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

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

CHAP. XXX.

Of Artheroma

I HAVE omitted several other Tu∣mours, which by most Authors have been ranked amongst Generals, and have them contracted amongst others in their particular places, where they generally or for the most part are re∣puted to take their abode: and of these I begin with such which frequently do possess and inflict the Head, and so then gradually usher in all such as do af∣fect the rest of the parts of the Body even to the Foot and Toes. Of these which do afflict the Head are reckoned Artheroma, Steatoma, Meliceris, Ta••∣pa, or Testudo, Hydrocephalos, Tinc••, Psydracium: all these being most com∣monly allowed to border and inhab••••

upon the outward,* 1.1 and inward, and up∣per part of the hairy Scalp and Crani∣um. Of the first of these is Artheroma, which is an Abscess containing in its Cistus or bagg Matter much resembling that of Pultice, arising from mixt Hu∣mours, in which is Flegm as its cheif Agent, from whence it gaineth its white Colour. It is also accompanied with o∣ther Waterish qualities, eroding the parts, being much like Whey. It is a longish round sublated Tumour, being pressed with the Finger not readily yeilding, nor yet making retrogradati∣on the fingers being taken off. The Cu∣rative Intentions here are the same with those of all other Abscesses:* 1.2 Yet here is to be observed, that the Curation of all Abscesses is contained in the Discharge and Evacuation of the Matter, the which is either Sensible or Insensible; the In∣sensible to be cured by Digestives, the Sensible to be ablated by Section.* 1.3 These being proposed, we are to cure Arthe∣romaes by Septicks, as Verdegrease, Chrysocolla, Arsenick, Orpiment, Lime, Chalk and the like: or this. ℞. Calc. viv. ʒij. faec. Vin. combust. Nitr. liquid. tost. ʒij. Min. ʒi. Lixivio terantur, & ad mellis substantiam reducantur. If it yeildeth not to these, or you find it

ripe for the Instrument, use this Method, place your Patient in a good form for your Operation, let his Head be shaven about the place where the Artheroma is; 'then mark with ink how far or long you intend to make your Incision, which should be quite through the whole Tumour, the which sometimes doth require a cross Incision, as that you pass it as far the other way, if it be large. Here use your Incision-knife, it being for this purpose the most pro∣per and convenient Instrument;* 1.4 and here are you carefully to observe that you only divide the upper Cutis, and that you perform this so dexterously, that you do no ways touch the Cistus of the Artheroma; and that you may do this more promptly, you are to have Spunges in readiness to dry up the Blood, that the part may better shew it self. The Section being made, sepa∣rate the Cistus either with a Probe or some other convenient Instrument, the which for the most part you may do with ease: separate it from the Cutis with your Incision-knife; but in the lower part, that you may divide the Vein or Artery that gave it its being, origination, and growth. After you have discharged the Matter, and the

Cistus, apply this following Digestive ℞. Terebinth. venet. ℥i. pulv. Thur. ʒi. Myrrh. ʒi. Ol. Hyperic. ℥i. Ol. de Vitel. Ovor.* 1.5 q. s. fiat Ʋuguentum. In this Ci∣ty of Norwich I thus cured A French Mans Wife of several Artheromaes which possessed her Head, one of which was very large and soft, the which I open∣ed with making a cross Incision, having well prepared and purged her Head with Cephalicks, as Extractum Rudii, Pillu∣lae Aureae, and the like: After this I opened the Abscess, and discharged the Matter, ablated the Cistus; and this being removed, I perceived a small Capillary Vessel upon the taking away of the Bag to spin and spend its Blood which streamed out, the which I speedily stopped by the application of some of his Majesties Stiptick water, which I applied to the part by dipping a small Pledget of Lint (the which an∣swered my expectation) and so bound it up: The Day following I drest her again with Spirit of Wine, & Elixar Proprietatis, by the application of which within few days the Woman was perfectly cured; her large Abscess dis∣charged; her other small ones, which were six (the which I believe were fed and nourished by the same small Arterial

Branch) were by degrees dispersed, and at length vanished. Coming to the same Patient not many Weeks after to en∣quire how she was, I found the rest per∣fectly were gone, which gave me satis∣faction of my conjecture: for upon the escharotizing of this Branch not only their growth were hindred, but also a perfect banishment procured of the whole, and (to the praise of the Highest) she remaineth very well without any fear of a new growth of the same.

CHAP. XXXI.

Of Steatoma.

THIS is an Abscess having in it the substance of Fatt or Sewet, small at first, but in process of time growing larger: It is a Tumour round, not elevated, but depressed; and Aetius doth add, it adhereth firmly to the Skin: Its substance is not fluid, but compact and coacted: It is not therefore contained in one Bag, as the former, but is lodged between two Coats. And when

it is in the Head, it doth contain in it a Matter resembling Sewet, a large Ba∣sis, and doth not yield to the touch; when it is in other parts, it is seen to contain in it Matter much like Fatt, more like this than Sewet; neither is its co∣lour there so white: It is generated, as is Sewet, by reason of the Intempe∣riety of the place, or by reason of ill Blood. They are scarce ever cured, but by manual operation. If the Vesicle be broken, and you do not draw all out, it will leave either a Fistula, or a foul Ul∣cer. As touching its Cure, in respect of its hardness, broad Basis, multitude of Sewets, it is only to be handled as other Abscesses; this Sevum is to be wholly separated from the Pericranium, lest the Abscess do make a fresh re∣turn. Here may you make a cross In∣cision, if it be large, and take care of touching the Vesicle, lest you make a faetid smell and ulceration: This being performed, press out your Cistus, cut off the branch that fed it, and have a care that the least particle remaineth not: this being done, cleanse it, and use your greatest care to produce a Ci∣catrize. There was a Gentleman, who was troubled with a Steatoma in his Inguen,* 1.6 weighing near forty pounds, his

whole Body redounding with pituitous Blood; a good and thin Dyet being pre∣scribed, ordering him to abstain from all viscid and thick food, as Milk, Cheese, and the like, and prescribing him a Ho∣ney-drink, in which Ginger and Time were boyled, and outwardly applying such Medicines as may discuss this Fleg∣matick matter, as Fomentations and the like being every Night and Morning repeated, and preparing the Humour with Oxymel of Squills, and then by intervals ordering him to take some of these Pills of Aloes Rosatae ℈5. Troch. de Agaric. ℈ij. Turbith. gummos. ʒss. Squi∣nanth. rad. Asar. an. gr. 5. ZZ. ℈ss. Cinamom. ℈i. Rhabarb. ʒss. Troch. Al∣handul. gr. 15. cum Oxymelit. Scillitic. q. s. fiat massa pillul ••rum. dosis a ℈ij. ad ʒi. And this Oyl being outwardly applied as ℞. Ol. Philosophor. La∣tern. lss. Thur. Mastich. gum. Arabic. Terebinth. venet. an. ʒiij. pistentur, & per alembicum distilla, & fine distilla∣tionis addatur Sal. ex ciner. Cerr. & iterum distilla, quod pro usu reserves. By these this great Tumour was dissi∣pated and digested; this you may read of in Langius Epistol. 4. lib. 3.

CHAP. XXXII.

Of Meliceris.

THIS Abscess hath a Matter con∣tained in its Cistus much resem∣bling Honey, and is thus by Ae∣tius described; It is an Abscess enclo∣sed in a Nerveous Coat, containing a Matter like Honey, wanting pain, ha∣ving a round Figure, easily yielding to the touch, and the finger being taken off it doth as speedily turn into its for∣mer condition.* 1.7 The cause hereof is a mixt preternatural Humour. And although every Abscess contained in a Bag hath Matter going along with it, yet are these divided into four Modes or Forms: hence in a Meliceris, because it is soft and thin, its Flegm is mixed with a greater quantity of Choler than in an Artheroma, or Flegm, out of which is made this Meliceris.* 1.8 This is to be cured three ways, by Digestives, Causticks, or Amputation. As touching the Sep∣ticks or Causticks, we have already treat∣ed in Steatoma: we shall here more pro∣perly treat of Digestives, the which be∣cause they do discharge this Matter per¦poros

cutis, they ought to be powerful and strong, and to exceed in their vi∣gour more than in those Abscesses which are enclosed in Bags. Whence in small and moist Melicerides a Decoction Pulegii, Calamenthae, Hyssopi & Melissae made and applied hot with a Sponge is here accounted very proper: but if stronger be required, you are to make a stronger Lixivium, in which boil the aforesaid Herbs, and apply it to the part affected: or for the same you may use this of Aetius, which he hath in his 15th Book, ℞. Sal. armoniac. Spum. argent. li. Cer. Terebinth. Galban. Opo∣ponac. an. ℥i. Rubric. Synopic. ℥.vi. Acet. heminam. misce; Or this, ℞. Dia∣chyl. ʒ 12. pul. Irid. ʒij. misce. or Dia∣chyl. cum gummi, to which may be ad∣ded a little powder of Ireos.* 1.9 Empla∣strum Alexandrinum here also is much commended, thus made ℞. Sal. Ar∣moniac. Litharg. Cerus. an. ʒi. Galban. Opoponac. an. ℈iiij. Sem. Sinap. ℥ss. Ol. veter. ℥iiij. Cer. Terebinth. an. ʒi. mis∣ce, fiat Emplastrum. If this Method succeedeth not, we are to come to the use of Suppuratives: And of these some may serve for the prohibiting the egress of Vapours, and not only obstructing, but also keeping in the inward native Heat:

others do not only obstruct, but do also heat, and by the calefying quality do rarefie and thin the parts; of the same qualities should our most proper Medi∣cines be framed, as this of Rhasis. ℞. Farin. Sem. Lin. ʒij. Faenugraec. ℥ss. pulv. Sem. Caul. ʒi. Mucilag. rad. Alth. q. s. fiat Empl. In the last place I take crude Figs, and beat them in a Mortar, and to these I add a Snail, and beat with them, and order this Medicine to be laid on, and so kept on, until it falleth off of its own accord. After you have made it fit to open, discharge the Mat∣ter, as I have directed you in the other two Chapters; then apply Digestives, convenient Detersives, Sarcoticks and Epouloticks. Amongst all these three Tumours I must acquaint you, that it is not very frequent for the putrid Mat∣ter to exalt it self in these Tumours of the hairy Scalp; and therefore Causticks are the most proper Instruments to oc∣casion this, but here not to be used. Langius lib. primo Epistol. 38. Writeth of a Woman, who having an Ulcer in her Matrix had also a Meliceris accom∣panying it; and when it gave the great∣est hope to the Chirurgion of its con∣solidation,* 1.10 a new Ichor began afresh, and forced it self out; she being thought

to be bewitched, by good Prayers and divine Ejaculations the Woman had her Ulcer spontaneously consolidated and cured.

CHAP. XXXIII.

Of Psydracium.

THIS is a yellowish sharp Pustle, out of which, if it be pressed, cometh a Moistness accord∣ing to Celsus. Galen seemeth to place it sometimes amongst the Tumours of the Eye-lids, sometimes he will have it a Tumour of the Head.* 1.11 It is called Psy∣dracium, either because it is seen to ap∣pear sharp in the Head, or else because it doth contain in it a great quantity of a waterish humidity. These do arise from mixt Humours; and by how much the whiter they are, this shows they have more Flegm in them, the harder come from Choler, and the sharp and small from Water.* 1.12 The Cure is to be performed by moderate Coolers, and Discussives; Coolers as for allaying and tempering the heat of Choler, and

Discussing in respect of Flegm: here also are to be observed a good order of Dyet, a good respect to the habit of Body to keep it open, and by purging it from its Flegm and waterish Humours as this. ℞.* 1.13 Extr. Rud. ℈i. Pil. Coch. ʒss. Resin. Jallap.* 1.14 gr. vi. misce: or this, ℞. Pil. sine quib. aur. Indic. an. ʒss. Resin. Scammon. ℈ss. misce for two doses. The part affected is to be treated with Cool∣ers and Discussives, as are Mallowes, with Barley Meal and Cicers being made into a Decoction, or some of my dis∣cussing Cataplasm already prescribed, or this ℞.* 1.15 Farin. Fabar. ℥i. Hord. ℥ij. co∣quantur poscâ ad formam Cataplasma∣tis, in fine ebullitionis adde pulv. Ro∣sar. rubr. ℥ss. post unam ebullitionem ab igne remove, tunc misce album. & vi∣tel. Ovor. n^o. Ol. Rosar. parum, misce, fiat Cataplasma. If the Psydracium be ulcerated, and a moist Humour cometh from thence, apply this ℞. Litharg. aur. ʒi. Ceruss.℥ss. Alumin. ʒij. fol. Rut. cum Aceto & Oleo simul mixt. fiat Ʋn∣guentum, with which anoint the Skin; and having well embrocated it with this, you may conclude your Cure with this Liniment. ℞. Lithargyr. aur. Ceruss. pulv. an. ʒij. Sulphur. ʒi. Ol. Rosar. q. s. fiat Linimentum: And lastly, aqua

Scahiosa is by many held to be most excellent here Alome being added to it.

CHAP. XXXIV.

Of Hydrocephalos.

THIS is a proper Tumour of the Head, arising for the most part from Water, and hence doth it take its name. This is a Distemper which doth very oft come into the World with young Infants, being ei∣ther bred with them in the Womb, or else so as they are bringing into it. It may also be occasioned by a careless, or ignorant, or unhappy Midwife. It may well be called a Cephalick Dropsie, for it doth contain in it a proper Waterish substance, known by its indolency, soft∣ness, its easie yielding to touch, but chiefly from its inundation of Water running out of one place into another in its compression. These Tumours do often times vary;* 1.16 for in some they are small, whilst in others they do appear very large; It is a peculiar Disease in

the Head of young Children, the which a∣riseth from too much Humidity of the Head; for which very Cause they which are much troubled herewith, do seldom live long, as both Galen, Aetius, and Paulus do observe. This Tumour by Galen in Libr.* 1.17 definitionis is thus designed, as being a collection of waterish Humours, or feculent Blood in some parts of the Bo∣dy, which doth force it self up to the Head. And here is a double meaning to be explained; the one, whereas he calleth it not only a collection of a Serous Humour, but also of a feculent Blood, as when the Head & Cranium suffers an outward Con∣tusion or Collision, and the Veins by this Collision do sprinkle their Blood between the Cutis and Pericrane. This Blood here thus putrifying doth make a most soft Tu∣mour; and if a serous aquosity were col∣lected, the which by dayly experience may well be offered to happen, from a Con∣tusion thus happening it may frame a Hy∣drocephalos. Aetius lib. 6. cap. 1. will have that a Hydrocephalos may be generated from a Feculent or bloody Matter, the which being changed into a thin substance. A se∣cond of Galens is, that a Hydrocephalos is a collection of an aquous Humour in some part of those Bodies, which have a forcing quality towards the Head; out of

which it may be conjectured, that Galen doth offer, that Hydrocephalos to be a Disease of some part of the Head, not a Dropsie of the whole Head; and this is confirmed by Aetius and Paulus, who treating of Hydrocephalos do allow four species hereof: First, when this Humour getteth between the Brain and Mem∣branes: Secondly, when it lyes between the Membranes and the Skull: A third between the Bone and the Pericrane: And Lastly, when between the Pericrane and the hairy Scalp.* 1.18 I have already shown you part of its Signs; that it is a Tumour soft in touch, whitish in co∣lour, indolent, turgid, much like a Pil∣low to other parts, easily yielding to touch, and as speedily filling up its former made vacancy, the Finger being removed. If it ariseth from a Contu∣sion, it doth appear first red, and doth carry pain with it, as Aetius doth write; but being afterwards changed into a thin substance, it doth spread it self without pain. In those where it hap∣peneth between the Pericrane and Bone, they answer plainly the rest; for here it is hard in Tumour, and very pain∣ful, by reason of the distention of the Pericrane; If it happeneth (as some∣times it doth) between the Membrane

of the Brain and the Skull, it will be a Tumour, but not yield to compression, nor soft to touch. Here it maketh the Infant soon to give way to it, and to yield up its Ghost.* 1.19 Its Causes may be said to be sometimes outward, some∣times inward. One of the outward may be said to be that which is mentioned by Paulus in Children newly born, who had their Heads but ill bound up by their Midwives; Another is contusion, or collision, or ruption of one or many Vessels; Another cause is a cold Air, or too much Water, or thinness of its passages or Vessels, out of which this Serum or matter do recide, as Aetius hath it; or also too cold or waterish Milk, which it may suck from the Nurse: these may be said to be the inward Causes hereof, as when the Brain is too much cooled, or the matter being here first collected, and hence sent to the Brain. Every Hydrocephalos is very slow in its motion, as Aetius doth prove. Lib. 6. Cap. 1. For it hath a cold Brain inward∣ly from its beginning, arising from its inward Cause, and also an outward by and from its outward Cause, by reason of its delay and contaction.* 1.20 To draw all these to one head, there is to be al∣lowed two Species of a Hydrocephalos:

One in which this waterish Humour is contained and made by an inward Cause, that is out of an abundant collection of this serous matter in the Body: The se∣cond doth not contain the sincere Se∣rum, but as it were a mixt feculent Blood, the which doth eat it self out of the lacerated Veins, arising from Contu∣sion or some other outward Causes. As to its Presage,* 1.21 Paulus Aetius and Galen do offer, that if this Humour be col∣lected between the Brain and its Mem∣branes, it is mortal; in other parts it may admit Cure, by curing its Causes, and removing its Effects. But here, as well as in other parts of the Body, the Rules of Celsus and Galen are to be ob∣served; every Disease is so much the more dangerous, by how much it gets into a greater bulk and bigness. As touch∣ing its Cure,* 1.22 we shall begin with that which is extant between the Hairy Scalp and Pericrane: And herewe are to observe, that every Hydrocephalos is to be cured by discharging of this waterish substance, which is to be performed by purging the whole, and cleansing the affected part. And with this we are to begin with general Cephalick Purgings; in which Case may be used these and the like for Pils: as ℞. Pil. Coch. ʒss. Resin. Jallap.

℈ss. Cambog. gr. iiij. misce. These are to be given to such as have arrived at Man∣hood; Children may be prescribed Syrup of Roses solutive, Syrup of Cichory with Rhubarb, Syrup of Buckthorn Berry and the like, either by themselves, or given with a Decoction made of Betony, Fen∣nel-Seeds, Anisc-Seeds, Asparagus, Li∣quorise, and the like. Sweating here also is very proper, for which you may make a Decoction of Sarsafras, Sar∣saperilla, Guaiacum with Seeds, &c. Hence are we to warm and strengthen the cold and moist Brain: and this is to be performed by Insensible Evacuation, the which I much better approve of than of a sensible; because it is neither so safe nor so secure, for oft times times here, as well as in making a Paracenthesis, the Patient dyeth in few days after the Ope∣ration, if not at the Operation. For dis∣charge of this contained Matter, by rea∣son of the thickness of the Cutis, this is to be rare••ied and softned; and for this purpose this Fomentation is very proper, in which we may dip Sponges and ap∣ply to the part, as ℞. Malv. Melilot. Aneth. an. M. i. Rad. Alth. ℥i. fl. Chamomel.* 1.23 Melilot. Rosar. rubr. an. M. ss. coquantur omnia in Vino albo q. s. & fiat Colatura, in hac colaturâ im••uatur

Spongia & parti admoveatur. In such which are large, to these you may add Roch Alume or Sal Armoniack, and boil with them, and so apply them. Gulielmus Placentinus doth offer Discussives as to be here most proper,* 1.24 and doth order this. ℞. Ol. Aneth. Chamomel. an. ℥ss. pulv. Sulphur. ʒss. misce. Fallopius on the contrary doth as much esteem of Repel∣lers, wherewith he doth declare he hath done very strange things, and saith, that only by the help of Oyl of Roses and of Oyl of Myrtils he hath cured se∣veral Hydrocephalick Tumours in four days space. Sometimes he doth add to those two Oyls green Cypress leaves and Wormwood bruised, and with this he frameth a Liniment.* 1.25 Amatus Lusita∣nus writeth, that he cured a Child of a Hydrocephalos in three days with this following Unguent. ℞. pulv. Absynth. fl. Melilot. Chamomel. an. ℥ij. Butyr. recent.* 1.26 Ol. Chamomel. an. ℥iiij. Cer. flav. q. s. fiat Ʋnguentum. Or here al∣so may you safely use this Unguent. ℞. Ol. Laurin. Costin. an. ℥ij. Ol. Spic. de Laterib. an. ℥i. Sulphur. Sal. commun. Alum.* 1.27 ust. an. ℥ss, Terebinth. ℥ij. misce, fiat Ʋnguentum: Or this Cataplasm, ℞. pulv. Absynth. Origan. an. ℥i. Mell. lss.* 1.28 Sal. ℥ss. misce, fiat Cataplasma: Or

this Emplaster of Empl. de Bacc. Laur. Sulphur. & Ammoniac. of each equal parts. If it yieldeth not to these, but you be forced to Section, be sure your part be ripe enough and fit for your Knife: and when you make it, let it not be made too deep, but make it through the middle, as Paulus doth order, if it be small; if large, then are you to make a transverse Incision like the Letter X, and afterwards get out all the Matter, cleanse it, and follow its Cure, as I have directed you formerly in Artheroma, S••eatoma and Meliceris. But before you proceed to this operation, consider with your self these Inconveniences, which may follow and ensue, that whilst you let forth this Serous Matter, you do let in Cold and Air, which do extinguish the native heat of the Brain. I rather assent in such despe∣rate Cases to the opinion of ••abritius, by letting out this matter by degrees, by making a small Orifice, and therein pla∣cing a silver hollow Pipe, which is shut up with a Silken Stopple, by the drawing forth of which you may let out as much or as little as you please, in the same method and manner as you use it in a Paracenthesis; through this Pipe also may you inject any convenient Liquors, or Decoctions; And this partly sen∣sibly,

partly insensibly this Humour may both with ease and safety be drawn forth. And if it should arise from any Rupture of the Vessels, in which not only the Serous Humour, but also fecu∣lent Blood is contained, these are to be both discharged, discussed, incised and attenuated; and for this you may dip a Sponge in Posca, or Wine and Vinegar, and apply it. Barly Meal and Oxymel well mixed together may be very properly ap∣plied here. I shall here give you some strange Examples, by which you may easily perceive, how soon our natural Fabricks may be pulled down and washed away, even at our first appearance on this mundatory Stage.* 1.29 Vesalius writeth, that he saw a Girle of two years old, whose Head was larger and greater than any Mans Head, occasioned thus by this sort of Tumour, and the Cranium not bony but membranous, and that there was nine pound of water did run out from this Tu∣mour.* 1.30 Leonellus de Morb. Pueror. Cap. 14. saw a young Child, which had its Head so much swelled with Water, that one might see through its outward Scalp the sutures of the Skull; the cause of this great quantity of Water thus ex∣pending it self out from the Skull was occasioned by the Midwife and Nurse, the one in the extracting of the Child

from the Womb, whilst the other did second it by compressing its Head too strictly, whence the Commissures were cut and opened, and the Humidity it self, which was in the Brain, came to the out∣ward covering of the Head, and thither pressed out its Humidities; and this was the occasion of this tumesied Head. Rhasis doth write, that he saw a Child, whose Head did so encrease in length and bulk, that its Body could not carry it: and it ceased not its augmentation, un∣til the Child ceased not to live. This you have Cap. 3. Lib. de morb. Pue∣ror. Forestus relateth of a Child being brought to him, having a very great Head occasioned by this Distemper, and this was his Curative Method: He com∣manded the Nurse that he might have a drying Dyet, it was oft times purged with Pills of Hiera Picra, and was a∣nointed with this Unguent. ℞. pulv. Absynth. Chamomel. Origan. an. ʒiij. pulv.* 1.31 Myrtillor. Rosar. rubr. fl. Me∣lilot. an. ʒi. Ol. Chamomel. q. s. fiat cum Bntyro & Cera q. s. ad formam unguenti: After the anointing with this, these Powders were sprinkled on its Head, made of Myrtils, Cloves, Roses, Cinamon, and Chamomile, by the bene∣fit of which it was perfectly cured.

And to conclude this, Montanus de In∣fant. pag.* 1.32 8. relateth of a Smith, who had his Head tumesied to that great∣ness, that it did exceed the bulk of an Oxes head, and that it obscured the whole Face with the Nose; he ordered a stick to be put into his Mouth, that he might obtain a free breathing, and by keeping every kind of a thin Dyet, and just Methods to carry off and remove the Humour, this Tumour at length abo∣lished and vanished.

CHAP. XXXV.

Of Talpa or Testudo.

THIS Disease is thus so called from the resemblance it hath with a Mole, which dwells and in∣habits in the Earth; for this is a creeping Humour, and gets between the Cutis and Pericrane. It differeth a little from Fi∣cus, because as that is a Tumour arising from mixt Humours; So is this elevating the Skin into a Tumour. It oft times doth so closely adhere to the Cranium, that it fouleth it. It differeth from a Ficus, in that it is larger and bigger, and therefore is longer in its coming to suppuration; for it is made of thick Hu∣mours. Its Causes are various,* 1.33 as salt and nitrous Flegm mixt with Choler, or a pu∣trefactive Water. In Children it doth breed most from sweet Flegm. Sometimes it doth breed of Flegm and Blood together, but seldom of Melancholy. We ought to be very careful and circumspective in Administring our Medicines here, because here we meet with both Humour and Fluxion; the Body therefore is to be pre∣pared and purged, the Humours cor∣rected,

and the Peccant Matter dis∣charged: and for these Pil. Aur. Coch. Aggregativ. Extract. Rud. Pil. sine Qui∣bus, these or any of these are very useful and profitable. Masticatories, and Ster∣nutatories, are here very convenient: and to the affected part we are both to use Emollients, and Digestives. If in the beginning of the use of Emollients the Humours may any wise rebel, quell their fury by Digestives, as by mixing Dia∣palma and Minium with a little Betony together. Stronger are Lilly-roots with Honey, Narcissus, Ireos with Honey, or the like applied. If it yieldeth not to these, it doth show it self tending to Suppuration; the which when you per∣ceive, you are not to disturb it, but rather help it forwards in its operation, by ap∣plying Empl. Diachyl. cum gummi Mu∣cilagin. Flos Ʋnguentor. In other Cases we are to use Digestives; as ℞. Caepar.* 1.34 coct. sub cinerib. n^o. iij. Vitel. ovor. indurat. n^o. iij. Mucilag. Alth. Faenugraec. Lin. an. ℥i. Ficuum contus. n^o. 10. Farin. Fenugraec. Lin. an. ℥iij. fiat Cataplasma, sub finem addendo Axung. Porcin. q. s. then let it be open∣ed, and discharge all the Matter; then cleanse it with Meal of Lupines and Ho∣ney, or Ʋnguent. ex Apis, and generate

Flesh with Ʋnguentum Basilicon or Au∣reum, and dry up with this or the like:* 1.35 ℞. Tuth. praeparat. Rosar. rubr. an. ʒi. Balaust. Bol. Armen. an. ʒss. misce cum unguento Diapompholigos, & fiat unguen∣tum. Guido in his Chirurgick Tract.* 1.36 2. Doctr. cap. 1. relateth of a Man who had an ulcerated Talpa upon the Musculous part of the Head, the which corrupred, and fretted the Cranium so far, as might with ease be perceived the motion of the Pannicles: more of which you may read in the aforesaid Tract.

CHAP. XXXVI.

Of Tinea.

THIS is a Disease of the Head,* 1.37 pos∣sessing the hairy Scalp. Of this there are three sorts, The first hereof by Galen said to be furfurous or squa∣mous, for upon scratching it there do fall off many squamous Dandriff fleaks: A second called Ficus, it somewhat re∣sembling the inward part of Figs: A third by Galen called Achor, and this commonly is called corrosive and ulce∣rous. All these species do arise from a corrupt Humour, erring more or less in quantity or quality. The first cometh of the mildest sort, the second is more cor∣rupt, and the third is more putrid than the two former. If this Disease do for∣bear to show it self, until the party which is therewith perplexed is arri∣ved at the Age of Man, he may both purge and bleed;* 1.38 and for this effect such Pills and Potions, as I have already pre∣scribed in an Erysipelas, may with ad∣vantage be used here. As touching To∣picks, let them be emollient and dis∣cussive; as Marshmallows, Lilly-roots and the like; a discussive Fomentation

and the like: Scarrification and applying of Leeches, are here also very profitable: and afterwards anoint the part with this Ʋnguent of Guido.* 1.39 ℞. Ellebor. alb. & nigr. Atrament. Sutor. Latharg. aur. Calc. viv. Vitryol. Roman. Alumin. gallar. virid. fuligin. Ciner. faec. Vin. ust. Argent. viv. extinct. an. ℥iij. Ae∣rugin. Aer. ʒij. fiat pulvis, incorpore∣tur in succo Borag. Scabios. Fumar. Oxylapath. Acet. an. quart. i. Ol. an∣tiq. li. coquantur usque ad succorum consumptionem, in fine decoctionis adde Pic. liquid. ℥ss. Cer. flav. q. s. fiat Ʋn∣guentum. This is by all Authors held as a most excellent Unguent in scall'd Heads. The Crusteous or Ficous is to be fomented so long, as until the crusts do fall away, and for this Nasturtium tritum cum Axungia Porcina do make all fall off in 24 hours. Or this of Am∣brose Parrey. ℞. Pic. nigr. ℥ij. pulv. virid. Aeris, Vitryol. Roman. an. ℥i. Sul∣phur. viv. ʒss. coquantur omnia in a∣ceto acerrimo q. s. fiat Ʋnguentum. This is to be laid on for three days, and afterwards to be removed, this being our general way used in St. Thomas Hospital in London, the place from which I took my First-fruits of Chirurgery, under that Worthy Master Hollyer, by

all allowed a most excellent Lithoto∣mist and Operator in London. As to the third, deterge it with Ʋnguentum Aenu∣latum cum Mercurio, Aegyptiacum, of each ℥ss. Vitriol. alb. ust. pulv. ℈i. mis∣ce, fiat unguentum. And when the business hath been thus successively treated, for easing of pain, and smoothing the Skin, anoint the parts with this following Un∣guent. ℞. Camphor. ℥ss. Alumin. Roch. Vi∣triol. Roman. Sulphur. viv. Fuligin. an. ʒvi. Ol. Amygdal. dulc. Axung. porcin. an. ℥ij. misce, fiat Ʋnguentum.* 1.40 Hercu∣les Saxoniae relateth in his Observations of a Woman troubled with a Disease possessing the Hairy Scalp, called Tinea, who by frequent washings of her Head re∣covered her health, but in the interim she endured a continual pain thereof, and Fever, the which were not to be conque∣red by any Revulsives, Derivatives, or Purgatives, and in thirty days after she dyed; and upon opening the Cranium, the half of the Brain with its Membranes were found putrid, and filled with a yel∣lowish Ichor much resembling Urine.

CHAP. XXXVII.

Of a Ficus.

THIS hath its Name from the re∣semblance it hath with a Fig, for it carryeth in it as it were the Seeds of a Fig. This sometimes doth arise from the Head, and doth descend into other parts; sometimes it is wholly in the Head. Our present Discourse shall be only of that which doth possess the Head, the which be∣ing rent will yield a fair prospective of the Seeds of a Fig. It is by Paulus called an ulcerous eruption, hard, and red; with pain. Hyppocrates doth number it amongst Tu∣mours. It is therefore a Tumour, because it doth soon degenerate into an Ul∣cer, as Galen hath it. 5. De Med. per Locum c. 4. It is a Tumour generally in the Head, especially of Children. It is made of mixt humours,* 1.41 as thick Blood, Flegm, and Serum, because it is a red Tumour, round in the Head, and by its Flegm mixing with it cometh this serosi∣ty; and hence it is that these sort of Tu∣mours do so suddenly run into Uucers, if not suddenly and well cured.* 1.42 In its Cure are we to prohibit its Ulceration, for it

soon exulcerates, if not well cured. And here we are to begin with purging and cleansing the Body from these Humours by Pil. Coch. Aggregativ. Sine Quibus, and the like, and by Diaphoreticks to dry up this moisture; the part affected is to be discharged of this Serum, and pro∣hibiting suppuration. And therefore to Children troubled with such a Disease you may use such a Medicine as this, ℞. Aqu. Marin. vel aqu. fontan. in quâ imponatur Sal M. j. in his coquan∣tur herbae Saliv. Rosar. rubr. Absynth. an. M. ss. cola. In this you may dip Sponges, and apply them warm to the affected part, and afterwards lay this Plaister-wise, Take Figs being boiled in Water to the form of a Pultice and apply them. If you require stronger Medicines, ℞. Alumin. Roch. Calcanth. ust. an. part. aequal. sqam. Aer. dupl. Glut. in Aceto diluatur, & cum reliquis impo∣natur. If it be exulcerated, apply Ceratum Citrinum, Sem. Lin. trit. cum aqua. Let it be deterged with the pulp of Figs, to which may be added a little burnt A∣lume: and skin it with Desiccativum Rubrum or Diapompholigos.* 1.43 There was a Minister of forty years of Age, who was much perplexed with a Scirrhous Tumour at the great corner of his Eye,

the largeness of a Chesnut, being of a livid colour, intertexed with many ca∣pillary Veins. The Body being well purged, and a good Dyet ordered, and being let Blood on his left Arm, the same side where this Tumour possessed, the Tu∣mour was extirpated with a pair of cut∣ting Forcipes. After which was ap∣plied the white of an Egg mixed with Rose water: then following were applied Anodine, Abstersive, and very drying Collyriums, oft time•• repeating the Pur∣gations, and Administring cupping Glas∣ses to the Neck and Scapulaes; and to the Forehead was applied this first being Anodine, and afterwards this second be∣ing very drying. The first was this, ℞. Mucilag. sem. Cydonior. & Plantag. cum aqu. Rosar. extract. Lact. muliebr. an. ℥ij. Camphor. Croc. an. ℈ss misce, apply i•• warm. The second this, ℞. A••u. Plantag. Rosar. an. ℥iij. Tuth. praeparat. 〈◊〉〈◊〉. ust. & praeparat. Ceruss. lot. an. 〈…〉〈…〉 fiat Collyrium. By the benefit of these, and observing his prescribed Direction he was perfectly cured.

CHAP. XXXVIII.

Of a Cataract.

I NOW proceed to Tumours of the Eyes, and under this Head I shall comprehend Suffusio, Hordeolum, unguis Oculorum and Encanthis. Suffusio or Cataract by the Greeks is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, and this is an affect of the Eye, whose cause is as it were a concreted glassy Humour gotten between the Cor∣nea and the Chrystalline Humour, cloud∣ing it and obscuring its Species of Ob∣jects, sometimes covering the whole Pu∣pil, whilst at other times it is seen only to cloud but half thereof. And accord∣ing to its more or less spreading, it doth either in process of time wholly abolish, or partly diminish the sight. And as Pla∣terus doth observe, it groweth in length of time to the thickness and hardness of an excocted Egg. It is oft times made by a concretion of a Flegmatick Humour,* 1.44 bred either between the Coats of the Eye, or its Pannicles or Spots: It ariseth also from an influx of Humours; or is occasioned by some outward Action, as a Blow, or Fall; or thick and fumid Va∣pours arising from the Stomach, and so

getting into the substance of the Brain, are from thence sent and diffused into the Eye, and at length do there contract its concretion. It may arise also out of weakness and cold. Celsus lib. 7. cap. 7. saith, that there is a space or distance between the Cornea and the Ʋvea, and in this empty space, as he does imagine, lodgeth this Cataract or Suffusion, and there takes its Origination. Paulus lib. 6. cap. 21. saith, that a Suffusion is a Concretion of an idle or sedentary Hu∣mour in the Cornea near the Pupilla; but this carrieth not so full a measure of truth as the former. Galen 10. de usu partium cap. 1. & 4. offereth that this Humour doth grow between the Cor∣nea and the Crystalline. Yet Fabritius ab aqua pendente doth affirm, that in the three persons which he hath couched, and that in all People which he hath seen use the same Operation, the Nee∣dle hath been applied backward under the Ʋvea before the Suffusion would ap∣pear: and therefore it is probable, as he mentioneth, that behind the Foramen of the Ʋvea this Humour should consist, because if it did grow in its Circumfe∣rence, it could not be dilated. Where this Cataract is confirmed, and comes to ma∣turity,* 1.45 we may with ease perceive the

thin Membranes visited with a strange Species of a thin clouded Pupil, va∣riously coloured according to the diver∣sity of Humours, as sometimes with white, or black, or blewish, yellow, red, or green; and by these or any of these the Eye is oft times clouded and depri∣ved of its sight. If it do possess half the Pupil, it takes away but half; but when it creeps and overcasts the whole, it doth cause perfect blindness.* 1.46 Its Cure is to be begun with a good order of Dyet, and convenient Medicines, and Instruments artificially prescribed and ap∣plied: Abstaining from Wine and such hot things, as may disturb the Brain; Shunning flegmatick Dyet, and such as is of a flatulent and pituitous Juice. If the Patients Bread have some Fennel-seed put into it, it will be so much the better; for this is generally reputed not only to help the sight, but also is very advanta∣gious for dissipating of cloudy Vapours. Bleeding, Purging, Frictions, are here very useful; Masticatories chewed in the Mouth are proper; Cupping Glasses and Vesicatories applied to the Neck and Shoulders are here also very requisite for Derivation; Pills and Potions for purging the Head of these flegmatick Tumours are wonderfully helpful. For Purging

Means or Methods take some of ℞.* 1.47 Pil. Sine Quib. ℈i. Pil. de Cynogloss. ℈iss. Ol. Faenicul. gutt. iij. cum syr. Beto∣nic. q.* 1.48 s. fiant pillulae. Or these ℞. Alo. optim. ℥ss. Turbith. gummos. Hermodact. Agaric. recent. trochiscat. an. ʒij. Dia∣grid. ʒi. ZZ. Caryophyllor. an. ℈ss. Croc. Sal. gemm. an. gr. vij. pulverisen∣tur & cum Syrup. de Staechade q. s. fiat Massa pillalar. hujus sumat à ʒss. ad ℈ij,* 1.49 &c. A potion for the same. ℞. Sen. ℥ss. sem. Anis. Caryophyllor. an. ʒss. fol. Menth. Betonic. an. M. ss. Summitat. Thym. Paralys. Anth. an. pug. ss. co∣quantur ad ℥iiij. colaturâ infunde A∣garic. recenter troch. ℈ij. Cinamom. ʒss. misce fiat potio. For outward Medicines there are innumerable by most Authors already mentioned: amongst the best of them all may be reckoned this, very oft times used by my self with good suc∣cess. ℞.* 1.50 Succ. Haeder. terrestr. Chelidon. Bellid. an. ℥ss. Aqu. Rosar. albar. ℥i. pulv. Sacchar. condit. albissim. ʒss. Mix these, and being made lukewarm let the Patient wash his Eye oft times in a Day. it both attenuateth, dissolveth, and penetrateth. And these are the most powerful intentions in this proposed scope. But if all these should fail, and this Cloud do still encrease and grow

thicker, leave off the use of external Me∣dicines, and let it grow until it be full ripe for manual Operation, and this you may gain by observing this Method; the sound Eye being shut, if the other be well rubbed with the Finger, the Pupil will presently dilate, and diffuse it self, and will very speedily return into its place, figure, colour, and State, and this by some is reputed to be ripe enough for manual Operation. Those Cataracts are by most Authors held to be incu∣rable, which do arise out of a sharp and tedious Disease, and having with them great pains of the Head, or that which cometh by a vehement blow or stroke; such as are black, green, livid, yellow, or of a Quicksilver colour are hardly cu∣rable. On the contrary, such as have a Chesnut colour, or resemble that of the Sea with some White, are cured without much difficulty. And since it is not such an easie Operation, but may and hath puzled the best Oculist and most exact professor of this Art, consider that this Cure by couching is not always suc∣cessful: But as it oft times happens well, so also hath it its intervals of bad success; for by these the Grapy Coat is too much diduced, sometimes rent, whence follow its amplification; or distorted, often after

[illustration]

Place this Figure Fol. 〈…〉〈…〉

this do follow inflammations and loss of sight. Therefore how careful, faithful, and diligent ought the manual Opera∣tor be, who undertakes this so curious an Art, the only piece to be admired of all Chirurgery? And here ought we to consider and understand the Coats, Muscles, and Humours of the Eye, so that not one part of the Eye may be injured by your operation: We ought al∣so to consider and observe, how these parts are connexed together, while we move the Needle upwards and down∣wards. And having given you this as a Caution or monitory Introduction, I come now to teach you the way of perform∣ing this Chirurgick Operation, a lively Protraict of which here you may see ex∣pressed, with all its necessary Chirur∣gick Instruments belonging and apper∣taining thereunto. Your Patient having both his Body and Head well cleansed, and all other accidents which may yield any appearance of obstructing your O∣peration, you are to remove, and then bind up the contrary Eye, and place the Patient to the best advantage, both for his ease, and your better sight, and exe∣cuting your Operation; and having your Needles both sharp and round pointed ready fixed, and fitted for your use, and

your other Dressings fit to be applied, then with an intrepidant Hand and un∣daunted Courage thrust through your Needle, so as that it may enter the Ad∣••ata in the middle, charging your Pa∣tient to turn the Eye towards his Nose, thrusting it near half a strawes breadth from the Iris into the Cornea; and having got it safely in, you are to work it unto the hollow of the Eye; and when the Needle hath touched the Cata∣ract endeavour to press it gently with the Cataract downwards, and this you are to do so often until you see the Pu∣pil quite discharged of its Cloud, and with that strength as to keep it down, that it may not rise up again; and or∣der your Patient not to stir his Eye; for if it sticketh below, and returns not again, you may be confident of a per∣fect Cure. Then is the Needle to be brought up again, not to be taken out presently. Upon which done, and your Needle taken away, close up the Eye with all speed, by applying to the Eye some linnen Clothes dipt in Rose wa∣ter, the White of an Egg, and a little A∣lume mixed together, taking as an Ob∣servation, that you beware of hurting the Crystalline Humour, and the sound Coats in the Operation,* 1.51 and with conve∣nient

Bolsters and Rollers compleat the rest of your Operation; after this get your Patient to Bed, and order him to ly high with his Head, from all Noise; and let your work be done with sobriety and carefulness, acquitting your selves of all Mountebank gestures and im∣postures. Let his Diet be Barley water, Ptysans, Gellies, poached Eggs, and the like: At the eight day you may remove your Dressings, and then wash the Eye with Rose water, being made lukewarm before you apply it to the Eye; and for some season, order your Patient to wear a piece of green Silk over his Eye, that it may not have the full Air come to it, but by degrees; and let this serve for your couching Method. I shall conclude this Chapter, wishing all success to the ma∣nual Operator, leaving this also with him to have in his remembrance, that it is the Eye alone which is Mans greatest Guide in this World, and therefore let Conscience and Charity perswade all Men that tender any thing of good, not to meddle with this Cure or way of curing, unless he be well Skilled and exercised in the Art, and understandeth the Parts and Coats very well, lest he comes off with no more Credit than that Mountebank, of whom Montanus Consil. 81. writes

the Story, I will here give you as a just example of impudence in these Locusts. A Person being troubled with an O∣pthalmy in part of the Cornea of the Eye against the Pupil,* 1.52 the which being but very small and scarce discernable, an Emperick coming under pretence of giving ease, applies an Apple which had been roasted on hot Embers thereunto, and ordered to let it remain on until the next Day; that Night the pain ceased, and the Patient slept well; Upon which the Mountebank began much to praise his Skill, and himself with hopes of a speedy Cure; but taking off his rare Me∣dicine, the Waterish Humour followed it, which preceded the Crystalline, so that contrary to his boasting expectation, the Patient was made blind in this Eye. A Day will hardly suffice to reckon up those mischiefs and injuries, which are dayly done by these Quacks and Moun∣tebanks. A Woman of thirty years of Age (as Riverius in his 100.* 1.53 Observations writeth) having a confirmed Cataract, and being for a whole year blind, recovered her sight, her Body being well purged and cleansed, by the benefit of Quarcitanes Opthalmick water; for the same I have oft times used the Juice of Celandine, Daisies, Rose water & Sugarcandy with very good success.

CHAP. XXXIX.

Of Hordeolum••

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

CHAP. XL.

Of Ʋnguis.

ALTHOUGH this by the Greeks is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, yet this is not so easie by us understood or de∣scribed: for if we may conceive the whole Fibrous Membrane arising in the great∣est Angle of the Eye, and produced a∣bove its White to the Cornea, and sometimes extended as far as to the Pu∣pil, we may view and perceive this lively expressed adherent in this part. Celsus doth oft times say, that it ariseth from part of the Nostrils, and some∣times from part of the Temples, and where it toucheth the Pupil it adhe∣reth to it. Paulus affirmeth this is without much difficulty to be discussed, as by applying thereunto white Wine and White Wine Vinegar mixed toge∣ther, or Eye-bright and Sugar, or Fen∣nel-water, Niter or Salt. If it hath had a long time to grow, and cometh to any perfection, as Celsus directeth, it is to be cut out,* 1.54 for which he useth this Method: Let the Patient be placed in a convenient State with his Head somewhat downwards on one one side,

that you may come the better at the Tu∣mour, and let him be so held and placed, as that he do not disturb your Operation; and then with a sharp Hook, being a little bent or made crooked, apprehend the Unguis, and with a small Needle and Thred draw through it, and so by compression eat it off.* 1.55 Paulus's way is thus: He uses a strong and long Horses hair, and with this he doth compre∣hend the Unguis, and so in a short time doth eat it off. And here ought we to take care how we apply our Silk, or Hair, or any other thing, with which we do or may intend to eat of those, lest when we come to the Angle, the Ca∣runcle it self benot cut off also, and so there happeneth another Mischief by the Greeks called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, out of which a Hu∣mour doth always flow. After it is clean taken away, Paulus would have a lit∣tle fine Pouder of Salt sprinkled on it, mixed with the White of an Egg, and so applied upon Cotton or Lint; We rather approve of Pompholix being pou∣dred both for deterging and drying, and over all to put a little Sheeps Wool. Celsus doth put over his Lini∣ment, being made of Honey; but the true and more proper way is, to use more drying Medicines, such as have

no corroding quality,* 1.56 or do stir up any Inflammation. A Girle of ten years old being much perplexed with a te∣dious and troublesom weeping at the right Eye, to which convenient Medi∣cines not being applied, the Humour that made its course thither grew sharper, after which followed an In∣flammation, and an Erosion of the Pu∣pil; hence the Pupil grew into a great, thick, hard, and white Cloudiness, which depraved the Sight, by its long conti∣nuance, there being but little hopes left of doing good to this Patient; yet by the request of her Friends, and perswa∣sions, by these following Medicines, she following directions recovered her sight: to the Front was applied this Defensa∣tive. ℞.* 1.57 Farin. Hord. ℥ij. pulv. Ro∣sar. rubr. nuc. Cypress. Gallar. Cort. granator. an. ʒiij. pulv. fl. Betonic. Euphrag. an. ʒi. misce in mortario cum aqua Betonic. Euphrag. & Acet. & Abumine ovi, fiat defensativum. Into the Eyes was instilled this Collyrium. ℞.* 1.58 Mucilag. Sem. Cydonior. cum aqu. Rosar. extract. ℥j. Aqu. Foenicul. Eu∣phrag. an. ℥ij. Mel. Rosar. ℥ss. Tuth. praeparat. & Corn. Cerv. ust. & prae∣parat. an. ʒss. Camphor. gr. iiij. With this Collyrium and a good Diet, with

a good Order in purging being observed, and by the benefit of a Seton she recove∣red her perfect sight. If the Collyrium be not strong enough, you may add Extract of Celandine to deterge the thick and viscid Matter which sticks to the Pupil.

CHAP. XLI.

Of a Polypus.

WE come next to the Nose, where we may meet with a Polypus, the which by Paulus lib. 6. cap. 25. Is said to be a Preternatural Tumour arising in the Nostrils; so called from the resemblance it hath with the Fish Poly∣pus, as Galen hath it, and also from its substance, it being made of a Flegma∣tick and viscous substance. Its proper place, wherein it inhabits, is the Nostrils, where it both obstructs the Nostrils Respiration, and in some measure doth hinder the Speech. Celsus doth add, that where a Polypus is thus pro∣duced as that it reacheth the Fauces,

they which are correpted herewith are soon suffocated.* 1.59 This Tumour is like White flesh soft, filling the Nostrils, not uniform, but doth appear as many Ca∣runcles knotted or joyned together, or hanging one on another, some coming to the Cartilages, some to the Bones either of the Nose, or Spongy Bones. Albucasis lib. 2. saith, that it ariseth from a flegmatick matter, and hath no Veins for its nourishment. Whence it is most likely it is made of pituitous Blood, which floweth to the Brain,* 1.60 and is thence sent through the Nostrils. There are many Differencies hereof,* 1.61 as Paulus Al∣bucasis and others do own, for some∣times it is hard, adherent, livid, pain∣ful, and cancerous, not to be cured with Instrument. Another sort is soft, loose, white, indolent, bordering only on the Cartilages of the Nose, or to the Bones, or to its Spongeous Roots, being pendulous. It is so pendulous, as it oft times is seen to hang out beyond the Nose. Sometimes it is drawn up∣wards, sometimes it passeth the other way to the Fauces. Hyppocrates doth describe all its Differencies, de Polypo, and the manner of curing.* 1.62 Celsus doth order us to put up a sharp Iron through the Nostril, made in form of a Spatula,

and with this to resolve the Polypus from the Bone, taking all care that the Cartilage be not hurt, and being cut with this draw it out.* 1.63 Paulus openeth the Nostrils and delateth it, and with a Spatula made in form of a Myrtle leaf, doth cut it out orbicularly: But I shall not hang on either of these. These do shew the Nostrils to be free from a Polypus, if breathing through the No∣strils be free, and without any Obstacle. I rather with a great satisfaction ad∣mire and approve of Fabritius de Aqua Pendente, whose Method and Instru∣ment is both safe and harmless, which Operation is made with safety and with repute; for this Instrument doth appre∣hend, cut and draw forth the Polypus, the which are the three chief intentions in this Cure. And besides these advan∣tages it keeps and defends all the other parts of the Nose in safety and harmless. It apprehends and draws it out without effusion of Blood, for it neither cuts nor divides no other Veins or Vessels, than such as are spread or interwoven into these Caruncles, of which this Polypus is made. I shall, after I have presented you with its commodities, shew you the exact Figure of this Instrument; it cu∣reth suddenly, safely, without pain, and

danger. This Instrument doth perform these Four Intentions, it apprehends, cuts or separates it, separateth its reli∣ques, and doth induce a Cicatrice. It hath an edge to cut, and apprehends like Forcipes, and therefore is to be made like a pair of cutting Forcipes: It ap∣prehends and draws forth like Forcipes: it presently separateth the Polypus from the Bone; and for the last we only blow up restrictive Pouder: And thus have I shown you its Four Intentions. It cuts inward to prevent all trouble and dan∣ger, and it bringeth this commodity with it, it showeth to every one appa∣rantly what it hath done. In the Cure of a Polypus certainly could there be ne∣ver a better framed.

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

[illustration]

Johannes Paulinus in his his Observa∣tions doth relate of a Countryman,* 1.64 who had such a large Polypus descending to his Palate, or in the Glandule hardned in the Larynx, that he was almost suffocated, & could scarce speak or swallow. Baynius in lib.* 1.65 5. cap. 3. saith, that he

[illustration]

cured the Secretary of a Re∣verend Cardinal of a Polypus, which not only stopped the No∣stril, but also at sometimes hanged out beyond it, by this Method of applying a Caustick at the end of a leaden Instrument, the which being made hollow at its end for receiving the Caustick, and not bigger than to put up into the Nostril, with which the Patient himself was to hold it with the Caustick next to the Polypus for the space of one whole hour; and then this being removed, he ap∣plied Butter, until the Eschar was ablated or removed also; and thus he as oft renewed the Caustick, and afterwards applied a conve∣nient Medicine for ablating the Eschar, as until he had quite ex∣tirpated the Polypus. A true Fi∣gure of Falloppius Instrument you have here expressed.

CHAP. XLII.

Of Parotis.

WE arrive now at a Tumour of the Glandules of the Ears called Parotes: And before we explain any further hereof, it will be here necessary that we understand what a Glandule is. It is a Spermatick Parenchyma included in one common Membrane,* 1.66 and with many private. And these may more properly be said to be Spermatick than Sanguinary, they being furnished with four kinds of Ves∣sels, as Veins, Arteries, Nerves, Lym∣phaducts. And since we have shown what a Glandule is, let us further in∣quire into the nature and substance of this Parotis.* 1.67 These are Glandules seated behind the Ears, and do fill up the whole substance thereof in the back part; they are more hard and viscid than the Ma∣millary Glandules. It is from these do come the Salival Ductuses: and by Fal∣loppius are said to be ordered for recei∣ving some superfluities of the hard branch of the fifth pair, and to send them into the Veins refocillating the inward and outward Ear by its Heat, and to ex∣plete

the same in its Circumference. This Tumour, which preternaturally gets into the Glandules and these Emunctuo∣ry parts, they being loose and spongeous, and so the more capable for the recep∣tion of Excrements) hath inflammation generally as its companion, both sharp and painful. As it is also oft times seen to arise from a viscid Humour; so also doth it very frequently succeed a long and tedious Disease, the which sometimes doth terminate hereby, throwing some of its Venome herein∣to. It is tedious in cure, it arising from a thick and viscid Humour.* 1.68 It is to be cured by good order of Diet; and if plethory appear, use Plebotomy, and then to discharge such peccant Hu∣mours as do occasion it. Galen adviseth us not to use Topicks here, as we do in other parts; for it is not to be repelled in its beginning, lest hereby you give the Enemy a deep impression into your Patient, and so encrease more Pain and Danger; but rather to attract and draw forth the Humour: But if Fluxion be large, Pain sharp, and thence Fever and Watching follow, here may we use Repellers; and by Galens Au∣thority we are to use Digestives mixed with Repellers:* 1.69 as ℞. farin. sem. Lin.

Hord. Fabar. an. ℥ij. coquantur cum decocto Melilot. Chamomel. fine adden∣do Ol. Rosar. Chamomel. q. s. fiat Ca∣tapl. Or ℞. Butyr. sine Sal. ℥ij. Ol. Chamomel. Aneth. an. ℥i. Dialth. ℥ss. Cerae parum,* 1.70 misce, fiat Ʋnguentum. The pain being ablated, come to the use of strong Resolvers, such as this; ℞. rad. Alth. Breon. an. ℥iss. fol. Rut. Scord. Origan. Veronic. an. M. fl. Me∣lilot. Chamomel. an. pug. 1. Coquantur in Hydromelite,* 1.71 trajiciantur fine adden∣do farin. Hord. Fenugraec. Lupinor. an. ℥i. pulv. Irid. iij℥. Ol. Rut. Chamo∣mel. an. ℥i. misce, fiat Cataplasma. A Woman of thirty years of age being perplexed with a Parotidal Tumour be∣hind her Ears,* 1.72 in which beginning was no Fever, neither did she keep in; but about the fourteenth day of her Disease her Tumour grew to a great bulk, and the matter was plainly prepared, but by reason of the toughness of the Cutis, it was kept in longer than it ought to have been: At length being broke, the Woman fell into a few swounding vo∣mitting Watchings, with pain of her Back and Kidneys; yet little or nothing came out of the Abscess, neither did she spit up any: Within a few days she dyeth. Hence may a Chirurgeon learn that Ab∣scesses

be either in the Emunctuories, or their neighbouring parts, that they do not break them, until they of their own accord break.

CHAP. XLIII.

Of Epulis and Parulis.

THIS is a Hypersarcosis, or fleshly Excrescence of the Gums, gathe∣red at the roots of the Teeth, and doth Tumefie with Pain, Heat, and Redness; it poureth fourth a saline and fetid Sanies, and oft times runneth in∣to a Cancer, which ought to be un∣derstood out of the property of its ex∣traneous Heat; and that which is not painful may be revelled, the manner of which may be this way acted and per∣formed, by tying a double Thread a∣bout it, and bringing the same every day straiter, until you have wholly eaten it away: when it is off, you are to burn the place by applying a Caustick there∣unto, being sent thither through a Pipe, but so safely that it hurts none of the ad∣jacent

parts. Parulis is a Tumour of the Gums with Inflammation, which is ve∣ry often resolved, and sometimes sup∣purated; It is made of hot Blood. This may be cured by prescribing in the beginning convenient purging, bleed∣ing, and cooling and repelling Garga∣risms, as Plantain, Roses, Adderstongue, Nettles, Sage, and the like, being boiled in Water with Alume, to which add some Syrup of Mulberries and dried Roses; If it tends to Suppuration, fur∣ther its progress by putting in here Marshmallow roots, Figs, Mallows, and the like. And being made ripe, open it with your Incision Knife or Lancet, and cleanse the Ulcer with Mel. Rosa∣rum, Wormwood or the like: If it be scirrhous, and proves very stubborn, draw out a Tooth where it fixeth: and by this means you will both dis∣charge it from its root, and have no reason to fear a new growth. Placen∣tinus Chirurg.* 1.73 lib. 5. cap. 20. cured a Gentlewoman of a very large swelling which was in her Gums in the upper Mandible, the quantity of which Flesh was very much above the Teeth swel∣led to the bigness of a Goose Egg. He removed this in four times applying an actual Cautery, and removing some of

the Teeth about it with some part of the Mandible: He let it bleed in a great quantity, at length he stopt the Flux with Vitriol applied on Cotton or Lint, pressing out all the clotted Blood with his Fingers, and so perfectly cured her within eight days.

CHAP. XLIV.

Of Ranula.

THIS Tumour by the Greeks is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, by the Latines Ranula, it lodging under the Tongue: It is occasioned by a moist, pituitous, gross, and thick Substance, falling from the Brain into the Tongue, much resembling in it the Substance of the White of an Egg, being some∣what of a more yellowish Colour. And here observe, if the party be pletho∣rick, breath a Vein under the Tongue, and use proper and peculiar Gargarisms for this purpose, and anoint it with some restringent Unguents, or rather open it with some red-hot Iron Instru∣ment

being sharp, the manner of which is thus: Get a bended hollow Iron∣plate which hath a hole in the midst; making the Patient to hold open his mouth, you must so fit it, that the hole is to be just upon the part which you intend to open; with the Instrument o∣pen the part, so as you may hurt none of the circumjacent parts; when you are ready to burn it, thrust your Thumb under the Patients Chin, that you there∣by may somewhat elevate the Tumour, and hereby you may open with more certainty. Being thus opened, throw forth the contained Matter; after which wash the Patients Mouth with Barley∣water and Sugar of Roses; and thus may the Ulc••r be safely cured. Guliel∣mus Placentinus doth order only Aqua Aluminosa to be held under the Tongue, in which hath been boiled a little Myrrh. Gesner in Histor. animal. lib. 2. pag. 51. writes,* 1.74 That a Physitian related to him, that he saw a Tumour under the Tongue the breadth of two Fingers, which hin∣dered the speech, and that this Tu∣mour was cured by drawing a Needle through it, and afterwards opening it with a sharp Instrument; the which be∣ing done, came out matter from thence much like that of an Artheroma, resem∣bling

coagulated Milk to the quantity of as much as would fill two hands; the which being discharged, he or∣dered the Patient to gargarize his Mouth with Aqua mulsa, and sent into the Ulcer of the same by a Syringe, and the Body being well purged, and by the use of Restringents the Patient perfectly recovered.

CHAP. XLV.

Of Strumae and Scrophulae.

THIS Tumour doth arise with much ••ase from too much fibrosity, thickness and viscidity of the nutritive Succus, and for this cause on∣ly is it that this Juice is so difficultly despersed into all the parts of the Bo∣dy, and therefore must confidently re∣dound in some place, and with ease lay its first grounds and Foundations of a Tumour. There is held a great difference between Strumae and Scrophu∣lae; and by Dr. Wharton in his Book De glandulis, the one of these is called by him Wenns, the other the Kings evil: Scro∣phula

signifying the first, and Struma the latter: Scrophulae are soft, Wenns hard: the first pale, carrying in them the colour of the Skin, the second ha∣ving a redness turning to lividness; Scrophulae soft and not much penetrating, Strumae immovable and deeply fixed: the Kings-evil swellings generally en∣crease into a great bulk and magnitude; and besides their glandulous Fleshes they do carry in them several sorts of Juices in their little Bags, the which do help much forward their growth and bulk. It is credible that these concreted Juices are as some rejected Excrements thrown from the glandulous Flesh in its nutri∣tion; for these Glandules have no excre∣tory Vessels, and therefore necessarily they should carry their Excrements in their Bags: And this is one reason of their growth. Secondly, the Blood effused from hence through the Arteries is more plentiful, than that which is reduced through the Veins; and hence therefore may there arise another reason of its growth. Thirdly, The Nerve which keepeth here is but small, and that makes them so dull; and hence is it that, were the parts pricked with Needles, the Patient would not much complain of pain. Now as touching Strumaes, these

are not always seen to run into a bulk or magnitude,* 1.75 but sometimes they en∣crease, sometimes they lessen, and at length do vanish. These Tumours do receive their proportion from the re∣ductory Vessel, and are discriminated from its first genus, here is nothing found besides Nerves V••ins and and Arteries. And by how much the Veins are bet∣ter capacitated and enabled to convey and carry off that which is sent them from the Arteries, by so much also are these Strumatous Tumours less capa∣ble of running into bulk, than such as are Scrophulated. And how these Tumours are translated from one place into ano∣ther, I attribute chiefly to the Nerves in their Operations, these being most pro∣per Messengers to carry to and fro. Now if there be any matter carried to the E∣munctuory Vessels or Glandules, and be there excerned, the Struma doth soon lessen, and sometimes doth wholly va∣nish, and is very often seen by applying of Hydrargyrical Mêdicines or Saliva∣tion to consume and waste away, these having in them a very powerful in∣fluence of making the Nerves spit forth their Humidities into the Emunctuory Glandules. And hence by Paulus and Cel∣sus these are said chiefly to arise in three

places more especially, as in the Inguens, Axillaries, or about the Neck or Throat, but most chiefly about the Neck and Throat, because here they be nearer the Head, their Fountain, from whence they draw their flegmatick Matter to their conglomorated Glandules.* 1.76 Some of these Strumaes do succeed other Distempers, whilst others do breed of themselves: Sometimes an outward Cause may occa∣sion them, as by applying too hot resol∣ving or too drying Medicines.* 1.77 As to their Presage, we ought here to consi∣der their different places where they make their abode; for these are also ei∣ther small or great, loose or fixt, few or many, painful or without pain, arising from Flegm or Melancholly: Some being in the inward part of the Neck, whilst o∣thers do border on the outward: Some terrifying young Children, whilst others do lay their impresses on people more aged: And by how much they are more movable, by so much are they with less difficulty cured; yet take them at the best, the Chirurgeon will find work enough to get well off, & clear them with repute. Such as adhere to the Bones are incu∣rable; there are three ways of eradica∣ting them:* 1.78 Either when the Radical Moisture, which is carried and reserved

in their several Cystuses or Bags, is sucked up by the Nerves, or the affluxed Blood reduced by the Veins, or a free transpi∣ration brought to the part affected. The first and main cause of this transla∣tion is the Nerve, which doth bring and breed the first rudiment of a Struma out of its matter, and to help forwards this work, both Veins and Arteries are as its Assistants. The curing also of these Diseases are very difficult, in that most generally such as are troubled with these swellings outwardly, they also have them inwardly.* 1.79 As to the Cure, the thick Lympha is to be incised, tem∣pered, and evacuated; the Glandules softned; the Humour, if possibly, either to be discussed or suppurated, and at length, if no otherwise to be overcome, is to be treated with Escharioticks. And first let the Body be well purged with Phlegmagogicks.* 1.80 As ℞. Alo. lot. cum aqu. Majoran. Agaric. troch. an. ʒi. Mastich. Cubebar. an. gr. vi. Troch. Al∣handul. ℈ss. cum Syrup. de Betonic. q.* 1.81 s. fiant pillulae. Or these, ℞. Pil. Coch. ʒij. Aurear. ℈i. Troch. Alhandul. gr. iij. cum Oximelit. q. s. fiant. Pil. Or ℞. Turpeth. optim. Zinz. Hermo∣dactyl. Diagrid. Sacchar. an. partes aequal. misce, fiat pulvis, of which the

Patient may take from a Dram to a Dram and a half with Oximel once in a Week,* 1.82 in the Morning. Or this, ℞. Turpeth. Zinzib. Sacchar. alb. an. ʒi. detur cum vino. If the Patient be of a pret∣ty good Age and strong, he may take this. ℞. Pulv. Turpeth. ʒss. Hermodact. ℈i. Zinzib. condit. ʒss. mix them for use. Pil. Cochiae, Sine Quibus, Tro∣chisc. Alhandul. and the like, are here very good and proper. Sweating also here is very advantagious, and taking inwardly of acid things is good: Or you may prescribe this Pouder.* 1.83 ℞. Ci∣ner. Spong. marin. Oss. Saep. Piper. long. Cinamom. Sal. gem. Pyreth. nuc. Mos∣chat. Cupress. Gallar. cort. Querc. fl. Rosar. rubrar. an. ℥ss. misce, fiat pul∣vis, dosis a ℈ij. ad ʒi. Or this, ℞. Lap. Spong. ʒiij. Sal. gem. ʒij. Tar∣tar. vitriolat. ʒj. misce, fiat pulvis, do∣sis ℈iss. vel ℈ij. And to the part af∣fected such things as are proper for a Scirrhus, are here also as prevalent; but such things here are more peculiarly to be added, which may more powerfully resolve, as these which have been ap∣plied with most excellent success.* 1.84 ℞. Ol. Philosophor. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Thur. Mastich. Gum. arabic. Terebinth. venet. an. ʒiij. pistata simul per Alembicum distillen∣tur,

tandem distillationi addatur Salex cinere Sevi, & iterum distilla, & serva in vitro ad usum. Or, ℞. Galban. Bdel. an. ℥i. Ammoniac. ℥ij. Scord. Alveor. Apum Oesyp. an. ʒij. Terebinth. venet. Pic. liquid. an. ℥iss. bacc. Laur. Sta∣phis acr. Cumin. Pyreth. an. ℥ss. Ster∣cor. Caprin. Anser. Alth. an. ʒiij. Axung. Porcin. Sev. Caprin. Ʋrsin. an. 3℥ss. ol. Chamomel. Lilior. an. ℥ij. Te∣rebinth. venet. ℥ss. Hydrargyr. ℥iss. misce, fiat Emplastrum, ℞. Ol. Laurin. ℥i. pulv. Ceruss. cum aqu. laevigat. ℥i. Alumin. Roch. ℥ss. Sal. commun. ʒij. mis∣ce, fiat unguentum.* 1.85 Or ℞. farin. Fa∣bar. Orob. an. ℥ij. pulv. flor. Chamo∣mel. Melilot. Rosar. rubr. an. ʒiij. Ol. Irin. Ʋnguent. Dialth. an. ℥i. succ. Rut. ℥ss.* 1.86 misce fiat Cataplasma. Or ℞. farin. sem. Lin. Fenugraec. ℥iij. fa∣rin. Orob. ℥i. fl. Melilot. Chamomel. Sambuc. an. ʒiij. fl. Anthos. ℈iiij. pulv. Irid. ℥ss. coquantur in vino mulso, tunc adde sub finem ol. Lilior. q. s. fiat Ca∣taplasma. Or this,* 1.87 ℞. rad. Alth. ℥iiij. rad. Lilior. ℥ij. flor. Melilot. Chamo∣mel. an. pug. ss. coquantur, pistentur & percolentur, postea adde pinguedin. Gal∣lin. Dialth. an. ℥i. medul. 'Pomor. sub. cineribus coct. ℥iij. Ol. Chamomel. Li∣lior. an.* 1.88 q. s. fiat Cataplasma. And for

this also the resolving Emplaster in Scirrhous Tumours is here very excel∣lent, it being by me very oft times applied with good success. Barbett writes of a Maiden of fourteen years of age,* 1.89 who was very much afflicted with many and grievous Diseases, as swelled Lips, and several ulcered Glandules in her Neck and Parotidals, and much tu∣mefied with Scirrhous swellings, so that she could scarce move her Neck, and by this following Method he recovered her: First ordering her a Decoction of Guaiacum, prepared with attenuating and opening Ingredients, of which she took three Ounces for Four days, into which was dropped of Spirit of Sal. Armoniac. eight drops, and once in a Week she took this Pouder. ℞. pulv. Jalap. ʒss. Tar∣tar. vitriolat. gr. 5. Ol. Faenicul. gutt. ij. This wrought with her three or four times: outwardly was applied Empl. de Ranis cum Merc. Ol. Rutae & Fuligin. malaxat. And to the ulcered Glandules Ʋnguent Basilicon: then Balsamum Sul∣phuris: and she within three or four Months was restored to her perfect health. Or this Emplaster may be well used. ℞. Empl. de Ran. cum Merc. ℥ss. Gum. Galban. ʒij. Sacchar. Saturn. Sal. vo∣latil. Armoniac. an. ʒ℥ss. malaxentur

Oleo Rutae q. s. fiat Empl. Sometimes these Strumaes will not yield to Resolu∣tion, but do much rather incline to Sup∣puration; that is, when any other Hu∣mour is mixed, which gives it a great∣er Heat, as Blood and Choler: and when it takes its course this way, we are to help forward with such Suppurating Medi∣cines, as may speed it in its operation; such as be Marsh-mallows boiled in wa∣ter, Diachylon cum Gummi, De Mucila∣ginibus, and the like: or instead of those take some of these following compounded Suppurating Medicines.* 1.90 ℞. Bdell. Am∣moniac. an. ℥ss. dissolvantur in Lixivio, adde Calc. viv. cum Axung. contrit. ʒi. Sulphur. viv. ℥ss. Alumin. ʒss. Mel. op∣timi ℥iss. Ferment. veter. ʒij. misce, fiat Cataplasma.* 1.91 Or this; ℞. Caepar. & rad. Lilior. albor. sub cinerib. coct. an. ℥iiij. farin. Tritic. ℥ij. Axung. Gallin. Anser. an. q. s. vitell. Ovor. n.. 1. Croc. ʒss. misce, fiat Cataplasma.* 1.92 Or this; ℞. farin. Fa∣bar. Tritic. an. ℥i. farin. sem. Lin. Foenu∣graec. an. ʒij. Ficuum contus. ℥iss. Axung. veter. ℥ij. Croc. ℈i. misce, fiat Cataplas∣ma. Being suppurated it is to be opened by a Caustick or Incision: and for a Cau∣stick there's none better than sublimated Arsnick; and upon applying it defend its neighbouring parts with a Defensa∣tive,

discharge the Matter, & remove the Eschar, fill up with Flesh, and then skin it. I shall conclude this Chapter with one Patient of my own (though on this sub∣ject I could offer many, having had the honour of obtaining the Touch from His Majesties hand) for many, most of which I have had afterwards to conclude their cure: amongst the rest in this City of Norwich was one Mr. Rootees son, much perplexed with Scrophulous Tumours, which tended after His Majesties Touch to Suppuration, who after having his bo∣dy well purged, and the Humour well pre∣pared, his Neck from his Ears was envi∣roned with these small filled bags of Fleg∣matick Matter: over these I applied Em∣plastrum Diachylon cum Gummi ℥ij: De muci••aginibus ℥i. Emplastrum de Ran. cum Merc. ℥ss. Ʋnguent. Dialth. ʒvj. misce. With this or the like Emplastrum was his whole tumefied part covered, and having brought it to Suppuration, I drew forth all its matter which was contained; then I mundified, digested, and incarned all the parts, and the Patient (I bless God) remains in perfect health to this day.

CHAP. XLVI.

Of Bronchocele.

THere is a Tumour (as Celsus cal∣leth it) between the Cutis and the Wind-pipe, which the Greeks call 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. This is not a Tumour in the Glandule, but arising upon the Aspera Arteria. It's thus called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, which signifies Aspera Arteria, and 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 Tumour; and therefore by Celsus is said to be a Tumour arising between the Cu∣tis and Wind-pipe, and by him is num∣bred amongst Abscesses, whose Matter is lodged in a Bag or a Coat, which is dull Flesh somewhat like Honey or Water. Celsus doth here also propose two sorts of Medicines, as Caustick and Instrument, by burning Medicines, so as that the Cu∣tis and Bladder may be burnt, and thus the Matter discharged: but this is a great deal of trouble to a little purpose; and therefore he more readily comes to Inci∣sion. And here he orders a direct Incisi∣on to be made into the Coat, so as the vi∣cious matter may be separated by the Finger; after which let it be well mundi∣fied with Vinegar, to which adde some Salt or Nitre: and in every Abscess we

are to take notice, that there is a small Vein or Artery that doth feed it, and its Membrane whereto it doth adhere to the sound part; in the other part it is free. If any Patient should come to your hand with such an Abscess, be al∣ways careful of these four Intentions, as in the ordering your Patients Diet, in pre∣paring and purging the antecedent Mat∣ter, in removing the Matter contained in the Tumour, and in applying convenient Topicks. Let his Diet be thin, his Air hot or temperate: for purging these may serve.* 1.93 ℞. Pil. de Agaric. Pulv. Hier. Colocynth. an. ʒij. cum syrup. de Stechad. q. s. ••i••nt pil. dos. a ʒi. ad ʒiss. In this case Sweating is also good. And as to Chirurgery, you may use this Ungu••nt and Emplaster:* 1.94 ℞. Sulphur. Sandarach. an. ℥ss. Euphorb. ℥i. cum Cerae & olei q. s. fiat Ʋnguentum. After an∣ointing herewith apply this Emplaster: ℞.* 1.95 Rad. Ireos, Sal. Gem. an. ℥i. Tere∣binth. q. s. Diachyl. cum Gummi Aposto∣lor. an. ʒi. misce, fiat Emplastrum. If these will not do, Rogerius does advise us to make a double Seton, so as that the Humour may slow out by degrees. In old people very commonly the Larynx is so attenuated, and the Muscles as it were so dried up, and as it were discharged of their

Fleshy Substances, that it happens fre∣quently in chewing, that some part of the Aspera Arteria is seen to fall: and this was verified by Osualdus Gabelchoverus de observationibus suis,* 1.96 who writes of an old Gentleman that could not take down any liquor, as Beer, Wine, or any liquid substance, but a great part of his Aspera Arteria would slip; yet he could take and eat his meat very well without any hin∣drance. The same I knew of one Mr. Goodman a Minister here in Norfolk, a man of about 40 years of age, who could eat his meat very heartily without any lett or disturbance; but when he hath had occasion to drink, was forced to bend him∣self forward, and by degrees let his li∣quor pass down very moderately, lest a part of his Wind-pipe should slip out, and so prove very troublesom to him. I have been oft in his company, when I have both seen him use this Method, and also taken all care to prevent the falling down or relapse of his Aspera Arteria.

CHAP. XLVII.

Of Angina.

IT is called Angina from 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, which is all one to S••rangulo, the which doth signifie every Affect both of the Jaws and Throat, whereby Breathing is hin∣dred; or if you please, it is that Affect of of the Throat, the Larynx being over∣straitned by some inward occasion, so causing Suffocation. It is a very acute Disease, and is an Inflammation of the Fauces. Of this there are two sorts, one Legitimate, the other Illegitimate. To the one a Feaver is a continual compani∣on; but it hath nothing to do with the other.* 1.97 There are three species of a true Squinancy: one with Inflammation, and not in the Fauces, neither apparent in the Neck, but in the Throat; and this bring∣eth speedy danger of Suffocation. A se∣cond accompanied with a manifest Phleg∣mon, with no Tumour or Redness in the the Neck. A third, when the Neck seemeth to be inflamed with the Fauces, having along with it Tumour, R••••ness, Heat,* 1.98 and Pain. The inward Cause is Blood abounding, and oft times peccant; the which doth not alone raise this, unless

more vitiated by a sharp and four Lym∣pha. The outward Causes are evident, Cold, Fish-bones being received the wrong way, cold Drinks, and too much Repletion. A Bastard Squinancy is made by a pituitous Distillation falling upon the Fauces and Muscles of the Neck, exciting a Tumour, without Redness, Heat, and Feaver.* 1.99 Of these are ••••de three Diffe∣rencies by some Author••▪ and these they christen with three 〈◊〉〈◊〉 names, as Cynanche, Parasynanche, 〈◊〉〈◊〉che: but these are but of small moment to∣wards our encrease of Knowledge. The Diagnostick Signs are, when the Patient cannot move his Neck, and breatheth with difficulty, neither can he well swal∣low, and finds a pain and heat in his Jaws. That is accounted most dangerous,* 1.100 which with the most speed doth threaten Suffo∣cation, and yet is neither perceived in the Cheeks, neither doth it any ways appear in the Neck, yet there is felt a vehement pain, and the Spirits scarce seem to be drawn; for oft times this Suffocation doth happen the first day. There is no Squinancy with safety, and the lesser the Tumour, the greater the danger: and Hippocrates lib. 4. Aphor. 34, 35. saith, if the Humour of the Angina be carried to the Lungs, it maketh its exition before

the seventh day; otherwise the Patient grows in danger of Suffocation. And if it hath made its efflux without leaving any evil symptom in this time, the Flux being converted into Matter, this is to be sup∣purated and not kept here; for where it is not cleansed from hence the Patient doth very readily run or fall into a Con∣sumption. This Lympha and Bilis is to be tempered in the Bloud,* 1.101 and to be ve∣ry speedily revelled and derived; and therefore are we first to breathe a Vein in the right Arm; and this is as oft to be repeated as necessity may offer. And if this will not do, breathe a Vein under the Tongue; but this is to be performed at the beginning: then cool the body with Clysters or Purges, and let your Patient have convenient Gargarisms prepared for him:* 1.102 as, ℞. fol. Rosar. rub. Balaust. an. pug. 1. cort. Granator. ℥ss. fol. Querc. m. 1. Alumin. ust. ℈i. coque ex aqua ferreata 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. adde syrup. Diamor. ℥iiij. misce. In the end you may order this discussive Gargarism:* 1.103 ℞. rad. Liquirit. cort. Gra∣nator. an. ʒij. fl. Balaust. fol. Rosar. rub. an. pug. 1. Jujub. n^o. 12 Ficuum n^o. iij. Passular. Corinth. ʒiij. coque in aqua Hord. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in his solve syrup. cap. Vener. Mel. Rosat. an. ℥iss. misce. This follow∣ing also in the beginning is very proper.

℞. fol. Ros. rub. Sambucin. an. M. j. co∣quantur in Cervisia tenniore q. s. fine ad∣dendo Alb. graec. ʒj. colaturae 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. adde Sacchar. Saturn. ℈ss. Sal. Prunell. ℈i. Or this Cataplasm:* 1.104 ℞. rad. Alth. Lili∣or. albor. an. ℥j. Nid. Hirundin. n^o. j. Ficuum Dactylor. an. n^o. iiij. Caepar. ʒvj. coquantur ex aqua Hord. & colaturae ad∣de farin. Tritic. sem. Lin. an. ℥i. Faenu∣graec. Alth. an. ℥iss. vitellor. Ovor. n.. ij. Croc. ʒij. ol. Chamomel. ℥ij. misce, fiat Ca∣taplasma. Galen doth report of one troubled with a Squinancy,* 1.105 after having used many proper Remedies, and these failing, this at last recovered the Patient; he ordered the Excrement of a Boy well dried and powdered, and mixed Honey therewith, and with this he anointed the Jaws of the Patient, and in the space of half an hour the Abscess did break, and the man was restored to his perfect health. Aetius cap. 5. lib. 6. saith, that Agarick doth suck up hidden Abscesses, and doth draw them outwards. And Jacobus Do∣vonetus apolog. lib. 3. cap. 2. writeth, that having a young Gentlewoman much troubled with a Squinancy, he cut a lit∣tle Agarick in pieces, and put them into a Decoction made of Marshmallows, Figs, with a little Ginger, and a fourth part of Wine and Water, to which he added a

little syrup of Marshmallows: this Potion he gave to the Patient, and ordered her that she might not swallow it, but hold it for some time in her mouth; she following his directions, whilest he was but dis∣coursing with another, a great quantity of white Matter came out at her mouth, and after this some putrid; this being dis∣charged she came to her perfect breath∣ing, and got off from her Fever and all other bad Symptoms, and perfectly re∣covered.

CHAP. XLVIII.

Of a Tumour of the Tonsils.

THese Tonsils are by the Greeks cal∣led 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, amongst the which is reckoned the Columella. And Nature hath placed two Glandules at the root of the Tongue, much resembling in figure and shape an Almond, and therefore by some these are called Amygdals. And before we proceed any further in this Discourse,* 1.106 let us take a more curious view of them, and see for what uses they were framed; and then if being either hurt, tumefied, inflamed or ulcerated, how they ought to be cured. They are as it were framed out of a cold, concre∣ted, oleaginous, and malleous Substance, save onely that it is thicker and more firm, they being of a yellow colour, soft in touch, but in being boiled hard, spon∣geous, and porous. They have belonging to them Veins, Nerves, Arteries, and pro∣per Cavities: Veins and Arteries from the Jugulars; Nerves from the third and fourth pair. Each hath its proper Ductus allowed it, opening into the Mouth, and very many small Glandules dispersed from thence about the whole Root of the

Tongue. Through all those Foramulaes is our mucous Substances expressed, and thence disposed through the Root of the Tongue.* 1.107 Their Uses are various, as be∣ing first the chief Organs of Tasting;* 1.108 for the same Membrane which covereth all the parts of the Mouth, doth also take this Glandule into it. Secondly, it is the Ex∣cretory Iustrument, for its office is to se∣parate the Mucous or Pituitous Matter which falleth from the lower part of the Brain, especially through the Nerves of the third Pair, and so to refund this into the Fauces and Mouth. Thirdly, this moisteneth and keepeth soft the Jaws, Larynx, Tongue, Oesophagos, and ma∣keth the Tongue so voluble, and the Oe∣sophagos the better capable to perform its office of Deglutition. Fourthly, in plentiful Catarrhs of the Brain, the No∣strils being obstructed, they do imbibe in∣to their spongeous substances the Mat∣ter, which might otherwise have been disposed the other way. And lastly, they help towards the Concoction of the Ven∣tricle by their Fermentative Faculty; for these with much ease do contract Acidi∣ties, which is the great Agent in Fermen∣tation, and its chief cause. All these are worthily allowed by the curious hand of Dr. Wharton, in his Book De Glandulis.

Now if this Saliva be spent or consumed by violent Fevers, the Patient does soon begin to grow impotent and weak, unless the Tongue and Mouth be kept moistned by some cooling Decoction or other; for these Glandules are planted in a hot and moist place, and therefore the sooner sub∣ject to Inflammation. Into these also with Blood do flow a pituitous Matter, crude and viscid; and this being conden∣sed by Cold, does elevate them into a Tu∣mour. Aetius telleth us, it may happen in a young body by drinking too much sharp Wine, and by eating very often of too sharp Meats. With these Glandules do frequently their neighbouring Glan∣dules of the Larynx joyn in Tumour, and then the Patient is ready to suffocate. It is very apparent both to sight and to feel∣ing.* 1.109 This eminent danger may be both prevented and resisted by Purging and Phlebotomy, Cupping glasses, Vesicato∣ries, applied to the Neck and Shoulders, then wash the Mouth and Throat with this Gargarism:* 1.110 ℞. Rosar. rubr. Plan∣tag. Balaust. an. ʒi. summitat. Papa∣ver. Myrtin. an. ℥i. Bol. armen. ℈i. fiat Gargarisma.* 1.111 Or this: ℞. fol. Plantag. acetos. Hyssop. an. M. i. gran. Sumach. ℥ss. Cort. Granator. Rosar. rubr. an. pug. i. fiat decoctum ad lbi. in quo solve syrup.

Moror. ℥iss. Lap. Prunell. ʒiss. misce. Or,* 1.112 ℞. fol. Salv. Plantag. Rosar. rubr. an. M. ss. Cort. Granator. Balaust. an. pug. 1. Santal. rubr. Bol. armen. an. ℈i. Be∣tonic. M. i. coquantur in aqua fontana ad lbi. colaturae adde syr. Myrtin. Sambuc. an. ℥iss. Sal. Prunel. ʒi. misce. These Trochischs are also very proper to moi∣sten the mouth and parts with,* 1.113 and also to allay Heat and Inflammation. ℞. Spec. Diatragaganth. frigid. Diapapaver. an. ʒi. Bol. armen. praepar. ℈ij. Amyl. succ. Liquirit. an. ℈. Sacchar. candit. ʒij. cum syrup. Papaver. erratic. q. s. fiant Trochisci, to be dissolved in the mouth. Or this: ℞. Aqu. Prunel. Plan∣tag. Rosar. rubr. an. ℥iiij. fol. Rosar. Cort. Grantor. Balaust. fol. Plantag. O∣phi••gloss. an. Mss. sem. Cydonior. ʒi. co∣quantur omnia simul, & colaturae adde sy∣rup. Diainor. ℥i. Granator. q. s. ad acidi∣tatem. To the outward Region of the Neck apply this Cataplasm:* 1.114 ℞. rad. Alth ℥i. Scabios. Sambuc. Rosar. rubr. fl. Cha∣momel. Melilot. an. M. ss. sem. Alth. ʒiss. coquantur ad mellis consistent. pistentur & his adde farin. sem. Lin. Foenugraec. an. ℥ss. ol. Rosar. Aneth. Chamomel. an. ℥i. misce, fiat Caplasma. Pills proper for purging the Patient may be these:* 1.115 ℞. Pil. aur. ℈i. Extract. Panchymagog,

Croll. ℈ss. ol. Cinamom. gutt. ij. Diagrid. gr. i. cum syrup. Rosar. q. s. fiant Pil. A very convenient Electuary may be this: ℞.* 1.116 Stercor. canin. alb. aq. Rosat. lot. & pulv. ʒiss. Sacchar. Rosat. ℥ss. syrup. Vi∣olar. Moror. an. ℥i. ol. Amygdal. dulc. re∣center extract. ℥ss. pulv. Irid. ℈i. spec. Diatragagant. ʒss. ol. Foenicul. Ch. gut. ij. misce,* 1.117 fiat Electuarium. Dodonaeus Ob∣serv. cap. 16. telleth of a young Child two years of age, who was troubled with an Inflammation of her Glandules; and whereas she could have nothing applied to her by reason of her youth, Nature found out a way to discharge this Matter. There are bred in the Neck under the Ear simple Tumours, the which being open∣ed with an Incision Knife, this Matter flowed out, and thus was she freed and discharged from this Abscess of her Ton∣sils. Forestus hath also another History of a Woman, (lib. 15. Observ. 27.) who having swallowed the Back-bone of a Fish, and sticking in her Throat, so that it had near suffocated her, the which could neither be removed, neither could she eat or drink without great difficulty; upon prescribing and taking of this fol∣lowing Eclegma she recovered. It was made of Figs, Marshmallow-roots, Mal∣low-seeds, Currants, Sebestens, and Ju∣jubes,

mixed with Syrup of Violets, the which he ordered her to have continual∣ly in her Mouth; and by applying such a Cataplasm as you have already prescribed outwardly, she speedily got discharged of this Bone, and recovered.

CHAP. XLIX.

Of Empyema.

THis is most properly called Empye∣ma, when there is a collection of purulent Matter got into the cavi∣ty of the Thorax: and if this within 40 days be not expurged by Spitting, Urine, or the like, it does either produce Suffo∣cation or Phthisis. The Matter which filleth the cavity of the Thorax, and does so frame it fit for Suffocation, is threefold, it being either Flegm, Water, or puru∣lent Matter. If this Matter be collected either in the Thorax, or in any other part, and be transmitted from the Head, and so flegmatick; from the Liver, and so se∣rous; and srom the Thorax, and so pu∣rulent; as also from the Squinzy suppura∣ted from the Fauces: but if it proceed from the Thorax, it does always come from an Abscess, and maketh Repletion.

This may also arise from the Pleurisie, if the Aspera Arteria hath not perfectly discharged its Matter.* 1.118 Its Signs are an obtuse pain, with Commotion of Hu∣mour contained in the Thorax with Flu∣ctuation. And as a most certain Sign it hath some Humour appearing outwardly, lodging between the Ribs and the Exte∣riour parts. Or if you will, this Hu∣mour is discerned by its Tumour, ac∣companied with Pain, Heat, Weight, Noise, and Fluctuancy: for it swelleth, and appears with a certain bluishness in the place outwardly where this Matter is collected; this is an infallible Sign, as clear as the Day, the which I have seen very often never to fail. The Native Heat being corrupted is the occasion of this change of Colour. It does rend and fret its Muscles by its Matter, and it breaks into them; the which Matter be∣ing discharged, the patient findeth some ease, but there remaineth a small and si∣nous Ulcer, which is very hard to cure. Such persons as are herewith perplexed, when they lie on their contrary side, the other part does seem to be very heavy and depressed, and are very apt to cough, and be soon weary of this posture. There is a manifest Noise and Fluctuati∣on apparent in the Side affected when

〈1 page duplicate〉〈1 page duplicate〉

〈1 page duplicate〉〈1 page duplicate〉

the Patient does turn himself, unless the Matter be thick, or so plentiful that it filleth up the whole capacity of the Tho∣rax, and does thereby hinder it. And here are we to observe, that this Disease at the best is not easily to be cured, nei∣ther can the whole Matter be discharged by Salivation; therefore does require more than an ordinary help. Out of Hyppocrates Counsel the Patient is to be nourished with Milk and Euchymick Meats, and the Matter must be digested, and to deferr for fifteen days from Rupti∣on; the which fifteen days being expi∣red, it is to be speedily opened either by Incision or Caustick, lest it do injury to the Viscera, and do weaken the Facul∣ties. When you make your Section, let it be between the fourth and fifth Rib, tending from the lower parts upwards; and by this Method may you prevent all fears of injuring Nerve, Vein, or Artery. Make neither Incisions, nor apply any Causticks right downward, but according to the Fibres of the Intercostal Muscles. This being performed, you are sparing∣ly or by degrees to let forth the Matter, both for keeping in the Spirits, and pre∣serving vigour and strength in your Pa∣tient. The Matter being thus educed, the Wound is to be healed with all con∣venient

speed, for keeping safe of the in∣ward parts. For which purpose such a Decoction as this is very excellent. ℞. Herb.* 1.119 Sanicul. Veronic. Pyrol. an. M. j. Consolid. major. Sarracenic. Botrys. an. pug. ij. fl. Borag. Bugloss. an. pug. j. sem. Anis. Foenicul. dulc. an. ʒij. Cinamom. ʒiij. Jujub. n^o. 6. Sebesten. n^o. 4. Dactylor. n^o. 4. coqu. omnia in aqua Hord: Hujas sumat ℥iiij. cum pulv. ocul. Cancr. ℈ij. misce. An∣other for the same. ℞. rad. Chin. ℥iiij. Sym∣phyt. Tormentil. Irid. an. ℥j. Capil. Ve∣ner. Tussilagin. Scabios. Marrub. Hyssop. an. M. j. flor. 3. cord. an. pug. j. fl. Paralys. Betonic. an. pug. ij. fl. Auth. pug. iss. Ca∣ricar. pinguid. ℥iij. Liquirit. ℥ij. scm. Anis. Coryander. an. ʒvj. infundantur omnia per noctem in aquae fontanae lbjj. & coleniur: colaturae adde Mellis lbj. mi∣sce, hujus sumat omni mane. Tro∣chischs made of Saccharum Rosatum and Diacodium Tabulatum do very well here. When your Eschar is out, and you have procured a small Orisice, you may inject into the part such a Decocti∣on warm as is this: ℞. fol. Salv. Hype∣ric. Scabios. Veronic. Virg. aur. Cen∣taur. Absynth. an. M. ss. Rosar. rub. pug. j. Alumin. Roch. ʒij. coquautur omnia in s. q. aquae fontanae, colaturae adde Mel. ℥ij. misce. You may meet with an Obser∣vation

of a pleurisie turned into an Empy∣ema in River.* 1.120 obsevat. 79. centur. 1. of a young man about 20 years of age, who fell into a pleurisie, so painful that he could not lie on either side of his Bed, but onely walk upwards. Many Remedies were prescribed in the Consultation of three physicians, and the patient was let blood above ten times; yet the Affect persevered. Although the pain of the Side sometimes seemed to cease, yet both his pain returned and a Fever with it. This Fever continued to the five and thir∣tieth day, then the Side began to swell, and proved painful to the Touch, suffu∣sed with redness; it was judged a pleuri∣sie turned into an Empyema; and for this reason suppurating Cataplasms were ordered, by which the Tumour might encrease its bulk, and the peccant Mat∣ter endeavour to discharge it self. But the opening of this Side being procrasti∣nated too much, the Abscess broke in∣wards, and the Patient did spit out some of this Matter with ease by coughing, which appeared very laudable, and not at all fetid; and this he did for many days in a great quantity. After the Abscess brake outwardly, it was with ease con∣verted into either Side, because he found and felt a great pain in the pained Side:

which thing is noted by Hippocrates in Prognostic. Having past the eighth day of its running, this purulent Excretion ceased, and he onely vomited up Flegm: then he perceived the pain again in the same Side, so as it turned not to the sound: then was conjectured that there was a new Collection of Matter in the Side, and he being prepared for the dis∣charge of the same, the Empyema was opened by a Caustick being laid on the Side, and Matter for a long while came from the Side, and at length the Patient perfectly recovered.

CHAP. L.

Of a Tumour of the Diaphragma.

THE Diaphragma hath two sorts of Tumours belonging to it, and either of them do bring the Pati∣ent in danger of death; the one long, the other short: for by the Excrements for∣cing here they may make a Tumour both with or without a Fever. If without a Fever, from the beginning pain and dif∣ficulty of breathing, a small and a hard Pulse, and these Excrements we are to allow to be thin and crude, and thence do follow a Tension of the Bowels, because the Muscles are extended to the Dia∣phragma. And if a Fever be joyned to these Tumours, Experience does satisfie, it is not sharp; and it ariseth from the too long contention of Excrements in the part affected. An Inflammation of the Diaphragma beginning, there necessari∣ly does follow a Fever; and in respect of the Affect, because the Tumour is made of hot matters, and in relation to the part affected by reason of its near bordering upon the Heart, there do generally fol∣low from this Inflammation, Pain, and Difficulty of Breathing: and therefore,

as Galen saith, Breathing here in this case is small and frequent, (lib. 5. de loc. affect.) sometimes Convulsions do suc∣ceed these Inflammations. When such a Tumour of the Diaphragma is offered to you for cure, let your first Intention be to discharge the Matter or Substance that is lodged. And because the Origination of this does generally arise from Fluxion, this also is to be prohibited, and this is done by discharging the fluent Matter. If you take them in the beginning, they may give some hopes of Cure: but if they be of any long continuance, they admit of no Cure; because they general∣ly hurry the Patient into a Consumption, and will not be taken hold of by the best of Medicines.* 1.121 As to the Cure, the first Intention is to discharge this Matter by well purging and clearing the Body of its Excrements: and here such things are most proper as can discharge both Flegm and Water; such as is Elaterium, Radix Sambucinus, or the like. Phlebotomy is no ways proper here; for the peccant Mat∣ter is cold, and therefore Discussives are here most convenient. And these may be said to be of two sorts; some to be ad∣ministred inwardly, whilest others are outwardly to be applied: and these ought to be both emollient and relaxing, as

Butter, Fats, Marrows, and the like; and these are to be ordered accord∣ing to the Humour and the Strength of the patient; first beginning with milde Medicines, and then proceeding with such as are stronger, as Oyl of Chamo∣mile, Dill, and the like. Here also you may use Emplasters and Unguents, as of Mallows, Marshmallows, Lilies, with Linseed, Fenugreek seed, &c. preserving and desending the inward parts with such things as can discuss, as Treacle, Methridate,* 1.122 Sarsaperilla, &c. I once saw in a Gentleman a Tumour bred in the Diaphragma out of crude and thin blood, in which pain and difficulty of Breathing, a hard and small pulse were present, the Matter and Humour was cold, and tough, and crude, and this shewed it Mortal, for it brought him into a Consumption, and the Abscess breaking he did spit up Blood and much indigested Matter. These Tu∣mours, although they are bred of a thin and cold Matter, yet in the place affected they thicken; and for the performance of this there is required pain, difficulty of Breathing, a hard and a small pulse, little or nothing changing it self, no apparent Tumour shewing it self: and if to these Tumours a Fever do joyn it self, as Experience does oft times shew it doth,

it is not sharp, yet they bring Death with them; and when they persevere, and are not resolved, they bring the patient into a Consumption, and so lay him even with the dust, as it did the aforesaid Gentle∣man.

CHAP. LI.

Of Exuberancy of Milk.

MAny Women in their first days, after being delivered of their Burthen, have a great redun∣dancy of Milk, because much Blood is sent thither, and not taken away or sucked out: for the helping of which it is thought by some, that Repellers are very proper to be applied before such Women be delivered, and so to hinder the address of Blood thither; for after this much Milk being received, it cannot afterwards be so well repelled, but ought to be dis∣charged by the Breasts, or drawn out by Sucking, or otherwise. It may be prohi∣bited, if the Blood do not flow violently, by these Medicines following;* 1.123 as, ℞. Bol. armen. ℥j. Sangu. Dracon. Oliban. an. ʒij. Ol. Rosar. ℥ij. Cer. acet. an. parum misce, fiat Linimentum. Or my Empla∣ster oft times used in this case with good

success.* 1.124 ℞. Emplastr. Diapalm. ℥ij. Ol. Rosar. ℥ss. pulv. Sangu. Dracon. ʒj. misce. Or this;* 1.125 ℞. Ol. Myrtin. ℥ij. Amygdal. dulc. ℥ss. Terebynth. Venet. ʒij. pulv. Ma∣stich. Bol. armen. Corall. Sangu. Dracon. an. ʒj. pulv. Myrtil. Balaust. Rosar. rubr. an. ℈ij. pulv. Salv. Betonic. an. ℈j. mi∣sce, & cum cerae citrinae q. s. fiat ••mpla∣strum. A Schirrus does oft times pro∣ceed from coagulated Milk in Women;* 1.126 as it fell out in a young Woman, whose left Brest, while she was giving her Child suck, was wholly correpted with an Inflammation; the which being allayed, a large Tumour and Hardness remained, which gave me suspition of a Scirrhus. Her Body being well purged with a leni∣tive purgation, the Brest and its circum∣jacent parts anointed with Oyl of Roses, to which was added a little Vinegar, and this for some days was used, afterwards the whole Brest was anointed with this Liniment:* 1.127 ℞. Empl. de Mucilaginibus ʒij. ol. Lilior. Amygdal. dulc. pingued. Gallinae an. ℥j. Gum. Amoniac. solut. in Acet. scillitic. & colat. ℥ss. misce, fiat Ʋn∣guentum. Over which was applied this Cataplasm:* 1.128 ℞. fol. & rad. Alth. q. s. in∣cidantur minutissime, postea coqu. in aqua, & mortario pistentur, fiatque cum farin. Fabar. Axung. Porcin. Gallinae & pro∣prio

decocto Malvar. Cataplasma. By these Medicines, and the Body being well purged, and a good order of Diet obser∣ved, the hard Tumour grew soft and re∣solved; and to the Ulcer I applied powder of Precipitate, and over this Empl. de Ra∣nis cum Merc. And with this method beyond expectation she recovered her perfect health.

CHAP. LII.

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

AMongst the most dangerous and frightful Affects which do seize on Humane Bodie,* 1.129 this of a Gonor∣rhaea may be well reckoned: and this is excited by many causes; for Acrimony and Thinness of the Sperm may be one cause so that it does continually flow. An Imbecillity of the Testicles does give an∣other great suspicion hereof. Another Cause amongst some is attributed to Co∣ition with a Menstruous Woman. Oft times it happens by overstraining the in∣ward parts; a thing very frequent in snch who being in their Drunken fits do act beyond their power of Reason. If the Seed therefore which is thus thrown forth be pure, and is not in any respect tinged with any strange quality, and is void of all fetid smell, this either does shew and express a plenty thereof, or a weakness of the Retentive Faculty, or Convulsion of the Spermatick Vessels. But if it be accompanied with any other vitious Humours, and furnished with thin ill Juices, and appears with another co∣lour

strange to its own proper nature, and yieldeth a smell which sheweth no good Concoction, this first of all does calefie, and by its acrimony does corrode, prick∣eth, and invadingly ulcerateth. And this Ulcer does much differ from that which exerciseth it self in the Bladder, and thus may with ease be distinguished: where the Neck of the Bladder is ulcera∣ted, the pus or Matter does as it were compactly precede the Urine it self; and the pain between making water is most mightily sharp about the ulcerated part. On the contrary, the Bladder it self being ulcerated, there is no pain felt, nor Mat∣ter pissed forth, secreted by the Urine, but cometh along with it. The Urine does yield a strange strong smell where the Bladder is affected with an Ulcer. When the Urinary passage is ulcerated, the Yard is very painful and heavy, and bendeth downwards. An U••••er contra∣cted in the Neck of the Bladder, or in the cavity of the penis, unless it be both spee∣dily and knowingly cured, does convert it self into preternatural Caruncles, by which the Urinary passage is obstructed: For as out of most pure Blood the best Flesh is generated; so also vicious Juices enwrapping or keeping company with the Ulcers, there is oft times seen a spon∣gious

Flesh to grow and breed. And therefore when we have arrived at the sure knowledge, that this unnatural Guest hath made his entrance into these quar∣ters, which we may speedily find out by the search of a Candle, and to gain ad∣vantage of this Disturber of the Humane peace, we ought, if Plenitude be a main wing of its vigour, to discharge this by Evacuation. And here let the Patient use a thin Diet; if the Juices be sharp and thin, thicken them, so as that they may give strength to the Spermatick Vessels; if we do here find or meet with any weakness, strengthen them. And for clear∣ing this Method, observe with me these Curative scopes. First, loosen the Body with emollient Clysters made of Mallows, Violets, Pellitory, Lettuce, French Bar∣ley, and the like, adding thereunto Cassia in the end: After this breathe the Basi∣lick Vein 〈◊〉〈◊〉 the right Arm. These two being premised, let the Thighs be wash∣ed with a Decoction of Red Roses, French Barley, Violets, red Poppies, and the like. Let the Kidneys, Spine, and Te∣sticles be cooled with this. ℞. Ʋnguent. Rosat. Refriger. Galen. an. ℥j. ol. Violar. ℥ss. pulv. Rosar. rubr. Santal. Citrin. Spod. an. ʒj. Camphor. gr••iij. Acet. Ro∣sat. gutt. aliquot. As to the part affect∣ed,

deterge it first with a Decoction of French Barley, in which have been put some Mel Rosarum: this being made lukewarm is by a Syringe to be injected into the Yard. Then produce a Cica∣trice with this following.* 1.130 ℞. Aqu. Ro∣sar. Plantag. an. ℥iiij. Sacchar. candit. ℥j. Ceruss. Lithargyr. aur. Alumin. Roch. an. ʒiss. Camphor. ℈ss. misce, fiat injectio. Trochisci albi Rhasis do here also very well; but if you have a mind to dry more powerfully, adde to the former a little Ae∣gyptiacum. Shun all strong Diureticks, which may force or drive the Humours to the ulcerated parts; and such things are especially to be used, which have a quality in them to lessen the pain. For this purpose Lac Amygdalatum is very good. A Hyposarcosis in the Neck of the Bladder, or in any part of the Urina∣ry passage, may be collected out of the great difficulty of Urine, the which comes not onely out by drops, but by forcing, and endeavour to perfect this: So that sometimes upon a great straining, while the Patient makes water, he hath a Laxi∣ty joyned with it. Neither can that U∣rine come right, which hath its passage obstructed by a Carunculous Flesh: Nei∣ther doth it easily come forth, unless it be compressed with the Hand. Oft times

there is seen such Obstruction, that unless the Catheter be called in use, there's no coming forth of Urine to be expected. There is a twofold Method in curing of a Caruncle of the Yard;* 1.131 the one is perfor∣med by Instrument, the other by Medi∣cine. A Fomentation for this purpose may be this:* 1.132 ℞. fol. Malv. M. j. rad. Alth. Ap. Faenicul. an. ℥iij. sem. Lin. Cydonior. Foenugraec. an. ℥j. fl. Chamomel. Staechad. Melilot. Puleg. Origan. an. pug. ij. Caricar pingu. ℥iss. coquant••r om∣nia usque ad radicum dissolutionem, & cum hoc foveatur radix penis. Or else dip Sponges herein, and apply them to the part affected. After it is thus fo∣mented, it is to be absterged with such an Unguent as this:* 1.133 ℞. Ʋnguent. Dialth. Agrip. Oesyp. Butyr. an ℥j. ol. Amygdal. dulc. Lilior. albor. Chamomel. an. ℥ij. Ammoniac. ℥iss. Succ. Ap. ℥iij. Mucilag. semin. Foenugraec. rad. Alth. Lin. an. ℥ij. boil them all untill the consumption of the Juices, then adde the Fats, and strain it off, and to the strained Matter adde a little white Wax. Here also are you to make use of searching Candles made of white Wax. And for this Affect a Lea∣den Probe is excellent good, for that whereas besides that it is an Anodyne, so also hath it a very drying faculty. When

these fail, we come to the use of a Cathe∣ter, but this without a very respective care and steddy hand does very often occasion strange Hemorrhagies, and so thereby doth frequently bring fear both to the Physician and the Patient. But should such a Flux as this appear, this may with ease be stopped by injecting into the Passage with a Syringe some Plantane water and Rose water, to which the White of an Egge should be added. Here also are you to mind, how upon ap∣plying your Candle, what part thereof is either bent, or bruised, or compressed; for upon this part is to be applied your Medicines you intend to use: and for this purpose Philips Emplaster is reputed to be a most excellent and sovereign Medi∣cine in this Affect, because it healeth the adjacent parts, and keepeth them whole and safe; but that which grows with the Ulcer it taketh away without pain. This is its description:* 1.134 ℞. Aerugin. Auripig∣ment. Chalcat. Alumin. Roch. an. ℥ij. his adde Acet. acerrim. perfus. inter duos marmoreos & fiat pulvis subtibissimus, ex∣ponantur Soli. Then put it into fresh Vine∣gar again, after dry it as formerly: let this be done for 8 or nine times, untill it hath lost all its Acrimony and Mordacity. This Powder being thus made, take of

Litharge of Gold ℥ij. Oyl of Roses ℥iiij. with which boil it, being mixed with the former, to the consistence of an Emplaster. This is to be put at the end of a Searching Candle or Leaden Probe, so as that it falleth not off. This is in much esteem for this Affect. But because all Bodies have not one and the same consti∣tution and temper, therefore are Medi∣cines to be changed accordingly: and af∣ter the Application hereof you are to in∣ject into the part affected Goats Milk, or other Milk, or Rose water; to which may be added a little Camphire; and these to be applied untill the pain cease. You may know when the Caruncle is ex∣tirpated, when out of its inordination it is perceived about the ulcerated part, and also out of the copiousness of the effluent Matter; the which also, whilest it is ex∣tracted, the Candle does appear as if it were wholly imbued with it: and af∣ter this, if the Urine flow liberally, free∣ly, quickly, and copiously, and in its right method, there will be left but little occasion of doubt, but your Patient will do well, it being discussed and extirpated. The Ulcer is to be discharged by a Li∣quor sent into the part affected through the Syringe: as, ℞. Centuaur. maj. Apii Caud. equin. an. M. ss. Hord. contus. ℥j.

coquantur in aquae fontanae lbij. ad con∣sumpt. med. colaturae adde mel ℥ij. & utere. The Ulcer being cleansed, you are to induce a Cicatrice, as with this or the like. ℞. Aqu. Plantag. Rosar. rubr. an. ℥iiij. Ser. Lact. caprin. ℥ij. Ceruss. ʒvj. Alumin. Roch. Marmor. candidissim. Spod. Crystal. an. ʒiss. Camphor. ℈j. fiat pulvis subtilissimus. And this is the whole Method which is and ought to be used for a Caruncle. Unto these also might I adde Phymosis and Paraphymo∣sis; but Fabritius Hildanus has writ most exactly hereof, and thereto do I commend the curious Chirurgeon.* 1.135 I shall conclude this Chapter with this History of a Gentleman, who fell into a suppressi∣on of Urine by a tumefied Caruncle in his Yard, generated by an impure and immoderate Coition. A Chirur∣geon being sent for to search him with a Catheter occasioned a great Flux of Blood: the Patient being in much pain, and thus suppressed in his Urine grew in∣to a Fever; for prevention of which I breathed a Vein, afterwards ordered an emollient and cooling Clyster, and anoint∣ed the Perinaeum and all its adjacent parts with a cooling Unguent: after this I pre∣scribed him a Vomit of Sal Vitrioli, by vertue of which he vomited up much

pituitous Matter, and in the second Vomit went out an Ounce or two of Urine, whereby he found himself somewhat cheared; and thus by degrees his Blad∣der was altogether unloaded within 4 or 5 hours, and the part affected being cu∣red with S••l Prunella, Injections and Clysters, such as you have already pre∣scribed, the Patient recovered.* 1.136 Riveri∣us in his 14 Observat. writeth that Charles the Ninth, King of France, being much afflicted with this Distemper, was by these following Medicines cured; for which Cure was given 200 Pieces of Gold. ℞. Cass. recenter extr. ℥ss. Suc. Liquirit. ʒj. Electuar. è succ. Rosar. ʒij. Aq. Lupul. ℥iiij. fiat potio mane sumenda. And for ten days after he drank of this Decoction half a pound. ℞. rad. Li∣quirit. Alth. Sebest. Passul. an. M. iss. Alth. malv. Apii. Petroselin. an. ʒss. aqu. fontan. lbij. coquantur ad mediae consumpt. After which were applied these two Un∣guents. ℞. ol. Rosar. lbij. Ceruss. Venet. ℥iiij. Camphor. ℥ss. Tuth. aqu. Rosar. lot. & prae∣parat. ℥ss. Lithargyr. praeparat. ℥iij. pulv. Antimon. opt. ℥iss. Op. Thur. mascul. vel Oliban. Mastich. Alo. Epatic. an. ℈ij. misce, servetur in pixide plumbeo. The second for Consolidation was this; ℞. Ʋn∣guent. Rosat. & aqu. Rosar. lot. Ʋnguent.

alb. Camphorat. an. ℥j. Pomat. ℥ss. misce. Keep thefe for use. The way of applying these is at the end of a Searching Wax Candle, it being rubbed over with Oyl of sweet Almonds; and if there be a double Carnosity, then apply the first Unguent to both of them for fifteen or twenty days; and as it seemeth to dissolve, and to turn into pus, then abate the applica∣cation of the first; the Urine coming free and with ease, and for eight or ten days afterwards, apply the second, untill no further Matter come forth. Hitherto hath our Discourse treated of the Parts as they arise from the Head even to the Pe∣nis; the next which we shall produce are the variety of Herniaes or Ruptures, and these as they arise shall offer themselves, with their several Forms, Shapes, and Places, their Causes, Signs, and Cures, and Differences; and shall begin with an In∣testinal Rupture, and so proceed to the rest in their order and form.

CHAP. LIII.

Of Ruptures in general.

WE arrive now to Herniaes or Ruptures, the which for the most part do dwell on the Hy∣pogastrick Region. And whereas other Humours have allowed them three Causes, as being bred either out of an In∣flux of Humours, or Decumbency of Parts, or Congestion: All these have their lively Forms and Shapes in the Tumours of the Testicles; for Tumours are made here either by Humours flowing, as In∣flammations, Erysipelaes, Oedema, and Scirrhus; or from the Decumbent Parts; or from Congestion, as from Water, or any other Humour. These kind of Tu∣mours are better and oftner cured by Chirurgery than Pharmacy. And as they are various in their Places, divers in Shapes, and manifold in Forms; so do these, and every of them, make various Intentions and Indications for the Chirur∣geon. And that every thing may fall successive to the wish both of Practiser and Patient, in this place it will be very proper to know well and understand the Parts framing the Testicles, they being

as the chief Causes and Effects of most of these Ruptures. Celsus lib. 7. cap. 28. does account the Testicles to be Glandu∣lous Bodies, wrapt about and twisted with various Vessels, Coats, and Ligaments. By the Greeks they are called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, as being two in number, and these are the Authors and Workmen of the Seed; for they have allowed them a vernaculate fa∣culty of attracting and educing the Sper∣matick Matter from all the parts of the Body. The Coats of the Testicles are four, the first called Epididymis, imme∣diately enwrapping the Testicles, from whence it taketh its Name: the second Elythrois, so called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, or quasi rubro similis, or vaginalis: the third Dartos, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, because it is easily excoriated, and lieth next the Scro∣tum: the last is the Scrotum it self. To these Testicles also belong Vasa deferen∣tia & Vasa praeparantia, the Cremaster Muscles, and the like. This may serve as a brief Anatomy of the Testicles and its neighbouring parts. We proceed now to the various Differences of Ruptures, before we treat singly of each by it self. And here be two kinds which do offer themselves, Bubonocele & Oscheocele, to each of which is bestowed its proper name, for 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 signifieth inguen, and 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉

Scrotum, as also 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 Tumor. Thus have we Bubonocele represent Hernia Ingui∣nalis, and Oscheocele Tumor Scroti. There are many Differences of either, ac∣cording to the Discriminancy of the Conjunct Causes and Tumefying Sub∣stances. Of Bubonocele are onely pro∣perly said to be two, Epiplocele and En∣terocele. Oscheocele hath six, Enteroce∣le, Epiplocele, Pncumatocele, Hydrocele, Sarcoccsle, and Cirsocele. Enterocele is called Hernia Intestinalis, Epiplocele Hernia Omentalis, Omphalocele Hernia Ʋmbilicalis, Pneumatocele Hernia Ven∣tosa, Hydrocele Hernia Aquosa, Cirsocele Hernia Varicosa, Sarcocele Hernia Car∣nosa and Hernia Humoralis, this being bred from a Repletion of the Testicles with unnatural Humours. Or (if you please) there are generally allowed eight Ruptures, one complete called Bubono∣cele, when an Intestine or the Omentum descend no lower than the Inguens; the second a complete Hernia, when they penetrate into the Scrotum, the Tunica Vaginalis being opened, or the Perito∣naeum; If the Intestine descends, it ma∣keth Enterocele, if the Kell Epiplocele, if a Tumour be made by a waterish Rup∣ture Hydrocele, if by Wind Pneumatoce∣le. If a Fleshy Substance grows within

the Scrotum Sarcocele, if the Veins be repleated beyond measure, and be dila∣ted in the Scrotum, Cirsocele. To these Avicen does adde Exomphalos, or a Prominency of the Navel; and of these he offers these four species to follow, as Enteroepiplocele, Hydroenterocele, Hy∣drophysocele, & Hydrosarcocele. Every Rupture does demonstrate its Signs and its Causes; Presages and Cure we shall offer in their proper places, beginning first with Enterocele or Hernia Intestina∣lis, an Intestinal Rupture; before which as an Introduction it will be most proper to discourse of Bubonocele, it being as a leading Card to the rest.

CHAP. LIV.

Of Bubonocele or Hernia Inguinalis.

CElsus and Paulus, lib 〈◊〉〈◊〉. 18. will have this reckoned amongst Ruptures, and there does call these Varices of the Groin, and a Tu∣mour of Inguen. Paulus, lib. 6, cap. 66. affirms it an Intestinal Rupture of the In∣guen onely or simply, that is, when the Intestine does not descend any further: by the Greeks called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. And here the large Veins which are in the Groin may so swell, and prove so vari∣cous, that they may create a Rupture here, so as this proves a Chirurgical Af∣fect. But before I proceed any further in this Chapter, be pleased to consider those many Errors, which are committed by unskilful Chirurgeons, who very fre∣quently do take Venereal Buboes for In∣guinal Ruptures, and so do cut for the In∣testine without either Wit or Honesty, or else do prejudice to the great Vein there ordered by Nature, and thereby bring danger of death. But that you may the better understand the difference, consider with me, that if you perceive a soft Tu∣mour in the Inguen, from the beginning

you may well suspect a Dilation being made by the Intestine; a Bubo in the be∣ginning being hard, especially being Ve∣nereal. It being a Rupture, if the Pati∣ent lie on his back, the Intestine falleth in∣wards with ease, and the Tumour does vanish; and upon the Patients rising it returns with as much ease: In a Bubo there is always a contained Tumour. But arriving to the matter of our present Discourse, a Bubonocele does most gene∣rally gain the name of being the begin∣ning of an Intestinal Rupture more pro∣perly, than the name of a Rupture; the In∣testine first making its fall through the In∣guen, before it enters the Scrotum, and so does necessarily dilate it: And therefore Paulus saith, that the Intestinal Rup∣ture of the Inguen does precede a Rup∣ture elsewhere; for if the Peritonaeum be made intense in its lower part by Wind, or any other cause, and the Inte∣stine makes its turgid way thither, being also filled with Wind; or by being filled with Excrements, and thereby forceth it self, it makes this Bubonocele; the which by Paulus requireth a double method of Cure, the one being to be performed by Incision, the other by Ustion. The first of these by Paulus is thus perform∣ed: He cuts upon the tume••ied place in a

streight line the length of three trans∣verse Fingers, and so passeth through the Membrana carnosa, and then makes so deep an Incision, untill he finds the Peri∣tonaeum bare, and the Fat also being ab∣lated and removed. Celsus will have this done with courage, and the Incision to be made to the middle Coat, which maketh the Vagina; afterwards he with a Probe does depress the Peritonaeum, and so as that the Intestine be compelled inwards; and having lodged his Probe, and com∣pressed the Peritonaeum, he by Sutures does draw the lips of the Wound toge∣ther; the which being done, he takes out the Probe, and cures the remain as you do simple Wounds. This is Paulus Method, which is performed by Suture, binding up only the Cutis, as by Astriction. The second of his, which is performed by Ustion, is both cruel, painful, and terrible, contracting the Cutis by the strength and force of the Fire, and making a contracted and hard Ciccatrice, and by this means do depress the Tumour, and will not suffer the Peritonaeum to lift it self up∣wards. But leaving these, a well made Truss is much better, performeth its busi∣ness with more ease, gentleness, and sa∣tisfaction; this having in it the faculty of prohibiting the soft Tumour, by com∣pressing

the Distention of the Peritonae∣um, and hindering the Impetuosity of the Intestine: to which Truss we usually six a Quilt or small pyramidal Pillow, it sometimes being made in form of a Myr∣tle Leaf: and after the Reduction this being sown to the Truss is to be ap∣plied to the part affected. In some cases here this may not be convenient; as should there happen a Varix in the Groin, and the Veins tumesie, the Veins by this being compressed by the tying of both its ends up; and if the preparing Vessels be varicosed, if they be bound up, the Generation of the Seed would be hinder∣ed. And therefore in this case Restrin∣gent Medicines are more proper, as Ba∣laustians, Cypress Nuts, Lignum vitae, Galls, Pomgranate Rinds, Red Roses, Medlers. Women for the most part are troubled with a Bubonocele, because the Womb falleth from the exteriour Coat of the Ʋterus, and so doth produce Hernia Ʋterina, as Casparus Bauhinus obser∣veth, Lib. 2. Anatom. Observ. 62. Fa∣britii you may read of a new married Woman, who in respect of an ill Dyet and bad Habit of Body was perplexed with the Itch, and not long after grow∣ing big bellied, and having a hard bur∣then, there followed a Prolapsion of the

Ʋterus; she coming to him for advice and help, he orders her this following Bag to be applied for three or four days to the part affected, and to carry it al∣ways about her, by the benefit of which she was speedily cured. The things which were put in it were these, and thus ordered ℞. Fol. Plantag. Salic. Mes∣pilor. Querc. Prunor. Sylvestr. summitat. Rosar. rubr. an. M. j. rad. Tormentil. Con∣solid. major. Bistort. an. ℥j. Nuc. Cupres. Balaust. an. ℥ss. sem. Anis. ℥iss. incidan∣tnr & contundantur omnia grosso modo pro sacculo intertexto.

CHAP. LV.

Of Enterocele or Hernia Intestinalis.

BEfore I proceed to the Cure of a perfect Intestinal Rupture, I shall begin with that which hath the Peritonaeum relaxed or dilated. The Intestine does descend, either because this Coat is either dilated or rent. The Signs of a Dilation are, because the Intestine does not suddenly descend, but does remain in the Orifice; then it does not descend to the bottom of the Testicle, the Tu∣mour is equal and profound. The Signs of its Coat being rent are, a sudden De∣scent of the Intestine, an unequal Tu∣mour, a speedy Relapse of it into the bot∣tom of the Testicle. Celsus cap. 14. lib. does offer these as Signs of an Intestinal Rupture; the Tumour sometimes encrea∣sing, sometimes lessening; encreasing, ei∣ther because a greater part of the Inte∣stine falls down, or because it is more re∣pleted than it ought, sometimes by Wind, sometimes by Excrement. If the Tu∣mour do encrease, because the Excrements are fallen into the Intestine, then Scarse it is to be expected to be drawn forth again; then is there pain in the

Scrotum, Inguen, and Abdomen; because here is made a solution of Continuity, whereby the Stomach is affected, and thereby throws forth Choler, afterwards green or black, then Excrement, and after these follows an inflammation of the Te∣sticles. A second Sign, the Tumour is not painful, sometimes it wholly vanish∣eth, and being compressed it with ease returneth into the Abdomen, and with as much ease falls out again with some noise, the Tumour being light, lubricous, and round. Most times the Ileon falls down, yet sometimes the other Guts come out with it, and do fall into the Scrotum. But this happeneth not by a simple Distention of the Peritoneal Pro∣cess, but it must necessarily burst in all great Ruptures. This oft times happens in Children by falling, leaping, vomiting, coughing, any vehement motion, crying, concussion, or the like. The Duodenum and Rectum cannot fall into the Scrotum, this Anatomy sufficiently maketh good. The Jejunum is tied by the Liver by the Meseraick Veins, and the Colon knit to the upper parts; and here is no Rupture without division of these. The Caecum, because it is slippery in the right side, and separates from the rest, does easily fall in∣to the right side of the Scrotum, the Pe∣ritonaeum

being either rent or dilated; and this Galen alloweth Com. ad Apho∣rism. 3. sect. 4. lib. 6. Epidid. Into the left side the Ileon also is subject to fall in∣to the Scrotum, and thus there may be a double Enterocele, one of the Caecum, another of the Ileon. This of the Ileon is the most dangerous and terrible, because by this is intercepted the distribution both of the Chyle and Nutriment, and the secretion of the Excrement, which is the necessary office of the Ileon as touch∣ing preservation of Life: besides this an intolerable pain is excited, and is oft times inflamed, whence follows a Gan∣grene, into whose sympathy of affection are all the rest of its neighbouring parts drawn. Here is also made the Iliaca Passio, after which follows vomiting both of Chyle and Excrements, this being as the Harbinger or Forerunner of Death. Now as touching Dilatation according to Avicen two things are required,* 1.137 the one a reduction of the Intestine upwards into the Abdomen or Belly, the second pre∣venting its coming forth again. The first is easily resolved, if the Intestine do not much fall out, or it be not swelled with Wind, or filled with Excrements, for then it may with ease be driven in by the Fingers, laying your Patient on his

Back, with his Legs somewhat elevated, and a little asunder: but if it be filled with Excrements or Wind, then are we to use another Method, by using of hot Baths, Cataplasms discussing Wind, and by prescribing lenifying Medicines, for which use and purpose take these as pro∣per Engines to work this; ℞. rad. Alth. ℥ij.* 1.138 Lilior. albor. ℥j. fol. Malv. Violar. Parietar. an. M. ss. fl. Chamomel. Meli∣lot. Rosar. rubr. an. pug. ij. coquantur omnia in aquae q. s. Colaturae adde farin. Fabar. Hord. an. ℥ijss. farin. sem. Lin. Fe∣nugraec. an. ℥j. ol. Rosar. Chamomel. A∣neth. Axung. Capon. an. ℥j. misce, fiat Cataplasma. This is to be applied when the Excrements are indurate. When the Wind swells them up use this Unguent: ℞.* 1.139 ol. Chamomel Rut. an. ℥j. ol. Aneth. Lilior. an. ʒvj. Spirit. Vin. ʒij. Cer. flav. q. s. fiat Ʋnguentum. And for a Bath use this as very excellent: ℞. Bislingu. Plantag, Polygon. nuc. Cupres. cort. Casta∣nar. German. Hypocyst. cort. Granator. Capular. Gland. rad. Symphit. major. an. M. ij. Gallar. M. j. aqua fabror. in quo ignita extinguuntur lb 20.* 1.140 infundantur per horas 24. & deinde lento igne redi∣gantur ad 3 partis consumpt. & ante ab igne removetur, adde Acet. Optim. lbiij. serva ad usum. This Fomentation is most

proper when the Intestine does lodge in the Inguen; a Cerate for the same of a Venetian Physician:* 1.141 ℞. Theriac. opt. Bol. Armen. Sangu. Dracon. in gutt. Alo. Succotrin. an. ℥ss. misce in mortario cum Terebynth. Venet. vel cum pice navali pro Cerato. For purging in this case Electu∣arium Diacatholicon and Powder of Rhubarb are very proper Medicines. Here also may you order Manna, Syrup of Roses, with convenient Decoctions, and the like. The Intestine being reposed, you are to use all restringent things after the applying of the former Bath, and such as have an agglutinating and drying qua∣lity, such as are Rupturewort, Betony, Compfrey, Solomons Seal, Plantane, Ba∣laustians, Red Roses, Pomgranate Rinds, Cypress Nuts, Bol. Armen. Dragons Blood, Mastich. Amber, Coral, Olibanum, out of which may be framed Powders, Electuaries, Pills, and the like. A Deco∣ction of Sarsaperilla, Guiacum, and Sarsa∣fras, are here also proper. The outward Topicks should also have the same sacul∣ties and vertues, being made of Galls, Cypress Nuts, and the like. Here also Empl. Adherniam is very good. Avicen does praise this;* 1.142 ℞. Nuc. Cupress. acac. Balaust. Gallar. immaturat. an. ʒj. Myrrb. Thur. Sarcocoll. Tragaganth.

Gum. Arabic. an. ʒiij. Sangu. Dracon. Mummiae an. ʒij. terantur cum Aceto. Or this accounted better:* 1.143 ℞. Malicor. Bol. Armen. Sangu. Dracon. an. ʒj. Te∣gul. pulverisat. ʒij. pulv. Bislingu. ʒijss. cum albumine ovi modico aceti & Colo∣phon. fiat Emplastrum.* 1.144 Or this Empl. ℞. Empl. Adhern. Grat. Dei an. ℥j. pulv. Sang. Draco. Osmund. Regal. pulv. Oliban. Guaiac. an. ʒiss. cum parum Ol. Myr∣tillor. fiat Empl. A purging Apozeme to give the Patient may be this:* 1.145 ℞. Os∣mund. Regal. Hernar. an. M. j. rad. con∣solid. major. Bistort. an. ℥iss. Hyperic∣flor. M. j. sem. Anis. ʒij. conquantur om∣nia in vino rubro, & colaturae lbiss. adde syrup. consolid. major. ℥iij. vel 4 pro A∣pozemate. These two Emplasters of Hollerius are much commended applied outwardly:* 1.146 ℞. Mastich. cort. Thur. Nuc. Cupress. Myrrh. Sarcocoll. glutin. pisc. Icthiocoll. an. ℥ss. solvatur Icthiocolla in Aceto & fiat Empl. super corio extenda∣tur. Or this:* 1.147 ℞. Balaustian. ℥iss. Gal∣lar. ℥ss. rad. Asphodil. rad. Narciss. vel rad. Arnogloss. & Betar. an. ℥iss. coquan∣tur in vino, fiat Emplastrum. All things being performed, the Patient convenient∣ly purged, the part affected well foment∣ed, and proper astringent Medicines be∣ing applied, after the reposition of the

part, we are after this with convenient Bolsters, and Trusses to finish our busi∣ness, and these are to be kept on so long, untill the lacerated Peritonaeum be so firmly united either together again, or to the Muscles of the Belly, that there can be no fear of any more Relapse. A general ex∣ample of all Trusses I will shew you at the end of this Tract, their various Forms and Fashions for single or double Ruptures.* 1.148 I shall conclude this Chapter with an Hi∣story of a Proctor, whose Intestine falling into his Scrotum, he afterwards fell into an Iliaca passio, the Intestine being so fil∣led and stuffed up with dried Excrements, that hindered its ••••position▪ and after many Remedies had been used for nine days in vain, he ordered the party to be opened to the production of the Perite∣uaenm, where the Intestine was choaked up, lest the Continuance of this Distem∣per might create a Gangrene; and fol∣lowing Celsus Opinion when he offereth, Satiùs est anceps remedium experiri, quàm certo exitio aegrum exponere. Up∣on which Consultation it was agreed, the Patient being conveniently placed, to make an Incision even to the production of the Peritonaeum, after which was sent in a small Silver Pipe, round at one end, and hollowed at the other, and into the

Cavity whereof this Incision was made to that length which was requisite; after this was the Intestine reduced, and sent into the Belly, then was the Process sown up, and the Wound of the parts healed up by Gastroraphia, and with Congluti∣nating Medicines the remainder of the Cure was performed, and the Patient per∣fectly cured.

CHAP. LVI.

Of an Intestinal Rupture, the Peri∣tonaeum being rent.

HEre are required the same Scopes as were discoursed in the former Chapter; the Intestine is to be reposed, and care taken that it cometh not out again, the which is performed if the Rupture be united and agglutinated. Pure drying Medicines for this purpose alone take no place, but such as have a glutinous and viscid quality, mixed with a driness; these are most operative and useful, as such as was in the last Chapter prescribed by Hollerius; or for this Af∣fect take some of these:* 1.149 ℞. Oliban. Sang. Dracon. Bol. Armen. Mastich. an. ʒvj. Alo. Epatic. Thur. alb. Mumm. an. ʒiij. lento igne fiat Emplastrum. Or these of Aquapendens:* 1.150 ℞. Terely. ••th. ℥iss. Cer. Thur. Myrrh. Icthiocol. carn. cochlear. an. ℥j. gluten triduo in aceto macerat. inde in mortario plumbeo levigetur ac conteratur, post igne liquescat, ac caeteris misceatur.* 1.151 Or this: ℞. Resin. arid. Ammoniac. Thur. Bitumin. Sulphur. vin. an. part. aequal. terantur terenda, lique. fiant liquanda, deinde Sulphur adjiciatur,

applicetur vel linteo vel corio; and let it remain on so long untill it spontaneously fall off.* 1.152 An Oyl for the same: ℞. Sar∣cocoll. Thur. Mastich. Sangu. Dracon. an. ℥ij. Terebinth. Venet. vel Resin. lbss. Gyps. pulv. lbj. stent in fimo equino per dies 40, & tunc distillentur, & ex hoc locus inun∣gatur. A Bath for the same is very excel∣lent, such as is this: ℞. fol. Myrtil. Rosar. immaturatur. Bisling. Consolid. major. an. M. ss. Balaust. Plantag. cort. Granator. an. ʒiij. Caryophyl. ʒiss. coquantur omnia in aqua fontana à lbviij. ad lbiiij. & coletur After this apply some of the former Em∣plasters, and then truss your Patient up. And this is the Methodical way of order∣ing your Patients. And in your Pro∣ceedings you ought also to take respect to the Habit of your Patients Body, by purging all such Humours as may seem to disturb our Undertakings; and here may be ordered inwardly several sorts of Medicines, as either Bolus, Syrups, Pills, Electuaries, or the like, being ordered ac∣cording to the strength, capacity, age, and constitution of your Patient; for which use you may take some of these: ℞. Ele∣ctuar. Linitiv. ℥ij. Spec. Hier. picr. ʒij. mix them with Sugar, and order it for a Bolus for your Patient to take some every morning. This Syrup is also excellent:

℞.* 1.153 Syrup. Betonic. Mel Rosar. an. ʒij. Decoct. Betonic. Bisling. Cichor. an. ℥iij. misce. An Electuary for the same: ℞.* 1.154 Limatur. chalyb. praeparat. decies cum aceto lot. & totidem cum aqua Rosar. ℥iij. Mastich. alb. ʒij. pulv. Rad. consolid. major. Pilosell. an. ʒiij. Sacchar. Rosat. lbj. cum syrup. è succ. Plantag. q. s. fiat Electuar. hujus sumat ℥ss. per dies 30. Pills here also very proper:* 1.155 ℞. Alo. succotrin. Agaric. praepar. Rhabarb. Pilosell. an. ʒii. cum Terebinth. Ven. q. s. fiant Pil. Let these serve for a Taste of inward Medicines; for outward Medecines avail but little, if there be not well observed a good or∣der of Diet, in which we are to take care both for the Patients quiet and rest. But if these fail,* 1.156 and will not answer expecta∣tion, Avicen adviseth us to use a second Method, which is performed by Adustion, making a strong impression by the hot In∣strument, which may hereby contract the Cutis, and also hinder the descent of the Intestine. But in this Operation take special care of not touching the Intestine with the Iron; for should this happen, it would or might bring danger of Death to your Patient. This is to be performed by many small pungent red hot Instru∣ments, keeping also all the Seminary Ves∣sels safe and secure from injury, the which

being any ways hurt, the Generation of Seed would consequently be impedited. Some of these should be semicircular, whilest others ought to be more pungent, having a very sharp point, ever beginning the Ustion from the upper part, so de∣scending through the whole Region of the Rupture.* 1.157 A third Method is Incisi∣on, and this is two fold, the one perform∣ed by the Chirurgeon, of which we will first treat; the other of an Emperick: the first Cure being performed without extraction of the Stones, the second with it. In the first let the Patient stand and hold his Wind, that the Tumour may more evidently appear; and when you intend the Operation, you are first to mark the place, with Ink where you in∣tend to open or incise, then are you to make your Incision through the length of the whole dilated Vaginal Coat, the Va∣gina being elevated either with the Fin∣ger or small Hooks, then with an Incision Knife you are to make a Diametrical In∣cision, both to the Membranes and Vagi∣nal Coat rent or dilated, then with a firm, thick, and crooked Needle, you are to make a Suture according to the length of the whole Dilatation in the dilated Vagi∣na, drawing a thick and strong Thred (the inward Vessels of the Seed inwardly re∣maining

safe and entire) through, the Coat is to be agglutinated, with∣out extraction or hurting of the Te∣sticles; then let the Patient be put to Bed, and after this apply such things as are agglutinative, then induce a Cicatrice, and keep your Patient well trussed.* 1.158 The fourth and last Method is performed the Emperical manner, and this is with Ex∣traction of the Testicle, a way very use∣less and dangerous. It is thus repeated by Paulus, cap. 65. lib. 6. The Patient being placed with his Head downwards, the Intestine being reduced, part of the Abdomen being compressed by an Assist∣ant, and the Patient being bound make an oblique mark in his Groin, after this make a deep Incision, so that the Testicle may come forth with the Spermatick Vessels, the which the Chirurgeon having in his hands, let him separate all the Coats, and draw forth the Testicle through the same Orifice, all the other parts being taken aside with small Hooks, let them be sown together or tied, after this above the place tied take them off, and with an hot cauterizing Iron being there instantly ready, cauterize the mouths of the Vessels, hereby hindering all Flux; besides which you will find the parts sooner agglutinated: the which

being done, they leave a long Thred re∣maining, applying Digestions inwardly. After this they make a Cavity in the Scrotum, and there applying a Digestive, they use Butter, to which they adde Frankincense, the Yolk of an Egge, and a little Turpentine; then they study the generation of Flesh with Basilicon, Aure∣um, Ʋnguentum de Betonica, or the like, and induce a Cicatrice with dried Lints and Unguents, Diapompholigos, Diapal∣ma, Desiccativum rubrum,* 1.159 &c. I shall conclude this Chapter with a History of Hildanus, who writes of a Gentleman, which for many years was troubled with an Intestinal Rupture, distended by Wind, having a great pain of his whole Belly, continual Vomiting, Watchings, Restlesness adjoyned to it; for whom this Clyster was first administred:* 1.160 ℞. Rad. Alth. Malv. cum toto, fol. Violar. Parie∣tar. fl. Chamomel. Melilot. Sambuc. an. M. j. sem. Fenugraec. Lin. contus. an. ℥ss. sem. Anis. Foenicnl. Caru. Cumin. an. ℥j. incidantur & contundantur omnia, postea indantur in sacculo ejus magnitudinis quâ totum Scrotum cooperiri possit: the which being sown up, boil it in twelve pounds of Water. Take of this Decocti∣on lbj. in which dissolve of Electuar. Diacatholic. ℥j. Vitel. Ovor. n. ij. Bu∣tyr.

recent. ol. commun. an. ℥iij. misce. fiat Enema. After the Bag being pressed out, apply it to the Scrotum, and this re∣peat very often by dipping it into the De∣coction, and so pressing it out, and ap∣plying it warm. Within half an hour af∣ter the Clyster was injected, there was administred the same Decoction, by which the Scrotum began to grow lax, and the Patient being put into his Bed, with his Head placcd supinely or down∣wards, and his Feet upwards, his Inte∣stine was reduced; and for keeping it in its place he applied to the Scrotum this following Restringent Bag;* 1.161 ℞. Rosar. rubr. Absynth. vulgar. prunor. sylvestr. Caud. equin. fol. salv. Mosc. Quercin. an. Mss. Cort. Querc. ℥ij. sem. Foenicul. Anis. an. ℥j. incidantur & contundantur, postea indantur in sacculo; which is to be sowed up, and boiled in red Wine, and after∣wards applied. The day following he prescribed this Purge:* 1.162 ℞. Rad. Foeni∣cul. Petroselin. Gramin. Polypod. Querc. an. ℥ss. herb. Agrimon. Veronic. Cuscuth. an. M. ss. sem. Anis. Foenicul. an. ʒij. fol. Senn. mundat. ℥ss. coquantur ut co∣latura redeat ad ℥iiij. in quibus sol∣ve Electuar. Diacatharm. Diaphae∣nic. an. ʒiij. aqu. Cinamom. Hordeat. ℥ss. misce. After this was applied Em∣plastrum

ad Herniam, and a convenient Truss: and by these Helps and Remedies he was perfectly cured.

CHAP. LVII.

Of Epiplocele or Hernia Omentalis.

THis 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 so called by the Greeks from Epiploon or Omen∣tum may happen in either side of the Scrotum, and may not very easily be reduced. This Rupture is occasioned by the Dilatation of the middle Coat onely, not because of the Peritonaeum being rent, by reason no great part of the O∣mentum descendeth, it being annexed to the bottom of the Ventricle, Colon, and Spine. This therefore is chiefly gene∣rated by the Coats Dilatation, especially the Omentum being armed with Fat, which gives a more easie cause to this Re∣laxation and Dilatation, although not to its Ruption.* 1.163 Signs of an Omental Rupture are these; the Tumour is always the same, unequal to touch, soft, and slippery in respect of its Fat, it lieth more in the Os pubis than in the Scrotum, and is small in Tumour. Its Curative Scopes are two, to reduce the Omentum inwards,

which is performed by the Hand, and to hinder its exition; and this is done by Pharmacy. And because this Dilatation generally is occasioned by Moisture, or the Fat relaxing this Rupture; therefore Restrictives are the most proper Medi∣cines in this place required; and here take Aquapendens his Emplaster: ℞. Alo. Malicor. in vino austero elixat. succ. Hy∣pocystid. Thur. glutin. fabror. an. partes aequales, gluten passo incoquatur ad inte∣gram dissolutionem, post teratur in mor∣tario, & cae••era addautur. As touching the rest, this Cure dissereth not much from an Intestinal Rupture, and therefore Trusses, Caustick, or Incision may upon occasion be used, observing Celsus Rule, lib. 7. cap. 25. If a small part of the Omen∣tum descend, this may properly be repo∣sed; but if a great part, this is to be burnt, or dealt with so that it falleth off: yet this is not to be attempted very readily, because this Rupture is seen very often beyond expectation cured. I shall shut up this Discourse with two or three plea∣sant Histories, very convenient for this purpose and matter.* 1.164 Hollerius relates of a pious youug man, who died Ileous, from a Prolapsion of the Ileon with the Omen∣tum into the Scrotum; the which Body being diffected, the Ileon was wholly

found gangrenated by reason of Inflam∣mation, which was conceived to be by this Prolapsion.* 1.165 Columbus lib. 15. Ana∣tom. writes, he saw above a pound of O∣mentum in the Scrotum.* 1.166 Jacobus Oe∣theus lib. Observat. propr. writes of a young Gentleman, who having been trou∣bled with an Inguinal Rupture, and the Intestines oft times falling into the Scro∣tum, he at length found somewhat else fall into it also, it being no part of the In∣testines, but the Omentum which swelled the Scrotum at this rate; and the Signs hereof were, he had neither Cholical Pains, nor Motions, nor Fever, nor Ob∣structions of the viscera. That part of the Omentum which was lapsed, by ap∣plication of convenient Fomentations, Emplasters, and Ligature to the part af∣fected, they were well reposed, the Pati∣ent soon felt ease, and in process of time received a perfect Cure.

CHAP. LVIII.

Of Exomphalos or Hernia Ʋmbilicalis.

EXomphalos is made by the Perito∣naeum being either relaxed or rent; and hence oft times happens that the Omentum and the Intestines do fall into its place. If it happeneth by the O∣mentum, it retains the colour of the Cutis; and there will appear a soft and almost in∣dolent Tumour, and is reposed without any noise; but happening by the Inte∣stines, it appears unequal, and upon its Reduction it maketh a Murmuration. If it happens from Flesh, it appears hard; if from Wind, soft: and this by the Learned called Exomphalos, by us a Navel Rup∣ture, proceeds from the same Cause as the former, and may be treated with the same Curative Method; save onely in this place you are to mind, that you co∣ver the whole Rupture with hard, and thick, and large Bolsters, that hereby it may sufficiently be kept in. If it hap∣pens that it proves a flatuous Tumour of the Navel, cure it as you do Physocele; if a waterish Tumour, this is to be thus treated, by making a small Incision, and keeping it open so long as untill you have

discharged the whole Water. Hildanus in his Centur. 3. Observ. 64. relates of a pleasant story to this purpose; so does Benivenius tell us of a strange one: the last I will produce first, because that of Hildanus I intend to give according to the Author himself, with his Figures and Method how to make and apply the out∣ward Dressings and Ligatures.* 1.167 Benive∣nius chap. 6. Abditis, relateth a strange story of John Binus, who had a Son whose Navel grew out like a Mans penis, four fingers in length, and as it were had a Coat of the Testicles joyned to it, out of which sometimes Spirits did fly, the which many Physicians saw; whereupon some of them judged, some of the Inte∣stines had thrust themselves out; others, the Omentum; others attributed it to Wind and Humours; but at length it was concluded, that it was a Fleshy Excrescen∣cy, and for the taking this off there was a strict Bandage made, the which was every day contracted or bound closer, untill the whole was eradicated; the which being removed, the Patient reco∣vered his perfect Cure and Health.* 1.168

This of Fabritius Hildanus is of a noble and pious Martron in Germany, in whom not onely the Navel it self, but a little above the Peritonaeum, and some

part of the Abomen, it hung down dila∣ted into a great Bag; in this Bag also not onely the Omentum, but somewhat of the Intestine was contained. Sometimes a murmuring was there perceived; and then pain was present, sometimes pro∣ving very vehement, otherwhile more remiss, according to the quantity of Winds then present. She affirmed to him, she got this Affect in the time of her Childbearing. Of the rest, because Pro∣lapses of this sort, of the Navel or Ab∣domen, can be seldom reduced into the Belly; or if they might be, they are not there retained without great difficulty; they produce wonderful troubles to the Patients that are therewith vexed, when they by reason of the weight do draw their upper parts downwards. For this purpose he hath invented a new Bag, by which this Extuberance may as well as possibly be drawn upwards, and so eleva∣ted, that the grieved Patient may bear the burthen with much less trouble and incommodiousness. This is to be made of a strong doubled Cloth fitted to the Thorax, so as that it descends no lower than the first Bastard Rib, and so back∣wards to the Thorax from the Region of the Omoplates, making a Ligature on either side placed two fingers breadth,

and perforated in several places, to fit it the better to the Thorax. To this Liga∣ture is to be annexed this large one with the Bag, so as it may be lifted up or taken down, according to the will and pleasure of the Patient; by the benefit of which holes this may be done. This Figure you may see very fairly described in this following Leaf, together with the Band∣age, with Figures directing how to make and use it.

[illustration]

CHAP. LIX.

Of Hydrocele or Hernia Aquosa.

HYdrocele or Hernia Aquosa do ei∣ther possess the whole Scrotum, or part thereof. This Aqueous Humour is not collected in the Scrotum, but in the Membrana Erythrois, contain∣ing the Testicle, for into this a thin fluid Humour does make its influx, being much of the consistence of Urine, distend∣ing this Erythroidal Membrane; and the subsistance of the Testicle in process of time is also corrupted by its acrimo∣ny. By Aetius Leonidas this Aqueous Tumour is said to be loose, and without pain, the which is not to be eased by any Cataplasms, Fomentations, Emplasters, or Unguents. There's one onely Remedy which must discharge it, and that is Se∣ction or Incision: and this is very mani∣fest and apparent, because the Seminal Vein of this part ariseth not from the Ca∣va, as do the right, but from the left E∣mulgent. The Kidney being by this e∣villy affected, not performing its proper function, part of the Urine, the which the Emulgent protracts to it self, whenas it cannot descend to the Bladder from the

ill-affected Kidney, it falleth into the Membrance Elythrois, and here breeds Hydrocele; and this being sublated with the Testicle, this Humour can no longer remain here, as Dodonaeus observes, cap. 39.* 1.169 Observ. The Causes hereof may be many, some being occult, others mani∣fest; occult, as this waterish Humour being gathered from the repleted Vessels. Guido adds a Vice of the Liver herein or Spleen, by reason of which there is a Liquor col∣lected in the Hypocondries, which with ease does make its descent manifest, as Percussion, Collision, Fraction of Vessels which are in the Testicles; for the Blood which flows into the Vessels is changed and turned, by reason of the weakness of parts, into an aqueous substance. Per∣cussion and Collision,* 1.170 and the like, are its Signs; the Tumour vanisheth if Hunger hath preceded. If the Habit of the Body be ill, this Hernia proceeds from the ill accident of some Bowel; if not hence, it may from too much Liquor, for Reple∣tion is made by too much Potation. Ae∣tius taketh the Causes from the Humour it self, the which if it be yellowish and pale, the Hernia will appear from the Repletion of the Vessels; if feculent, from Percussion; if white, from a Vice of the Liver or Spleen; the Veins of the Scro∣tum

are tumefied; if it be compressed, the Humour floweth into the Vessels which formerly were empty. It shineth and appears very bright, and is soft, light, and clear, by viewing it, and applying a Candle on the opposite part. It is a par∣ticular Dropsie; and as a general Drop∣sie is bred by a collection of Matter, as in a Critical Abscess, by drinking more free∣ly of Water than can be discharged by Vomit, by Generation, by interception, or alleviation of a Sanguisick Faculty. So a Hernia aquosa & flatuosa do either come by a primogene affection, or by successi∣on of some other Distemper: and for this reason Hollerius does prescribe here such things as are to be given in either kind of Dropsie, this sometimes happen∣ing between this and the Erythrois, some∣times between the Erythrois and Dar∣tos. As touching the Cure,* 1.171 all Causes are to be removed, the ill Habit of the Body corrected, from too much Drink the Patient ought to be prescribed, the plenty of this watery Humour to be dis∣charged and evacuated, and the whole Habit of the Body amended. And for the performance of these, Purgatives, Diaphoreticks and Diureticks are very proper instrumental Weapons to dis∣charge this invasive companion, of which

I have already presented you with many in my Tract of Aqueous Tumours.* 1.172 As touching outward Applications, these ought to contain in them a power to dis∣charge this Water contained in the Te∣sticles, this to be performed either by Repellers driving it back, or by educing it by the part affected,* 1.173 or by Scarrificati∣on. Hollerius does offer this as an ex∣cellent Plaster, being made of fresh Cows Dung, adding thereto a third part of Bol. Armen.* 1.174 and Dragons Blood. A Fo∣mentation for the same may be this: ℞. Lixiv. Barbito••sor. iiij. in his co∣quantur Cumin. ℥iiij. Rut. Absynth. Pu∣leg. Petroselin. Apii an. ℥ss. Sal. j. with this let the part affected be fomented. Or this:* 1.175 ℞. Cumin. Bac. Laur. sem. Sesel. Rut. an. ℥j. fiat Decoctum in vino rubro, & fiat Fomentum. Or for this use take this Cataplasm;* 1.176 ℞. Stercor. Vaccin. ij. Sulphur. Cumin. an. ℥ij. Empl. de Bacc. Laur. pulv. Juniper. Anis. an. ʒij. misce, & cum pauco mellis fiat Cataplasma. Or these; ℞. Cumin. Baccar. Laur. fimi Co∣lumbin. Castor. an. part. aequal. coquan∣tur cum oleo Rosarum & pauc. Cerae. First apply your Baths, then anoint the part affected, and afterwards apply your Ca∣plasms. If these fail, we are to come to Apertion, which may be used two ways,

either by Incision or Caustick; if by Cau∣stick, the place is to be cauterized in the place where the Water is, and then after it is once discharged, a new Collection is to be prevented. And here Galen does order the part to be kept open for a long while, by placing in a Silver Pipe into the affected part. Guido maketh a Se∣ton, and keeps it a long while. Celsus teacheth the place of Incision, saying, If it be a Child that is herewith troubled, it is to be laid open in the Inguen, and the wa∣ter to be drawn upwards. If in one of a greater age, this is to be opened in the bottom of the Scrotum, and that way the water to be let out; taking this as Ad∣vice, that water is not to be left long in the Scrotum, lest by its delay there it does the Testicle injury; or hereby there grows a Hernia carnosa. The Body be∣ing well prepared for your Operation of Incision, and a good order of Diet prescri∣bed, let the Patient be well placed, then in the upper part even to the Tunica E∣rythrois is the Scrotum to be incised; this is somewhat to be separated in its outward part from the Membrane it self. And because the Water wholly is con∣tained in this Coat, so the Testicle swims therein; and lest this Water should de∣scend, with a crooked Needle and double

Thread the whole Coat is to be appre∣hended (besides the Seminal Vessels) and then to be moderately bound and tied; after this divide the Membrane in the lower part of the Ligature lengthways, and draw out the water or liquor con∣tained within; then with a long Tent, it being of a moderate thickness, being dipt in the White of an Egge, to which some restrictive Powders have been ad∣ded, apply it to the side of the Testicle, and about the lower part of the Scrotum, an∣ointing the Inguens and Abdomen with Oyl of Roses: the day following let this Digestive be applied; ℞. Terchinth. lot. ʒij. Cer. nov. ℥ss. Gum. Elem. ʒj. ol. Ro∣sar. & Amygdal. dulc. ℥ss. ol. de vitell. O∣vor. ʒij. dissolve Gummi lento igne cum ol. Terebinth. & Cerâ cum pauxillo Oleo∣rum liquefactis, fiat Ʋnguentum, fine ad∣dendo Croc. ℈j. With this let the Tents be armed, which are to be put into the Orifice; afterwards apply a mundefying Powder to cleanse the Ulcer, and keep it open for near two moneths; and then close up the Wound with a Cicatrice. I conclude with a History of Hildanus,* 1.177 who writes of a Commissary 40 years of age, a man strong and of a good Habit of Body, vexed for many years with a watery Rupture, unto whom both many inward

and outward Medicines were prescribed and applied without any success; and it growing to a great bulk, that it occasion∣ed a large Tumour in the Scrotum, and proved so painful that the Patient would rather yield to any Method which could give appearance of ease; his Body being prepared, and a good order of Diet order∣ed him, with administring Purgings, and their reiterations, with Bleeding, &c. he being conveniently placed, the Scrotum was opened in the upper part of the Coat Erythrois, and this on the fore part somewhat separated; and because the whole Testicle did swim in water, which was contained in that Coat, that the wa∣ter might make no further descent, with a crooked Needle and double Thread, the whole Coat and Seminary Vessels were moderately taken up and bound; after this in the lower part of the Ligature the Membrane was divided lengthways, and by degrees was drawn forth some pounds of Water, after which was applied a Pled∣get long and thick enough, dipped in the White of an Egge, Bol. Armen. and the like, then was applied the same Digestive I formerly have described, and with this were armed the Tents and Pledgets, and over these Ʋnguentum Basilicon; and with all care the Ulcer being mundefied,

digested, and filled with Flesh, it was skinned, and the Patient perfectly reco∣vered. Riverius relates another story of a Child of 15 moneths old, who was troubled with a watery Rupture in his right side of his Testicle, with Matter contained in the Dartos, equalling the bigness of a small Egge; and this he had almost from his first coming into the world: how he received his Cure I will commit you to the Author himself.

CHAP. LX.

Of Pneumatocele or Hernia ventosa.

THis windy Rupture does happen with and without a Dropsie; if with a Dropsie, cure the Drop∣sie, and the Rupture will be dismis∣sed; if without a Dropsie, we are to use Topical Medicines, and these ought to be Digestives, and purge the Body from the flegmatick and windy Hu∣mours, and if possibly gain a digestive fa∣culty in the Stomach, and these you have already prescribed in Tumours arising from wind. This Tumour is known from the former, because it is more lucid and red than it; the Veins are puffed up, and the splendour appears more bright than the former, and is suddenly framed, and as speedily discharged. And having al∣ready furnished you with Medicines for discharging the Antecedent Cause, we now arrive at the Conjunct Cause, which is this flatuous Spirit got into the Scro∣tum, or its Coats; the which we shall thus endeavour to discharge by outward Medicines, as Fomentations, Oyls, Un∣guents, Emplasters, Cataplasms, and the like, neither here using Caustick or In∣cision

For Fomentations you may use these:* 1.178 ℞. Origan. Calamenth. Puleg. an. M. ss. sem. 4 Calid. major. sem. Vitic. Bacc. Laur. Juniper. sem. Cumin. an. ʒij. fl. Melilot. Chamomel. an. pug. ij. Sal. ʒij. coquantur in s. q. vini albi ad 3 par∣tis consumptionem.* 1.179 Or this: ℞. Lixiv. Barbitonsor. iij. Cumin. Bacc. Laur. an. ℥ij. fol. Laur. Rorismarin. Rosar. rubr. Meliss. Menth. Majoran. an. M. j. Sal commun. ℥iiij. with this bathe the part affected with a Sponge.* 1.180 Or this: ℞. A∣cet. fortissim. ij. in quibus coquantur rad. Pyreth. Staphis. ac. Bacc. Juni∣per. Laur. Cumin. an. ℥ss. fol. Laur. Haeder. terrestr. Salv. Thym. Rorismarin. an. pug. j. bathe also with this the affected part; or with this:* 1.181 ℞. sem. Cumin. Bacc. Laur. Rut. Chamomel. Bacc. Juniper. Absynth. an. ℥i. misce, fiat Fomentum, cum aqua & vino mixta.* 1.182 Oyls for the same are these: ℞. ol. Rut. Laurin. an. ℥iss. ol. Petrol. ℥i. ol. Spic. Terebinth. an. ℥ss. misce. Or, ℞▪ ol. Chamomel. Rut. an. ℥i. ol. Aneth. Nard. an. ʒiij. spirit. vin. ʒij. Cer. q. s. fiat Ʋnguentum.* 1.183 Or, ℞. ol. Castor. Rut. Eu∣phorb. an. ʒvj. Ʋnguent. Martial. ℥ss. misce.* 1.184 Or for Cataplasms take these: ℞. sem. Cumin. Bacc. Laur. sem. Sesel. Rut. an. ℥i. stercor. Bovin. j. Sulphur. viv. Cumin. an. ℥ij. mel. q. s. fiat Cata∣plasma.

Or this;* 1.185 ℞. Farin. Fabar. ℥iiij. sem. Danc. Cumin. an. ℥ss. Bacc. Laur. Juniper. an. ʒij. fl. Chamomel. Melilot. Rosar. rubr. & Lavendul. an. pug. j. Sal∣pug. iss. cum vini albi q. s. fiat Cataplas∣ma. Or,* 1.186 ℞. Farin. Fabar. ss. sem. ••••∣nugraec. cumin. an. ʒij. sem. Apii Rui. an. ʒj. fl. Chamomel. pug. ij. pulv. Rui. Absynth. Scord. Rosar. rubr. ad. ʒss. c••∣quantur omnia in vino albo q. s. fine ad∣dendo Oximelit. Scillitic. q. s. fiat Cata∣plasma. Empl.* 1.187 de Bacc. Laur. is here also very good; or this mixt Emplaster: ℞. Empl. de Melilot. de Bacc. Laur. de Ran. cum Merc. an. ʒiij. nitr. Cumin. Sulphur. Calc. viv. Sal. an. ℈j. ol. Laur. & Cerae q.* 1.188 s. fiat Empl. Benivenius cap. 81. Abditor. writes of a Person of Quali∣ty, who having his viscera and Stomach so filled with Wind, that it proved very troublesome to him; and when the part was compressed, there was perceived no exition: and hence not onely the Bowels and the Brest, but the Scapulaes also were extended with incredible pain, and the Spirits very narrowly con••ined; all con∣venient and proper Medicines being pre∣scribed and used without any effect, the third day the Gentleman dieth; the dead Body being dissected, the Intestines and the other viscera were seen to be much

swelled and puffed up with wind, and in the left Ventricle of the Heart was found a hard Callosity equalling the largeness of a Nut, and these two were general∣ly held to be the onely Causes of his Death.

CHAP. LXI.

Of Sarcocele or Hernia carnosa.

THis is a Tumour contra naturam, which is generated about the Te∣sticles out of a Scirrhous Flesh; or it is a Tumour bred out of the defluxion of thick Humours, which are collected between the Coats of the Testicles, and they there not assimulating, there oft times grows as it were a Hyposarcosis, oft times Varices accompany the Tu∣mour, and these are very troublesom; and these Humours being thick and viscid, bred from Flegm and Melancholy, as they breed Scirrhous Tumours in other parts, so also do they generate a hardness in these.* 1.189 It is known by its Hardness, Aspe∣rity, Inequality, and Indolency. It ari∣seth from Melancholy, it having a sublu∣cid colour. If it ariseth from Flegm, it does not differ from the colour of the Cu∣tis.

If it ariseth from burnt Melancholy, it hath a pricking pain, and the Tumour is inequal, in some places soft, in others hard. If the Tumour be not confirmed, cure it as you do a Scirrhus, by using E∣mollients, then Discussives; but the last seldom does any good here. But if these fail, you are to come to Section; but if it be Cancerous attempt nothing. Mat∣thiolus affirmeth, that he hath absumed a Sarcocele by the onely using of Pulvis Radicis Anonidis being taken for many moneths. But if it yields not to Medi∣cine, Incision is the next remedy; and this way or method is not void of danger, the Testicle being either left in or taken out. And by the way we are to consider, that if any fleshy substance grows about the Coats or Testicles, this is wholly and absolutely to be taken away in this case for more safety; the Vessels are there∣fore to be drawn out and tied, and after∣wards incised and cauterized: for to leave any part hereof, does more represent the ignorance of a Quack, than know∣ledge of an Artist; for no Son of Art will give the advantage of a new growth, whenas he may well prevent any ap∣pearance of the same by a careful mana∣ging of his Operation, and taking care of preventing all accidents; for a small

quantity, but left remaining, will soon run up (like a rank Weed) to a great bulk, and this in a short time grows worse and worse. If the Tumour be not very hard, the Chirurgion comprehending the whole Tumour, that is the whole tumefi∣ed Substance in the Testicle, every way encompassing it, let him make his In∣cision even to the Tumour above the Scrotum; then abduce the Testicle from the Scrotum, drawing a strong Needle and Thread through the middle Process above the Region of the tumefied Testi∣cle, and then drawing it back again through the same part of the Process; then tie both of them; these being per∣formed cut off the whole Process, the Te∣sticle being concluded with it. It being ablated, apply a Repercussive Medicine, and strengthen the neighbouring parts with convenient rollings and bolsterings, and heal up your Ulcer as you do others. Fabritius Hildanus tells a very pleasant story of a young man,* 1.190 who embracing his Mistress in Veneral Ceremony, he be∣ing near ready to eject his Spermatick succus, was prevented of his intended purpose by a Messenger which rushed in unawares, by opening the Chamber door, and disturbing him in his pursuit, on which his Sperm receded, and was retained.

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

CHAP. LXII.

Of Circocele or Hernia Varicosa.

THis is nothing else than a Dilatati∣on of the Veins in the Testicles, conglomerated in manner of Varices: and these (as Celsus and Pau∣lus write) are either the Veins of the Scrotum, or those in the Membranes of the Dartos, or those which do nourish the Testicle: and therefore Celsus adviseth, if the Rupture be in the Scrotum, you are to apply thin and sharp Instruments to the Veins, and with these the Veins are to be cauterized, and there to be most cau∣terized where most variced or twisted. The general Curative Method here is the same to that prescribed in curing of a Scirrhus;* 1.191 the Intentions here are three, to repell the flowing Humour, to dis∣charge and dry up that which hath alrea∣dy slowed, and to astringe the dilated Ves∣sels. Now Astringents do satisfie these two scopes; for as being cold and restrin∣gent, they repell the fluent Humour; as being drying, they dry it up; and by its Astriction do also bind up the dilated Ves∣sels. And for this Affect, Balaustians, Red Roses, Pomgranate Rinds, Juice of Hy∣pocystus,

Bol. Armen. Dragons Blood, Mastich, Olibanum, Glue, Amber, and the like; these, or any, or some of these mixed with the White of an Egge and a little Vinegar, may very well be used here: but if these do no good, come to the use of Incision or Caustick, and here are we to be very careful in onely caute∣rizing the parts where they are thus twined or twisted together; after which done remove the Eschar, then deterge and digest it. But if the Veins of the Dartos be tumefied, you are to make your Incisi∣on in the Groin, and the Membrane is to be drawn through there with the Testi∣cle, and after this separate the dilated Vessels from the Coat either with your Fingers or a convenient Instrument; then tie up the Vessels, and cut them off under your Ligature; then repose or reduce your Coat and Testicle. And if the Rup∣ture be in the Erythrois or Tunica vagi∣nalis, and either two be dilated, proceed in the same Method as in the Dartos; but if it be between the inward Coat and the Testicle it self, make your Incision in the Inguen, draw out the Vessels, ampu∣tate the Testicle, and cauterize the parts. And this is Paulus his Method and Di∣stinction. As touching Hernia Humo∣ralis, take this brief Description of it:

It is framed out of a Confusion of ma∣ny Humours in the Scrotum,* 1.192 or be∣tween the Coats which enwrap the Te∣sticle. Oft times also it is seen to be bred in the proper Substance of the Te∣sticles. You are to cure this as you do the former. And thus much of Rup∣tures.

CHAP. LXIII.

Of a Venereal Bubo.

WE arrive now at the Inguens, where we may meet with these four following Tumours, Bu∣bo Venereus, Pestiferus, Phyma, Phy∣gethlon; of each of these in their order. These Glandules have their proper names as well as others, and hence is it that they are called Bubones, by us in Eng∣land called the Popes eye, in veal and mutton. They are held to be eight in num∣ber and very large. There is held to be a great commerce between the Nerves and these Glandules: for it is very credi∣ble that the Nerves do conveigh some∣what hither, as their excrementitious succus, and also do send hither any ner∣veous quality that at any time doth per∣plex them; but they do not unload them∣selves into these as into their excretory ports, but into their adjoyning vessels; and hence it is that they are placed at the greater division of the vessels: neither is it less probable, that they take some∣what from hence as a nutritive juice, the which being allured by a similar at∣traction of the Glandulous substance, the

Lymphaducts to pour out their Lympha here, and by the benefit hereof these Glandules do separate one and leave the other: And this is confirmed by their sweetnes and delicacy, they having a fa∣miliarity with the nutrive Succus. And the reason they are so large and numerous is, because the Crural Nerves had need to have such large Organes for discharging their superfluities. We come now to their Diseases with the Affects; these being ei∣ther simple or not malign Tumours, or pestilential or venereal Tumours. The Causes of all which may be reduced to two. The first being the hindrance of the Circulation of the Blood, and hence ariseth a Tumour by reason of the conti∣nuity and impetuous afflux of the Blood from the heart through the Arteries, and by reason of its making no reflux from these through the Veins: An evident ex∣ample we have hereof in Contusions of the Glandules and in their Obstructions. A second common Cause ariseth general∣ly from the Nerves themselves, spitting forth their superfluous Humidities being either here vitious in Quantity or Quali∣ty: now these are 2 common causes. Eve∣ry special Tumour hath its specifick causes & differences: and thus if these superflui∣ties only err in quantity or quality, as in viscidity, thicknes, or the like, it frameth a

simple Tumour: If from a malign quality, there ariseth a Tumour being of the same nature (as malign;) and thus being either venereal or pestilential it occasioneth a ve∣nereal or pestilential Tumour.* 1.193 We are now to enquire of the efficient causes of this ve∣nreal Bubo: and this poyson oftimes is com∣municated to the Liver, and hence is sent into the Inguens, as its proper Emunctuo∣ries, and hence ariseth these venereal Bu∣boes. The cheif matter of which they are bred is of a part of thick, cold and viscid Humours, which may wel be perceived by the hardnes, whitenes, ilnes of pain, and co∣lour of the Tumour. Sometimes they arise from a hot, sharp, & cholerick Humour with a great pain, and a conjunct heat, and these make them so oft to run into Ulcers, being both virulent & corroding.* 1.194 As to the cure, never-use digestives, lest the thinner part being resolved, the thicker excrement lyes and encreaseth inwards; much less Repellers, for these do drive the virulent matter inward; and therefore Attractives and Suppuratives here only do take best place. The Tumour being made ripe, o∣pen it with a potential Cautery. As touching the cure of the whole body, neither purge, bleed, or keep any order of dyet. Make your orifice not very large, but so as you may lodge in it a pretty handsome large Tent for discharge of this

peccant Matter, you may keep it open for 20 or 30 dayes according to the greater or lesser quantity of Matter. This being discharged, we may both prescribe purg∣ing, bleeding, and a good order of dyet. It being discharged, cleanse it well, fill up with flesh, and skin it. And thus may you cure the kinder sort of a Venereal Bubo: but if it proves more rebellious, then instead of Suppurating Medicines we should come to the use of Cupping Glasses every other day, and after these to apply Diachylon cum gummi mixed with black Soap, and these will ma∣turate the most rebellious Buboes; and having brought it thus, deterge the Ul∣cer by keeping it a long while open, and freed of its peccant Matter; then fill up with flesh,* 1.195 and skin it. Hildanus tels us of one, who in an impure coition with a Strumpet had all his genital parts so di∣lated, that a malign Vapour passed to the next immediate Veines, and afterwards coursed through the greater to the Liver, and so infected the whole mass of Blood, hence were generated many crudities in∣stead of Blood. And as nature is alwaies careful to defend her noble parts, and to vindicate them from blemish and injury, she generally sends these Humours to the Ing••ens, as to its Emunct••ories: and

here they breed these Tumours we call Buboes, which were made of a hot and san∣guinolent matter, the which with ease came to suppuration; others there be which being generated of could and thick Humours do require a longer time to sup∣pur ate, and a greater diligency to cure, the Matter was sharp and malign, and many Medicines being used both inwards and outwards with small success. The Tumour appeared but small, and was very hard, and after having applied ma∣ny attractive Cataplasms and Empla∣sters, by the benefit of a Caustick it did break, out of which for six or seven dayes space it did run near ten pound of Mat∣ter. About the Rotator of the Thigh broke out several Abscesses, out of which did also run such a great Quantity of Mat∣ter for some months, that many thought him scarce curable, but by care and con∣venient Medicines he recovered.* 1.196 Schenkius relates of a noble man about 30. years of age, who having recreated himself in Ve∣nereal embraces with a young noble wo∣man being filled well both with wine and venery had soon after his fulness of plea∣sure an implacable pain about his Hips, and in his left Groyn did grow a large and red Tumour, the which after wards turned it self into an Ulcer to which applying

Diachylon cum gummi and such like Medicines it was speedily brought to sup∣puration; the which being opened a great quantity of Purulent Matter came out much like to that of Pultice; his Spi∣rits almost being exhausted, he fell into a consumption, accompanied with a Hectick, and afterwards within a little while leaves the world with his pain. I write this as a Caution to young Chirurgions, that they do not supress such Venereal Buboes, or leave any Venenate or Viru∣lent matter to lodge in such Tumours or Abscesses, they at last turning to Fistu∣laes, if not bring a Consumption with them, and so Death.

CHAP. LXIV.

Of a Pestilential Bubo.

THis Tumor by the Arabians is cal-Althois. It is a Tumour long, and moveable, in its Vigour sharp with a mucronated Turbination, immoveable and deeply fixed in the Glan∣dules, in which the Brain exonerates it self into these Glandules somewhat of its venenate and pestiferous Matter, as to those which are in the Throat and Ears, the Heart to those which are under the Axillaries, and the Liver to the Inguens. It consisteth of a thick and viscid sub∣stance, as a sharp Anthrax ••ixing an Es∣char in the part. Of these are two con∣junct Causes, the Efficient is strength and vivacity of the expulsive Faculty of these principal parts, which expulsion is made by these to the Emunctuories. The mate∣rial Cause is corrupt Blood deprived of its proper Nature, Effence and benign Quality, and altogether altered and chan∣ged from its pristine Substance, that it turneth an enemy to its nature. And here ought we to enquire into the cause of this Corruption. It is to be noted in an Inflam∣mation and Erysipelas the fluent Blood

is good, because it is not expelled, on∣ly aggravated in Quantity: This is ex∣pelled in respect of its ill Quality.* 1.197 Galen giveth this as a Cause, as Corruption, when that be received be of an evil juice, they being of the worst Nutriment. A∣nother Cause is corruption of Air, the which being attracted doth force it self into the Spirits, and so corrupt the whole Mass of Blood. we do own a Pestife∣rous Bubo to be an Inflammation of the Glandulous parts: and here therefore we are to mind the whole colour of the Bo∣dy; For in a Pestiferous Bubo this is sometimes changed.* 1.198 Another sign is a dry and black Tongue; another is a thin and waterish Urine, his Excrements ve∣ry fetid, because this putrid Heat doth corrupt them. In a Pestiferous Flux there is oft times a Cholerick Flux ad∣joyned, and the Excrements are of various colours, frequent Vomiting and stinking Sweats, a general Itch over all the Body, pains of the Head, oftimes Delirium, great pain and griping in the Stomach, by reason of the putrid Humours sent thither from the Guts; then Syncope and at last Death.* 1.199 In this case Death is gene∣rally to be presaged, the disease being so potent and forcibly assailing the natu∣ral Fort, that it cannot long hold out. As

to the Cure;* 1.200 First cure his Air, this be∣ing as a main Actor in this Tragedy, and therefore sprinkle his room with Vi∣negar, or burnt Tarr, &c. let his Dyet be thin, because his Humour is thick; all Pas∣sions are to be shunned; Venery ••led from as the greatest enemy, because it is a great disease. Galen ordereth Venae Secti∣o; and in every putrid Fever you may see him ordering Phlebotomy as you may see it in 11. Meth. cap. 14. And in a Pestilential Bubo there is concomitant a putrid Fe∣ver; and therefore Bleeding is very requi∣site. Besides these, the common signs of the Bloods offending in Quality requires Bleeding: But this is to be done and per∣formed both warily and judiciously; for in some cases it is by no means to be ad∣mitted, as in the Small Pox appearing, or Buboes; for by Venesection here we send the peccant Matter inwards to some noble part, and so instead of quenching we rather add Fuel to the Fire. And in purging be sure you observe to mix somewhat of an Alexipharmick to strengthen the Parts. As to the out∣ward Applications, Epispasticks, Cup∣ping Glasses and the like Medicines, are the only proper Instruments to abate the Fury and fetch forth the Malignity. Som∣times Causticks also do take goop place

here, anointing the Skin first with Oyl of Lilies, that the more loose the Skin be made, the deeper the impress the Cup∣ping Glass may make. And being thus brought to Suppuration apply Venice Treacle or Mithridate plaster-wise. Or for this use you may use this Unguent. ℞.* 1.201 Ʋnguent. Dialth. ℥iss. Ol. Scorpion. ℥ss. Mithridat. Solut. in ••q. vitae ʒss. this hah in it a discussing Quality. Or this,* 1.202 ℞. Ʋnguent. Basilicon. ℥iij. Fer∣ment. acr. ℥ij. Ol. Lilior. alb. Chamo∣mel. an. ℥ss. Theriac. Andromach. cum vitellor. Ovor. n^•. ij. misce fiat Ʋnguen∣tum. A Vesicatory applied under the Bubo is very proper: As if it were in the Throat apply a Vesicatory to the Scapulaes; and after they have perform∣ed their work, cut them open, and dis∣charge the Matter, and keep them open for some time, by applying Beets, or I∣vy-leaves, or Melilot-plaster to them. These may be ufed if your Patient lives to use them: But this is very rare, for they seldome are cured, they dying the first day, and very few living beyond the fourth. I shall conclude this Chap∣ter with this History related by Petrus Bayrus lib. 20. cap. 8. of a Woman which had a Pestilential Tumour bred behind her Ear, and he being sent for

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

CHAP. LXV.

Of Phyma and Phygethlon.

IN cap. 1. lib. 2. ad Glauc. Phyma is said to be a Tumour in a Glan∣dule, which encreaseth with some Vehemency, and hasteth to Suppurati∣on; for 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 agrees with all sorts of Tumours arising out of the Earth: and these happen not only in the In∣guens, but very oft in the Axillaries; for these Glandulous Bodies being very loose are the most apt to give Entertain∣ment to all strange Appearances, Fluxi∣ons and Tumours, particularly in the Groins, because of their depending Site, strong Motion, and humid Redundan∣cy. After here having prescribed a conve∣nient Dyet, and the general Method, which we have already shown you in a Bubo, we are to apply Digestives to the place affected, and then Suppuratives; and the Tumour being by these made ripe, we are to discharge the Matter ei∣ther by Caustick or Instrument; and the rest of Cure perform, as you have alrea∣dy directions in curing of a Bubo.* 1.203 Phy∣gethlon is an In••lammation and part of Erysipelas, or an inflamed Erysipelas; and

this you are to cure by Phlebotomy, Purging, and Diet. As touching the af∣fected part, you had better apply Dige∣stives than Suppuratives, because this Tu∣mour hath a mixture of Choler: and hence it is that Galen. lib. 6. Simpl. doth praise Atriplex, and the Leaves of Gar∣den Mallows, and a cold Cerate, and is at length to be cured with mild Discus∣sives. Lusitanus Cent.* 1.204 6. Curat. 82. telleth of a young Gentleman troubled with a Phygethlon under his Axillary, the which did spread to a very large bigness, in pro∣cess of time it grew soft and livid, and so proceeded with Pulsation, that both Phy∣sician and Chirurgion conjectured Mat∣ter to be lodged in it; and therefore by a general consent it was opened; but the Success was miserable, for it was scarce opened but the Blood flew out impetuou∣sly, with a great noise of Spirit, upon which the Patient presently dieth with his inclining downwards, and he speedily departed this miserable Life.

CHAP. LXVI.

Of the Hemorrhoides.

HEmorrhoid is a Compounded word 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, which signifies San∣guis, and 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, fluo; and this is a Flux of Blood. The Veins of the Anus onely gain the place of their dwelling and being: or they are Tumours encom∣passing the Veins of the Anus, excited by the great in••lux of Melancholy Blood, re∣sembling somewhat of a species of a Va∣rix. Some of these at certain times do open themselves, and so do discharge and exonerate the Blood: others there are that onely tumefie. Some are hid∣den, others more manifest. Such as flow, they pour out almost all Blood mixed with a yellowish Serum, which is as a Vehi∣cle to make its more speedy exit, and by its acrimony does make a more speedy opening of the Vessels. Such as do not flow, do either lodge in some small Blad∣ders, and by some called Vesicales; and these are made by the influx of Flegm and Serum, resembling Grapes, from whence they are called Ʋvales, from the efflux of Bloud, being laudable in quality, but bred by a copious Redundancy. They

are different in their Magnitude, some being large, others small; in their mul∣titude, some having many Orifices, o∣thers few; in their Figure some narrow, some broad; in their Colour, some being of a blackish colour, others more red; in their Place, some being in the Anus, o∣thers in the Sphyncter, others bordering upon the right Gut; in their Constituti∣on, some being mild, others more cruel and painful.* 1.205 These Hemorrhoides arise (as both the ancient and modern Anato∣mists allow) from the Splenetick branch, deducing its issue from the Porta produ∣ced downwards towards the Rectum, and then carrid backwards to the Coccix, and there to be inserted and propagated. But from the Vena cava there are two Bran∣ches produced from the Os sacrum or Coxendix, and sent to the Anus; the one from the right, the other from the left part, the which are disseminated through the Muscles of the right Gut and Anus, and do there constitute these Hemorrhoi∣dal Veins, here pouring forth their Blood: and this is confirmed with good reason, for the rectitude of the Vessels, the Blood flowing downwards by its weight must necessarily fill its Vessels, and being girt up or constringed, being thus filled by the Muscles, does make way for this

Apertion. And to give a better light to the well ordering and curing of both sorts, let us make an exact Anatomical Inquiry about these parts. These He∣morrhoidal Veins again have an Artery belonging to them to feed them, this Blood first coming from the Porta to the Anus; for from the great Branch of the Porta is this carried to the Spleen, and thence through the Mesentery is it sent to the right Gut. These Veins are onely two, arising from the Cava and the Porta for this cause, because these serve, as do the other Veins of the Body, for nourish∣ing the parts with Blood: and thus are the parts of the Anus nourished there∣with (This was a thing unknown to the Ancients;) and therefore it is necessary that the Melancholy Blood should this way be discussed; for by this Passage one∣ly is Melancholy best discussed, and the Schirrus of the Spleen cured. Besides these, these also are by nature as Scavin∣gers to cleanse the feculent Blood, and make a sound Body; and when therefore she cannot perform these, we make our speedy address to Phlebotomy: and the Evacuations thus made we daily find to yield great comfort and ease to the trou∣bled Patient. Besides, these not being kept open, a man having a great quanti∣ty

of Melancholy Humour lodged in him, the whole Body will hereby be less ca∣pable to undergo any other Method which may be prescribed. And lastly, in Malign Fevers, being lodged in the lar∣ger Vessels, and there putrefying the Blood, these most properly ought to be opened, being nearer related to the af∣fected part, where more good may be expected than from the Arm. Should these be stopped, they breed a Consum∣ption in the Lungs, a Dropsie in the Liver, by suffocating the Liver as it were in its native heat; and if they flow im∣moderately, the Blood being evacuated the Liver is cooled, thereby is excited a Dropsie, and a decay of the whole Bo∣dy. For this immoderate Flux take these: ℞.* 1.206 pulv. Alo. Thur. Balaust. Sangu. Dra∣con. an ℥ss. misce cum albumine Ovi, fiat Ʋnguentum. Or this: ℞. ol. Rosar. Cer. alb. nov. an. ℥j. Axung. Porcin. ℥ij. pulv. Plumb. alb. ℥iss. liquefiant praedi∣cta, & supra marmoream injiciantur, tunc adde plumbum.* 1.207 Or this: ℞. Axung. Porcin. ol. Lin. an. ℥ij. succ. Taps. Bar∣bat. Cynogloss. an. ℥ij. coquantur ad succo∣rum consumptionem, postea adde Sacchar. Saturn. ℥ss. & cum pulv. sem. Lin. q. s. fiat Ʋnguentum.* 1.208 Or this: ℞. Tuth. prae∣parat. Coral. rubr. Plumb. an. ʒiij. Lap.

Calaminar. Lithargyr. aur. an. ℥ss. ol. Ro∣sar. ℥iss. succ. Taps. Barbat. ℥iss. misce, fiat Ʋnguentum. Or if Pain, Heat, or Acrimony be urgent, you may use some ot these:* 1.209 ℞. ol. Rosar. ℥ij. Ceruss. ℥ss. Li∣thargyr. aur. ʒij. Cer. nov. ʒiij. Opii ℈ss. vel ℈j. misce, fiat Ʋnguentum. Or this: ℞.* 1.210 Thur. Myrrh. Croc. an. ʒj. Opii ℈j. fiat Ʋnguentum cum ol. Rosar. & Muci∣lag. sem. Psyl. addendo vitellor. Ovor. n^o. j. Or this:* 1.211 ℞. ol. Rosar. Olivar. Myrtin. an. ℥ij. succ. Plantag. Milii an. ℥ij. Acet. ℥j. coquantur ad succorum consumptionem, tunc adde Bol. Armen. Sangu. Dracon. Thur. Chalyb. praeparat. & pulv. an. ʒj. Cer. flav. q. s. fiat Ʋnguentum. Or this: ℞. Vitellor. Ovor. n^o. j. ol. Rosar. Violar. an. q. s. fiat Ʋnguentum, addendo Ʋnguent. Rosat. Popul. an ʒiij. misce. Amatius Lusitanus Cura.* 1.212 3. Cent. 5. writeth of a man about 45 years of age, who was former∣ly vexed with a Venereous Disease, from whence came from him every moneth Blood through his Hemorrhoids, as the Menstrues in Women elsewhere. He had such a plentiful Evacuation of Blood, the which when he failed of his accom∣panied time performing its duty by these Veins, he vomited much Blood out of his mouth, being of a yellowish red, without Cough or Fever: and for the preventing

of which evil he comes to advise with Lusitanus, who advised him to be chear∣ful, and to the parts he orders 4 Leeches to be applied, the which extracted six Ounces of Bloud; after this prescribed him a good Diet, and cooling Syrups, as Syrups of Endive, Fumitory, Woodsor∣rel, and the like, for some days together; and taking a purging Potion of Manna, Rhubarb, with Diaphoenicon, &c. with this order the Blood followed its former course, and the Patient grew well. Oe∣thius writes also of one, who, when his Flux was obstructed below, he did every moneth spit Blood at the mouth, as you may have it lib. Observat.

CHAP. LXVII.

Of an Aneurism.

THis is a soft Tumour▪ yielding to the Touch, made by Dilatation or Relaxation of an Artery: Every Artery, except those which are dispersed through the Brain, have allowed them a double Coat, the inward of which be∣ing either corroded or rent, the outward may extend so much as to cause an Aneu∣rism. Aneurisms may be made by Ana∣stomasis, Diapedesis, Ruption, Erosion, or Wound of the Arteries. It happeneth in most parts of the Body, but chiesly in the Throat. It is a Swelling encreasing by degrees, and hath the same colour with that of the Skin, a continual Pulsati∣on. If it be small,* 1.213 it easily yieldeth to the Touch. It is difficult in Cure. If it be large, and in the Axillaries or Inguens, in which the Vessels are large, here ex∣pect no cure. Incision very oft times causeth such a Flux of Blood and Spirits, that it both dischargeth Art and Life ve∣ry speedily. This too often happens by the imprudence of an ignorant Chirurgi∣on, by pricking of an Artery instead of a Vein, and so occasioning this Pulsation,

Pain, and Tumour. Some allow inward Causes, as Intension of the Spirits, Contusi∣ons, Concussions, Obstructions, these being accounted as the chief of the inward Cau∣ses. Some also do adde Melancholy Blood to be a Cause hereof lodged in the Veins and Arteries; but the most usual sign of its Causes is drawn from the ignorant Chi∣rurgion, who by pricking too deep does wound the inward Artery, the which is not easily to be cured by reason of its Spermatick Substance and Motion; and thus the Blood by degrees is percolated out of the Arteries, and making a Cavi∣ty for it self formeth this Aneurism, the Matter hereof being a Spirituous Blood made by Dilatation, the outward Mat∣ter is made by Grumous Blood thus rai∣sed together. It generally receives these two Methodical Scopes in its Cure, viz. Pharmacy and Chirurgery; and where the one takes not, the other must be at∣tempted. The first are Repellers and Restringents, and convenient Ligatures, or Lead strictly bound over the part; or such an Astringent as this may serve the turn,* 1.214 as, ℞. Pulv. Bol. Armen. Terr. sigillat. an. ℥ij. Pulv. Rosar. rub. Sang. Dracon. an. ʒij. Gallar. immatur. nuc. Cupress. an. ʒi. misce, & cum Albumine Ovi, parum Aceti & Oleo Rosarum fiat

Restrictivum. Let this remain on for two or three days. These are to be used in smal Aneurisms, but in large Aneurisms not happening in the Head or in the Groins, they are accounted Mortal, according to Aetius, lib. 15. cap. 10. Some Artists do tie up the Artery both above and below, and then divide between these two Liga∣tures; but this Operation is dangerous, painful, and troublesom, and seldom bringeth any benefit. But to preserve Life I would rather, if it happen in a place where it may lawfully be perform∣ed and exercised, have Amputation made; and before you begin this, be sure to purge the body with Cassia, Manna, and the like; and order cooling Juleps, Emul∣sions, and Hordeate Decoctions, and keep the Body open by Purging and Clysters. Hildanus in his 44 Observat.* 1.215 relateth of a young Gentleman, who being troubled with the Itch, upon which sending for a Barber to breathe a Vein for him, he pricked the Artery instead of the Basilick Vein; whence did arise an Aneurism. For the ablating of which above a moneth was used variety of Medicines to little or no purpose; the Tumour equal∣led the bigness of a Goose Egge; it was pale and hard, in which was so perfect a Pulsation, that it elevated the Dressings

and Rollers, as they might with ease be perceived. He could not extend his Arm; his pain was not great, but onely when he would extend it. Seeing how desperate it was, he was very unwilling to under∣take its Cure; but being perswaded by the Prayers, Desires, and Requests of the Patients Friends to take it in hand, he used this Method, a good Order of Diet being prescribed, to the part affected was applied Emplastrum de Cicuta, and this Clyster was administred; ℞. Rad. Alth. cum Tot. fol. Violar. Malv. Parietar. Mer∣curial. an. M. j. fl. Chamomel. Melilot. an. M. iss. coquantur in aqua s. q. ad tertiae partis consumptionem, in j. colaturae sol∣ve Benedict. Laxativ. ℥j. Mel. Mercuri∣al. ℥ij. ol. commun. ʒiij. Sal. pug. j. mi∣sce, fiat Enema. The next day was or∣dered this Apozeme for digesting of this Melancholy Humour;* 1.216 ℞. Herb. La∣path. acut. Rad. Polypod. Q. Petroselin. an. ℥j. Herb. Agrimon. Veronic. Cuscuth. Fumoterr. summitat. Lupul. a. M. j. fl. 3 Cordial. an. pug. j. Liquirit. Ʋvar. pas∣sar. Rhaharb. Rapontic. an. ℥j. sem. Fae∣nicul. Anis. an. ℥ss. coquantur in aqua fontana s. q. ad tertiae partis consumptio∣nem: hujus colaturae accipe j. syrup. de Fumoterr. Epithym. an. ℥ij. Aqu. Cina∣mom. ℥iss. misce, fiat Apozema, pro tribus

dosibus, to be taken for three mornings. Afterwards was prescribed this Purging Potion; ℞. Decoct. praescript. ℥viij. in quibus infundantur & macerentur Rha∣barb. optim. ʒij. Senn. mundat. ℥j. in di∣midia parte hujus Decocti solve Diatur∣bith. cum Rhabarb. ʒj. syrup. Rosar. So∣lutivar. ℥j. misce, fiat Potio. Empl. de Cicuta was every day renewed, and after∣wards he took this Purge; ℞. Confect. Hamech. ʒiss. Extr. Cort. Esul. ℈ss. aqu. Ci∣namom. ℥ss. misce fiat Potio. After this the Tumour began to lessen, and then was applied this Emplaster; ℞. Empl. Dia∣palm. ℥ij.* 1.217 pulv. Mastich. Rosar. rubr. Myrtilor. Radic. Symphyt. major. an. ʒj. cum q. s. ol. Rosar. fiat Emplastrum. Af∣ter this he applied a small Knot oft times doubled, and this was joyned to the Li∣gature, and this was for repressing the Tumour, and for dilating or throwing out of the coagulated Blood: and by these Remedies, and by Gods blessing, he per∣fectly recovered the use of his Arm.

CHAP. LXVIII.

Of a Paronychia and Pterygion.

ITs place and seat is generally at the Fingers ends; here it fixeth it self, and from hence does it send forth its pains.* 1.218 Its Figure is longish, somewhat Oval.* 1.219 It is a Preternatural Tumour apo∣stemated, small and scarce perceivable, beginning at the Fingers ends, arising from a hot, venenate, and nitrous Blood, and oft times places it self between the Bone and the Periostium. At its first ap∣pearance it is mild and gentle; but af∣terwards grows fierce and troublesom, causing pains, Fevers, sometimes a Caries and Putrefaction of the Bones. It's cal∣led Paronychia, because it is a Distemper 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, marching to the roots of the Nails.* 1.220 Fabritius de Aqua Penden∣te maketh no difference between Paro∣nychia and Pterygion. Pterygion is a Hyposarcosis or Excrescence of the Skin, and this does not immediately reach the Nail. Aeginetta cap. 81. lib. 3. shews the difference, where he calls Panaritium an Abscess fixing it self about the roots of the Nail; Pterygion to be an Increment of Flesh spreading out of another part of

the Nail.* 1.221 The Blood of its nature is hot here, being kept in and denied a Difflati∣on, Redness arising from this great Heat, Pain from this Intemperancy, and Solu∣tion of Continuity by this violent Matter, distending and aggravating the nerveous, tendonous,* 1.222 and membranous parts. These are sometimes said to be bred by an in∣ward cause, occasioned by a nitrous, sharp, cholerick, venenate, fervid, and most thin Blood or Humour; the which is infixed in the affected part. External Causes may be Contusions, after which followeth an Ecchymisis of Blood under the Cutis, or between it and the tendonous parts, or between the Bone and Periostium; this Blood being putrefied, large Inflammati∣ons increase, and Pain and other Symp∣toms appear. The Generation of this ni∣trous Blood is to be hindered, and that it may not flow is to be intercepted and re∣velled; and that which hath already flown is to be weakened by Repercus∣sives or Suppuratives; but of these in their order.* 1.223 Revulsive Medicines are such as are to be applied to the opposite part, and these are hot and attracting; amongst which may be reckoned Scarri∣fication, Friction, Vesication, and the like.* 1.224 Interceptives, commonly called Defensatives, have a Stiptick Faculty,

shutting the Mouths of the Vessels and by the Coldness and Stipticity they thic∣ken, coagulate and hinder the Flux of Blood:* 1.225 Of either of these you may find various in my former Tracts Of Repellers these are Cold, Moist and Re∣stringent, and do repell the in••••uent Blood, and hinder its coming to the part affected. So long as you have any hopes of repelling an Humour, follow this free∣ly; where this is not to be done, come to the use of Suppuratives. Take this one for all,* 1.226 in this place most proper. ℞. Pulv. rad. Bismalv. Consolid. Major an. ℥ss. sem. Lin. Foenugraec. an. ʒiij. Malv. Alth. an. mj. Plantag. Hyosciam. an. mss. Ʋngul. Rosar. rubr. mj. Farin. Hord. Lol. an. ℥iss. fl. Melilot. Chamomel. au. pug. ij. pulv. Gallar. Melicor. an. ʒij. Bulliant simul in lacte vaccino vel aqua fontana Caepar. Sub. cinerib. coct. ℥ss. fi∣ne addendo Ol. Rosar Myrtin. an. ℥ss. Lilior. albor. Chamomel. an. ℥i. Vitel∣lor. Ovor.* 1.227 n••. Croc. ℈ss. misce, fiat Ca∣taplasma. Fabritius Hildanus useth a decoction of Cows milk here, wherein were boiled Mellilot flowers, Chamomel flowers, Quinch-seed and Lin-seed, and so Fomented the part: after which he opened the Skin, the which being open∣ed dropped one or two drops of a reddish

thin Substance; this being discharged, he applies a little Venice Treacle which was dissolved in Aqua vitae, and with this the pain soon vanished. The Inci∣sion being made, we are to Mundify the part with Mel rosarum, unguentum ex Apio, or Aegyptiacum. For this use also Precipitate is very good. Glandorp is fearful of using these sharp Medicines, these being very subject to cause Pain; and so he prescribeth Anodyne Mundi∣fiers, as Oyl of St. John's Wort, affirm∣ing that this doth both Digest and Mun∣dify the compact Matter, lenify the Pains, deterge and incarn. Very oft a Caries of the Bone follows a Parony∣chia: and here most drying Medicines are most proper, as Falloppius his Pow∣der. ℞. Pulv. Rad. Peucedan. Irid. an. ℥i. Euphorb. ℈i. misce. As curing a Pterygion;* 1.228 Having already acquainted you that it is nothing else but a Hyposar∣cosis about the Nail, and this sheweth its own Indication, which is to ablate the superfluous Flesh: and for this cause Ʋn∣guent. Egyptiacum or Alumen ustum or Praecipitatum is excellent good. Or this.* 1.229 ℞. Ʋnguent. Populeon. ʒiss. Alu∣min. ust. ʒij. misce. Or this ℞. Ʋnguent. Diapompholig. ʒij. Alum. ust. ʒi. or the like. And thus much of those.

CHAP. LXIX.

Of Nodes of the Legs.

THese very often happen after a long continued venereal Disease, the which do not shew them∣selves very speedily, but in what pla∣ses so ever the lurk in, they creat very great and Nocturnal Pains, being and having in them a contrary quality to most of other Tumors to bereave the Patient of his rest by perplexing him more in the Night than in the Day. These Tumours are hard, bred from a hard, Flegmatick, thick and viscid Flegm, which are not to be discussed but by hot Medicines, and such as have a Faculty of making the Nerves spit forth this Matter contained in them, these carrying with them an Emollient and lenifying quali∣ty; and hence may you confidently make use of such Medicines here as I have set you down in my Tract of a Scirrhus, adding thereto Argentum vivum: Empl. de Ranis cum Merc. is very proper here also. In the whole time your Pa∣tient lyes under your hands take care that he be ordered a sober Lie, shun∣ning Venery as the greatest enemy ima∣ginable.

It proves much better, if it have not touched the Bone, than if it had: but suppose it should get thither, and foul it; this is to be Scaled either by actual or potential Cautery, the which being re∣moved, apply such convenient Sarcotick drying Medicines, as may produce a new Skin over this: And for this affect, Pow∣der of Myrrh. Aloes, Ireos, Euphor∣bium, Gentian, Aristolochia rotunda and the like are proper. I have seen these very frequent in St. Thomas Hospital in Southwarke, and sometimes here in Norwich, where I have met with the Signs very exact, painting out Pains and Aches, and nocturnal vexations as con∣tinually, as the Day leaves it self to be shut up by the Clouds of the Night.

CHAP. LXX.

Of Tumours and Apostems of the Knee.

AFter long and difficult Diseases Tu∣mours are oft seen to breed in the Knees; and by how much the lon∣ger they are in breeding, by so much the longer expect will be the getting of them extirpated. They bring sharp and bit∣ter pains with them, because these Hu∣mours are crept into very sensible parts, as Membranes, the which do both distend and rack them. The Cure hereof is diffi∣cult, because this Humour is seldom seen bred but in Cacochymick Bodies, and such as are of an evil habit of body; and then because the part affected is cold and weak, being far from the Fountain of Heat. Sometimes it is made by Flatuencies, crude and serous Humours; the which do flow and mix themselves betwixt the ner∣vous parts and Membranes. As to the Cure, if it proceed from Blood, order a thin and cold Diet; and for Revulsion Venesection is good; and here observe your 4 times in its Cure. But if it co∣meth from a waterish Matter, the Body is to be purged by Phlegmagogicks; and for your Topicks apply such Medicines as

have in them an incisive, attenuating, ra∣rifying, and a powerfully drying quality, as these:* 1.230 ℞. Farin. Orob. & Hord. Lent. & Lol. an. ℥j. furfur. ℥ss. fl. Chamomel. Melilot. Sambucin. summitat. Absynth. Scabios. Veronic. an. pug. Stercor. Caprin. lbss. Sapae ℥ij. ol. Rut. Chamomel. Aneth. an. ℥iss. coquantur in Lixivio vel in a∣qua Absynth. composit. cui addere possis Oximelit. Scillitic. q. s. fiat Cataplasma For this Affect this Emplaster is also held. to be good: ʒ. Diachylon cum Gummi Paracels. an. ℥ss. Oxicroc. ʒij. Melilot. ℥ss. Empl. de Ran. cum vel sine Merc. ʒiij. misce, fiat Emplastrum. A Maid of 18 years of age falling on the Ground hurt her Knee,* 1.231 out of which did arise a large In••lammation, accompanied with many pains; by applying Empl. ex Ar∣gilla, Bol. Armen. Bran, the White of an Egge, and a little Vinegar, the pain some∣what abated, and the Inflammation grew remiss. About the Rotula a very large Tumour did arise, which was also very hard, in so much that without great pain to the Patient it was not to be contracted. Hence was collected, that there was Mat∣ter gathered about the Rotula, and a very large Tumour did arise, which was also very hard, in so much that without great pain to the Patient it was not to be con∣tracted:

And for the Cure hereof this Me∣thod was used, that the Blood and Hu∣mours might be lessened, and their Afflux to the part affected prohibited; a drying and thin Diet was prescribed, and the Pa∣tient afterwards thus purged;* 1.232 ℞. Herb. & flor. Betonic. Scabios. Cuscuth. Agri∣mon. Veronic. an. M. ss. sem. Anis. ʒj. fiat Decoctum in s. q. aquae fontanae, in ℥iiij. solve Diacatholic. ʒvj. Electuar. e succ. Rosar. ʒij. misce, fiat Potio. After this a Vein was breathed in the Arm, out of which was drawn 10 Ounces of Blood; then was prescribed a purging Apozem made of opening Roots; Agrimony, Ve∣ronica, Majoram, Rosemary, and the like, being made into a Cataplasm, was af∣terwards applied to her Knee; then was applied this Cataplasm;* 1.233 ℞. Farinae Hord. farinae Fabar. an. ℥iiij. pulv. Rosar. rub. Bacc. Laur. Myrtillor. an. ℥j. pulv. fl. Cha∣momel. Melilot. Sambuc. Inae. Arthritic. an. ℥ss. fim. Caprin. ℥ij. cum vino rubro q. s. fiat Cataplasma, fine addendo Sapae ℥iiij. ap∣ply it warm twice in a day. This was used for 3 weeks, and the Apozem pre∣scribed and taken; and by these and a good order of Diet the pain ceased, and the whole Tumefication vanished. But in the lower part of the Rotula there was perceived a manifest Hardness, for the

emolliating of which all care was taken, but in vain; at length was applied a potential Cautery to this lower part, the breadth of the Tendon, then was the Eschar removed by this Liniment:* 1.234 ℞. Ʋn∣guent. Basilicon. Butyr. recent. sine Sal. an. ℥j. ol. Amygdal. dulc. & de vitell. O∣vor. an. ℥ss. ol. Rosar. ℥j. misce, fiat Ʋn∣guentum, fine addendo vitell. Ovor. n^o. j. Croc. ℈ss. This being removed, there was found a thick viscid Matter lodging in the lower part of the Rotula, and by apply∣ing of Pulvis Aluminis usti cum pauxillo Praecipitati, taking great care that the Tendon might come by no injury or de∣triment, the Ulcer was mundified, and af∣terwards was induced a perfect Cicatrice: and by these means the Patient perfectly recovered.

CHAP. LXXI.

Of an Abscess of the Foot.

THe Foot as well as the Hand is troubled and perplexed with vis∣cous and strumatous Tumours, oft times planting themselves in the Joynts, sometimes making the Bones bare and foul. The onely way to cure this Evil is to discharge the Matter by Resolution, and if possible not to open it. At the end of the Toe there oft times falleth a sharp pain, arising without any manifest cause, not without some inward occult Malignity, without Tumour or Redness, depriving it of sense or motion; and hence oft times the end of the Foot being destitute of its native heat and colour, is affected with a Lividness and Blackness, and in process of time does terminate in∣to a Gangrene and Sphacelus; this more frequently happening more in aged peo∣ple than in youth; because as the parts themselves are a great way from the Fountain of Heat, so also are aged people less capable to help towards the produ∣cing of this Heat into those parts; and therefore in such cases let it be your first Intention to apply warm and comfortable.

Medicines here. If they run into a Gan∣grene, treat it as I have already directed you in the cure of a Gangrene.* 1.235 Hildanus writeth of a young Gentleman, who up∣on too much walking had a Tumour occa¦sioned in his Foot, and for want of conve∣nient Medicines thereto applied, there speedily happened an Inflammation, and within a very few days a very large Phlegmon accompanied with great pain and Fever; yet by this following Method his Patient was eased and recovered. To him first was prescribed a thin Diet, then was ordered this Purging Potion: ℞.* 1.236 Electuar. è succ. Rosar. ʒij. pulv. Rha∣barb. ʒss. cum syrup. Rosar. solutivar. ℥j. & Decoct. Agrimon. Veronic. Rad. La∣path. acut. Cort. interior, rad. Frangul. & sem. Anis. fiat Potio. The day follow∣ing he breathed a Vein in the Arm: the Hip, Knee, and all the inflamed parts, were freed from Inflammation by this follow∣ing Unguent;* 1.237 ℞. ol. Rosar. ℥ij. ol. Lum∣bricor. Axung. Human. an. ʒij. misce; and afterwards was applied this Cata∣plasm:* 1.238 ℞. sem. Cydonior. Foenugraec. Alth. an. ʒij. pulverizentur & macerentur in aqua calida, tunc adde farin. Hord. ℥iij. pulv. Rosar. rubr. ℥ss. coquantur s. q. aquae fontanae ad Cataplasmatis formam, fine addendo vitella ovorum n^o. ij. cum albu∣mine.

Apply this, and renew it as of∣ten as occasion requireth. By these the Pain abated, the Matter began to shew it self, and by Basilicon being applied to the part it was discharged, and by the use of the Cataplasm the Patient was perfectly recovered. Thus have I carried you through the whole Discourse of Preterna∣tural Tumours, both in General and Par∣ticular; in which I have with all care and industry endeavoured to shew you their Definitions, Differences, Causes, Signs, Presages, and Cures.

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

FINIS.

Notes

• * 1.1

  What Ar∣theroma is.
• * 1.2

  Observa.
• * 1.3

  Care.
• * 1.4

  Observ.
• * 1.5

  History
• * 1.6

  History.
• * 1.7

  Its Cause.
• * 1.8

  Cure:
• * 1.9

  Empl.
• * 1.10

  History.
• * 1.11

  Whence its Name:
• * 1.12

  Cure.
• * 1.13

  Pil.
• * 1.14

  Pil:
• * 1.15

  Catapl.
• * 1.16

  its diffe∣rencies.
• * 1.17

  Its Defini∣tion.
• * 1.18

  Signs:
• * 1.19

  Causes.
• * 1.20

  Two Spe∣cies of a Hydroce∣phalos.
• * 1.21

  Presage.
• * 1.22

  Cure.
• * 1.23

  Decoction:
• * 1.24

  Oyl.
• * 1.25

  History.
• * 1.26

  Unguent.
• * 1.27

  Unguent:
• * 1.28

  Empl.
• * 1.29

  History.
• * 1.30

  History.
• * 1.31

  Unguent:
• * 1.32

  History.
• * 1.33

  Its Causes
• * 1.34

  Digestive.
• * 1.35

  Unguent.
• * 1.36

  History.
• * 1.37

  Three sorts hereof.
• * 1.38

  Cure.
• * 1.39

  Unguent.
• * 1.40

  History:
• * 1.41

  Cause.
• * 1.42

  Cure▪
• * 1.43

  ••••story.
• * 1.44

  Cause.
• * 1.45

  Signe.
• * 1.46

  Cure.
• * 1.47

  Pil.
• * 1.48

  Pil:
• * 1.49

  Potion.
• * 1.50

  A Medi∣cine of the Authors.
• * 1.51

  Observ:
• * 1.52

  History.
• * 1.53

  History.
• * 1.54

  Celsus Method.
• * 1.55

  Paulus's Way.
• * 1.56

  History.
• * 1.57

  Defensa∣tive.
• * 1.58

  Collyrium.
• * 1.59

  What a Po∣lypus is.
• * 1.60

  Cause.
• * 1.61

  Differencies
• * 1.62

  Celsus's way.
• * 1.63

  Paulus's way.
• * 1.64

  History.
• * 1.65

  History.
• * 1.66

  What a Glandule is.
• * 1.67

  What the Parotides are.
• * 1.68

  Its Cure.
• * 1.69

  Catapl.
• * 1.70

  Unguent.
• * 1.71

  Catapl.
• * 1.72

  History.
• * 1.73

  History.
• * 1.74

  History.
• * 1.75

  Descript••on of Stru∣maes.
• * 1.76

  Signs.
• * 1.77

  Presage.
• * 1.78

  Three ways to eradi∣cate them.
• * 1.79

  Cure:
• * 1.80

  Pil.
• * 1.81

  Pil.
• * 1.82

  Pouder.
• * 1.83

  Pouder.
• * 1.84

  Aqva.
• * 1.85

  Unguent.
• * 1.86

  Catapl.
• * 1.87

  Catapl.
• * 1.88

  Catapl.
• * 1.89

  A History.
• * 1.90

  Catapl.
• * 1.91

  Catapl.
• * 1.92

  Catapl.
• * 1.93

  Pil.
• * 1.94

  Unguent.
• * 1.95

  Empl.
• * 1.96

  Histo••y.
• * 1.97

  Three speci∣es of a true Squinsey.
• * 1.98

  Ca••ses.
• * 1.99

  Signs.
• * 1.100

  Presag••.
• * 1.101

  Cure:
• * 1.102

  ••argarism:
• * 1.103

  Gargarism.
• * 1.104

  Catapl.
• * 1.105

  History.
• * 1.106

  What the Amygdals are, 〈◊〉〈◊〉 how made.
• * 1.107

  Uses?
• * 1.108

  They being the chief Organs of Tasting.
• * 1.109

  Cure.
• * 1.110

  Gargarism.
• * 1.111

  Another.
• * 1.112

  Another.
• * 1.113

  Trochisc.
• * 1.114

  Cataplasm.
• * 1.115

  Pil.
• * 1.116

  Electuary.
• * 1.117

  History.
• * 1.118

  Signs.
• * 1.119

  Decoction.
• * 1.120

  History.
• * 1.121

  Cure.
• * 1.122

  History.
• * 1.123

  Liniment.
• * 1.124

  Empl.
• * 1.125

  Another.
• * 1.126

  History.
• * 1.127

  Unguent.
• * 1.128

  Cataplasm.
• * 1.129

  The Causes of a Gonor∣rhaea.
• * 1.130

  Injection.
• * 1.131

  A double Method in its Cure.
• * 1.132

  Fomentati∣on.
• * 1.133

  Unguent.
• * 1.134

  Empl••
• * 1.135

  History.
• * 1.136

  History.
• * 1.137

  How the Intestine is to be repo∣sed.
• * 1.138

  Cataplasm.
• * 1.139

  Unguent.
• * 1.140

  Decoction.
• * 1.141

  Cerate.
• * 1.142

  Empl.
• * 1.143

  Empl.
• * 1.144

  Empl.
• * 1.145

  Apozem.
• * 1.146

  Empl.
• * 1.147

  Empl.
• * 1.148

  Histo••y
• * 1.149

  Cerate.
• * 1.150

  Empl.
• * 1.151

  An••ther.
• * 1.152

  Oyl.
• * 1.153

  Syrup.
• * 1.154

  Electuary.
• * 1.155

  Pil.
• * 1.156

  A second Method by Adustion.
• * 1.157

  A third Method is Incision.
• * 1.158

  The fourth Method.
• * 1.159

  History.
• * 1.160

  Clyster.
• * 1.161

  A Restrin∣gent Bag.
• * 1.162

  Purge.
• * 1.163

  Signs.
• * 1.164

  History.
• * 1.165

  Another.
• * 1.166

  Another.
• * 1.167

  History.
• * 1.168

  History.
• * 1.169

  Causes.
• * 1.170

  Signs.
• * 1.171

  Cure.
• * 1.172

  Topicks.
• * 1.173

  Empl.
• * 1.174

  Fomentati∣on.
• * 1.175

  Another.
• * 1.176

  Catapl.
• * 1.177

  History.
• * 1.178

  Foment.
• * 1.179

  Another.
• * 1.180

  Another.
• * 1.181

  Another.
• * 1.182

  Oyls.
• * 1.183

  Unguent.
• * 1.184

  Catapl.
• * 1.185

  Another.
• * 1.186

  Another.
• * 1.187

  Empl.
• * 1.188

  History.
• * 1.189

  Signs.
• * 1.190

  History.
• * 1.191

  Intentions.
• * 1.192

  Hernia Humoralis.
• * 1.193

  Causes.
• * 1.194

  Cure.
• * 1.195

  Hist.
• * 1.196

  History.
• * 1.197

  Causes.
• * 1.198

  Signs.
• * 1.199

  Presage.
• * 1.200

  Cure.
• * 1.201

  Unguent.
• * 1.202

  Another.
• * 1.203

  What Phy∣gethlon is.
• * 1.204

  History.
• * 1.205

  Their Ori∣gination.
• * 1.206

  Unguent.
• * 1.207

  Another.
• * 1.208

  Another.
• * 1.209

  Another.
• * 1.210

  Another.
• * 1.211

  Another.
• * 1.212

  History.
• * 1.213

  Its Causes.
• * 1.214

  A restri••∣gent 〈◊〉〈◊〉.
• * 1.215

  History.
• * 1.216

  Apozem••.
• * 1.217

  Empl.
• * 1.218

  Its Figure.
• * 1.219

  what it is.
• * 1.220

  Its diffe∣rences from Pterygion.
• * 1.221

  Its Signs.
• * 1.222

  Its Causes and man∣ner of breeding.
• * 1.223

  Revulsives.
• * 1.224

  Intercep∣tives
• * 1.225

  Repellers.
• * 1.226

  Catapl.
• * 1.227

  History.
• * 1.228

  •••• Pterygi∣an.
• * 1.229

  Unguent.
• * 1.230

  Catapl.
• * 1.231

  History.
• * 1.232

  Potio pur∣gans.
• * 1.233

  Catapl.
• * 1.234

  Unguent.
• * 1.235

  Hist.
• * 1.236

  Potion.
• * 1.237

  Unguen.
• * 1.238

  Catapl.