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. VI. Of Vomiting, and of the Cholerick and Iliack Passion.

VOmiting is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, ab 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 vomo.

It is a deprav'd motion of the Stomach, and a certain sign of health weakned; for in perfect health nothing is wont to be ex∣pell'd out of the Stomach by the Mouth.

In vomiting, sometimes food, (either crude, or more or less fermented) is cast out by the Gullet and Mouth; sometimes Bloud, some∣times Choler, and other times manifold hu∣mours and matter of divers Colours, Taste and Consistency; and sometimes the Excre∣ments returning to the Stomach (as in Iliaca passio) is expell'd by that preposterous way of vomiting, wherein, omnia naturae praepostera legibus ibant.

All the differences occurring in several sick People, are very difficult to be numbred, or reduc'd into a certain order; and much more to make an exact Examination of all the Symptoms, and thence to give a solid Judg∣ment of every one.

In this distemper the Stomach is either primarily, or secondarily affected.

The Stomach is primarily affected to vo∣mit, when the cause is in it self.

As by taking a Vomit, or when there is an Inflammation, or Exulceration of it; for then it is easily stir'd up (by food, or any other thing swallowed) to a violent and preter∣natural Contraction, and turning of its mo∣tion, whereby it is compell'd to cast out whatsoever is contain'd in it.

The Stomach is secondarily affected, when it is drawn by consent of other parts first distemper'd; as by the contracting motion of the Guts, either in part or wholly, in that most grievous disease called Ileos, or Iliaca passio; or by the vehement shaking of the Midriff, together with a potent Contraction of the Muscles of the Belly, caused sometimes in a grievous Cough: By which all the Bowels contain'd in the Belly are compres∣sed upward, toward the Breast, and urge the Stomach to change its natural motion.

As often as Cholerick humours are plenti∣fully voided out, as well upward, as down∣ward with great force, accompanied with troublesome Anxieties of the Midriff; it is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 bilis. And in Latin cholerica passio.

When there is a forcible pouring out of Bloud by vomiting, it is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, and in Latin vomitio sanguinis.

The Cause of Ileos, or Iliaca passio, is an excrementitious viscous matter that doth adhere unto the Gut called Ileo; which in time is coagulated into a very hard substance, almost in the form of Bullets; (of which I have had large experience) whence all pas∣sage through for the excrements by siege is stopt, and anon their regress and ascent to the Stomach follows, with a miserable vo∣miting of them.

The Rupture of the Peritonaeum may be also the cause of this grievous disease, espe∣cially if it be so great, that not onely the small Guts, but the great ones also fall through the lacerated hole, either by reason of their weight, or else by the perpetual ap∣proaching of what is contain'd in them, which renders them uncapable to be reduc'd, or put back through the same hole; whence the excrements, (having not passage down∣wards) are more and more hardned to that degree, that they can hardly be dissolv'd, so that a hard and unsupperable Tumour doth soon follow, which hinders the reflux of bloud, and causeth an inflammation, and consequently a gangrene of the Guts, atten∣ded with a violent vomiting of the excre∣ments, 'till death do put a period to the Patient's misery.

These evils are often encreas'd by fo∣mentations too hot apply'd, as also by a pre∣posterous

and strong rubbing of the swell'd part, and violence us'd to repell the Guts.

The immediate causes of the cholerick passion, are sharp, putrid, cholerick hu∣mours collected in the Stomach and Bowels, because of external errours commited in diet, or by the taking of poison uncorrected, which doth immediately disturb and corrupt all the humours.

The cause of vomiting bloud, is to be de∣duced (most commonly) from the Pancreas, by reason of some vessel open'd by its over sharp juice, caused by a vitious effervescency with Choler, from whence most of it is dri∣ven up to the Stomach to be vomited out; whilst some of it may descend downward to be voided by stool.

This distemper may also be caused by bloud flowing out of the vessels of the Stomach or Guts, either broken by vehement Cough∣ing, or corroded by sharp humours.

1. If vomiting be from repletion, or be cri∣tical, 'tis a good benefit of nature, and there∣fore must not be stopped: but if it be sympto∣matical, 'tis an ill sign, especially if it be caused by inflammation of the Stomach, or adjacent parts, or by poison taken.

2. If the cause of Ileos, be from excre∣ments indurated in the Gut Ileon, it may be cur'd, if taken in time; but if it be from a Rupture of the Peritonaeum, 'tis dangerous,

and for the most part mortal, especially if there be inflammation and Tumour of the Guts, &c.

3. If the sick vomit bloud, 'tis dangerous: neither is the cholerick passion without dan∣ger.

The Cure of this manifold vomiting, may be performed diversly, according to the variety of each cause.

If vomiting be rais'd too much by an E∣metick, or any other nauseous thing taken, it may be represt by this aromatick Opiate, or one like it.

Take of Mint-water, four ounces; Tinc∣ture of Cinamon, half an ounce; Syrups of Mint, Erratick Poppies, of each six drachms: Laudanum opiatum six grains; Spirit of Ni∣tre twenty drops; mix it.

Let the sick take a spoonfull of this e∣very quarter of an hour, till the vomiting ceaseth.

If a Catarrh be the cause of vomiting look for the cure in its proper Chapter.

If the cholerick passion be caused by poison, or plentifulness of cholerick hu∣mours in the Stomach, &c. then nothing hinders but that a gentle Antimonial Eme∣tick may be given, to which may be added those things which will temper the too great effervescency of the aforesaid hu∣mours. For example.

Take of the infusion of Crocus Metallorum, Mint-water, of each six drachms; Cinamon∣water, two drachms; Syrup of Erratick Poppies, half an ounce; Laudanum opiatum, two grains; mix it.

After the evacuation of the peccant hu∣mours upward, and downward, an Opiate may be profitably used; because it will not onely temper the Acrimony of Choler, but asswage the acid juice, and stupefie the outward sense, and procure rest, which will be very gratefull to the sick.

Take the waters of Fennel, Plantain, Mint, Purslain, of each two ounces; Cinamon∣water, Syrups of Myrtles, Purslain, white Poppies, of each one ounce; Confect. de Hya∣cintho, Diascordium, Venice-treacle, of each two drachms; Laudanum opiat. eight grains; Spirit of Niter twenty drops; mix it.

Let the sick take two Spoonfulls of it of∣ten, which will conduce to amend the faul∣tiness of any humours, whether acrimonious, salt or sour; for in the disease of Cholera, it will powerfully asswage the too much effer∣vescency that is raised in the small Gut, staying the fierce motion of the troubled hu∣mours.

A bloudy vomiting requireth speedy help, whence soever the bloud cometh.

The following Astringent medicine will wonderfully conduce to the cure.

Take the waters of Plantain, Comfrey, of each three ounces; Cinamon-water, dis∣till'd Vinegar, of each an ounce and half; Syrups of Mirtles, Quinces, of each one ounce; Powder of Dragons-bloud half a drachm; Laudanum opiatum six grains; mix it.

The sick may take two or three Spoon∣fulls of this Astringent Julep every hour, with good success, for it will cure the most ruptions of Vessels, and stop the flux of bloud beyond expectation.

After Vomiting is supprest, if the Patient be troubled with belching of wind, &c. in this case, the following exemplary mixture may bear the praise; for it doth not onely conduce to curb and discuss wind, remain∣ing as well in the Stomach, as Guts; but it doth temper and correct both Phlegm and Choler, and hinder wind in its rise, and will dissipate it, when it is bred.

Take the waters of Mint, Fennel, of each four ounces; the Carminative water of Syl∣vius, Syrup of Mint, of each two ounces; Spirit of Niter twenty drops; Chymical Oil of Mace ten drops; Laudanum opiatum ten grains; mix it.

Let this be taken by Spoonfulls, often or more slowly, as pains or stretchings do more or less urge.

If bloud be thought or feared to be clot∣ter'd in the cavity of the Guts; to dissolve

it, you may add to the above mentioned Carminative Julep, pul. ocul. Cancror. Antimon. Diaphoret. Sperma Coeti, of each one drachm.

The voiding of matter by vomiting and stool, is not to be staid, but mildly promo∣ted, seeing it is wholly unnatural, and hurt∣full to the Body: but its new rise is to be hindred as much as may be, seeing it is bred of bloud, which is the fuel of our vital fire, and the sustenance of all parts of the Bo∣dy.

Among all the medicines that move or promote the voiding of matter, and hinder the continual breeding of it, out of corrupt bloud; I prefer and commend Antimonials, rightly prepar'd; as well Emeticks, as other preparations of it, as Antimonium Diaphore∣tic. and above all, a Balsam made artificially of its flowers, which will powerfully conduce to alter and correct the harms befalling the Body by matter, and hinder the new produ∣cing of it.

Also Balsam of Sulphur with Oil of Anise∣seed is excellent to cleanse and consolidate any inward Ulcer; if two or three drops of it be taken often in a day in any pleasant healing vehicle.

In all preternatural vomitings keep the Belly open, so that the sick may have (at least) every day a stool, either by Nature or Art; and let the peccant humours remai∣ning

be emptied out by siege, with these or the like Pills.

Take Extract. Rudii half a drachm; Re∣sin of Jallop, Salt of Wormwood, Tartar vitriolated, of each ten grains; Oil of Ci∣namon three drops; mix it for two doses, to be taken in the morning.

The cure of Ileos, or Iliaca passio, may (for the most part) be performed by the a∣foresaid medicines.

But for the sake of young Practitioners, I shall add some few directions for the cure of this lamentable contracted motion.

Wherefore to appease the troublesome ir∣ritation of the Guts, let fat Broths be often taken in at the Mouth, and also injected in∣to the Fundament as a Clyster; but if an emollient Clyster can conveniently be made, let the following be prepared and often used, the Decoction of which may be also taken at the Mouth, with a few drops of Oil of A∣nise-seed.

Take the Roots of Marsh-mallows two ounces; of Mallows, Marsh-mallows, Mul∣lein, of each two handfulls; the Seeds of Anise, Sweet-fennel, Coriander, Flax, Fae∣nugreek, of each two ounces; let them be cleansed, bruised and boiled in a quart of Spring-water till half be consumed, then strain it, and add oil of white Lillies, the Fat of a Hen, of each one ounce; mix it for a Clyster.

Of which ingredients you may also make Fomentations and Cataplasms to be applied to the region of the Navel, moderately hot, adding Swines or Goats dung to the Pul∣tess.

The following Emulsion will conduce not onely to allay the irritation, and temper the sharp humours, but will make the passages slippery, and (by degrees) moisten the hard Excrements contained in the small Gut, and in the mean time, will mildly procure rest, and stop vomiting.

Take of sweet Almonds blanched, white Poppy-seeds, of each two ounces; French∣barley boiled four ounces; the waters of Fennel, Plantain, Roses, of each half a pint; Barley-water a pint, let it be made an Emul∣sion; to which add Syrup of Violets three ounces; confectio Alkermes de Hyacintho, of each two drachms; Laudanum twenty grains; Spirit of Niter forty drops; mix it.

Let the sick take three Spoonfulls of it of∣ten.

In this grievous Disease, nothing is to be neglected, either outward, or inward, that may procure ease to the Patient.

The intrails of Animals, as sheep, &c. ap∣plied very warm in hot cloaths, and often repeated, are very effectual.

Also Ventoses applied to the Navel have prov'd succesfull; after which let a little Ci∣vet

wrapt in Cotten be put to the Navel, and upon it apply a Plaster e Cymino, or Sylvius's Carminative Plaster; or else let the aforemention'd Pultess be applied warm.

Golden bullets swallowed are excellent, but for want of them, leaden bullets may serve.

Some give great Pills of Antimony; and crude Mercury or Quick-silver well depura∣ted is also highly commended, to be given to three pound at a time, and walk or ride after it, to agitate the Body; but before you give either of them let the sick take an ounce of oil of sweet Almonds or Sallet oil, and likewise after it: and be sure that no a∣cid thing be given after the Quick-silver till it be evacuated, lest it coagulate the Mer∣cury, and hurry the Patient to the grave.

Notes

• Ileos.
• Choler. Cholerica passio.
• Hoemopty∣sis.
• Cause of Ileos.
• Causes of the chole∣rick passi∣on.
• Causes of vomiting Bloud.
• Progn.
• Cure.
• Cordial Opiate.
• Cure of Cholerick Passion.
• Vomit.
• Cordial Opiate.
• Cure of bloudy vo∣miting.
• Astrin∣gent Iu∣lep.
• Carmina∣tive Iulep.
• Purging Pills.
• Cure of Iliaca passio.
• Clyster.
• Emulsion.