which is called of the same writers ps••ra. Among this hard swelling kinde of tumours, are accounted the diseases called in the Latine tongue of the interpreter of Auicene, verrucae, which be swellinges like vnto little hillockes appearing in the skinne,* 1.31 whereof they haue this name, being called of the common sort porra.* 1.32 To this kinde also may be referred myrmeciae, as if one should call them formicula, and acrochordones, which of our countriemen are termed pensiles verrucae and clauus also, which in forme is like to a harde rounde pillar called of the Greekes 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, of Auicene they are called almismar, Thymion, or thymon representing the knobbie toppes of the herbe thyme. Auicene semeth also to haue giuen it this name tusiū, or (as another translation hath it) tarsecum. Also among the diuerse kindes of verrucae, there be euils called of Auicene cornua, so called, because they being verie long, are tur∣ned againe croked like vnto hornes.* 1.33 In like case also there be calli which the Greekes call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, these are engendred by meanes of the skinne being obdurated & hardened through much labour. Vnto choler also there seemeth to partaine this euill, which the grecians call dracontion,* 1.34 the Latines dracunculus, according to the liuely similitud or likenes of that name, Auicene calleth it vena medeni, Haly Abbas, vena saniosa. Whereof Paulus Aegine∣ta intreateth cap. vltimo lib. 4. This disease is not great rife with vs. Besides these tumours which we now haue rehearsed, there chaunce other also, affecting oftentimes the super∣ficiall partes of the bodie (that is to say) certaine small appearings,* 1.35 which they call pustulae, and bothor. Which although they differ both among them selues, and also from those tu∣mours, which we haue aboue recited, yet they are caused of the same humours, of the which also they are now called great tumours. Therefore they onely seeme to differ from them

in respect of their greatnes and smalnes. But that such little tumours (which truely a chy∣rurgion ought not to be ignoraunt of) might appeare more manifest, and easie to be cō∣ceiued of euerie man: I haue thought it expedient, and a thing worthy the labour, to set downe in this place the names of them, both in Greeke and Lataine, and also their barba∣rous title, with a certaine rude discription thereof, as we haue alreadie done in the grea∣ter. Therefore that we may enter into the matter it selfe, there are of the kinde of pustu∣les or pushes, lepra, so called of the Greekes and retayning the same title amongest the La∣tines, and ps••ra called of the same writer scabies, being truely diseases verie neere of affi∣nitie among them selues: for there is roughnes and sharpnes of the skinne with itching & pritching in the bodie, comming of the same humour (that is to say) of choler. Not∣withstanding they differ in this,* 1.36 because lepra doth consume the skinne with manifest sca∣les somewhat deepe, as it were in a circle: but ps••ra doth onely hurt the outward part with diuerse formes and doth vnlose a cer••aine scurfe of the bodie. Hitherto also doth pertaine that light infection of the skinne, called of the Greekes licene, of the Latines impetigo, in English the ringworme and commonly of some (as Manardus reporteth) they be called volatica. This chaunceth by reason of the mingled putrefaction of wilde bloude being thinne and sharpe, with other that be thicke: and verie often and easilie it doth turne it selfe (Galene affirming the same) into the aforesaide euils (that is to say) into lepra and scabies, which they call ps••ra. Yet there are some which thincke, that that, which the Greekes call lepra, is called of Celsus impetigo. But truely, seeing he doth write specially of impetigo, appointing foure kindes thereof lib. 5. suae medicinae, it is euidently apparent, that he meant some other thing by this worde impetigo, then licene amongest the Greekes,* 1.37 see∣ing that truely we neuer read in any Greeke authour, that there were so many kindes of licene euer agreed of or acknowledged. Therefore if we will with Galen speake properlie lepra & lichene or impetigo, cannot be one and the same euill:* 1.38 otherwise the same should be chaunged into it selfe. That I may therefore draw the whole matter into few words: when the skinne is lightly infected, with an onely roughnes and itching, that is called in Greeke lichen, but in Latine impetigo. But when the griefe waxeth worse, it chaungeth the name togeather with the forme. But if lichene doth cause manifest scales, and doth pearce the skinne somewhat deepely, it is properly called lepra. But if it be stretched out onely by the outwarde superficies, and doth cause brannie or scaly bodies it is called ps••ra of the Grekes,* 1.39 of vs it is called properly scabies. Although this worde scabies doth extend verie farre com∣monly also among the Physitions of late time, who doe name all the euill of the skinne to be scabies. But they speake verie improperly, for the pure and true scabies, so called of the Latines, is without all doubt that disease which is called of the Greekes ps••ra, of Auicene also albara and morphea, cleane contrarie to the opinion of some. For that which is saide of him and almost of all the Physitions of Africke to be albara, is named of the Greekes & of Celsus also leuce. But mongest them it is called morphea, among the Greekes alphon,* 1.40 in which disease the whole flesh is not affected, but onely the externall partes of the bodie, euen as though (as Galene saith) it were set about with certaine scales. But these alphi (as it is in Galene) in their kinde are of two sortes (that is to say) white,* 1.41 which come of fleame: and blacke, which proceede from a melancholike humour. But these thinges we now haue spoken of being led by the consequence of thinges. For neither leuce, nor alphi them selues are accounted amongest the tumours besides nature, but rather among the euilles of the skinne. Which thinges although they hurt verie little yet because they doe dishonest and bring shame, they are wont to be for the most parte a greater heauines and werynes (especially vnto women). then many other diseases which truely doe hurt, but yet they be secret. both these euilles (that is to say) rucae and alphon, Celsus hath com∣prehended vnder the name of vitiligo (making three kindes thereof) although other stu∣dentes of Physicke, turning Greeke into Latine,* 1.42 doe conuert lucae in all places into vi∣tiligo, which would more aptly agree, if it were put with his epithete or addition, as to say alba vitiligo. Ʋitiligo therefore, if we will comprehende it vnder any certaine heade or kinde, is a filthie colour of the skinne, proceeding of an euill habite of some parte of the bodie, which could not well receiue any nourishment to it selfe. For this euill chaunceth

through the default of the nourishing facultie, whereof some doe constitute two kindes, the one, which doth infect the skinne onely with certaine markes, which doe cleaue fast vnto it like vnto little scales, the other which goeth in some what deeper, so that it touch∣eth the verie fleshe, and coloureth the hayres: for in it there aryseth gray hayres, like vn∣to a certaine kinde of moosynes: this is gathered togeather of viscous & glutinatiue fleame, but both of them do defile and staine either with their white, or especialy with their black colour. The first species, which is aloft and superficiall, wheather it be white or blacke, it is called of the Greekes alphūs, by the same name (as before) because it chaungeth the colour of the skinne, for 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 (whereof 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 is deriued) signifieth amongest the aun∣cient Greekes to chaunge. Auicene calleth it morphea. But the other kinde, which we haue declared to pearce somewhat deeper, is called of the Greekes, and of Celsus also leuce, and of the rest of the Latines alba vitiligo, of Auicene albara. Haly Abbas onely a∣mong the Arabians calleth lepra, a filthie disease, which is harde to be cured, yet he doth not declare it to be pernicious and deadly, who hath not accounted it altogeather as a light thing (as the Greekes affirme it) and little differing from a scabbe: neither (as Auicene thought) pernicious and grieuous, but onely lothsome and filthie. Whereby we may coniecture, that little credite is to be attributed to wordes or names, vnlesse the matter be throughly discouered.* 1.43 For one and the selfe same worde by varietie of authours hath en∣forced to vphold many diuerse & different significations, as in their commentaries doth e∣uerie where appeare. But we haue spoken by the way of the euilles and defedations of the skinne, only that the confusion of things might be eschewed, which happeneth by words misunderstood. Therefore omitting these thinges, we will returne vnto out purpose, and with as much breuitie as we can, we will dispatch the discourse of the residew of swelling sores, amongest which, besides those, which we haue rehearsed and touched alreadie, are reckened by the Greekes ionthi, epinyctides, hidroa, psydraces, exanthemata, celsi papule, and Plinij mentegra.* 1.44 Ionthi are little swellings and those harde which arise in the outwarde skin and superficies of the face (as Paulus and Galene thought) proceeding from a grosse hu∣mour, which are either resolued, or else rypened by a little matter which springeth with it. The Latines call them vari: Galene maketh mention lib. 5. de medica. secundum locos, of an affect, which he calleth ionthosus affectus, which he sayth is the foundation and beginning of elephantiasis, vnder the which disease he seemeth to comprehend the thirde and fourth kinde of that which Celsus nameth impetigo.* 1.45 Epinyctides, (as Celsus supposeth) are pesti∣lent pushes either of pale colour, or of a blacke colour, or of a white hewe, not exceeding the bignes of a beane arysing either in the legges or in the fette. About them there is al∣wayes a verie vehement inflammation, and when they are opened, there is founde a verie thicke and clammie exulceration within. His colour is like vnto his humour: but the griefe greatly surpasseth the bignes of the sore, which in quantity surmounteth not a beane. They borrowed their title frō the night,* 1.46 either (as Celsus thought) because that in the night time they pricked & molested more grieuously, or because they most cōmonly aryse in the night. Plinie termeth thē blewish pushes, disquieting specially in the night time. The Arabians call them essere, sere, or saire, which words explane the forenamed nature of the sore. Those which are called of the Greekes hidroa, the Latines terme sudamina, and Plynie papule su∣dorum.* 1.47 Auicene planta noctis, & almansorus, & alhasaphum: whereby it commeth to passe that epinyctis doth much differ from Auicene his plantanoctis, although the Greeke worde epinyctis doth draw his originall from the night. But these sudamina (as Galene sayth) lib. 4. Apho. Aphor 21. are reckened among those kinde of pushes or whelkes, which sticking in the verie superficies of the bodie, doe pricke & shoote, not vnlike to our common vlcers, and they come (as their name doth declare) by many bilious swettes, which byteth the skinne and maketh it to itch and pricke like vlcers. But this affect is common to boyes and young men, and to those which are cholericke, but in the time of heate: but it is so ea∣sie to be cured, that of it selfe without any aide it will heale, rypening with a white toppe. But Auicene thinkes that these desudations, by their discription, agree ratheir with Celsus his exanthemata, then with Galene his sudamina. But he, who will obserue the nature of the wordes,* 1.48 will thincke, that Auicene his desudations may well be the Greekes hidroa,

which the Latines call sudamina. But we must not followe the names so much among the Barbarian and Arabian writers, but the genuyne and sincere descripitons of the thinges them selues. Psydraces or psydracia,* 1.49 are pushes which abyding in the verie vttermost part of the skinne, are resembled to bladders excited by fire, which are called phlyctane. These ryse specially in the heade. Psizacionis not truly read in Celsus for psydracion. Those pu∣shes, which grow in the skinne first comming by thicke humours stuffed in the skin, which are commonly called morbili and variola, of Galene because they swell, and waxe bigge, as it were the bud of a floure they are called exanthemata, but of Hippocrates,* 1.50 because they doe breake out of them selues, they are termed ecthymata. For 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, whereof exanthe∣ma is deriued, signyfieth a floure, and 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, whereof ectyma commeth, signifieth to burste out. Plynie callet•• such pusshes, whelkes, and the eruptions of fleame. But these are of two kindes: for some of them are steipe, and some goe out into breadth those which are steipe, doe growe of a more thinne and hote humour and doth excyte itche. But those which are broade, doe flowe, and proceede from a more colde & thicke humour, and doe not a whit procure itch. The first sorte, of the common Physitions are knowen by the name morbile: the seconde by this name variole. But the French men pre∣posterouslie abusing the names haue called the lowe and broade kinde rubeole, but the higher sorte variole. Hippocrates. lib. 3. Epi. doth deuide these kindes of pushes into little and great ecthymata, in calling the steeper kinde magni herpete, either because (as Galene sayth) they occupie a great place, or else because they happen with a vehement gnawing. For in deede these sometimes appeare great in heyght only, sometimes both in height and breadeth. Cornelius Celsus lib. 5. medicinae suae in his treatise of impetigo re∣membreth two kindes of whelkes: the one some what small,* 1.51 which if it be dayly rubbed with fasting spittle, it waxeth whole: the other somewhat greater, wherein the skinne is made more sharpe, and is exulcerate, and groweth verie vehemently, and looketh red, and is hardly cured. He saith, that this is termed of the Greekes 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, in Latine fera. But in both these kindes he confesseth that there is lesse impediment or corruption then in impe∣tigo, so that he affirmeth, that that euil, whose cure is harde, except it be taken away, doth chaunge and turne into impetigo. The Frenchmen (if I may iudge thereof) doe call both these kyndes, but especiallie the first, dartrae. For that euill beginneth to be verie round, and after the same manner it commeth (as it were) into a cyrcle, and creepeth slowelie.* 1.52 Which whelkes or pusshes doe agree in all thinges to be those, which are sayde of Cel∣sus to be of the first kinde. Some doe constantly affirme that these whelkes so named of Celsus doe nothing differ from lychene among the Greacians, or the impetigo among the Latines. And we haue read that that onely authour among the Latines hath tur∣ned lychene into papulae. Mintagra a Latine worde vsed of Plynie, wherein he seemed in the beginning lib. 26. to haue altogeather meant another thing from impetigo,* 1.53 and that it was farre a waie a worse euill, then that which the Greekes comprehend vnder the name of lichene, although in his Physicke he hath interpreted sometime lichene among the Greekes to be impetigo, and the like disease called mentegra, he termeth also in the same place li∣chene. Furthermore the same Plinie reporteth,* 1.54 that this euill crept first into Italie in the raigne of Tiberius Caesar, which griefe in all the time before was vnknowen to all Europe, much lesse vnto Italie. It was of so great filthines and corruption, that any death was to be preferred or wished before it, and also of so great infection, that by the swifte pas∣sage thereof onely by kissing one another it infected the people but chiefely those that were gouerners and rulers among them. This euill beganne almost at the chinne, for that it did chiefely affect and annoie, whereuppon it toke this name mentagra. This per∣happes is that scabbe, which certayne of the Frenchmen call mala dartra. Galene also seemeth to acknowledge this disease:* 1.55 for in his first booke de medicam. compos. secundum locos, he remembreth a most vile kinde of impetigo of the chinne, which (as he rehear∣seth, out of Crito (prouoketh itcheing, it afflicteth also the patientes, and bringeh them into no small daunger. For sometime (sayth he) it runneth ouer the whole face, and goeth vppe to the verie eyes, and it causeth the greatest deformitie of the bodie al∣most that can be, which description of impetigo doeth consent in all thinges with the

mentagra of Plinie. But they doe greatly erre, which doe thinke that this most contagious lichene called of Plinie, mentagra, is that disease which at this day commonly some do call Gallicum malum,* 1.56 some Neapolitanum, other some not bearing any hate or iniurie to their con¦tries do call it venereum. For this infection was altogeather vnknowen to the ancient Phi∣sitions, and also of the former age, and first of all it crept into Neapolis in the yeare after the incarnation of Christ. 1493. At which time Charles the eight, that most inuincible king of Fraunce did ouercome and winne the Alpes, going abount also to inuade Italie: al∣though not long before, it had spred it selfe abroade through the countries of Spaine (as some report). Wherefor hauing as it were the originall & beginning from thence, it be∣gan to be called Hispanica lues, the spanish pestilence, which plague being sent vpon the earth as it were by the iust reuengment of God (as we may thinke) for their filthie and ab∣hominable whoredome forbidden of God, hath corrupted and ouerthrowen with the cō∣tagion thereof a great part of humane kinde. For the same sicknes the magistrates and offi∣cers tasted of, the prysoners and captiues felt, the heades of their countries sustained, & the common people also were infected withall: so swift was the passage thereof from one to another, and now also it straieth and wandreth through the countries of Spaine, Fraunce, Italie and all Europe to the great annoiance of the people. There are also certaine pusshes besides these,* 1.57 rehersed euen now out of Auicene lib. 4. called glandosae, which do seeme to differ nothing from the disease called ganglion, but in respect onely of the lesser or the grea∣ter. There is mention also made by the same Auicene. lib. 3. of certaine whelkes, which he calleth in the same place, bothores iuncturarum, & in lib. 4. he calleth them almatim, which, because he sheweth that they be blacke, & resembling greene corne, they must doubtlesse be those which the Greekes call terminthi,* 1.58 which a little before we accounted among the species of phyma. These Celsus seemeth to compare vnto vari, which be spottes in the face, who also iudgeth them to be called of the Greekes helcodes, that is, vlcerosae, full of scabbes or sores.* 1.59 These white and milkie pushes, so called of Rasis and Serapion, and of Auicene lenis bothor if their descriptions be throughly considered, they will seeme to partaine vnto the whelkes called of the Greekes Ionthi, which we in Latine haue named vari: although the selfe same remeadies, which Auicene hath set downe for them, be taught of Dioscori∣des for the disease ephelide (that is to saie) for the roughnes and swartnes of the face, be∣ing caused by the heate of the Sunne. Hitherto haue we intreated of the differences of tumours aboue nature, which chiefly haue their residence outwardly aboue the bodie. Now let vs proceede to declare the causes of them.

CAP. III. Of the causes of tumours aboue nature appearing vni∣uersally on the outside of the bodie.

THERE are two causes of tumours chauncing besides nature, agreed of a∣mong the latter sort of Physitions and Chyrurgians:* 1.60 that is to saie, generall and speciall causes. Generall causes are these, the fluxe, which the Greekes call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, and the congestion or heaping togeather of humours. Againe by the same writers there are appointed to be six causes in number of this fluxe,* 1.61 that is to saie. 1. the strength of the repulsiue member. 2. the weakenes of the retentiue. 3. the aboundaunce and plentie of matter. 4. the loosenes or fulnes of the poores of the bodie, through the which the fluxe happeneth. 5. the straighnes of the repulsiue partes. 6. & the lower situatiō of the place retayning the fluxe. But these may be reduced vnto foure heads, as vnto the repulsiue mēber, the part that reteineth, the state of the humour that flow¦eth,* 1.62 & the place or course, through the which the flowing chāceth. But the flux is prouoked either by the meanes of the expulsiue mēber, or because of the fortitude of the expulsiuever tue, or by reason of the naturall knitting togither that it hath with the retentiue mēber, or because of the straitnes of the particular poores, but some part receiueth the fluxe because

it is either painefull, or hote, or somewhat weake, or seldome, and base, or settled in the neather roume. Furthermore by meanes of the humour there is a defluxion or flowing down into some part of the bodie, because it is in aboundance superfluous, of nature troublsome, and of substance thinne. But the space or place is a cause of the fluxe by reason of the larg∣nes of the passages, as of the veynes, arteries and poores. But of congestion,* 1.63 (which is the other generall cause of tumours which chaunce aboue nature) there are assigned two cau∣ses: (that is to say) the fault of the vertue nutritiue,* 1.64 and the imbecillitie of the vertue ex∣pulsiue. By the which things we gather, that hot tumours happen for the most part through the defluxion of humours, but colde tumours are rather prouoked by their congestion. But after what manner a hote fluxe excyteth the tumour,* 1.65 Galen doth declare plainely and wit∣tilie, in that little booke which he intituled inaequalis intemperis, writing after this manner. A hote discending of a fluxe (sayth he) assone as it hath once placed it selfe in the mus∣cle, first the greater arteries and veynes are filled & stretched out, then by their meanes the lesser are distended, and so it proceedeth vntill it commeth to the least of all. In them, whē a fluxe is strongly compact togeather, and can no longer be conteyned, parte thereof issu∣eth out through the extreame partes of them, and part is strained out through the holes of the tunicles, and is speadily sent forth, and then those voide places are filled with the fluxe, which are betweene the best and chiefest bodies. Thus all thinges proceeding of the hu∣mour do waxe hote in euerie place, and also are still poured forth. And these are they the synewes, the bindinges or ligaments, the small silmes, the verie flesh, and besides these, the arteries and veynes, wich truely being the principall, are diuersly and many waies afflicted aboue the rest. For inwardly by reason of the fluxe they are both made hote, and also are stretched out, and torne and pulled a sunder. And outwardly also, they are not onely made hote, but also are suppressed and made heauy. But the other partes of the bodie, some truely are onely made hote or kept downe, and some are affected with both. And this disease is called phlegmone. Hitherto Galen. Therefore in such kinde of tumours chauncing besides nature, which are caused of the flowing of humours, something alreadie (at the least waie at the beginning, and before the fluxe did beginne to striue) is made and engendred, and something is yet to come, and resteth in the generation. That which doth happen as yet, is the matter which went before, which as yet abydeth in the fluxe: but that which is engē∣dred alreadie, is the ioyned matter, which hath alreadie flowed: and is compact in the a∣grieued place. Hereupon therfore there must be vsed a diligēt care of the Physition in such kindes of phlegmone which as yet remaine in generation (as in all other tumours also, & dis∣eases, which are yet in begetting, neither as yet haue obtained perfection) as Galen lib. 13. meth. med. doth declare thē to be known & perceiued, both by that which foreseeth,* 1.66 & that which cureth: but these things pertaine to an other kinde of study. But it is conuenient, that we set down the speciall causes of tumours which are aboue nature, to the which these three are commonly appointed: Primitiue causes, which we cal both praegressae & euidentes, & cau∣ses antecedent, which we name antecedentes, & ioyned causes, which we terme coniunctae or continentes. These be called of the Greekes, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. The primitiue causes are said to be these, which while they do worke any disease are separated, as a fall, a stripe, a blow, a bruise, a tumour, or a solution, or that euill which is committed by admitting a dissolut diet. Antecedent causes are those, which of themselues are fit & materiall to beget any disease or affect, as are four humours both naturall & not naturall. Naturall humours are those which serue to nourish the body, & haue their being with the blouds, & are com∣prehended vnder the name of bloud. Which if they be sent out from the veynes & arteries, they do sodenly congeale & gather togeather, wheather they flow without the body, or do remaine still in the place wherein they be conteined. But they call those vnnatural humours,* 1.67 which are founde seuered from the bloude with the which the bodie is norished, and by reason of their corruption and naughtines by their owne nature, are not nutritiue, the which doe sometime grow although they remaine in the aire which compasseth vs. And these as it were by a certaine kinde of prouidence of nature, being destyned and ordey∣ned for some vse, are demitted and sent into certayne receptakles, either into the vt∣termost partes of the bodie, and so engender vnkinde swellinges called abscessus, or

whelkes, scabbes, defedations and alterations of the skinne, and vnnaturall swettes: or sometime by an insensible ayer inwardely infused they doe excite sweatinges. Some∣time also they putrifie within, and beget feauers. But such like (say they) are impro∣perly termed humours assuming to them selues the names of naturall humours. For they holde this opinion,* 1.68 that onely those iuyces, which come from the liuer in the generati∣on of bloude, and of nutrition and moysture, are properly to be termed naturall hu∣mours. Such are sincere and pure bloude, cholericke also, flegmaticke and melancho∣licke, by the which foure kindes all the partes of the bodie are generally, nourished and maintayned: some partes with a more pure, and (as I may saie) a more bloudie humour: other with a humour more cholericke, other with a flegmaticke, and other with a melan∣cholicke, as the nature of euerie parte requireth. Therefore all the humours are conteined in the veynes and arteries, the which may appeare by their varietie of colour and consi∣stencie (as Galene hath expressed in in libro de atra bile. Furthermore of those foure tu∣mours which are called naturall,* 1.69 foure especiall tumours are engendred, which are com∣monly called apostemata. In the which the swelling is verie bigge, and the matter doth of∣fende rather in quantitie then in qualiltie. They are called by their proper names, phleg∣mone, erisypelas, aedema, scirrhus. Of tumuors not naturall (as it pleaseth the latter Phy∣sitions) doe procede abscessus, which they also call exiture and pustule, which they thinke cannot well be called apostemes. To the which they will adde and reduce two other kindes also, flatuous and waterie, which proceede of a fluible substaunce, and are cōmon∣ly called apostemata ventesa & aquosa (that is) windie and waterish apostemes. There be therefore six titles attributed vn••o simple tumours, (that is) phlegmonosi, erysipelatosi, adematosi, scirrhosi, flatuosi, & aquosi. But the compounde tumours are not all called ac∣cording to the concourse of humours, (because a great many may happen in one disease) but they are named by the predominant humour especially as we haue manifested hereto∣fore, and will hereafter more plentifully in his owne place. But coniunctae causae or conti∣nentes of those tumours besides nature,* 1.70 which they commonly call apostemata, pustule and exiture are matters and seuerall substances, which are founde to be aggregated and stuffed togeather in the affected parte, and which doe yet remaine after they haue excited the swelling: and while they encrease the tumours also doe greatly augment, and when they decrease, the tumours are deminished, and when their substaunce is vtterly spent and ex∣tinguished, the tumours also of them selues doe fall awaie. And this cause called coniu∣cta or continens causa, of all the maladies and sundrie dispositions of the bodie, is after this manner by Auicene defined,* 1.71 that, when it is present, his disease alwayes accompanies him, and also when it is taken away, his disease also vanisheth. But for all this, some Physitions of our age, and those verie well learned, doe contende that Galene woulde ad∣mitte but two causes (that is to saie) an externall, and an internall (or as they saie nowe) a primitiue and an antecedent. Of the which that (he sayth) doeth happen to the bodie outwardely, which altereth and chaungeth the same greatly, the which alwayes is seperated, vntill it hath established his maladie, as heate, colde, the byting of a Scor∣pion. But the internall hath his being within the bodie, and doth presently procreate the maladie, as are humours affected besides nature. But they doe constantly affirme, that he neuer so much as dreamed of that, which they terme causa coniuncta, when as accor∣ding to his opinion, euerie affect which letteth and hindereth the actions and duities of the bodie, is a maladie it selfe, and not the cause of a maladie, and that coniuncta causa, which Auicene and his secte haue inuented, according to their owne description, which they assigne vnto it, is nothing but a certaine kinde of affect letting the execution those duties partayning to the bodie: which is the verie definition of a maladie it selfe. And therefore they proue that it nothing differeth from a disease it selfe, which is wonte to preiudice those actions which agree with nature.* 1.72 But because one, and the selfe same o∣pinion hath occupyed all mens mindes of this latter age concerning this triple kinde of the causes of all such diseases, it shall not seeme altogeather absurde, if that I throughout all this treatise of myne, for playnesse sake, shall deuide and distinguishe these three causes, into these three kyndes and titles:: I meane primatiua, antecedens and coniuncta.

And thus much for the causes of tumours happening besides nature. Nowe the course of our treatise doth exact, that we should adde the signes and tokens of the same, if that be∣fore, we shall intreat somewhat of the nature and generation of the abscessus.* 1.73 Abscessus therefore, called of the Greekes 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, and of the common Physitions exiture, are cal∣led of Galene (libro de tumoribus praeter naturam, & secundo ad Glauconem) dispositions, in which the partes of the bodie doe depart one from another, which before did touch and meete: for the matter which doth excite these tumours, being thrust out without the flesh of the muscle, doth bring the partes out of their places, and maketh them part and feuer. Therefore sayth Galene, there must of necessitie be a place voide in the middest, which borroweth either some flatuous moist, or tempered, or mixed substaunce from the partes, which in length of time is altered, into many and sundrie substaunces. But there is a double kind of these abscessus, one is, when as the inflammation being turned into matter,* 1.74 the mat∣ter it selfe is packed vp togeather in a corner or hole: the other is, when as no inflammatiō proceeding or going before, a certaine humour either vaporous, or else a substance mixed of both parts, is in some part collected togither which also happeneth two waies: for either in the space lying betweene the seuered partes, such like substaunce is engendred, or else it runneth into the partes them selues, and that eitheir in the beginning, or else that waie by the which those diseases happen called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉:* 1.75 which (saith Galene) then doe chaunce, when as humours which before haue infested and greaued some one parte, doe thence remoue, and are inforced into another. And this substaunce, which begetteth this abscessus, worketh him selfe a place betweene the skine and the flesh. And in time it doth flea of all the skinne, either because it is very vehement, or else because the plentie of mat∣ter doth putrifie, and so breake the skinne. But if those humours, with the which, the space situated betwene the seuered partes is filled, doe continue any time: they haue (as I saide before) many alterations, and are chaunged into many substaunces, which doe repre∣sent the proprieties not onely of humours, but euen of solide and harde bodies. For you shall finde sundrie matters within these spaces, some like vnto stones,* 1.76 some to grauell and sand, some to wood, some to coales, some to durte, some to the foame of oyles, some to the dregges of wine, the varietie of substaunces, some ignoraunt men haue thought to proceede from the force of incantation.

CAP. IIII. Of the signes of tumours besides nature generally appearing togeather with the iudgements therof.

TVMOVRS besides nature, being resyaunt in the extreamest partes of the bodie (the examining and speculation whereof doth appartaine to the chi∣rurgion) being surueyed by the iudgement of the senses,* 1.77 & the affected parts being touched and felt with the handes are easilie descried and knowen. For in euery part of the bodie there appeareth a certaine kinde of encreasing ex∣ceeding the naturall state, and distending aboue the measure of nature that parte which it affecteth, and it letteth the duities or actions thereof, because either some humour, or some such substaunce proceeding of the humour, or which doe fauour somewhat of the nature of the humour, or a vaporous spirite hath excyted it, there also must needes happen a tu∣mour besides nature. But the tumours which they call true Apostemes, are discerned by their swelling, by their paine, & by their heate, being stretched out more or lesse. But they are not counted to be true apostemes in deed, which we haue termed pustule & abscessus, be∣sides that tumour, which maladie the Grecians call cacôethia, and also in the greater or les∣ser sequestratiō, determinata. But the signes of euery particular difference,* 1.78 & of their matters wherof they be engēdred, shalbe declared in their due place, in that which followeth. In the meane time we will handle the simple differēces of those tumours, which are aboue nature, by the which the compounde differences shall also be easely knowen. But we must not

come vnto particular thinges, before we haue throughly discoursed of vniuersall, for that order is wonte to be obserued in the institutions of the Artes neither truely vnworthely or without cause. For those vniuersall and common thinges are more manifest vnto vs then particular, because these particular things are more confused and more mixed one with an other (as Aristotle teacheth lib. 1. Physicorum cap. 1. Let no man therefore maruell, though euerie where in this treatise of chyrurgie, we alwayes beginne of more common thinges, and of those which comprehende many thinges vnder them. But let vs returne to our pur∣pose, [ 1] & let vs prosecute the iudgements of tumours consisting aboue nature. In the which first of all we must note,* 1.79 that all those tumours which they call true apostemes (if we will credit Galene and Auicene) are greatly complicate and folded togeather, neither can any of them be easely iudged or founde, out to be pure and sincere: for (as Galene sayth) with phlegmone (that is) with an inflammation comming of bloude,* 1.80 there is something chiefly mingled which doth preserue the nature either of erysipelas, or aedema, or scirrhus. But erysipe∣las, because it representeth a kinde of phlegmone, or aedema, or scirrhus, and so likewise cō∣sider & marke in all the rest of the tumours. But truely those tumours besides nature, which they terme not true apostemes, are verie often found sincere and pure. But we will handle the cures of simple and sincere tumours in those thinges which followe, by the which the remeadies also of compound & intricate tumours shall manifestly appeare. For I thinke it good to discourse of all the kindes of tumours, and also to dispose aright that which shall seeme superfluous. For if a man shall knowe all the simple tumours, and learne after what manner they be compounded togeather, he shall be furnished sufficiently to exercise him selfe particularly in the rest. But now let vs set other opinions and iudgementes generally concerning the tumours them selues. Periodi, paroxismi, and the crises of tumours besides nature doe followe the analogia of the humours whereof they be conflated or engendred (Guido affirming the same) which analogia, we here declare to be a propertie, or pro∣portion, a nature, or a likenes of substaunce, which they call forma specefica & occulia, a speciall and hidden forme. Such kinde of tumours, especially they which be holsome, & which are caused of the flowing of humours,* 1.81 are distinguished by foure times (that is to say) by their beginning, by their increasing, by their state, and by their declination. The [ 1] signe of their beginning is, when the member beginneth to be stretched out, and when the beginning of fluxe is present,* 1.82 but yet with small griefe. We may also iudge augmenta∣tion [ 2] to be present, when we see the tumour to be raised: like a heape or pyle, and the place affected to be filled,* 1.83 and the symptomates, which are wont to followe euerie tumour, to be [ 3] manifestly increased. But the token of their state is, when all the aforesaide thinges (that is to say) the tumour,* 1.84 and the symptomates of the differences of euerie tumour, hath his owne proper force and vigoure: neither can they any longer admit any encreasing but the [ 4] matter causing the tumour doth degenerate and chaung it selfe into another kinde of sub∣stance.* 1.85 But their declination is then knowen to be present, when the pyle of the tumour, and the proper symptomates thereof are decreased and diminished, or when the matter which prouoketh the tumour beginneth to be transformed into another substance. There∣fore such kinde of times do receiue their differences from three kindes especia••ly (that is to say) from the essence of the tumour it selfe (that is) from the greatnes or smallnes,* 1.86 from the disposition of the matter, and from the accidentes, which doe very much alter the declara∣tion of the cure. But these foure times, sometime doe seeme to happen altogether, be∣cause of the short hardnes of euerie one of them, which almost cannot be perceiued, (as it chaunceth in venemous inflammations,) yet not mortall or deadly, which straight way do flourish and increase.* 1.87 Furthermore these kinde of tumours, which doe chiefly happen through the influxiō of humours, except they be hindred by repressing the matter that flow¦eth, or except they lurke secretly within, either of their own accorde, or without any mani∣fest cause (the fluxe hauing recourse thither:) it is necessarie that they should be comprehē∣ded vnder one of these foure either vnder insensible exhalation or resolution, or vnder suppuration, or putrefaction, or induration & hardning. But of all these waies the best and the most to be desired is that which is made by an insensible dissolution, & next to that, that which cōmeth by suppuration or mattering. But that which is caused by induration & hard¦ning

is said to be euill, & that which happeneth by the corruption of the affected part is to be thought the worst of all, the which Galen doth insinuate in libello de inaequali intemperie,* 1.88 writing on this manner. Therefore of the two, we must of necessitie followe the one, either that the bodie be putrified and corrupted, because fluxion is predominant, or else we must graunt, (that this putrifaction being resisted and ouercome) the musckle must returne to his naturall habite and constitution. Let vs therefore imagine that all fluxion is withstood and impeached, then you haue two meanes to cure it, either by digesting those humoures which were in the affected part, or by dissoluing or loosening them: of these the dissolu∣tion is best. But in the concoction of the humours, these two thinges are speciallie requi∣red: vi••••. the perfect generation of the matter, and also his abscession into some space by it selfe. And a little beneath he addeth also these wordes. But if that fluxion do make the parts as it were subiect to it, then they do fall to so great an intemperature, that their ordi∣narie action perisheth and in processe of time they are corrupted and putrified. Thus farre Galene. The tokens of dissolution and loosening of the humours are these,* 1.89 the softnesse of the sore, and the little throbbing and beating thereof. But the signes of predominant fluxiō, and of the putrifaction of the part it selfe, are the blacke & blew colour, to which also some∣time happeneth an odious stinch. But the tokens of a stonie hardnesse of the tumour are, the imminution of the tumour, and also the extreame hardnesse therof. The notes & signes also of the egestion and lurking of the tumour, are the sodeine diminution thereof, which chaun∣ceth sometime by to much refrigeration and coldnesse, sometime by reason of a secrete ve∣nime, which lurketh in the place. And this same sodaine and oftē imminution of the tumour, succeedeth commonly some feuer, and also other euill simptomates. And thus farre of the signes & tokens of these tumours. Which our common Phisitions haue comprehended vn∣der this name Apostema. The tokens also of those tumours which we call pustulae, shall not be forgotten, when we shall haue occasion to handle them. But the tokens and signes of the abscesse••, commonly called exiturae, either these which do foreshew their comming, or else those which do manifest their presence alreadie, are these. When thou seest (saith Auicene) pulsation and beating, or hardnesse to haue continued a great time,* 1.90 and also that the griefe togither with much heate doth augment, then you may imagine that the next euent that followeth is, that the Aposteme wilbe turned into matter and suppuration, and so conse∣quently to be an Abscession. But when thou findest that the place is soft,* 1.91 and that the griefe is somewhat asswaged, and the heate mitigated, and that one place of the tumour is supere∣minent aboue the rest, and againe if by thrusting it with your finger, you shall perceaue a waterish inundation to subsist, and againe that the colour of his top shall wax white, then you may well thinke that the tumour is mattered, and also that it is turned into Abscession. And therefore it was verie well iudged of Hippocrates, that Feuers did oftenner happen,* 1.92 when that the matter was in ripening, then when it was alreadie come to his maturitie. Moreouer the markes & tokens as well of the present Abscession, as also of the Abscession to come are comprehended in these common verses:

Durities longae, pulsus, dolor, & calor aucti, Signant pus fieri: sed factum, dictae remissa. Sub digitis vndans, albescens pars & acuta.

which may be thus Englished:

By hardnesse long, by pulse and griefe, and eke by heate encreasd, We knowe that matter doeth approch: but made we iudge indeede, If that it yealdes to finger weight, and whitenesse doeth appeare,

—and painefull be also.

But you must be verie attentiue and vigilaunt in discerning and iudging of the matter it selfe. For the manifest knowledge of the matter and suppuration is sometime with∣holden from the Phisition by reason of the thickenesse of the skinne in the which it is in∣cluded, (as it is proued by this Aphorisme of Hippocrates.* 1.93) Whosoeuer is ignorant of the suppuration which is in the bodie, his ignoraunce proceedeth of the thickenesse of the matter, or of the place, wherin it is comprehended. And thus much for the signes of Abscessions. Nowe of the iudgementes of them, these thinges are deliuered vnto vs of

Auicene and his sect.* 1.94 Abscessions which are planted neare vnto anie strong member or vnto anie iuncture or ioynt, and in those places where there are most veynes and sinewes, and againe in a weake parte, hauing gathered his debilitie by the defect of naturall heate, being indurate also and couered with a thicke skinne, conteyning also thicke matter, and so the more slowe in motion, the outward place being plaine also, and euen, not ascen∣ding like a little hillocke, I say, such a like sore is greatly suspected, and verie hardlie and slowlie ripened, and such a one as is euerie way by description opposite and contrarie to this,* 1.95 is of good and laudable habite, for both soone and easilie it mattereth, and often∣times also (no outwarde medicine aiding or assisting) of it selfe it gapeth and openeth. If therefore the abscession doe growe vp into a sharpnesse, and the substance of the matter be thinne, and the skinne not thicke or harde, of his owne nature and power it will expell and thrust foorth the conceaued humour without anie forreine aide, vnlesse a man by ma∣king incision will anteuert and preuent his voluntarie opening.* 1.96 Such like Abscessions are digested sometime by breathing or winde (no solution being made subiect with∣in the skinne,) but that happeneth when the matter is small in quantitie, good, and thinne, and not sticking verie deepe. But if there be anie emissarie, or way made into the tumour either by nature or by Art, the humour conceaued within doeth breake foorth oftener then digest. But that opening or apertion which is made by nature, is a great deale safer, then that which is made by the hand: but if it be so, that it must be mollified by Art,* 1.97 you shall saflier doe it by a sharpe penne knife, or other cleare and bright instru∣ment of yron, then by that medicine which they call ruptorium medicamentum. And there∣fore (as before I sayed) euerie apertion, which is made and enforced by Art, is worse then that which nature affoordeth of it selfe, because such like manuell openinges to make the matter rancke, may perhappes tourne into Fistula. But when necessitie vrgeth, and when wee can not vse a better remedie, wee must boldlie attempt that. And by this meanes you shall eschewe those discommodities, which before I named, if (when the matter so requireth) you doe seasonablie make apertion, and by that meanes hasten the ripening of the other baggadge which lurketh in the tumour. Hippocrates in his last Oracle of his first booke of Praedictions hath expressed the verie notes and markes of the worst matter,* 1.98 and of the best, speaking after this manner. That matter it estee∣med best, which is of colour white, and euerie way like it selfe, and soft, and gentle to the toucher, and as little vnpleasant to the nose as may be. And that which is euerie waye contrarie to this, is the worst of all. But the tokens and signes of all the other humours and solide substances also which are included in these abscessions, shall be manifested and shewed in their particular Chapters, as they shall by consequence and order ensue.

CAP. V. Of the generall method of curing of all tumours besides na∣ture, but of those especiallie vvhich proceede from the influxion of humours, as Apostemes, and Abscessions commonly called Exiturae.

OF all Tumoures aboue nature, as well those which are alreadie ingendred, as those which are not yet in generation,* 1.99 there is one common and principall or∣der of curing (as it is in Galene lib. 13. and 14. method. Medic.) namely that that, which is aboue nature resident in any member, and raiseth the same into a Tumour,* 1.100 should altogether be emptied out. But those which are yet in begetting, in them there is a certaine obstruction of the humour that floweth to the aggrieued place, be∣fore the euacuation. In them therefore there is required a diligent and singular care of the Phisition, to declare the cure of them. But these common manifestations, according to the difference of the Tumour it selfe, and the nature of the affected membre, doe verie much differ and alter. For truely in all Tumours alreadie ingendred, and in euerie part of the bodie, the euacuation of that which annoyeth, and infesteth, is in no case to be vsed and

ministred, as Galene teacheth libro 2. ad Glauconem, and in the places aboue recited, which also shall manifestlie appeare in that which followeth. But we must not cure those tumors with such remedies, which are yet but beginning and occupying euerie member, or emptie, out that which is alreadie ingendred in them, but we are enforced (if we intend to followe the right order of curing) to vse sometime one remedie, sometime another, which is of force to stop the fluxe, and auoide out that which is engendred, so farre foorth, as the kinde of the tumoure and the nature of the affected member doeth require.* 1.101 Galene therefore chieflie draweth the demonstrations of the cure of tumoures aboue nature from these two thinges. vidz. from the disposition it selfe or essence of the euill, and from the nature of the affected member. Moreouer the disposition of the euill (which we haue nowe in hande, or the essence thereof doeth comprehend three thinges in it, according to the iudgement and consent of the later sort (that is) the quantitie, the qualitie,* 1.102 and the matter or substance which prouoketh the tumour. By the meanes whereof that chiefe and common declaration is chaunged, and from them is taken also the perticular order of cu∣ring. For a great tumour is cured one way, and a small tumour another way. For the dif∣ference of them is knowen by their greatnesse and smallnesse (as some suppose.) And one way is a mightie phlegmone, & another way a little herpes healed. Otherwise also is that Tu∣mour remedied, which is caused by fluxe, and is yet in begetting, then that which it pro∣created through congestion, or is alreadie ingendred and congealed. Also a hote tumour as Erysipela•• is otherwise cured then a colde, as is oedema and schirrus. The quantitie therefore which in a tumour aboue nature varieth the cure is either great or small. The qualitie is the fluxe, or (as some tearme it) the deriuation and congestion. The Matter thereof is the hu∣mour, be it either hoate or colde.* 1.103 But in the nature of affected members foure thinges chieflie are to be considered. vidz. their temperature, their forme or fashion, their situation or place, and their power and strength. To the which also may be added a fift thing, which is the facilitie (as I may terme it) and difficultie of the senses. Except you will with Galene comprehend and containe it vnder the last thing, which is the vertue and strength of the tu∣mour. These things therefore also doe much alter that generall order of curing, which is commonly obserued throughout all kinde of tumours aboue nature. It is therefore requi∣site, that, in curing those tumoures which chaunce besides nature, we remember all those declarations which are taken from them. For Phlegmone, or anie other tumour which hath his abode in the fleshie parts of the bodie, is otherwise cured then those which are situated in the sinewie places: otherwise in the eye, then in the knee or neck: and otherwise are the kernels in the throte cured, then those which are resident in other parts of the bodie. But to be short, the temperature, the fashion, the situation and the strength of the member that is affected, and beset with the tumour, do change all those operations, which we shal attempt and proue in their cure: reteyning still that generall intention,* 1.104 which Galene hath taught to be alwayes taken from the disease. Therefore first we haue here decreed to set downe a common & generall method of curing of tumours aboue nature▪ especially of those, which are caused through the influxion of humours, taking their manifestation from the affect or euill it selfe, nothing respecting the affected part. Afterward we will teach the vniuersall cure of them, but chieflie of inflammations, when as they shall degenerate and change into abscessions. Then moreouer we will declare the perticular order of curing all differences, es∣pecially of those which be simple, by whose proportion or Analogie, the cure of compound tumours shall easilie be learned. And in the meane time, as the place shall require, we will rehearse out of Galene certaine thinges concerning the order of curing, which haue their assumption from the partes which are affected, & as it were besieged with a tumour which things being rightly weighed and considered, it shall be easie for anie reasonable Phisition or Chiruigian▪ by our certaine methode & order,* 1.105 to cure all kind of tumours which are insi∣dent in anie part of the bodie. We therefore imitating Galene, will draw the beginning of the cure of tumours which are said to be aboue nature frō the flowing of ingendred humors and from the inuention of the cause of the verie euill, that so both the causes which excite the same, may be preuented, and that which is alreadie ingendred in it may be taken away. Therefore by the example and analogie of one difference of tumours, which are caused tho∣rough

defluxion (for here we mind to intreate only of them) we will vnderstand also other differences,* 1.106 which do grow through the flowing of humours. And here we will set downe a briefe and compendious curing of one kind of phlgemone, which chanceth verie often, and procureth feauers and other verie daungerous euilles and simptomates. But in this place vn∣der the name of phlegmone, our intent is not to comprehend euerie hote and flaming dispo∣sition▪ which the Greekes call phlogosis, but that onely which proceedeth by the meanes of a bloudie fluxe, chieflie incident to fleshie and fat bodies, wherin is vehement paine, & red∣nesse appearing in the outward parts, and as it were a burning heate, a stretching out, and a striuing or thrusting, and when the euill is increased, there is sence of the pulses beating. For this inflammation with Galene and other Greeke writers, as Paulus, Aetius, and Oribasius, which do followe him as their best guide,* 1.107 we properlie call phlegmone. That we may there∣fore come to the matter it selfe, these are the verie wordes of Galene. The common ingen∣dring of euerie phlegmone commeth by the influxion of bloud, and that more aboundantlie then was wont to happen to that member. For bloud doeth flowe verie aboundantly (some∣time one or other member sending it foorth) and that part doth entertaine and receaue it, which beginneth to be affected with phlegmone: but sometime that member which is af∣flicted doeth drawe it vnto it selfe. But the partes which sendeth it foorth do driue out the iuyce, being either superfluous by reason of the plentie therof, or grieuous bicause of the qualitie, or els because of both. But they which are attractiue, do draw or pull with a sicklie heate or griefe. But to these also are adioyned certaine helping causes. vidz. the weaknesse and basenesse of the member, the fulnesse of the conduites and passages thorough which the flux passeth, the straitnesse also & narrownesse of the poores & expulsiue parts, & the in∣feriour place,* 1.108 as we haue already declared. Therfore of all these, there are three intentions or orders of curing those tumours, which haue their beginning of flowing, collected & ga∣thered of the later sort of Chirurgians. 1. The first is to turne away the fluxe, & preuent it al∣together. 2. The second is, to mitigate the griefe, & altogither to remoue that cause, for the which, the member intertaineth or also draweth the flux vnto it. 3. The third is to empty out all that humour that hath flowed to the aggrieued place. But how the first intention should be finished, Galen hath fitly taught li. 13. meth. med. where he declareth vnto vs all the waies to auert & turne away the flux, & the meanes to stop & inhibite phlegmone, which as yet re∣maineth in generation, writing after this manner: when humours are equally augmented a∣mongst them selues (which the Greekes call plethora) yea also when all the bodie is void of excrements & doth containe a mediocrity of iuicie humours, (paine & the heate of that mē∣ber also wherin phlegmone raigneth raising the flux) through the emission of bloud we helpe and remedy phlegmone which now beginneth to rule. Plethora also is cured both with often bathing and with exercise, and also with much friction and rubbing. Furthermore it is cu∣red by medicines that will digest, so that a feuer be not present, and besides all these it is hel∣ped through hunger, & a good diet, although the sick be feuerous. But when the body is stuf¦fed either with melancholie, or choler, or fleume, or with other clammie & viscous humors (which state of the bodie the Greekes call cacochymia) the euacuation thereof must be la∣boured by a purgation,* 1.109 which is a fit remedie for euerie humour that raigneth. But of them we will speake more at large in their perticular Chapters.* 1.110 Nowe Antispasis (that is) a re∣uulsion the contrarie way, is a common remedie against all these kind of tumours, while the fluxe doeth yet stronglie preuaile, as in the beginning and encreasing of the euill: but in the end of the state, and in the declination thereof, while the fluxe nowe remaineth and sticketh in the member, and the whole bodie is sufficientlie emptied, the euacuation must be attempted and fetched either from the affected part, or from that which is next adioy∣ned thereunto.* 1.111 The second intention contayneth remedies to prouoke sleepe. vidz. which do mitigate paine, and also bind and preuent the fluxe. Morouer it teacheth remedies, which are able to loosen and dissolue the naturall poores, by the which the affected member is wōt to be throughly purged. But the matter of all these shall be aboundantly described hereaf∣ter.* 1.112 But we will handle the third intention, which is perfited with such things as do euacuate the matter that exciteth the tumour, from the affected place. And that matter is euacuated not only by medicines which do euaporate & dissolue, but also by such as do repell and re∣presse

such as the Greekes call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. And therefore in the beginning of these phleg∣monous tumors, and other whatsoeuer do deriue their beginning from the influxion of hu∣mours, we may rather vse repressing medicines, then those which do euaporate: except in certaine cases, of the which (saith Guido) Galene seemed to haue appointed foure.* 1.113 1. The first is, when that such tumours be in cleane and pure members. 2. The second is, when the subiect therof is venimous. 3. The third is when the matter is thicke, and not pliable to re∣pulsion. 4. The fourth is, when it is verie vehementlie packed togither. Auicene excepteth only two causes, vidz. when it happeneth in anie cleane or pure part, or in any other place, out of the which it is to be feared that the matter will flowe to some principall part of the bodie. Some other appoint onely one cause, other sixe, other tenne, other nineteene, other twentie three. But before we do establish any thing of this so doubtfull a cause, we must know that there be two kinds of repulsiues, both amongst the late Phisitions & also the A∣rabians (that is to say) common & proper.* 1.114 Common repulsiues are such as do inhibite all flux keeping vnder & repressing the same, & that is done either by cooling it, or by thickening it, or else by stuffing it (that is) by reason of the thicknes of his substāce, by shutting & occlu∣ding the poores & wayes wherby it would flow out, or else by confirming the parts affected These things following do represse flux by refrigeration & cold, sengreene, lettuce, psillium, cotyledon (that is to say (vmbilicus Veneris, lenticula palustris, caphura. And these also do stuffe & stop the passages farma called volatilis, the white of an egge, amylum, gluten, & the kindes of gummes. To conclude all such things as do refrigerate with ease and without biting. But those thinges which doe confirme and roborate (I meane such as do restore the naturall temperature to the part affected) as oyle of roses, oleum omphacinum, oile of mirtles, oyle of chammomill, absynthium, horehound, nux cupressi, and such like thinges, which being ap∣plied do strengthen the affected part, and so do free it and defend it from all imminent flux. But proper repulsiues are such, as when the humoures doe slide into some other part,* 1.115 doe meete with the same, and do enforce them to retire againe. And these are to be vsed then, when the member is grown thicke, as attractiue medicines are commonly applied to thinne Tumoures. Of these manie are of a colde qualitie, and manie of a hoate, but both sortes, (that is) both hote and cold are in operation astringent, and binding. The medicines re∣pressing which of nature are cold, are these, vine leaues, plantaine, nightshade dipsacos,* 1.116 vidz. virga pastoris, or bursapastoris, Glaucium, balaustium, omphacium, sumach, terra c••••••lia, com∣monly so called, and terra sigillata, and others of that kinde. Those be the simples out of the which manie compoundes are made, as oxycratum, the ointment of bole, the ointment of Galene, and such like. But the hote repulsiues are, allome, Cipresse nuttes,* 1.117 called galbu∣lae iuuens rotundus or odoratus, called of the Grecians 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, called also blatta biz▪ intia, lu∣pinorum farina, and certaine austere and sharpe wines, and manie other such like things. But we will set downe the whole order of applying of repelling medicines in the beginning of fluxions, prescribed by Guido in two seuerall prologues. In the beginning of all tumoures,* 1.118 which proceede from the influxe of humoures, but especially of such humoures as are phlegmonous, it will be auailable to vse repulsiues as they are called, these tenne causes one∣ly excepted, that is to say, when the tumour is in a fat member, or when it proceedeth of a venimous matter, or a substaunce which is verie thicke, and so vnfit to be repelled, or else, when the humour is vehemently packed in the affected part, and deepely also, if the Tu∣mour be inclined to suppuration, or descending from a primitiue cause,* 1.119 if it be in a pletho∣ricke or full bodie and verie weake, if it be seated next vnto a principall member: to con∣clude, if it happeneth with vehement griefe, for in these cases, we may better vse medicines, which will mitigate the tumour and the paine thereof, rather then such as shall repell and resist the humoures. The seconde Prologue is after this manner.* 1.120 In the beginning of all tumoures, but chieflie of those which are phlegmonous, common repulsiues are profitable: (three cases onelie excepted,) that is, if the tumour happen in those partes which are cal∣led glandulose, if they be enclined to suppuration, or if they proceede of a venimmous mat∣ter. And in all these cases, but especially then, when the humour doth stand, and when the fluction consisteth, and is almost made a tumour, it is behouefull to dissolue and scat∣ter the matter, applying to the swolne place, diaphoretica, not biting or sharpe, but milde,* 1.121

and gentle, being moderately hote and moyst, but this must be done principallie in the three last remembred cases, in the which we must endeuour to attract and drawe the mat∣ter which is dispearsed, to the head, where the tumour most appeareth, and we must en∣crease the tumour as much as we can, and so inhibite the course and fluxion of the mixed humours. Which truely we may sometime do, by vsing attractiue emplaisters, and often∣times by fastening cupping glasses to the aggrieued place,* 1.122 (as Auicene teacheth.) Let this therfore be a generall rule or canon of art, In the beginning of all tumours, which proceede of the influxion of humours, (those three excepted which were named a little before) one∣lie pure repressiues are to be vsed. But in their increasing we must mingle with these repul∣siues, some of those thinges which do dissolue and discusse. But in the state of tumours, yea and somewhat before the state, wee must commix repressiue medicines equallie with dis∣cussiue, and when there is declination present, or the end of the state, we may lawfully vse onely resoluing and releasing remedies: to conclude, so long as the humour doeth yet a∣bound, we must labour to repell it, and driue it away: but if the fluxe doth still remaine, we must seeke to digest it. But if it dependeth vppon both, (that is to say) that partly somthing hath alreadie flowed, and cleaueth fast to the place, and partly some thing may yet abound and flow: then it shall be lawfull to vse commixed remedies, (that is) partly those, which can resolue & vnbind, and partly those which are able to bring backe, and repell. For (contrary diseases being gathered into one place togither, we must vse also compound cures, as Ga∣lene saith. 13. Therap. Furthermore, al these things truly are to be vnderstood, as thus, if a tu∣mour aboue nature is to be dispatched & cured by resoluing medicins, or (that I may speake generallie) by the way of resolution. But their cures, whereby we will finish all those inten∣tions whereof we intreated before, according to their diuerse matter that exciteth the tu∣mour shall be described and declared in their perticuler Chapters, as by consequence and order they shall followe.

CAP. VI. Of the cure of abscessions generallie. DE CVRATIONE ABSCESSVVM IN VNIVERSVM.

* 1.123BVT if Phlegmone, or anie other Tumour doeth degenerate and turne into Abscessus, the cure thereof in the beginning is finished and ended (as saith Galene lib. 2. ad Glauconem) by helpes and remedies that doe mitigate, which the Greekes call chalastica, (that is) by resoluing and remitting medicines: of the which nature and force is that medicine, which is called of Galene tetrapharmacum, being verie softe, and prouoking sleepe: with the which according to the opinion of the same Galene. lib. 13. Therap. there must be com∣mixed a little honie.* 1.124 But Tetrapharmacum consisteth of foure thinges, of the which there must be of euerie one a little portion or quantitie (that is to say) of waxe, of rosen, of the gumme of the herbe colophonia, which distilleth from the roote thereof, and of bulles tallow. But in processe of time, we must passe ouer vnto those things, which are able to concoct and digest, or to ripen and bring to suppuration. But those, which are tourned into another kinde (that is) into another substaunce, and that altogether besides nature, they are to be remoued and cured by the Art of Chirurgie. Moreouer in remouing them according to the counsell of Galene. 14. Therap. it shalbe requisite to consider, that among all the wayes and meanes, whereby we intend to finish our purpose, we should alwayes make choice of the best of them.* 1.125 The best meanes and wayes are declared and manifested vnto vs, three manner of wayes: vidz. by the shortnesse of the time to cure in, by curing without paine, and chieflie by curing saflie, & without danger. Againe that thou maist cure saflie, there are three [ 1] espciall things diligentlie to be considered. The first, & the chiefest is, that you throughly at∣taine [ 2] to the perfection of your labour. 2. The other is, that if you can not attaine to the same, [ 3] yet at the least, that you hurt not the sick. 3. The third is, that the euill or disease may not easi∣lie returne or come againe. By these considerations, if you will declare the best methode of curing, you shall find in all those tumoures before mencioned, when the cure is to be en∣ded

by the helpe of Chyrurgie, and when by the force of medicines. But truely the studie of Chyrurgie in these chiefly, which how we doe intreat of, (that is) in those tumours, which are altogether aboue nature, doeth make and tend to the killing and destroying of them, and doth wholy declare, after what sorte they may be taken away. But if it cannot bring this to passe, the next counsell is, to transferre the euill, as we vse to do in those humours called Hy∣pochyma••••, (that is to say) the webbe in the eye. But that which is fetched from medicines, doth first tende vnto this end, that that which is aboue naiure, may both turne into matter, & also into putrefaction: but this he appointeth in the second place. These thinges hath Galene. Therefore when the partes, which are troubled with phlegmone, do beate very vehemently, so that now you begin to despaire of their cure, (they being not yet mattered:) all the auncient Chyrurgians (sayeth Galene 4. Therap.) do minister and apply such kind of medicines,* 1.126 which do speedily procure matter: but before it be mattered, they vse none at all. And although those partes which are annoyed with phlegmone, be annointed with a cataplasme, which may both heat them and moisten them, and bring them to suppuration, yet the same doth not ap∣peare by the first reason or way, that is, as the remedy and helpe of the euill, but as the miti∣gating & easing of the symptomate, that is, of the paine. For truely the remedies of phlegmone are of a drying nature. And the same Galene addeth moreouer a litle after, that a short and compendious cure of those partes which are affected with phlegmone is quickly ended & di∣spatched, by remedies which are able to drie and vnbind, which truely do altogether either remoue the affect, or else, if they leaue behind them some litle relict, which may turne to sup∣puration, it is needfull to vse some other sharpe medicine, which is able to bring out the mat∣ter, or if the skin about the tumour be thinne, and you willing, speedily to ease the sicke, you necessarily must vse incision. And this truely is that, which Auicene sayth, namly,* 1.127 that the cure of an Aposteme, (as it is an Aposteme) is the extraction & drawing out of the straung matter which raiseth the Aposteme. But to declare the remedies of them, wherwith it is expedient to draw and moue the matter, & to manifest other thinges also, which we spoke of a litle before, they are to be sought, out of their particular Chapters. Furthermore,* 1.128 the Abscession being al∣ready come to Suppuration, or chaunged, or strongly compact together, if the matter, or any other baggage therin conteined, be not discussed & dissolued, or if, in conuenient season, and while the occasiō is offered, it be not opened without the labour of the hand, you must make an issue by incision for that, which otherwise will not be digested. But this thing chiefly is to be proued and interprised, if there be feared any erosion or gnawing to ensue,* 1.129 or any other daunger yea if necessitie commandeth, it ought straight way to be opened, and the matter to be drawen out, as speadily & safely as is possible, for the cause before alleaged. But Apertion is made more safely with a knife, then with burning and scalding medicines, if nothing do hinder it, and commonly such kind of phlegmonous tumours, being already turned into sup∣puration, are opened with a penknife. Moreouer Apertion, or the letting out of the matter ought to be done, by reason, both of the aboundance of matter there gathered together, and also of the affected place. But if any part of the mattered member, shall seeme to be putrified & rotten, it is needful to cut it of, to the forme or liknesse of an oliue or mirtle leafe, that it may heale the more easily. But Galene commandeth to auoid & eschew alwayes any great inci∣sions, who did heale such kind of mattered tumours, both in the partes about the priuy mem∣bres, and also in the armeholes onely by incision (as he vsed chiefly to do) and by medicines that were of force to dry: Now if neede sometime required to cut of somwhat, by reason of the plenty not only of matter, but also of the corrupted partes, he vsed no greater incision thē the breath of a great mirtle leafe. For by wide & large sections, whē the member is brought vnto a scarre, besides that it is made most filthie, it also becommeth very weake, and vnfit to moue withall. But these kind of sections imitating the mirtle leafe are vsed in those tumours especially, which do matter vnder the armeholes, and about the share. And in those truely, the lenghtes of them must be drawen ouerwart, and not by the straitnesse or rightnesse of the legge or body: for when we bend the legge or the arme, the skinne naturally doeth apply it selfe with it. But in other places, we alwayes almost do vse simple incisions. Now in this a∣pertion or incision, seuen thinges are especially to be marked, according to the consent of the later Chyrurgians. First that incisiō be made in that place wherin the matter is conteined. [ 1]

[ 2] The second, that incision be made in the neither place of the tumour that the mattered and [ 3] corrupted filthinesse may the better be voided out. The third, that it be made next the wrin∣ckles [ 4] and processe of the muscles. The fourth, that you doe auoid and eschew the senowes, [ 5] veines and arteries, as much as you can. The fifte, that all the matter be not brought out a∣boundantly together and all at once, especially in great abscessions, lest that, by to much em∣ptying out and that sodainly, and also by the resolution of the spirites there follow weaknesse [ 6] and faintnesse. The sixt, that the place be handled and touched very gentlely, and with as litle [ 7] paine as can be. The seuenth, that apertion being made, the place be wiped very cleane, and filled with the flesh againe,* 1.130 and brought to a scarre after the maner of other vlcers. But Ga∣lene lib. 13. Therap. warneth vs chiefly to marke two thinges in the incision of a suppurated abscession, writing ofter this maner. 1. If at any time the aboundance of matter execeedeth & ouercommeth your medicines, neither do they seeme vnto you to be able to digest all the corruptiō, it is requisite to make an issue by incision for that matter which yeeldeth not to di∣gestion, [ 1.2.] in that place especially, where it is most highe. 2. Moreouer in the incision also of an other abscession, which pertaineth vnto fluxe, & yet respecting both the kindes▪ you must not forget to cut and launce that which is already come to suppuration: and then apply some medicine therto,* 1.131 which can dry it vp without erosion or gnawing. But after the imposthume be opened, you must vse remedies that be of a scouring and cleansing nature, & fit to purge the filthie vlcer, as are soft floxe or linte, and soft linnen, emplaistres, and ointmentes, which shalbe spoken of in their particular Chapters. At the first time, Guido did apply the yolke of an egge being thickened with alume zuccharinum, which medicine Guilielmus à Saliceto did also vse.* 1.132 But afterward you must come to the applying of mel rosatum, and inundificati••••m ex ap••o: and last of all, to vnguentum Apostolorum, and Aegyptiacum, if the matter so requireth. But aboue without, you must minister ointmentes, as basilicon, diachylon, and diaphoenicon so commonly called, and other of that sorte, which are appointed for vlcers. For when you haue cut an abscession, it must be cured after the maner of other vlcers. Galene lib. 13. Therap. after the skinne was cut in those phlegmonous tumours which chaunce about the arme holes & pri∣uie members,* 1.133 did fill the affected place with that medicine, which the Greekes call Manna, which is thuris purgamentum. For this hath a light adstriction or binding. But you must also (sayeth he) first asswage the launced member, (as much as you see cause,) first with fomentes, then with cataplasmes, & straight after with some moisting medicine, or else with such as do not much dry (all these being applied outwardly vpon the vlcer.) For in the very vlcer, both of Manna (as hath bene said) & also of those remedies which are taught & declared by vsing of linte, those thinges truely are first to be laid on, which do moue and prouoke the matter, and afterward those which do purge and clense. After the applying of which thinges, if there remaine any hollownesse, you must minister those thinges which may fill the same: but if it fall out otherwise, you must vse thinges to bring it to a scarre. Moreouer if the sicke will not suffer incision to be made either with some bright instrument, or with penknife, by reason of the softnesse therof, then the apertion is to be finished with burning medicines. For this pur∣pose Auicene prayseth the sead of line or flaxe,* 1.134 leuen, & doues dounge, which you may make more excellent and forcible, if you mingle them with a litle softe sope, or with the filthinesse that cōmeth of mustard sead. But that medicine which is called ruptorium or causticum, which is made of lime, and sope, in this matter is most excellent, and obteineth greatest fame. He∣therto haue we spoken of Tumours aboue nature generally, now it followeth that we in∣treate of the particular differences of them, as they follow in order.

CAP. VII. Of a true Phlegmone, & of other tumours ingēdred of bloud.

HAVING spoken generally of those Tumours, which consist aboue nature, it is conuenient, that we entreate particularly of the differences or euery one of them, taking our Exordium from Phlegmone, as a tumour, which chaunceth very often,* 1.135 and exciteth (as Galene sayeth) very daungerous symptomates. Therfore Galene lib. 1. de morbis & symptomatis, taketh phlegmone two kind of

wayes. One way generally ofter the maner of the Auncient writers which were before his time (that is) for euery kind of inflammation of any member, and for any heating or burning,* 1.136 (that is) for euery hote and flaming disposition, which the Greekes do properly call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Another way, both with Galene and other late writers, it is taken for a true and pure tumour ingendred of bloud, that is, the best, and that also, which reteineth but meane thickenesse or grossenesse. And this truely borroweth his name of the kind therof, and of the Latines it is called diuersly by reason of kind, Inflammatio, of the Greekes absolutely, Phlegmone. But this, after the minde and consent of the later sorte is two fold, videlicet, Vera, & non vera. A true Phlegmone is caused of good bloud, which is the best both in qualitie, and substance or essence, but yet more aboundant then naturally should happen to the member. But phleg∣mone which is not a true and lawfull phlegmone, is caused of naughty and vnnaturall bloud. For bloud is a hot and a moist humour proceeding from a more temperate parte of the very Chylus, which is a certaine iuice that commeth of the meate in the first digestiō.* 1.137 And it is two wayes: Naturall and not naturall. Naturall bloud is a hote and moist humour,* 1.138 slender and meane in substance, but of a very red colour, in sauour and tast it is sweete, gentle and good. But that bloud is said to be vnnaturall, which differeth or digresseth from the former descrip∣tion of bloud: yet notwithstanding conteining it selfe within the boundes of his breath and largnesse, which if it doth once passe, it is no more to be called a bloud, but some other hu∣mour. But bloud doeth chaunce to degenerat from his proper nature two kind of wayes.* 1.139 The first way is (as they terme it) in it selfe, that is, in respect of it selfe, (his proper substance being chaunged without any commixtion with an other.) The second way is by an other, or in respect of an other. And yet it consisteth two wayes by it selfe, (that is to say) either be∣cause the substance therof is more thicke, or more thinne then it ought to be: or because it is burnt, and that which is thinnest of it, is turned into melancholie, but that which is thicke in∣to choler, and that without separation. But in respect of an other, bloud becometh not vn∣naturall, whenas an other humour is mingled withall. Which may happen many wayes, ac∣cording as the diuerse kindes of choler, fleume or melācholy may be commixed with bloud. By which thinges it is manifest, that of bloud,* 1.140 there are ingendred foure kindes or differences of tumours aboue nature. First, of naturall and good bloud, there is ingendred a true phleg∣mone. But of bloud, which is corrupted through the admixtion of other humours, there doe grow three differences of that kind of phlegmone, which is neither true nor lawfull: because that the three other humours (that is to say) fleume, choler and melancholie may be easily commixed with bloud. Therefore if melancholie be mixed with bloud, it is called phleg∣mone Scirrhodes, if choler, (which then is conflated of both kindes) it is called phlegmone E∣rysipelatodes, if fleume, is is termed phlegmone Edematodes. But of bloud, which is filthie and corrupted through the adustion and corruption of his owne proper substance, according to the maner of the thinnesse or thicknesse therof, there are ingendred either Carbuncles, which are called of the Greekes Anthraces, or else Gangraenae and Sphacelus, which we call Cancres. Of the which diseases we will speake of hereafter, in that which followeth.

CAP. VIII. Of the causes, Signes, and Iudgementes of Phlegmone.

THERE are three causes of phlegmone:* 1.141 as there are also of all other tumours be∣sides nature, which doe chaunce through the defluxion of humours. videlicet. 1. Primitiua, which we call both praegressa and euidens: 2. Antecedens: 3. and Coniuncta. Euident causes of inflammation are outward causes: as,* 1.142 beating or belking, diruption, conuulsion, breaking or brusting, a wound, a voluntary vl∣cer, a loosenesse, and other of that sorte, which doe prouoke fluxe, by exciting paine in the affected member. The Antecedent cause, as aboundance of bloud,* 1.143 which is good and fault∣lesse, as when the veines touche much together to the moderate repletion of the Arteries. For then is bloud prouoked (as a certaine superfluous thing,) to flow and descend to some member which is either weake, or immoderatly hote, or affected with paine, where it is

thrust, and abideth compact together, vnlesse it be by and by repressed from the beginning, (as we haue said before in our generall Chapiter:) to the which we must therfore haue con∣tinuall accesse, that we may attaine to a more perfect knowledge of particular tumours, wherof we now entreate.* 1.144 The Coniunct or continent cause, is the bloud it selfe, which is already stuffed in the affected place. The markes or tokens of phlegmone are the tumour, or the augmenting of the member aboue the naturall habite,* 1.145 vehement heate, so that the mem∣ber seemeth to burne. There appeareth rednesse in the outward partes, such as is wont to come through bathes which are made hote either with the fire, or by some other meanes. There is extreme paine, vnlesse the member hath altogether a dull sense. There is also grei∣uous beating,* 1.146 and pulsation very vehement inwardly. There is also extension or streatching out of the member, which not onely we alone haue found out, but also the patient him selfe may perceiue by his owne feeling. There is furthermore resistance of the member if it be tou∣ched, after the maner of extension. There be also other such like signes, which doe testifie that aboundance of bloud is present in some parte of the bodie.* 1.147 Phlegmone hath foure times, 1. the beginning, 2. the increasing, 3. the state, 4. and the declination: except at the least waye, fluxe hath recourse within, or it be straight waye repressed by repulsiue medicines. But when it shall lightly passe ouer these foure times,* 1.148 it is needfull, either to resolue and draw out the matter of it, or to bring it to suppuration, or else to putrifie and rotte it, or to turne it into a scirrhous and stony hardnesse. And truly the signes of all these are to be sought out of the Chapter that intreateth generally of them: where the markes of all times, and the meanes to finish tumours aboue nature, (which they commonly call apostemata) be decla∣red and expressed.* 1.149 But phlegmone is accompanied with many other euill symptomates, which do altre and chaunge the order of his cure, as are, vehement paine, which doeth great∣ly occupy the sensible parte, recourse of the matter from the kernells (which the Greekes call Adenae, and commonly they be called Emunctoria) to the internall partes. Also mortification of the affected member (which they call corruptio esthiomenica) proceeding of too much refrigeration, and of a strong compacting or stuffing of the matter, which did cause the in∣flammation. Also a stony and almost an indissoluble hardnesse, commonly called Sclirotica, which proceedeth through a certaine ouerthwart and vntoward dissolution of the thinner humour.* 1.150 Wherfore in curing tumours, which consist aboue nature, we must diligently of∣tentimes marke and consider, how farre we meane to proceed in the matter, and what ac∣cidentes may chaunge vnlooked for, that so, we may chiefly insist, and be occupied about that most, which appeareth, and is most vrgent. Which Galene hath admonished vs of very well lib. 2 ad Glauconem, and 13. Therape. speaking after this sorte: In diseases, whose resolu∣tion is difficult, and hard, it is to be feared, least some remnaunt of them be left behind which is very hard. Wherfore in euery resolution, we must diligently consider, into what thing e∣uery tumour, whose cure is once begon, may be chaunged. For that cure which is attempted by medicines, that do mightely dry, doeth leaue very hard knobbs, which art hard to remoue hetherto Galene. But the time requireth, that we now declare the cure of phlegmone.

CAP. IX. The order of curing Phlegmone caused of the defluxion of humours, affecting the outvvard partes of the body.

* 1.151SEEING that inflammatio, which is called of the Greekes properly phlegmone, doeth ingender and grow through the influxion of bloud, happening more aboundantly to some member then nature requireth, and fluxe also (phlegmone being yet but beginning to raigne) is partly in begetting, and partly begotten already: there must needes truely be a double consideration in the cure of the phlegmone being yet but beginning (that is to say) to empty out and auoid that which hath flowed already, and to hinder and stoppe that which is now a flowing. More∣ouer,* 1.152 we shall stoppe fluxe, if we shall draw backe and repell the humour that floweth, if we shall adde strength to the afflicted member, and if we shall seeke to remoue that which cau∣seth

the fluxe. We shall draw it backe,* 1.153 and bring it into a contrary defluxion of other hu∣mours, by bloud letting, if strength and age will suffer it, but if not, we shall do it by applying cupping glasses, or by vsing bindinges and frictions, or by heating those partes which haue a direct passage to the affected parte. We shall bring backe and repell fluxe,* 1.154 by ministring those medicines, which are able to driue and turne the fluxe another way.* 1.155 We shall also re∣moue the causes that do bring or fetch defluxion to the member already infested with phleg∣mone, by confirming and strengthening the member, if it be weake, by vsing astriction if it be to loose, by cooling it if it be hote, as it is wonte to be, by easing the paine if it be vehe∣ment, and by emptying the whole body with bloud letting, if it doeth abound with bloud, and if it sendeth infection to the member: of all which thinges we will speake by and by. But we doe empty out and auoid that which is flowed already,* 1.156 and hath gotten it selfe into the affect parte, not onely by those medicines which do digest, that is, which do discusse and resolue, but also by those remedies which do bind together and refrigerate. And truely in phlegmonous tumours now beginning, we must rather vse (sayeth Galene) cooling and astri∣ctiue medicines, then those which do concoct & digest, and so much the rather, if that, which floweth be not of a thicke substance. But if bloud be greatly compact together in that parte which phlegmone hath caught and taken vp, you must not apply any longer repercussiue re∣medies (as we said before) but then it is conuenient to vse those which can digest. Also in an old & inueterate inflammation, which after the euacuation of the whole body, & other some fit cure, hath lefte behind it a certaine hardnesse and blacknesse in the member: it is not vn∣profitable (Galene also affirming the same) to take away the bloud by scarification.* 1.157 And these thinges haue we spoken briefly and by a generall methode concerning the cure of in∣flammations that do happen through the defluction of humours, which the Greekes pro∣perly are wonte to call phlegmone: which thinges may be sufficient to content a reasonable Physition, & one which is exercised in this kind of studie. But because we haue taken in hand to write these thinges for the practitioners of Chyrurgie, and not for the learned onely, it shall not be amisse, neither any thing from our purpose, if after this generall and compen∣dious methode, we set downe more particularly those thinges which not onely the auncient Physitions, but also the later sorte of Chyrurgians hath left behind them in writing.* 1.158 Therfore aboue the generall rule (as they terme it) the Chyrurgians of our age are wont to reduce the order of curing phlegmone, into foure braunches or particular intentions: that is to say, into a iust obseruation of a good diet, 2. the stopping of fluxe, or the turning away of the matter [ 1.2.] which went before. 3. the emptying out of the humour, which hath already interteined him [ 3] selfe in the member (which they call materia coniuncta.) 4. and the correcting or amending of [ 4] the simptomates.* 1.159 The first intention therefore is made perfit by the due vsing or admini∣stration of six thinges, commonly called vnnaturall thinges, and by the vsing of those thinges also, which are said to be annexed vnto them. And these thinges, which are six in number, called of the Physitions res non naturales,* 1.160 (as hath bene declared from the beginning of this treatise) are, the ayre, meate and drinke, mouing and rest, sleepe and watching, emptying and filling, the affections of the minde or the accidentes. All which thinges (because phlegmone doth commonly prouoke feuers) ought to pertaine vnto coldnesse and moderate moistnesse. For which causes we haue thought good to set downe these preceptes following. Let the sicke be in a pure and cleare ayre, & that somewhat cold. Let him keepe a thinne diet, cold,* 1.161 and moderatly moist. Let him drinke small ale, or beere or other small drinkes.* 1.162 But if a ve∣hement feuer shall haue any accesse (which is wonte often to happen) let him altogether abstaine from wine. Let him not exercise,* 1.163 or moue that member which is be set with phleg∣mone. Let him be quiet as much as he can, especially if there be very great aboundance of hu∣mours in the body. Let him keepe a measure in sleeping and watching: and let him shunne sleeping on the day time especially about none. Let him diligently beware of dronkennesse and gluttony. Let the belly be alwayes kept softe and soluble, and now and then let it be washed with clisters, if neede require. Let him flye, anger, cryinges out, and wrathe, as deadly enemies. Let him abstaine from venereous actes, as a mortall foe.

The second order in curing Phlegmone, which is the turning away of the fluxe,* 1.164 is dispat∣ched by letting of bloud, if strength and age doeth suffer. But in all members of the bodie,

whether you intend to reuell (that is) to draw backe among an other way, or to turne it from that place at the side,* 1.165 either streight ouer against the place, or directly forth (which is called in Greeke 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉) a veine must alwayes be cut, although there be great aboundance: but di∣rectly, the right sides do aunswere to the right partes, and the left to the left. Therefore if ophthalmia doeth annoy the right eye, or the squinancie doeth affect the right side of the throte, the shoulder veine, or some other in his place (if that doeth not appeare) must be cut in the right arme, by and by at the beginning of the fluxe. But if a humour doeth flow in the knee, you must cut a veine in the elbow either the outward or the middle veine except you meane to scarifie the other legge, or breake the veine a sunder in it, as Galene counseleth in a certaine place.* 1.166 Therefore the election of the cutting any veine, and the inuention to turne the humour another way, (which Hippocrates calleth antispasis) is manifested and declared by the affected parte, and by the place or situation of the member that is to be cured, as Ga∣lene 13. and 14. meth. med. and in other places, doeth oftentimes teach. But that body, which phlegmone occupieth, not onely when it is plethorike and full of humours, but also when the greatnesse of the euil doth exhorte vs to it, (though it be but meanely stuffed with humours,) we must empty and euacuate by letting of bloud, if we will follow the aduise of Galene, who lib. 13. meth. med. commandeth that, it should be so, thus writing. Paine truely, and the heate of the member wherin phlegmone hath setled him selfe, (although the whole body be void of excrementes) do happen by reason of the fluxe. But then it is expedient to do it but mean∣ly. (that is) to draw fourth bloud and to make euacuation, no further then it shall best agree with the age and nature of the patient. Further, you must haue consideration both of the time of the yeare, of the nature of the ayre wherin the sicke remaineth, and also of the former cu∣stome of the man. Also these do profit not a litle to draw backe the bloud that floweth to the affected parte, walkinges, frictions, and binding of the apposite member, but first chiefly the detraction of bloud, (as hath bene said.) Therefore if phlegmone appeareth in the handes, the legges are to be exercised, bound and rubbed, if in the legges, the handes must be also so vsed. But these thinges belong more vnto the Physition then the Chyrurgian.

* 1.167We now dispatch the third scope or intention, in the beginnings of phlegmone, onely by applying repulsiue thinges to that member which laboureth with the inflammation (excep∣ting these cases before rehearsed.) For that which is filled with corrupted matter (as Galene sayeth) is emptied out, not only by those medicines which do digest, but also by those which do bind and refrigerate: as be those, which are called repellentia and regerentia repulsiues, and restrictiues. But in the increasing therof at the present intention, (that is) to emptie out that, which is flowed, and also to stoppe, that no more doeth abound, you must ioyne digestiue me∣dicines with repressiues:* 1.168 but yet so, that the aboundance and strength of the one may yet pre∣uaile with the other. But in the state they must be equally cōmixed together by euen portiōs, and somewhat more milde and mitigating remedies must be applied, if paine be vehement. But in the ende and declination of the state, it is requisite to euacuate by digestiues onely that which is compact together, if that phlegmone must be ended by resolution or discussion. If truely it doeth turne into abscession,* 1.169 and that it cannot be, that the gathering together and erup••ion of the matter should be letted, it shalbe lawfull to vse medicines which can both mattre, open, and clense the vlcer. Furthermore those remedies which do dry, are profitable in the ende of both the euills (that is) of phlegmone and abscessus, for they do altogether con∣sume that which remaineth of the humour, but when incision is made in the abscessiō which is already come to suppuration, you must lay on such a medicine as may dry without erosion or gnausing,* 1.170 (as hereafter shalbe said.) But in those phlegmonous tumours which now are but in the beginning▪ the most apteremedy to repell and driue backe, is oxycraton in Galene, which the Latines call pusca aquosa. It is a mixture of water and vineger, so tempered toge∣ther; that it may be drunke: and then (a sponge being wet and laid in this oxycratu••, must be applied to that parte, where phlegmone is. But in stead of oxycratum, by the counsell of Ga∣lene; we may take sharpe wine, or apply cold thinges only, to the partes, which are about the sinewes.* 1.171 These are the wordes of Galene. In those members which are about the sinewes, it shalbe sufficient, in the beginning of phlegmone, to lay on a sponge dipped either in cold wa∣ter, wherwith a litle vineger is mingled▪ or in water onely, or in sharpe and soure wine.

For the same purpose also this cataplasme of the same Galene very effectuall,* 1.172 made of sen∣greene and the rindes of pomegranates sodden in wine, of rh••, that is, sumach, and polenta. This, by restraining doth repell that which floweth, & by drying doth empty out that which is conteined in the tumour, and both wayes it doth strengthen and corroborate the affected partes. This remedie hath bene described of the later sorte: of Auicene ofter this sorte,* 1.173 as followeth, ℞. of the iuice of sengreene, lb.j. of wine, that is thicke of substance, and sharpe in taste, lb.ss. of barley meale, one quarte, of the rind of pomegranades, and sumach poude∣red, ana. ℥.ss. boile them and make a liniment. There is also another, which greatly auaileth for the same purpose, inuented of Haly Abbas, ℞. of santalum, white and red,* 1.174 ana. ʒ.iij. of me∣mitha, which is called Glaucium. ʒ.ij. of terra cimol••a, and bole armoniacke, ana. ℥.j.ss. let all be brayed into very fine flower or pouder, and well searced, then dissolue them in the iuice of sengreene, or purselaine, or lettuce, and make a liniment.* 1.175 Another also in the beginning of phlegmonous inflammations, very common and much vsed, which is very profitable for greene woundes, and bruises taken lately. It is made of the white of an egge, of oile of roses, and of the distilled water of roses, (that is) of rose water, wherin you must wet fine cloutes, and lay them to the inflamed member, and let them be chaunged often. But there are ma∣ny other medicines both simple and compound, which do profit in the beginning of phleg∣mone to restreigne and repell fluxe, which are to be sought out of other Authours, which haue written of this thing. But these shall content vs for this time.

Amongest the remedies which in the increase of phlegmone,* 1.176 being outwardly applied do greatly helpe, oile of roses is marueilously effectuall, (the Greekes call it rhodinon.) For this doeth partely draw backe, and partely doeth digest through the vapour: bycause it perfect∣ly holdeth a midle nature betwene the oile and the roses. Therefore in oile of roses there is a certaine astriction, which cannot (sayeth Galene) ouergo the weake partes of the tumour:* 1.177 but when they haue pearced somewhat deeper, it beginneth then to worke outwardly ac∣cording to the strength, both to thrust together, to draw into one place, and to thicken great∣ly, wherby it commeth to passe that in the augmenting of phlegmonous tumours,* 1.178 oile of roses, is a most excellent and ready helpe. In the augmenting of phlegmone there is another in Auicene very profitable, ℞. of the leaues of mallowes. M.j. of wormewood, roses, ana. ℥.ss, of barely meale. ℥.j. of oile of chammomil. quart. ss. seath them, and braie them together, and bring them to the fashion of a softe emplaistre. Another of the same, ℞. of wine boiled ei∣ther to the halfe or the third parte, (one we call sapa, the other defrutum.) quart. j. rose wa∣ter, and vineger, ana. quart. ss. saffron. ʒ.ij. let them be a litle het ouer a softe fire, then straine them, and dippe clouth in the liquour of that decoction, which you must applie to the phleg∣monous member after the maner of an epitheme. Moreouer such kind of remedies, which are vsed in the increasing of the inflammation, and haue their power and vertue commixed together of repressiue and digestiue medicines, ought seeldomer to be remoued and chaun∣ged, then those which repell the matter, being ministred in the beginning of phlegmone.

Actius, in the vigour or state of phlegmone, and when there is vehement paine felte,* 1.179 hath set downe these remedies: as mallowes, mingled with a litle bread and with oile of roses. Also melilote boiled in the licour called passum, and applied with a litle bread, of the like vertue (sayeth he) are dates sodden in passum, and mingled with bread and oile of roses: Another also, which digesteth through breathing, in the vigour of phlegmone very effectuall, ℞. pellitory of the wall, mallowes, ana. M.j. fine branne the flour of meale, ana. p.j. fengreeke, dill, ana. ℥.ss. oile of chammomill. quart. ss. let them be boiled in wine, and well braied toge∣ther, till they be well incorporate, and make an emplaistre. Another taken out of Galene,* 1.180 lib. 13. Therap. ℞. of the crummes of bread made of corne. lb.j. steipe it in hote water the space of one houre, then streigne it, and commixe therwith of the best hony, quar.j. and make it to the forme of a cataplasme. This doeth dissolue and mitigate paine. Auicene counseleth to minister in the rigour of phlegmone, vnguentum basilicon, & that which is made of the iuices therof called diachylon: but the one is good to mollifie, the other to ripen and bring to mat∣ter: although notwithstanding both of them do cary with them a digesting qualitie. But these and other such remedies, which are ministred to dissolue that which is already flowed, and to ease paine, because they are of a very moist nature, must be chaunged very seeldome.

Furthermore, when as by the remedies before mencioned, the humour which is falen into the member that is troubled with phlegmone, is dissolued and discussed, and the tumour toge∣ther with the extension therof is deminished, and the griefe somewhat asswaged, then it is to be iudged that the declination of the inflammation is at hand, at which time you must vse onely discussiue thinges,* 1.181 as are wild mallowes bruised annointed, raisons (the kernells being taken out▪) applied with bread and a litle hony, and barely meale vsed also with hony. Also moist wooll, flaxe, a sponge, or some such like thing, wet in hote wine, then streigned or wrin∣ged, you must minister it: for all these haue an excellent discussiue nature, and doe not pro∣uoke paine. But if, by reason of the stubburnesse and hardnesse of the disease, the affected place doth conteine too great plenty of matter and that such as resisteth resolution, you must not by and by (as some do) breake forth vnto Chyrurgie, that is, to make incision, or to seald it and burne it, but you must labour by all meanes possible, that the humour collected to∣gether may be digested and dissolued by such medicines as can worke this effect. For it is conuenient to attempt the digestion of the humour by such medicines as can profit in that case, before you begin to cut the inflammation. But if the tumour will not yeeld to dige∣stiue medicines, and no further hope doth remaine to dissolue that which is compact in it, but the matter seemeth rather to pertaine vnto suppuration, you must come vnto those, thinges which can ripen & procure matter.* 1.182 And we hope that a tumour (although it degenerate in∣to abseession) may through the vapour be digested, if the matter which exciteth the same, be thinne and litle, and fute to be resolued: or if it remaineth not any thing deeply within, and the skinne of the affected member be thinne. But if the humour be plentifull, and thicke, and lurketh very deepe, and the skinne also thicke, exhalation or resolution is not to be ho∣ped for.* 1.183 Therefore you must come vnto those helpes which can ripen and prouoke matter, of which force is this cataplasme, made of wheate meale, sodden moderatly in water & oile: for this (Galene being our Authour) doeth speedily bring to suppuration those inflamma∣tions,* 1.184 which will not yeeld to digestion, and it hath also a heate like vnto our heate, that is, temperate and meane, and by reason of the meale and oile (which haue a certaine clammy and glewish property, wherby in stopping the pores, they hinder the naturall heate of the member) it hath the force of an emplaistre, which two thinges are most required in medi∣cines that do ripen and moue matter. There are some which do mingle with this cataplasme a litle saffron to colour it. But if a tumour, by reason of the thicke & viscous humours which are stuffed in it, be hardly brought vnto suppuration, this cataplasme doeth notably helpe which is made of the decoction of the rootes of althea, and of figges that be sweet and fat, which do resemble the thicknesse of hony,* 1.185 commixed with wheat meale, as followeth, ℞. of the aforsaid decoction, lb.j. of wheat meale, lb.ss. boile them throughly together, and bring them into the forme of a cataplasme. But if in stead of wheate meale, you vse barely meale or crible bread, which the Greekes call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, it more auaileth to discusse the inflamma∣tion then to bring it to suppuration (as Galene hath noted lib. secundo ad Glauconem.* 1.186 There is another also excellently profitable to prouoke matter in the declination of phlegmone, which is commonly vsed of the common Chyrurgians,* 1.187 ℞. of the barke of the roote of marsh mal∣lowes, that is, of althea, of the roote of lillies, grownswell, called in Greeke ••rigeron, leaues of mallowes, ana. M.j. wheat meale, quar.j. of the meale of the sead of flaxe. ℥.j. fresh swines greace, lb.ss. seath the herbes in sufficient quantitie of water, and bray them with the other thinges in a mortar, and make a cataplasme. But if, (when the matter is gathered together and dispatched,) the abscession wherinto phlegmone is tourned, doeth not open of the owne ac∣cord: (the members now being free from the inflammation) you must go about to euacuate and empty out the matter which cannot be digested, with a penknife, or some such instru∣ment, or by some drawing medicine. Then you must bring the vlcer vnto a scarre, like vnto other vlcers, which you must do by cleansing the sore, by filling it with flesh, and ioining it together, which at the last will cause a scarre. Moreouer, if the matter be thicke, which brin∣geth fourth the tumour, and very disobedient to resolution and digestion, and be exceeding∣ly compact in the passages of the flesh (as is wonte to be in continuall inflammations which be naughtely cured, the thinne parte of the humour being resolued, and the thicke parte re∣maining still in the passages, then you must not be afraid to vse scarification, especially (as

Galene admonisheth lib. 2. ad Glauconem) whē hardnesse, bluenesse or blacknesse do appeare.

The fourth intention,* 1.188 which in the cure of phlegmone was propounded to the Chyrurgian & Physition, is the correction and remouing of the symptomates, which do sodeinly come v∣pon the inflammation, and those are paine, recourse of the matter, wherof the tumour is rai∣sed, to the inward partes, putrefaction and corruption of the mattery member, and as it were a certeine stony hardnesse remaining behind, by reason of some mightie drying & digesting medicines. Therefore if vehement paine shall happen to the tumour,* 1.189 you must labour by all meanes possible to mitigate and asswage the same, because, (besides that it weakneth the strength, and hindreth the lawfull duties of the body) it prouoketh fluxe and draweth bloud vnto it. If paine therefore doth grieuously torment in phlegmone, straight way you must lay on those medicines,* 1.190 which can lenifie and ease the vehemencie of the paine without any hurte, as is this of Galene, which is made of the licour called passum, of oile of roses, and a litle waxe melted with them both: but this is to be taken in moist wooll, which hath much oile in it, and to be ministred cold in Sommer, and hote in Winter, Therefore such a medi∣cine being tempered and applied (as is said before) doth rarefie, extenuate, digest, and eua∣cuate: it maketh the humour that is sharpe, viscous, grosse, or plentifull, and which cleaueth to the aggreaued partes, to be equall constant and moderate, and it discusseth the thicke va∣pour which can find no fit issue, and so it mitigateth paine: it bringeth no hurte with his hear, for it maketh dull or taketh away the heate of the oile of roses. Wherby it commeth to passe, that this remedie doeth asswage paine without doing any hurte, and disprofiteth not the euill, as hote water, oile, and wheate meale, which thinges in an inflammation that happe∣neth with paine, cannot be profitable (as Galene witnesseth.* 1.191) For these do loosen and re∣lease through their heate and moisture, and do resolue the strength of the member, wherby it is made more weake, and more prone and apt to interteine fluxe. To the same vse (that is to alay the paine in phlegmone) you may apply affectually oile of roses, yolkes of egges, crummes of white bread steiped in hote water, and then streigne them, and commixe them with oile of roses. These also are a present remedie, mallowes sodden in water, and mingled with branne and oile of roses, or with oile of violettes.* 1.192 But Auicene in mitigating euery paine vseth saffron, which he profitably commixeth with assuaging medicines. Furthermore if the sharpnesse of paine be so great and vehement, that it cannot be eased with those thinges, which because they mitigate and lenifie paine, (the succours of nature being stretched out) are properly called Anodyna & paregorica (that is) prouokers of sleepe and helpers of paine: you must passe ouer vnto those aides which we call narcotia, (that is) stupefactiues. Amongest the which we haue tried by daily experience besides the authoritie of some writers,* 1.193 that hen∣bane hath profiteth in this case marueilously, whose leaues you in must take, and bake them in the hote embers, then mingle with them fresh swines greace and apply them to the place. This doeth pacifie vehement paine, and bringeth plegmonous tumours vnto suppuration. But, while you attempt this thing, you must haue a diligent care least you apply to much moisture, because it is a thing, which in the beginninges of inflammations, whē fluxe aboun∣deth with great griefe, is very pernicious (as we said a litle before.* 1.194) But if you feare recourse of the matter, that exciteth phlegmone, to the inward partes, and that chiefly toward the prin∣cipall members: you must cause him to come fourth by some drawing medicines, or else by applying cupping glasses, which doe draw vehemently from the inward partes.* 1.195 But if by reason of vehement drying and digesting medicines being rashly applied to the inflamma∣tion, the relictes of the tumour do turne into Scirrhus: you shall boile in water the rootes of wild cucumber (which is commonly called in herbaries and shoppes cucumer asininus) or of briony or of Asarum, seathing them oftentimes alone by them selues (as Galene commaun∣deth) and sometime putting to them fatte figges. Then commixe meale with water,* 1.196 to the which also put a litle suet, either of a goose or a cocke, but if there be not plentie of these at hand adde swines grease and make a cataplasme. This doeth notably heale that schirrhous affect which through mightie drying & digesting medicines in the member which phlegmone occupied, doeth still remaine behind. Also the aforesaid herbes together with the rootes of althaea, being, after a moderate boiling well mingled with bread and suet, and then applied, do discusse and dissolue such hardened tumours: as Galene doeth plainly teach lib. 2. ad Glau∣conem.

Therefore if you feare, that plegmonous tumours, which are scarely, digested through their vapour, neither yet are easily concocted, be turned into Scirrhus: you must alwayes commixe with digestiues those thinges which can mollifie and soften. Moreouer if any parte of the mattering member shall putrifie, you must straightway cut it out, or else seeke to cure it by many deepe scatifications:* 1.197 afterward you must sprinkle on it salte water, and then lay on it an emplaister made of the meale of beanes or tares sodden in oxymel. There be other thinges also to be proued in this case, which we will by and by set downe in the cure of Gan∣grena. But now it shalbe more profitable, if we comprehend the Chapters concerning the cure of such phlegmonous affectes,* 1.198 in some shorte sentences. And first we will begin to de∣clare the summe of the cure of phlegmone, being yet but beginning, and not yet vexing with [ 1] any grieuous paine. 1. Let the whole body be emptyed with conuenient purgations, and [ 2] especially by letting of bloud, if nothing do let it. 2. Let the inflamed member be all to wa∣shed [ 3] and annointed with such thinges, as haue power to driue backe the flowing of the hu∣mour. [ 4] 3. Let the humour, which is conteined in the aggreaued place, be emptied out by drying and digesting medicines.* 1.199 4. Let the affected parte, and those also which are about it, be strengthened and fortified. Now followeth the summe of the cure of the said phlegmone, when it tormenteth with a more greiuous paine. 1. Whenas inflammation being caused through the defluxion of humours, doeth vexe with great paine, you must mitigate the ve∣hemencie of the same without any hurte doing. 2. Then, you must not minister those things, [ 1.2.] which doe strongly bind, or vnloosen through their heat and moisture, or resolue strength. [ 3] 3. But you must apply to the inflamed place such helpes, as, by meanly binding, can repell [ 4] that which floweth, and euacuate that which infesteth the affected member. 4. Apply to the tumour, a sponge dipped in sharpe wine or posca, that so you may preuent the passage of [ 5] the humour that floweth. 5. If these thinges shall profit, and yet the matter appeareth not any where, you must vse soft and gentle emplaisters, and those especially, which are made as [ 6] remedies against fluxe. 6. Amongest those thinges, which are of power to drie, and repell the fluxe of bloud without paine, you must choose the best, as is that resolution with oile of roses, which it made of the stone chalcitis: then lay vpon it pure wooll dipped in sharpe wine. [ 7] 7. But when matter appeareth in the member, you must often applie the aforesaid cata∣plasme, [ 8] or that rather, which is made of barely meale. 8. If the aboundance of thicke mat∣ter doeth exceed the medicines so that there is no hope of resolution you must make an issue for that which yeeldeth not vnto digestion in that place especially, where it is highest. [ 9] 9. After incision, you must drie the wound, if paine be not vrgent, and clense it and scoure it [ 10] without greife. 10. If after incision, paine be vehement, you must first assuage it with fo∣mentes, then with a cataplasme, straight after with some moist medicine, or with such a one [ 11] as dryeth not. 11. If the member be still enflamed, lay on a cataplasme made of a certaine pulse called chittes, which doeth empty out and driue backe.

CAP. X. Of a Carbuncle, and a Cancre, and of the maladie named Sphacelus, all vvhich they call sanguineae pustulae, 1. bloud pushes.

* 1.200SEEING that we haue intreated aboundantly, as much as pertaineth to a Chy∣rurgian, of Phlegmone, which is the first difference of inflammations, and most incident to mans body: it now remaineth that we speake first of Carbuncu∣lus, which is called in Greeke 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉: next of Gangrena, the Cancre, and last, of Sphacelus, (which with the expounder of Auicene they commonly call esthiomenon) for that hath his beginning of a bloudy fluxe, as phlegmone hath, and doeth prouoke a most sharpe feuer, but these are wonte oftentimes to acompanie great phlegmones, as Galene libello de Tumoribus praeter naturam, and in many other places hath diligently noted.* 1.201 A Carbuncle therefore proceedeth of the flowing of bloud, which is blacke, thicke, filthie, burning, and exceedingly hote, with the which if there be mingled but certaine thinne humours: there are raised vp on the out side of the skinne whelkes or

pushes, like thinges that be burned or scalded,* 1.202 and then this inflammation is called Car∣bunculus cum pustula, the Carbuncle with the pushe, which euill truely doeth happen ve∣ry often. In the meane time notwithstanding it beginneth (although seeldome) without pushe or pushes: but then is caused a crustie or hard vlcer: I saye without pushe or pushes,* 1.203 because sometime there ariseth with this euill one onely pushe of some greatnesse, which being broken, the vlcer is brought fourth with a scurse or scabbe:* 1.204 but oftentimes not one pushe alone doeth breake out, but many litle and sclender ones, sticking thicke in the mem∣ber like vnto the seades of hirse: which being brust fourth, there doeth likewise arise a cer∣taine crustie vlcer, such as hote iron doeth cause. But betwene their beginning, before that the pushes doe appeare, they trouble the member throughly.* 1.205 Now these scales or scurfe doe sometime receiue an ashye or earthly colour, sometime blacknesse, and in that place the skinne cannot be eased, but it is, as it were fastened to the inner flesh. The flesh also about it, is brought into an exceeding hote inflammation, which the Greekes call Phlogosis, and is blacke in colour, and shineth after the maner of lime or pitche,* 1.206 as though there were a litle blacke commixed with a great quantitie of redde. This colour is caused altogether of melancholie. And these truely are the signes and tokens of a Carbuncle drawen from the very affecte it selfe,* 1.207 to the which also may be added a very greeuous and vehement paine of the afflicted member, as though it were bound with strong chaines. They also which are thus affected doe necessarily fall into a feauer, and that sooner, then they,* 1.208 which are vexed with Phlegmone Erysipelatosa. But if any poison doeth lurke within (as oftentimes it chaun∣ceth) the sicke persons are miserably tormented with perbraking and continuall vomiting,* 1.209 together with a want of appetite and lothing of meate.* 1.210 There are present also with them quaking of the hearte, panting or mouing of the stomache, and an often fainting of courage.* 1.211 This euill is called properly of the Chyrurgians of our age, Anthrax,* 1.212 differing from Car∣bunculus, by reason of the malice and cruelty of the euill (as they please.) Whenas in very deede 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 among the Greekes is the very same, that Carbo,* 1.213 or Carbunculus is among the Latines. Therefore it is superfluous to distinguish, and to handle in diuerse Chapters the signes and cure of them (which all Chyrurgians almost doe vse at this time.* 1.214) But these Car∣buncles doe chiefly arise of violent causes killing the people sodenly, and they follow a pe∣stilent plague. Wherefore there is required a diligent heede or care about them, neither in any case must they be neglected. Moreouer although 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 or euery Carbuncle be a sharpe disease, daungerous and contagious: yet the worst of all and the most deadly is that of Auicene, which doeth arise in the purest places and neere to the principall members. For it is to be feared, that this venemous matter which exciteth the Carbuncle, doeth so∣deinly returne to the inward partes, and to some principall member: which if it shall hap∣pen, the sicke is in great daunger of his life, especially if any euill signes shall bewraye the same. But if the exhalation therof be onely filthie and corrupted with abhominable poy∣son, it is enough to kill the man. If a Carbuncle chaunceth about the stomache, or about the cheekes or lawes, it sodeinly oftentimes (as Celsus sayeth) bursteth out the stomache. And lesse deadly is that Carbuncle in Auicene, which appeareth first redde, and then yelow or of orenge colour. But if it waxeth blue or blacke, it killeth almost euery man, and there is none that is iudged more daungerous of the one nature then it. If the Accidentes, which are wonte to accompanie this disease, be very much remitted or released there is some hope of recouerie. But if they be still more and more continually stretched out, and made more vehement, then truely the matter is in great despaire.

CAP. XI. Of the cure of a Carbuncle.

GALENE lib. method med. 14. & secundo ad Glanconem,* 1.215 commandeth that the cure of a Carbuncle (hauing set downe a conuenient order of diette) must be begun with bloud letting by and by at the beginning (if none of those thinges doe let it, which

are wonte to forbidde the cutting of a veine) who also willeth to draw bloud euen to the fainting of the hearte. For it profiteth muche those that be troubled with this euill: and this alwayes is to be marked,* 1.216 that the veine be strooken directly against the vlcer. But the choose of the veine is manifested vnto vs of the affected member (as we haue said in the cure of Phlegmone.) Therefore in that matter, euen a skilfulll Physition must take counsell of the Chyrurgian, who hath the knowledge to declare, from what place and how much bloud is to be drawen out. The veine (as it behoueth) being cutte, if nothing (as I said) doe hinder you,* 1.217 it shall not be amisse to scarifie the said tumour, vsing somewhat deepe cuttes or woundes by reason of the thicknesse of the malicious humour, (that is) such cuttes as are somewhat deeper then ordinarie (as it pleaseth Galene.) There are some, which would haue scarification made in the crustie or hard vlcer onely, and then they straight waye sprinckle those incisions with hote salte water,* 1.218 that bloud might not meete together in them or encrease, but that it might be emptied out. Sometime also they applie some gnawing medicine, as is arsenike, which in this case among the rest hath the greatest ver∣tue, but some doe minister to the scarified place horsleches or bloud suckers. But strong re∣pulsiues are in no wise to be vsed or applied to the aggreaued member (although refrige∣ration be needefull which in deede doeth belong vnto the inflammation.* 1.219) For you cannot so turne awaye the fluxe or preuent the malice hereof, because of the thicknesse of the hu∣mour. And if at any time you shall doe it, you shall finde some other naughtie humour (as Galene sayeth) which is setled in the deepth or inward partes of the bodye: but this hu∣mour must not be suffred to flowe aboundantly (the same Galene being our Authour.) Therefore such remedies are to be sought for, as by a moderate repression can digest or dis∣pearse the humour.* 1.220 Such truely is that cataplasme, both that which is made of plantaine, and also that which is made of lintels twise sodden. But with this you must commixe crummes of bread, which haue bene baked in an ouen. Let the bread (after Galens coun∣sell) be neither altogether without branne, nor very full of it. But this kind of cataplasme is called of the latter sorte Emplastrum de Arnoglossa,* 1.221 which they make after this sorte, ℞. of plantine, lintles, breade baked in the ouen, of eache a like portion, let them be boy∣led in water. To these Auicene putteth gaules, who also for this purpose doeth alowe the cataplasme which is made of the two pomegranates sodden either in vineger,* 1.222 or in sharpe or tarte water, and these they applye both to the affected member, and also to the partes about it. Of this minde also is Paulus Aegineta, who sayeth, that, if you will plucke vp a Carbuncle as it were by the rootes, and disseuer it from hauing any societie with the partes about it, you must seath in vineger a sharpe pomegranate cutte in small peeces: when the sore is corrupted you must wipe it smoothe, and clense it with a linnen clothe, and when it waxeth drye,* 1.223 you must moisten it with vineger. Also the kernell of the olde filberd nutte or of the young doeth ripen and breake Carbuncles. But the best remedie for the partes lying about it, is the ointment made of Bole armoniacke, of oile of roses or mirtles, and of vineger: which is vsed, because the humour, which hath flowed alrea∣dye, should not returne backe againe within. There are some which doe drawe and al∣lure the poyson,* 1.224 and malicious humour in a pestilent Carbuncle with sucking or draw∣ing it, with cupping glasses, and with medicines that can bring the humour to the place which is be set with Carbo. Which thing truely I would also counsell to doe, if 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 doeth occupie the arteries, and the partes about the lesser veines, and if fluxe doeth moue but slowly. But if it rusheth or breaketh fourth strongly and aboundantly, the rage of the humour must be tamed and bridled by medicines that can moderatly represse (as of late we recited out of Galene) least that there be caused too vehement paine through the fluxe that floweth so strongly in the affected member, and so the euill be made more painfull and angry.* 1.225 But vpon this harde or crustie vlcer, especially when the member is putre∣fied, you must laye some strong medicine both which can greatly drye (but not that which can concoct or digest) and also which can moue the matter, (seeing that so, you shall fa∣uour the putrefaction of the member,* 1.226) of this nature is that of Andron Musu, Pusro, or Po∣lyida: and it must be washed in some sweete wine, or in Sapa, by reason of the thicknesse of the filthie humour. That cataplasme also which in Galene is made of the meale of Tares

and oxymell, is rightly applied, when as the vlcer is malignaunt and corrupted. But com∣monlie the oyntment called Ʋnguentum Aegyptiacum is to be applied. But if these thinges doe little profite, you must come vnto more sharpe remedies,* 1.227 which haue euen a fierie force. Of the which kinde are these, the roote, of Dracunculus or Aristolochia broken and layed in vineger, lime, arsenicke, yellow oker, and other of this, sort,* 1.228 which do burne like fire. These do profit sufficiently, if they do throughlie resolue the corrupted member euen from the quicke. This being done, whatsoeuer is corrupted and dead within, you must by and by pull away and plucke it vp by the rootes. But when after these gnawing medicines there foloweth a scurfe or scarre, which is drawne euerie way from the quicke flesh,* 1.229 the wound truelie, which is raised through them, must be diligently regarded, as in other sores that be burned. But seeing in extreame diseases (as Hippocrates saith) extreme remedies are perfectly the best, we are constrained sometime (our medicines not preuailing with the euill) to roote out a malicious carbuncle by actuall or manuell instrumentes (as they call it) that is, with a bright knife or some other such thing. But the ende of burning is,* 1.230 while there is sense of paine euerie way, as Celsus hath taught verie well. After these thinges the crust or scabbe, which is vpon the vlcers must be resolued by such medicines as are meete for that purpose. But if the sicke shall refuse to suffer adustion, the help of some poore and base fellowe is to be vsed, who by laying holde on the carbuncle with his teeth may quite extinguish and pull vp the same. As were in time past certaine people in Italie named Psilis,* 1.231 who did suck their woundes which they receaued by the stinging of Serpentes, and that without anie harme taking thereby. Moreouer the carbuncle being thus taken away, or consumed anie other way, the hollownesse thereof (the inflammation nowe ceasing) must first be cleansed, and afterward being made pure and cleane it must be healed with filling medicines (which the Greekes call Synulotica.) Which when it is throughly filled, nei∣ther doth there remaine anie hollowe place at all in it, it is conuenient to vse those thinges which can bring it to a scarre, as in other vlcers. But if the euill doeth not rage verie much, but shall seeme to offer vs truce and peace,* 1.232 it is ripened and opened (as Auicene sayeth) by applying figges commixed well togither with leauen and salt. And when this Cata∣plasme or the like is layed to twise or thrise, the place is wont to appeare altogither blacke and full of chinckes or clyftes, and then the place is to be scoured and cleansed with mun∣dificatiues made of Apium. That medicine also,* 1.233 which is made of the yolkes of egges and of salt, if it be often applied, it ripeneth and openeth a Carbuncle, (as Theodaricus writeth.) For the same purpose we vse commonly at this day that medicine, which is made of honie, salt, wheate meale, and the yolkes of egges. Consolida maior,* 1.234 (that is) comferie (which the the Greekes call symphyton) being brayed betweene two stones, doth heale Anthrax verie maruelouslie (as they report) and within the space of one day it quite destroyeth it, so that it needeth no other curing after any more, besides also it is a common help for other wounds. Some also do declare wonderfull things of Scabiosa: because that,* 1.235 (it being eaten or dronk in wine) it thrusteth out internall tumoures to the externall places, and it doth dissolue and discusse them without paine.

In the vlcers of a carbuncle these do resolue the crustes or scurfe, fresh butter,* 1.236 swines suet, and other fatte thinges of that sort. For this purpose also this emplaister followinge doeth maruelouslie profite: for besides that it resolueth the scarre, that is, the crust, more speedelie, then the aforesaide thinges, it also asswageth the paine that is caused either of the sharpe and burning medicines, or of the bright instrument, and it mightely discus∣seth the malicious humour, which exciteth the Carkuncle. ℞. of wheate and barley meale. ana. ℥.iij. of the which make a solide emplaister with the decoction of mallowes, violettes,* 1.237 and the rootes of Althaea, and put thereunto of butter, and swines suet melted. ana. ℥.ij. the yolks of two egges, which must be put in, when they are taken of the fire: & all these must be diligently commixed & incorporat togither with the aforsaid roots & herbs, which must be well beaten & brayed togither the one with the other, & then sifted through a scarce. As concerning their diet, epithemes, cordials, and other of that kinde, which are made to stren∣gthen the heart▪ also Euacuations, if they be needefull, they doe altogether pertaine vn∣to that part of Phisicke, which cureth with diet and medicines. Wherefore in ministring

them, you must aske the aduise or counsell of some learned Phisition. But commonlie all men almost do vse theri••ca,* 1.238 which is wont to be ministred to the greatnes of a beane, made of the water of scabeous, or if a verie sharp and vehement feuer be present, you must make it of rose water, or water of buglosse: which the sick must take sixe houres after meate. But because we haue made mention before of the Trochiskes of Andr••••, Polyida & Musa (which Galene so greatly vsed) it shall not be amisse to set down here the description of them.

* 1.239℞. of Cytines (that is) of the first floures or buddes of a Pomegranate. ʒ.x. of alume that may be cut. ℥.iiij. of coperous or vittioll. ʒ.xij. of mirrhe. ʒ.iiij. of frankensence, Aristolo∣chia, and gaules. ana. ʒ.viij. of salt ammoniacke. ʒ.iiij.

* 1.240℞. of pomegranate rindes. ʒ.vj. of mirrhe. ʒ.viij. of Alume that may be cut. ʒ.v. of fran∣kensence. ʒ.iiij. of coperous. ʒ.iij. of the gall of a bull. ʒ.vj. let these be taken in sweete wine.

* 1.241℞. of cut or clouen alume. ʒ.iij. frankensense. ʒ.iiij. of mirrhe as much, of coperous. ʒ.ij. of the floures of pomegranates. ʒ.xij. of bulles gall. ʒ.vj. Aloes. ʒ.viij. Take these in sharp wine.

* 1.242℞. of cut alume, aloes, mirrhe, coperous. ana. ʒ.vj. of saffron, and of the dregges of the oyle of saffron. ʒ.iij. of the floures of pomegranates. ʒ.iiij. Let them be taken in mulsum made of Faler••••um.

CAP. XII. Of Gangrena and Sphacelus.

* 1.243GALENE lib. 2. au Glanconem, calleth them Cankers, which by reason of the greatnesse of the inflammation be made and chaunged into mortifications, yet they be not throughly engendred and alreadie confirmed. The force and tyrannie of this euill is so outragious, that except it be remedied verie spee∣delie, the affected member doeth easilie represent the habite of death (that is) it doeth verie readilie drawe together the extinction and quenching both of life,* 1.244 sence and mouing. But when the member is so corrupted and so feeble, that it is altogether without sence, and as it were dead, so that whether it be stroken, or cutte, or burned, the sicke feeleth it not, then the Greekes call this euill no longer Cangrena, but Sphacelus, the Latines Syderatio, the later sort call it Esthiomenon: which name also they giue vnto Gangrena.* 1.245 But Auicene calleth it Esthiomenon, when as the corruption thereof doeth passe to the continuall partes, which tearme the Grecians do vse in an other order. Some call this affect sometime Herpeta esthiomenon,* 1.246 sometime verie improperly, Cancer vlceratus. But this affect chaunceth also to the bones, when as the flesh being beset and compassed about with them, bringing foorth and engendring filthie and stinking corrup∣tion, doeth infect them with this horrible poison and consumeth them with most corrupti∣ble rottennesse. Therefore when as the member shall altogether appeare voide of life, sence and mouing,* 1.247 you must by and by pare it to the quicke as neare as you can to the sound flesh. Sphacelus therefore differeth from Gangrena, because the one doeth growe vp in the bones (as we haue declared) and not in the flesh and vesselles of the bodie onely, but the other commeth not to the bones. Not withstanding it is one kinde of Sphacelus but it borroweth a proper and singular name beside the common tearme. This kinde of cor∣ruption being perfect in the affected part, and altogether depriued of sence, is called com∣monlie in Fraunce Ignis Sancti Antonij. In another place Ignis Sancti Martialis. But this mortification of the members,* 1.248 or the extinguishing and destroying of the life in them, chaunceth three wayes. One way, when as the member can no longer receaue the life that is sent to from the heart thorough the Arteries, by reason of the dissoluing of the [ 1] mixture and consent of the affected member. Which mixture and harmonie of the mem∣ber is dissolued and destroyed either because of too much colde, (as sometime it hap∣peneth in sharpe and boysterouse winters) or by reason of immoderate,* 1.249 rash, and vnad∣uised refrigeration of the inflammation, or else because of the exceedinge, and vnmea∣rable vehement heate, and poyson of the inflammations, and malignant vlcers (as they call

them.) Another way Gangrena and Sphacelus are caused, whenas the life being gotten in∣to [ 2] the member is choaked and stopped, as it oftentimes happeneth in great inflam∣mations, which sometime doe so close vp, and stop the veynes, Arteries, and poores of the skinne, that there the spirites, (the breathing foorth of the vaporous streames, and the drawing in of the aire, being altogither hindred) are strangled and choked. The thirde [ 3] way, these mortifications and destroyinges of life are caused in the members, whenas the passage and flowing of the vitall breath from the heart to some member is letted and for∣bidden, and that happeneth either by reason of a vehement and strong binding, or else be∣cause of some bruse receaued in these passages and poores, through the which the breath is caried. To conclude, Gangrena and Syderatio, which the Grecians call necrosis and sphacelus, do chaunce vnto mens bodies, destroying either the member, or the vitall facultie,* 1.250 or the naturall heate and temperature of the bodie. But the signes of Gangrena and Syderatio, Ga∣lene in his little treatise of Tumours aboue nature declareth to be these: First truelie that flourishing colour is extinguished in them, which is wont to be in phlegmonous inflam∣mations, [ 1] then paine, and beating of the pulses (that is) the mouing of the Arteries, [ 2] which is felt of the sicke, doe depart a little aside, yet their naturall disposition not altoge∣ther ended, but their sense altogether dead and mortified. Whereupon the member straight way appeareth blacke, and it is verie soft, and full of corruption, it breatheth out a fithie sa∣uour [ 3] and it is like vnto a dead thing without life. Whereby it commeth to passe, that when [ 4] it is touched with the finger, it easilie yeeldeth verie deepely, neither after doth it rise vp a∣gaine or returne, but the skinne appeareth as though it were separated from the flesh. But this mortification of the affected member, (which the Grecians call Gangrena,) is of so great crueltie and madnesse (as Paulus sayeth) that except you presently seeke a remedie for it without all delay, the affected member soone perisheth,* 1.251 and then it inuadeth the o∣ther parts that be next vnto it, and killeth the man.* 1.252 But if (as Celsus reporteth) it yet hath but small power, but is nowe a beginning, it is not verie hard to cure, especially in a young mans bodie, and so much the rather if the muscles be sound and whole, if the sinewes be not hurt, or smallie affected. But when this euill hath taken deepe roote, and is turned al∣readie into sphacelus, it it vncurable, and verie manie do die of a cold sweat.

CAP. XIII. Of the cure of Gangrena caused of great inflammations, and of the destroying or curing of Sphacelus, vvhich is en∣gendred of Gangrena.

BECAVSE aboundance of bloud doeth ingender a canker,* 1.253 the order of the cure therof must be straight way attempted by a plentifull & copious eua∣cuation of the corrupt bloud, which is packed togither in the affected mē∣ber. But in the meane season, you must not neglect those thinges which shall seeme to belong vnto diet, medicines, cutting of a veyne (if neede require) and strengthenning of the hart, in which thinges the Chirurgian must take the aduise of some learned Phisition, who knoweth how to enstruct him there∣in (as the matter shall require.) But there must be great plentie of that congealed bloud (which causeth mortifications) drawne out from the affected part, either in the veyne that is cut, if it appeareth anie thing full, and swolne about the same member, or in the whole skinne of the part affected, together with his substaunce either kept downe and made obedient, or cut, or deuided by manie deepe scarifications. Some to this ende doe applie horse-leaches, and they doe open the little veynes that be next the sore, but those deepe and often sections or scarifications are much more effectuall to cure that Euill. But because of the greatnesse of the Cankre, wee vse verie great sections, or of∣ten incisions (which we call Scarifications:) the one, when the eueill is neare rotten, the other when it onelie beginneth to rotte. For the greater the euill is, the greater remedie it

requireth (as euerie man may knowe.* 1.254) But when you haue drawne out bloud abundant∣ly by those deepe slashes or cuts, you must wash the place with salt water, that the thicke bloud which otherwise would abound there, may be brought foorth. Then you must ap∣ply some medicine, that can let and dissolue putrifaction, as is the meale of tares or darnell, (which the French men call yuraia, because it doth prouoke dronkenesse after the maner of wine) or if there be scarcitie of them, you must vse the meale of beanes with oxymel and syrupus acetosus. It shall be profitable also to wash the scarified place twise in a daye with hoate vinegre, but especiallie with mulsum. For these by reason of the drinesse, doe con∣sume the filthinesse and corruption, and do cleanse it, but bycause of their coldnesse they do chalenge of putrifaction that, which is not yet defiled and corrupted. But when this feruēt heate is nowe abated, and the furie of the euill somewhat remitted and slaked, you must lay aboue vpon the sore that oyntment which is commoly called vnguentum Aegyptiacum,* 1.255 made of verdigrease, alume, honie, and vinegre, of eche a like quantitie commixed and boyled togither. This doeth stop putrifaction and resolue it: and it doeth disseuer also the putrified and corrupted humour from the sound and whole partes, and it doeth cause it to fall and perish. Moreouer it procureth a crust or scarre, and preserueth and defendeth the whole partes from anie infection. But if you will apply a more strong and effectuall medi∣cine, mingle salt with the aforesaide thinges: or if the euill shall encrease yet more and more,* 1.256 minister some of the Trochiskes before mencioned, being thoroughly brayed and beaten togither, and then washed in vinegre and wine: as that either of Andron or Polyida or Musa: or one of those which are called of the later sort, calidicon, Aldaron, or that made of Asphodelus, which by reason of the burning force do separate the corruption from the sound partes. In this matter before all other thinges Arsenicon is praised and allowed of, which they call sublimatum,* 1.257 purum or correctum, which must be dissolued either in some pou∣der or in wine, and taken in linnen or cotten (which the French men call Coton.) And so applied betweene the sound and corrupted member. For this doeth straight way stay the euill, and that truely without paine. But if necessitie requireth, you must deuide the good from the euill with a certaine instrument called a probe, or sklise. But in ministring such me∣dicines: that the matter may be handled more without care, you must be diligent to knowe the nature of the sicke bodie, (as Galene hath well taught vs saying.) If the bodie be rusti∣call and hard by nature,* 1.258 it requireth verie vehement medicines: but if it be tender and soft, it requireth more gentle and milde medicines. Infantes also or children, and they which loue to liue at their owne pleasure in idlenesse, must haue gentle medicines ministred to thē. Moreouer the nature of the partes which are euill affected must be regarded as well as the whole bodie. VVhen you do either cut of, or cut about that which is putrified & corrup∣ted. For there are some sores, which verie quickly do come to matter, & corruption, if they be negligently cured: and some verie slowlie: some also do slowlie feele the force and benefite of medicines applied, and some verie soone.

* 1.259Furthermore if (notwithstanding these burning medicines) the euill shall yet remaine, you must burne that place which is beetweene the whole and corrupted member. But all these remedies are wont sometime to profite nothing at all, and then this is the onelie helpe,* 1.260 although (as Celsus sayeth) it be a miserable helpe (that is) to cut of the member, which by little and little waxeth dead, that so the other partes of the bodie may be without daunger. For that which is once corrupted, euen with touching, it doeth infect and corrupt that part which is whole and sound after the maner of poyson. But if at anie time you shall cut of this putrified and dead member, or shall launce of that which is corrupted in anie member euen to the sound flesh,* 1.261 then by the counsell of Galene for more quietnesse sake, you must seare or burne with some bright instrument that member, which as a roote, is ioyned to the whole and sound bodie, for so you shall quickelie stay the flowing of bloud, and debarre corruption.* 1.262 Nowe adustion being done and ended, you must vse the iuyce of leeks, or (as Paulus saith) you must applie salt with the leekes, or some of those reme∣dies, which wee haue spoken of a little before. For these doe drie and binde the cor∣ruption, and do also stop the fluxe of humoures. But when by vsing these remedies rotten∣rennesse or corruption shall seeme to cease: that the crustes and scurfe may soone fall

away, you must vse a Cataplasme made of bread, or barly meale, or wheate meale boyled in hydraleon. Also that medicine, which they call Cephalicum, annointed with honie. These through their cleansing or scouring, do resolue the crust from the flesh which lieth vnder it. Moreouer that medicine which is called Tetrapharmacum, and that also called macedonicum, by mouing & mollifying the matter do bring the scurfs from the parts that ly vnder thē, as all other thinges do, which do bring the sores vnto suppuration. For these remedies do both mollifie, & ripen or end the matter vnder the crust, which matter doeth resolue it: (I meane that matter which lyeth betwene the crust & the flesh. Bread also beatē & brayed with apiū, or ocinium, through their clensing doth mightely draw the crustes frō the whole parts with∣out erosion or gnawing, of the like vertue also is Iris, or the roote of panax, or of aristolochia,* 1.263 or of acorus mixed with honie. But they are commonly wont to vse butter or some other an∣nointing thing to resolue the crusts. But when the crust is fallen of, they wash the place with vinegre, and then apply this plaister following, which is rehearsed by Guilielmus de saliceto.* 1.264 ℞. hony. lb.ss. raw yolkes of egges iij. or iiij. of barley meale. lb.ss. mingle these togither & bring them into the fourme of an emplaister. But two or three dayes after, that the mun∣dification or cleansing may be the better accomplished, you may ad to this emplaister of chosen mirrhe. ʒ.x. But in tender and yong bodies for the separation of the crust, and deter∣sion of the filthie corruption, the meale of tares mingled with honie,* 1.265 or frankensence (which was vsed of Galene) doth aboundantly suffice. These thinges being rightlie ordered, such kind of vlcers must be brought vnto some soundnesse of health with such kind of medicines as can drawe together the flesh, and procure a scarre: the Grecians call them synulotica and epolotica. 1. Empty out aboundantly the corrupted bloud, which is stuffed in the affected member. 2. After scarifications or sections, wash the affected place with salt water. Then [ 1 2] lay on a medicine appointed for corrupted sores. 3. When the furie of the euill is somewhat slaked, minister vnguentum Aegyptiacum. 4. If the euill will not yeald to these remedies, [ 3] seare with a bright and hoate yron that place which is betweene the filthie and corrupted [ 4] member. 5. But if all these thinges shall nothing help, and now Gangrena is chaunged into [ 5] sphacelus, cut of that member verie speedily, which is so perished euen to the whole, so that no filthinesse remaine behind. 6. When you haue cut of that which was putrified, you must [ 6] vse some hote burning instrument, that so you may the more quietly pull vp euen the very root of the euill. 7. After exustion, minister the iuyce of leeks, and other such thinges, which [ 7] do drie, bind, and stop fluxe. 8. Make no great speede to resolue the crust or scurfe by v∣sing [ 8] burning medicines, or some hoate instrument from the subiect places (for then there is wont to follow abundance of bloud.) 9. When rottennesse or corruption is ceased, and [ 9] you feare no more the flowing of bloud, apply those thinges which can drawe of the crust. 10. VVhen the crusts or scurfes be falne from their places, you must vse the same cure, as in [ 10] other vlcers.* 1.266

1. First appoint a thinne and coling diet for them which are vexed with Gangrena and sphacelus. 2. If nothing doe let it, tourne awaye the fluxe by letting of bloud: and drawe it out aboundaunlie, if it floweth plentifullie. 3. Purifie the bloud with the medicine which is called Catholicon, or with the blacke pith of Casia fistularis, or with the deco∣ction [ 3] of Tamarinds, of hoppes, and fumitorie. 4. Let the sicke take Theriaca, and o∣ther of that kinde, which are able to defende the heart, (which is the fountaine and be∣ginning [ 4] of life) from those corrupted and filthie smelling fluxes, which are mounted vp from the putrified member.

CAP. XIIII. Of Erysipelas and other tumoures caused of Choller.

ALthough fleume in the genration of humours, doth follow next vnto bloud,* 1.267 and there be greater abundance of that humour in the bodie next vnto bloud, thē of other humours, yet because tumours aboue nature proceeding of choler (which they cōmonly call cholerike apostems) do in manie things greatly conspire & a∣agree

with bloudie humours, it followeth (after the determination of phlegmone, and of o∣ther tumoures consisting aboue nature, which proceede of bloud) that we nowe speake of those swellings, which are caused of choler, and are called of the Greekes by this generall name Erysipelata,* 1.268 but of the auncient Latines Ignes sacri. Erysipelus therefore is the braunch or bud of cholericke fluxe, most abiding about both the skinnes, (that is) both about that which outwardlie couereth all the partes of the bodie, and also about that filmie and thinne skinne which inwardly compasseth the internall parts. But oftentimes also it occupieth some of the flesh that lieth vnder it, as phlegmone (which is the issue of bloudie fluxe most incident to fleshie bodies) doeth also possesse some of the skinne. Therefore when verie thinne choler, or hote bloud which is thinne also in substaunce, (called of the later sort cho∣lera naturalis, but of Galene 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉) is spread abrode ouer the skinne onely, nothing mo∣lesting the flesh vnder it, and yet somewhat raising the member into a tumour with a lan∣guishing inflammation and yellow rednesse, and altogither doth yeeld when it is touched. This affect is properly called of Galene,* 1.269 a true and exquisite Erysipelas. But this is for one consideration, or (as they say) it chaunceth vniformely, and without vlceration. Auicene calleth it spina.* 1.270 But when a humour of bitter choller shall be more thicke and sharpe, then that it can returne againe naturallie it doth exulcerate or fetch of that little outward skinne, (which the Greekes call Epidermida) and sometime that exulceration of the skinne in pro∣cesse of time pierceth somewhat deepely, so that it toucheth the inner flesh vnder it, and then that affect is called also Erysipelas but with vlceration,* 1.271 which (as Galene sayth) is all one with Herpes. But if it be neither a cholericke fluxe, nor a bloudie humour, but equallie congealed of them both, it is not then called Erysipelas onelie, but Galene tearmeth it a dis∣position throughly commixed with Erysipelas and the inflammation.* 1.272 But of that which is predominant in the mixture, is the title giuen to the euill. For when bloud ruleth, it is called phlegmone erysipelatosa: but whē choler raigneth, we tearme it Erysipelas phlegmonôsum. But when neither hath superioritie, but the accidents of them both appeare equall toge∣ther in power,* 1.273 then that euill shall be called a meane betweene phlegmone & Erypelas. Now also of other mixtures there shall be the like interpretation, that is, if much choler be min∣gled with a thinne and small humour, either of fleume or melancholie, it shall be called Eri∣sipelas oedemat••sum or schirrbosum. Moreouer when we speake simplie of choler, or of a bili∣ous humour,* 1.274 after the maner of Galene and other Phisitions, we meane pale choler, yelow, and bitter, and not that which is soure and blacke. And this is called of others, naturalis & certa cholera, hauing his generation of bloud that is thinne and hote. But melancholy we ne∣uer absolutely do tearme choler, but alwayes with an adiection of the humour, which ioy∣neth the colour of the name. Choler therefore, which is called of the Greekes 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, & com∣monly cholera, is a hote & drie humour, proceeding of the thinner & hotter part of chylus, or of thinne and hote bloud (as we saide a late.) And this is two maner of wayes according to the diuision of the newe Phisitions,* 1.275 that is to say, naturall and vnnaturall. Naturall choler is a humor of power hote & drie, in substance thin, of colour yellow or red, declining vnto a certaine colour like orengetaunie, but in tast verie bitter, & not sharp or soure (as some vn∣truly haue affirmed.* 1.276) Vnnaturall choler is said to be that, which doth degenerate from the aforesaid bilious humour, and yet it keepeth it selfe within the bounds of his circuite, which if it doth once passe or go out of, it is now not to be accounted choler, but rather some o∣ther humour.* 1.277 But this (I meane choler) doth happen to transgresse the limites of his liberty or circuite two wayes. 1. One way (as we may say) by it selfe, and in it selfe. 2. The other way by admixtion with others. By it selfe and in it selfe is also two fold. 1. one way, whenas that naturall choler doth putrifie, and is burned within, and that is called adustae per putrifa∣ctionē .i. burnt through patrifaction. 2. The other way, whenas vnnaturall choler called vitel∣lina,* 1.278 is throughly concocted euen with a fierie heate in the liuer, or in the stomach, or in the veins, & it is made of the colour of leeks, which they also call prassina, or it is caused to be ru∣stie or cankred, which truly are extreme griefes. But vnnaturall choler, or choler aboue na∣ture, through admixtion, is caused, when as another humor doth come vnto it extraordinari¦lie. And this truly happeneth many waies. For if thinne & waterish fleume be mixed with it it is made yellow & like vnto saffron, if thick & viscous fleume be commixed therwith, it is

made like to the yolks of egs: but if burned melancholie be ioyned therwith,* 1.279 it is made bilis adusta per admixtionē. And so after Auicenes minde & iudgement, there are six kinds of na∣turall choler with: Halyabbas, foure only, for he maketh no mention at all of the two kinds of adusted choler. But Gal. lib. 2. de virtut. naturalibus saith that there is no choler besides nature, but that which is vitellina, very like both in colour & thicknes to the yolkes of egs: for he saith that porracea & aerubinosa bilis are engendred oftentimes in the stomach, of naugh∣tie and corrupted humours, by reason of the cruditie or rawnes of meates and drinckes, as are, the herbe called beete, oynions, coolewortes. And also sometime, when these things are not wel digested, it is engendred in the verie veynes, by reason of sicknes, or some other euill disposition. By these thinges therefore it is gathered, that there are foure kindes or differences of inflammations engendred of choler (which commonly are called cholericke apostemes). That is to saie. Of true sincere,* 1.280 and laudable choler (which we call thinne & hote bloude) is engendred that kinde of inflammation, which Galene lib. 2. ad Glauco. calleth a true and exquisite erysipelas, which is as it were a passion of the skinne onely: in Greeke it is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. But of vnnaturall choler, being mixed with other hu∣mours, there do arise three other differences, as erysipelas phlegmonôdes, erysipelas aedematodes, and erysipelas scirrbodes. And of choler which besides nature is caused of adustion, by rea∣son of the thinnes or thickenes of the substaunce thereof there are engendred either her∣petes esthiomeni (that is) excedentes, which are of the same kinde with those erysipelata,* 1.281 which doe chaunce with vlceration, or there are engendred phagedaene, which doe somewhat deepely gnaw the flesh togeather with the skinne, & there are caused exulcerat cankres, & other such gnawing euils, there are also engēdred cacoethe (that is) malignant vlcers, which are called of the late chirurgians pustulaa corrosiuae. Therefore in such kinde of humours, that is truely the most thinne, which raiseth the exulcerated herpes: & that most thicke, which prouoketh the cankre. Then that which parteineth vnto thicknes, occupieth the next place, which doth engendre phagedene, as Galene hath noted lib. 14. meth med. The causes of a true erysipelas as also of a true plegmone are three. Praegressae,* 1.282 which are called also primatiue 2. antecedentes 3. and coniuncte. But epysipelas is seeldome caused of anie primitiue cause: not∣withstanding violent frictions, the applying and ministring of attractiue medicines doe of¦tentimes excite or cause the same.

CAP. XV. Of the signes and tokens of a true erysipelas.

THE markes and tokens of a true and exquisite erypelas are gathered & knowen by conferring the same with phlegmone according to the doctrine of Galene 14. Therap. and 2. ad Glauconem:* 1.283 whereby it plainely appeareth that a true and lawfull erysipelas is a certaine species of plegmone (that is) of an inflamma∣tion, as it is generally taken. The signes therefore of erysipelas are these, a red colour to beholde, declining somewhat to yellow,* 1.284 which yellowish colour doth easely yeld to touching or handling of it, (that is) by thrusting it downe with the fingers, and then it slydeth in againe, a small tumour rather remaining in the skinne, then descending deepe∣ly, vehement heate causing a more vehement feauer then that which is accended of phleg∣mone: for erysipelas is farre awaie more hote, then phlegmone No great or strong breaking of the pulses, which is the proper simptomate of a great phlegmone. A byting and pricking paine without any extension, as it chaunceth in phlegmone, & many other like signes which doe signifie the dominion and rule of choler. But that which partayneth vnto the iudge∣mentes hereof, erysipelas doth chiefly laie holde one the face, and beginneth commonly in that part of the nose, which is commonly called lepus. then straightwaie it spreadeth ouer the whole face, and that through a double occasion, that is, for the thinnes of the skinne, & lightnes of the choler. But in the vncouering or laying naked of any bone, erysipelas is a so∣daine and maruelous disease, as Hypppocrates writeth lib. 7. Aporism. 19. that is to say, it is an euill symptomate, if the flesh lying rounde about the naked bone doth seeme to be occupied of erysipelas, but this, as Galene witnesseth, chaunceth verie seeldome. Againe

the same Hippo. writeth in the Aphorisme following, that of erysipelas there commeth cor∣ruption, suppuration, togeather with the disease, which thinges (saith Galene) neuer doe chaunce vnto erysipelata, except it be to them,* 1.285 which are verie malignaunt. A true & law∣full erysipelas hath foure times or seasons, as other tumours also aboue nature haue: the si∣gnes whereof are to be sought out of those thinges which went before. An exquisite erysi∣pelas is seeldome ended by suppuration, but chiefly through an insensible transpiration or resolution. There happen sometime in erysipelas certaine symptomates, which oftentimes by reason of their greatnes do exceede the verie cause of the euill it selfe and therefore they do hinder the order of the cure (that is) they doe chaunge and peruert the method of cu∣ring (as hath also bene saide before in phlegmone). Moreouer erysipelas followeth the mo∣uing of a tertian feauer, with whose matter it hath a certaine analogie and proportion, for the matter of them both, is a cholericke humour. But it is not good to driue or turne erysi∣pelas from the outward partes to the inwarde, but contrariewise, from the inward mem∣bers to the outward partes, as Hippocrat. hath written lib. 6. Aphoris. 25. But those erysi∣pelata,* 1.286 which doe arise about the head do put vs to more trouble, which (as Paulus sayth) are wont to be so daungerous, that except they be holpen with some effectuall remeadie, they sometime strangle & choake the sicke. Hippo. also writeth that erysipelas is verie mor∣tall & deadly, if it chaunceth in the wombe of a woman with childe, for erisipelas being thus engendred in the wombe, the childe of necessitie dieth. For truely a sharpe feauer (as Ga∣len saith in his commentaries) oftentimes destroyeth it without inflammation.

CAP. XVI. Of the cure of erisipelas.

* 1.287SEEING that erysipelas (as is also phlegmone whereof we intreated a little be∣fore) is a hote affect, and engendred of the defluxion of humours: the me∣thod of the whole curing thereof shall also be two fould (: that is to say) refri∣geration, and euacuation. And as in plegmone the order of euacuation did ••urmount and ouercome the methode of refrigeration: so in erysipelas refrige∣ration is more needefull then euacuation. For the one doth trouble and mo∣lest in quantitie, but the other (which is erysipelas) in qualitie. Therefore erysipelas must be greatly cooled and little emptied, whereas contrarywise an inflammation ought to be plentiefully euacuated, and little refrigerated. Although there be a common chapter and summe of curing both affectes, as Galene saith, that is: the vacuation of the trou∣blesome humour. And therefore after that erysipelas hath bene cooled, we vse those medi∣cines which can digest or discusse. Furthermore that we may attaine vnto this vniuersal me∣thode which we haue saide to be twofoulde (I meane refrigeration and euacuation of the noysome humour):* 1.288 it shall not be amisse, if we declare this cure by foure other particular orders after the consent of the Chirurgians of our time. The first scope consisteth in the [ 1] right obseruation of a good diet. The second concerneth the auersion of the humour that [ 2] floweth to the affected member, which they call antecedens materia. The third consisteth in [ 3] the emtying out of the humour, which hath flowed alreadie into the diseased part, which [ 4] they also call, materia coniuncta. The fourth & the last is busied & occupied about the cor∣rection and keeping backe of the euill symptomates that may happen thereunto.* 1.289 We shall easily dispatch the first scope, if the applying of all those thinges, which they call res non naturales shall belong vnto moistnes and coldnes, as in a feauer tertian, seeing that erysipelas hath his beginning of choler,* 1.290 which is of a hote and dry temperature. Therefore chuse & prepare an aire as neare as you can, that is somewhat colde and moist. In sommer let the sicke be in a veri colde house somewhat within the ground, that is windie, and towardes the North. But if there be no such place to be had, and the ayre verie hote, make it ready for him your selfe by arte. Poure colde water verie often out of one vessell into another sprinkle the pauementes of the house dayly with water that is altogeather ye••e, and colde. spread vpon the floore, roses, and violettes, vyne leaues and braunches, fallow ••oughes, &

other floures and buddes, which are of a colde and moist facultie. Let no great companie of men come into the parlour or place where the sicke abydeth. Let him eschew all fatte, sweete, soure, and hote meates. Let him eate luttuse, gourdes, purslane, sorrell,* 1.291 (which they call acetosa) ryce, and other thinges of that kinde, which doe thicken and refrigerate bloud. Let him altogeather abstaine from wine. Let his drincke be Ptysan broath,* 1.292 or bareley water. Let him keepe a temperate diet. Let his bellie be alwaies soft and soluble. Let him abstaine from all exercise, and mouing,* 1.293 especially that which is vehement and immoderate. Let him eschew anger, contentions, and all vehement motions and pertur∣bations of the minde as mortall enemies. Let all things be cleane & handsome about him. Let him refraine from carnall copulation. And let these things suffice concerning the first scope. But we shall also bring to passe out second intent about the cure of erysipelas,* 1.294 if by conuenient euacuation we take away that humor which is left behind in the bodie. Ther∣fore in a true and lawfull erysipelas not necessariely as in phlegmone, we must draw bloud out of a veyne, but we must also purge the bellie downeward with some medicine which can expell choler (called of the Greekes cholagogon) if that the affect be great, and the bodie doth seeme to abounde with choler. Therefore when erysipelas doth accend and kindle fe∣uers, & those more vehement then phlegmone, those medicines which are exceedingly hote and the iuice of scammonium, called of new Greece dacrydion) and that also which is com∣monly called in the shoppes electuarium de succo rosarum, are in no wise meete or conueni∣ent for this disease, and therefore you must vse either rubarbe, or that potion which of Ra∣sis is called aqua tamarindorum, which is made as followeth. ℞. damaske prumes .24. tama∣rinds that be new. ʒ.x. of broken sugar. quar.ss. to the which things to make them more ef∣fectuall, you may adde rubarbe that is well washed. But if the euill be verie little and small, these medicines called cholagoga shall not neede, but it shall be sufficient to vse at that in∣staunt some sharpe clyster, (as it pleaseth Galene.* 1.295) But in a phlegmonous erysipelas your labour shall not be frusteate, if you shall beginne the cure with bloudletting (if nothing do let it). For that kinde of erysipelas doth often lay holde on the face, whereupon Paulus cō∣mandeth that by & by in the beginning you must cut a veyne in the elbow especially cho∣sing in it the shoulder veyne. But if that doth not appeare, you must take that which is most obiect to the sight. And if any thing doe hinder the detraction of bloud, he commaundeth to vse a purgation made of some medicine which is dedicated and appointed to driue out choler, yet Paulus doth not contend with Galene: for whereas Paulus hath commaunded to cut a veine in that erysipelas which doth rise about the heade or face, he meant that of a phlegmonous erysipelas, which verie often molesteth the face: but Galene speaketh of a lawfull erysipelas, wherein he vsed no detraction of bloude. But in erysipelas aedematosum or scirrhosum, you must vse a purgation which hath a mingled and manifolde force, that is, which can purge, partly choler, partly fleame, or a melancholie humour. And truely in all these thinges the aduise of some learned and wise Physition is to be asked,* 1.296 from whose coū∣sell and decree the chirurgian out not in anie wise to swarue or digresse. And let this be sufficient that once you haue bene admonished, that the chirurgion ought to attempt no∣thing at all in those thinges which belong vnto purging and bloodletting, without the counsell and warrant of some cunning Physition, except sometime necessitie shall com∣pell him, and when no Physition is readie at hande. The thirde intention is finished and perfourmed by cooling and repelling medicines in the beginning of the fluxe,* 1.297 excepting those causes which we haue mencioned in our generall discourse. But the beginning being passed, and fluxe now remaining, you must emptie that which cleaueth fast vnto the member and is compacted therein, by applying outwardly digestiue or euaporatiue medi∣cines, that is to say, through the transpiration and breathing through to the sense. But of all these kind of tumours thus consisting aboue nature, there is a double euacuation. Gal. lib. 14. Therap. one truely of repulsiues to other partes, the other of outwarde digestiues, through that vaporous breathing, which doth flie the sence. But because erysipelas doth afflict and molest not onely in quantitie, but also in the verie qualitie by reason of the vehe∣ment inflammation: it doth require a more often and greater refrigeration then phlegmone,* 1.298 doth. Therefore after the emptying of the whole bodie, as we haue saide a little before, we

will vse repressiue remeadies, cooling it as it is cōuenient) the afflicted member, or that part which susteyneth the skinne: especially when erysipelas is engendred without any mani∣fest cause. But the ende of refrigeration is the mutation or chaunge of the colour: for that which is a pure erysipelas doth by and by rest and cease with this,* 1.299 but that which is not pure, but after a sort phlegmonous, if you shall refrigerate it much, it maketh the skinne blacke and blew, but if you shall desist from seaking to chaunge the colour, it waxeth blacke, es∣pecially in an aged bodie: so that some of those refrigerated tumours cannot parfectly be healed, no truely not with digesting medicines, but that some scirrhous tumor will remaine behinde in the member. It is farre better therefore (saith Galene) when you see the co∣lour of the affected member altered,* 1.300 to passe ouer from refrigerating and moderating hel∣pes vnto their contraries (that is) vnto dissoluing or digesting and drying remeadies, be∣fore that the member be altogeather blue or blacke. But you must alwayes beware and take good heede, that those thinges which be annoynted, be verie liquid and moist, and that they be often chaunged, and that those thinges which be applyed, be often washed with sponges dipped in some colde liquor. For the great heate of the member quickly bru∣sting forth into a vapour, doth drie vp these thinges. But amongest those thinges which carie with them a refrigerating and repelling force verie conueniēt for this affect. Auicene chiefly prayseth among simple remeadies the sprinckling on of colde water. But Galene commendeth the iuice of nightshade,* 1.301 of sengreene, of purcelaine, of psyllium, of henbane, of lettuce, of vmbilicus veneris (which herbe is called of the Greekes cotyledon) of endiue, and succorie, of fenne lintles, of gourdes, and other of that sort. Also that cerote made of verie colde water,* 1.302 which conteineth foure times asmuch of oyle of roses with white waxe. ℞. oyle of roses with oyle of vnrype grapes made without salt, which being made verie soft & pliable in a morter, sprinckle on cold water, as much as you thinke good, with the which if you commixe a little vinegre that is thinne, and verie cleare, you shall make the medi∣cine more excellent and more effectuall. Moreouer all these thinges must be ministred cold, and often chaunged, before they be any thing dryed or withered. It profiteth also verie much and that presently to annoint the member annoyed with Erysipelas with ceruse onely, or mingled with vinegre and lycium, or with terra cimolia, or with potters claye, with nightshade, or with spuma argenti with oyle of roses, and with acatia with vinegre. To this purpose also this compound following helpeth much. ℞. iuice of plantaine. ℥.j. oile of roses ℥.iij,* 1.303 lithargyri nutriti. ℥.j. cerusae lota. ʒ.iij. of womans milcke. ℥.ss. let all be com∣mixed togeather and brayed in a leaden mortar, and make a lyniment. But lythargyrum and cerusa ought first to be beaten, and then the oyle and iuice aforesaide must be poured one them softly by litte and little, vntill they be throughly incorporate togeather the one with the other. But if you desire greater coolers, you may commix with these and other remeadies before recited (according to Paulus minde) a little opium or cicuta, or mandrake. But I thincke it good to abstaine from applying either of them or the like, which are of a stupefactiue nature, except great necessitie doth moue you thereunto. But when the inflā∣mation of the affected member is somewhat abated, & the heate of erysipelas slaaked, Ga∣lene (before that any blewnes did appeare through refrigeration) did vse to dissolue the hu∣mour gotten into the member (which they call coniuncta materia) by laying one a cata∣plasme of bareley meale,* 1.304 or of cruda polenta (called in Greeke 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉) & of other things before mēcioned in the order of curing phlegmone. For euē as the signes of erysipelas were de¦sumed & knowen by the annalogie of the tokens of phlegmone: so also the remeadies of the cure of erysipelas are to be fetched from the proportion of the remeadies of healing phlegmo∣ne.* 1.305 Furthermore of such kinde of medicines, which haue a dissoluing and breathing qua∣litie verie necessarie in this euill, there are verie manie, both simples and compoundes, re∣hearsed of Paulus Aegineta lib. 4. cap. 21. and of Aetius lib. 14. de re medica. But nowe it shall be sufficient to rehearse among so many, one onely remeadie which of all the rest see∣meth in my opinion to be most excellent. ℞. of the tender leaues of althea lib. j. boyle thē in hydreleum,* 1.306 and being well boyled, braie them well togeather, putting thereunto of oyle of roses. ℥.iiij. of argenti spuma, and cerusae. ana. ℥.ij.ss. againe plane or smoth them with the iuice of coriander, of sengreene, or nightshade, then put thereunto a few crummes of bread

and annoynt them after the manner of an emplayster.* 1.307 But if paraduenture blewnes shall nowe occupie the place, (the skinne being cut before) you must lay a cataplasme aboue vpon it, and sprinckle the place aboundantly, as Galene hath commaunded, with hote water: for it doth digest & wash the woundes: also water and salt brine in the meane sea∣son shall auaile to nourish or cherish the place, when it is somewhat thicke, and grosse, which thinges doe scoure and clense the thicknes thereof.* 1.308 The fourth intention of the cure of erysipelas, which is the correction of the accidentes, is perfited, (as we haue said in the cure phlegmone) when as we shall returne and driue blacke the recourse of the matter, induration, and corruption togeather with the payne and the heate. For these symptoma∣tes are wont to happen as well vnto erysipelas, as vnto phlegmone. Moreouer the best re∣meadie to asswage paine and vehement heate, is made of the leaues and rootes of henbane,* 1.309 which you must rowle vp in towe and seath them with prunes: then commixe them with the ointment commonly called populeon, or with swynes greace (as is saide before in the cure of phlegmone). But if erysipelas shall chaunce to be exulcerated,* 1.310 you shall cure it with applying vnguentum album or vnguentū de lithargyro, with the which if you shall commix a little scoria, which is the drosse of lead molten in the fire, you shall make the remeadie most excellent and effectuall. But it shall be more profitable to comprehend the whole order of the cure of erysipelas in some shorte sentences, after the maner of an Epilogue, that those thinges whereof we haue spoken before somewhat at large, may take the deeper roote in our mindes and memories.* 1.311 For this cause therefore we haue taken out of Galene these seuen Aphorismes following, which summarily doe containe the whole cure of erysipelas. 1. In an exquisite erysipelas make no detraction of bloud. 2. If the bodie be full of choler and the affect be great, purge the bellie downward with the medicine cholagogon. 3. If the disease be little & small and the bodie without choler, vse no medicine to purge choler, but [ 1] content your selfe with some sharpe clyster. 4. When you haue purged the whole bodie (as [ 2] you must) annoint the affected member in the beginning with medicines that can mode∣rately [ 3] represse and aboundantly refrigerate, euen to the chaunging of the colour. 5. When [ 4] you see the cholour of the aggreaued member altered, and the heat of erysipelas slaked, and [ 5] the inflammation ceased, you must passe ouer from refrigerating and adstrictiue medicines [ 6] before that the member be throughly blew or blacke, vnto their contraries (that is) vnto digestiues or discussiues and drying remeadies. 6. Those erysipelata which are caused of vl∣cers, and of other manifest causes you must first scarifie, and afterwarde apply a cataplasme of barely meale. 7. If erysipelas be not exquisite or true, but phlegmonous: you may let bloud [ 7] without fearing any thing, especially if bloud do abound in the bodie.

CAP. XVII. Of Tumours which doe associate Erysipelas as Herpes both Miliaris and exedens, which are called of the late Chirurgians cholericke pusshes.

THOSE tumours aboue nature, which haue any societie with the aboue menci∣oned erysipelas,* 1.312 or any waie do seeme to partaine thereunto (for that they haue their proceeding of vnnaturall, & hidden choler (that is) which is not mingled with other humours, both the latter sort of Physitions and also of Chirurgians do call mala cholericae pustulae: but the Grecians, as Hippo. Ga∣lene and Paulus doe call them herpetae,* 1.313 which worde doth almost sounde and agree with the Latines, as malum quod serpit, the creeping euill. For 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 in Greeke is all one with serpo in Latine, whereupon 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 is called serpens, yet herpes doth not perfectly signifie among the Physitions malum quod serpit, but a certaine kinde of disease whereof we now entreate, therefore the creeping euil extendeth and stretcheh further then herpes for phagedene are al∣so called serpentia vlcera, creeping vlcers. But Auicene calleth all these kindes of pusshes formica, and Galene numbreth them among inflammations,* 1.314 but Celsus seemeth to com∣prehend

them vnder the name of sacer ignis. lib. 5. cap. 28. herpes therefore is caused when yelow choler,* 1.315 vnnaturall, alone, and secret (that is to saie) which is commixed with no o∣ther humour, doth flow into some member and there remaineth: whose substaunce if it be any thing thicke and sharpe,* 1.316 it exulcetateth the whole skinne euen to the flesh which lyeth vnder it, and then this euill is called of Hippo. and other Greecians 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, but of [ 1] the Latines herpetes exedens or depascens, an eating or feeding herpes: & it is called 14. The∣rap. of Galen by this absolute name,* 1.317 herpes. But if choler be some what thinne and not so thicke and hote, it exciteth small whelkes outwardly in the superficies of the skin (for that it doth onely as it were burne and scald) like vnto the seedes of millet or hyrse: thy reason of which similitude and likenes the affect is then termed of the Latines miliaris herpes: but of certaine of the Greecians after Hippocrates time it was called for the same reason 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉: [ 2] for 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 in Greeke, is called milium with vs. And this kinde of species of herpes (Galen witnessing the same lib. 2. ad Glauconem) doth borrow his name or title of the ge∣nerall worde,* 1.318 seeing that the same Galen calleth it herpes simply and without addition. Not withstanding in another place by the name of herpes, Galene calleth it herpes esthiome∣nus (that is) exedens,* 1.319 as afterward shall be said. But this kinde doth not altogether cause the vlcer, as the other doth which is called exedens, but as it hath bene said, it exciteth little small pusshes to the likenes of milium, which pushes in processe of time, when they are broken out, doe turne vnto an vlcer. Therefore not without any great reason or cause did Oribasius and certaine other also before Galens time, iudge and thincke, that in this kinde of euill,* 1.320 there was mixed with choler some thinne fleame, which did bring forth those little pusshes, whereupon it was called of some pustulosus herpes. But the other which is called esthiomenos,* 1.321 is not so mixed with fleame, but seemeth to be a pure choler infected with no other humour: and therefore it chaunceth with erosion, which continually affecteth the skinne, whereupon this name is attributed vnto it. For esthiomenos is all one with erodens o•• exedeus. And truely this euill is of one and the same kinde with a pustulous and exulcerate erysipelas, from the which notwithstanding it some what differeth by reason of the thinnes of that bilious humour (whereof both of them doe take their beginning). That is that which Galene testifieth in these wordes. It is (saith he) a verie thinne humour which rai∣seth herpes,* 1.322 and so thinne truely, that it passeth through not onely all the inward members, which are euerie where of a fleshie substaunce, but also through the verie skinne euen vnto the outward little skinne (which is called of the Greekes epidermida) which onely because it staieth there, it both gnaweth and feedeth on: but if it should also pearse through this, af∣ter the manner of a sweat, it should in no wise excite any vlcer, for that is a common thing vnto vlcers which doe aryse of a byting humour, which vlcers they call spontanea, because the humour which causeth them, is stayed and tarieth still in their going out or issue. Hea∣therto Galene. When he nameth herpes simply and without any addition, he meaneth her∣pes esthiomenus, as it is easie to be knowen by the ioyning togeather thereof, by the signes and cure, and so in that place it borroweth his title of the generall word, when it is simply and absolutely called herpes, as in that litle booke de Tumeribus prater naturam, where the same Galene writeth thus of that kinde of herpes word for word. Herpes also feadeth and gnaweth vpon those partes which are about it,* 1.323 but the exulceration is of the skinne onely. But almost all the barbarous sort of Chirurgians euen they of late time do comprehēd both these kindes of herpes videl. miliaris & exedens, vnder this title formic••, to whom both in this thing and in many other also Auicene first gaue the occasion of errour, who being de∣ceiued by the likenes of the name,* 1.324 because the Greekes call myrmecia, that is, formica, a cer∣taine kinde of verrucae hath through a maruelous ouersight euē in the same chapter confoū∣ded those verrucae with herpetes. Guido notwitstanding maketh a difference betweene herpes & formica, and confoundeth the name of formica sometime with verrucae, which the Greekes call mirmecia and acrochordonae sometime with herpes exedens, which (I meane her∣pes comedens) is sometime named of the same Guido herpestes,* 1.325 sometime absolutely herpes, who also thought this herpes to be nothing else, but a pustulous and vlcerated erysipelas, whē this notwitstanding, as we haue alleadged out of Galene do differ from the other by reason of the thinnes of the humour. For that choler which excitech herpes is thinner then that

which causeth an vlcerate erysipelas. Furthermore erysipelas, which chaunceth with vl∣ceration, doeth not onely occupie the skinne, but with it also, it annoyeth some parte of the fleshe vnder it. But herpes, whereof we now intreate, layeth holde on the skinne onely, and exulcerateth it. Therefore although these euilles are of one and the same kinde (as Galene thought) yet they are not altogeather one, neither are they alike.* 1.326 Those whelkes also, which the interpreter of Auicene and the vnlearned companie of Physitions doe terme morbili, Hippocrates libro tertio epidemiarum hath comprehen∣ded vnder herpes. But these morbili are caused of a more thinne and slender matter then those pushes which are commonlie called variole.* 1.327 For these (as Auicene wri∣teth) proceede of bloude, but the other are caused through the admixion of choler and bloude. But if any man doeth longe or desire to knowe what name the auncient Phy∣sitions did bequeath vnto these pustulous vlcers: we haue declared that in Latine they were called of Plinie papula, and sometime pituite eruptiones, fleumaticke eruptions:* 1.328 but in Greeke of Hippocrates libro tertio epydem ecthymata. Of Galene exanthemata. But the signes, iudgementes, and causes of both kindes of herpes, may sufficientlie be knowen by those thinges which went before. It remayneth therefore that we nowe declare the cure of them. In curing these euilles called herpetes,* 1.329 (as in other such like volun∣tarie vlcers, which haue their originall of a byting and vehement humour) three in∣tentions are to be obserued and marked. The first is, that the confluxion of the homour into the affected parte be stopped and letted. The seconde is, to make euacuation, of that, whatsoeuer is flowen already into the aggreued member and sticketh fast in the same. The thirde is to heale the vlcer. We doe finish our first intent, by purging the whole bo∣die [ 1 2 3] with some medicine that can bring forth the humour, whereof the euill doth grow,* 1.330 and when the bodie is throughlie emptied, by repressing and driuing backe the humour that floweth. Therefore in herpes exedens we must vse some medicine, which can prouoke choler downewarde,* 1.331 seeing (as we haue saide before) a pure and sincere biluous humour doth procreate this euill. It happeneth therefore that in respecte of the emptying of the whole bodie, comedentes herpetes must be cured like vnto erysipelata. Therefore because it is a thinne & waterish humour which causeth this euill, Galen hath sufficientlie declared to moilifie and soften the bellie gentlie, or to prouoke vrine with those thinges, which can moderatlie cause the same. But in the other kinde of herpetes,* 1.332 which by reason of the simi∣litude which it hath with milium, we haue saide to be called in Greeke miliaris and cen∣chria, there is required some remeadie which is of a mixed facultie (that is) which can purge furth both choler and fleame. For some haue thought and that not with∣out great reason (as Galene sayth) that in this euill there is some fleame commix∣ed with choler. Furthermore that humour which aboundeth in the bodye, and cau∣seth the euill, being emptyed out (as it is required) you must apply those medicines which can represse and keepe backe the flowing of the humour, for then the ministring of them shall be more without daunger, and more conuenient also,* 1.333 seeing that (as Galene sayth) if one doe thrust backe but a little portion of the vicious humour, which after conuenient purging, remaineth yet in the bodie, to the bowelles and great vey∣nes, yet will not cause any sensible euill at all, that can be felte.* 1.334 But if the quanty∣tie of the humour be great, it sometyme coucheth it selfe in some pryncipall mem∣ber, whereas through the force of the purgyng nature the whole bodye is not eua∣cuated either by purgyng downewarde, or by the vrine, or by the skinne, which in∣cludeth the whole bodye. But repressiues and repulsiues be not onelie those which doe bynde, but also those which can refrigerate without anie adstriction. Of the which nature are these, as lettuce, bnottegrasse, fenne or ponde lintles, purcelayne, endiue, sengreene, and other of that sorte, which were verie conuenient also for erysipelas. But those medicines,* 1.335 which besides their cooling are also apt by nature to moysten, herpetes especially depascentes doe in no wyse require, but they doe one∣lie admitte those refrigeratiues, which can also greatlie drie vp. For those remeadies which haue but a meane and weake force to coole and drie as is nightshade, are not suffi∣cient for them. Therefore by Galenes counsell you must in the beginning laye vppon them

the yong tender buddes of the vine,* 1.336 bremble leaues, leaues of rubum caninum, and plantayne. After applie also with these, lentles, sometime honie and bareley meale. Also minister that cataplasme sine semper••ino, which is appoynted for those phlegmonous tumours which proceede of fluxe, for it doth repell that which sloweth, and it dryeth vp that which is con∣teined in the affected member, and it strengthneth the parts about it. The beginning of the euill being past,* 1.337 this remeadie auaileth greatlie. Make a cataplasme of the ryndes of pom∣granades sodden in wine, & of rhu or rhoe (that is) of the seedes of the shrub coriariū (which of the late Physitions is called sumach) and of the meale of bareley. But by this cataplasme you shall verie well accomplish the second intention or scope of curing herpes,* 1.338 because it is of sufficient power to digest that, which is flowen alreadie into the affected place, for it ap∣peareth euidently, that those remeadies which haue a repressing facultie, ought to exceede in the generation of the vlcer, but when the vicious humour doth cease to flowe any more into the affected part then those medicines are requisite which do digest. As concerning our third intent which declareth the cure of the vlcer,* 1.339 it behoueth you briefly to know these thinges following: videl. that euery vlcer wheather it commeth of the owne accorde, or be caused by some accidentall cause, doth desire to be dryed vp by some medicine) as Hipp. saith) that is not sharpe, byting, or vehemently prouoking, except, when the vlcer be malicious and full of corruption, for such euills (saith Galen) require more sharpe medi∣cines, and those which haue euen the power of fire, as is, mysos and chalcitis, and arsenicum, and lyme, and saendaracha, & other thinges of that kinde, which burne as hote as fire. Those places therfore that are exulcerated in herpes exedens, must be tēded with pilles, & trochisks, writtē for the cure of herpes in those bookes, which are called pharmacentici: which remedies, when necessitie cōpelleth vs to vse them, must be throughly washed in passum or in some o∣ther sweete wine, or if sweete wine be not readie at hand, in thinne & somwhat sharp wine, which is not to old (that is which for age hath no sharpe tast) or else in posca aquosa (which they call oxycratum.* 1.340 Paulus in the cure of herpes, which annoyeth vnder the skinne, vseth these remeadies the scouringes of leade steyped in the iuice of smooth rew, or a cerote of myrtles in stead of rew. Another, of olde woll, washed and burnt about a torch. ʒ.xij.ss. of wax. ʒ.xxv. of the scouringes of lead. ʒ.j. of goates tallow, trimmed and washed with water. ʒxxv, of mirtles. ℥.v. But for those herpetes, which do gnaw and byte vehemenly called depascentes, he chargeth to vse this remeadie: ℞. of the ryndes of sweete pomegra∣nates. ʒ.vj. argenti spume. ʒ.vj. of washed wooll cleauing to the torch or to some sweete wood, and that burnt. ʒ.iij. of waxe ʒ.xij. of ceruse ʒ.viij. of frankensence, alume scissible, ana. ʒ.j. let them be steiped in wine or in oyle of mirtles. But now the vlcers being of long continuance,* 1.341 those trochiskes abouesaid, and other such like medicines which are appoin∣ted to cure herpetes, must be washed neither in sweete wine, nor in posca aquosa, but rather in wine that is some what sharpe, especially in that which is blacke, and if that be not to be had, you must vse white wine. But those medicines which are most effectuall & most meete at that time, when vlcers be inueterate, are the pilles of musa, andron, & polyida, whose des∣criptions are set downe in the ende of the cure of carbunculus, & those trochiskes also, which of Auicene and the latter sort of Physitions are called calidicon and aldaron. But those her∣petes,* 1.342 which do onely exulcerate the outward skinne, as they be, which we haue called mi∣liares, must in no wise be enioyned to any of those medicines before hearsed (if we wil cre∣dit Galen) For they be verie vehement, and doe greatly drie. But those medicines what∣soeuer they be, which haue the nature and force of glaucium (that is) of memytha, shal suf∣fice these vlcers, and you must washe them with this, but especially with water. But if these thinges shall nothing auaile, you must also commixe vinegre therewith. Also if you annoint it with iuice of nighshade, or plantaine, you shall help it greatlie. Heatherto haue we spoken of herpes. Now because in that which we haue saide, we haue not as yet tou∣ched by the waie any thing concerning the euilles called formice, which both the Arabians, and the latter sort of physitions doe erroniouslie, as we haue said, confound with herpetes: this present place doth require, that we set downe a few wordes both of them and of other tumours and increasinges appearing in the skinne, which the Latines call verrucae.

CAP. XVIII. Of the euils called Formicae, and of other differences of verrucae.

THOSE little tumours, or low swellinges, which are seene to appeare in the skinne like little hillockes, the Latines haue fittely called verrucae,* 1.343 for verru∣ca signifieth properly the hyest parte of a mountaine or hill: but the common sort call them porra, leekes, because somtime they haue certaine threads lying betweene them not much vnlike vnto the rootes of leekes.* 1.344 The Greekes haue no name, wherein they may comprehend all those kindes of verrucae, but they doe call a certaine kinde thereof by proper names, which be these, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Verrucae therefore of them be called myrmecia, which are of a large foundation, and as it were sitting iust to the grounde, and when they be touched,* 1.345 they are felt payneful like vnto the byting or stinging of an ant, whereupon their name is giuen vnto them, for the Greekes doe call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, formica. Wherefore the Latines applying the name thereof to the Greeke word, haue called formicae, verrucae, and for their forme and fashon,* 1.346 sessiles ver∣rucae. These euils sayth Celsus lib. 5. doe grow either in the palmes of the hands or in the sooles of the feete: but these take deeper roote, and are lower and harder then a wart, and doe cause greater payne: and they send forth more store of bloud, and they scarce at anie time exceede the bignes of a hoppe. But acrochordon is a verruca that is as it were hang∣ing,* 1.347 and of a more narrow foundation (that is) a certaine round highnes or growing vp in the skin, which hath the foundation (that is) the neather part verie straight to the skin. It is so called because it semeth to hang as though it were tyed with a string.* 1.348 By this diffe∣rence therefore, acrochordones are distinguished from myrmecia, because they are very smal at the neather ende next the skinne, but at the other ende are verie large and broad: con∣trarywise myrmecia, (as hath bene saide) are of a large foundation, but at the other end they are verie small and slender. But these oftentimes are equall altogeather with the skin▪ and acrochordones doe alwayes appeare aboue the skinne, (as Galene. 14. lib. de morbis curandis hath manifestlie declared.) Besides these thinges, acrochordones (as Celsus saith) doe grow vp thicke and manie togeather, and doe most trouble children, and oftentimes they fall againe sodainely: and sometime they cause but meane inflammation, there are some also, which ar turned into corrupted matter, but they seeldome passe the greatnes of a beane. They be called of Auicene claui, but the Latines doe terme claui, verrucae albae,* 1.349 be∣cause they be like to the round heades of nayles. These do chiefely happen in the fingers, and the soles of the feete, where they doe cause great paine, the Greekes call them 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉,* 1.350 but Auicene almismar. These be often caused of a bruise, and sometime otherwise. But thy∣mion or thymon, in English a warte, is called of Celsus and of the Greekes verruncula, a li∣tle hillocke, appearing aboue the bodie, which at the neather part next the skinne is verie small (as acrochordon is) but aboue it is more large: it is also somewhat harde, and verie sharpe in the toppe, which doth represent the colour of the floure time, whereuppon the name is giuen vnto it, and also it is easely spread abroade. Oftentimes it giueth forth some bloud, and is almost as great as an Aegyptian beane, seeldome bigger, but sometime lesser:* 1.351 sometime there grow vp one alone, sometime many togeather, either in the anckles of the feete, or in the handes, or in the sooles of the feete.* 1.352 But the worst thymia of all are in the filthie partes of the body, where they do commonly bleede. Auicene seemeth to haue na∣med this kinde of verruca, tusium, or (as another translation hath) tarseum. Of the kinde of verrucae be those euils also, which Auicene calleth cornna, not much differing from the o∣ther sortes,* 1.353 but that they be somewhat long and are turned crooked againe like vnto hor∣nes. The euills called calli, (called of the Greekes also 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉,* 1.354) doe not much differ from the aforenamed claui, but that they be of themselues without griefe and nothing painefull, and of the cholour of the skinne wherein they are resident, neither doe they ingender of themselues or of their owne accord, but of the hardnes of the skinne caused by labour.

CAP. XIX. The iudgementes and cure of verrucae.

AMONG all these euilles acrochordon and Thimion, are oftentimes (as Cel∣sus reporteth) ended and doe heale of themselues,* 1.355 and the lesser they be, the soner they be ended. But myrmecia and claui doe scarce at any time cease without curing. If acrocordon be cut of, it leaueth noe roote he hinde it, and therefore it groweth not againe. But where thymeon and clanus be cutte of there ryseth vppe vnderneath a little rounde roote, which descendeth downe some∣what deepe into the flesh, and there abyding, it doth cause the aforesaide euilles to grow againe. Myrmeciae doe holde fast with verie broade rootes, and therefore they cannot be cutte of without great vlceration. It is verie profitable to cutte of clanus and then sprinckle it ouer with hote water, for so it doeth waxe softe and tender without any more adoe, and if it doth bleede, it oftentimes dyeth and ceaseth. It is also taken awaie, by clensing it rounde about, and by laying on it rosen mixed with the beaten powder of la∣pis molaris. But the other kindes (as the same Celsus affirmeth) must be cured with hote medicines. Nowe the fittest remeadie for the other euilles is that, which is made of the dregges of wine,* 1.356 and that medycine is good for myrmecia, which is made of alumme and yelow oaker. Paulus Aegineta lib. 4. cap. 15. rehearseth verie manie re∣meadies,* 1.357 which doe take awaie and vtterly abandon these verrucae, especially those which be sessiles and pensiles of the which kinde are claterium (which is the iuice of wilde cucumbers) rubbed on with salt, the barke of franckensence with vinegre, rathe rype figges, which are rype before their time, with vinegre, meale and nitrum. Also the iuice or liquor of the aforesaide figge tree annoynted doth greatlie helpe, the iuyce of tythy∣malus, in English spurge, the heade of the fish smaras salted and burnte, the ruste of some mettall with quicke brimestome, (that is) which is not throughly burnt in the fire, the leaues of ocymum with shoemakers bleache, (which the Greekes call chancalthum,) the water of the greene twigges of the vine burnt in the fire) sheepes dounge with vineger,* 1.358 goates gall anaointed, the fruite of the great herbe heliotropium applyed by it selfe, or mini∣stred with wine, rewe with nitrum and pepper, nitrum with the vrine of a younge boy not yet accustomed with venerous actes,* 1.359 oxes dounge ministred in vinegre. But these, which we haue mencioned as remeadies for the extirpation of myrmecia and acrochordones, are greatly also effectuall for those euills called claus and thymia. They doe vse also the heade of a lysarde to take awaie myrmecia, acrochordones, and claui. There are some which doe boyle the heades of salted fishes in that water,* 1.360 which distilleth out of the greene braunches, while they be burning: which they doe declare to be a most excellent remeadie for the a∣foresaide euils. Othersome to extinguish these diseases doe make a lynament of the rust of brasse (which of the late Physitions is called virride aris & flos aris) of brimstone, and of the distilled water of vine braunches. And this is the onely methood of curing, which they are wont to vse in racing out of verrucae, (that is) by gnawing and scalding medy∣cines. But this one thing is most diligentlie to be obserued in administring such kynde of medicynes, which Celsus doth admonish vs of in his fifte booke: namelie, that those partes, which are about the euilles, ought to be couered with leaues, least they al∣so be exulcerate, for which cause some doe annoynt the places about the diseases, with oyntment of bole armoniacke, with terra sigillata, with rose water and vinegre. Furthermore we abolish achrochordones, myrmecia, and thymia, not only with these afore∣saide burning medycines: but also with the flame of the fire, or with some hote instrument rightly applyed to them. Oftentimes also we cutte them of. But sometyme we doe take them awaie and vtterly destroie them by a lygature cunninglie made and prepa∣red for them,* 1.361 (as it happeneth in that true disease called ficus) or else by setting to the fore teeth,* 1.362 as some at Rome in Galenes tyme were wont to doe. But if you shall applie fire or some hote instrument to verruca, you must prouide, that a plat of Iron or some such thing being boored through be made readie for the burnt sore, the hole where∣of

must so fittely comprehende the same, that none of the skinne about it may be seene Adustion being now made, you must resolue the crust with butter,* 1.363 or with some other annoynting medecine. Afterward you must cure the sore like vnto other vlcers. But how mirmecia, which doe not appeare out of the skinne, but are altogeather, equall therewith, ought to be brought forth & cut of: Gal. teacheth verie well lib. 14. method. med. where he maketh mention of one in his time at Rome, who deuised a new order to cure these ver∣ruca, first he brough out the euilles by applying his lippes vnto them or by sucking them, and then (which did seeme maruelous) he plucked them from the roote, afterward, setting to his foreteeth he vtterly destroyed them. But acrochordones,* 1.364 appearing aboue the skinne he straightway bote of with his teeth, and so quickly dispatched them. Galene also setteth downe another double manner to cure these euills, saying: but a Chirurgian being some∣what exercised in manuell practise, may easily cut of these verrucae, both with that instru∣ment made to the forme of a mirtle leafe, and with that also, which the Greekes can scolo∣pomacherion: (this alwayes prouided) that the sore be kept and separated from the skinne or partes about it. We also bring fort myrmecia, by laying some strong and stiffe quill about the compasse or circle thereof, the hollownes of which quill must be equall with the thicknes of myrmecia, that it may pinch it round about in euerie place. Which being after∣ward turned about the sore and enforced downward it will quickly bring forth the whole myrmecia togeather with the very roote, but you must marke, that the verie end of the quill, which shall cut it in a circle, ought to be not onely thinne and slender, but also sharpe and strong. The quill therefore of an olde cocke,* 1.365 or rather of an egle is verie fit for this pur∣pose. But you must cut it of, onely towardes the roote, seeing the hollownes of the other part of the quill may easely comprehend myrmecia,. And truely by this abscession, if it be done cunningly, you shall learne great arte. Hitherto speaketh Galene. But the vlcer which remaineth, (verruca being thus taken away) must be filled vp and brought vnto a scarre, as other vlcers be.

CAP. XX. Of Oedama and other colde fleumaticke and flatuous tumours.

HAVING sufficiently entreated of those tumours, which are engēdred through hote humors: we are now againe determined to handle those tumors which haue their originall of a colde matter, taking our exordium from that euill, which of the Greeciās is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. For as erysipelas is caused of a cholerick fluxe: so adema proceedeth of a fleumaticke humour.* 1.366 Oedema therefore (Galen defining the same) is a certaine loose and vnpainefull tumour, or it is a cer∣taine thinne swelling without paine, rysing of a flegmatick humour that floweth into some member of the bodie, so that the same Galene lib. 14. The. thought of adema, that it was a disease and no symptomate. For truely we know (saith he) that ademata doth come o∣therwise then of the flowing of a flegmaticke humour, (that is to witte) of a flegma∣ticke humour, or vaporous spirite gathered into some member, and sometime engendred in the same, as in the legges and feete, which are troubled with a corrupted water run∣ning vnder the skinne, & with the euilles called phthoe, & cachexia, which are euill habites and deformities of the bodie. For in those daungerous dispositions,* 1.367 adema is an accidentall symptomate of that affect which oppresseth the man (that is) an accident necessarilie fol∣lowing, which requireth no seuerall or proper cure, (as afterward it shall appeare). Oedema (as phlegmone and ••ryspelas also) is decerned of the chirurgians by two differences (that is) by the true, or vntrue or vnlawfull adema. A true adema commeth of naturall choler,* 1.368 which truely is nothing else, but a rawe bloude not throughly digested,* 1.369 which is founde in a lumpe of bloude, verie fitte to nourish fleugmaticke members. An vntrue and vnlaw∣full edema proceedeth of vnnaturall fleame.* 1.370 That we may not deale herein any thing obscurely, naturall choler is cold and moist humour, in substance crude or raw, in colour

enclyning to a certayne whitenesse, but in ta••t, and (if I maie speake it) in smell, it is sweete and pleasaunt: vnnaturall fleame is that which doth degenerate and differ from that fleame before described, & yet it keepeth it selfe within the boundes of his circui•• & liberty, which if it shall once passe, it is then no more to be called phlegma or fleame, but some other humour▪ But this fleame chaunceth to degenerate from his own proper nature two manner of waies.* 1.371 One way is (as they say) in it selfe, when in his owne naturall & proper substance it is chaunged without any admixion with any other humour, which truely happeneth very often for it is turned either into a waterish substaunce, or into a flatuous substaunce, or into a verie thinne matter, and then it is called phlegma aqu••sum flatu••sum or ••enne: or it is turned into a thicke and viscous substaunce, which maketh the fleame verie grosse and clammy, and through a greater (or as we may say) through a further induration, it is caused to looke like a playster or like glasse, or it doth putrifie and is altered, and then it is made both salt, nitrous, and corrosiue. The other waie, vnnaturall fleame is caused through admixion, that is, when as some other humour doth happen to come vnto it extraordinarily, as for ex∣ample, either bloud, or cholor of melancholie. If bloud be commixed with fleame, it is made sweete: if choler be mingled therewith, it is caused to be salt, if melancholie, it is made soure and sharpe. There are therefore eight kindes of vnnaturall fleame after the opinion of Auicene. Haly Abbas appointeth foure onely. But Galen, saith Guido, seemeth to assigne vnto it two onely kindes,* 1.372 that is, salt and sower, although in his second booke of the differences of feauers, and in his second booke de locis affectis, and in many other pla∣ces also, he maketh mention of the flame called vitreum, which oftentimes doth ioyne him selfe with sower fleame, by reason of that affinitie and acquaintaunce that it hath with it. By these thinges therefore it is gathered, that of fleame there are ingendred eight spe∣cies or differences of tumours besides nature.* 1.373 For first of fleame that is naturall, commeth a true and lawfull aedema. Secondly of vnnaturall fleame by reason of admixion there pro∣ceede three other differences of tumours, because that three other humours may be com∣mixed therewith and these be they: aedema phlegmon••dos, aedema crysipelatôdes, and aedema schirrhôdes. Thirdlie of vnnaturall fleame, through the alteration of his proper substaunce, there aryse foure other differences of tumours. For first of windie and vaporous fleame doth come that tumour, which of the Latines is properly called inflatio, but commonly a∣mong the Phitisitions it is termed apostema ventosum, a windie aposteme, secondly, of wa∣terish fleame there proceedeth a waterish Aposteme. Thirdly of rawe, thicke, and grosse fleame there are engendred those tumours, which some doe call leues nodi, and there are also engendred flegmaticke abscessions, which they doe commonly call exiturae phlegmati∣cae. But these are called of the interpreter of Auicene dubelet frigida, of which sort are these s••ea••om••••a, atheramata, and melicerides, ganglia also, which be called of Auicene glandula, and other of that kinde, which shall be spoken of in that which followeth. Now of hard or rather of indurated, and (as I may say) of caked fleame, there doe arise all those harde knottes; which are most founde in the ioyntes, and those euilles also called strumae, which are commonly called scrofule. Fourthly of corrupted and putrified fleame, the do come fistulae and other vlsers which they call scrufulosa.

* 1.374The causes of aedema, as also of other tumours besides nature are threefolde. 1. Primitiue causes are these, a fall from some high place, a stripe, a naughtie dyet. 2. Antecedent, [ 1] causes, as the aboundaunce of a flegmaticke humour running downe into some member [ 2] of the bodie. 3. Coniunctae causae, is the verie fleame, which is alreadie stuffed and heaped [ 3] in the member that is beset with a tumour.* 1.375 The signes of aedema are these, a loose and softe tumour, which yealdeth to the weight of the finger, and is hollowe after the manner of a ca••e or defie, it doeth not ryse vppe agayne at the remouing of the finger, but it doeth retayne the verie footesteppe or marke of that which presseth it. There is felte verie small payne, or almost none at all. Verie little heate, a verie white colour, or as some will haue it) a meane betweene whitenesse and palenesse, and other such like signes, which doe testifie the dominion and power of fleame.* 1.376 Oedema (as other tumours also) hath four times, the beginning the augmenting, the state, and the declinatian of the tumor. This kinde of tumour is most cured by resolution, or exhalation, but seeldome by suppu∣ration,

verie often by turning and chaunging them into knottes or kernelles called nodi, or into other increasing (as they call them) which are tearmed of the Graecians 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, but of the Latines Abscessur. But the markes and tokens of the ending and finishing of these kindes of tumours are handled before in our generall discourse of tumours. These oedoma∣tous tumours are rather excited in the winter time, then at other seasons, for then very much fleume is gathered togither in mens bodies. These tumours also do greatly and verie often trouble olde men, and them which be giuen to gluttonie.

CAP. XXI. Of the cure of Oedema caused of a fleugmatike humour flowing into some member.

BECAVSE oedomata, after the manner of other tumours,* 1.377 are raised through the flux of humours into some member the scope and order of their cure, shall also be two fould. 1. The one is to dissolue the substance of these hu∣mours which now do occupie the member. 2. The other is, to withstand & restraine the fluxe. And as the one scope doth excell the other, so the re∣medies of their cure must be commixed togither, the one with the other, either somewhat plentifully or somewhat sparingly. When therefore the order of rastray∣ning shall ouercome that, which counselleth vs to vse euacuating and digesting remedies, the force of restrictiues must be augmented. But when there is more neede of euacuation then of restriction, the nature and vertue of digesting or discussiue and drying medicines, must of necessitie excell in the mixture. Morouer both the plentifull flux & the small deale of matter in the affected part doeth tell vs that in the mixture the vertue of restrictiue medi∣cines must be more effectuall of greater force. Contrariwise you must vse a greater measure of drying & digesting remedies, when matter aboundeth in the member very plentifullie, & the flux verie little. But in an old & inueterate oedema, & that which is alreadie ingendred,* 1.378 you shall not vse any longer this order of curing which hath a mingled power, but you shall applie such things as can dispearse & deuide the matter. VVhich thing also is diligētly to be obserued in all other continuall vlcers. But oedema,* 1.379 which is an euill simptomat following o∣ther daungerous affects, as leannesse of the bodie, the dropsie & an euill habite of the body, which the Grecians call cachexia) doth desire no proper, peculiar or seueral cure (as we haue before mētioned) for it cannot be cured but by expelling that euil affect, wherof it first grow¦eth. Yet somewhat is to be remitted out of it, if it doth debilitate the strength or increase the chiefe affect, or else hinder the cure. It shall therefore be sufficient (if it shall neede any cure) to rub diligently the swelling place, sometime with oxyrhodinum, sometime wirh oile min∣gled with salt, or else with oxyrhodinum with salt. For this kind of friction doth slake the tu∣mour, and doth mitigate paine, if it be prouoked through to much distention (as sometime it chaunceth.) Oxyrhodinum doth stay the fluxe, oyle with salt hath power to digest & emptie out that which is compact in the member. But oxyrhodinum with salt, doth partly digest & drie vp, and partly restraine and stop the affluxion of humours. But our generall method be∣ing before declared, let vs turne our penne to declare the proper and particular order of cu∣ring a lawfull oedema, which hath his beginning of the flowing of thinne fleume, which me∣thod according to the opinion of the Chirurgians of our time, doth consist of foure thinges,* 1.380 (as hath bene said of Phlegmone and Erysipelus) that is to say, 1. In a iust order of diet. 2. In preparing of the fleugmatike humour, which they call aequatio, an equall diuision, and in purging the same. 3. In repressing, dissoluing and drying vp the humour that is flowed al∣readie and nowe doeth occupie the member. 4. And last of all in correcting and remouing the simptomates or Accidentes which doe followe oedema. These therefore are the foure perticular intentions, by the which we dispatch those two generall orders before mencio∣ned.* 1.381 The first intention therefore is perfited or finished by the dewe and iust vsage of sixe vnnaturall thinges, which shall be well and fitly applied to the sicke bodie, if they shall all

decline vnto heate and drinesse with a certaine attenuation or deminishing. Therefore choose and prepare a thinne and drie ayer.* 1.382 Let him take for his drinke wine that is fined and cleane from dregges, cleare, white, or some what red, which they call claret wine, which in his kind must be excellent good, and alayed a little with water. Let his bread be verie well baked,* 1.383 and well handled. Let him eate the flesh of sheepe, or the flesh of the birdes of mountaines and of the plaines, and those rather rosted, then sodden. Let him vse sparingly fat brothes, potherbes, and other fat meates. Let him abstaine from thinges that be vnlea∣uened, rawe, & verie moist. Let him not eate of anie kind of pulse or cheese, nor of vntimely and vnripe fruites, nor of fishes (except they be those which liue in grauellie places, and those also either rosted, or boyled in wine.) Rosted meates generally are better then soddē, and better then those thinges also,* 1.384 which the industrie of the baker can prouide. Let him eate little, and drinke lesse. In all his diet let him eschew lecherie, and gluttonie. If the bel∣ly be bound, loose it with figges or with Carthamus. Take therefore fiue or six dry figges, & fill them with the pith of the seede of Carthamus, and eate them either in the morning, or be∣fore dinner. Let the bodie be exercised moderately, if so be, the affected member can permit the same without hurt.* 1.385 Let his sleepe be little and short. Let him altogither auoide bathing, and all other moystening thinges. The second intention is accomplished by preparatiues, or by remedies equallie deuiding (which they commonly call digestiues) and by medi∣cines which can euacuate that fleugmatike matter, wherewith the bodie of the sicke doeth abounde. Therefore you must giue him some kinde of oxymell, which can cut, deuide, & purge foorth the sleume thar lurketh in the bodie. Afterwarde the matter going before the expulsion being thus prepared, at the appointment of some cunning Phisition, must be emptied out with some medicine, that can purge fleume called phlegmagogon. But if (saith Guido out of Cauliacus) aboundaunce be present in the bodie, you may safelie open a veyne, but yet not without the aduise of some expert Phisition. But in a plethoricke and full bodie there are scarse at anie time seene anie oedemeta, especiallie, these which be law∣full, for fleume doeth not abound in it more plentifullie then other humoures doe. There∣fore it being simple and alone, not commixed with other humoures, it can seeldome flow into anie part of a plentifull bodie, wherefore letting of bloud especiallie in a lawfull oede∣ma doeth seeme to be nothing profitable.* 1.386 The third intention is finished in the beginning by applying repercussiues, and not by those remedies, which by binding vehementlie with their naturall coldnesse do repell and driue backe, but by those which haue power to drie greatlie, and digest well, which they call prouokers of drinesse and resolution. But in the increase, by vsing discussiue remedies somewhat more forcible. But in the state there∣of, especiallie about the end, the fluxe being alreadie stayed, by pure medicines, and by those which do verie strongly digest and resolue. But in the declination by consuming and drying helpes if the cure be to be dispatched by resolution. But if it doth degenerate & turne into Abscessions, which they call Exitura, it shall be cured by ripening medicines and by o∣ther helpes,* 1.387 which are set downe for the cure of Abscessions. Moreouer repressing reme∣dies endued with a drying and digesting nature, which do profite in the beginning of oede∣ma comming of the influxion of a fleugmatike humour, are comprehended vnder three spe∣ciall [ 1] rules. The first is out of Galene libr. 14. Therapeut. & secundo ad Glauconem, where he saith, that if Oedema doeth consist of a fleugmatike humour flowing into some member, a sponge wet in water wherin is a little vinegre, shall sometime aboundantly suffise. But these must be so well tempered and commixed togither,* 1.388 that they may either be dronke, or that they may not haue much vineger vpon it. But you must bind the sponge to the place, begin∣ning at the neather part, & ending aboue. Let the sponge be verie new. And if there be not a newe to be gotten, you shall cleanse and scoure the old verie diligently by washing it in nitrum and aphonitrum, and in lye. Auicene commaundeth that in steede of a sponge, you sometime apply a double linnen cloth, or some such like thing. The second rule is mencio∣ned [ 2] of Auicene him selfe. ℞. Baurach of the decoction of water (that is) of salt peter, or of [ 3] the some of salt peter, of ashes, of vinegre, of eche as much as shall suffice. The third rule is described of Razi•• after this maner. ℞. Aloes, mirrhe, lycium, acatia, sief, memitha (that is) of Glaucium,* 1.389 of Cyperus, of crocus orientalis, of bole armoniacke, of ech a little quantitie: pouder

them, and commixe them with the iuyce of colewortes called Brassicae, and with vinegre: & make an emplaister. Furthermore those remedies which were of late rehearsed,* 1.390 do also help much the increasing of this oedematous tumour, if you do put vnto them a good quantitie of vinegre, and a little Alume, especially in strong bodies, which haue a harde skinne, and when as aquosior posca shall not auaile. Therefore if oedoma doth not cease or rest with these helpes mencioned a little before, when you binde it to againe, you shall commixe a little more vineger, that the posca may be the stronger: or you shall lay on a little alume, and ap∣ply a newe sponge. For this doth helpe as an excellent medicine, and doeth long continue verie effectuall, and with his substance it doeth drie vp the affected member. If there be no plentie of new sponges, it is better (saith Galene) to vse that which the common sort call,* 1.391 elychnion. But aboue all things let it be soft, which kind is vsed at Tarsis, whereof if there be anie plentie, you may boldly vse: for you shall trie it to be more profitable, then the vsing of sponges. But let it be wetted in Posca, & a little alume therewith. Then (as it is set down alreadie) let it be bound to, and let the binding beginne at the neather partes, and end aloft. Let the binding be meane and small, as in the setting of a bone. But truly the first casting a∣bout of the swathing band, which must begin beneath, ought to be tied somewhat strait, but all the rest, must be slaked by little and little, but yet not so,* 1.392 that any part of the binding be loose. Now the remedies which are to be ministred after the vigour of the state, whē the flux is stayed, and in an vniuersall declination (if oedema doth require resolution) are wont also to be described and contained vnder a three folde rule. 1. The first is of Auicene, which is a [ 1] sponge dipped in lye, of the ashes of the figge tree, of the vine, and of the holine, which is a kind of oke, apply these to the mēber,* 1.393 for truly in them there is great power and vertue both to drie and to cleanse. 2. The second is of Brunus which Theodoricus also vsed. ℞. of Alume, [ 2] brimstone, mirrhe and salt, of ech a like quantitie. Commix all these with oyle of roses, and with vinegre, & make a liniment,* 1.394 which yet doth drie more strongly then the former reme∣die. 3. The third is of Auicene likewise, whose description is this as followeth. ℞. of cowes [ 3] dung. lb.ss. of olibanum, of styrax, of Vsnea (that is) of the mosse of trees,* 1.395 which is called of the Grecians bryon, of calamus aromaticus, of spikenard, of wormwood. ana. ℥.ss. apply all these with vineger, and with the decoction of coleworts, and make an emplaister. And this trulie is the way to cure oedema, which is finished by resolution. But if they do not yeeld vnto dige∣stion, but doe come vnto suppuration, you may apply and that verie profitably vnguentum è succis called diachylon, and that ointment especially which Rogerius was wont to make. To the same purpose also this emplaister following is verie effectuall. ℞. mallowes, branke vr∣sine, or hircina, which is called Achantus and achanta, roote of Althaea, roote of lillie, rosted o∣nions, snailes, leauen, lineseede, sodden and kneaded, and mingled with swines greace, or with butter, bring them into the forme of an emplaister, or rather of a cataplasma. Another for the same purpose verie effectuall. ℞. of the iuyce of elder, of walwort, of sorrell (which our countrimen do call lapatium acutum) of leuisticū or ligusticum, & of fennel: of ech of thē,* 1.396 as much as you thinke good, yet of an equall weight, boile them with dialthaea, with hony, oile, and butter, and of them make a cataplasme. The Aposteme being ripe, do not tary till it open of the owne accord, for that happeneth seldome, or peraduenture neuer, but let aper∣tion be made with some hote iron, or some burning medicine,* 1.397 wherwith the matter may be purged out, according to the maner and forme before expressed. Then let the filthinesse be cleansed out and wiped away with that ointment commonly called vnguentum Apostolorum, or with a mundificatiue of apium, & with the iuyce of wormewood, or with this ointmēt fol∣lowing which doth draw and cleanse the thicke and grosse matter. ℞. of galbanum,* 1.398 of Ammo∣niacum, of rosen, terebinthina, pitch, of bullocks tallow, of old oyle. ana. a like quantitie: dis∣solue the gummes in vinegre, & let them melt or boile vpon the fire with the rest, & make an ointmēt. Afterward let it be cured like vnto other filthy vlcers. But we dispatch our fourth in¦tention, according to the nature & qualitie of the accidents that chaunce verie sodenly,* 1.399 as if paine doth happē, it must most especiallie be mitigated, by applying moist oyle of wol, (af∣ter the doctrine of Auicene) or by boiled wine, or by a cerate made of the oile of chāmomil, of the oile of wormwood, of the oile of speake & of wax. But if hardnesse be present it must be dissolued & mollified with the marrow of the bones of bullocks, or with harts marrow, or

with some such like thing,* 1.400 as hereafter shall be said. But Galene in an inuerterate oedema did annoint the sore with oile, & then ministred a sponge dipped in lie, and binding it somwhat iust or straite did perfectly cure the euill.

Now it remaineth that we set downe the summe of the cure of oedema. 1. First therfore vn∣to [ 1] an oedema, which is a symptomate happening and comming sodeinly with other diseases (as the dropsie,* 1.401 leannesse of the bodie, & that euill called cachixia) apply such medicines as can discusse & dry vp without griefe. 2. Therfore rub the swolne place diligētly with oxymel, [ 2] or with oxyrhodinum, or with oyle and salt, or else with oxyrhodinum & salt: for by this frictiō you shall both mitigate the paine (if any be caused through distention) & remit the tumour [ 3] also. But to an oedema which commeth of the influxion of thinne fleume, if flux doth not yet cease apply those medicines,* 1.402 which can partly digest, & partly cōstraine & restraine. 4. Ther∣fore bind to a new spong, or some other dipped in lie, or wetted first in alayed Posca, especi∣ally [ 4] in soft and tender bodies, & (if the tumour doth possesse the members of the bodie) bind about them softely some swadling band from the neather part to the vpper, as we vse to do in setting of bones. 5. But if by these remedies, the tumour doth not slake or yeeld, put a little [ 5] alume with posca. vidz. with oxycratum. 6. But if the affect shalbe of any cōtinuance you must [ 6] not vse anie more these remedies which haue a mingled faculty (that is to say digesting and restraining) but rather digestiues & discussiues.* 1.403 7. Therefore, the member being first annoin∣ted [ 7] with oyle, you must minister a sponge (as we haue said) dipped in lie, & bind it with swa∣thing bands somwhat iust and strait.

CAP. XXII. Of Tumours aboue nature, which the Latines call inflationes, but they are commonly called vvindie Apostemes, apostemata ventosa.

IT is nowe verie requiesite for vs to dispute of the tumours called Inflationes, whose cure is diuerse from the cure oedemata.* 1.404 For they (as Galene saith lib. 14. Therap.) haue their originall of a phlegmaticke humour, and therefore do yeeld vnto touching and handling, and our fingers being layed theron do de∣scend somewhat deepely into them. But Inflationes doe come of a flatuous spi∣rite gathered togither, breeding sometime vnder the skinne, somtime vnder the thin filmes, which are compassed about with the bones, or they doe shut in and include the muscles, or else some part of the bowelles. Furthermore sometime there is also not a little of this hu∣mour gathered togither in the belly and in the inward partes, and also in the middle space of them, and of the peritonaeum, as in that kind of water (saith Paulus) vnder the skinne (which euill we call a Timpanie.* 1.405 These also differ from oedemata, because they being touched with the fingers do not retaine anie mark, and they do giue a sound like a tabour, and also because somtime, they are contained in a sensible hollownesse, and that oftentimes verie great. The cause of these kinds of inflations, is the weakenesse of the naturall heate, which is placed in a flegmatike matter to prouoke windinesse.* 1.406 For truely heate may take vp such a vapour of a moist substance, but it can not deuide nor discusse it. For euen as (saith Galen) we se in out∣ward things, that a verie cold constitution (especially when the North wind bloweth) doth make the aire verie calme, and a verie hote constitution in sommer maketh the ayre pure & cleare, but the middle constitutions do cause cloudes, so it happeneth in liuing creaturs. For heate, neither by extreame weakenesse, nor yet by vehement strength can beget wind, but when it getteth a meane betweene these affections. For this vapour is holden in some place (as Auicene saith) either because of the thicknesse of the member, or for the grosnesse of the vaporous spirite.* 1.407 Which thing also Paulus after the opinion of Galene witnesseth in these wordes: saying, that the thickenesse of the members, and the grossenesse of the spirit or va∣pour doeth cause, that the same vapour is not dispearsed abrode.

The signs of inflation are these, a tumor not yelding to any touching or handling, it appea∣reth very cleare & bright,* 1.408 & whē it is beatē on, it giueth a soūd like vnto a bottle, or timpany Moreouer there is felt oftentimes windinesse throughout the whole bodie, somtime running this way,* 1.409 sometime that way, which causeth extensiue paine. But concerning the iudge∣mentes

and opinions hereof, a flatuous or vaporous spirit, which is not dissolued and dsper∣sed, doth procure manie discommodities. But a breathing and windie vapour▪ coursing vp and downe within the bodie with paine and great anguish, is greatly to be feared, because it doth seeme to be drawn from some venemous matter. But now seing these three thinges. vidz. the moist matter, the imbecillity of the naturall heate,* 1.410 and the thicknesse of the poores of the bodie, do concurre togither to the generation of inflatio (as hath alreadie bene decla∣red) the order therefore of the cure thereof shall be this, first to strengthen the substance of the heate, to extenuate the vapour and flatuous matter, & to preuent or open the thicknesse of the poores of the bodie (wherein this vaporous spirite gathered nowe togither, is con∣tayned.) Nowe wee make perfect and we finish the two later thinges, that is, the rary∣fying of the thicke bodie, and the extenuation of the grosse vapour, by one and the same kinde of medicines, which is by vsinge those remedies which doe profite to the extenuation of the members and by applying those helpes, which can heate either more or lesse according to the inflation of the afflicted members according to the thickenesse or thinnesse thereof, and according also to the grosenesse or thinnesse of the vapours. For according to the difference of these things, the power or facultie of those medicines, which are ministred, ought to be intended and remitted. The thinne parts therfore, & the vapour or spirit which is not verie thick, are but meanely to be dealt withall: but the grosse members, & that vapour which containeth much thick matter, do require medicines, which may great¦ly extenuate & heate them. But if the substaunce of naturall heate shall perish or deminish, it must be repaired againe, regarding the greatnesse of the losse thereof. But if it shall be al∣tered, you must bring it vnto a certaine mediocritie. But if greefe therewithall shall vexe or molest the sicke, you must hasten vnto those helpes which can mitigate paine. Verie well therefore haue the Chirurgians of our age declared,* 1.411 that the cure of Inflationes (which they call Apostemata ventosa) is dispatched by three intentions. The first consisteth of a iust and due obseruation of diet. The second of a good concoction or digestion, and the thirde dependeth of the discussing and dispearsing of the windie spirite, which is assem∣bled in the member. Therefore let the institution of diet be after this manner.* 1.412 First of all you must abstaine from all grosse, viscouse, rawe, fleugmatike, and windie meates:* 1.413 as are, sweete meates, all kinde of pulse, rawe fruite, rape rootes, Chestnuttes, and other thinges of that sort, which doe ingender a flatuous vapour. You must vse hoate and drie thinges, and those remedies also, which can attenuate, and dissolue windinesse, as is bread made of barley with a little salt and commin seede. Let the patient his drinke be white wine, or claret wine, or vinum Graecum.* 1.414 Let him vse the decoction of Cicers mixed with onions, let him take apium hortense (which is commonlie called petroselynum, parsley) ca∣lamint, rewe, commin. Let the flesh which he eateth on, be rather rosted then sodden, and especially the flesh of birdes (as hath bene saide in the former Chapter.* 1.415) But nowe that you may dispatch the second intention, you must strengthen and corroborate the ver∣tue concoctiue with some sweete and odoriferous sauours, and by confections, and by e∣lectuaries appointed for this purpose, as be these, diacuminum, diacalaminthae, Aromati∣cum rosatum, and this confection following, which they call Drageta. ℞. of annise,* 1.416 of fennell, Caruus, daucus, commin, of laurell bearies, beaten togither. ana. ℥.j. of liquo∣rice, galingale, white ginger. ana. ℥.ss. of Cloues, cubebs, of long pepper, seede of rewe. ana. ʒ.ij. of annise seede couered ouer with suger. ℥.iij. of suger. lb.ss. make a pow∣der. But outwardlie let the stomach be annointed with oyle of speke, of Costum, and rewe: or make an Epitheme of those thinges which can discusse winde, and which are appoin∣ted to helpe concoction, and let it be applied to the stomach. But these things do rather pertaine vnto Phisicke, then vnto Chirurgie.* 1.417 The thirde intention is accomplished by ap∣plying some medicine, which hath a double vertue (that is) which can both concoct, di∣gest, and moderately binde, neither will increase paine. But to the perfiting of these things, there are appointed three manner of remedies. libr. 14. Therapent. The first is mentioned of Galene in these wordes. In the arteries (saith he) and in the muscles, which are vnder the skinne, or vnder the filmes which doe couer the bones, when Inflatio is risen, if it be with∣out griefe, some liquor applied to the thinnest members shall profite greatly, of the which

nature is lye ministred with a newe sponge. But if griefe doeth also trouble him, you must annoint the member with some oyle,* 1.418 which hath power to mitigate and remit the same. These diseases happen through a stripe or bruise, when as either the muscle, or the filme, which compasseth the bone, is bruised or hurt, vppon which filme that goeth about the bone, the aforesaide sponge must be layed. 2. The second rule is described also in the same place after this sort: but vnto the muscles (for they sometime are painefull) you must apply some medicine which can mitigat paine in greater measure, so that to them you must applie not onelie lie alone,* 1.419 but you must put into it both Sapa, and also a little oyle. But it shall be more profitable in the beginning not to applie lye, but to vse Sapa with wine, and a little vinegre, and to put to them a little oyle, which thinges when they are mingled togither,* 1.420 it is good to heate them, and lay on vnwashed wooll (which they call succida) dipped in them. But if there be no plentie of such wooll, then the oyle of wooll is to be vsed with the former mixture,* 1.421 but if oyle of wooll be at hand neither, you shall commix very well some Cerate,* 1.422 which is made of the oyle of wooll. For the brused muscles must needes be lenified with some medicine which hath a double strength (that is) which can both con∣coct, digest, and moderately binde. But if the medicine containeth no astriction, it increa∣seth sometime phlegmone, and especiallie in those bodies, which are plethoricke and full of humours. Being mindfull therefore of these three indications alreadie declared (that is, of concoction, digestion, and moderate adstriction) in the muscles which are inflated by meanes of some bruse or stripe, when great paine doeth afflict, you shall the rather vse a more mitigating remedie, and you shall greatlie resist paine, by vsing more oyle and wine, whose force I knowe to be mightie, when as paine togither with the inflation doeth spee∣delie hast to an end. And truely the time is the shorter, if you minister those things, which haue a strong and mightie effect, as are these, lie and vinegre, and next after them wine hath a mightie operation. As often therefore as you minde not to asswage paine, you shall cast into the mixture a greater quantitie of lye and vinegre. Againe when you intend to repell and driue backe, you must put in more of wine then of other thinges, which wine shalbe the more effectuall for this purpose if it be blacke and sharpe. But if you please to digest, you shall minister the greater quantitie of lye. But if you shall mingle vineger with them, the mixture shall be profitable both wayes, because that vinegre hath a double & mingled fa∣cultie. But when the muscle is not pained, you may lawfully for want of lye vse Aphronitrum but it must not be grauellie,* 1.423 but rather foamie. The third rule is an emplaister made of the filthinesse which is wiped from the bodies of men that wrastle, and of vnslaked lime, boiled togither in water and wine. These are the words of Galene lib. 14. Therap. But those infla∣tions (saith he) which through negligence are inueterate and of some antiquitie, you shall apply to them those helpes which are made of lye (as hath bene said before) and secondlie you shall minister some emplaister.* 1.424 But I will declare also the example or order how to pre∣pare these thinges. First the filthinesse that cometh of mens bodies must be heat, and tho∣roughly strained, that it may be cleane and pure: then againe take the lime, which must be brayed as small as meale, and sprinkle it in the vessell where the filthinesse is, and tempter it togither to the thicknesse of clay. That medicine also is very good for these inflations, which is made of Sycomorus, and other remedies of that sort do greatly help also. But if this flatuous spirite,* 1.425 which causeth the inflation, shall be smokie, wicked, corrupted, and excited of a ve∣nemous matter, with intollerable paine, and vehement heate, running vp and downe in the members of the bodie, no more safe or better counsell can be giuen, then that (when it is re∣sident in some perticular member) that member be straightway bound beneath and aloft, & in the middest the tumour be opened with a rasour, or wi••h some hote instrument, so that the venemous vapour may easily come foorth. Afterward the gaping wound must be filled with Aloes, and with bole armoniacke dissolued in oyle of roses and vinegre. But within three or foure dayes after,* 1.426 you must fill vp the wounde with flesh, and bring it to a scarre. But in such venemous inflations, a verie thinne diet must be obserued, and the bodie must be emptied with some purging medicine. And if you minister Theriaca to the sicke, it will helpe him greatly. Nowe there remaineth the summe of the cure of a flatuous tumour, [ 1] which we minde to declare in these wordes following. 1. First confirme and strengthen

the weake substaunce of heate that is in the affected member, restore the same againe, and when it is altered bring it into some mediocritie. 2. Extenuate the vaporous and windy hu∣mour, [ 2] which raiseth the tumour. 3. Open the thicke pores of the skinne, and of the whole [ 3] affected member with medicines that are effectuall for the thinnesse of the members, after∣ward seeke to discusse the flatuous vapour. 4. But according to the difference of the affected [ 4] partes, and according to the thicknesse of the flatuous vapour, or the thinnesse of the medi∣cines which are applied, intend and remit aswell the matter, as the facultie & vertue of them. 5. Furthermore, if such a vaporous tumour shall chaunce with greife and with inflammatiō [ 5] (as it happeneth in the muscles which through some bruise are stuffed out with wind) apply in the beginning mitigating medicines: but in processe of time, vse such remedies, as haue power to dissolue, encreasing by little and little the plentie thereof. 6. Inflations, through [ 6] negligence are inueterate, first annoint them with lie, and then lay to some plaister, which can mollifie, dissolue and discusse them.

CAP. XXIII. Of a Tumour caused of a thinne substance, which they call Aquosum Apostema (that is) a waterish Aposteme.

IF fleame doth vniuersally abound throughout the whole bodie, that kinde of disease (which is a waterish humour running betweene the skinne and the flesh, called Leucophlegmatia) doth accompanie the same,* 1.427 as Galene hath no∣ted in his sixte booke de symptomatum causis. But when this flegmaticke hu∣mour doth flow in one onely member, there is engendred oedema: for so they call a loose tumour, which is without paine. But if waterish excrementes doe abound,* 1.428 they are wonte to bring the d••opsie (which they call ascites) which if they shall couche them selues in one onely member, they doe raise in it phlyctaenae (that is to say) pushes or whelkes. Furthermore the latter sorte of Physitions haue bene accustomed to call this kind of waterish tumours, Aquosum phlegma, as also they doe terme that humour to be fleame,* 1.429 which flow∣eth in the feete and legges of them, that are troubled with the dropsie, and aboundeth in the leane partes of the bodie, and in other members, which doe labour of an euill habite, (which the Grecians call Cachexia. And these kindes of tumours which doe proceede of waterish fleame, or of the aforesaide serous encreasing, they doe also call vnlawfull and vntrue oede∣mata. But in those daungerous dispositions or diseases they call it Tabes, which name Hy∣drope and Cachexia doe require,* 1.430 but oedema (as hath bene alreadie declared out or Galene) doth not deserue the name of a disease, but of a symptomate, for that truely it needeth no particular or seuerall cure. For the onely rubbing of it with oxyrrhodinum, or sometime with salt and oyle, or with salt and oxyrrhodinum doth stop it, and many other things or that kinde doe worke the like effect. But the causes of these tumours are these, the altering of the ver∣tue or facultie of the members through a colde and corrupted intemperature of the bodie,* 1.431 & the naughtynesse of nourishment, declining to aquositie, as you may easilie gather out of the sixth booke de symptomatum causis.* 1.432 The signes and iudgementes are almost all one with a true oedema. Yet they differ in this, because in the waterish tumours the tumour is more loose, then in a lawfull oedema: and therefore it doth not so resist touching, neither doth it sound like winde, but rather as water, and it doth seeme to shine after a sorte, when one be∣holdeth it against the light. Now concerning the iudgements of this kinde of tumour there is no doubt but that a waterish tumour proceedeth of a greater coldnesse then a flatuous tu∣mour doth,* 1.433 as Galene declareth in the eleuenth commentarie of his fourth booke of Apho∣rismes. But it seemeth (sayth he) that a waterish Hydrops, which they call Ascites, is en∣gendred of great coldnesse, but a Tympanie of lesse colde, which disease is named of Hippo∣crates a dry water running betweene the skinne. For a moyst substaunce cannot be chaun∣ged into a flatuous vapour without some heate. Moreouer waterish tumours doe happen oftener in the feete, in the stones, and coddes, in the heade, and in the ioyntes, then in any

other partes of the bodie, both because such a kinde of humour doth readily rush into those partes, and also, because heate is verie meane and litle in them: for because they be farre of from the hotest members. And as a flatuous vapour is seeldom found without a waterish hu∣mour: so a waterish or serous humour is scarce contained at any time in any member with∣out a windie spirite. Hitherto haue wee spoken of the generation, the causes, signes, and iudgementes of a waterish Tumour: nowe we will set downe the cure thereof. Seeing that these waterish tumoures are caused (as we haue said alreadie) of the flowing of a se∣rous humour,* 1.434 there needeth no other meanes, especiallie no other generall order to Cure them, then that methode, which we haue expressed alreadie in the Cure of other tumoures, which are ingendred of the influxion of humoures into some member.* 1.435 The order therefore of remedying such kinde of tumoures in the beginning shall consist of two pointes (that is to say) 1. to emptie out that which is flowed. 2. and to stop and inhibite the fluxe of the hu∣mour. Wherefore, as in all other diseases, which are yet but a begetting, so also in these affectes, the Phisition must be carefull and diligent, as well in curing them, as in foreseeing the daunger following. (that is) both to remedie the disease, and prouide for the fluxe. The first order therefore is subiect to that part of the arte of Physicke, which cureth the disea∣ses: but the second belongeth to that part, which preuenteth the disease to come. But that we may profit and dispatch this doubt and generall methode,* 1.436 it is necessarie to recite fiue o∣ther particular intentions, expressed of Guido out of Cauliacus for the cure of a waterish tu∣mour in this manner & order, as followeth. The first consisteth in a iust institution & obser∣uation of a good diet. The second in the helping & furthering of concoction. The thirde in [ 1 2 3] purging out the waterish humour by the bellie. The fourth in bringing out of the waterish [ 4] humour through the passages of the vrine. The fifte & the last consisteth in the euaporating [ 5] and drying vp of that waterish humiditie which is compact & contayned in the aggreaued member. But because the foure first intentions do rather partayne vnto the Physition then vnto the Chyrurgian, for whose profit we haue taken this worke in hande, and also because they may sufficientlie be knowen by those thinges, which went before: we are determi∣ned to handle in this place the last intention onely, which requireth some newe inuented remedies. The fift intention therefore is ended with those medycines which can drie vppe, and resolue these waterish and serous humours, which are contayned in the affected mem∣ber. [ 1] But of these remedies there are commonly set downe three rules or orders. The first is out of Galene lib. 2. ad Glauconem, and lib. 14. method. medendi. which is made of oxyrrho∣dinum [ 2] and salte (as hath bene before declared.) The seconde is out of the same authour, which is a new sponge, dipped in lie, and to this purpose serueth those remedies also, which we haue before set downe for the cure of oedemata: with the which helpes (that they may drie vppe and discusse the more stronglie) you must commixe, Aphronitrum, alume, and b••ymestone. The thirde rule is a certayne emplayster described of Auicene for the [ 3] cure of scrofule, which emplayster he attrybuted to Galene in libro suo de compositione me∣dicamentorum 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. But this emplayster (as he sayth) within one weeke at the most, and oftentimes within three dayes doth resolue all the hardnesse of the euill. But although this emplaister cannot be founde in the booke before rehearsed to belong vnto Galen: not∣withstanding we may vse the same verie fitly to the dissolutiō of a waterish and flatuous hard¦nesse: whose discription out of Auicene is this that followeth. ℞. of mustard seede, of nettle seede,* 1.437 brimstone, spuma maris, aristolochia rotunda, and bdellium ana. ℥.j. of ammoniacke, old oyle, & wax ana. ℥.ij. But if the hardnesse of the tumour be not discussed by this emplayster, you can deuise no other more excellent or more present remedie, then to open it with some instrument, & then to clense it & scoure it, & afterward to cure it after the maner of other fil∣thie vlcers.* 1.438 The summe of curing a waterish tumor is this. 1. Appoint such a diet to the sick, as can attenuate, heate, & dry vp. 2. Let him vse a moderate exercise of his body, let him eate & drinck litle, let him not sleepe much, let him oftētimes prouoke his belly & bladder to auoyd [ 1 2 3 4] excremēts. 3. Take heed that he digesteth his meate wel, & that it begetteth not windines. 4. Purg out the waterish humor, wherwith the whole body of the sick doth aboūd by the belly, & by the pores of the vrine. 5. Dry vp, & digest through breathing that serous humor which [ 5] [ 6] is included in the affected mēber. 6. But if it cannot thus be discussed, put some penknife, or

some other hote instrument into the tumour, if it occupieth the arteries, and open it in that place where it is most inclined downward, that so the humour may the more easily come foorth. 7. Euacuate the humour, which did cause the tumour by some emissarie, and then [ 7] without delaie dispatche all other thinges which doe pertaine vnto the cure of other cor∣rupted vlcers of the like nature.

CAP. XXIIII. Of the diseases called Glandulae, Nodi, and Strumae, together vvith other Abscessions, vvhich they call Phlegmaticae Excrescentiae.

GANGLIA so called of the Grecians, Choerades (that is) Strumae,* 1.439 which they al∣so call Scrofule, Bronchocêle, which they name Bocium, and Hernia gutturis, Melicerides, Steatomata, and Atheromata: also Testudo, Talpa, Nacta or Nap••a, which names giuen to Tumours were inuented of the late Physitions, and are not to be found amongest auncient writers: Those Tumours also which Aui∣cene calleth Fugille, also Nodi, and vulgaris Bubo, together with many other tumours of that kind, in what parte soeuer of the body they do grow, they haue their generation of fleume, and for that cause they are iustly referred vnto phlegmatike tumours. But although certaine of the aboue named Abscessions do degenerate into a stony hardnesse and into scirrhous dis∣eases: yet the roote and the originall beginning of them for the most parte is fleume, (as A∣uicene declareth) yet we will not deny, but that some other humour may sometime be com∣mixed with fleume, wherof such kind of Abscessions do come, and so there do grow vp those Abscessions which are both compound and of an other kind. But our intent is to speake here of simple Abscessions onely, by whose proportion or analogie the knowledge of compound tumours shall appeare most euidently:* 1.440 for the one must alwayes be referred vnto the other as it were vnto certaine rules or canons (as we haue said else where.) Therefore all the afore∣said tumours are comprehended vnder the kind of phlegmatike Abscessions or (that I may speake after the maner of the cōmon Chyrurgians) vnder the Genus of phlegmatike increa∣singes, which diseases haue certaine speciall differences among them selues, (as it shall after∣ward appeare.) For Glandula, (as Guido thought) tooke his title of the liknesse of Glans,* 1.441 an acorne, which forme he doeth seeme to vnderstand in this place: This Glandula, sayeth he, is euery where softe, one alone, moueable, and disseuered from the other partes lying about it, oftentimes growing in the cleane and pure partes of the body.* 1.442 But Glandule in Auicene doe breed either in the hande, or in the foote, or in some other place ioined to the sinewes and cordes of the body, and these Glandule he would not haue destroyed, least the sicke therby should fall into Spasmos, the crampe. They do happen also in the palme of the hand, and in the forehead, as Auicene sayeth, who also calleth them sometime Glandulosa Apostemata, sometime Nodi: for he doeth intreat of these euills very rashly in diuerse Chapters, as in his Chapter de Nodis euen vnto the ende, and in his treatise de Glandulis. Therefore Auicens Glandulae doe seeme to be diuerse from Guido his Glandule, and Ganglia among the Grecians to be all one with Auicene his Glandule which thing Paulus his wordes next following doe plainly testifie. Ganglium (sayeth he) is a gathering together of the sinowes,* 1.443 which is caused of some stripe or of wearynesse, & that in many partes of the body especially in those which are alwayes mouing, as in the middest of the hand and in the feete. Aētius sayeth, that it seel∣dome possesseth the elbow and the head, and it doeth seeldome also arise voluntarily. And againe the same Paulus lib. 6. cap. 39. declaring what Ganglium is, how it doth grow, in what members chiefly it doth arise, & what signes or tokens doth accompanie it confirmeth those very wordes which we spoke before saying: Gangliū is a conuulsion of the sinewes, caused of some blow or of labor, chaūcing for the most part in the iointes of the hands, & of the armes, and in the ancles and iointes of the feete, although also it ariseth in other partes of the body. These are the signes of Ganglium, the tumour is all of one colour,* 1.444 resisting touching or handling, and without paine, but if you doe thrust it any thing violently, it is felt painfull,

being not deeply rooted, but lying vnder the very skinne next the sides: but againe, if you prouoke it by force it doeth so neither before nor after. Hetherto speaketh Paulus Aegine∣ta de Ganglijs. Now we will discourse of other fleugmatike tumours. Those Abscessions which the common sorte call Scrofula are nothing else,* 1.445 but hard kernels conteined within the litle filmes, videlicet, Glandula chiefly, appearing in the necke, the arme holes, and in the partes about the priuie members, where Glandula are placed by the vessells of the bodye that ly vnder them: yet sometime (although seeldome) they are caused by meanes of the flesh of the same places, which through a certaine kind of affinitie is turned into the nature of Strumae, and is increased by the addition of matter (as it pleased Laeonidas.) The Latines call them Strumae,* 1.446 but the Greekes, Choerades, either truely because of the stones called Choe∣rades growing in the Sea, or else because of those beastes called Sowes that bring foorth a great companie of pigges at once (for these euills do rise vp many together) which beastes are often infected with that disease.* 1.447 For Scrofa, that is to say, Sues haue thicke and glandulous neckes and commonly they be strumous and full of kernells. But Celsus sayeth that Strumae is a tumour, wherin vnder the congealed place there do arise certaine thinges like glandule of matter and bloud. But these do not onely possesse the necke, but also the nosethrills, the pri∣uie partes of the body, & the sides. The Chyrurgian Meges declareth also that he hath found them in the pappes of women.* 1.448 Paulus also speaketh thus of them: Strumae, sayeth he, do arise in the fore parte of the necke, or in one parte or other both at once, either two or more: But all are included within their filmes,* 1.449 as Steatomata, Atheromata, and Melicerides. Lupia, sayeth Guido, is softe and round like vnto a hoppe, and chiefly choseth his place in hard and drye places of the body, as in the eye liddes and in other sinowy members: the Frenchmen call it commonly vne L••upe. Therefore if the description and cure of it, (which shall be afterward handled) be conferred with the description and cure of Ganglium amongest the Greekes: the diseases will appeare not much different or vnlike: but they do greatly erre▪ which do make this euill called Lupia,* 1.450 to be all one with that disease called Lupus. For Lupus is a malignant vlcer quickly consuming the neither partes, but specially annoying the thighes and legges, and it is very hungry like vnto a woulfe (wherof it seemeth to receiue this title) eating vp the flesh that ly next vnto it, which euill without doubt is of the kind of Phaged••nae. Diseases therefore are farre diuerse among themselues the one from the other, although in name they be somewhat acquainted.* 1.451 Nodus, (as the knot of a rope) is said of the same Guido, to be round, harde, and abiding in one and the same place, growing especially about the sinowy places of the body.* 1.452 But Auicenne in a certaine place defineth Nodi to be dubeleta a frigida, and he compa••eth this name with Steatomata, which are called adiposi & adipini nodi, fat ••u••les, and with Melicerides, which are called melli••ij nodi, and with Atheromata, which consist of a certaine kind of matter like vnto a pulse, which the Greekes call Athera. But be∣cause these three kindes of Abscessions, that is to say, Steatoma, Meliceris, and Atheroma, are most incident to mens bodyes, and Galen also maketh mention of them in very many places: we thinke it conuenient (hauing here gotten so fit oportunitie to intreat of them) plainly to declare their nature and their markes wherby they may be knowen, and in what thinges also they do differ and dissent,* 1.453 and in what thinges they do also conspire and agree. Atheroma therefore is a tumour of one and the same colour and without paine, conteining within the filme or sinowy tunicle a softe humour like vnto Athera, that is, a kind of pulse, which is made of boiled meale. Sometime also in Atheromata together with a softe humour, there are found certaine stony and hard substances, and other thinges like vnto small peeces of brimstone, oftentimes there are found in them certaine thinges like vnto the chewed bones of a henne, and like vnto heares wound vp together. This tumour Atheroma, appea∣reth in forme and figure very long, and somewhat eleuated in height, which being pressed with the fingers, by reason of the clammishnesse and thicknesse of the humour, it doeth slowly yeeld or go backe, and the fingers being remoued, it doth slowly also returne againe. But Meliceris is a tumour,* 1.454 which is voide of paine also, but yet it is round, wherin the humour, which is also included in some sinowy tunicle, (which they call Cystis) is found somewhat thinne, representing the substance of hony: whereupon some of the Latines doe call it mellifanium, a hony combe. Meliceris therefore doeth differ from Atheroma in

fa••••••ion; and in the substance of the humour: for both the forme is more round, and the su••••••nce of the humour more sclender. This hony tumour therefore is further extended th•• Atheroma, and by pressing it with the fingers it doeth speadily giue place, and when 〈…〉〈…〉 are remoued, it doeth with the like celeritie returne to the former place. But 〈◊〉〈◊〉 is a tumour also besides nature, all of one colour,* 1.455 and very gentle to be handled in th•• ••eginning truely it is very small, but in processe of time it increaseth and becommeth 〈…〉〈…〉, wherin is conteined a humour very like vnto tallowe, which is also compre∣hend vnder the filmes of the bodye. This is distinguished from Meliceris and from Athe∣rom•• by reason of the hardnesse therof, for it is both full and plentyfull, and it doeth so re∣sist•• aching, that it will in no wise yeeld to the thrusting of the fingers. But let vs now pro∣cee•• to declare other kindes of Apostemes, which are almost reduced vnto these three, whe••••••f we haue now intreated. Testudo (sayeth Guido) is a great Abscession,* 1.456 very humo∣rall, 〈◊〉〈◊〉, and of abroad fashion, after the maner of a targette, (wherupon it receiued the 〈◊〉〈◊〉 which euill if it groweth (sayeth he) in the head, it is called Talparia or Talpa: if in 〈…〉〈…〉, it is called Bocium: if in the stones, Hernia: but sometime it is found with mat∣ter, 〈◊〉〈◊〉 with certaine scales, or with a fistula accompanying it. But Testudines and Talpae, a∣mon••st the auncient Physitions, had neither any proper name, nor yet once entreated of. But 〈◊〉〈◊〉 of our dayes doe define Testudo to be a softe tumour, or not greatly hard, yet some 〈◊〉〈◊〉 bigge, in the which is conteined a grosse matter lying hid in a certaine tunicle, whic•• ••loth so cleaue vnto the whole head of a man (for it is a disease incident to the skinne of the ••ead) that it oftentimes corrupted the same. This euill (no doubt) is to be accoun∣ted a••••ng the number of Abscessions, and comprehended vnder Meliceris, or Atheroma, but it ther seemeth to incline vnto Meliceris: but Talpa,* 1.457 because it conteineth a white matte•• 〈◊〉〈◊〉 rather referred vnto Atheroma, then vnto Meliceris: Notwithstanding Guido af∣firmet•• ••hat it is a kind of Testudo, yea also that it is Testudo it selfe (as we said a late) as Hernia 〈◊〉〈◊〉 and Bocium, which he also nameth: but these affectes haue barrowed there di∣uerse 〈◊〉〈◊〉 according to the varietie of the places, wherin they are found. But that which the comon sorte call Bocium,* 1.458 the Greekes (fetching their title or name euen from the ve∣rie deep) doe properly call Brouchocêle, but our countrey men call it Hernia gutturis, whereupon they also call them Gutturosi, which doe labour of that diease.* 1.459 Brouchocêle is a great 〈◊〉〈◊〉 chauncing in the necke, verie round betwene the skinne and the wind pipe, wherin ••••ere is included, sometime deade flesh, sumetime a certaine humour like vnto ho∣ny, or 〈◊〉〈◊〉, or sodden meale, or water. Sometime also (as Celsus sayeth) there are found in such t••mours certaine heares mingled with litle bones.* 1.460 Nacta (as Guido writeth) is a great tu••our, full of flesh, like vnto the flesh of a mans buttockes, of diuerse formes and greatness: as are melons and gourdes, and therefore it borroweth sundrie names according to the va••••etie of the fashion and member wherin it is placed. Moreouer this tumour which of the lat••r sorte is called Nacta or Napta, is voide of paine,* 1.461 except peraduenture it be so great, th••t by the continuall drawing of the partes of that member, it bringeth some griefe to the pa••es about it. This also is of the number of Abscessions, and doeth parteine vnto Steatomaa (as we said before in the enumeration of tumours besides nature.* 1.462 Bubo (sayeth Galene) is a disease of the loose members, or of Glandulae, (which the Greekes call Adenae) that is to say, a simple inflammation. Wherfore Guido hath either vnfitly here rehearsed it among the number of flegmatike abscessions: or else he vnderstandeth some other matter then Galene doth. But Bubones, which are caused through a fall from some place, or by other vlcers & diseases, are without any danger: but those which are wonte to happen in pestilent feuers, are the worst of all, whether they inuade the thighes, or the nosethrills, or the necke. Fugilla (sayeth the interpreter of Auicene) is of the kind of glandulous Apostemes, and this terme (sayeth he) is appropriated vnto it, because it is a disease chauncing behind the eares.* 1.463 By the which description it may easily be coniectured, that Fugille, so called of Auicene, is that tumour, which is called of the Greekes Parotis, that is,* 1.464 a glandulous disease growing vnderneth the eares. But some do thinke Fugille to be all one with Bubo: but then Bubo is farre otherwise taken of them, then of Galene and Paulus, which is (as they say) a tumour that is deeply planted and rooted, and oftentimes not compassed with any skinne or filme, it is

very hard also after the maner of the euills called Scrofule, & in that signification (as I iud••) is Bubo takē of Guido, because he doth register Fugillinus Bubo amongst the number of fle••∣matike abscessions. But there are now found out very many titles giuen to these kin•• ••f phlegmatike abscessions. But we ought not greatly to stand vpon the names of them, so 〈◊〉〈◊〉 we know and vnderstand the onely differences of them, because it falleth so out, that ac••••∣ding to the diuersitie of their names,* 1.465 their cures and iudgements do varie. Therefore of 〈◊〉〈◊〉 kind of abscessions, some truely are included within a certaine skinne or tunicle (which 〈…〉〈…〉 call Cystis) and some are deeply planted in the flesh: some haue a sclender foundatiō, or 〈◊〉〈◊〉 roote, and some againe are very large and broad. Also some are easie to be resolued, 〈◊〉〈◊〉 some are farre otherwise: some great, and some litle. Some also do come vnto suppuran, and some do not. To conclude some tumours are scaly, fistulous, and cancerous, but 〈◊〉〈◊〉 do admit or suffer none of these thinges.* 1.466 The causes of these kindes of tumours are 〈◊〉〈◊〉 fould: videlicet. 1. Primitiue causes, as a fall, a stripe, excessiue or inordinate liuing, 〈◊〉〈◊〉 an euill diet. 2. Antecedentes causae, as are vnnaturall humours, especially those which be ••••••g∣matike, and true oedemata, which do degenerate into abscessions. 3. Coniunctae causae, 〈◊〉〈◊〉 are the diuerse substances, and properly the matters of euery abscession, conteined in 〈◊〉〈◊〉 af∣fected member. But in these kindes of tumours there are conteined certaine humours, 〈◊〉〈◊〉 be either serous or waterish as is vrine, or putrified and corrupte, or filthie, or dirtie, 〈◊〉〈◊〉 else humours, like vnto hony, or sodden meale, or vnto fatte. But there are sometime 〈◊〉〈◊〉 within these abscessions phlegmatike, and waterish and glandulous flesh, sometim•• also stones, sand, shelles, wood, coales, and other such like solide substances. Notwithsta••ding these three kindes of tumours do most frequent mens bodyes (as we haue said before) her∣of euery one hath borrowed in Greek his proper title:* 1.467 as Atheroma, Steatoma, and Meeris, which are thus called by reason of the similitude of the substaunces conteined in the••▪ For there is another tumour amongst these, like vnto tallowe, or some other fatte thing, a••other like vnto hony,* 1.468 another like vnto a thinne kind of meate, which they call Athera. Th•• ••ignes and iudgementes of such kindes of tumours, which belong vnto fleume, may easily bound out by their descriptions and differences before declared. But the marke, wherby 〈◊〉〈◊〉 may know whether they be couered with any vale or not,* 1.469 is this, there is mouablenesse 〈◊〉〈◊〉 in∣constancie of the filme or skinne, called Cystis, which the auncient Physitions haue 〈◊〉〈◊〉 tunica, and there is a separation of the skinne: but when they be surely fixed, that is, ••iding in one place, and do cleaue fast to the flesh, it is an euident token, that they are garde•• about with no filme or tunicle at all.* 1.470 Futhermore those tumours which are new and tr••ctable, may easily be discussed, but they which be hard and inueterate can in no wise be r••••olued. Rednesse, paine, and increasing of heate do declare that those abscessions will either 〈◊〉〈◊〉 to suppuration, or else degenerate into a fistula or a Cancre. Strumae numerosae, which 〈◊〉〈◊〉 affect the outward members, and do often chaunge their place, wandring here and there a••out the body, with a certaine extraordinary heate, do testifie and declare very plainly, that ••••ey will beget and breed those inward diseases called Chaerades,* 1.471 as Arnaldus hath noted in a ••ertaine place. Those remedies therfore, which are outwardly applied to them, do profit li••e or no∣thing. But these diseases (as Auicene thought) are increased and do multiplie by so••e fall, or by some hurt or bruise in the body.* 1.472 Now these strumous tumours are greatly helped by vsing purging medicines, diureticall potions, & electuaries, (as they call them) which can drie vp. Also the chaunge of age doeth greatly auaile in young children.* 1.473 But children, by reason of their excessiue eating and immoderate diet, and the sclendernesse of body, are very often annoyed with Strumae. But olde men by reason of the contrary causes, are seeldome trou∣bled therwith. Moreouer they which haue a narrow forehead, and straight temples, and great checkes, are subiect to Strumae. For in such, the matter is readely brought downe to the necke, as one Henricus among the number of the late Physitions, hath noted very well. But Strumae (as Celsus sayeth) are wont commonly to weary Physitions,* 1.474 because they pro∣cure feauers also, neither do they at anytime ripen easily, and they are cured either with some hote instrument, or with medicines, and oftentimes they do rise vp againe beside their scarres, and a long time after they require medicines againe, and moreover it so commeth to passe that they remaine in the flesh along season. The inscision, and corrosiuing of such tu∣mours

is greatly to be feared about the belly, the necke, and the iointes, by reason of the af∣finitie and knitting together of the veines, the arteries, and the sinowes, and also of the in∣ternall capacitie. In the incision also of great Glandule, it behoueth greatly to eschew that veine, which lyeth at the roote of them, and doth bring nourishment vnto them. For often∣times it causeth great profusion of bloud, wherupon there ensueth straight waye no small danger. These euills called Strumae, do greatly differ amongst them selfes both in greatnesse, nature, place, beginning, multitude, and ioining together of the vessells (as Aetius hath gathe∣red out of Leonidas. Therefore litle Strume are sooner and more easily cured then the great, euen as the gentle tumours are more tractable then those which are enflamed. Noysome Strume cannot be remedied. For seeing all such diseases called Strumae are cancerous,* 1.475 and do stuffe vp the vessels of the body, while they are curing, they must needes bring the daun∣ger of profusion of bloud, besides that also,* 1.476 they are found very deepe in the flesh and ther∣fore they cannot any way be cut of. For a malicious and hurtfull Struma doeth possesse the best vessells, (that is) the greatest veines and arteries (which are called Carotides) euen as though it should hold by certaine rootes.* 1.477 The superficiall Strumae are more easie to be cu∣red then the internall by reason of their place, and those also are curable which do happen in the necke, where yet you must, be very diligent to eschew the loud and great senowes: for many by cutting Strumae about the windpipe, and by cutting other loud senowes haue cau∣sed the sicke all the time of his life after to remaine speachlesse. For beside the excision of that senowe, the great vessells being laid bare, and cooled in the cure, do hurte the dutie of the tongue. For the multitude of Strume, it appeareth,* 1.478 that one alone may easilier be cured them many together. And concerning the maner of their rising, it is manifest also, that they which hange downward are a great deale sooner healed, then they which are planted in the flesh. Thus much concerning Struma, which Aetius hath recited out of Leonidas. The cure of these kindes of Abscessions, which haue their originall of fleume,* 1.479 is of the late Chyrur∣gians appointed to be two fould (that is to say.) 1. Generall, and vniuersally common at all, 2. and particular, which is proper in euery difference. Therfore our generall methode of cu∣ring these tumours shalbe, to appoint such an ordinarie and conuneient diet to the sicke, as that the matter, which causeth such abscessions, be not heaped vp together in the body, and by all meanes to preuent and turne away the antecedent matter (as they call it) which now is gathered together in the sicke bodye, least at the lenght it be vnited to the ioined cause, that is, vnto that matter, which now bringeth the disease. But we shall accomplish the first intention of our generall cure, if the sicke do diligently obserue that kind of diet, which is prescribed in our former Chapters (this one thing excepted) which is,* 1.480 that they ought to keepe a very thinne diet, and that, which is more conuenient to deuide thicke and clammie humours. Therefore if they will follow the counsell of Auicene, let them eschew all those meates which are of a grosse iuice, the drinking also of cold thinges, too much satietie and immoderate fulnesse, and those thinges also which procure vomite and abhorring of meates. But they must abide as much hunger as can be. They must chiefly procure good digestion, and auoide a moist house, that is either situated in lowe vallyes, or in fennes, or frequented with corrupted waters. Let his drinke be wine that is excellent and of the best, or else let it be water of alume, or of brimstone. For such kind of minerall waters,* 1.481 especially those which do represent in tast the dregges of wine, do not onely diminish & discusse these inward Stru∣mours and flegmatike abscessions: but those also which do outwardly affect the superficiall partes of the body (as Arnaldus affirmeth.* 1.482) But we do perfit the other parte of our former proceeding (that is to saye) to turne away the antecedent matter, least it be mingled with coniuncta materia, by foure kindes of euacuations, that is, by some medicine to purge fleume downward, and sometime by letting of bloud, also by those thinges which can prouoke vrine, and last of all by those remedies which can through their vapour both resolue and di∣gest the humour which is gathered together in the inward partes of the body.* 1.483 To purge the body downward, the powder of Turbith is greatly commended, which is made thus in A∣uicene, ℞. of Turbith, ginger, and sugar, of eache a like portion, but he taketh therof two drammes, and he affirmeth also, that (besides that it doth resolue grosse fleume) it doth nei∣ther heate, nor violently wrest the inward members. But Razes,* 1.484 who was verie bold in de∣claring

and vsing purging medicines, made this kind of powder, in his ninth Chap. de dole∣ribus ve••••ris ad Almansorem, of twenty partes of Turbith, of tenne of ginger, and thirty of suger,* 1.485 and ministreth of it at one time, ʒ.iij. Benedicta also and hierapicra, and pillule de aga∣ric••, and pillule maiores de hermodactylis do greatly helpe these diseases. To prouoke wrine, Guido out of Ca••liacus was wente to vse this potion slollowing,* 1.486 which (he sayeth) he ga∣thered out of the writinges of many Physitions, ℞. of Scrofularia, partes iij. of phylipendula part .ij. of pimpernell, mouseare, Tanacetum, of red coleworts (which of some are thought to be Brassica marucina) of rubia maior, ana. part .j. of the roote of Aristolochia, of spathula satida, of the roote of radish, ana. part .ss. put them altogether, and boile them in white wine and hony, vntill halfe be consumed, then streigne them, wherof euery third day in the mor∣ning let the sicke take three onces, and let it be dronke hot. But in the applying of all these remedies, (as also for bloud letting, if at any time it be required) the counsell of some lear∣ned Physition is to be vsed, who may prescribe both the qualitie, quantitie and vse of them, But to resolue through breathing,* 1.487 and to digest the humour, which is gathered together in the deepth of the bodye, and doeth excite inward Glandule, (which also are the causes of outward diseases) Galene lib. 14. Therap. willeth vs to minister Theriaca, Athanasia, Ambro∣sia, and that medicine also, which is made of cretica calaminthe: the Greekes call it Diacala∣minthe: whose composition is to be sought out of the fourth booke de Sanitate tuenda. Ma∣ny other helpes are appointed for the cure of these abscessions, as potions, electuaries, and oiles, which are cast into the eares. There are also very many remedies called Empirica, con∣sisting in practise described and celebrated of the auncient Physitions, the vse wherof I do not allow, and therefore I thinke it good to pretermit the declaration of them in these our commentaries. Notwithstanding this one thing I steadfastly affirme that the Christian king of Fraunce is indued as it were by inspiration with so wonderfull a gifte,* 1.488 that with the onely laying on of the handes he can restore them which be diseased with Struma or Scrofula, to their perfect health againe. King Edoward also (as Histories doe reporte) was wonte mar∣ueilously to cure Strumous persons onely by touching them which gifte immortall, doeth come as it were by inheritaunce to the kinges that succede. For the kinges of England at this day, by laying on of handes, and rehearsing certaine ceremoniall prayers, do heale Stru∣ma. And these thinges truely are generally spoken in all the abscessions before mentioned. Now those thinges which follow,* 1.489 do concerne the particular and proper methode of curing euery difference: which methode is made not only diuerse, but also it is chaunged, both by the substance of matter, wherof they haue their beginning, and by the quantitie of them, whether they be great or small, and by the nature also of the affected member, and of the whole body. But the continuaunce of time, although it declareth not the cure, yet sometime it sheweth vs and it doeth insinuate the qualitie of the disposition therof, (as Galene hath set downe. lib. 4. de morbis curandis.) Therefore although many indications and intentions of their cure may be gathered and learned by those thinges, which we haue spoken before: yet, for our present purpose, we haue reduced them vnto six pointes, which we also haue ex∣pressed [ 1] in these six canons following. 1. The first wherof is after this maner: imprimis, let those flegmatike abscessions that are softe and small, (which are commonly called Lupiae, & of the interpreter of Auicene, Glandule) if they be feated in the strong partes of the body, and (because they are not yet inueterate) haue their thinne Cystis, that is, their filme to couer [ 2] them, let them, I say, be appeased, suppressed, consumed, and afterward dryed vp. 2. Molli∣fie, discusse, and consume the great abscessions which be not greatly hard, nor inueterate, [ 3] after the maner of oedematous tumours wherof we haue before intreated. 3. Ripen, open, and clense such fleugmatike, corrupted, and vlcerous Apostemes, which doe pertaine vnto [ 4] suppuration. 4. Those Strume which are not cured by the former remedies, and yet are [ 5] moueable, gentle, tractable, and obedient, cut them of and draw them out. 5. Those, which are vnmoueable, deeply rooted, inwardly planted, and wound about the veines and arteries, [ 6] and broad at the roote within, corrosiue them about, and clense them througly, 6. Those, which are fastened but to a thinne and sclender roote, bind them about, & plucke them out. The first canon,* 1.490 according to Auicene his opinion is perfited after this maner, if, when you do consume and suppresse vehemently these soft and litle abscessions, (which Auicene doth

call Glandule, and the new Physitions Lupie) you do lay on a plate of lead made fitte for the tumour, and bind it very strongly in the middes, lest it slide from the place. For this doeth digest these kindes of tumours. First therefore let Lupia be softely rubbed with the hand,* 1.491 vn∣til it waxe somewhat hote, and vntill it be after a sorte softer then it selfe. Afterward let the affected member be surely laid hold on with the handes, and let it be so often, and so vehe∣mently stroken with the bottome of a saucer, or with some other solide thing, that it may be disseuered and that the inward Cystis therof (which is the filme wherin it is included) may be rent and broken, and so the matter therin conteined may be dispersed. Which thing being done, apply the plate of lead vpon the place,* 1.492 & let it be bound very strongly with a swathing band that hath two endes, neither let it be remoued for the space of nine or ten dayes, but let the plate be of that greatnesse (as it was said a late) that it may aunswere to the proportion of Lupia. But there are some, which before the application of any plate of lead, do minister this ointment made of burnt lead, of the barke of the elder tree, or of the figge tree,* 1.493 with oile and vineger. Other do first vse an emplaister made of Aloes, acacia, mirrhe, olibanum, scarco∣colla putting to them a litle vineger, or the white of an egge, as much as shall seeme sufficient to commixe with the reste. Henricus was wonte to lay vpon them litle flakes (as he & other Chyrurgians of that secte do call them) made of flaxe, dipped in the white liquor of an egge, with salte and alume zuccharinum vnthicked.* 1.494 Moreouer Philagrius almost after the same maner was wonte to cure Ganglia (as it is in Aetius) which diseases are tumours vnequall (as we said before) speaking after this sorte. We deny (sayeth he) the labour of the Chyrur∣gian, that is bloud letting, in Ganglia, especially if they chaunce in the handes or in the feete, but we must cure them onely by medicines. For we annoint them by the fire with ammo∣niak which must be made pliaunt to the thicknesse of an emplaister: afterward we apply a plate of lead equall for the tumour and least it should slide away from the place, we bind it in the middest with straight bandes. But a few dayes after, when we know that Ganglium is mollified, we take away the bandes, and (not saying any thing to the sicke) while the place is yet hote, we fasten the thumbe of our right hand vpon Ganglium, and laying fast hold on the member with our other foure fingers, we violently breake it, and so Ganglium is presently dissolued. Hetherto Philagrius. Therefore by this our order of cure, it may easily be gathered, that Lupia amongest the late Physitions, Auicene his Glandule,* 1.495 and Ganglion among the Greekes, is all one disease, which, the former descriptiōs of them do also manyfestly declare. Archigenes in this disease, commendeth to lay our lime, with the fatte of a goose, and with rosin Terebenthina, which is the right turpentine. The same Archigenes also did oftentimes vse that medicine, which is made of the stone called Lapis achates, as Paulus reporteth. But Oribasius vsed very often this medicine, ℞. of cerusse, resinae piceae. olde oile,* 1.496 ana. ℥.j. of ammoniake Thymiama, and Galbanum, ana. alike quantitie, of waxe. ℥.iiij. The same medi∣cine is to be seeme in Aetius, but the quantitie doe varie in certaine thinges, as thus, ℞. of ce∣russe, olde oile, and resina piceae, ana. lb.j. of waxe. ℥.ij. of ammoniacum Thymiama, and of Gal∣banum, ana. ℥.j. boile the ceruse with oile, till it looseth his staining facultie, then bray the am∣moniake, and cast it into the ceruse with the oile, afterward cast in the resina picea, and the waxe, and last of all the Galbanum, which first must be made very softe and tender. Moreouer that famous Physition of Greece, I meane Oribasius, did not apply any plate of lead, as Phi∣lagrius, Auicene, and other late Chyrurgians were accustomed, but he did lay and bind vn∣to Ganglium, a thicke round peece of leade, like vnto a wherue,* 1.497 which do hange vpon wo∣mens spindles to make them turne rounde, which was more large and ample for the disease. For truely, sayeth he, with the weight therof, it doeth more speedily dissolue the euil. There∣fore in the cure of Ganglia, it is farre better to vse such mollifying and discussing medicines, then the diligence of the Chyrurgian, (which is excision of the tumours) especially when they doe grow in the legges, or in the armes, or in the principall partes of the body. For it is to be feared, that, if they be cut of, the member is made lame and vnperfect. But those diseases which do occupy the head or the forehead, may safely be cured with the hand, that is, may be cut of, or plucked vp by the rootes.* 1.498 Therefore diuide the outward skinne with a pen-knife, and then, (if the tumours be small) lay hold on the foundation of them with a paire of pinsers, or some such like instrument, & cut them of from the roote. But if they be great,

thrust them through with a hooke, and lift them vp, and winde them round about, vntill you haue plucked and drawen them forth; last of all, sow vp the sides, or brimes of them together, and vse those medicines which are appointed for bloudy vlcers. But these things belong vn∣to the fourth canon.* 1.499 The second Canon (because I will be silent in those medicines which are appointed for fleugmatike and oedematous tumours, which we haue described already, and yet, together with these remedies following, they be very profitable and expedient for these Abscessions wherof we now intreate, and also for all kind of Hernia) is finished by the applying of a certaine emplaister,* 1.500 which is described of Galene libro sexto de compositione medicamentorum 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉: which emplaister (as he himselfe testifieth) doth digest through breathing, and doeth repell Phlegmone, and is affectuall against the diseases called Strume, Taxi, and Parotides: it is auailable also against the goute, and it benefiteth many other dis∣eases.* 1.501 The emplaister is this, ℞. of olde oile. ʒ.100. spumae argenti, picis sicce. ana. ʒ.50. of La∣danum. ʒ.25. of aerugo rasa. ʒ.8. of Galbanum. ʒ.4. let Argenti spuma, which they call Lithar∣girum, be brayed, and boiled in the oile, and when they are somewhat thickened together, put in the pitche and the rust or scouringes of brasse, then the Ladanum, and Galbanum. After∣ward power them out into a morter and bray them and mollifie them, and reserue them to your vse. Some, to make it haue a good colour, and to looke somewhat browne, do commixe with them also the offall of brasse. ʒ.viij. for otherwise it would be very blacke. This em∣plaister is found otherwise described in Guido his commentaries, vnder this forme, ℞. of old oile. ℥.xij. of the scouringes of brasse. ʒ.xiiij. of dry pitche. ℥.vj. of Ladanum. ℥.iij. of Lithargi∣rum. ʒ.xij. of Galbanum. ℥.iij.* 1.502 For the same purpose Diachylon also, which is called Com∣•••••••• & treatum, doeth profit much, wherof you must take one pound, and commixe ther∣with of the powder of the roote of ireos. ℥.j. The same effect likewise hath that Diachylon, cal∣led magnum Mesnes, whose description shall afterward ensue. Some do counsell vs, for the di∣gestion of these Abscessions,* 1.503 to apply vnto the aggreiued place, the olde dounge of a goate with hony and vineger, which must be het ouer the fire vntill they be well incorporate toge∣ther & then brought to the forme of an emplaister, also an emplaister made of fenugreeke, of the seed of flaxe, & of coleworts, with the scrapinges of the roote of Althaea, which medicine, (if there be any hope of suppuration) doeth ripen it notably.* 1.504 Haly Abbas also for the same purpose doeth greatly commend this emplaister following, ℞. of beane meale, and of bare∣ly meale, ana. ʒ.x. of the roote of liquorace, of the roote of Althaea, and of pitche, ana. ʒ.v. of white waxe, gooses suet, ana. ʒ.x. Bray them, and mingle them together with old oile, and with the vrine of a child, that hath not yet tried venus sportes, and ouer a softe fire make an emplaister.* 1.505 Another out of Auicene, which Guido vsed, ℞. of oxes dounge. ℥.ij. of the roote of coleworts, of the roote of capers, of the fish called a shrimpe, of fat figges, ana. ℥.ss. of hoppes, and bdellium, ana. ʒ.ij. of vineger, hony, sowes tallowe, of the dregges of olde oile, of eche as much as is sufficient,* 1.506 wherof make an emplaister. Brunnus approueth this remedie following, whose opinion Theodoricus also doeth confirme, ℞. of ammoniake, bdellium, Gal∣banum, of eche a like quantitie. Steipe them three dayes in vineger, wherto (when they be dis∣solued) you may adde of small branne, as much as shall suffice, and make an emplaister. Ro∣gerius was wont to vse this remedie for Strume (which they cōmonly call Scrofule) ℞. of the roote of brakes,* 1.507 of daffadill, or of walworte (if you please) of eche, as much as you thinke good, let them be boiled in the best wine, and then brayed in a mortar, and adde to them a litle quicke brimstone,* 1.508 and make an emplaister. Guido his maister in monte Pessulano, hath often tried this emplaister to be most effectuall, which, is made of xij. snailes (which they also call Limaces) boiled in wine, or in lye made of ashes commonly called clauelata. But (that which is more profitable) he did minister euery day to the sicke to be eaten, one snaile either dry, or otherwise prepared, and as they terme it, made ready to chew. Paulus also was wont notably to discusse Strume with vnslaked lime, steiped in hony, or in the filthinesse of mens bodies that do arise either in exercising thēselues or in bathes, or else in oile, or sowes greace. The like vertue, sayeth Aetius, hath the filthinesse of exercising places, scraped from the walls, which must be well beaten together, & spred vpon a linnen cloth, and applied after the ma∣ner of an emplaister. For the same purpose, this helpeth effectually, ℞. of lime, and nitrum. ana. a like portion, of Cardamomum, & fenugreke, foure times as much with hony, & apply it after

the maner of a mollifying plaister. Also the meale of bitter hoppes boiled, and annointed with oxymel doth discusse Strumae. For the same purpose also oxes dounge boiled in vineger, & annointed, doth notably auaile, which being applied after the maner of a cataplasme, doth marueilously dissolue all hard and scirrhous tumours. Rathe ripe figges also, especially of the wild figge tree, applied with hogges greace, do discusse all kindes of tumours. Therefore by this our methode in curing, you shall heale all kindes of Strumae, which are but newly begon, and not yet inueterate, aswell in children, as in them which cannot abide manuell practice, e∣uen by the applying of such medicines as can dissolue, digest, and discusse, But first you must labour to mollifie, and afterward to discusse, or else vse some medicine of a double qualitie, which can worke both these effectes together, of which kind are all those remedies almost, which are before described. Now if digestiue medicines shall nothing preuaile in these Ab∣scessions, they must be either brought vnto suppuration, or consumed, or else cured by Chy∣rurgie, (as it shalbe said herafter.) But here we must not omit that thing,* 1.509 which is recorded of some very diligently, (namely) that they which are diseased with Strumae, and with any le∣prosie, are marueilously holpen by the vsing of vipers and serpentes, and by the drinking of the gumme called Laser, euery day fasting, to the quantitie of a ciche pease. There fore cast the dead serpent into a potte, and stoppe the mouth therof very iuste with some plaister, and set it in the fire, then take the ashes of the burned serpent, & mingle them with the like quan∣titie of fenugreeke, and vse them in wine. For this doeth excellently helpe them which be strumous. Also in them that labour with Struma, you must prouide that the belly be made soluble, and a sclender diet obserued: you must daily prouoke vomiting, and endeuour to purge fleume vpward, you must also dry the head, and apply cataplasmes to the fore parte therof, which can raise litle pushes in the skinne, as is the roote of capers with polenta, and other such like thinges. And you must also vse purging medicines, and fine powders, that be of the like vertue. We also do generally dipatche the declaration of the third rule, by the [ 3] vse of the former remedies. For all mollifying and resoluing medicines,* 1.510 if they finde any place or matter disobedient vnto resolution, they doubtlesse doe ripen the same matter, and bring it to suppuration: especially if the said matter be gentle and tractable, or commixed with bloud. But Haly Abbas,* 1.511 that he mought bring these kindes of abscessions vnto matu∣ritie, ministred a plaister, made of barly meale, pitche, and olibanum, and of the vrine of a young child, all well incorporate together. But Auicene, to represse the vehemencie of the heate, willeth to commixe the decoction of coriander with the aforesaid vrine. But if these thinges do nothing helpe, and there be required a more effectuall remedie: take of mirrhe, pars .j. of licium, part .ij. and mingle them with the aforesaid decoction. This medicine vnder written doeth bring Strumae vnto suppuration,* 1.512 which medicine is recorded of Paulus Aegine∣ta Lib. 4. ℞. of mirrhe. ʒ.x. of ammoniacum Thymiama. ʒ.vij. of viscus quercinum. ʒ.viij. of Gal∣banum. ʒ.iiij. of propolis. ʒ.j. beate them in a mortar. But when these abscessions be ripe, and brought vnto suppuration (which you shall easily perceiue by the tokens of the matter) they must be opened and clensed within, which you shall do very well, if you do clense them after their apertion with that ointment cōmonly called vnguentum Apostolorum,* 1.513 which is an oint∣ment of great efficacie in malignant and vlcerated Strumae. To this purpose also the oint∣ment called vnguentum Aegyptiacum is very profitable,* 1.514 and the Emplastrum de succis (which they call Diachylon) and Diapalma, (which the Greekes call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉) whose descriptions are to be found in other places. But if these Abscessions shall possesse any member, wherin there subsisteth any putrefaction, and corruption of the bones, or any euill symptomate shall haue accesse to them: they must be cured after the maner of vlcers, with the which they haue some affinitie and acquaintaunce. Concerning our fouth Canon, you shall cure, gentle, obe∣dient, superficiall, and curable Strumae, very cunningly and shortly after this sorte. First, [ 4] * 1.515 commaund the sicke to lye down: for that, when he sitteth, his heart will quickly faile him. when he is thus laid, binde his legges surely together, and tye them to the beadstead, and charge the seruauntes about him to holde his head very hard. Then cut the skinne that com∣passeth the tumour either with a right or a litle ouerthwart section, but that incision, which is drawen ouertwhart in the neck, is altogether vnprofitable, because in it the vessells and sinewes are extended right foorth. But you shall not cut the whole thicknesse of the skinne

hastely at one time without ceasing: for out minde is to vse no violēt thing in this our work. And truely in little tumours, that is, in small strumae, make but a simple incision, or diuide them with a small line; but in great abscessions cut the skinne to the forme of a myrtle leafe: then those vesselles which are vncouered (as the veynes and arteries) put them softely and easily aside. After these thinges, distend and stretch out the sides of the section, or the edges of the diuided skinne, with pinsers, or with other such instruments, and plucke out the filmes within, either with your fingers, or with some other instrument appointed for that purpose, and so by little and little picke out struma, where it appeareth bare and vnfolded from the tu∣nicles. But if struma shalbe wound about the vessells, you must handle the cure with great attention, least through negligence, there followeth a copious profusion of bloud. There∣fore in dispatching this cure, drawe one onely side of the section at once with the pynsers, and so by little and little seperate it with the poynt of a penknyfe from the other partes ther∣unto adioyned, and when you haue drawen and loosed the connexion on the one side, doe the like also on the other side, and then cut out the whole foundation or ground worke be∣cause of the sinowes and vesselles lying vnderneath. But in those strumae, which do chaunce about the armeholes, and about the pryuie members, you must make an ouerthwart inci∣sion by reason of the doubling of the skinne. Moreouer in that section, which is made in strumae that possesse the necke, you must haue a singular care, least either the arteries, which they call carotides, or the quiuering sinowes be touched and hurte. But if by the cutting of any vessell when you make incision, the profusion of bloude doth delaie and hinder your worke, either take vp the vessell with a small corde, or (if it be not verie great) cutte it quite of (as Paulus counselleth) or else, (if it bursteth not out with great violence) applie such remedies, as are appoynted to stench the bloud. Afterward returne againe vnto your enterprysed labour. Therefore, when the foundation of struma is brought into a narrowe roome, cutte it cleane of, cunninglie and handesomlie, and then put in the forefinger, and searche the place diligentlie, wheather there be any other strumae thereunto adioy∣ned or not, which, (if there be anie founde) you must also drawe forth after that manner, which we haue before expressed. Moreouer you shall easily represse a meane fluze of bloud by applying those thinges which haue power to drie vppe, as flaxe, sponges, or lynamen∣tes made of cotten, infused in colde water, or in vineger, or in a mixture of both, (which they call oxycraton) and afterwarde wronge out. But if the section shall continue without bloudeshead, fill it vp with the powder of franckensence, and applie linymentes, and for the longer preseruation of the lynimentes,* 1.516 bynde to woll dipped in winne. But if anie full veyne worthie the speaking of, be connexed within the roote or bottom of Glandula, or struma, or some such like tumour, it is not conuenient to cut it of at the verie ground, but to take it vp and binde it with a small corde, that it may fall out of it owne accorde: peece by peece without any daunger. In which fall the cure must be followed with lynimentes, But the corde must be of some matter, which will not easily putrifie, as are those threedes which are called serica,* 1.517 or small lute stringes: for those bandes which doe quickely rotte, doe sone fall from those members whereunto they are tyed. But if when the worke is fini∣shed, some of the skinne that couereth the matter of the former abscessions, or some o∣ther strang thing shall remaine behind,* 1.518 Albucasis willeth it to be drawen out, first by filling the wounde with cotten, or with some other like thing, dipped in salte water. But Gui∣do, to drawe out those relickes which remayned behinde did fill vppe the gaping vlcer, first with the white of an egge, and with Alume sprinckled ouer it, afterwarde with vnguen∣tum Aegyptiacum, or with some of those corrosiuing medicines which are descrybed in the Antidotarie. Moreouer in all these operations, you must applie such medicines as can leni∣fie payne, but among all other thinges we doe commonly lay on flaxe dipped in the whyte of an egge, and in oyle of roses. You shall finish the scope of our fifth rule after this sorte: breake the skinne with some burning hote medycine according to the greatnesse of the Ab∣scession,* 1.519 but while you attempt that thing, you must giue diligent heede, least the scal∣ding medycine doe touche the other partes lying about the tumours. You shall no∣tablie dispatche this labour,* 1.520 by applying some hote medycine made of lyme, of sope, which thinges doe happelie execute their effectes with in the space of twelue houres,

but though they remaine somewhat longer, yet there will ensue no daunger or discommo∣ditie thereby. The skinne therefore being thus broken by some burning medicine, & crust procured in the place, you shall deuide the tumour with a straight line all a long through the middest of the crust (but you must make incision somewhat deepely, almost to the ve∣rie quicke) and then lay vpon the cut, or gaping wounde, a lyniment striked with some consuming or eating medicine, as is, the powder of Asphodelus. Moreouer although manie do apply a great number of medicines in these abscessions:* 1.521 yet Arsenicke in this case ob∣tayneth the preheminence, so that a man knowe howe to vse it aright. But the certaine quantitie of vsing the same can not be described (as Galene hath noted. lib. 3. Therapeut.) It is not therefore to be vsed rashly, because it is a medicine vehement and violent without measure, exciting feuers, and procuring manie other vitious symptomates. Besides that also the ministring of a small quantitie doth perfourme a maruelous and almost an incredible ef∣fect,* 1.522 notwithstanding the common measure or quantitie thereof is the medietie of one graine of wheate, in a strong bodie, and in those members which are farre of from the prin∣cipall partes: but in weake natures, and in those places which are situated neare vnto the principall members, a lesse quantitie must be applied. But to be short, it is better, and more safe to minister a little at once, and often, then at one time to applie an immoderate quantitie. The operation or effect of Arsenicke remaineth three whole dayes, in all which time the sicke must vse the diet of them that are feuerous. But the affected member, and the partes lying about the same, both for the owne defence, and to stoppe the fluxe, (which immoderate heate may cause) ought to be annointed and all to washed with the ointment called populeon, with water also, or with the iuyce of nightshade and with vine∣ger, and with other refrigerating remedies of the like kinde. But when you are certaine∣lie assured, that Glandula is destroyed and wasted away (which you shall know by the hard∣nesse and swelling of the procured crust) then the crust must be resolued euen from the quicke, by washing it with butter, and by applying a little wheate meale thicked together,* 1.523 or by some other fat and vnctuous thing that is not salted, as swines greace and such like. But when the crust is fallen from the tumour, if anie thing either of glandula, lupia, or stru∣ma doe yet remaine behinde, it must be fetched out with some gnawing medicine, as with the powder of Asphodelus, with vnguentum Aegyptiacum, or with some such like thing. But if there remayneth nothing behinde it must be brought vnto a scarre after the manner of other vlcers. But nowe, that wee may also accomplishe the intention of our sixt ca∣non: [ 6] these abscessions which haue verie narrowe bases or foundacions, must be fast bound either with a corde of silke, or with horse hayre,* 1.524 and they must be bound daylie more and more, either with the former bandes, or with other newe cordes, vntill they ap∣peare verie drie, and voluntarilie doe fall awaye of their owne accorde, (as wee haue sayed of those Abscessions, which are deepelie planted, and foulded, about the great ves∣selles.) But the bande must be ayded with some consuming and drying medicine. The paine also must be asswaged with the white of an egge, with oyle of roses, with vnguen∣tum populeon, or with some other remedie that can mitigate payne. But when the cordes shall fall of alone of their owne accorde, the tumour must be cured after that manner, which wee haue before expressed. And thus much generally concerning those Absces∣sions which vniuersallie consist aboue nature, especiallie of them that haue their ori∣ginall of fleume. Nowe wee haue here thought it conuenient, to set downe the pro∣per and peculiar methode of Curinge Melicerides, Steatomata, and Atheromata, which diseases are alwayes and often incident to mennes bodies, and doe comprehend vnder them other certaine kindes and differences of tumoures besides nature, called of the late Phisitions after certaine newe titles and names, which among the auncient sort were neuer hearde of, as Talpa, Testudo, Nacta, and others of that kinde, which wee haue expressed in our former Chapters. In those three kindes of Abscessions,* 1.525 which do most frequent mennes bodies, (I meane in Steatomata, Atheroma, and Meliceris) there is one generall order of their Cure, namely, that that matter, which is contayned in that tunicle, which they call Cystis, may be discussed, or that the whole tumoure together with the verie tunicle, may be consumed by medicines, or taken away by section. But some of those Tu∣mours

require a three fold method of Curing,* 1.526 as these, which containe a more liquide hu∣mour as is meliceris. Some againe are cured two wayes, as Atheroma, which is destroyed by section, and consumed by medicines. But Steatoma can neither be discussed, nor consumed: but it is cured by the onely labour of the hand (that is) by section onely. Moreouer of medi∣cines, which in these affectes haue power to discusse and dispearse, you shall find plentie a∣mong those remedies,* 1.527 which we before haue set downe for the cure of strumae. But Paulus doth perticulerly and properly discusse melicerides with that medicine, which conteineth, of pressed grapes (the kernels being taken out,) xx. of the scourings of brasse. ℥.iiij. which medicine must not be applied before the member be nourished with foments. Another em∣plaister appointed for melicerides,* 1.528 which Aetius reported vnto Leonidas. ℞. of pressed grapes, (the kernels being detracted. lb.j. of comin seede beaten verie small. ℥.vj. of nitrum. ℥.iij. bray all togither in a morter, and bind them to the tumour. Another discussiue medicine ex∣pressed of the same writer, verie profitable against melicerides. ℞. salis ammoniaci, of the scou∣rings of siluer, and of Ceruse. ana. lb.j. of wax, Terchinthina, chalbana, opoponax. ana. ℥.j. of rubrica sinopica. ℥.vj. of vinegre. ℥.vij.ss. boile the scourings of siluer, ceruse, and salt beaten very small, altogether, then cast in the rubrica sinopica, which first must be steeped in vine∣gre, and melt them togither, last of all, when they be all boyled togither and cold, commix therewith op••ponax and chalbana, both dissolued in vinegre, and conserue them to your vse. But if in such kinde of Abscessions you mind to wast the humour by applying of gnawing medicines (which the Grecians call Septica) it is expedient first to vncouer them (as also in struma) by hote burning medicines applied to the skinne,* 1.529 whereof (saith Paulus) the best remedie is that, which consisteth of quick lime (that is) which is not yet quenched with wa∣ter of sope, and of the ashes of lye that are made in a stillatorie. There is another more di∣uerse remedie, which may be kept a long time. ℞. of vnslaked lime. ʒ.iiij. of sphecle, (that is) of the burnt dregges of wine, of liquide nitrum parched in the fire. ana. ʒ.ij. of minium or ru∣brica sinopicae. ℈.j. Let them be brayed with the distilled ashes of lye, and when you haue brought them to the thicknesse of liquide honie, heate them thrise ouer the fire, that it may be of a meane substance, and lay on pixis plunubra, with the distilled lye aboue, left it dry vp to soone. Therefore first breake the skinne that is beset with such medicines, as can procure a crust: but when the crust is falne of, apply consuming remedies, among which this reme∣die following doth notably wast without gnawing and biting. ℞. of the offall of brasse. ʒ.iiij of Sandaracha (that is) of red arsenicke,* 1.530 and of Helleborus niger. ana. ʒ.ij. apply them with oyle of roses. Another remedie verie effectuall for the same purpose. ℞. of a burnt hedghog, of Testasepia, and of orpine or arsenicke. ana. an equall portion. Commix them with oyle of roses. But the partes which lye about the tumour, and are adiacent therunto, let them be first annointed with ceruse and oile.* 1.531 But if we purpose to cure these kinds of Abscessions by ma∣king incision (that is) by Chirurgerie: truly in that method of curing (whether it be a mealie humour, or a hony, or a fat humour, or of what substance soeuer it be, which is contained in them) we must obserue one only and perpetuall intention, (namely, to take away the tunicle wherein the humour is included.) But in enterprising the same, we must be verie attentiue & warie (as wee haue saide before of strumae) that we rashly hurt not and teare in peeces the filme or tunicle, whereupon the humour, which was contained therein, gushing out plen∣tifullie, doeth both hinder our operation, and some portion thereof also remaineth still behinde. For if (when the tunicle is deuided, and the humour issued) the tumour shall sinke downe, the tunicle will hardlie be plucked away and cured. But if anie remnaunt of the humour be lefte behinde in the Abscession, it is to be feared, that the disease will growe a∣gaine (as doeth struma) when as anie portion thereof sticketh behinde. But if anie such thing doeth happen, it is not expedient to sowe together the Abscession, but to drawe out the relictes thereof either with those consuming medicines, which we haue before expres∣sed, or by some such like remedies. Nowe if steatoma hath a verie broade toppe, and a ve∣rie narrowe and sclender foundation, then (setting aside all other superfluous remedies) you must cut it vp quite euen by the verie roote,* 1.532 for so the labour of the Chyrurgian shall quicklie be ended, the vlcer made plaine and equall with the other partes, and the Cure shortlie dispatched.

CAP. XXV. Of harde and Scirrhous tumoures, ingendred of melancholie.

WE haue hitherto discoursed of those tumoures which are caused of bloud, cho∣ler and fleume: of Ʋerrucae also, and of those abscessions, which are excited through a waterish humour and a flatuous vapour: of those Apostemes also which haue their beginning of a phlegmaticke substaunce, and of other tu∣moures generallie consisting aboue nature. Nowe it remayneth that wee in∣treate of those Abscessions, which doe proceede of a melancholike humour, as are scir∣rhous, indurated and cancerous tumoures, which they call Cancerosi apostemosi. To Scir∣rhus therefore (as also to phlegmone, Erysipelas, and Oedema) there is assigned of the late Chirurgians a double difference, which notwithstanding is comprehended vnder the same title, vidz. Scirrhus verus, & Scirrhus non verus.* 1.533 But a true and lawfull Scirrhus is saide to proceede of naturall melancholie. Also naturall melancholie is the dregges of good bloud, and as it were a certaine slimie superfluitie, and verie grosse bloud, whose colour is blacke,* 1.534 but the tast thereof sharpe and soure (as it is not vnknowen to them that doe vomite the same) it is lodged in a certaine bloudie corner, wherein all the humoures are contayned, and appointed of nature to nourish the melancholike members.* 1.535 But an vnlawfull Scirrhus after the opinion of the late Chirurgians, is that which is ingendred of vnnaturall melan∣cholie. And vnnaturall melancholie is that, which differeth from the former description of the naturall humour, and yet it keepeth within the precinctes of his libertie, which if it shall once pretergresse (they say) it is no longer to be called melancholie, but some o∣ther humour. But melancholie (to enter into the generall definition thereof) is a colde and drie humour, proceeding (as Guido sayeth) of a verie grosse portion of that which wee call Chylus.* 1.536 But of vnnaturall melancholie there are commonly appointed foure dif∣ferences. The first is, when as that melancholike humour, which is called naturall, and doeth daylie ingender in the bodie, euen when a man is in perfect health, is in his owne proper essence, burned, putrified and become exquisite melancholie.* 1.537 For that (as Galene sayeth) is ingendred of a blacke humour, that is vehemently burnt, and it glistereth like vnto lime and pitch. But this is soure, and being powred on the grounde, it is hoate like vinegre, and it riseth vp like leauen. It is also verie vnpleasaunt vnto all creatures liuing, so that neither mice nor flies will tast thereof. It sheweth likewise, like vnto aboundaunce of salt, wherein no liuing thing can vpholde his life, as the sea which is sayed to be dead. Furthermore this blacke kinde of choller is then ingendred, when as that slimie bloud,* 1.538 (which we haue said to be naturall melancholie) doeth continue long in the bodie, and is purged out neither by anie sensible nor secret effluxion: but is transformed, corrupted, and rotten. For truely this humour (sayth Galene) when it waxeth vehementlie hoate, either because of the corruption thereof, or because of a burning feuer, it causeth melancholie:* 1.539 which truely is cold because it resembleth the nature of the earth, but yet it is not voide of heate, as is ashes and vinegre, and when it is purged downewarde (as it happeneth some∣time to them which are diseased with Dysenteria) it appeareth more glistering and more blacke then that thicke and blacke bloud, which we doe call a melancholious humour. 2. The second species or difference of vnnaturall melancholie is that,* 1.540 which commeth through [ 2] the adustion of other humoures, as that which proceedeth of choler vehementlie burnt, which is of so great malice and rancour, that it raseth the earth, and lifteth it vp on high, after the manner of exquisite melancholie. But the flyes also doe abhorre it, as in a trewe melancholie. If bloud also or fleume shall be vehementlie heated in the bodie, and burnt, there is also caused a melancholike humour, which Auicene because of the adustion tearmed to be vnnaturall. But these two last kindes, which doe come of the adustion of bloud and fleume, Auicene hath thought to be verie milde and gentle, yet Galene writeth, that that kind of melancholie, which is ingendred of burnt choler, is a great deale more daungerous then that which hath his generation of grosse bloud,* 1.541 which is like vnto the

dreggs of wine in the bottome of a vessell, or in proportion resembling the dregges of oile, for this is more gentle & milde, yea and especially when as it tarieth not long within the bo∣die with any aboundaunt heate exceeding nature. But before it be chaunged into exact melancholie, it passeth first into a yellowish forme, secondly into a leekye substaunce, and [ 3] thirdly into a rustie colour. 3. The third species of vnnaturall melancholie is that, which bo∣roweth his originall of a certaine stonie concretion,* 1.542 as when through the ignorance of vn∣skilfull Phisitions or Chirurgians, Erysipelas, and those inflammations (which the Grecians call phlegmone) or anie other tumours proceeding of naturall humours, are too vehemently cooled and bound by the applying of extraordinarie remedies: or else when those medicins which do mightely drawe & digest, are ministred to the same tumours. For then (the whole substance which was verie small in them, being dispearsed) the grosse matter which remai∣neth, being exceedingly dried, will resemble the hardnesse of a stone, & be conuerted into a [ 4] melancholious humour. 4. The fourth difference of vnnaturall melancholy ariseth, when as some other humour is mixed with naturall melancholy,* 1.543 which thing, while it happeneth, it is made sweete, & doth wax mild, vntill such time as one burnt choler or other be commixed therewith, for then it waxeth sharp, and bitter, & is made pertaker of immoderate gnawing. We may gather therefore by our former words, that the foure differences of tumours aboue nature do proceede of melancholy: for first of naturall melancholy (which we haue said to breede dayly in found bodies) there is caused a true and lawfull scirrhus, called among the Arabians seph••ros, but of the Greekes 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 & 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 (that is) scirrhus or scirrhus non exactus, seu non exquisitus, which kind of tumour truly is very hard, & void of paine, but yet not altogither insensible: Auicene calleth it impurus. Yet Galene lib. 14. meth. med. pardoning them which do contend about the names of tumours, calleth it a tumour conflated of a me∣lancholious humour, and then properly scirrhus, whenas notwithstanding it is expert of any feeling or sense, but if it be not yet made altogither insensible, it is rather to be called a scir∣rhous tumour,* 1.544 then scirrhus it selfe. Secondly of vnnaturall melancholie through the admix∣tion of other humoures there doe growe three other differences of tumoures (that is to say) Scirrhus phlegmonodes, oedema••ode, and Erysipelatôdes, which diseases are here re∣hearsed for one onely difference. Thirdlie of vnnaturall melancholie caused through a cer∣taine stonie hardnesse,* 1.545 and concretion, there is engendred an exquisite Scirrhus, harde, and voide ofe sence and paine, it is called of Auicene purus, which euill admitteth no cure. Fourthly, of vnnaturall melancholie thorough deustion, are all the kindes of Cankers ingendred,* 1.546 as well vlcerate, as not vlcerate: of the which kinde is Scirrhus canerosus. Scirrhus therefore properly is a Tumour verie harde and without paine, but yet not al∣together without feeling, proceeding of a naturall melancholie, and vncorrupt humour, which definition the late Chirurgians haue assigned thereunto. The causes of Scirrhus, as of other tumours besides nature are three. First Primitiue, as is an euill diet, ingen∣dring and gathering grosse and melancholike bloud. Seconde Antecedent, as a me∣lancholike humour collected in the bodie, which is drawen from the spleene (whose due∣tie it is to purge the liuer from that grosse and muddie bloud) and yet is not expelled with∣out the bodie (as it ought to be.) Thirde, Coniuncta causa, is the melancholike humour it selfe,* 1.547 compacted in the affected member. The signes of Scirrhus his presence (as Guido reporteth) are these, a hard tumour, & mightely resisting, a middle colour betwene a red and a blacke, which is a browne colour. This Scirrhus when it happeneth in the parts of the bodie,* 1.548 manie of the Phisitions (as Galen saith) do call it pelidnon, that is to say, black and blewe. Morouer if thaffected member hath any manifest veines appearing in it, you shall see them puffed vp and swolne by the meanes of thicke and blacke bloud, such as is some∣time purged downward in them which labour with the disease of the liuer, but then it is cal∣led scirrhus impurus & cancrosus.* 1.549 For these signes which Guido doeth here ascribe vnto scir∣rhus, do properly agree with the signes of Cancer (as Galene writeth decimo quarto methodi medendi.) And truely they may verie fitlie be attributed vnto Scirrhus, if this one thing be excepted, namely, that Scirrhus hath not such swelling and full veynes, as Cancer hath, except Scirrhus (as wee haue sayed before) chaunce to be cancrosus, for Scirrhus doth oftentimes degenerate into Cancer, & that not without great cause, seeing they both

proceede of one matter (that is) of a melancholike humour. The proper signes therefore of a lawfull scirrhus are these, a harde and stonie tumour, verie obstinate and resisting tou∣ching, wherein there is present a verie dull sense. There doe also appeare manie other signes which doe testifie the dominion of a melancholie humour in the bodie.* 1.550 Such tu∣moures as are truelie scirrhi, in their beginning and first conception are wont to appeare verie small, but in processe of time, they increase by little and little, and become great and mightie, whereof some doe annoy one onelie member, but some doe leaue that member, which they did first infest, and afterwarde doe passe ouer to the possession of another, which thing when it happeneth, then Auicene calleth the euill ferinos. Furthermore,* 1.551 these kindes of melancholious tumoures, if they be rightly handled, they are commonly cured by reso∣lution, oftentimes they continue indurated and hard, and many times (which is worst of all) they degenerate and chaunge into Cancer.

But nowe wee will prosequute the absolute cure of these kindes of harde tumoures a∣boue nature, which are called true Scirrhi, and not exquisiti, by three speciall intentions.* 1.552 The first prescribeth a conuenient order of diet. The seconde admonisheth to take awaye the antecedent matter, which is readie to procure the disease. The thirde warneth vs to enterprise the vacuation of that coniunct matter (as they call it) which nowe causeth the euill. Therefore (to speake generallie) you must appoint to them which are diseased with scirrhus a sober and a moderate diet, and such a one as declineth vnto heate, and moysture in those thinges (which they call res non naturales) as before. Giue him therefore meates of good iuyce, and which can ingender good bloud. Let his bread be made of wheate, well knodden and baked in an ouen with a soft fire, and let it haue some leauen, and salt, as much as shall suffise. Let his drink be thinne, and odoriferous wine, eschewing that which is thick and black. Giue him rere egges, the flesh of chickens, capons, hens and the brothes of them. Let him also eate the flesh of partriches, pheasaunts, quailes, yong kiddes, sucking calues, & of weather of a yeare old. For potherbes, let him vse that which the Arabians call Aspa••ar, but we somewhat altering the name, do call it spinach, also lettuse, hoppes, borrage, bu∣glosse, and other herbes of that nature, which can purge foorth bloud, and make it more pure. To conclude, let him flie and auoide all those thinges, which naturallie doe ingender melancholike bloud, which things Galene libro tertio de affectis capite sexto, hath described vnto vs, as are, the flesh of goates, and of oxen, and of bulles,* 1.553 but especially the flesh of Asses and of cammelles, of foxes and of dogges, of hares also and of bores. Furthermore snayles, (if they be accustomed to be eatē) & the flesh of all terrestriall creatures seasoned with salt. The flesh also of fishes, as of the Tunie, of the fish called Balaena, the sea calfe, the Dolphin, the dogge-fish, and of all kinde of whales. But of potherbes,* 1.554 Coolewortes is wont onelie to ingender this kinde of bloud. The buddes also of trees, when they are seasoned either with brine, or with oxalme, especiallie of the tree called a mastixe tree, of the Terebinth, of the brier, and of the wilde eglantine brier which the Greekes call Cynosbatos.) But of all kinde of pulse lintles chieflie are accounted amongest the number of melancholike meates. Bread also made of branne,* 1.555 and that which is made of Rye and of other cor∣rupt and naughtie seedes, which other Countries doe vse in steede of corne. Moreouer, thicke and blacke wines are verie fitte to engender a melancholious humour: especiallie if one drinking them aboundauntly, doeth by occasion keepe his bodie in great heate. Finallie olde cheese, when as by chaunce it shall be exceedinglie hoate in the bodie,* 1.556 doeth easilie breede this kinde of humour. These thinges haue we hitherto recited out of Galene. Furthermore you must diligentlie beware of meates that are burnt, rosted,* 1.557 and fried, which doe vehemently drie vp, of salt meates also, and of those which are sharpe and soure (as onions, garlicke, pepper, mustarde, and of other thinges of that kinde, which do burne the bloud. You must also eschewe, anger, wrath, sadnesse, watchings,* 1.558 hea∣uinesse, carefulnesse, and immoderate exercises. Quietnesse and tranquillitie of minde, with mirth and gladnesse is greatly to be desired: and you must diligently endeuour, euerie day to emptie the belly. Hitherto concerning the first scope. 2. Now that we may accomplish that, [ 2] which our second intention doth propound:* 1.559 let vs somewhat consider the precept of Aui∣cene, who willeth vs to euacuate the whole body both by bloudletting, if too black & grosse

bloud shall appeare, and also by some purging medicine, which can expell melancholie as are these which followe, out of Mesua, Epithyntum, Sene, polypodye, fumus terra (which of the Grecians is called Capuos or Capuios, of the Latines fumaria) lupulus, and the herbe called volubilis. Also Casia fistula, myrobalani Indi, lapis lazuli, which the Greekes call Cya∣neus, the Romanes Caeraleus, Diasene, diacatholicon, hiera Ruphi, all which things do purge foorth melancholike humours. But these thinges, which pertaine vnto Phisicke do exceede the boundes of Chirurgians. Omitting therefore the professours of the art of Phisicke, we will hasten vnto the third scope, which we shall verie speedily dispatch, if we labour to em∣ptie [ 3] out all that matter, which vnnaturallie is compacted in the aggrieued member. Which, truly is the generall and principall indication of all tumoures which consist aboue nature:* 1.560 in which that leekie matter (as wee haue sayed before) is not yet ingendred. But this is the onelie and proper waye to euacuate them, about the which the Chirurgian ought to be verie circumspect and attentiue. For truelie the matter of such kinde of tumours, is na∣turallie so malignaunt and stubborne, that it will turne into a stonie hardnesse if it be rash∣ly resolued.* 1.561 Againe, if it be mollified more then is requisite, it is greatly to be feared, that it will putrifie and corrupt, and that Schirrus will degenerate into Cancer. We must there∣fore in this case followe the counsell of Galene and Paulus (who wrote of this thing long before Auicene.) Namely, that in such schirrous affectes, wee must not apply anie vehe∣ment, hoate, and drying medicine, neither any thing else, which hath the power onelie to mollifie and moysten. For that tumour, which hath a superfluous humour, it doth nothing at all dissolue: but that which hath a small fluxe, it doeth more drie vp then neede requireth. Hereupon Auicene did well admonish vs, to apply to these indurated tumoures by turnes, sometime mollifying,* 1.562 and sometime digesting remedies. But because that order was very tedious, and hard to be done, it pleased Galene to vse for the cure of these euilles, such medicines as h••d a mixed and a double facultie, which deuise was more safe and lesse daun∣gerous. For by this meanes we shall both mollifie and digest the indurate and harde sub∣staunce all at one time: yet in the beginning we must commix something with them which can moderately represse. For this purpose, Auicene hath set downe manie kindes of reme∣dies, which, because they are rather appointed for those Schirri, which proceede of phleg∣mone and Erysipelas when they be exceedingly cooled (as wee will declare in the Chapter following) wee will omit them,* 1.563 making choise of that medicine which Razis libro septimo ad Almansorem hath described: vsing notwithstanding at the beginning some equall re∣pression of the flowing of humours (by applying some moderate repelling remedy.) The forme of the medicine is this. ℞. of Bdellium, Ammoniacum, and Galbanum. Of eche a like quantitie. Beate them in a morter with oyle de ben, which the Greekes call balanum myrep∣fice, the Latines, Glaus vnguentaria,) or with oyle of lillies. Then take of the filth of fe∣nugreeke, of lineseede, and of figges: the weyght of all the former thinges. Bray them altogether, till they be thoroughly incorporate the one with the other. Galene for this cure both greatly commendeth the barke of the roote of Althea,* 1.564 (which the common sort, saith he, doeth call Anadendromalache, as though one woulde say, arborescent ma∣lua) melted with the fat of a goose or of a cocke, and then beaten togither, and brought in∣to the forme of a cataplasme. But if the tumour doth belong vnto suppuration, you must be verie warie,* 1.565 lest the affected member be incended or stirred with hoate medicines, or by anie other meanes, for so Cancer should easilie be procured. But if the tumour be ope∣ned, and the substaunce thereof alreadie tourned into matter, you must vse the helpe of that ointment, which is called diachylon. Againe, if it shall degenerate into a stonie hardenesse, you must straight way repare vnto those remedies which shall be described in the Chapter following.* 1.566

But nowe when as thorough the vnskilfulnesse and ignoraunce of Phisitions, those inflammations which, the Grecians call Phlegmonae) or Erysipelata are exceedinglie refri∣rated, or else rashlie resolued thorough the ministring of such medicines, as can vehe∣mentlie drawe, and digest by their vapour: then all that substaunce which is anie thing thinne and sclender in them, if dissolued, but that which remayneth behinde, beeing as it were congealed togeather, and maruelouslye dreyed vppe, doeth take vnto it a

stonie hardnesse, and at the last commeth to that disease,* 1.567 which is called of the Greekes scirrhus. But it chaunceth sometime that some member is hardened thorough extension of the fleshe, which commeth by reason of wine or by some other waterish humour (as wee haue saide before in our treatise of flatuous and waterish tumours.) Oftentimes al∣so there aryseth vp in certaine members a stonie hardnesse, caused of the priuation of the moysture of the bodie and thorough too much drynesse, as it happeneth in the hardnesse of the ioyntes, and in the poores of the bodie when the goute or such like diseases do raigne. But here we will onely discourse of scirrhus, or of other harde tumours, which haue their originall from phlegmone or erysipelas or else from aedema, when as they be greatly refrigerate and cooled, which tumours we haue termed not without some reason scirrhi ex coinciden∣tia procreati, (that is) scirrhi proceeding of an vnitie,* 1.568 being as it were a double disease in∣cident both at one time. The signes and tokens of an vnlawfull scirrhus, which is not ex∣quisite or perfect, are these, a harde tumour, scarce sensible that is, as though it were with feeling and payne, parfitlie representing the colour of the bodie, drawing his beginning from vnnaturall melancholie. This euill is not altogeather incurable, and yet it admitteth no easie cure, neither is it easely remedyed. For that humour, whereupon this euill gathe∣reth his force is clammish, glewish and thicke, or (as Galen sayth) a partaker of both kinds,* 1.569 which when it is stuffed in the hard members, it doth obstinately withstand resolution, and when the humiditie thereof is throughlie resolued, then that which remaineth behinde, is dryed vp, and made as harde as a stone. But an exquisite scirrhus,* 1.570 and such a one as is alto∣geather insensible, doth not receiue any cure. But if it may be holpen any way, it must be done by some moystening medicine. That hardnes also which commeth through too much exciccation, and when the moysture of the bodie is cleane extinguished, is also incurable, for it is sufficient if you stoppe it, that the drynes may proceede no further. But those scirrhi also, wherein there do grow certayne heares, and which are great, and verie hard,* 1.571 and doe resemble the colour of the bodie are neither cured, not yet chaunged at any time into any other disease (as Auicene hath declared.

The common and generall declaration of curing these tumours, is in this order described (namely) to euacuate all that matter, which vnnaturally is contained in the member.* 1.572 For the only waie of euacuation (as Galen hath noted lib. 14. meth. med.) is this, euen to clense and draw out that corruption, which stubburnely doth cleaue to the humour. But if anie man shall assaie to make euacuation by those medicines which do vehemently draw & di∣gest, neither shall mollifie and soften with any drying and moistning remeadies, the cure shall seeme to him within few dayes greatlie to haue preuailed, for scirrhus will manifest∣ly appeare to be deminished. But that which remaineth of the disease, will be incurable, for truely when the whole substaunce, which is verie thinne in the tumour, is digested or dis∣persed, then that which remaineth behinde, is turned into a certaine stonie concretion. For this cause therefore there is no medicine that doe vehemently heate or drie vp, meete and conueniet for these hard & scirrhous affectes, but such remeadies only,* 1.573 which can fitly both mollifie, and also digest: as are these things following: the marow of a harte and of a calfe, also goates suet, bulls suet, the tallow of a lybard and of a lyon. Among the fatte of byrds,* 1.574 gooses greace is chiefly commended, next that the fat of a cocke and of a phesaunt. Also ammoniacum thymiama, (videl.) suffimen, perfume galbanum, and bdellium of both kindes,* 1.575 but rather that which is called scithicum, because it is somewhat moyst. Styrax also, which is something moyst and fat. Moreouer the rote of althea, and of the wilde mallow, which groweth almost euerie where, the leaues whereof must be moderately boyled with gooses or cockes suet, or if there be none of those at hand, you may vse swynes greac, these reme∣dies are greatly profitable for this intention. But Auicene warneth vs not to commix anie hogges tallow that is salted, with the former thinges, and to vse mastiche, ladanum, oyle of wooll, strygmenta gymnasiorum, (which they call the filthines of bathes) asses dounge, and the dregges of oyle of lillyes, of oyle of alchanna which they call cyprinum, and of cherna, which of the Greekes is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, but of the Latines ricinium.* 1.576 But that cure which is administred by vineger is profitable for this euill, that is for scirrhus which is full growen, and when the member is prepared to receiue mollyfyng medicines, as Galene also hath de∣clared,

for truely saith he, the force of vinegre, if it be vsed moderatly and in due time, is ve∣rie holsome for these diseases,* 1.577 because it doth diuide and resolue the grosse humours inclu∣ded in them: but if it be applyed immoderatly and out of a conuenient season, it violentlie consumeth the thinner partes, and maketh that, which remaineth behinde, to become ve∣rie harde, also if it be vsed longe, it will diminish and corrupt the verie substaunce of the sinowes. For this cause therefore, we must not verie often nor at the beginning, nor a∣ny long time, apply those medicines to the great sinowes or cordes of the bodie, which are compounded and made of vineger. Wherefore Galene did cure the childe of one Cer∣cilius,* 1.578 who through to much cooling, and vehement bynding of erysipelas, had a hard and scirrhus tumour remayning in his thighe, after this manner. First he annointed his thighe, with oleum sabinum, which of all oyles is most thin, in steede whereof they vse in these daies olenum sambucinum, oyle of elder, which the common sort call iasminum. When he had thus washed & annoynted the member, he applyed amnoniacum thimiama, which must be grosse and not verie olde,* 1.579 commixed with the aforesaide suettes and marrowes. Afterwarde he annoynted his whole thigh rounde about with verie fatte ammoniacum, dissolued in excee∣ding sharpe vineger, and commaunded the childe to hoppe on the other legge, that so the more nourishment mought be brought vnto it. By such medicines therefore as coulde re∣lease and mollifie the tumour, & by digesting or resoluing remeadies also, and by the mo∣derate and right vse thereof, he perfectly cured the childe. But in those great sinewes and ligamentes of the bodie,* 1.580 which are drawen togeather and couered with scirrhus, you must vse vineger after this sort, as Galene counselleth vs. Take a stone, and heate it verie hote in the fire, and quench it in verie sharp vinegre, if it be possible, let the stone be that, which we call pyrites, but if there be no plentie thereof, take the stone called lapis molaris, which the Greekes call mylites, then let the affected member be holden ouer the hote vapour that ryseth vp from the ston•• out of the vineger, that it may receaue the steeming vapour, which doth dissolue scirrhus: and afterwarde lay one againe some mollyfying medicine: yet the affected part must be euerie daie euen from the beginning throughly annointed with oyle and not with water, which oyle must not be astrictiue in any case, but of a thinne substance, as is oyle of sauin. But sometime you may boyle in oyle the rootes of althaea, and of the wild cucumber,* 1.581 and other thinges of that sort, by this method of curing, many men truely haue bene perfitly healed in a shorte space, so that some haue thought it (as Galene sayth) to be done by the arte of magicke.* 1.582 By these thinges therefore it doth plainely appeare, that with that cure, which is accomplished by mollifying remeadies, aswell in the sinowes, as in the ligamentes of the bodie, you must commixe some medicine that can cutte, dissolue and diuide,* 1.583 among which number vineger is chiefly the principall. Now as concerning o∣ther medicines which can mollifie the hardnesse of these tumours, we haue spoken nothing hoping that they may easily be gathered out of our former discourse. Now followeth the summe of the cure of scirrhous tumour,* 1.584 which we haue drawen into a compendious forme hereafter ensuing. 1. That kinde of scirrhus, which hauing all his humiditie and moisture consumed and wasted, is growen into a stonie hardnesse, and is altogeather destitute of [ 1] sence (as is that which Galene calleth exquisitus scirrhus) of such a scirrhus, I say, attempt not the cure, but leaue it as an euill incurable. 2. To scirrhus non exquisitus (which is not [ 2] altogeather insensible, & yet scarce feeleth any thing) apply such medicines as carrie with them a maruelous heat, and a meane moisture (that is to say) which by mollifying, can also mederatly digest. 3. Vnto such members as are infected with scirrhus, minister no re∣medies [ 3] which do vehemently digest, and immoderatelie drie vp, for in them their small hu∣miditie is quicklie resolued, and then that which abydeth still behinde, is dried vp and tur∣ned into a stonie hardnes. 4. In hard and grosse members which are annoied with scirrhus [ 4] (as are the great vessels of the bodie) and in other places also, where the euill is inueterate, you must commix such medicines at haue power to cut and diuide, as is vinegre, with those remeadies which can mollifie and moderatly digest. 5. Also commaund, that this scirrhous [ 5] member which is hard and grosse, or anie other part besides, which is affected with scirrhus, be holden ouer the hote vapour of lapis molaris burnt in the fire and quenched in vinegre, [ 6] and let this be done often. 6. Furthermore let the aggreaued member be euerie daie an∣nointed

with some thinne oyle, wherin either the roote of the wild cucumber, or of althaea, or greene and fresh dill, or some such like thing hath bene boyled and infused, 7. Applie vnto the aforesaide scirrhous members such medicines as can drie, diuide, and resolue the [ 7] grosse humours moderatly (that is to say) neither often, nor anie long time, nor out of cō∣uenient season, that is, not at the beginning of the disease, to preuent the vse of mollyfying remeadies. 8. To conclude, all such scirrhous tumours, as are not indurated and of a stony [ 8] hardnesse, let them be cured with such medicines as can fitly digest and mollifie. 9. Last of all commit the cure of a scirrhous splene and a lapidous liuer, to the wisedome of the [ 9] Physition.

CAP. XXVI. Of a Cancerous Tumour, which thy commonly call Cancer Apostematosus.

THE name and title of the disease called cancer, among the Physitions & chy∣rurgians hath diuerse and sundrie significations:* 1.585 for the notifying or declara∣tion thereof is extended vnto two kindes of diseases (that is to say) vnto a cancerous tumour (which they cōmonly call cancer apostematosus aswell that which is euident and appeareth in the outwarde members, as that which is [ 1] hidden, and lyeth in the in warde and secret partes of the bodie, as in the hippes, the roufe of the mouth and in the pappes of a woman) the other significations partaineth vnto an vl∣cerate [ 2] cancer.* 1.586 But both these euils are ingendred of melancholie (that is to say) of such a humour, as resembleth the dregges of wine, & the filthines of oyle, which thing Gal. libro decimo quarto therapeutices, and in his little booke de tumoribus praeter naturam doth plainely testifie. Now this aforesaide humour, when it is quiet, milde, and gentle, it engendreth a secret or an inward cancer without any vlcer. But if it happeneth to be sharpe, fierce, and malignant, it gnaweth the skinne, and causeth a cancre with an vlcer.* 1.587 But here we will onely discourse of that kinde of cancre which hath his residence in the outwarde partes of the bodie, & of that which is not yet exulcerate, which also sometime (as Galen affirmeth,) is saide to be a priuie cancre. That cancre therefore, whereof we here intreate, is a harde tumour, vnequall, rounde, hauing the veynes rounde about it, swo••len and puffed vp,* 1.588 it is blue or browen, and (as Paulus sayth) it is more blacke in colour then in an inflamma∣tion, it is also hote, but yet not so vehement as inflammations are, it sodainely increaseth, and greatlie wearieth the sicke, & afflicteth them almost with a continuall griefe: in greeke it is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, and 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉,* 1.589 which title aswell the Latines as the Grecians haue assi∣gned to this disease of the fish called a crabbe, because the veynes about this euill are fil∣led and it stretched out, verie like vnto the feete of crabbes, descending from the round com∣passe of their bodies. But some haue giuen it this name, because it is verie hardly pulled awaie from those members, which it doth lay holde on, as the sea crabbe doth, who ob∣stinately doth cleaue to that place which it once hath apprehended. Moreouer this tumor doth also represent the colour of a crabbe, whose hue is verie blacke. But the first begin∣ninges of these cancres are sometime so confused and so small,* 1.590 that the common sort may be ignoraunt thereof: for when they doe beginne, they do scarce resemble the greatnes of a pease or of a beane. Wherefore it is no maruaile (sayth Galene) though the common sort doe not knowe them, for they be like vnto the little rootes that arise out of the earth, which are not discerned but of skilfull husbandmen. But afterwarde they growe vp into such a huge greatnes, & do bring with them so vehement, great, & manifest symptomates, that a childe may easily discerne them. Let no man therefore doubt of the name thereof, seeing all men with one consent do terme this kinde of disease cancer, because (as we haue saide) the veines in this euill doe swell one euerie side, and are greatly stretched out, and they doe represent the forme and likenes of a crabbe.* 1.591 A cancerous tumour (as we haue saide before) is harde and vnequall, which by the touching of it doth plainely ap∣peare. It hath a blue or browne colour, which is a meane betweene red and blacke, called

of the Greekes 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. About the place where cancre is lodged, there is felt a certaine bea∣ting or pulse, and as it were a pricking: sometime also (as Celsus saith) the tumour is a sleepe, and as it were deade. It maketh the veynes rounde about it to swell and ryse vppe, like vnto the cancre in the armes. Oftentimes also in some they are secretly hidden, and when the place is touched, it is felt in some verie painefull, but in other some it is contra∣rie. This tumour also is maruelouslie stout, and resisteth touching. Moreouer it hath in it a certaine straunge,* 1.592 and extraordinarie heate. Cancer or carcinoma generally is a grieuous and pernicious disease, for it can scarcely be healed any way by reason of the grossnes of the humour, neither can it be repressed or discussed, neither wil it yeald to any purgatiō, though it be throughout the whole bodie. The malice also of this disease is so great, that it con∣temneth all gentle and easie remeadies, putting furth but the middle finger to them (as the prouerbe is) but it must be stirred and chafed, and ouercome with verie vehement remea∣dies (as we wont to do in the euill called crabro.* 1.593) This disease is wont to happen in euerie part of the bodie, but especially in the vpper partes about the face, the nosethrills, the eares, the lippes, and about the pappes of women, and of those chiefly, which are not naturallie purged of menstruis. But cancres do also commonly haunt men, whose accustomed pur∣ginges are suppressed through hemorrhoides growing in the fundament:* 1.594 for by them, that grosse and thicke bloud (whereupon this euill taketh his first beginning) is wont natural∣ly to be purged out. Moreouer when this melancholious humour resembling in proportiō the dregges of wine, doth descend and flow into any member, and there abydeth compact togeather: it causeth sometime the disease called varices, and sometime it breedeth a can∣cre, as when the same is somewhat cooled. But when it is thrust out to the whole skinne, it causeth that euill, which they call elephans. Cancer therefore is a certaine particular ele∣phantiasis, which the common sort call lepra, the lepry. But the thicker and the blacker the bloud is whereof cancre proceedeth the more daungerous will the disease be. Now when cancre is full growen, as they say, and inueterate, it admitteth not any cure, except it be plucked vp by the rootes either by sectiō or by adustion: but those cancres, which haue their constitution in the inward partes of the bodie, doe not desire any such kinde of cure, as that auncient Hippocrates simplie the prince of Physitions hath taught vs very well in the A∣phorisme following:* 1.595 saying that it is not good to cure all inward cancres: for when they are cured, they doe soone perishe againe, but when they are not cured they remaine a longe time. For experience hath taught vs, as Galene witnesseth in his commentarie vppon this Aphorisme, that they which enterprise the cure of these cancres either by section or vstion, doe rather encrease their furie then abate it, whereby they shortly destroy those men, whō this euill hath attached. Those cancres therefore are onely curable which doe sticke in the outward part of the bodie, and which are exulcerate, and doe so wearie the sicke, that they willingly desire the diligence of the chyrurgian: and these tumours also do consist in those partes, which a man may cut and seare of hard by the rootes. Nowe when I name the roo∣tes of cancer,* 1.596 I meane as Galene affirmeth, those veynes which are full of melancholike bloud, and which euerie way are extended toward the places lying about the tumour. But of an vnulcerate cancre, there often proceedeth an vlcerate tumour, when as in processe of time, the humour doth putrifie, and the disease is couched in the vessels of the bodie, or else when it is stirred and made worse by medicines vnaduisedly ministred. This exulcerate can∣cre of all others is thought to be most vile,* 1.597 because it doth altogeather resist that true cure, which attempteth and worketh all thinges to bring the sicke member vnto health, for this tumour, to cure it perfitly and absolutely, doth require gnawing, sharpe, and vehement medicines: howbeit by such remeadies, as we haue saide, it is the more prouoked and stir∣red to anger, and therfore it cannot be, that it should either be lenified, or cured by them. It shall therfore be sufficient to hinder the encreasing of vnulcerate cancres, which as yet doe occupie the outward partes of the bodie, especially those which be great and inueterate, with drawing our skill frō any perfect cure, which thing Hippocrates also hath admonished vs of in his former Aphorisme. For those tumors which doe wearie the sicke without exulce¦ration,* 1.598 Galene also hath called them secrete & inwarde cancres wherein both their vehe∣ment heat, and their great pulse or beating doe threaten or foretell exulceration to ensue.

The cure of a cancre which is not yet vlcerate, but newly begone, hath three principall in∣tentions. 1. The first is to stop the generation of the melancholike humour.* 1.599 2. The second is to emptie out the melancholious humour dispersed throughout the whole bodie. 3. The thirde is to digest the humour which possesseth the affected member, and to strengthen, & confirme the diseased place.* 1.600 The first intention is finished by a iust and due obseruation of that kinde of diet, which is before prescribed in the chapter de scirrho legitimo. But a∣mong other thinges this is chiefly and principally to be obserued, (namely) that such nou∣rishment be giuen to the diseased, as haue vertue to refrigerate and moysten,* 1.601 and which doe engender good and slender iuyce: as are these the iuyce of bareley steyped in water & pressed, fishes of grauelly places, birds of all kindes, saue those which liue in fenny groūdes, the yolkes of egges, but especially of rere egges, (which the Grecians call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉) & other thinges of that sorte. But if any extreeme heate shall infest the aggreaued place, and yet without a feuer, you may safely giue him bullockes milcke, from the which the butter is taken, or else the whey of milke. Potherbes also, which haue a coole and moyst nature, as mallowes, orage, spinache, & when time serueth gourdes: citrons also and borage may be giuen him in meate. The seconde scope (which is to purge the whole bodie from that melancholicke humour,* 1.602 whereof this euill proceedeth) is accomplished by the applying of purging medicines which are appointed to euacuate melancholie, wherof you may finde plentie in the chapter of scirrhus: among the which epithymum (which the Romaines cal•• inuolucrum) as a present remedie doth obtaine the preheminence, whereof you must take foure drammes styeped in the whey of milke or in mulsa, (as Galene commaundeth lib. 14. meth. med. But this quantitie of epithymum, or somewhat more, must be offered euerie thirde daie, that the melancholike humour, which is gathered togeather in the veynes, and causeth the generation of cancre, may by little and little be emptyed and purged out, be∣cause it is impossible to euacuate all at one time. But we cannot alwayes prohibite the fluxe, least afterward the like humour be engendred in the bodie, and compact togeather in the veynes. The purging therefore of the antecedent matter must be attempted at the beginning, as it were by turnes, by the applying of some simple medicine: afterwarde, (if the matter so requireth and the ministring of simples doth little auayle) you may vse the helpe of some compound remedies, as is that medicine of Galene dedicated for the purg∣ing of melancholie, which consisteth of two and thirtie simples, or hiera Ruffi,* 1.603 or hiera A∣••icennae, which is made of blacke helleborus. But you must not desist from those former re∣hearsed purgations, vntill the whole melancholious humour which is stuffed in the veynes, be brought out, and vntill the member which is beset with this cancrous tumour, be tho∣rowghly reduced to his naturall state. But if nothing doe let it, as age and strength, it shall not be amisse in these cancres to let bloud,* 1.604 and then to purge (as we haue saide be∣fore:) and if they be women, you must labour to purge menstruys, if they be not aboue fif∣tie yeares olde (as Galene hath taught vs lib. 2. ad Glauconem.) This seconde indication (saith Galene) is the first and chiefe of all, for that which is put in the first place, doeth rightly chaleng the second degree. The generall manifestation therefore (saith he) of the cure of a cancre, consisteth in the spedie emptying out of that humour whereof this euill groweth, and in the prohibition and stopping thereof, and to foresee, (if it be possible,) that this melancholious humour be not collected in the veynes by the meanes of another. But if that thing cannot be brought to passe, you must euacuate the humour by turnes now some and then some, and you must also endeuour to strengthen the member, least the a∣boundaunce of the humours doe plentifullie flow vnto it. 3. The thirde intention, which is generall to all such diseases cōming of the flowing of humours,* 1.605 doth will vs to digest the humour, which lurketh in the affected member, and to roborate the same, least the humors aboundantly haue accesse thereunto: moreouer you must appoint a conuenient time to re∣pell that which is flowen, and that truely in the beginning, aswell in the verie time of pur∣ging, as before, but now, when the whole bodie is throughly purged, then may you law∣fullie endeuour to digest, and if there went before but a small and meane purging, then you must applie some remedie which hath a mixed facultie, that is to say,* 1.606 which can both re∣presse and digest. Nowe, that we may iustlie accomplish these intentions, we must make

choice of those medicines, which are of a meane force, and of a gentle qualitie, for such remedies are most conuenient for these diseases. For those which carie with them a weake and feeble power doe worke no effect (as Galen saith) but are easily ouercome:* 1.607 but such remedies as are strong and mightie, do vehemently either digest or thrust backe the thinne bloud which lyeth in the veynes: but the grosse and melancholike partes, which we haue likened before to the dregges of wine, they neither purge forth nor represse: but rather do make them more obstinate and more hard to be dissolued and discussed. Therefore to cure these cancres, but yet beginning, you must vse medicines of a meane & moderate strength, which neither their imbecillitie can be vanquished, nor for the vehemencie can mightily thicken the bloud. Furthermore you must apply (as it is saide) such medicines as are gen∣tle and which doe not gnaw or bite: because the malignitie of the euill through such vehe∣ment medicines is stirred, and prouoked, and made more fierce and sauage (as we com∣monly terme it.) But when the matter, whereof these cancres doe come, is for the most parte grosse and thicke and disobedient to resolution, and partener also with many other vitious humours, we shall deale sufficiently in this case (especially, when we feare the daū∣ger of chirurgie, and that the euill cannot otherwise be cured) if wee by the vse of the for∣mer remedies, which are made of burnt and washed metalles (as Galene counselleth) shall stop and hinder their growing and encreasing, especially, if they be great tumours: or else after the opinion of Auicene, if we seeke to defende them from vlceration. For the which intentions, Galene lib. 2. ad Glaucon. doth greatly commend the iuice of nightshade, and that medicine which is made of pompholygos,* 1.608 or that which consisteth of chalcites common∣ly called diapalma. Therefore Theodoriticus also for the same purpose, appointed the oint∣ment named diapompholygos, which is made of oyle of roses, of white waxe. ana. ℥.v. of the iuice of red pomegranates, and of nightshade. ana. ℥.iiij. of ceruse washed. ℥.ij. of lead burnt and washed, of pompolygos, which is commonly called tuthia, ana. ℥.j. of francken∣sence. ℥.ss. Galene also reporteth libro primo de compositione pharmacorum secundum locos, which booke is entituled of the auncient interpreter myamis, a certaine ointment inuented of Apollonius for vlcers appearing in the head, which the Greekes call achorae, which oint∣ment he affirmeth to be verie effectuall against these cancrous tumours.* 1.609 The medicine is this. ℞. of oyle of roses, or of vnrype olyues, hemina, which the Greekes call cotyle vidz. ℥.vij.ss. which must be infused or put into a leaden mortar, and stirred vp and downe with a leaden ladle, or else brayed with a leaden pestill so long till it waxeth thicke and blacke, resembling the verie colour of lead: then beate by the selfe alone, of lythargirum, lib. 1. of ceruse as much, and commixe them with the oyle, and make an oyntment. Moreouer how great the force of leade is in all such cancrous dispositions, especially that which is burnt and washed:* 1.610 all men may sufficiently know, which haue had some experience there∣of, and which haue studeouslie perused those thinges which Galene libro nono de simplicium medicamentorum facultate doth write of leade, which he himselfe calleth in Greeke molyb∣dos. For this cancrous disease Paulus and Auicene doe greatly commende the emplaister made of sea crabbes, especially if it be mingled with an equall quantitie of the scouringes of brasse. Take therefore of sea crabbes burned, and of the off all of brasse an euen portion, beate them to flower, & straw them vpon the tumour, or else laie on the ashes of the crabbes with a searce cloath or cerate. But the same Auicene willeth to plucke vp these little can∣cres hard by the rootes, or else to cut them of, and then to wring and crouse out the thicke bloud on euerie side, and afterward to seare the place with some hote instrument. For this doth dissipate the relictes of the matter, and consumeth them, it strengthneth the mem∣ber and stoppeth the fluxe of bloud. Galene also before Auicene his time, did allowe that cancres might sometime be cured by chirurgie.* 1.611 But truely although Galene and Auicene doe permit this manuell cure by chirurgie: yet to auoide the daunger of immoderate fluxe of bloud, and of vlceration, yea and of the life of the sicke, omitting those things, we ought to follow that prescript rule of curing,* 1.612 which is onely accomplished by gentle and milde medicines, as a more safe waie and lesse troublesome, and to content our selues with that onely methode: because that if such a cancrous tumour, which is growen to a mightie big∣nesse, should be cut round about in those places, which are ioyned to the whole parts, the

daunger of immoderate profusion of bloud woulde straightway followe, by reason of the greatnes of the vessells and widenesse of the arteries, which partes (saith Galene) if you should take vp and binde them with cordes, the other members by reason of their neare ac∣quaintance would be troubled and greatly grieued. Moreouer Celsus saith,* 1.613 that although carcinomata be cut of, and brought to a scarre, yet they will returne againe, and giue occa∣sion of death. But if you intende to seare of the rootes of this euill, yet truely you can∣not doe this neither without hurting of the next partes, especially if you make exustion neere vnto the principall members. Great cancres therefore, and those which are inue∣terate, must neither rashly be burned with any instrument, nor cutte of with a penknife, but rather handled gently and mildly (as we haue saide before.) For many men not by the applying of any forcible or vehement medicines to take away this euill, but by the one∣ly ministring of easie and gentle remedies, which can as it were please or delight, haue so hindred these tumours, that they coulde not attaine vnto any perfect age or rypenesse. Now followeth the summe of the cure of Cancer non vlceratus, which is yet but beginning,* 1.614 and doth occupie the outward partes of the bodie, briefly in these wordes. 1. Imprimis in a canker which is but newly begone, and which consisteth of noe verie thicke humour, nor causeth the veynes to swell greatly: purge out the melancholicke humour which causeth [ 1] this euill vniuersally throughout the whole bodie. 2. If age and strength doth suffer it, cut a veine in the elbow, and draw out as much bloud as neede requireth. 3. Afterward myni∣ster [ 2] to the sicke such medicines as can purge melancholie downewarde: in the beginning [ 3] let them be gentle and easie, but afterwarde somewhat vehement increasing their force by little and little. 4. If the purging of menstruis in women before fiftie yeares of age, or of hemorrhoides both in them and in men be so suppressed, that bloud aboundeth not at times [ 4] nowe and then, you must prouoke them by all meanes possible. 5. In the meane time ap∣point vnto the sicke a thinne diet, which can engender good iuyce, and cause no melan∣cholike [ 5] bloud. 6. If you cannot auoyde it, but that a grosse and melancholious humour be [ 6] gathered togeather in the veynes: you must euacuate the same by turnes, both with simple and compound medicines. But these former Aphorismes doe pertaine vnto the Physition: nowe we will declare the dutie of the Chyrurgian. 7. applie vnto the affected member bothe before purging, and in the verie time of purging, such medicines as can repell, and [ 7] driue backe: but when the bodie is vniuersally purged, then vse digestiue remedies, but let them be such as are of a moderate strength and of a gentle nature. 8. Therefore minister [ 8] to the aggreaued place iuyce of nightshade, or the medicine made of Pompholygos, or that which consisteth of Calcites, commonly called Diapalma, and othe remeadies of that sort. 9. But if by the arte of chyrurgie you dare enterprise the cure of Cancer, you must first [ 9] (taking the Physitions counsell) purge furth the melancholike humour, and then cut the corrupted tumour cleane of, and suffer a good quantitie of bloud to come forth, and wring the thicke bloude out of the adioy∣ned partes, and afterward cure the disease after the maner of other vlcers.

Libri quinti finis.

Notes

• * 1.1

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.
• * 1.2

  Abscessus.
• * 1.3

  The common definition of Apostema.
• * 1.4

  Three kindes of diseases ap∣pointing the essence of tu∣mours besides nature.
• * 1.5

  Accidentall definitions.
• * 1.6

  Definitio pri∣ma.

  Secunda.

  Tertia.
• * 1.7

  A perfect de∣finition besides nature, taken out of the wri∣tinges of Ga∣len.

  The diuision of a tumour besides nature into his spe∣cies after the opinion of the later sort.
• * 1.8

  Apostemata.
• * 1.9

  Pustulae.
• * 1.10

  Exiturae.
• * 1.11

  The diuision of a tumour in it his diffe∣rences.

  From whence the differences of tumours be∣sides nature are taken of the latter sort. S••••stantiae.
• * 1.12

  Materia.
• * 1.13

  Accidentia.
• * 1.14

  Pars affecta.
• * 1.15

  Causae eff••cien∣tes.
• * 1.16

  From whence the difference of tumours a∣boue nature doe come and arise.
• * 1.17

  Ephysema.
• * 1.18

  Callidi tumo∣res.
• * 1.19

  Tumores fri∣gidi.
• * 1.20

  Tumores sero∣si.
• * 1.21

  Tumores com∣plicati.

  One euill see∣meth to haue some affinitie with the other.
• * 1.22

  The chiefe tu∣mours that are caused of flow∣ing of humors.
• * 1.23

  VVhat tumors doe associate phlegmone.
• * 1.24

  Erysipelatos•• tumores.
• * 1.25

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.
• * 1.26

  O••dematos•• tumores.
• * 1.27

  Certaine newe names of tu∣mours giuen of the latter sorte of Phisitions. Testudo. Talpa. Nata. Ganglium.
• * 1.28

  Strumae.
• * 1.29

  leucopbleb∣matia. Scirrb••si 〈◊〉〈◊〉. Cancer. Carcinoma.
• * 1.30

  Elephantiasis.
• * 1.31

  Verrucae.
• * 1.32

  Porra. Myrmeciae. Acrochordo∣nes. Clauus. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Thymion.
• * 1.33

  Cornua. Calli.
• * 1.34

  Dracunculi
• * 1.35

  Pustulae.
• * 1.36

  Lepra. Ps••ra. Lichene.
• * 1.37

  Four kindes of impetigo.
• * 1.38

  Impetigo.
• * 1.39

  Lepra. ps••ra Scabies.
• * 1.40

  Albara. Leuce.
• * 1.41

  Alphon is of two sortes.
• * 1.42

  Vitiligo.
• * 1.43

  Small credit to be giuen to wordes of na∣mes.
• * 1.44

  Ionthi.
• * 1.45

  Epinyctides.
• * 1.46

  VVhy they be called epiny∣ctides.
• * 1.47

  Sudamina. Planta noctis.
• * 1.48

  Desudationes Auicene.
• * 1.49

  Psydraces.
• * 1.50

  Morbili. Variolae. Exanthemata. Ecthymata
• * 1.51

  Papulae C••lsi.
• * 1.52

  Dartrae Gal∣inae.
• * 1.53

  Mentagra.
• * 1.54

  Plinie lib. 26.
• * 1.55

  Galene ac∣knowledgeth mentegra.
• * 1.56

  M••rbus Nea∣politanu••, & venereum.
• * 1.57

  Pustulae glan∣dosae.
• * 1.58

  Terminthi.
• * 1.59

  Pustulae albae
• * 1.60

  The causes of tumours besi∣des nature.
• * 1.61

  Fluxionis cau∣sae.
• * 1.62

  Part propel∣leus.

  Particula ex∣cipens.

  〈◊〉〈◊〉 fluens.
• * 1.63

  Spatium.
• * 1.64

  Causes of con∣gestion.
• * 1.65

  How a hote de fluxion pro∣uoketh a tu∣mour.
• * 1.66

  There is a twofold decla∣ration, of all those euills which are yet in begetting. Speciall cau∣ses of tumours aboue nature. Praegressae. Antecedentes. VVhich are saide to be na∣turall humors.
• * 1.67

  VVhich are saide to be vn¦naturall hu∣mours.
• * 1.68

  VVhat iuices are properly termed natural humours.
• * 1.69

  Of the foure natural hu∣mours: are en∣gendred foure lawfull and 〈…〉〈…〉.

  VVhat tumors 〈…〉〈…〉 of vnnatura•••• hu¦mours.
• * 1.70

  Coniunctae causae tum••rū praier naturā.
• * 1.71

  VVhat it is which is called continens cau¦sa.
• * 1.72

  Some thincke that coniuncta causa nothing differeth from the maladie it selfe.
• * 1.73

  VVhat absces∣sus Galene thinketh to be.
• * 1.74

  Two kindes of abscessus Gal. lib. 14. Thera. meth. & lib. 2. ad Glauco∣nem.
• * 1.75

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.
• * 1.76

  VVhat things may be found in abs••essus.
• * 1.77

  Generall sig∣nes of tumours aboue nature.
• * 1.78

  Particular si∣gnes.
• * 1.79

  Iudicia.
• * 1.80

  Lib. de diffe. 〈◊〉〈◊〉.
• * 1.81

  Foure times of tumours be∣sides nature.
• * 1.82

  Principium.
• * 1.83

  Augmentum.
• * 1.84

  Status.
• * 1.85

  Declinatis.
• * 1.86

  The times of tumours doe take their dif∣ference from three thinges chiefly.
• * 1.87

  Tumoures a∣boue nature are contained vnder 4 mo∣des.
• * 1.88

  Gal. lib. de in∣aequali intem∣temperie.
• * 1.89

  Signes of disso¦lution.

  Signes of pu∣trifaction.

  Signes of in∣duration.

  Signes of the regression and lurking of a tumour.
• * 1.90

  Signes of Ab∣scessiō to come
• * 1.91

  Signes of Ab∣cession alrea∣die present.
• * 1.92

  Aph. 47. lib 2
• * 1.93

  Aph. 41. lib. 6.
• * 1.94

  Indicis absces¦suum.
• * 1.95

  VVhat absces¦sions may easi∣ly be digested.
• * 1.96

  VVhat absces¦sion may soo∣nest be ended through reso∣lution.
• * 1.97

  Abscessions are saflier ope¦ned with a 〈◊〉〈◊〉 then with ruptor••ū medicamentū
• * 1.98

  The notes of the best and worst matter, out of Hippoc.
• * 1.99

  The common order of cu∣ring of tumours
• * 1.100

  The common method of cu∣ring of tumors doe chaunge according to the difference of the tumour and the mem∣ber affected.
• * 1.101

  The order of curing of tu∣mors is chiefly taken from two things.
• * 1.102

  The essence of a tumour doth containe three thinges in it.
• * 1.103

  Foure thinges to be conside∣red chiefly in the nature of affected mem∣bers.
• * 1.104

  Libro 2. ad Glauconem. The order ••f handling that which follow∣eth.
• * 1.105

  The finding out of the 〈◊〉〈◊〉 is the beginning of the cure of tu∣mours aboue nature.
• * 1.106

  Phlegmone quod.
• * 1.107

  Gal. lib. 13. me••h. med. The common ingendring of euery phleg∣mone.
• * 1.108

  The helping causes of flux. Three orders are set downe for the cure of those tumours which are cau¦sed, through the influxion of humours. Primus sco∣pus.

  P••ethora quod.
• * 1.109

  Cacochymia.
• * 1.110

  Antispasis.
• * 1.111

  Secundus sco∣pus.
• * 1.112

  Tertius scopus
• * 1.113

  Cases in which we may not vse repelling or repressing remedies.
• * 1.114

  Repellentia communi••.
• * 1.115

  Repellentia propried••••ia.
• * 1.116

  Frigida rep••i∣men••••a.
• * 1.117

  Callida repel∣lentia.
• * 1.118

  The first pro∣logue of Guido in repressiue things.
• * 1.119

  Gal. 2. ad Glauconem.
• * 1.120

  The second Prologue.
• * 1.121

  Si ••umeri•••• factus est.
• * 1.122

  Emplastri••••. C••c••••bicula. 〈◊〉〈◊〉 canon generalis.
• * 1.123

  Of the cure of tumors which are turned in∣to abscessions, which they cal Exit••ra.
• * 1.124

  Tetrapharma¦cum.
• * 1.125

  The best order of curing is de¦clared three wayes.
• * 1.126

  Ex lib. 4. The∣rap. meth.
• * 1.127

  Auicene.
• * 1.128

  VVhē Absces∣siōs are chiefly to be cut and opened.
• * 1.129

  A mattered tumour is more saf•••• opened with a knife, thē with bur∣ning medi∣cines.

  Lib. 13. Ther. A section imi∣tating the o∣liue or mirtle leafe.

  Great harte commeth by wide incisions. VVhy ma••te∣red impost∣humes about the share must be ••ut ouerth∣wart.

  Seuen thinges to be diligētly marked in the apertion of an abscession al∣ready ma••te∣red.
• * 1.130

  Two thinges considered of Galene in the apertion of a 〈…〉〈…〉.
• * 1.131

  Detergentis.
• * 1.132

  Ointments are to be 〈…〉〈…〉 is opened.
• * 1.133

  The vse of Māna & th•••• after the inci∣sion, and the vertue of thē. The 〈…〉〈…〉 be eased.

  VVhat things are to be layed to an vlcer.
• * 1.134

  Auicenn•••• in fine tract••. 1. ••e••. 3. lib. 4.
• * 1.135

  Phlegmone taken two wayes.
• * 1.136

  Phlegmone taken for phlo∣gosit. 2.

  Phlegmone also is taken for an inflam∣mation com∣ming of the best bloud. Phlegmone. 2. 1. Vera. 2. Non vera.
• * 1.137

  Sanguis quid.
• * 1.138

  Sanguis quo∣••uple••.
• * 1.139

  Bloud 〈◊〉〈◊〉 de∣generate 〈…〉〈…〉 proper na∣ture two waies.
• * 1.140

  Foure diffe∣rences of tu∣mours caused of bloud.
• * 1.141

  The causes of phlegmone.
• * 1.142

  1. Praegressa.
• * 1.143

  2. Antecedens.
• * 1.144

  3. Coniuncta.
• * 1.145

  Signes of a true phleg∣mone.
• * 1.146

  Lib. de Tumo. praeter naturā. & 13. method.
• * 1.147

  Foure times of phlegmone.
• * 1.148

  Iudicia.
• * 1.149

  Symptom••••es 〈◊〉〈◊〉 hinder 〈◊〉〈◊〉 cure of phlegmone.
• * 1.150

  Ca••. 5.
• * 1.151

  The methode of curing phlegmone which is yet in generation.
• * 1.152

  By what meanes fluxe is stayed.
• * 1.153

  1. Retractio.
• * 1.154

  2. Repulsio.
• * 1.155

  3. Causae su••∣motio.
• * 1.156

  Vacuation of that which is flowed alrea∣dy.

  Gal. Ther. 13.
• * 1.157

  Scarificatio.
• * 1.158

  Foure intētiō•• in the cure of phlegmone.
• * 1.159

  1. The first in∣tention is an order in diet.
• * 1.160

  Res non natu∣rales.
• * 1.161

  Aer.
• * 1.162

  Cibus potus.
• * 1.163

  Mo••us. Qui••s. Somnus. Repletio. In••••••ti••. Animi pathe∣m••••••. Venus.
• * 1.164

  2. The 〈◊〉〈◊〉 of the fluxe is the second in∣tention.
• * 1.165

  A veine is al∣wayes to be cut directly.
• * 1.166

  The choice of bloud letting is declared of the affected parte.
• * 1.167

  3. The third in∣tention is the euacuation of the 〈◊〉〈◊〉 or alread•• com∣pact in the member.
• * 1.168

  Repressiues in the increase, must exceede digestiues.
• * 1.169

  If phlegmone doth turne in∣to abscession.
• * 1.170

  Repulsiues are to be vsed in the beginning of phlegmone. Oxycraton.
• * 1.171

  Lib. 13. Meth. 〈◊〉〈◊〉.
• * 1.172

  Galeni cata∣plasma, lib. 2. ad Glau.
• * 1.173

  Fen. 3. lib. 4. trac. 1. cap. 3.
• * 1.174

  Haly Abbas Linimeruum.
• * 1.175

  Aliud.
• * 1.176

  Remedies to be vsed in the increasing of phlegmone.
• * 1.177

  Lib. 3. de 〈◊〉〈◊〉 medic.
• * 1.178

  Oile of roses a present reme∣die in the in∣crease of phleg¦mone.
• * 1.179

  VVhat things do helpe in the state of phleg∣mone.
• * 1.180

  Emplastrum Galeni.
• * 1.181

  VVhen reme∣dies must be vsed in the decla••ation of phlegmone.
• * 1.182

  VVhat resolu∣tion is to be hoped for.
• * 1.183

  Put 〈◊〉〈◊〉.
• * 1.184

  Lib. 2. ad Gla••••••.
• * 1.185

  Haly Abbas remembreth this cataplas∣me.
• * 1.186

  Ali••d.
• * 1.187

  A common ca∣taplasme.
• * 1.188

  Symptomatum correctio.
• * 1.189

  Dolor.
• * 1.190

  Lenifiers of paine in phleg∣mone.
• * 1.191

  Lib. 2. ad G••.
• * 1.192

  Cr••cum.
• * 1.193

  N••ta de s••.
• * 1.194

  Recursus ••a∣teriae ad inte∣riora.
• * 1.195

  Durities reli∣cta.
• * 1.196

  Galens cata∣plasme for hard tumours.
• * 1.197

  Putrefactio.
• * 1.198

  Galen. lib. 2. ad G••anc.
• * 1.199

  The summe of the cure of phlegmone, when is 〈…〉〈…〉 much paine.
• * 1.200

  De Carbuncu∣l••.

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Gangrena &, Sphacelus doe follow great phlegmones.
• * 1.201

  The generatiō and descriptiō of a Carbūcle.
• * 1.202

  Carbunclus de plex.

  Signes of a Carbuncle.
• * 1.203

  1. Vlcus cru∣stosum.
• * 1.204

  2. Some great whelkes, some small.
• * 1.205

  3. The colour of the c••ust ei∣ther earthy or blacke.
• * 1.206

  4. The flesh blacke abou•• it.
• * 1.207

  5. Greeuous paine.
• * 1.208

  6. A vehement feauer.
• * 1.209

  7. Nauseae.
• * 1.210

  8. 〈◊〉〈◊〉.
• * 1.211

  9. VVante of stomache.
• * 1.212

  10. Ca••dis tre∣mor.
• * 1.213

  11. 〈…〉〈…〉.
• * 1.214

  Carbuncle 〈…〉〈…〉.

  1. VV••en a Carbunc••e ••s m••st deadly, (the iudgemēt therof being taken from the affected p••a∣ce.)

  2. Another iudgement ta∣ken from the affected place.

  3. Iudgement of the colour.

  4. Iudgement of the acci∣dentes.
• * 1.215

  The cure of a Carbūcle must be begun by bloud letting.
• * 1.216

  Ven•• è ••••••e∣cto secunda.
• * 1.217

  Deepe scarifi∣cation.
• * 1.218

  Sprinckling of hote salte wa∣ter.

  Arsonicum. Sanguisugae.
• * 1.219

  Fluxe in a Caerbuncle can¦not be turned away, neither ought it, Lib. 14 Ther.
• * 1.220

  A Cataplasme good for a car∣buncle.
• * 1.221

  Cataplasm•• de Arnoglossa.
• * 1.222

  A Cataplasme of pomegra∣nates. Pa••••••••.
• * 1.223

  Nux ••uella∣na.
• * 1.224

  Remedies to draw the poy∣son in a Car∣buncle.
• * 1.225

  VVhat must be applied to a crustie vlcer.
• * 1.226

  A Cataplasme of the meale of Tares & oxy∣mel.
• * 1.227

  Vnguentum Aegyptiacum.
• * 1.228

  Adurentia medicamenia.
• * 1.229

  VVhē adustiō must be vsed.
• * 1.230

  Finis adurēdi.
• * 1.231

  Psilis.
• * 1.232

  Ma••urati••um Auicenne.
• * 1.233

  Mundifi••ati∣••um ex ap••••.
• * 1.234

  A common ca∣tapla••me vsed in Paris.

  Cōsolida maior
• * 1.235

  Scabiosa.
• * 1.236

  VVhat things do resolue the crusts of vl∣cers.
• * 1.237

  Emplastrum eschar••m re∣soluens.
• * 1.238

  Theri••ce.
• * 1.239

  Andronis Tro¦ch••s••••••.
• * 1.240

  Polyida Po∣still••s.
• * 1.241

  Polyidae pa∣s••••ctus 〈◊〉〈◊〉.
• * 1.242

  Musae ••••••his∣ku••.
• * 1.243

  VVhat a Can∣ker is, and whēce it hath his beginning
• * 1.244

  Gangrena pes¦simus tyrānus
• * 1.245

  Sphacelus.
• * 1.246

  Sydenatio os∣s••••••.
• * 1.247

  The benūmed member must straightway be p••••ed.
• * 1.248

  Ignis Sancti Antonij.

  Thre causes of mortificatiō
• * 1.249

  VVhat things do dissolue the mixture of the member.
• * 1.250

  Signes of Gan¦grena & spha¦celus.
• * 1.251

  Iudicia lib. 4
• * 1.252

  Lib. 5
• * 1.253

  Emptying of corrupted bloud.
• * 1.254

  After scarifi∣catiō you must wash the place with salt wa∣ter.

  Medicines pu∣trefactiues.
• * 1.255

  Vnguentum Aegyptiacum
• * 1.256

  B••••ning Tro∣chiskes.
• * 1.257

  Arsenicon sublimatum.
• * 1.258

  Lib. 2. ad Glane.
• * 1.259

  VVhē adustiō is to be vsed.
• * 1.260

  If the canker turneth into sphacelus.
• * 1.261

  Li. 2. ad Gla••••
• * 1.262

  Lib. 4. Remedies that can losen the crusts frō the seared members.
• * 1.263

  Butyrum.
• * 1.264

  Emplastrum Guilielmi à Saliceto.
• * 1.265

  Lib. 2. ad Glau¦conem.

  The summe of the cure of Gangrena & sphacellus.
• * 1.266

  Apherisms 1· pertaining 2. to a phisitiō
• * 1.267

  Fleume in the generation of humours is next vnto bloud
• * 1.268

  Erysipel•••• q••••d.
• * 1.269

  Erysipelas ex∣quis••••••.
• * 1.270

  Spina.
• * 1.271

  Erysepelas cū vlceratum.
• * 1.272

  Erysipelas non legiti••••••.
• * 1.273

  Mediū 〈◊〉〈◊〉
• * 1.274

  〈◊〉〈◊〉.
• * 1.275

  Bi••is flena duplex.
• * 1.276

  Not naturall.
• * 1.277

  Choler doeth digresse from his owne na∣ture.
• * 1.278

  Bilis vitellina Porr••acta. Prassina. A••••uginosa
• * 1.279

  Crocea. Auicene. Haly.
• * 1.280

  Foure diffe∣rences of in∣flammations comming of choler.

  Verum erysi∣pelas.

  Three vnlau∣full erysipelas.
• * 1.281

  Herpes exe∣dens.

  Phagedaena. Can••ri ••••e∣rati.
• * 1.282

  Causae veri erisipelatis.
• * 1.283

  Signes of ery∣sipelas.
• * 1.284

  A yealowish rednes ••eiding to the finger. a small 〈◊〉〈◊〉▪ vehement heat.

  Small pulse. Pricking paine. Indicia.
• * 1.285

  Erys••pedas fol∣loweth the or∣der of a tertiā 〈◊〉〈◊〉.
• * 1.286

  Erys••pelata a∣boue the head are verie hard to be cured. Erysipelas in the wombe of a womā 〈◊〉〈◊〉 the 〈◊〉〈◊〉.
• * 1.287

  Two generall orders in the cure of erysi∣pelas.
• * 1.288

  Foure particu∣lar intentions of curing ery∣sipelas
• * 1.289

  Primus sco∣pus.
• * 1.290

  Aire.
• * 1.291

  Cibus.
• * 1.292

  Potus.
• * 1.293

  Motus. Animi affe∣ctus. Venus.
• * 1.294

  Secundus sco∣pus.
• * 1.295

  2. ad Glan••. In a Phlegmo¦nous erysipelas it is good to let bloud.
• * 1.296

  In phlebato••y and purging the chirurgian must be taught by the Physi∣tion.
• * 1.297

  Tertia inten∣tio.
• * 1.298

  Hic Guido de∣pra••••••è citat. Gal.
• * 1.299

  How much e∣rysipelas is to be refrigera∣ted.
• * 1.300

  Lib. 14. Ther.
• * 1.301

  Materia refri¦gerantium ex Gal.
• * 1.302

  Ceratum.
• * 1.303

  A compound medicine.
• * 1.304

  Euacuation of the ioined ••at¦ter by euapo∣ratiues.
• * 1.305

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.
• * 1.306

  Hydreleum is a mixture of water and oyle.
• * 1.307

  Silin•••• 〈◊〉〈◊〉 lo∣cum occupari••.
• * 1.308

  Quarta inten∣tio.
• * 1.309

  A remeadie to mitigate paine and heat.
• * 1.310

  If erysipelas be exulcera∣ted
• * 1.311

  Seuen Apho. out of Galene cōcerning the whole cure of erysipelas.
• * 1.312

  De herpet••.
• * 1.313

  Pustulae cho∣lericae vn••go appella••ae her∣petes.
• * 1.314

  Formica Aui∣cennae.
• * 1.315

  VVhen her∣pes is caused.
• * 1.316

  Two kindes of herpes.
• * 1.317

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. 1. ex∣edens vel de∣pasce••••.
• * 1.318

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, some herpes 〈◊〉〈◊〉.
• * 1.319

  Lib. 14. the∣rap.
• * 1.320

  Ex Paulo, & Gal.
• * 1.321

  Lib. de 〈◊〉〈◊〉 praeter naturam.
• * 1.322

  Lib. 14. meth. 〈◊〉〈◊〉. The cholerick humour, which causeth her∣pes as verie thinne.
• * 1.323

  Herpes exul∣cerateth onely the skinne.
• * 1.324

  Auicen cōso••̄∣deth myrme∣ciae with her∣petes.
• * 1.325

  Herpes esthio∣menus and e∣rysipel vler∣ratum are not all one.
• * 1.326

  Morbili sunt, ex herpetum genere.
• * 1.327

  Variole.
• * 1.328

  Papularum e∣ruptiones. Ecthymata. Exanthemata
• * 1.329

  Herpe tum cu∣ratio.

  Three thinges to be marked in the cure of herpes.
• * 1.330

  Primus s••••∣pus.
• * 1.331

  Herpes requi∣reth the med••∣cine 〈◊〉〈◊〉.
• * 1.332

  Herpes 〈◊〉〈◊〉 requireth a remeadie which can purge both choler and fleame.

  Reprimendi tempus.
• * 1.333

  Lib. 14. The∣r••p.
• * 1.334

  Repressi••es a•• not to be vsed if the humour be plentifull. Repriment•••••••• materia.
• * 1.335

  Those remea∣dies which doe coole & moy∣sten are not meete for her∣pes exedens.
• * 1.336

  Repress••••e•• meete for her∣pes exedens.
• * 1.337

  Cataplasma.
• * 1.338

  Sumach. These thinges doe accom∣plish the se∣cond intentiō.
• * 1.339

  The cure of the vlc••r in he••pes 〈◊〉〈◊〉 our 〈…〉〈…〉 must be dryed vp.

  Lib. 2· ad Gla••. How exulce∣rated places must be looked to.
• * 1.340

  P••s••ae. Remeadies ta∣ken of Panius. Aliud. A•• herpetes depascentes.
• * 1.341

  For inueterate vlcers.
• * 1.342

  VVhat is to be done in p••stu∣lae miliares if they turne in∣to an vlcer. Lib secendo. ad Glaucon.
• * 1.343

  Verrucae. Porra.
• * 1.344

  There be di∣uerse kindes of verrucae.
• * 1.345

  Myrmecia.
• * 1.346

  Sessiles ver∣rucae.
• * 1.347

  Acrochordon pensi•••••• ver∣ruca.
• * 1.348

  The differēce betweene a∣crochordones, & myrmecia.
• * 1.349

  Claui.
• * 1.350

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Almismar. Thymion.
• * 1.351

  Thymij mag∣nitudo.
• * 1.352

  Thymia in ob¦scaenis pessima
• * 1.353

  Coruna.
• * 1.354

  Calli. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.
• * 1.355

  Acrochordon. Thymion. Lib. 5. Myrmecia. Cla••••••.
• * 1.356

  Myrmeciae.
• * 1.357

  The cure of verrucae 〈◊〉〈◊〉 of Paulus.
• * 1.358

  Aqua ex sar∣mentis d••st••l∣l••••s.
• * 1.359

  Stercus bulu∣i••••.
• * 1.360

  Lacertae ca∣p••••.
• * 1.361

  Other orders of curing.
• * 1.362

  How verrucae are safely bur¦ned.
• * 1.363

  The cure of myrmecia be∣ing equal with the skine.

  A new cure of myrmecia out of Galene.
• * 1.364

  Another cure of myrmecia Lib. 14. meth. med.

  Scalprion. Scolopomach••¦rion.

  Another cure inuented by a quill
• * 1.365

  Prima scitè radicem ver∣sus abscind••̄∣da.
• * 1.366

  Oedema quid.
• * 1.367

  Oedema est 〈◊〉〈◊〉
• * 1.368

  Oedema du∣plex verum.
• * 1.369

  〈◊〉〈◊〉.
• * 1.370

  VVhat fleame is.
• * 1.371

  VVhat and af••e•• wh•••• sort fleame d••••h 〈◊〉〈◊〉 from his owne 〈◊〉〈◊〉.
• * 1.372

  Galene ap∣pointeth two kinds of fleam
• * 1.373

  8. Differences of tumours be∣sides nature comming of fleame.
• * 1.374

  Three causes of aedema.
• * 1.375

  Signa ••de∣ma i••.
• * 1.376

  Iudicia.
• * 1.377

  Curandi oede∣matis scopus duplex, cum ad huc gigni∣tur.
• * 1.378

  The order of curing an ••••de oedema.
• * 1.379

  Oedematis 〈◊〉〈◊〉 symptoma est curatio.
• * 1.380

  Foure perticu¦lar orders to be kept in curing a lawfull oede∣ma.
• * 1.381

  Prima intētio,
• * 1.382

  A••r. Po••••s.
• * 1.383

  Cib••t.
• * 1.384

  Rep••••t••••. lu••••i••io. Mo••us.
• * 1.385

  S••••••nu••. Balne••••••. Secunda intē∣tio.
• * 1.386

  Tertia intētio
• * 1.387

  Remedies to be vsed in the beginning of oedema.
• * 1.388

  Posca aquosa.
• * 1.389

  Emplastrum Razi••.
• * 1.390

  Remedies to be vsed in the time of increa¦sing.
• * 1.391

  Lib. 14. Ther. & 2. ad. Glau.
• * 1.392

  Remedies 〈◊〉〈◊〉 the state and declination.
• * 1.393

  S••••ng••a aqua 〈…〉〈…〉
• * 1.394

  Lini••entum.
• * 1.395

  E••••••••asirum 〈◊〉〈◊〉. Vsnea 〈…〉〈…〉 seu 〈◊〉〈◊〉
• * 1.396

  This is giue•• to Theodori∣cus.
• * 1.397

  Apertio.
• * 1.398

  A mundifica∣tiue ointment which is attri∣buted to 〈◊〉〈◊〉
• * 1.399

  Qu••rta inten∣tio.
• * 1.400

  Li. 2. ad Gla•••• Oedemare 〈◊〉〈◊〉. C••pi••a curatio 〈…〉〈…〉.
• * 1.401

  Oedema mor∣bi accidens.
• * 1.402

  Oedema mor¦bus.
• * 1.403

  Oedema i••••e∣teratu••.
• * 1.404

  The differēce betweene in∣flatio & oede∣mae.
• * 1.405

  Lib. 4
• * 1.406

  Inflation•••• causae. Lib. 6. de mor∣bis et sympto∣••a.
• * 1.407

  Lib. 4.
• * 1.408

  Inflationum notae.
• * 1.409

  Inflationum prognostica.
• * 1.410

  Inflationum curatio.
• * 1.411

  Three inten∣t••••ns of 〈◊〉〈◊〉 inflations.
• * 1.412

  Prima intētio
• * 1.413

  Cibus.
• * 1.414

  Potus.
• * 1.415

  Secunda in∣tentio.
• * 1.416

  Drageta hel∣peth digestion
• * 1.417

  Tertia inten∣tio.
• * 1.418

  Inflatio com∣meth of a bruse in the arteries, mus∣cles, & filmes which couer the bones.
• * 1.419

  Sapa.
• * 1.420

  Lana succida.
• * 1.421

  Oesipus
• * 1.422

  Ceratum e••t 〈◊〉〈◊〉.
• * 1.423

  Proliximio Aphro••irum. Formnia ter∣tia.
• * 1.424

  How an olde inflation must be handled.
• * 1.425

  If the ••iddie vapour shalbe venemous.
• * 1.426

  Victus ratio. Theriaca. The summe of curing of a fla¦tuos tumour.
• * 1.427

  Leu••o••••••••g∣matia.
• * 1.428

  〈1 paragraph〉〈1 paragraph〉
• * 1.429

  〈◊〉〈◊〉.
• * 1.430

  Li. 2. ad Glau. 〈◊〉〈◊〉. & 14. Therap.
• * 1.431

  Causae.
• * 1.432

  Signae.
• * 1.433

  Indiciae. Ascites is cau∣sed of more 〈◊〉〈◊〉 then Tim¦pani••e••

  VVhat partes these tumuors do most occu∣py.
• * 1.434

  Aqu••si in••o∣ris c••••atio.
• * 1.435

  Curatio du∣plex.
• * 1.436

  Fiue particu∣lar intentions in curing a waterish tu∣mour.
• * 1.437

  Auicennes emplaister to discusse wate∣rish tumours.
• * 1.438

  Capita cura∣tionis aqu••si tumoris.
• * 1.439

  Enumeratio abscessu••••m pitu••••os••rum.
• * 1.440

  〈1 paragraph〉〈1 paragraph〉
• * 1.441

  〈1 paragraph〉〈1 paragraph〉
• * 1.442

  Auicen•• Glā∣du••e are a••l 〈◊〉〈◊〉 with Gan∣glia.
• * 1.443

  Cap. 16. lib. 4. Ganglium quid.
• * 1.444

  Signa Gan∣••••••.
• * 1.445

  Scroful••.
• * 1.446

  Ch••rades Graec••rum.
• * 1.447

  Sues. Struma. Cels••.
• * 1.448

  Lib. 6.
• * 1.449

  Lupia.
• * 1.450

  Lupus mor∣b••s.
• * 1.451

  Nodi.
• * 1.452

  Auice••••ae nodi.
• * 1.453

  Atheroma.
• * 1.454

  Meliceris.
• * 1.455

  Stea••••••••.
• * 1.456

  Testudo.
• * 1.457

  Talpa.
• * 1.458

  Bocium.
• * 1.459

  Broucho••l••e.
• * 1.460

  Nacta.
• * 1.461

  Nacta or Na∣pta is referred vnto Steato∣mata.
• * 1.462

  Bubo.
• * 1.463

  Fugillae.
• * 1.464

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. VVhat Bubo is with Guido and other late Physitions.
• * 1.465

  The differēces of flegmatike abscessions.
• * 1.466

  Of the causes signes & iudg∣mentes of the aforesaid tu∣mour••.

  Causes of tu∣mours which pertaine vnto fleume.

  The matter of flegmatike abscessions.
• * 1.467

  14. Therap.
• * 1.468

  Signa.
• * 1.469

  Notae absces∣su•• relament•• 〈◊〉〈◊〉.
• * 1.470

  Indicia ab∣scess•••••• pi∣m••••s••••um.
• * 1.471

  Arnaldus à villa 〈◊〉〈◊〉.
• * 1.472

  Auicema••.
• * 1.473

  In what ages and bodyes Strumae doe raigne.
• * 1.474

  Celsus.
• * 1.475

  Magnitude Strumae.
• * 1.476

  Natura.
• * 1.477

  Locus.
• * 1.478

  Multitude. Ortus.
• * 1.479

  Duplex ab∣scessuū pitui∣tosorum curā∣di ratio.

  1. Vniuersalis.
• * 1.480

  Victus ratio.
• * 1.481

  Aquae ••l••••i∣nosae vi••.
• * 1.482

  Antecedenti•• materia eua∣cuatio.
• * 1.483

  Vacuantia pe•• alnum.

  Puluis Tur∣bith.
• * 1.484

  Razes.
• * 1.485

  Hierapicra.
• * 1.486

  Prouokers of vrine.

  Po•••• Guido∣•••• à Ca••lia∣co.
• * 1.487

  Quae per ha∣litum dege∣••a••••.
• * 1.488

  The kings of Fraunce doe cure Strumae by applying the handes.
• * 1.489

  VVhat things doe ••••••er the particular cure of absces∣sions fleugma∣tike.

  Tempus quid insa••e••.
• * 1.490

  Copress••o & artritio.
• * 1.491

  Lupia cura∣tio.
• * 1.492

  Lamina plum∣bea.
• * 1.493

  Vnguentum Rogerij.
• * 1.494

  Ganglij cura∣tio ex Phila∣grio.
• * 1.495

  Lupia & Gā∣glion is all on euill.

  Archigenes lib. 4
• * 1.496

  Oribasius his medicine to mollifie Gan∣glia.
• * 1.497

  Verticillum bl••••mbe••••.
• * 1.498

  Ganglierum per Chyrurgiā curatio.
• * 1.499

  Secundus Ca∣non.
• * 1.500

  Discussion by digestiues.
• * 1.501

  Emplastrum.
• * 1.502

  Diathyl••n
• * 1.503

  Siertus ••a∣pri••um ve••u••.
• * 1.504

  Haly Abbas emp••astrum.
• * 1.505

  Emplastrum Auicennae.
• * 1.506

  Brunni & Theodorici emplastrum ad strumas.
• * 1.507

  Rogeri em∣plastrum.
• * 1.508

  Emplastrum praeceptoris G••••d••nis ex L••••••cibus.
• * 1.509

  The vsing of vipers & ser∣pentes doeth marueilously helpe them which are stru¦mous.
• * 1.510

  Terta Canoris declaratio.
• * 1.511

  Suppurantia, ce•• mararan∣tia.
• * 1.512

  Pauli medi∣camentum ad strumas sup∣purandas. Detergentia.
• * 1.513

  Vnguentum Apostolerum.
• * 1.514

  Vnguentum Aegyptiacum. Diachylon. Diapalma.
• * 1.515

  The waye to cure and de∣stroy Strum••, one of Albu∣casis and Leo∣nidas.
• * 1.516

  VVhat is to be done, of a veyne be an∣nexed v••to struma.
• * 1.517

  Cordes made of silke.
• * 1.518

  Albucasis.
• * 1.519

  C••••r••sio & ••••••••dificatio.
• * 1.520

  Casticum ex calce & sap••∣ne.
• * 1.521

  Arsenicum.
• * 1.522

  Quantit••s arsen••••••.
• * 1.523

  Quādo 〈…〉〈…〉
• * 1.524

  L••ga••t••r••e & 〈◊〉〈◊〉.
• * 1.525

  Curatio Athe∣rom••ti••, steato¦matis & me∣liceridis.
• * 1.526

  Ho•• manie wayes these abscession may be cured.
• * 1.527

  Lib. 4. Curatio per digerentis.
• * 1.528

  Lib. 15.
• * 1.529

  Curatio per 〈…〉〈…〉 4
• * 1.530

  A medicine to wa•••• without biting.
• * 1.531

  Curatio per Chirurgiam.
• * 1.532

  Aetius lib 15.
• * 1.533

  Scirrhus du∣plex.
• * 1.534

  Melancholia naturales.
• * 1.535

  Scirrhus ille∣g••••mu••.

  Melanchola non natura••is.
• * 1.536

  Differentiae 4. non natural•••• me••••ncho••••ae.
• * 1.537

  B••is a••ra ex∣quisite.
• * 1.538

  Gal. co••. 21.
• * 1.539

  Lib. 4. Apho. Lib. 14. The∣rapeutices.
• * 1.540

  Melancholy cōmeth by the adustion of o∣ther humours.
• * 1.541

  Com. 29. lib. 3 praed••ct. Hyp.
• * 1.542

  〈1 paragraph〉〈1 paragraph〉
• * 1.543

  Melancholy through 〈…〉〈…〉 humours 〈…〉〈…〉
• * 1.544

  Scirrhus phleg¦mon••de••, oede∣ma••••de••.

  Erysipela••••des
• * 1.545

  Scirrhus ex∣quisit••••.
• * 1.546

  Scirrhus can∣••rosus.

  Scirrhus pro∣p•••••• quod.

  Cause•• 3. scir∣rhi ••••g••••m••.
• * 1.547

  Signae.
• * 1.548

  14. meth. med.
• * 1.549

  Guido n••tas Cancri tribuit scirrho.
• * 1.550

  Iudicia scirrhi
• * 1.551

  Ferinos.
• * 1.552

  The cure of a true & lawful scirrhus, yet not exquisite, & growen in∣to a stony hard¦nesse, altogi∣ther insensible Three Inten∣tions.

  V••ctus ratio. Euchyma. Panis. Potus. O••a. Carnes. Olera.
• * 1.553

  Carner. Limacet.
• * 1.554

  Pisces. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 is made of vine∣ger and salt.
• * 1.555

  Legu••inum panis. Typhae. Vinum.
• * 1.556

  Caseus.
• * 1.557

  Sanguinem adurentiae.
• * 1.558

  Animi 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.

  Exercitatio.
• * 1.559

  Vacuatio ma∣teria antece∣demi••.
• * 1.560

  Vacuatio ma∣tr••••ae 〈◊〉〈◊〉.
• * 1.561

  Materia 〈7 words〉〈7 words〉.
• * 1.562

  Medicines 〈…〉〈…〉 scir∣rhus.
• * 1.563

  〈◊〉〈◊〉 medica∣•••••••••••• ad 〈◊◊〉〈◊◊〉 & di〈7 letters〉〈7 letters〉.
• * 1.564

  Ga••eni cata∣p••asma. T••••rap. 14
• * 1.565

  I•• scirrhus wil m••••ter.
• * 1.566

  ••••rhus illegi 〈◊〉〈◊〉 & non 〈◊◊◊〉〈◊◊◊〉.
• * 1.567

  The causes of hardnes in the partes of the bodie.
• * 1.568

  Scirrhi ex co∣incidentia pro¦creati.

  The signes of an vnlawfull scirrhus.
• * 1.569

  Iudicia.
• * 1.570

  Scirrhus ex∣quisitus cura∣tionem non ad 〈◊〉〈◊〉.
• * 1.571

  Scirrhi incu∣rabiles.
• * 1.572

  Summa curan∣dorum scirrho¦rum.
• * 1.573

  Medulla sena
• * 1.574

  Adipes.
• * 1.575

  Gal. 14. meth. med.

  Anadendro∣malache.
• * 1.576

  Oleum reci••••••
• * 1.577

  14. Meth. med. 〈◊〉〈◊〉 A••eti.
• * 1.578

  Historia. Lib. 2. ad Glauconem. Oleum sabinum.
• * 1.579

  〈◊〉〈◊〉.
• * 1.580

  The cure of scirrh••us si∣••••••es & vey∣nes, out of Ga••ene and Pae••lus.

  Lapis milites. Lap••s pyrites.
• * 1.581

  Oleum sabi••ū.
• * 1.582

  2. ad Glauco∣nem.
• * 1.583

  Lib. 6.
• * 1.584

  The summe of curing scir∣rhous tumours.
• * 1.585

  Cancer partai∣neth vnto two kindes of dis∣eases.
• * 1.586

  Of 〈…〉〈…〉 engendred. Cancer fine vlcers.
• * 1.587

  Cancer 〈◊〉〈◊〉 vlcere.
• * 1.588

  Cancre 〈…〉〈…〉.
• * 1.589

  Can••ri nomen à ••ancro aqua ••ico.
• * 1.590

  Cancri notae per i••itia con∣fuse, & ob∣scurae.

  Lib. 14. The∣rap.
• * 1.591

  Notae cancri ••urdentis non vlcerati.
• * 1.592

  Iudicia. Lib. 14. Ther.
• * 1.593

  Celsus lib. 5.
• * 1.594

  Ga••. lib. 2 ad. Glauconem.
• * 1.595

  Apho. 38. Lib. 6.
• * 1.596

  VVhat cancre must be rotted out, and what not.
• * 1.597

  An exulcerate cancre worst of all.
• * 1.598

  VVhat things doe foretell exulceration.
• * 1.599

  Curatio cancri non vlcerati.
• * 1.600

  Primus sco∣pus.
• * 1.601

  Victus ratio tenuis sit & probi succi.
• * 1.602

  Secundus s••o∣pus.

  Humoris me∣lancholi•••••• a∣c••ratio.

  Epithymum.
• * 1.603

  Hiera Ruffi Hiera A••i∣cennae.
• * 1.604

  Sanguinis ••us¦sio.

  Lib. 14. meth. medendi.
• * 1.605

  T••rtius sco∣pus.
• * 1.606

  Quod 〈…〉〈…〉 cancris.
• * 1.607

  Lib. 14 Ther.
• * 1.608

  Su••••••s solani. Diaphompho∣lygos.

  〈◊〉〈◊〉 ••enicon s•••• ••ma Vnguentum 〈…〉〈…〉
• * 1.609

  Arp•••••••• me∣dicamentum.
• * 1.610

  The force of leade it mer∣uelous in can∣crous tumours. Paulus lib. 4. 〈◊〉〈◊〉 archigene.
• * 1.611

  Lib. 14. Meth. med.
• * 1.612

  Chirurgery not rashly to be vsed in can∣cres.
• * 1.613

  Lib. 5.
• * 1.614

  Capita curati∣onis Cancri non vlcerati.