The store-house of physical practice being a general treatise of the causes and signs of all diseases afflicting human bodies : together with the shortest, plainest and safest way of curing them, by method, medicine and diet : to which is added, for the benefit of young practicers, several choice forms of medicines used by the London physicians / by John Pechey ...

CHAP. LXIX. Of an Inflammation, Abscess, and Ʋlcer of the Stomach.

THough in the Stomach, as in all other Parts, all sorts of Tumours may happen, yet here we only treat of an Inflammation or Phlegmon, which is most frequent, for other Tumours rarely happen, and may be cured by the same Method, wherewith the Tumours of other inward parts are.

An Inflammation of the Stomach is a preternatural Tu∣mour arising from Blood poured upon the Substance of the Stomach, and its Membranes. And this Blood is either pure and sincere, and then it produces a Phlegmon properly so called, or it is mixed with Choler, Flegm, and Melan∣cholly, and then it produces an Oedematous, Schirrhus, Phlegmon, or a Phlegmon mixed with an Erysipelas.

There may be many external Causes, viz. Whatsoever renders the Blood hot, as hot Medicines; drinking of Wine, or whatever forces the Blood thither, as a Bruise of the Stomach, especially when it is full of Meat; to which may be added hot and acrid things taken inwardly, as Cantha∣rides, Sublimate, and the like.

The Diagnostick Signs of this Disease are, a great Burnining, Pricking Distending, Pain with Pulsation, stretching it self to the Back. The Tumour may be felt and sometimes seen; the Shoulders are drawn backward; the Breathing, Swallowing, and Belching are difficult. Sometimes something Bloody is Vomited up; there is a violent Feaver accompanied with dreadful Symptoms.

If the Inflammation be purely from Blood it is some∣what gentler, but if it be joined with an E••ysipelas, the Symptoms are very violent, and there is an inward Fea∣ver, though the outward Parts are cold, and the Thirst is unquenchable: To this Inflammation of the Stomach that Inflammation is near of kin, which either seises that Part of the Liver, wherewjth the Stomach is covered, or that lies upon the Region of the Abdomen, which can be only

distinguished by the violence of the Symptoms; for the Inflammation of the Stomach is the most violent and most dangerous.

From what has been said, it may be easily prognostica∣ted that this Disease is very dangerous and most common∣ly deadly.

Nevertheless that is most dangerous which seises the up∣per Orifice of the Stomach, and partakes of the Nature of an Erysipelas.

If the Inflammation do not kill, and be not resolved, it degenerates into an Abscess, which is known by the Re∣mission of Heat and Feaver, the Tumour remaining.

The Abscess being broken an Ulcer is left behind, which may be known by the Evacuation of Matter by Vomit and Stool.

But an Ulcer of the Stomach does not only proceed from an Abscess broken, but also from other causes, which must be here mentioned, least any thing should be desicient in the Theory of it.

Therefore the causes of an Ulcer of the Stomach are either Internal or External; the Internal causes are acrid Humours bred in the Stomach, or transmitted from another place to it, as Yellow and Black Choler, or salt Flegm.

The external causes, are acrid and corroding Medicines or Poisons, and hither may be referred Wounds of the Stomach ill cured, which degenerate into an Ulcer; and also the Rupture of some great Vein, which can∣not be well cured after vomiting much Blood up.

An Ulcer bred in the Stomach, may be known chiefly by the Evacuation of Matter by Vomit and Stool, to which primary Sign others may be added: For first, There is perceived in the Stomach a pricking Pain with Heat, especially when any thing acrid, salt, acid, or any thing very hot or very cold is taken inwardly. There is more∣over a Loss of Appetite, Stinking, Belching, and a small and continual Feaver.

The Prognostick is most commonly deadly, unless the Ulcer be very small, and possess the Superficies, and has not a Feaver joined with it; for the Membrane of the Stomach being ulcerated is difficultly cured, and the Nou∣rishment cannot be well concocted, and it is rejected before

a due concoction; besides Medicines can do little good, for things that cleanse, which are necessary for the Cure of the Ulcer, cause Pain; and things that dry, which should satisfie the other Indication of Healing the Ulcer, are continually spoiled by the Meat and Drink, and Chyle, and other Humours which always stagnate in a weak Stomach.

The Cure of the foresaid Diseases is to be instituted particularly.

And first, The Cure of the Inflammation is to be be∣gun by Bleeding repeated in the Arm as often as the Strength will bear; and though it may seem to be dejected at first by reason of the fainting and Coldness of the extream Parts, yet this Infirmity of the Strength proceeds from an Op∣pression which requires Evacuation, and therefore Bleed∣ing ought not to be forbid.

Moreover, the opening of the Hemorrhoid Veins, if the Sick has been accustomed to this Evacuation, may conveniently cause a Revulsion of the Blood from the Sto∣mach. Cupping-glasses applied to the Back and Buttocks, both dry and moist, Frictions and Ligatures of the extream Parts, and the heating those that are wont to be cold, by applying hot Cloaths, and by anointing them with Oyl of Orris, Nard, and with other hot things, may be also conveniently used to draw the Blood from the Stomach.

But Purging is not allowed of, because it disturbes the Humours, and draws them to the Part affected. Yet Avi∣cen commends a Decoction of Tamarinds, or half an ounce of Cassia, dissolved in Endive-water, or in Whey, and would have it given daily till the seventh Day; yet it is better to abstain from all purging at the Beginning; but the Seventh Day being over, and some Signs of Con∣coction and Declination appearing, Purging may be in∣stituted with a dram of Rhubarb, and a Scruple of red Sanders infused in Borrage-water; you must add one or two ounces of the Syrup of Roses, that the Filth sticking to the Part may be evacuated.

In the mean while Lenient, cooling, and emollient Glist∣ers must be daily injected.

Take of Chicken-broth, or a Decoction of Mallows and Violets, one Pint; of Cassia fresh drawn one ounce, of Oyl of

Roses and Violets, each two ounces; of Sugar one ounce and an half, Yolks of Eggs number two; make a Glister.

The same altering and corroborating things may be taken inwardly, which were proposed for a Cure of the Pain of the Stomach occasioned by a Cholerick Hu∣mour.

But Syrup of Water-lillies, and of the Juice of Pur∣slain, are peculiarly proper, especially at the beginning; because they may serve instead of a repelling Medicine.

Emulsions also of the four cold Seeds, and of the Seeds of white-Poppies are proper, for they are lenitive, and qualifie the Heat, and so do also the following Juleps.

Take of the Waters of Roses three ounces, of Plantane two ounces, of the Juice of Sorrel one ounce and an half, of Sugar of Roses one ounce, boil them a little and strain them. Let him take two ounces twice or thrice a Day.

If the Pain be very violent, Syrup of Poppies may be taken.

Let him use for his Drink Barley-water sweetned with Syrup of Violets, which he must drink cold.

In Progress of the Disease, Medicines are to be mixed with the foregoing, which may help the Resolution; to which end the following Julep may be prescribed.

Take of the Syrups of Water-lillies, of Apples, and of the Juice of Purslain, each one ounce; of the Syrup of Ro∣man Wormwood half an ounce, of the Waters of Sorrel, Lettice, and Fennel, each three ounces; of the Species Diamargarite frigid one dram; make a Julep for three Doses to be taken twice a day▪

To these may be added restorative Opiats, Narco∣ticks and the like; all which are to be varied according to the Judgment and Discretion of the Physician.

Turpentine washed in Wormwood-water taken twice or thrice, resolves and ripens Imposthumes of the Sto∣mach.

The following Fomentation may be applyed outwardly in the beginning.

Take of the Roots of Sorrel two ounces, of the Leaves of Endive, Succory, and Mallows, each one handful; of the Seeds of Lettice, and of white Poppies, each three drams; of white and red Sanders, each half a dram; of the Flow∣ers of Violets, and of Water-lillies, each one Pugil; make a Decoction, add to it a little Rose-vinegar, fo∣ment the Region of the Stomach with it warm.

After the Fomentation, anoint the part with Oyl of Roses and Oyl of Violets mixed.

Cataplasms are not convenient in the beginning, be∣cause they oppress the part by their Weight, and by re∣taining the Heat increase the Inflammation.

If the Disease come to a Declination, and if the Tu∣mour should be resolved, which is most to be wished for, a resolving Fomentation may be applied made in the follow∣ing manner.

Take of the Roots of Florentine-orris two ounces, of the Leaves of Mint, Marjoram, Penny-royal, and of Roman Wormwood, each one Handful; of the Seeds of F••e∣nugreek and of Annise, each two drams; of the grains of Kermes one dram, of the Flowers of Staechas, Rosema∣ry, and Camomil, each one Pugil; adding towards the the end a little White-wine, make a Decoction, where∣with foment the Region of the Stomach.

After the Fomentation, anoint the Part with Oyl of Nutmeg, Wormwood, Nard, and the like; to which Wax, and the Powder of Florentine-orris, and of Cin∣namon being added, an Oyntment may be made; but Plaisters and Cataplasms are not convenient, because they oppress the Part.

But if the Tumour seem to tend to Suppuration, foment the part with a Decoction of the Flowers of Camo∣mil, and red Roses, and afterwards apply the follow∣ing Cataplasm.

Take of the Roots of Marsh-mallows two ounces, of the Leaves of Bears-breech, and of Roses, each one handful; boil them well, and then add of the Flower of Barley, and of Linseeds, and Faenugreek-seeds, and of the Pow∣der

of Camomil, each half an ounce; of white and red Sanders, each two drams; with Oyl of Roses and of Camomil, and with a little Hens-grease, make a Cata∣plasm to be renewed often.

The Abscess being broken, cleanse the Ulcer by drink∣ing Hydromel, to which must be added sometimes, ac∣cording to Galen's order, Manna of Frankincense, or Bar∣ly-water, with Sugar of Roses in the beginning in a hot Constitution.

When the Ulcer grows old, from what cause soever it prooceeds, Broths are proper, altered with cooling, and moderately astringent Herbs, Barly-broths sweetned with Sugar of Roses, new Milk sweetned with Sugar and a little Honey, Steel-waters for the ordinary drink, or Water wherein some Bole-armonick or sealed Earth has been infu∣sed; to which may be added, a little red rough Wine, if there be but little Heat in the Part; afterward the follow∣ing Apozem may be used.

Take of whole Barley one Pugil, of the Leaves of Scabious, Agrimony, Burnet, and of Maiden-hair, each half an handful; of the seeds of Melons two drams, of red Roses dried one Pugil; make a Decoction to one Pint, wherein dissolve three ounces of Syrup of dried Roses, make an Apozem for four doses to be frequently re∣peated.

For internal Ulcers, a Decoction of China is also very good, when there is no Feaver, for being taken for twen∣ty Days or more, it gently provokes Sweat, and dries the Ulcer by degrees.

But if there be danger of a Consumption, the foresaid Root must be boiled in Chicken-broth, with the foresaid Herbs, and with cleansed Barley.

When the Ulcer has continued long, Chalybeat or Purging Waters drank for a Month do good; and gentle Catharticks, as Rubarb, and Tamarinds, Myrobalans, Syrup of Roses, are to be used once a Week. Lastly, The following things are to be used.

Take of Bole-armenick, sealed Earth, red Coral, Blood-stone well washed in Rose-water, each one dram; of Dragons-blood, Gum-arabick, and Tragacanth, each half a dram; of the Seeds of white Poppies gently bruised and roasted, of Hypocistis, Sarcoco, and Frankincense, each one Scruple; of Sugar of Roses one ounce; make a Powder, whereof let him take a dram in Plantane-water, or with Conserve of Roses daily.

Or of the same Powder may be made an Opiat with Conserve of Comfry, and Roses, and with Syrup of Quinces or of Myrtles; or Troches may be made of it, with the Mucilages of the Seeds of Psyllium, or of Tra∣gacanth; of all which the Sick may take by turns, least his Stomach turn by taking of one Medicine a long while: And outwardly, to heal the Ulcer, may be applied to the Region of the Stomach, a Fomentation made of Wormwood, Roses, Pomegranate-peel, Galls, Balaustins, Myrtles, Frankincense, Mastich, and the like: And after∣wards the part must be anointed with some Astringent Oyntment, and an Astringent Plaister must be applied over.