Van Helmont's works containing his most excellent philosophy, physick, chirurgery, anatomy : wherein the philosophy of the schools is examined, their errors refuted, and the whole body of physick reformed and rectified : being a new rise and progresse of philosophy and medicine, for the cure of diseases, and lengthening of life / made English by J.C. ...

CHAP. L. A Cautery or Searing Remedy. (Book 50)

1. A Cautery is nothing but a remaining Wound. 2. No prerogative of a Can∣tery made by fire. 3. The name of an Issue or little fountain is a Iuggle. 4. What things God hath seen entirely good, are praised by the Schools, as rent or toren. 5. The promises of a Cautery are childish. 6. The denyal of a Ca∣tarrh denyeth the use of a Cautery. 7. Ridiculous necessaries for defending Cauteries. 8. The position of the Schools is shewn to be absurd and impossi∣ble. 9. What may be purged by a Cautery. 10. Nine conclusions against the appointments of Cauteries. 11. Foolish desires or delights in a Cautery. 12. Cauteries, whom they hurt. 13. The undstinction of the Schools. 14. The scope or end of a Cautery ceaseth. 15. They have circumvented the World by Cauteries. 16. That there is no communion of a Cautery with the brain. 17. Absurdities following upon the doctrine of Cauteries. 18. The one only refuge of the Schools. 19. Answers. 20. Cauteries are dri∣ven against the Rocks. 21. What the Schools may answer in the difficul∣ties proposed. 22. The multiplying and choosing of a Cautery, by what bold∣ness it hath arose. 23. Some Stage-play trifles of the Schools. 24. The Gowt of Physitians is a mockery. 25. Cauteries are foolish. 26. They are vain in their own desperate cases. 27. It is not yet determined by the Schools in what cases Cauteries can help. 28. A case wherein a Cautery profiteth. 29. How the cruel and stinking remedy of a Cautery may be prevented. 30. A Cautery is unworthy a Physitian.

CAtarrhs or Rheums have found out Cauteries: those therefore being taken out of the way, the treatise of these might seem to be in vain, unless I should write these things for young beginners; I distrusting that my studies will any thing profit the learned or skilful: Wherefore I have determined to declare the ends and effect [unspec 1] of a Cautery. Cauteries therefore are first of all made of fire, bright burning Iron; a corrosive caustick Medicine, yea with the rasour or penknife it self, or scissers, by cutting off something. It is sufficient, so the fleshy membrans are broken or pierced with a wound: But others do prefer a wound prepared by fire, or a caustick Medicine, before that which was laid open by cutting: Because they think that by actual heat

and dryness, a flux of humors is the better stopped. As if, at one only moment, the [unspec 2] fire should burn any thing besides the escharre it self, or should dry up an other thing which they seign, is afterwards to flow to the wound. Indeed dreams are on both sides greatly esteemed by the Schools: For an issue or small fountain (for so they call [unspec 3] a Cauterized wound, that the vulgar may believe diseases to be drawn out as it were by a fountain) profits nothing before the escharre be taken away,, and the foot∣step of heat and dryness be withdrawn: Because the institution of a Cautery hath the avoyding of excrements or superfluities for its object, which doth not begin before the decay of the escharre; and because it is alway less able to exhale thorow the es∣charre, than otherwise, thorow the sound skin: therefore successours have accoun∣ted it to be all one after what sort soever an issue shall be made, so they shall divide that which holds together, and keep it divided. For that which God hath made whole and entire, that it might be very good, seems to the Schools that it should be better, if it be kept wounded: Therefore to be oftentimes wounded, and to have kept the [unspec 4] wounds open, doth conduce to the health of the Schools. Surely its a wonder, that they have not transferred [to be wounded] unto the precepts of defending health; even as indeed, Cauteriet, or constant wounds, have been referred thither: But in the time of wounding, or burning, letting out or shedding of blood only, doth in∣terpose; which ought to excel by that title, in the Schools, unless the deceit of Phlebotomy or cutting of a vein did manifest it self. For they presume and decree, that a Cautery is a new emunctory or exspunging place, whereby Physitians are able [unspec 5] to restrain nature, according to their pleasure to unload her self, whereby, they seign, that she doth not indeed otherwise flow down by Catarrhs, and unload her self, or on every side so doth, but only by a hole made: That is, they cite rheums, to appear personally in a place, as the Physitian listeth. Handsomely indeed, if alike truly. Notwithstanding, these marvels have been so profitable, that now Caute∣ries are also made in Children, before the age of three yeers: But I, first of all, have alwaies beheld an implicite blasphemy in a Cautery, whereby they openly accuse the Creator of insufficiency in framing the emunctories: For I have hidden above a thousand issues to be filled up with flesh, whereof it hath not hitherto (as I know of) repented any. In the next place, I have considered, a Childish presumption of Physitians, because they seriously perswade themselves, that nature will hearken to their own commands: also that a defluxion and falling down of humors which they command, being supposed, is a most exceeding absurdity. But let it be sufficient for [unspec 6] my foundation, to wit, that there is no dismissing, or voluntary defluxion of a rheum: which negative subsisting, vain becomes the foundation of Cauteries: For the Schools teach, that by issues, evil, yea destructive humors are allured forth, which else, should either be sent to some other place, or of their own accord flow down. A fine thing, surely, that nature doth with a loose bridle, expect the Will of the Physitian, and opening of the skin, that it should there throw off its fardle, [unspec 7] which else it would divert on a more noble member: As if sending nature should threaten, unless ye shall maintain a fleshy membrane open to me by a wound, where ye shall see meet, that by revulsion or drawing back ye shall appease me from fury, and do divert me from the conceipt of dismissing, Wo unto you: for that which else I would purge forth under the Skin, I will draw back unto a noble member in revenge. But I pray, in what center, or in what spring-head is that evil humor prepared? Is it in the Liver the shop of the four humors, as they will have it? But surely there [unspec 8] is a difficult, long, and rough way, as that evil humor is derived from the liver tho∣row the hollow vein, and so thorow the heart, unto the outmost skin of the arm, thigh, or neck, without defiling the venal blood, but the evil humor it self to be sin∣cere. Surely that is a cruel emunctory, which brings an evil humor thorow the foun∣tain of life: And so, the Physitian is cruel, and the Schools more cruel, which com∣mand a hurtful humor to be brought thorow the heart. But if further, that evil hu∣mor, unknown to this day, hath the brain for its fountain; where I pray you? on in what sink of the head, is that evil humor bred? Is it in its bosomes? Or in its basin? not indeed in the first place, in the vessels of the brain, shall there be made a daily collection and nest of that malignant humor, without a present or sudden fear of death. But if in the basin that be made evil, which before was good; now it shall of its own wonted accord flow down thorow the nostrils and palate, neither shall it want a Cautery. Or what is that corrupter, which in some part of the head may vitiate by his endeavour, a humor that was before good, that it may be brought

down malignant from thence, unto some part between the skin, which the Physitian hath commanded to be stricken? For how obedient is that, which being an evil humor (indeed now a dead excrement) shall suffer is self to be wrested back and sent to another place; which otherwise, being no more solicitous of the family-govern∣ment of life, doth obey the law of scituation, by its weight only! But that the evil humor to be wiped away by a Cautery, is a vapour translated and collected from the stomack into the head thorow the brain, coats, and scull, and from thence dismissed between the outward Muscles and skin, that was before peremptorily hissed out, con∣cerning Catarrhs.

In the next place, those things being granted, it should want the essence and Etymo∣logie of a humor; by consequence also, of an evil humour, to wit, of Phlegm, one of the four: For whatsoever had once been lifted up in manner of a vapour, and had grown together into drops, is neither thick nor tough, nor any more of one of the four humors made in the Liver; but it should be a Post-hume distillatory liquor. Wherefore if any evil humour, the finall cause of a cautery, be not bred in the Li∣ver, Brain, or Stomack; which at length shall be the shop of evil humors for Ca∣tarrhs? Or which is the sending, and lofty part, from whence they may be the more steeply brought unto a Cautery?

For in so great a strait of trifles, the Schools are constrained to confesse, that not [unspec 9] any evil humor is dismissed unto the hole of a Cautery; but that the venal Bloud degenerates in the wound it self, and in its Lips being evilly disposed: For this also is proper to all wounds, which want Balsame. Truly if the Schools do examine that [unspec 10] Aphorisme, while corrupt Pus or snotty matter is making, the pain, labour, and Fever is greater, then when it is made; they would certainly know that corrupt pus is ma∣terially produced out of the Blood, by the labour of the faculties, and consequently, that in an issue, corrupt Pus is wished for, for the same ends: The which standing, the position falls to the ground, which supposeth that evil humors are de∣rived by Cauteries. 2. That the bringing forth of corrupt Pus in a wound, is not from the Center of the Body. 3. That it is not the excrement of Rheum flow∣ing down. 4. That Cauteries do not purge bad humours, which do prepare good venal Blood into an excrement, with the labour of the digestive faculty. 5. That Cau∣teries do not any thing conduce to the preventing of a malignant humor which is locally made in the Lips of the wound it self. 6. That corrupt pus, and Sanies, cannot go back-wards from the hole of an Ulcer, and slide into a noble part, and much lesse the good Blood from whence the corrupt Pus is made. 7. If the venal Blood be an evil humor before it come down to the issue, then nature ordaineth some bad humor from the masse of the Blood, for the wounded part only, that it may nourish it, or this is ordinary within all particular parts: now then nature wholly laboureth with the vice of folly. 8. That it is a foolish thing, that to have made much thick corrupt matter, is for the Cautery to have well purged; Seeing that cor∣rupt Pus sheweth the corrupting of good Blood: And so while a man is not in good health, the issue, instead of snotty matter, weepes forth liquor. 9. If therefore a Cautery should make for the evacuation of ill humours, a man should needs be better in health, while liquor flows, than while snotty matter is made: Which in the posi∣tion is false. From hence therefore it is rightly inferred, that no select ill humor, or pernicious excrement, which otherwise should fall down elsewhere, is evacuated by an issue; but that, that whole matter, whether it be corrupt pus, or a thin poyson, is nothing else but meer Blood, designed for the nourishing of the Cauterized part, and there corrupted by the vice of the part; and so that the corruption of it self, doth measure the goodness, and malignity of digestion in the place of the issue: And there∣fore while the whole Archeus doth in any sort labour, there is also a greater weak∣ness of digestion in the issue, and the Pus is the nearer to putrefaction: and in this re∣gard, the issue, by reason of a more powerfull hurting of digestion than was wont to be, weepeth liquor. Therefore it is the wish of the Schools, that of harmless bloud, there may very much and white Snotty matter be made: And that they call a good purg∣ing, [unspec 11] if very much Blood be corrupted in the last digestion: which thing, if it be rightly considered, it will now plainly appear, that a Cautery is not to be imprinted for the purging out of a malignant humour, neither that a bad or evil humour doth exist; but only for the diminishing of the abundance of Blood; and so from a beholding of an exesse of a good humor only.

Whence it follows, that it is not convenient for Young Folks, not for those that [unspec 12]

are become lean again, not for such as are brought low by any disease, as neither for those that live orderly, and least of all, for religious abstashing Persons.

But they have not yet distinguished, whether corrupt pus in an issue, be only of [unspec 13] the venal Blood, or of one of the four feigned humours, or indeed of a co-mixture of the four: If the first should be true, then the Pus should not be from an ill humour, but from the best of the four humours, and so an Issue shall be made void, and the best Pus, or the effect of an Issue shall be worst of all, feeing it was not but the corruptive of the best of all: But if they had rather devise, to wit, that the Blood is not at first evil, but becomes evil while it is seperated from its other fellows; At leastwise the three remaining ones, shall in that severing, be as yet more bad than the bloud, and upon every event, an Issue shall not be made but for an evil end, that it might corrupt the good and guiltless Blood: But if they will have the corrupt Pus to be made of the four humours being co-mixt; then a Cautery errs in its end; seeing a Cautery prevails not to purge out hurtful humours, but to corrupt the good ones, [unspec 14] which are by nature (not erring) sent daily unto it self for Nourishment.

In the next place, a Cautery shall not be to be reckoned, as a preventing of a Ca∣tarrh; or else, the matter of a Catarrhe should not be a vapour, nor also Phlegm; but venal Blood it self, which the Issue in it self corrupteth: For corrupt pus is not made of Phlegm, but only of venal Blood, as hath been sufficiently instructed in the Schools. Therefore by the essence of corrupt pus, being well searched into, in its matter, & efficient cause, the ends of Cauteries & the purgings out of Catarrhs and evil humours do cease: For indeed any sumptom of wounds being taken away in Cau∣teries, and a supposed health, it must needs be, that a loosing or seuering of that which held together, doth produce snotty matter in the Issue, and that that doth not flow from elsewhere; but that it is generated in the part it self. Also the Archeus daily dispenseth so much of the venal Blood to the parts proportionally, as they have need of for their own nourishment. Therefore the Pus or corrupt matter, is venal Blood vitiated in that part wherein the Wound is, and an effect of digestion vitiat∣ed in the same place.

Therefore to have vitiated the entireness, continuation or holding together, and digestion of the parts, next, to have converted the venal Blood into corrupt Snotty [unspec 15] matter, is reputed the very same thing in the Schools, as to have gone to prevent Ca∣tarrhs or Rheums; or thorow the hole of a Cautery, to have extracted from the Head (from whence they originally fetch all Rheums) an excrementous humor, which otherwise had threatned to fall down on a noble part; whether in the mean time, there be an agreement between the Head, and the Wounded part or not; for it is all one, so the Skin be deteined Wounded, whether that excrementous humour be Blood, or be made snotty pus, or liquid Sanies, is all one, so by the thred-bare words of Catarrhe, prevention, derivation, revulsion, and an Issue, the world be circumvent∣ed. For I behold a small Infant of a Year old, now breeding Teeth, and to suffer a Fever, froath of the Mouth, and Spittle, without ceasing; And a••••ength that there are wringings of the Bowels, and Stools of Yellow-Green-coloured excrements: At least that Tooth is a part of the Head, wherefore the Flux shall be a Rheum of the Head: But what consent is there of a Tooth about to break forth, or a swollen Gum with a Bowel? Or what power thereof is there of begetting or sending a∣way that Catarrhe out of the Stomack of a little Infant, unto his Head? And from thence into the Ileos? By what right shall a vapour dropped or stilled out of the Sto∣mack, be made Cankered Choler in the Head? Hath perhaps the shop of Choler now wandred from the beginning of Life unto the Head? Could a Cautery (if an Infant were for undergoing it) suck unto it a leeky Flux into it self? And by a few small drops of corrupt matter, recompence or Ballance the leeky Choler of some pounds? Why doth the Stomack of a small Infant frame a Catarrhe by reason of the pain of his Tooth? Why is it sent into a Bowell, and not unto the paining Tooth? Doth not the reader yet see, that a Flux is not a Rheum? But that the Archeus (wheresoever yee will have it) being enraged, is ready in the Bowels, to transchange the nourishable juyce into excrements, which by the Schools are rec∣koned Choler, Phlegme, &c. If therefore the Flux be not a Rheume, and the Arche∣us being wroth, can transchange any thing into a troublesom Liquor, if the Gum be but afflicted; shall not he be able, on every side to unload himself by the appoin∣ted emunctories? And not to wait for the Skin to be opened by a Caustick? Alass, hath cruel dullness caused the Schools to be cruel towards their mortal kinsfolks? For

neither do they consider, that in Women, and those that are somewhat fat or gross, there is in the fleshly membrane, about the ordinary places of a Cautery, a meer grease to the thickness of two fingers at least, for which persons notwithstanding, the more frequent Cauteries (and those the more profitable ones) are perswaded; where∣fore also the bottom of the Issue shall scarce be in the middle of the grease: therefore there is not a passage, whereby the evil banished feigned humour of a Rheume, may rush down out of the Brain, or between the Scull, and Skin, thorow the middle of the fat.

But what is that solitary humour, in the next place, which for its offence, being banished from the sending part, descending thorow the Substance of the grease unmix∣ed, [unspec 17] doth degenerate into corrupt Pus? If it be an exhalation of vapours out of the Stomack, why shall it not be more frequent to younger and hot Stomacks, than to weak, old, and cold ones? In what sort shall that water that droppeth out of a vapour, put on the form of Snotty matter? How shall it hasten thorow the Brain, Coats and Scull, to find a hole made by a Cautery, that it may flow down thither only, and be purged? Why doth not the vapour fly, first an hundred times into the Air, before it reach to the place appointed it by the alluring Cautery? How shall the Water which climbeth from the Stomack, be now venal Blood, and the mother of corrupt snotty matter? How shall venal Blood (the matter of corrupt Pus according to Galen) be the matter of a Catarrh? Wherefore is the blood to be reduced into the order of evil humours, which being not yet defiled, is dispensed by nature unto the wounded place? Why when the wound is made, shall nature cease to thrust down the condemned mat∣ter, by, and in to places accustomed unto it? For shall it, the Skin being opened at the will of the Physitian, become afterwards ignorant of the waies? Or hath it perhaps laboured only to find a passage elsewhere? And that being now done, shall it after∣wards come the into obedience of the Wounder? Therefore these four particulars are false, to wit, that corrupt Pus is the matter of a Catarrhe; that a Catarrhe is materi∣ally from a vapour of the Stomack; that a Rheumy mater is expelled by an Issue; and that this Rheumy matter is diverted on a noble part, unless it be revulsed or drawn back to some other place by a hole. The Schools have (at least) one escape:

To wit, that Cauteries, in Chronical or long continuing Diseases, and likewise in the more fat Petsons, and such as abound in humours, have oftimes profited: There∣fore [unspec 18] it must needs be, that an evil humour at least is purged, and that the Body is un∣loaded by making of the Wound. Unto which privy shift I say;

The matter of a Catarrhe, its essence, manner, waies of derivation, and affect, and likewise an evil humour, and the ends of the Cautery, are feigned Dreams, the [unspec 19] vails of shameful shoath and ignorance; and so that examples of events, are not sufficient for destroying the Superstructures of Truth.

What if Cauteries have sometimes profited: At least, that is not from the Root and essence of a Catarrhe, there being altogether none in it self: therefore if they [unspec 02] have profited, let the Schools confesse that Cauteries do ptofit from means, and ends unknown to themselves; and that they do extol a conjectural remedy, uncertain and by accident, with so great a Praise: For they worthily have admired Cauteries to have profited from the event: for if any affect which was to cease of its own accord, or presently after a fullness of time, hath perished; do they therefore think that they have a right by Birth, of miserably torturing two hundred in vain, if a Cautery shall not prove unhappy to one by accident?

What if on the contrary, the Histories of many are compared, whereunto Cau∣teries have proved ill; they presently say we are not Empericks, nor are we moved by [unspec 21] examples: For the Schools are rational, and are supported moreover, by the Autho∣rities of the Antients. And that thing they thus loftily thunder out, as oft as they being destitute of reasons, and convicted by experiences, do cease to be most expert Masters, neither will they be bowed by experiences contrary to their own: But they flee with one accord, unto the reasons of predecessours, the which I have shewn to be wan, sluggish, false, and stumbling in their first entrance.

For truly when the Schools had discerned, that some perhaps by fortune had felt ease by a Cautery, presently a bristle, or cord being drawn on both sides thorow the Skin [unspec 22] of the Neck, is believed to be a Remedy for an Opthalmy or Inflammation of the Eye, blear-eyedness, yea for Cataracts themselves, and a vitiated digestion of the Eyes: A Cautery in the opposite Leg, is believed to be a Medicine for the pain of the Sciati∣ca or Hip-bone.

They have made tryal of diverse Cauteries or Searings, and smiths have made a large house-hold-stuff, they have instituted Arabick burnings (indeed nothing but Goats-dung fryed in a pan) deep in the great toes, for those that have the Sciatica, and joynt-sickness or Gowt: Indeed they have every where set to sale Stage-play trifles, and dreams, for truth, in healing: But the Schools have at length admired, that one only joynt-sickness, designed to Catarrhs, hath derided all their speculations and Cauteries;

To wit, that it hath shewn it to be false, that the gowt was made by a defluxing [unspec 24] Catarrh or rheum, and that a Cautery was a vain devise of derivation and revulsion, for a humor falling down. I do also more admire their doating Cauteries, in a consump∣tion, defects of the Lungs, head, eyes, reins, to wit, from vain rheumy defects, and [unspec 25] so their butchery, together with their juggle, than I do strive to excel their vain at∣tempts: For so, in persons that have the falling sickness, the Paduans, Florentines, [unspec 26] and Mount Pielirians, do drive a hot burning Iron even to the seam of the Scull, and they promise that Epileptical fumes will depart out of the brain thereby, not only that they would lessen the continuance of the fit, but that they would oftentimes sus∣pend it for the future: But the sick undergo these things with a deaf hope of health; but without example: Neither do they once weigh, that dreamed vapours do not affect the brain, through want of passage; but on the other hand, that causes do stir up the tempest of a Disease, before they can come unto the skin of the hair. Where∣fore, wan and vain is the endeavour and aid of a Cautery, which begins from the effect, incuring of Diseases: For it hath not yet been determined by the Schools, in what affects Cauteries may be convenient, because they do seldom and by accident, alone [unspec 27] help, and so, that it is impossible, their own suppositions standing, that Cauteries should be profitable, therefore also to find out the reasons, manners, means, and scopes of Cauteries. But besides the decrees of the Schools concerning a Catarrh and a Cautery being left behind, the case may also easily be found, wherein Cauteries may profit: For truly, by reason of the necessary innovations of the venal blood, at e∣very station of the Moon (even as concerning a lunar tribute elsewhere) indeed whatsoever shall be left of the old blood abounding, beyond the period of the forego∣ing Moon, all that ought to go either into fat, or into the excrement of the last di∣gestion: The which, because it is dispersed and drawn forth by a Cautery, beyond [unspec 28] the daily transpiration, therefore fat or gross, devouring, plethorick, and sitting bodies, do now and then feel succour by a Cautery, and no other: Because the mass of venal blood is taken away, towards a just weight and requisite proportion: the abundance whereof, doth otherwise load and burthen the Archeus, the parts, and the digestions, and distributions of these. For thus far the fear of an evil at hand is preven∣ted. Therefore the whole benefit of a Cautery to be hoped for, is scituated in the [unspec 29] moderating of the abundance of the blood, by a daily and peece-meal diminishing hereof: Else, the remedy of a Cautery is cruel, and stinking, which may easily be pre∣vented by exercise, a just sparingness of dyet, and temperateness of living: whatso∣ever a more sparing food cannot heal, ease may not be hoped to be brought thereto by a Cautery, For the same things which make to the contemplation of a healthy and long life, excuse Cauteries. At leastwise the healing of a Cautery is alwaies cloa∣kative, and that only in some, indeed hitherto unworthy of the Schools of Medi∣cine: [unspec 30] for they are wont to say, unless the issue which is once imprinted, be continu∣ed, the fear of a greater evil is incurred: But be it the meer ignorance of the Schools, which have applyed a Cautery for every event, not unto the former or unto the cause and root of the Disease, but unto the latter or product, which was no where worthi∣ly to heal. Therefore it is as yet not known by the Schools, by what positions, and in what Diseases, this dissembling cure of Cauteries may prevail: Because perhaps, fortune and ignorance being their leader, they have attempted all things, and do now attempt them: So as they command of course, that if a Cautery shall not help here, not there, nor being repeated, nor much of snotty and liquid matter be poured forth, let Issues be purposely closed up.