Praxis medicinæ reformata: = or, The practice of physick reformed Being an epitome of the whole art: wherein is briefly shewed, the true causes, signs, prognosticks, and cure, of most diseases. Published for the benefit of all persons. By Robert Johnson, Med. Professor.

CHAP. XIII. Of Dropsies.

THE Dropsie is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, * 1.1 ab 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 aqua, quod nomen sumpsit ab a∣quoso humore Cutis.

The Ancients have assigned three sorts of Dropsies.

1. The first is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 * 1.2 uter, pellis.

'Tis called in Latin aqua intercus, ex inter & cutis, because the Water is between the Skin and the Flesh.

This is the most proper Dropsie, in which the Abdomen, Secrets, Thighs and Legs are affected.

2. The second is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, quod tumor est ad similitudinem tympani, vel tympani sonum referens.

As this is the most rare, so 'tis the most cruel and afflictive.

3. The third is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, ab 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 per, & 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 caro, quod hydrops toto corpore diffusus; It is also called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, ex 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 album, & 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, phlegma vel pit uita; because it is caused of white Phlegm gathered in all parts of the Body.

Some Authours make a difference between Anasarca, and Leucophlegmatia; that Anasarca is caused by a serous humour, and Leucophleg∣matia by a phlegmatick and more viscous humour; but all Dropsies except Tympanies seem to me, to be little less than a distinction of degrees of one and the same Disease. * 1.3

The Ancients did take the Liver to be the chief part male-affected in these distempers; but Helmont (who was happy in a remedy to cure it) doth severely reprove them, and is so bold to tax the whole Schools with the ignorance of Anatomical dissections; he ha∣ving inspected many Carcases of dropsical Persons (of whom he makes distinct men∣tion) doth assert the Livers of them all no∣way vitiated, and therefore he concludes the Liver faultless in dropsical affects; and he derives the Cause of Dropsie to be an ob∣struction of the Kidneys with the Stone or Gravel; and so the water which should be transferr'd through the Kidneys, to the Blad∣der, (to be evacuated by pissing) is forced into the Cavity of the Abdomen.

But experience teacheth that Dropsies may

be caused many ways; wherefore I shall betake my self to a more evident description thereof.

The causes of Dropsies are either external, * 1.4 or internal.

The external Cause is the Constipation of the porous Skin, impeding transpiration, whereby the discharge of sweaty Vapours through the Habit of the Body is lessned and interrupted; hence what moisture is usually carried off by sweating, doth rebound in∣wards, and condense into an Ichorous water, and is there (by degrees) aggravated and increased, through the hindrance of the ne∣cessary transpiration; till at length a great quantity of water is accumulated, and stagna∣ting in the affected parts, in time may work farther alterations on the subjected Bowels.

Matter of fact hath evinced this to me, having cured several Hydropical patients onely by sweating, and external applications.

The internal Cause of the Dropsie, may be over viscous Chyle, or Phlegm of the Guts, coagulated in the lacteal Veins, and causing an obstruction in more or fewer of their Branches, so that the Liquour rising ei∣ther from the continual Conflux of Choler, the Juice of the Pancreas, and the Phlegm of Spittle; or else from Chyle, or from drink plentifully drunk, being stopt and intercep∣ted in its motion, it doth by degrees more

and more distend the Vessels, that at length they burst; and the moisture receiv'd into them, is poured out between the Membranes of the Mesentery, and presently after into the Cavity of the Abdomen.

This disease is sometimes suddenly pro∣duc'd by much drinking in a burning Fever, join'd with an urgent and permanent Thirst.

After the same manner (though difficult to be known) may a Dropsie of the Breast be caused, viz. by an obstruction of the la∣teral Lymphatick Vessels, by glutinous Phlegm carried together with Lympha into the said Vessels, and there coagulated, by which the motion of Lympha is hindred, so that the Lymphatick vessels being much distended, by the great quantity of Lympha gathered in them, at length they burst, and the Lympha piercing (through the Pleura) into the Cavity of the Breast, procureth a Dropsie in it.

The cause of a Tympany is wind, together * 1.5 with a serous humour piercing through the Guts into the Cavity of the Belly, and being there detained, it is more and more rarified, by which the Peritonoeum is not onely expan∣ded, but the whole Abdomen inflated, and violently distended.

The signs of Ascites, are swelling and * 1.6 fluctuation of the Belly, difficult breathing, a dry Cough accompanied sometimes with a symptomatical Fever, and great Thirst.

The signs of Anasarca are weakness, faint∣ness, * 1.7 and swelling of the whole Body, which being pressed with the Finger, it doth pit, and leave an impression, breathing is also diffi∣cult, with a continual Fever.

In a Tympany the Belly is distended, and * 1.8 being struck upon, there is a noise like a lit∣tle Drum.

1. Every Dropsie is difficult of Curation, * 1.9 especially if it hath been of long continu∣ance.

2. If the Hydropical persons have a good digestion, and void more moisture both by stool and urine, than they either eat or drink, it is a hopefull sign of recovery, & e con∣tra.

Dropsies may be cured by strong Hydra∣gogues, * 1.10 Sudorificks, and Bathing, and some∣times by a Paracenthesis or boring the Belly.

The Best Hydragogues are prepared of Elder, Dwarf-elder, Jallop-roots, Elaterium, Gum-gutty, Crystals of Silver, &c. of which you may prepare purging Infusions, Pills, &c. for example.

Take the Roots of Flower-de-luce, Dwarf-Elder, * 1.11 Madder, Liquorish, the five opening

Roots, of each one ounce. the tops of Saint John's wort, Centaury the less, Agrimony, the best Senna, of each one handfull; the Barks of Capers, Ash, Tamarisk, Cinamon, of each six drachms; Flowers of Beans, Elder, Dwarf∣elder, Broom, of each half a handfull; seeds of sweet Fennel, Parsley, Gromwell, Juniper-Berries, of each one ounce and half; Cloves, Salt of Tartar, of each half an ounce; let them be cleansed, bruised and infused in two quarts of White-wine, for two or three days; then strain it, and add Syrup of Succory with Rhubarb, six ounces; mix it, and give four ounces of it in the morning fasting.

If any like Pills better, I commend the following.

Take the Resins of Jallop, and Scammony, * 1.12 Tartar vitriolated, Mercur. dulcis, of each half a drachm; Oil of Juniper one scruple; make it into Pills with Venice-Turpentine, of which you may give twenty grains at a time, in the morning fasting.

The following Pills are also very effectual.

Take of Elaterium, Gambogia, Resin of Jallop, * 1.13 of each ten grains; Oil of Nutmegs six drops; make it into Pills with Venice-Turpentine for two doses.

The obstructions in the Lacteal veins, or Lymphatick vessels, may be cur'd by Me∣dicines that do powerfully cut, and happily open the said obstructions.

This Aromatick Sudorifick may be com∣mended for these intentions.

Take the waters of Treacle, Scurvigrass, * 1.14 Fennel, of each one ounce; waters of Par∣sley, Fumitory, of each two ounces; dis∣till'd Vinegar half an ounce; Syrups of the juice of Carduus, and the five opening Roots, of each six drachms; Powder of Crabs-eyes, Antimony Diaphoretick, Salt of Amber, Beans, Worm-wood, of each one scruple; Spirits of Salt Armoniack, Niter, of each twenty drops; mix it, and give four spoon∣fulls of it every two or three hours.

After the Vessels are freed from the noted obstruction by the medicines before-men∣tion'd, or such like; they will be easily con∣solidated again by conglutinating food, in which you may boyle the Roots of Comfry, Plantain, and Solomon's Seal, for the more quick and easie cure.

In a Tympany, the dulcifi'd Spirit of Niter is excellent, being taken in Broth or Sack, three or four times in a day, from six to twelve drops at a time, for it doth cor∣rect both Phlegm and Choler, and hinder Wind in its rise, and dissipate it when it is bred.

Also the following exemplary Julep doth curb and discuss Wind, remaining as well in the Stomach as Guts.

Take the Waters of Mint, Fennel, of * 1.15

each four ounces; the Carminative Spirit of Sylvius, Syrup of the juice of Mints, of each two ounces; Laudanum opiat. eight grains; Spirit of Niter one drachm; Salt of Amber half a drachm; Chymical Oil of Mace ten drops; mix it, and take three or four spoonfulls every three hours.

You may prepare a Medicinal Wine for the rich, very beneficial in Dropsies.

Take the Seeds of Anise, Fennel, Cara∣way. * 1.16 Coriander, Berries of Bays, and Juni∣per, of each two ounces: Salt of Tartar half an ounce; let them be bruised, and infu∣sed in three pints of White-wine, for three days, then strain it, and add Spirit of Niter half an ounce; Salt of Amber two drachms; Syrup of Mint three ounces; mix it, and take four or five spoonfulls of it often.

Sweating is very profitable in all Dropsies, either in Bed, with the forementioned Sudo∣rifick, or in a Bagnio, or Hot-house, by which the water standing beside nature in any part of the Body, will (by degrees) be emptied through the pores of the Skin.

Also it may be necessary, especially in persons more elderly, to use warm Baths. That which is prescrib'd for the cure of the Belly-ach in page 201, 202. is also very profi∣table in Dropsies; into the which it may be agreeable to descend at evening, before Bed∣time, and there to continue so long as the

Patient can well endure without fainting; after which Frications may have their pro∣per use, and great benefit.

And to strengthen the cutaneous Fibres, and restore their true tone, for their better service of the offices of Nature: let the af∣fected parts be anointed with the following fragrant Balsamick Ointment.

Take of Flanders Oil of Bays, Nerve-oil, * 1.17 Oil of Earth-worms, of each two ounces; Oil of Mace by expression, half an ounce; mix it.

Galen commendeth a Cataplasm of Snails bruised with their shells, and laid upon the Navel.

But a Pultess prepar'd of the ingredients of the Bath, and applied to the affected parts, will be more effectual to discharge the Ichorous water.

Or you may make a Cataplasm after this manner.

Take the tops of Elder, Dwarf-elder, Ver∣vain, * 1.18 Worm-wood, Chamomel, of each two handfulls; Horse-radish-roots four ounces; let them be cleansed, bruised and boiled in two quarts of the juice of Wild∣cucumbers, till they are very tender, then strain it, and beat them very well, and add Barley-meal, one pound; and with the same liquor boil it into the consistence of a Pultess.

Let the Patients diet be drying, and let

them drink moderately; you may infuse Juniper-berries, Tamarisk and Elicampane∣roots in their ordinary drink.

And for the benefit of those Physicians and Chirurgeons, that live in the West-Indies; there groweth (almost every where in moist places) a large Cane, much like the Sugar-cane; the Planters generally call it the dumb Cane, because they that taste it, are presently dumb, and unable to speak for two or three hours; after which the Tongue returns to its former use and volubility with∣out any prejudice.

The reason why this remarkeable Plant doth so affect the Tongue upon the touch of it, is its power of attracting such plen∣ty of moisture into it, as doth distend all the Vessels thereof, and render it immovea∣ble, till the crouded moisture be gradually discharged.

Hence we may conjecture, and indeed ex∣perience teacheth, that of this Plant may be prepared diversity of medicines as Cata∣plasms, Oils, Ointments, &c. Which will be effectual to attract, and easily and kindly discharge the swollen part of the Ichorous water; which may be used for some time after the evacuation of it, the better to pre∣vent a farther accumulation, or return of the Disease.

Likewise may medicines be prepared, (by a skilfull Artist) of this Plant, very effectu∣al to be taken inwardly, not onely against Dropsies, but the Scurvy, Gout, &c.

If these choice medicines are not to be had, and nothing be effected by other means; A harmless Paracenthesis may be instituted in the Dropsie of the Breast, or Abdomen; provided the Apertion be made by such a little hollow instrument as is describ'd in page 81, 82. of the Cure of the Pleurisie, for by such a small wound, there is no danger to the sick.

But this operation must not be delay'd, lest the humour collected, get an hurtfull Acrimony, and by degrees corrode and corrupt the Membrane, and hence the sub∣stance of all the parts contain'd, and so make the Disease incurable.

Notes

• * 1.1

  Hydrops.
• * 1.2

  Ascites.
• * 1.3

  Cause.
• * 1.4

  Cause.
• * 1.5

  Cause of a Tympany.
• * 1.6

  Signs of Ascites.
• * 1.7

  Signs of Anasarca.
• * 1.8

  Signs of a Tympany.
• * 1.9

  Progn.
• * 1.10

  Cure.
• * 1.11

  Purging Infusion.
• * 1.12

  Purging Pills.
• * 1.13

  Pills.
• * 1.14

  Sudorifick.
• * 1.15

  Carmina∣tive Iulep.
• * 1.16

  Medicinal Wine.
• * 1.17

  Ointment.
• * 1.18

  Pulcess.